Mind-Body Medicine: Psilocybin and the Gut

Episode Transcript
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SPEAKER_03 (00:02):
Maintaining a healthy gut is key overall
physical and mental well-being.
Whether you're a healthconscious advocate, an
individual navigating thecomplexities of living with
Giovanni issues, or a healthcareprovider, you are in the right
place.
The Gut Health Podcast willempower you with a fascinating

(00:23):
scientific connection betweenyour brain, food, and the gut.
Come join us.
We welcome you.
Hello, friends, and welcome tothe Gut Health Podcast, where we
talk all things related to yourgut and well-being.
We are your hosts, I'm KateScarlotta, a GI dietitian.

SPEAKER_02 (00:44):
And I'm Dr.
Megan Real, a GI HealthPsychologist.
And we are diving into a noveland exciting topic today.
The topic psychedelic therapiesand the potential role in gut
health as well as far beyond.
We're very excited to welcomeour guests today, and we're
going to kick things off withDr.

(01:04):
Emran Mayer, agastroneurologist,
neuroscientist, anddistinguished research professor
in the Department of Medicine atthe David Geffen School of
Medicine at UCLA.
He's the executive director ofthe G.
Oppenheimer Center forNeurobiology and Stress and
Resilience and founder of theGoodman Leskin Microbiome

(01:25):
Center, also at UCLA.
He is one of the pioneers andleading researchers in brain gut
microbiome research, and he haspublished well over 400 highly
impactful scientific papers andco-edited three books.
He also has his own books, TheMind Gut Connection, which sits
on my shelf, The Gut ImmuneConnection, which was published

(01:47):
in June of 21, and the recipebook, Interconnected Plates, in
2023.
You may have also caught him onTV or in the air because he's
got a masterclass, and the PBSdocumentary is available for you
to check out too.
Among many prestigious honors,he was awarded the 2016 David
McLean Award and the 2017 IsmarBoas Medal.

(02:10):
We are so thrilled to have him.

SPEAKER_03 (02:13):
So it's my pleasure to introduce Dr.
Aaron Monnie.
We have two guests today.
Dr.
Monnie is a pediatricgastroenterologist and obesity
medicine specialist at TuftsMedical Center here in Boston,
where she focuses on innovativetreatments for complex digestive
and metabolic disorders.
She maintains a researchappointment at Massachusetts

(02:36):
General Hospital, leading astudy on psilocybin assisted
therapy for irritable bowelsyndrome.
She is passionate aboutexploring how emerging mind-body
therapies can transform patientcare and quality of life.
Psychedelic therapies have beenaround for thousands of years,
but the modern story reallystarts in 1943 with the

(02:59):
discovery of LSD.
That moment kicked off twodecades of research, including
more than 40,000 patients andover a thousand studies using
LSD alone.
By the 1960s, psilocybin, whichis the active compound found in
certain species of what we callmagic mushrooms, was being

(03:19):
explored for psychiatricsymptoms and addiction.
At Harvard, psychologistsTimothy Leary and Richard Albert
helped bring it into thespotlight.
The results?
Larry and Alpert's controversialpsychedelic experiments at
Harvard led to their 1963dismissal, ending their academic
careers but launching them ascounterculture icons.

(03:42):
Leary was later blamed for thebacklash against psychedelics,
lost credibility.
Yet research into theirtherapeutic potential,
especially for anxiety,depression, and addiction,
continued worldwide.

SPEAKER_02 (03:55):
Yeah, it's fascinating because then came
the Nixon area and really thiswar on drugs.
And much of this research wasabruptly shut down, even as
studies were very active.
And this went on for decades.
And so recently there's been aresurgence of interest,
especially in the areas ofsubstance use and eating

(04:16):
disorders.
However, today we are talkingwith these two experts about how
these therapies may offer newhope for conditions like IBS by
simultaneously targeting braingut dysregulation as well as the
common comorbid mental healthconditions that come along with
them.
So let's start with some mythbusting about

(04:39):
psychedelic-assisted therapy orany aspect of gut health.
We're going to begin with you,Dr.
Mayer.
What myth would you like to bustpertaining to these topics?

