August 5, 2024 • 31 mins
Ever wondered how something as simple as stomach acid could be a miracle molecule in your digestive health? Join us on the Inflammation Nation Podcast as we unravel the complexities of gut health and the miraculous roles of hydrochloric acid and bile. After sharing a personal story about our recent RV breakdown in Virginia and treasured family moments in Canada, we shift focus to debunking the myth that supplements can solve all health problems. We emphasize why a balanced diet and healthy lifestyle are irreplaceable foundations for well-being.
Discover the brain-gut connection and how your brain orchestrates key digestive functions such as motility, blood flow, and secretion of essential digestive components. Learn about the step-by-step process by which stomach acid and bile break down proteins and fats, turning digestion into a finely-tuned symphony. This episode takes you through the intricacies of how your digestive system works and why addressing core health mechanisms is far more effective than relying on trendy health solutions.
In our final discussion, we uncover the critical role of stomach acid and bile in our immune defenses as we age, and how decreased production of these vital substances can make us more susceptible to infections and conditions like SIBO. We also touch on the impact of medications like proton pump inhibitors on stomach acid production. Remember, the information shared is for educational purposes and is not a substitute for professional medical advice. Tune in to equip yourself with the knowledge and tools you need to tackle inflammation and achieve optimal health.
You can listen to the Inflammation Nation podcast on
You can also watch on YouTube.
Check out my online store for self-learning/DIY programs for thyroid, gut health and detox.
You can use this form to reach out and request an Initial Consultation
Visit my LabShop store to self-order the same tests I use with my one-on-one coaching clients.
https://labs.rupahealth.com/store/storefront_3GMxe4p
SOCIAL LINKS
Instagram
Facebook
TikTok
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
Hey everyone, welcome to the Inflammation Nation
podcast.
I'm your host, Dr SteveNoseberg.
Speaker 2 (00:08):
One of the greatest obstacles to crafting health and
wellness is identifying andcontrolling inflammation.
It's at the core of all complexand chronic diseases and it's
the driving mechanism thatunderlies the most common
symptoms that people like youstruggle to overcome.
Join us as we explore cuttingedge science and research to
give you the information andtools you need to create the
(00:28):
quality of life you want anddeserve.
And now here is the host ofInflammation Nation, dr Stephen
Nosworthy.
Speaker 1 (00:36):
Hey guys, welcome back to the podcast Once again.
I've been off the podcastairwaves for I guess it's been
about a month or so now, so letme just quickly fill you in on
what happened.
You may know that we spend mostsummers in Canada with my dad,
my sister and our extendedfamily.
(00:57):
I'm originally Canadian, spentmore than half my life in the
States I'm actually a dualcitizen at this point, but
anyways, we were coming up forour annual trip and life in the
States I'm actually a dualcitizen at this point, but
anyways, we were coming up forour annual trip and visit for
the summer, towing our RV, andwe were in the mountains of
Virginia and we had thiscatastrophic engine failure in
(01:17):
the truck that I used to pullthe RV and we got stranded in
this quaint small town right onthe border of Virginia, north
Carolina.
And in fact the North Carolinatown was the model for the town
Mayberry, if you're old enoughto remember the Andy Griffith
show, that was placed in atheoretical town in North
(01:38):
Carolina called MayberryActually not a real town, but it
was modeled after thisparticular town and so we ended
up having to spend four daysliterally stuck in this small
town in the mountains, which youknow doesn't sound too bad,
does it?
But nevertheless it just kindof took me out of my normal
routine.
And then, as soon as we gothere to Canada for the summer,
(02:00):
my daughter, my son-in-law andfour of my grandchildren came up
to visit from Texas and we had10 days of just fantastic family
fun.
Nevertheless, again, it took meout of my routine.
So here we are and we're back,and so we're still talking about
miracle molecules, and I hopethat you've enjoyed this series.
It's one of those things where,gosh, I could probably keep
(02:24):
doing this for years, justsimply because there are so many
unique and special things thathappen inside your body,
compounds that we either make orthings that we might take, say,
from a supplemental standpoint,but nevertheless, there's
probably an inexhaustible supplyof things that we could talk
about in the context of thingsthat we consider to be miracle
(02:47):
molecules.
And so the next two might bethe last.
I just have to put a littlethought into whether or not I
want to keep going on with thisor move on to some other topics,
but today we're going to betalking about actually two
things.
We're going to be talking aboutstomach acid, or hydrochloric
acid, and bile.
I know it doesn't sound allthat appetizing or maybe
(03:09):
scintillating, but it's onething.
It's very interesting to notethat what is bandied about on
the internet as cutting edgeways to enhance your health and
longevity are either old schoolthings that get rebranded as if
they're something new or theyget presented as if they're the
(03:29):
only thing that you need to door need to take.
For example, in the last yearwe've seen specific probiotics
touted as the answer toprediabetes, for example, and I
can guarantee that a lot ofpeople with prediabetes are
taking this specific probiotic,hoping that they don't have to
change their diet or move theirbodies.
Likewise, almost every year orso, there's a new supplement
(03:54):
that is supposed to enhancelongevity by improving
mitochondrial function.
But if you don't remove thething that is impairing your
mitochondria to begin with, youcan take boatloads of these
supplements and it's really notgoing to make that much of a
difference.
This is probably a good timejust to remind you that the word
supplement as in nutritionalsupplement, it means something
(04:16):
that completes or enhancessomething else when added to it.
That's what a supplement is.
So if all you do is takenutritional supplements but
you're not adding that to anoptimized diet and lifestyle,
then you're missing the point,and you've probably heard me say
before and I know I'vecertainly said this in the
(04:37):
functional medicine seminarsthat I've taught over the last
15 years or so is that diet andlifestyle like you can't
out-supplement a bad diet, youcan't out-supplement a bad
lifestyle.
Those have to be your first andforemost strategies when it
comes to reclaiming your healthand getting back to the person
that you used to be or to becomethe person that you want to be
(04:59):
in the future.
So supplements are just thatthere's something that's added
to other things that are morefundamental, so to speak.
Now, this might not be true whenyou take a nutritional product
that is designed to, say, fix anutrient deficiency.
For example, I often prescribevitamin D to someone whose
(05:20):
vitamin D levels are eitherfrankly deficient or they're
suboptimal.
Maybe it's vitamin A, but maybeit's glutathione, maybe it's
iron, just depends on the case.
But I guess technically I'mstill supplementing their
dietary content or perhapsaccounting for some type of gut
malabsorption issue thatprevents them from getting all
the nutrients in their food.
In that case, the vitaminprescription, if you will, that
(05:43):
I give them is supplementing myrecommendation.
That will help to fix their gut.
But hopefully you get my point,like I don't want you to expect
nutritional supplementation tofix your problems when you're
ignoring the core mechanismsthat are creating your
complaints.
Right, supplements are justthat the things we do in
addition to the things that aremore fundamental.
(06:03):
Now, since I just mentioned thegut, that's a good segue into
this next installment of MiracleMolecules, and today, again,
I'm going to double up and talkabout two things that each
function on their own, but theyalso work together, and these
are hydrochloric acid, orstomach acid, and bile or I
might refer to them as bilesalts and bile, or I might refer
(06:29):
to them as bile salts.
Now let's dive in by talkingbriefly about the GI system as a
whole first, and then we'llfocus in on both of these
miracle molecules.
We'll probably take twoepisodes to do this.
So one of the things that Iteach to new doctors in our
functional medicine seminars isthat you have to approach the
gut from top to bottom, orsometimes we might say north to
south, meaning that we startwith the concept that the brain,
(06:52):
which is topmost, or furthernorth, if you will, the brain,
exerts significance and perhapseven primary control over how
the gut functions and when thecommunication between the brain
and the gut is off, then thingsbelow that, things that are
further south, so to speak, tendto go wrong.
(07:13):
In general, the three thingsthat have the greatest control
over how your gut functions arethe brain, the thyroid and the
local gut environment itself,meaning what is happening inside
the gut.
But the brain is still primary,and I can say that confidently
because we have studies thatshow when the connection from
(07:34):
the brain to the gut is severedby cutting the vagus nerve I'm
sure you've heard about that thegut still works.
It just works with much lesscapacity or it's much less
efficient.
So the brain is absolutelycritical to gut health.
So, very quickly, your braincontrols four major functions of
(07:54):
your gut.
It controls gut motility, whichliterally refers to moving food
from the mouth to the anus,moving food from the mouth to
the anus.
It controls blood flow, whichhelps keep the lining of the gut
healthy and, say, prevents orhelps to repair leaky gut.
It also controls acid enzymeand bile secretion, which are
(08:16):
best known for their roles indigesting protein, fats and
carbohydrates.
And then, finally, the braincontrols the muscular valves
that keep the differentcompartments of your gut
separate from each other, sothat food moves only in one
direction.
It moves from north to south,top to bottom, and these valves
(08:38):
basically act as one-way shutoffvalves so that bacteria in the
colon don't migrate up into thesmall intestine, where they're
not supposed to be.
That's a very quick and dirtyoverview of how the brain-gut
axis is organized, but for todayI want to focus on the part of
the system where we find stomachacid and bile, and I just noted
(09:01):
that these are best known forthe rules in digestion.
So let's break that down first.
No pun intended, all right.
Hydrochloric acid it's used tobreak down dietary proteins, but
it doesn't do that directly.
In fact, the most potentdigester of proteins is
something called pepsin, whichis activated by hydrochloric
(09:24):
acid.
So here's how this works whenwe eat food that contains
proteins, the brain sends asignal down to the gut to
release pepsin in an inactiveform.
You see this feature of humanfunction all over the place.
That we have things in theirinactive form, they have to be
converted to the active form toactually do something.
(09:44):
That we have things in theirinactive form, they have to be
converted to the active form toactually do something.
So the brain sends signals downto the gut to release pepsin in
the inactive form when weconsume protein.
But at the same time it alsoreleases the neurotransmitter
acetylcholine and hydrochloricacid into the gut from
specialized cells in the gutlining.
Now we usually think ofacetylcholine as, hey, that's a
(10:05):
neurotransmitter.
That means the brain.
Well, if you've never heardthis before, the neurological
system called the entericnervous system in your gut is
referred to quite often as thesecond brain.
In fact, we have so muchneurological tissue in the gut
that it rivals other parts ofthe brain in terms of the
density of the neurons that wehave in the gut, that it rivals
other parts of the brain interms of the density of the
(10:26):
neurons that we have in the gutthat help to control gut
function.
So, nevertheless, the brain.
Once you consume protein, thebrain releases pepsin in the
inactive form.
At the same time, it releasesacetylcholine and hydrochloric
acid.
And so the acetylcholine andhydrochloric acid, together with
a few other minor players, takethis pepsin and convert it from
(10:48):
the inactive to the active form, and the pepsin is actually
what does the work in breakingthe protein bonds that keep
together the amino acids thatmake up the proteins.
In essence, the hydrochloricacid changes the pH of the
stomach lowers the pH, meaningit's more acidic, which is the
primary signal that activatespepsin, which then breaks down
(11:11):
your dietary proteins intosingle amino acids that can be
absorbed by the cells of yoursmall intestine, because your
gut lining cannot absorb wholeproteins, it can't even absorb
peptide or protein fragments.
We have to break it down intoindividual single amino acids to
be able to do that.
So, in essence, thehydrochloric acid changes the pH
(11:34):
of the stomach, which is theprimary signal that activates
pepsin, which then breaks downyour proteins into single amino
acids that can be absorbed bythe small intestinal cells.
So again, the basic process isthat, while pepsin does the work
of protein digestion, it needshydrochloric acid to activate it
first, and this is perhaps oneof the reasons why hydrochloric
(11:55):
acid to activate it first.
And this is perhaps one of thereasons why hydrochloric acid is
something that's very commonlyprescribed in the world of
nutritional medicine, because ofwhat it does changes the pH and
then activates a whole bunch ofother things.
So that's a very quick overviewof hydrochloric acid.
Now let's talk about bile, ofhydrochloric acid.
(12:18):
Now let's talk about bile.
Bile, in its digestive role, isused to emulsify dietary fats
so that we can break those downeven further using pancreatic
enzymes called lipasesEmulsification just if you don't
know what that is.
It's the chemical process ofbreaking large fat droplets into
smaller ones that are theneasier to process.
So again, it's kind of astepwise system.