SPEAKER_00 (04:50):
There's certainly several.
I wouldn't bust any myths aboutpsychedelics.
I think, you know, there's a lotof things out there that are not
evidence supported and personalexperiences, including my own.
So I don't think this is theright time and topic for to
busting myths.
So for me personally, it's beenthe obsession with SIBO and the

(05:13):
treatments and the diagnosiswith breath tests.
And the reason is simple.
I mean, like when I did mytraining decades ago, you know,
SIBO was a real rare diagnosis,it's typically happening in
people with compromised smallbowel transit and motility,
scleroderma sort of being thekey disease entity that I saw,

(05:37):
several patients.
And, you know, I mean thesymptoms were pretty severe.
I mean, not just bloating, butalso malabsorption.
What has happened since then,you know, I mean, having seen in
the meantime thousands ofpatients with functional GI
disorders or, you know,disorders of altered gut brain
interactions, it's such acommon, I mean, the symptoms

(06:01):
that are now called SIBO or aregiven this simple explanation,
SIBO, are so common that it'sextremely unlikely that there's
an underlying mechanism as smallbiointestinal overgrowth
underlying them.
And obviously for patients, it'sa wonderful thing because for

(06:21):
the first time there is amedically recognized label to it
rather than blaming them for,you know, it's neurotic, yes, it
is, it is, and nothing helps.
For the patients, it's great.
Many patients come now and theydon't say, I feel bloated, they
come, I have SIBO.
There's been a recent reviewarticle, a critical review

(06:44):
article on this, which hascaused a lot of smoke in the in
the in the GI community, of someopinion leaders basically
arguing against the validity ofbreast tests in making a
diagnosis of uh SIBO, and SIBOplaying a major role in in the
common IBS symptoms of I mean,actually I shouldn't say this
because non-painful symptomshave been taken out of the

(07:07):
diagnosis of IBS, I think, in myopinion, wrongly.
So it has to be pain, it can'tjust be the abdominal
discomfort, which almost everyIBS patient has.
But this re-article byprominent, you know,
representatives of the GI andthe functional GI community
critically discussed theproblems that we have with the

(07:29):
diagnosis and the and thetesting.
And one aspect or oneconsequence of this
overdiagnosis or wrong diagnosisof a microbial disorder is the
extensive use of antibiotics.
I mean, it's pretty clear thatantibiotics will suppress gas
production, even physiologicalgas production by bacteria in

(07:54):
the colon, not just in a smallintestine.
So if you have a hypersensitivegut and you suppress gas
production with an antibiotic,you will temporarily feel
better.
In most of the patients that Isee, I see the spillover from
our neighbor medical center inLos Angeles.
Use any names in thisconversation.

SPEAKER_03 (08:15):
Good idea.

SPEAKER_00 (08:32):
So I wouldn't mind people calling themselves the
FSIBO, but I really disagreewith this excuse to use
antibiotics.
And some people actually won'teven stop it.
You know, if I say, don't youthink after five times, only
temporary successful treatments,it's time to to do something
else, they won't stop it.

(08:53):
You know, they they they sort oftotally believe in it.
So anyway, long a long story,but this uh my two favorite
myths.

SPEAKER_03 (09:00):
It's definitely a controversial topic.
And I think you know, we justneed more science.
Clearly, the tests, the breathtests, have very little
validity.
So what we're using to test itis not very good.
So there's room for improvementthere.
All right.
So moving to Dr.
Mani, what are as a myth busterthat you'd like to do pertaining

(09:22):
to gut health or possiblypsychedelic use?

SPEAKER_01 (09:26):
Yeah, I think a myth that's already sort of busting
itself, which I'm very heartenedto see, is that gut health is
all about what you eat.
I think there has been such anincreasing recognition among the
lay public and among scientistsand doctors that yes, what you
eat obviously matters a lot, buthow your brain and your gut are
in communication matters just asmuch or even more for disorders

(09:48):
like IBS.
And so I think that that'ssomething that's just been very
exciting to see because Ihaven't been practicing as long
as Dr.
Mayer, but even when I startedpractice, I think if you
suggested that someone had IBS,there was almost like a feeling
that you were dismissing it assort of it's all in your head.
And I think that I don't reallyget that pushback as much
anymore.
I think people are very on boardwith the mind-gut connection,

(10:11):
which is really exciting to see.
And I think that these new areasof therapy that we'll talk
about, including potentiallypsilocybin-assisted therapy or
other psychedelics, really aimto treat the connection between
the gut and the brain and thecommunication involving, you
know, motility, sensitivity,microbiome signaling, others.
But it's a whole new avenue.
And I think it's like a muchmore sophisticated way of

(10:33):
looking at health.
In kind of the larger scheme, Ifeel like it almost reverses
sort of this Cartesian mind-bodyduality that has really not done
any favors for the practice ofmedicine or for human health.
So I'm very excited to see thatthere's a lot more openness and
interest in what was once morefringe, holistic, crunchy.
I think that's really moved muchmore into the mainstream, and

(10:54):
that's really exciting to see.
Absolutely.

SPEAKER_00 (10:56):
It's wonderful to hear this from Zor for jumping,
but I can't help wonderful tohear this from you, Erin.
As you say, uh, you know, I'vebeen in this business for
probably a lot longer than youhave.
And the first two decades of mycareer, the hostility that was
generated by myself and ourgroup giving talks on the
brain-gut connection.

(11:17):
I'm just surprised why I didn'tstop pursuing that.
You know, both in the clinic,patients were not didn't like it
because they thought we meanpsychological factors.
But the colleagues, the fieldjust totally rejected it.
I should have recorded some ofthe comments that we got from
some very prominent people.
You know, it's remarkable.

(11:38):
I mean, this paradigm shift isreally remarkable.

SPEAKER_02 (11:40):
Yeah, you've spent your career just deepening all
of our understandings of the gutbrain access.
And so we are really curious tosee how you feel the potential
of psychedelics fitting intothis very big picture view of
gut health.
And we recognize this is very,we are in an infancy of

(12:03):
connecting psychedelics topotentially IBS.
But Dr.
Mayer, from your perspective,how might psilocybin or some of
these other psychedelictherapies integrating them into
the evolving understanding ofthe brain-gut microbiome
connection?

SPEAKER_00 (12:22):
Yeah, as a disclaimer, you know, I had my
first experiences withpsilocybin, not in the 60s or
70s as party drugs.
You know, I somehow bypassedthat phase.
But I was introduced to them bya young physician who plays a
significant role and then spendsa lot of effort in legalizing

(12:42):
psilocybin.
And so I had a few, or I shouldsay, we together with my wife,
we had a few sessions in ourhouse with this individual.
There were guided sessions.
It was just such a remarkableexperience, I have to say, that,
and most people say that, thatdo it under guidance or you

(13:03):
know, for a spiritual reason,that it has profoundly changed
the way that you look atreality.
You know, it's it's just thatyou have this experience of
intense interconnectedness withyour surrounding, if you do it
in nature, with you know, thatyour breath is synchronized with
the movement of the mountainsaround you and and then the

(13:26):
colors.
It's both a beautifulexperience, but also it's a
really profound psychologicalexpansion of the way you look at
things, you know, and and itstays.
It's not just during the actualsession, it lasts.
I mean, like initially a coupleof weeks, but uh it hasn't
really gone away completely.

(13:48):
And I have to say it fell in inmy case on fertile soil because
I've always been interested inin union psychology.
Debated before I went to medicalschool if I should go into
psychology.
So this has always fascinatedme.
And then that experience is thisself-experience really
re-emphasized the importance.

(14:09):
And since it has such a profoundeffect on the brain, and you
know, being a strong advocate ofthe brain-gut connection, there
almost has to be this connectionwith this altered communication
between the brain and the gut,even though we don't know as
much about this as we know, forexample, about the 5H2A
serotonin receptor in the brain,which seems to be the main

(14:32):
mechanism for the psychedelicexperience.
I think thinking about it as ascientist, I mean, I wish I
could dial back my career 20years and getting the
psilocyphine field and the braingot infractions.
This assumption now, you know,it's pretty more than an
assumption that it hasneuroplastic effects.