(12:42):
Now bile is formed in the liverand it's concentrated in the
gallbladder where it sitswaiting to be released, and the
signal that causes thegallbladder to contract and to
release its stored bile is thefat content of the food passing
from the stomach to the upperpart of the small intestine,
(13:02):
just like protein, triggers therelease of hydrochloric acid and
pepsin to digest proteins.
The more fat that's in yourfood, the more bile gets
released, and vice versa theless fat you have, the less bile
you need released, and viceversa, the less fat you have,
the less bile you need.
So whether we talk aboutprotein or fat digestion,
hydrochloric acid or bile, thegeneral process is the same.
(13:23):
The presence of certain typesof macronutrients in the food
that you eat triggers theproduction of specific chemicals
and molecules that are used tobreak the macronutrients down
protein, fat and carbs intotheir smaller or smallest
components so that we can absorbthem and that absorption
happens in the small intestine.
It doesn't happen in thestomach, it doesn't happen in
(13:44):
the colon.
But these core functions arenot what make hydrochloric acid
and bile miracle molecules.
Hydrochloric acid and bilemiracle molecules, that comes
from their roles in immunity andyour microbiome.
There are others, but we'rejust going to focus on those.
So let's talk about immunity.
When we look at how we fight offinfections, or perhaps how we
(14:08):
get infected, there are only afew ways that things that want
to infect us can get inside usto do that.
So things like viruses,bacteria, parasites they only
get into us in one of three ways.
They can cross our skin barrier, like if you have a cut in your
skin, that can get infected.
We can breathe them in.
Like you know, you go to yourcousin's house and he or she has
(14:33):
a cold or the flu and youbreathe that in and then you get
sick yourself.
Or we can swallow them, andthat's where we're going to
focus here.
Right, honestly, there's not asingle bite of food that you
swallow that doesn't havesomething in it that wants to
infect you.
No matter where you source yourfood and how you're prepared, it
(14:53):
can still infect you, and thisis why hydrochloric acid is
placed up front in the digestionprocess.
It appears earlier in this topto bottom or north to south
progression, not only because weneed to break down large
protein molecules into smallerones and then eventually amino
acids, but because hydrochloricacid it's an acid, which means
(15:15):
it's a powerful sterilizingagent, and in this sense
hydrochloric acid is a uniquepart of your immune system, more
specifically a branch of theimmune system called the innate
immune system.
Now, when I use the term innateimmune system, I'm usually
referring to immune cells,things like macrophages or
(15:40):
neutrophils or perhaps naturalkiller cells.
But the very first exposure toyour immune system that any
potential pathogen that youswallow encounters is stomach
acid, and this is followed veryclosely by the antimicrobial
capacity of bile.
Once your food leaves yourstomach and reaches the top of
(16:02):
your small intestine, and infact before any infections get
spotted and attacked by yourgut-based immune cells, they
have already taken like aone-two punch from stomach acid
and bile.
Now this raises a few questionsand potential issues that I'll
do my best to answer probablynot sequentially, no particular
(16:23):
order as we go through the restof this episode and the next one
.
What happens if stomach acidand bile production is reduced
for some reason.
What happens to stomach acidand bile production as we age?
What happens to stomach acidand bile production as a result
of very common metabolic issues,say Hashimoto's disease or just
(16:46):
hypothyroidism in general?
And what happens to stomachacid when you use very commonly
used medications that areclassified as proton pump
inhibitors, things like Zantacor Pepsid AC or whatever flavor
pill of the day they're using tosuppress acid reflux?
And what happens to bileproduction when you have things
(17:10):
like fatty liver or gallstones,which might be associated with
hormonal imbalances or commonmetabolic disorders like insulin
resistance or prediabetes?
And again, we'll try to answerthese in no particular order,
but these are, as a clinician,these are questions that I would
have if someone comes into meand I think, as part of the
constellation of problemsthey're facing.
(17:32):
Maybe hydrochloric acid and bileinsufficiency is part of that.
It's one thing to give someonea supplement that has
hydrochloric acid in it, or evenbile salts, for example.
It's another to identify whythey got there, because,
remember, supplements are addingto things that are more
fundamental and the morefundamental thing is answering
(17:54):
the question well, how did thishappen?
And let's see if we can fixthat.
So, again in no particularorder, let's talk about
hydrochloric acid and the agingprocess.
Like, we know that ourhydrochloric acid status changes
as we age, and starting aroundthe age 65, low stomach acid is
(18:16):
very common.
It's way more common after 65than it is prior to.
That it doesn't mean you can'thave low stomach acid if you're,
say, 42.
And low stomach acid can leadto a myriad of consequences, not
only things like poor proteindigestion or even poor amino
acid status, which can lead to aloss of muscle mass and frailty
(18:38):
, right, since these amino acidsare the building blocks of your
skeletal muscle.
And all of that, of course,would be made worse with an
inactive lifestyle, particularlyif you're not engaged in some
kind of resistance training tobuild your muscles.
But the loss of hydrochloricacid status as we age opens us
up to more infections from thefoods that we eat.
(18:58):
And this is one reason why wetend to see certain types of gut
dysfunctions like SIBO, orsmall intestinal bacterial
overgrowth, in the elderlypopulation than we do in the
younger.
And again, it doesn't mean youcan't get SIBO if you're in your
20s, 30s or 40s.
You certainly can.
But we see certain things inthe elderly population because
(19:22):
as we get older, things go wrong.
Now you might recall that SIBOagain small intestinal bacterial
overgrowth is where we havebacteria that are too high up in
the small intestine, where theyfeed off the fermentable sugar,
starches and fibers that arefound in certain fruits and
vegetables.
And all fruits and vegetableshave these fermentable compounds
(19:44):
, there's just different typesand they're found in higher
concentrations in certain fruitsand vegetables.
Now, in reality there are twoprimary ways to get SIBO.
One is bottom-up and the otheris top-down.
In the bottom-up model,bacteria from the large
intestine and colon migrate upinto the small intestine because
(20:05):
the brain-gut axis fails tocontrol the ileocecal valve we
talked about that in theintroduction.
To control the ileocecal valvewe talked about that in the
introduction so that thebacteria in the lower intestine
can move in a retrograde fashionup into the small intestine and
in other words, we lose theseparation and
compartmentalization thatnormally keeps bacteria in the
(20:25):
large intestine and the colon.