(14:53):
It can actually change circuits.
I mean, there's very fewtherapies that we have today in
psychology, and certainly not inthe treatment of functional GI
disorders, that has thatdisability to actually change
circuits.
And so that I find really uhreally attractive because
clearly IBS is not somethingthat you get for a month or for

(15:16):
it's usually if you take adetailed history, it's it's a
pattern of your brain at how itinteracts with the gut that
often goes back you know tochildhood, maybe not manifesting
in the gut, but manifesting asas anxiety.
So to be able to reprogram thisis fascinating.
And and I think the potentialboth in psychiatry but also in

(15:38):
in functional GI disorders.
The one thing and we we may comeback to this question.
So I I looked as much as I couldto find out.
My initial thought was well, oneof the best explanations would
be if these 5HT2A receptors arepresent on certain microbes and
you can actually change thebehavior of the microbes.

(15:59):
And uh surprisingly, I did couldnot find that evidence.
Uh, there's a few papers thatstate that they have not been
detected on.
But they are present on parts ofthe gut that regulate the
habitat in which the microbeslive in.
So motilde, accretion, bloodflows, serotonin release.

(16:21):
So it's most likely an indirecteffect that they have on the
gut.
And they also some vagal nerveafferents, sensory fibers
express that receptor as well.
So, which is always a big thingbecause you know, vagal
stimulation is being debated asa potential treatment for IBS.

SPEAKER_01 (16:41):
I thought it might also be helpful to add that
while kind of the serotonin,5-HT2A receptors get all of the
glory in terms of causing thepsychedelic effect, psilocybin
is actually a relativelynonspecific serotonin agonist,
meaning it acts at manydifferent serotonin receptors,
including ones that arewidespread in the gut, in
addition to the 5-HT2A ones.

(17:03):
And I wrote a review articlewith some of my colleagues at
MGH, which is in out in ACG,like I think a few months ago,
or Journal of Clinical Gastro,that kind of looked at like some
of these potential putativeeffects and where psilocybin
could be acting.
We need a lot more basic scienceto kind of pin down exactly
where that might be.
But these serotonin receptorsare used just very widely in the

(17:24):
body, even in addition to beingexpressed on gut neurons.
We see them also on differentcomponents of the immune system.
And so this interaction betweenthe microbiome and the immune
system, it's it's just this likevery delicate dialogue.
And I think it's, you know, verylikely that there are some
indirect interactions there aswell.
So I think we need a lot of helpfrom basic scientists to figure

(17:45):
this out.
But there's so many places thatcould be acting peripherally
that just haven't really beenstudied yet.
So interesting.

SPEAKER_02 (17:52):
And Dr.
Mayer, do you think there arecertain personality constructs
that make somebody more of agood candidate for this?
So you are describingpersonally, you know, some
things about yourselfspiritually and maybe from an
openness perspective.
Do you have some insights onthat?

SPEAKER_00 (18:11):
Yeah, so what I noticed talking about this
topic, so a lot of people, youknow, older people have tried
Sangosaibian and otherpsychedelics in the 70s as party
drugs.
Very few of them had a specialexperience.
Yeah, it was fun, you know, Iloved the colors and uh, but
I've not heard many times thatthey would say to God, this was

(18:34):
a this was the best experiencethat I've, or the most profound
experience, which a lot of theserious uh practitioners
actually have reported.
So I think a survey, it's one ofthe most common things that
people say was the mostimportant or most profound
experience that they've everhad.
I would say it's partially truein my experience as well.

(18:55):
I mean, I've not experiencedsomething that is comparable.
And so if you go into thistherapy as with your perception,
yeah, this is a fun thing to doand it's entertaining, it's less
likely they're gonna help you.
With one caveat, you know, we wehave not talked about this, this
whole microdosing phenomenon.

(19:17):
Well, you won't have theseexistential experiences, but we
don't have enough data really toknow does this do anything
objectively, or is is it a bigplacebo that people say for a
disorder like IBS or anxiety orI I think with these kind of
interventions, the placeboeffect is always a good
explanation looming over the youknow the reality.

(19:41):
Being best prepared for it,yeah, clearly if you have some
kind of a a spiritual interestor psychological interest,
you're probably a bettercandidate for that than somebody
who comes cold to this field,because then you would need a
lot of explanations anddisclaimers, what this is not.