That's a bottoms-up model ofhow someone acquires SIBO.
But the top-down model of SIBOis where we eat food with some
organism in it like bacteria,and there's actually something
called SIFO, which is a fungalovergrowth, but let's just stick
(20:46):
to bacteria.
So with this top-down model ofSIBO we eat something that has
some bacteria in it and we can'tsterilize it because we don't
have good stomach acid, and sothese bacteria take up residence
in the upper small intestine,where they're really not
supposed to be.
And that happens again becausewe can't sterilize the food
we're eating, because we're notmaking enough stomach acid right
(21:10):
, so the bacterial load that weswallow doesn't get neutralized
or sterilized and then it caninfect the small intestine as we
age and we tend to losehydrochloric acid because of
atrophy of the hydrochloricacid-producing cells.
Remember I said, hydrochloricacid is made by certain cells in
(21:31):
the gut.
These are called parietal cells, and when we can't sterilize
our food, we get infections inthe stomach or high in the small
intestine and that can manifestas SIBO, which classically
presents as gas or bloating anddistention, particularly when
you eat certain sugars, fibersand starches.
And this is also a very commoncause of IBS.
(21:52):
I mean, the last statistic Isaw was that about 80, well, it
depends on the study anywherefrom 40, let's say upwards of
80% of people who have IBS haveit because they have SIBO.
And then the question is well,why do you have SIBO and what
can we do to try to change that?
And the answer is quite a lot.
(22:12):
Now, one of the common organismsfor infections in the stomach
itself or at the very top of thesmall intestine is an organism
of bacteria called H pylori, andH pylori is perhaps the most
common cause of gastritis andgastric ulcers.
And in fact H pylori isconsidered to be the most common
cause of gastritis and gastriculcers.
And in fact H pylori isconsidered to be the most common
(22:35):
infection in the world, sinceat any given time, roughly half
the world's population has Hpylori present in their stomachs
.
But here's the kicker 80 to 85%of the time these infections
are asymptomatic, which meansthat you don't even know you
have it.
And over time the H pylorishuts down stomach acid
production by impairing theseparietal cells that make
(22:57):
hydrochloric acid.
And the research suggests thateveryone with these silent H
pylori infections willeventually develop gastritis and
a high percentage haveincreased risk for stomach
cancer because of the long-termlow-grade inflammation that H
pylori induces.
And for the longest time,scientists thought that the
(23:18):
stomach was completely sterilebecause of its acid content.
That is until they discovered Hpylori.
I think it was early 80s, I'mgoing to say 1982.
And then for decades H pyloriwas thought to be the only
bacteria that could colonize thestomach, because it controls
the acid production.
It shuts it down.
(23:39):
That is until better techniquesdiscovered that a strain of
streptococcal species could alsoinfect the stomach, and I'm
sure more will be discovered inthe future.
Now, one particular form ofstrep that can infect the
stomach is something calledstrep mutans, which is a major
(23:59):
contributor to cavities in yourteeth, and so we have studies
that show that strep from yourmouth can seep into your stomach
and then create biofilm and Iknow I've talked about biofilm
before to your stomach and thencreate biofilm and I know I've
talked about biofilm beforewhich, it turns out, creates the
perfect habitat for H pylori togrow, and this is why people
(24:20):
with poor dental hygiene havehigher rates of H pylori in
their stomach.
Now, as I said, h pylori shutsdown stomach acid, which allows
H pylori, strep and otherorganisms to get past that first
line of immune defense, whichis not an immune cell, but it's
a highly acidic stomach.
Now, low stomach acid can alsohappen with hypothyroidism or
(24:45):
Hashimoto's disease.
When thyroid hormones are low,we can't make sufficient amounts
of another protein calledgastrin, which is part of the
production process ofhydrochloric acid.
Right, remember, hydrochloricacid changes the pH of the
stomach, which then activatespepsin.
But in order to makehydrochloric acid we need this
(25:06):
thing called gastrin, whichtends to be low in people with
Hashimoto's.
Gastrin does several things inthe gut, one of which is
activating this thing called theproton pump, and I'll refer you
back to proton pump inhibitormedications like Zantac and
Pepsod that shut down acid.
This is how it does it byshutting down the proton pump,
(25:28):
gastrin activates the protonpump, which sends both hydrogen
and chloride ions hydrochloricacid, hydrogen and chloride ions
into the gut, where theycombine to make stomach acid or
again hydrochloric acid.
And this is one of severalreasons why people with
Hashimoto's tend to have GIcomplaints.
(25:49):
There's not many people I'veworked with and I've worked with
hundreds, if not more, ofpeople with Hashimoto's over the
last 15 years.
I'm sure it's in the very highhundreds, if not in the
thousands, and very few of themhave normal gut function.
Right, gastrin does severalthings in the gut, one of which
(26:11):
is activating the proton pump,which then sends hydrogen
chloride ions into the gut.
They make the hydrochloric acidand, again very common with
Hashimoto's they tend to have GIcomplaints, which range from
protein maldigestion to low gutmotility, to SIBO infections, to
leaky gut, and the list couldcontinue.
(26:31):
Finally, and I've mentionedthese proton pump inhibitors
like Pepsin, ac, zantac and soon, these are used to control
acid reflux and they cancertainly do that right, they
reduce the acid symptomatology.
But there are some downsides.
The first is that the lowerstomach acid means less
sterilization and an increasedpotential for H pylori, strep
(26:54):
and other gut infections, andthat's not cool.
But perhaps the worst potentiallong-term outcome of proton
pump inhibitor use is that insome people it causes gastrin
levels to get too high becausethe body is now you're using a
medication to shut down theproton pump and the innate
(27:14):
intelligence of the body issaying well, I need more acid.
So it keeps trying to make more, so it makes more gastrin, and
this is a risk factor forneoplasia or uncontrolled tissue
growth.
Call it cancer.
And this is why people who havelow stomach acid from any cause
whether it's H pyloriinfections, low thyroid or
(27:35):
proton pump inhibitor use have agreater risk for stomach cancer
than those who have adequatehydrochloric acid status.
All right, I'm going to leaveit there for now.
Next time we're going to talkabout the role of bile, also as
part of the innate immune system, but also we'll talk about its
role in detoxification, andwe'll come back to both
(27:57):
hydrochloric acid and bile andtheir roles in the microbiome.