(20:03):
Overall, I think the initialdoing this initially together
with a guide, an experiencedguide, and I don't know how many
psychologists are now trained inproviding that kind of guidance.
So in my case, the initial twosessions made a huge difference
to have somebody who sort ofkeeps you uh focused on it.

(20:25):
Because I would always ask aquestion during the session,
what is this, what is this, anddoes this help me with this?
And so this guide, this thisperson would just say, I'm just
your guide.
You know, it would never nevergive me any concrete answer, but
just focused me on theexperience itself, which I think
is is important.
Then there's also this thiswhole thing about the

(20:47):
integration, you know, thisclearly opens up parts of your
brain and your memories that younormally wouldn't have easy
access to.
I mean, some meditators do, butmost people don't.
And then when this materialcomes up, I've also personally
noticed that you have a desireto talk for uh I've never talked

(21:08):
as open with somebody, includingwith my wife, for hours
afterwards.
So it does something to yourwhole processing, you know, this
this openness and touchingthings that you normally
wouldn't talk about.
So I I think that's alsosomething that has to be an
essential part of it.
I mean, just giving getting asession, getting a shot of

(21:30):
medication in an office and thenleaving again, that probably
would not have the same effect.
I think.

SPEAKER_02 (21:36):
Yeah, it's fascinating in looking in you
know, into the history of thisand some of the experiences in
early research in the area ofaddiction.
So, you know, one of thefounding fathers of AA claims
that psychedelics helped him tobasically break his addiction.
And that's where a good bulk ofresearch was in substance use

(21:58):
and more severe psychiatricconditions in those early LSD
years.
So the fact that, like you'realluding to in one or two or a
couple sessions, theseprofoundly ingrained,
significantly impactingpsychiatric conditions could be
altered and changed thetrajectory of somebody's

(22:20):
experience in life is reallyfascinating.
And there's, you know, there's alot of hope there.
But as you've mentioned, youknow, lots of hurdles in terms
of the data and the sciencepresently.
And so I guess to kind of bringus back a little bit more to the
present, what are some of thehurdles that you think stand in
the way of maybe some of theresearch that Dr.

(22:42):
Monet is doing and Wani isdoing?
And how do we get it to be partof mainstream gastroenterology?
How far away are we from that?

SPEAKER_00 (22:52):
Yeah, I mean, obviously there's quite a few
obstacles.
It's not as well known andfamiliar to the majority of
gastroenterologists.
I mean, it tookgastroenterologists a long time
to accept the psyche as, youknow, this whole field of
neurogastroenterology took along time.
I think this is another stepthat you hope, you know, many
gastroenterologists would jumponto.

(23:13):
So it definitely won't hurl.
I mean, if unless the physicianwho recommends this is familiar
with it, both the benefits andthe risks and the limitations,
and can give a good explanation.
I I think uh it's difficult touse this as a therapy in a GI
practice.
Yeah, so the other thing is isthe financial, so the business

(23:37):
side.
You know, this is like a prettyinvolved thing.
This is not just tellingsomebody do your abdominal
breathing or you know, go tothis app and use it.
So both from the person thatinitially does an intake, a
psychologist, a trainedpsychologist, does an intake,
does an assessment of thatperson, then guides this person

(23:59):
during the session, and thenhelps integrating afterwards.
I mean, this is not done in 15minutes.

SPEAKER_03 (24:05):
Yeah.

SPEAKER_00 (24:06):
And there's not enough practitioners as far as I
can see that have this ability.
I mean, there used to be quite afew people, I think, probably in
the 50s and 60s, who had theseabilities, but they're not
really available now for youknow for GI practice or for
interacting with patients.
So until and and this isobviously expensive.

(24:28):
So let's say if you need atleast three hours of for the
complete session andintegration.
I would say that those twothings, the acceptance and
awareness by the physician, bythe gastroenterologist, and the
business model to build thisinto a GI practice, I think is
definitely two hurdles, twosignificant hurdles.

(24:48):
I'm curious what Erin has to sayabout this.

SPEAKER_01 (24:51):
Yeah, I completely agree with those being two very
major issues that need to befigured out in terms of how to
fit this therapy into theexisting healthcare framework.
A couple that I would add wouldbe that, you know, these are
currently Schedule I drugs,which means that in the view of
the FDA, they have no acceptedmedical use.