We're going to do that nexttime right here on the
Inflammation Nation podcast.
This podcast is for generalinformational and educational
purposes only only, and does notconstitute the practice of
medicine in any form or capacity.
No doctor-patient relationshipis formed.
(28:19):
The use of the information inthis podcast or any materials
associated with or linked to thepodcast is at the listener's
own risk.
The content of this podcast isnot intended to be a substitute
for professional andpersonalized medical advice,
diagnosis or treatment, andlisteners should not disregard
(28:39):
or delay obtaining propermedical advice when a health
condition exists and warrantsthat.
And finally, functionalmedicine is not intended or
designed to treat disease, butrather is a natural approach to
support restoring health andwellness.
The use of diet and lifestylemodifications and nutritional
supplementation is supportivefor adjunctive care.
Hey everyone, welcome to the Inflammation Nation
podcast.
I'm your host, Dr SteveNoseberg.
Speaker 2 (00:08):
One of the greatest obstacles to crafting health and
wellness is identifying andcontrolling inflammation.
It's at the core of all complexand chronic diseases and it's
the driving mechanism thatunderlies the most common
symptoms that people like youstruggle to overcome.
Join us as we explore cuttingedge science and research to
give you the information andtools you need to create the
(00:28):
quality of life you want anddeserve.
And now here is the host ofInflammation Nation, dr Stephen
Nosworthy.
Speaker 1 (00:36):
Hey guys, welcome back to the podcast Once again.
I've been off the podcastairwaves for I guess it's been
about a month or so now, so letme just quickly fill you in on
what happened.
You may know that we spend mostsummers in Canada with my dad,
my sister and our extendedfamily.
(00:57):
I'm originally Canadian, spentmore than half my life in the
States I'm actually a dualcitizen at this point, but
anyways, we were coming up forour annual trip and life in the
States I'm actually a dualcitizen at this point, but
anyways, we were coming up forour annual trip and visit for
the summer, towing our RV, andwe were in the mountains of
Virginia and we had thiscatastrophic engine failure in
(01:17):
the truck that I used to pullthe RV and we got stranded in
this quaint small town right onthe border of Virginia, north
Carolina.
And in fact the North Carolinatown was the model for the town
Mayberry, if you're old enoughto remember the Andy Griffith
show, that was placed in atheoretical town in North
(01:38):
Carolina called MayberryActually not a real town, but it
was modeled after thisparticular town and so we ended
up having to spend four daysliterally stuck in this small
town in the mountains, which youknow doesn't sound too bad,
does it?
But nevertheless it just kindof took me out of my normal
routine.
And then, as soon as we gothere to Canada for the summer,
(02:00):
my daughter, my son-in-law andfour of my grandchildren came up
to visit from Texas and we had10 days of just fantastic family
fun.
Nevertheless, again, it took meout of my routine.
So here we are and we're back,and so we're still talking about
miracle molecules, and I hopethat you've enjoyed this series.
It's one of those things where,gosh, I could probably keep
(02:24):
doing this for years, justsimply because there are so many
unique and special things thathappen inside your body,
compounds that we either make orthings that we might take, say,
from a supplemental standpoint,but nevertheless, there's
probably an inexhaustible supplyof things that we could talk
about in the context of thingsthat we consider to be miracle
(02:47):
molecules.
And so the next two might bethe last.
I just have to put a littlethought into whether or not I
want to keep going on with thisor move on to some other topics,
but today we're going to betalking about actually two
things.
We're going to be talking aboutstomach acid, or hydrochloric
acid, and bile.
I know it doesn't sound allthat appetizing or maybe
(03:09):
scintillating, but it's onething.
It's very interesting to notethat what is bandied about on
the internet as cutting edgeways to enhance your health and
longevity are either old schoolthings that get rebranded as if
they're something new or theyget presented as if they're the
(03:29):
only thing that you need to door need to take.
For example, in the last yearwe've seen specific probiotics
touted as the answer toprediabetes, for example, and I
can guarantee that a lot ofpeople with prediabetes are
taking this specific probiotic,hoping that they don't have to
change their diet or move theirbodies.
Likewise, almost every year orso, there's a new supplement
(03:54):
that is supposed to enhancelongevity by improving
mitochondrial function.
But if you don't remove thething that is impairing your
mitochondria to begin with, youcan take boatloads of these
supplements and it's really notgoing to make that much of a
difference.
This is probably a good timejust to remind you that the word
supplement as in nutritionalsupplement, it means something
(04:16):
that completes or enhancessomething else when added to it.
That's what a supplement is.
So if all you do is takenutritional supplements but
you're not adding that to anoptimized diet and lifestyle,
then you're missing the point,and you've probably heard me say
before and I know I'vecertainly said this in the
(04:37):
functional medicine seminarsthat I've taught over the last
15 years or so is that diet andlifestyle like you can't
out-supplement a bad diet, youcan't out-supplement a bad
lifestyle.
Those have to be your first andforemost strategies when it
comes to reclaiming your healthand getting back to the person
that you used to be or to becomethe person that you want to be
(04:59):
in the future.
So supplements are just thatthere's something that's added
to other things that are morefundamental, so to speak.
Now, this might not be true whenyou take a nutritional product
that is designed to, say, fix anutrient deficiency.
For example, I often prescribevitamin D to someone whose
(05:20):
vitamin D levels are eitherfrankly deficient or they're
suboptimal.
Maybe it's vitamin A, but maybeit's glutathione, maybe it's
iron, just depends on the case.
But I guess technically I'mstill supplementing their
dietary content or perhapsaccounting for some type of gut
malabsorption issue thatprevents them from getting all
the nutrients in their food.
In that case, the vitaminprescription, if you will, that
(05:43):
I give them is supplementing myrecommendation.
That will help to fix their gut.
But hopefully you get my point,like I don't want you to expect
nutritional supplementation tofix your problems when you're
ignoring the core mechanismsthat are creating your
complaints.
Right, supplements are justthat the things we do in
addition to the things that aremore fundamental.
(06:03):
Now, since I just mentioned thegut, that's a good segue into
this next installment of MiracleMolecules, and today, again,
I'm going to double up and talkabout two things that each
function on their own, but theyalso work together, and these
are hydrochloric acid, orstomach acid, and bile or I
might refer to them as bilesalts and bile, or I might refer
(06:29):
to them as bile salts.
Now let's dive in by talkingbriefly about the GI system as a
whole first, and then we'llfocus in on both of these
miracle molecules.
We'll probably take twoepisodes to do this.
So one of the things that Iteach to new doctors in our
functional medicine seminars isthat you have to approach the
gut from top to bottom, orsometimes we might say north to
south, meaning that we startwith the concept that the brain,
(06:52):
which is topmost, or furthernorth, if you will, the brain,
exerts significance and perhapseven primary control over how
the gut functions and when thecommunication between the brain
and the gut is off, then thingsbelow that, things that are
further south, so to speak, tendto go wrong.
(07:13):
In general, the three thingsthat have the greatest control
over how your gut functions arethe brain, the thyroid and the
local gut environment itself,meaning what is happening inside
the gut.
But the brain is still primary,and I can say that confidently
because we have studies thatshow when the connection from
(07:34):
the brain to the gut is severedby cutting the vagus nerve I'm
sure you've heard about that thegut still works.
It just works with much lesscapacity or it's much less
efficient.
So the brain is absolutelycritical to gut health.
So, very quickly, your braincontrols four major functions of
(07:54):
your gut.
It controls gut motility, whichliterally refers to moving food
from the mouth to the anus,moving food from the mouth to
the anus.
It controls blood flow, whichhelps keep the lining of the gut
healthy and, say, prevents orhelps to repair leaky gut.
It also controls acid enzymeand bile secretion, which are
(08:16):
best known for their roles indigesting protein, fats and
carbohydrates.
And then, finally, the braincontrols the muscular valves
that keep the differentcompartments of your gut
separate from each other, sothat food moves only in one
direction.
It moves from north to south,top to bottom, and these valves
(08:38):
basically act as one-way shutoffvalves so that bacteria in the
colon don't migrate up into thesmall intestine, where they're
not supposed to be.
That's a very quick and dirtyoverview of how the brain-gut
axis is organized, but for todayI want to focus on the part of
the system where we find stomachacid and bile, and I just noted
(09:01):
that these are best known forthe rules in digestion.
So let's break that down first.
No pun intended, all right.
Hydrochloric acid it's used tobreak down dietary proteins, but
it doesn't do that directly.
In fact, the most potentdigester of proteins is
something called pepsin, whichis activated by hydrochloric
(09:24):
acid.
So here's how this works whenwe eat food that contains
proteins, the brain sends asignal down to the gut to
release pepsin in an inactiveform.
You see this feature of humanfunction all over the place.
That we have things in theirinactive form, they have to be
converted to the active form toactually do something.
(09:44):
That we have things in theirinactive form, they have to be
converted to the active form toactually do something.
So the brain sends signals downto the gut to release pepsin in
the inactive form when weconsume protein.
But at the same time it alsoreleases the neurotransmitter
acetylcholine and hydrochloricacid into the gut from
specialized cells in the gutlining.
Now we usually think ofacetylcholine as, hey, that's a
(10:05):
neurotransmitter.
That means the brain.
Well, if you've never heardthis before, the neurological
system called the entericnervous system in your gut is
referred to quite often as thesecond brain.
In fact, we have so muchneurological tissue in the gut
that it rivals other parts ofthe brain in terms of the
density of the neurons that wehave in the gut, that it rivals
other parts of the brain interms of the density of the
(10:26):
neurons that we have in the gutthat help to control gut
function.
So, nevertheless, the brain.
Once you consume protein, thebrain releases pepsin in the
inactive form.
At the same time, it releasesacetylcholine and hydrochloric
acid.
And so the acetylcholine andhydrochloric acid, together with
a few other minor players, takethis pepsin and convert it from
(10:48):
the inactive to the active form, and the pepsin is actually
what does the work in breakingthe protein bonds that keep
together the amino acids thatmake up the proteins.
In essence, the hydrochloricacid changes the pH of the
stomach lowers the pH, meaningit's more acidic, which is the
primary signal that activatespepsin, which then breaks down
(11:11):
your dietary proteins intosingle amino acids that can be
absorbed by the cells of yoursmall intestine, because your
gut lining cannot absorb wholeproteins, it can't even absorb
peptide or protein fragments.
We have to break it down intoindividual single amino acids to
be able to do that.
So, in essence, thehydrochloric acid changes the pH
(11:34):
of the stomach, which is theprimary signal that activates
pepsin, which then breaks downyour proteins into single amino
acids that can be absorbed bythe small intestinal cells.
So again, the basic process isthat, while pepsin does the work
of protein digestion, it needshydrochloric acid to activate it
first, and this is perhaps oneof the reasons why hydrochloric
(11:55):
acid to activate it first.
And this is perhaps one of thereasons why hydrochloric acid is
something that's very commonlyprescribed in the world of
nutritional medicine, because ofwhat it does changes the pH and
then activates a whole bunch ofother things.
So that's a very quick overviewof hydrochloric acid.
Now let's talk about bile, ofhydrochloric acid.
(12:18):
Now let's talk about bile.
Bile, in its digestive role, isused to emulsify dietary fats
so that we can break those downeven further using pancreatic
enzymes called lipasesEmulsification just if you don't
know what that is.
It's the chemical process ofbreaking large fat droplets into
smaller ones that are theneasier to process.
So again, it's kind of astepwise system.
(12:42):
Now bile is formed in the liverand it's concentrated in the
gallbladder where it sitswaiting to be released, and the
signal that causes thegallbladder to contract and to
release its stored bile is thefat content of the food passing
from the stomach to the upperpart of the small intestine,
(13:02):
just like protein, triggers therelease of hydrochloric acid and
pepsin to digest proteins.
The more fat that's in yourfood, the more bile gets
released, and vice versa theless fat you have, the less bile
you need released, and viceversa, the less fat you have,
the less bile you need.
So whether we talk aboutprotein or fat digestion,
hydrochloric acid or bile, thegeneral process is the same.
(13:23):
The presence of certain typesof macronutrients in the food
that you eat triggers theproduction of specific chemicals
and molecules that are used tobreak the macronutrients down
protein, fat and carbs intotheir smaller or smallest
components so that we can absorbthem and that absorption
happens in the small intestine.