(25:12):
And therefore, studying them isvery difficult.
So when I kind of naively setout to study psilocybin in IBS
at the beginning of my GIfellowship, I would have never
imagined the degree ofbureaucracy and logistical
hurdles would come up against.
But you have to get things downto the level of like the safe
that the drug is going to bekept in inspected and everyone's

(25:34):
badges looked at by the FDA andby the IRB at your institution
and by the state licensing boardas well.
There's just layers and layersof like almost this Kafka-esque
bureaucracy.
It's kind of ridiculous withsomething like psilocybin has
like an incredibly high safedosing, right?
It's very hard to die frompsilocybin.
I don't think anyone ever has.
And yet it's treated verydifferently.

(25:56):
And so I think it just shows youkind of the discomfort that our
society has with thesemedications.
And I think that really goesback to sort of this like
counterculture backlash from the60s and the fact that these
experiences that can be elicitedby these drugs are so powerful
and they can be disruptive tothe status quo.
And I think that the status quo,therefore, on the one hand, says

(26:18):
that they want to studyinnovative medications and drugs
that might improve human health.
And they also, on the otherhand, hold this at a distance
with some anxiety towards it.
And so that's just been veryinteresting to navigate.
And people individually alsohold their own biases and
anxieties about these drugs.
You know, we've had people,nurses who are giving them in

(26:39):
our clinical research center,push back against it or be very
kind of uncomfortable with likemusic playing for the whole
time, for example.
Again, it's just not the waythat other therapies are
delivered.
And so it's new and people havea sense of some anxiety towards
it, I think.

SPEAKER_03 (26:55):
Yeah, and I would say like it's never really
spoken about at theseconferences.
You know, I go to DDWACG, youknow, every year and it's not a
big topic.
And I know research is expensiveand clearly there's obstacles,
right?
But yeah, with awareness, that'show things move forward too.
And so, you know, I'd love tosee this topic broached at some

(27:17):
of these conferences a littlebit more so that at least it
could pique some interest.
I mean, when Dr.
Monty reached out to me when shewas recruiting for her IBS
study, I was like, what the heckis psilocybin?
Like, let me just dive into thisa little bit and was so
intrigued by just all theinformation that's really out
there that I had no clue about.

(27:39):
So I think it is, you know, eventhis podcast, I think we'll get
to some general consumers outthere that have never heard of
it, like I really hadn't.
And I'm in the scientific field,you know.

SPEAKER_02 (27:51):
And we're so embedded in the GI world.
But I think the good news isthat, like at the American
Psychological Associationconference this year, there were
a couple of sessions thatincluded psychedelics.
So 2025, there were some, youknow, additional sessions
looking at this in terms of,again, more from a mental health
perspective, but we're pushingthe needle.

(28:12):
And as we always know, bridgingthe psychological world with the
gastrointestinal world, it comeswith its nuances, as I'm sure
that Dr.
Mayer has lived with his entirecareer.
Exactly.

SPEAKER_01 (28:24):
Exactly.
Well, it's funny you mentionedDDW because we've submitted
three abstracts about this studyto DDW, my study, and all have
been rejected.
So call me DDW if you'relistening.
And I think in time it will be,you know, it will be accepted
and people will will want tohear the results, whether
they're positive or negative.
And I understand that there islike a desire to study things

(28:46):
very rigorously and not reporton like preliminary data to some
extent.
So I understand that.
On the other hand, doing thesestudies takes a long, long time.
You have to screen a lot ofpeople to find people who fit
these like very narrow windowsthat, again, primarily because
of the FDA and all of theregulations attached to them,
people need to fit into toenroll in the study.

(29:06):
And so it takes a long time,it's not like just testing like
a new constipation drug andgetting, you know, 300 people
and six-month follow-up.
It's just like a very differentprocess.
And I think this is not uniquenecessarily just to
psychedelics.
I think any sort of like braingut therapy that psychologists
are trying to study are alsotime-intensive, lengthy, and so

(29:27):
it can be hard just to get thedata to kind of convince people.
But I would love to see moreopenness in the field of
gastroneurology and interest injust sort of like what we're
doing and the possibility thatthese drugs could have.
And I think that that it'sstarting to spring up.
We're definitely seeing it likebubble up.
I've had differentgastronologists reach out to me

(29:47):
from across the country.
I know that NYU is now alsostarting an IBS study, so with
psilocybin.
So I think it's starting, butwe're just at the very, very
beginning of it.

SPEAKER_03 (29:57):
And there's psilocybin in psychedelic
sensors.
Centers that are at biginstitutions around the country.
This isn't just like somegrassroots effort.
I think people read there arebig centers at Stanford, at
Harvard.

SPEAKER_00 (30:10):
Hopkins is one of the centers for the yeah.

SPEAKER_01 (30:14):
Yeah, more commonly for psychiatric indications and
not as many for mind-body kindof indications.
But, you know, this is outsidethe context of GI, but really
every aspect of medicine has itslike functional thing, you know.
I think these issues, kind ofthese brain-body issues, can be
manifested through manydifferent parts of the body and

(30:34):
chronic pain, if that'sfibromyalgia or you know,
chronic non-cardiac chest painand cardiology.
You could just sort of pick anorgan and it would have its own
equivalent IBS.
And so what I think is exciting,even beyond the possibility of
psychedelics for GI is canpsychedelics be used in this
whole emerging kind of mind-bodyparadigm?

(30:55):
And it's a little bit funnybecause I think we're like kind
of recreating or likerediscovering what, like how
these molecules have been usedby indigenous populations for a
long time, even though theywouldn't necessarily say they're
like treating IBS or have aconstruct like that.
I think they have a sort of amuch different view of how the
mind and the body are connectedand how these agents could be

(31:18):
used to sort of reset or bolsterthat connection.
And, you know, they're oftenused in those practices and
group settings.
And so also how are they used inkind of the context of the whole
society?
So it really opens up a lot ofquestions beyond even GI, but
more about like medicine broadlyand how to improve human health.

SPEAKER_00 (31:36):
And the thing is interesting that, you know, this
is a similar situation that Ifaced, as I said earlier, for
two decades, just to introducingthe brain into the, you know,
these so-called functionaldisorders.
It's a similar barrier now, youknow, to introduce something
that acts on the on the brain,probably primarily.
I would also say a lot of datahas been accumulated to show

(31:59):
that there are differences inbrain circuits, very specific
differences, not general on thebrain or psychology, but very
specific changes at the brain,the brain stem level, and to
have a compound that has theability to change these circuits
is by itself extremely exciting.

(32:21):
We don't know exactly how to useit and what doses, and is the
microdosing effective?
Is that the better way to do itin the long term?
More economically realistic.
But it's also conceivable, Ithink, that this, I mean, nobody
knows really in which directionthis goes with the Meha
movement.

(32:41):
You know, there's clearly sortof a more critical view of
pharmacological interventions.
And I don't know if ifpsilocybin and psychedelics will
fall into a category that'sbeing looked upon as more
attractive.
It's possible, but it could alsogo the opposite way.
You know, I mean, right now youdon't really know how this is

(33:02):
evolving.

SPEAKER_02 (33:06):
Hi, I'm Dr.
Megan Real.
As a GI psychologist, I've seenthe powerful impact that gut
brain therapies can have forpeople living with
gastrointestinal conditions suchas IBS, IBD, and more.
That's why I often recommend GIpsychology.
Their team specializes inevidence-based treatments like
gut-focused cognitive behavioraltherapy and clinical hypnosis,

(33:29):
proven in dozens of studies tosignificantly reduce symptoms
and improve quality of life.
These therapies work, and GIPsychology delivers them
exceptionally well.
They're also the only practiceof their kind seeing patients
via telehealth in all 50 statesand Washington, D.C.
So wherever you are, expert careis accessible.

(33:50):
If you're ready to feel better,schedule a free 15-minute phone
consultation atGIPsychology.com.
It's a chance to ask questionsand see if it's the right fit
for you.
GI Psychology is a trustedresource and they might be the
next step in your path torelief.