It doesn't happen in thestomach, it doesn't happen in
(13:44):
the colon.
But these core functions arenot what make hydrochloric acid
and bile miracle molecules.
Hydrochloric acid and bilemiracle molecules, that comes
from their roles in immunity andyour microbiome.
There are others, but we'rejust going to focus on those.
So let's talk about immunity.
When we look at how we fight offinfections, or perhaps how we
(14:08):
get infected, there are only afew ways that things that want
to infect us can get inside usto do that.
So things like viruses,bacteria, parasites they only
get into us in one of three ways.
They can cross our skin barrier, like if you have a cut in your
skin, that can get infected.
We can breathe them in.
Like you know, you go to yourcousin's house and he or she has
(14:33):
a cold or the flu and youbreathe that in and then you get
sick yourself.
Or we can swallow them, andthat's where we're going to
focus here.
Right, honestly, there's not asingle bite of food that you
swallow that doesn't havesomething in it that wants to
infect you.
No matter where you source yourfood and how you're prepared, it
(14:53):
can still infect you, and thisis why hydrochloric acid is
placed up front in the digestionprocess.
It appears earlier in this topto bottom or north to south
progression, not only because weneed to break down large
protein molecules into smallerones and then eventually amino
acids, but because hydrochloricacid it's an acid, which means
(15:15):
it's a powerful sterilizingagent, and in this sense
hydrochloric acid is a uniquepart of your immune system, more
specifically a branch of theimmune system called the innate
immune system.
Now, when I use the term innateimmune system, I'm usually
referring to immune cells,things like macrophages or
(15:40):
neutrophils or perhaps naturalkiller cells.
But the very first exposure toyour immune system that any
potential pathogen that youswallow encounters is stomach
acid, and this is followed veryclosely by the antimicrobial
capacity of bile.
Once your food leaves yourstomach and reaches the top of
(16:02):
your small intestine, and infact before any infections get
spotted and attacked by yourgut-based immune cells, they
have already taken like aone-two punch from stomach acid
and bile.
Now this raises a few questionsand potential issues that I'll
do my best to answer probablynot sequentially, no particular
(16:23):
order as we go through the restof this episode and the next one
.
What happens if stomach acidand bile production is reduced
for some reason.
What happens to stomach acidand bile production as we age?
What happens to stomach acidand bile production as a result
of very common metabolic issues,say Hashimoto's disease or just
(16:46):
hypothyroidism in general?
And what happens to stomachacid when you use very commonly
used medications that areclassified as proton pump
inhibitors, things like Zantacor Pepsid AC or whatever flavor
pill of the day they're using tosuppress acid reflux?
And what happens to bileproduction when you have things
(17:10):
like fatty liver or gallstones,which might be associated with
hormonal imbalances or commonmetabolic disorders like insulin
resistance or prediabetes?
And again, we'll try to answerthese in no particular order,
but these are, as a clinician,these are questions that I would
have if someone comes into meand I think, as part of the
constellation of problemsthey're facing.
(17:32):
Maybe hydrochloric acid and bileinsufficiency is part of that.
It's one thing to give someonea supplement that has
hydrochloric acid in it, or evenbile salts, for example.
It's another to identify whythey got there, because,
remember, supplements are addingto things that are more
fundamental and the morefundamental thing is answering
(17:54):
the question well, how did thishappen?
And let's see if we can fixthat.
So, again in no particularorder, let's talk about
hydrochloric acid and the agingprocess.
Like, we know that ourhydrochloric acid status changes
as we age, and starting aroundthe age 65, low stomach acid is
(18:16):
very common.
It's way more common after 65than it is prior to.
That it doesn't mean you can'thave low stomach acid if you're,
say, 42.
And low stomach acid can leadto a myriad of consequences, not
only things like poor proteindigestion or even poor amino
acid status, which can lead to aloss of muscle mass and frailty
(18:38):
, right, since these amino acidsare the building blocks of your
skeletal muscle.
And all of that, of course,would be made worse with an
inactive lifestyle, particularlyif you're not engaged in some
kind of resistance training tobuild your muscles.
But the loss of hydrochloricacid status as we age opens us
up to more infections from thefoods that we eat.
(18:58):
And this is one reason why wetend to see certain types of gut
dysfunctions like SIBO, orsmall intestinal bacterial
overgrowth, in the elderlypopulation than we do in the
younger.
And again, it doesn't mean youcan't get SIBO if you're in your
20s, 30s or 40s.
You certainly can.
But we see certain things inthe elderly population because
(19:22):
as we get older, things go wrong.
Now you might recall that SIBOagain small intestinal bacterial
overgrowth is where we havebacteria that are too high up in
the small intestine, where theyfeed off the fermentable sugar,
starches and fibers that arefound in certain fruits and
vegetables.
And all fruits and vegetableshave these fermentable compounds
(19:44):
, there's just different typesand they're found in higher
concentrations in certain fruitsand vegetables.
Now, in reality there are twoprimary ways to get SIBO.
One is bottom-up and the otheris top-down.
In the bottom-up model,bacteria from the large
intestine and colon migrate upinto the small intestine because
(20:05):
the brain-gut axis fails tocontrol the ileocecal valve we
talked about that in theintroduction.
To control the ileocecal valvewe talked about that in the
introduction so that thebacteria in the lower intestine
can move in a retrograde fashionup into the small intestine and
in other words, we lose theseparation and
compartmentalization thatnormally keeps bacteria in the
(20:25):
large intestine and the colon.
That's a bottoms-up model ofhow someone acquires SIBO.
But the top-down model of SIBOis where we eat food with some
organism in it like bacteria,and there's actually something
called SIFO, which is a fungalovergrowth, but let's just stick
(20:46):
to bacteria.
So with this top-down model ofSIBO we eat something that has
some bacteria in it and we can'tsterilize it because we don't
have good stomach acid, and sothese bacteria take up residence
in the upper small intestine,where they're really not
supposed to be.
And that happens again becausewe can't sterilize the food
we're eating, because we're notmaking enough stomach acid right
(21:10):
, so the bacterial load that weswallow doesn't get neutralized
or sterilized and then it caninfect the small intestine as we
age and we tend to losehydrochloric acid because of
atrophy of the hydrochloricacid-producing cells.
Remember I said, hydrochloricacid is made by certain cells in
(21:31):
the gut.
These are called parietal cells, and when we can't sterilize
our food, we get infections inthe stomach or high in the small
intestine and that can manifestas SIBO, which classically
presents as gas or bloating anddistention, particularly when
you eat certain sugars, fibersand starches.
And this is also a very commoncause of IBS.
(21:52):
I mean, the last statistic Isaw was that about 80, well, it
depends on the study anywherefrom 40, let's say upwards of
80% of people who have IBS haveit because they have SIBO.
And then the question is well,why do you have SIBO and what
can we do to try to change that?
And the answer is quite a lot.
(22:12):
Now, one of the common organismsfor infections in the stomach
itself or at the very top of thesmall intestine is an organism
of bacteria called H pylori, andH pylori is perhaps the most
common cause of gastritis andgastric ulcers.
And in fact H pylori isconsidered to be the most common
cause of gastritis and gastriculcers.
And in fact H pylori isconsidered to be the most common
(22:35):
infection in the world, sinceat any given time, roughly half
the world's population has Hpylori present in their stomachs
.
But here's the kicker 80 to 85%of the time these infections
are asymptomatic, which meansthat you don't even know you
have it.
And over time the H pylorishuts down stomach acid
production by impairing theseparietal cells that make
(22:57):
hydrochloric acid.
And the research suggests thateveryone with these silent H
pylori infections willeventually develop gastritis and
a high percentage haveincreased risk for stomach
cancer because of the long-termlow-grade inflammation that H
pylori induces.
And for the longest time,scientists thought that the
(23:18):
stomach was completely sterilebecause of its acid content.
That is until they discovered Hpylori.
I think it was early 80s, I'mgoing to say 1982.
And then for decades H pyloriwas thought to be the only
bacteria that could colonize thestomach, because it controls
the acid production.
It shuts it down.
(23:39):
That is until better techniquesdiscovered that a strain of
streptococcal species could alsoinfect the stomach, and I'm
sure more will be discovered inthe future.
Now, one particular form ofstrep that can infect the
stomach is something calledstrep mutans, which is a major
(23:59):
contributor to cavities in yourteeth, and so we have studies
that show that strep from yourmouth can seep into your stomach
and then create biofilm and Iknow I've talked about biofilm
before to your stomach and thencreate biofilm and I know I've
talked about biofilm beforewhich, it turns out, creates the
perfect habitat for H pylori togrow, and this is why people
(24:20):
with poor dental hygiene havehigher rates of H pylori in
their stomach.
Now, as I said, h pylori shutsdown stomach acid, which allows
H pylori, strep and otherorganisms to get past that first
line of immune defense, whichis not an immune cell, but it's
a highly acidic stomach.
Now, low stomach acid can alsohappen with hypothyroidism or
(24:45):
Hashimoto's disease.
When thyroid hormones are low,we can't make sufficient amounts
of another protein calledgastrin, which is part of the
production process ofhydrochloric acid.
Right, remember, hydrochloricacid changes the pH of the
stomach, which then activatespepsin.
But in order to makehydrochloric acid we need this
(25:06):
thing called gastrin, whichtends to be low in people with
Hashimoto's.
Gastrin does several things inthe gut, one of which is
activating this thing called theproton pump, and I'll refer you
back to proton pump inhibitormedications like Zantac and
Pepsod that shut down acid.
This is how it does it byshutting down the proton pump,
(25:28):
gastrin activates the protonpump, which sends both hydrogen
and chloride ions hydrochloricacid, hydrogen and chloride ions
into the gut, where theycombine to make stomach acid or
again hydrochloric acid.
And this is one of severalreasons why people with
Hashimoto's tend to have GIcomplaints.
(25:49):
There's not many people I'veworked with and I've worked with
hundreds, if not more, ofpeople with Hashimoto's over the
last 15 years.
I'm sure it's in the very highhundreds, if not in the
thousands, and very few of themhave normal gut function.
Right, gastrin does severalthings in the gut, one of which
(26:11):
is activating the proton pump,which then sends hydrogen
chloride ions into the gut.
They make the hydrochloric acidand, again very common with
Hashimoto's they tend to have GIcomplaints, which range from
protein maldigestion to low gutmotility, to SIBO infections, to
leaky gut, and the list couldcontinue.
(26:31):
Finally, and I've mentionedthese proton pump inhibitors
like Pepsin, ac, zantac and soon, these are used to control
acid reflux and they cancertainly do that right, they
reduce the acid symptomatology.
But there are some downsides.
The first is that the lowerstomach acid means less
sterilization and an increasedpotential for H pylori, strep
(26:54):
and other gut infections, andthat's not cool.
But perhaps the worst potentiallong-term outcome of proton
pump inhibitor use is that insome people it causes gastrin
levels to get too high becausethe body is now you're using a
medication to shut down theproton pump and the innate
(27:14):
intelligence of the body issaying well, I need more acid.
So it keeps trying to make more, so it makes more gastrin, and
this is a risk factor forneoplasia or uncontrolled tissue
growth.
Call it cancer.
And this is why people who havelow stomach acid from any cause
whether it's H pyloriinfections, low thyroid or
(27:35):
proton pump inhibitor use have agreater risk for stomach cancer
than those who have adequatehydrochloric acid status.
All right, I'm going to leaveit there for now.
Next time we're going to talkabout the role of bile, also as
part of the innate immune system, but also we'll talk about its
role in detoxification, andwe'll come back to both
(27:57):
hydrochloric acid and bile andtheir roles in the microbiome.
We're going to do that nexttime right here on the
Inflammation Nation podcast.
This podcast is for generalinformational and educational
purposes only only, and does notconstitute the practice of
medicine in any form or capacity.
No doctor-patient relationshipis formed.
(28:19):
The use of the information inthis podcast or any materials
associated with or linked to thepodcast is at the listener's
own risk.
The content of this podcast isnot intended to be a substitute
for professional andpersonalized medical advice,
diagnosis or treatment, andlisteners should not disregard
(28:39):
or delay obtaining propermedical advice when a health
condition exists and warrantsthat.
And finally, functionalmedicine is not intended or
designed to treat disease, butrather is a natural approach to
support restoring health andwellness.
The use of diet and lifestylemodifications and nutritional
supplementation is supportivefor adjunctive care.
Popular Podcasts
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.