SPEAKER_03 (34:09):
So I want to just switch gears a little bit, Dr.
Mayer, and talk a little bitabout the potential for diet and
maybe even probiotics, and sortof giving individuals better
response to psychedelicinterventions.
Is there any research out there,or do you think there's any
evidence that these diet orprobiotics could enhance the

(34:32):
effects?

SPEAKER_00 (34:34):
So I'm not aware for psilocybin, other than you know,
the recommendation before youhave a session, you you should
probably not eat a heavy mealbecause a minor side effect in
some people is vomiting.
I've had that experience, not ina major way, but if you had a

(34:54):
full stomach, maybe this wouldbe a bigger issue.
It's not like with ayahuasca,you know, where you have major
side effects in terms of the GItract.
It's definitely nothing likethat.
And yeah, I would say thegeneral guideline would be to
not do it with a full stomach.

SPEAKER_03 (35:12):
Any long-term, like just benefits to serotonin
production or like enhancingcertain effects because of
dietary interventions, or isthat just too high in the sky?

SPEAKER_00 (35:24):
I think at the moment, with the information
that we have, I think it's highin the sky.
Okay.

SPEAKER_01 (35:30):
We don't know.
I think we do see, I'll talkabout this a little bit in my
bit too, but we see likeextremely variable responses to
psilocybin that the same dosecan cause such wildly different
experiences and differentintensities of experiences.
And some of that, I think,probably most of that, it might
be something to do withpsychological factors, it might
be something to do withserotonin receptor polymorphisms

(35:54):
or other things that we don'tfully understand.
But definitely some of it, Ithink, could be like driven by
or influenced by the microbiome.
But I think at this point, wedon't have anywhere clear, close
to enough data to say like ifyou eat X, Y, and Z, you can
enhance these bugs and thereforemaybe change the experience.
I think we're like so far outfrom being able to say that, but

(36:15):
it's definitely food for futureresearch.
Awesome.
Food for thought.
Food for thought.

SPEAKER_03 (36:20):
I know it was like on the tip of my tongue.

SPEAKER_02 (36:21):
Yes.
All right, Dr.
Mayer.
I think we're going to bepiquing a lot of curiosity with
this episode.
But what guidance would you giveto either clinicians or patients
that are listening in terms ofthe unanswered research
questions?
What do you think we need toaddress before considering this
wider adoption?

SPEAKER_00 (36:43):
I think what we can say, uh, you know, and I totally
support this idea that this highbearability.
I mean, some people havenegative experiences, some
people have I count myself inthis some of the best
experiences in their lives.
And, you know, I'm I'm uheternally grateful to the person
that introduced me to it in theright way.

(37:04):
So I think for physicians uhright now to recommend it for
medical indications, I thinkthat's too early outside a
clinical study.
I I think if somebody wants todo it, I think to enroll in the
clinical trial is the best wayto do it.
If somebody wants to do it forconsciousness expansion, then
they should only do it with aexperienced guide or teacher

(37:30):
that plays a big role in thequality and the extent of that
experience.
Just saying so if somebody comeswould come to me and say, you
know, I I've tried so manythings in in IBS, should I try
silos Ivan?
I would tell him I I can'treally give you a an
evidence-informed answer to thisbecause we don't know, you know,

(37:50):
and but as Aaron has you knowsaid earlier, I mean, there are
studies that people are nowlooking for patients, same at
Stanford, they're advertisingfor studied participants.
So this is what I wouldrecommend right now.

SPEAKER_02 (38:06):
Yeah, we don't want people going out into the forest
and foraging these magicmushrooms on their own and
trying to do this in their ownhome without a guide.
There certainly uh have to besome safety parameters that I
think give people the bestopportunity for uh potential.

SPEAKER_00 (38:23):
And I mean, I have a sort of an interesting exposure
to this whole field ofpsychedelics.
So we live in in a place in LosAngeles which was has a long
tradition.
So Topanga Canyon, you know,going back into the 50s and 60s.
And it's still it's kind of theepicenter in in California for
psychedelics, you know, andthere's once you get on the

(38:43):
mailing list almost every everyweek, there's another event
that's somewhere that they callprayer ceremonies.
So they have the world ofpsychedelics.
And I've gone to a couple ofthese just out of curiosity.
I mean, they're beautifulexperiences combined with uh
sound baths and meditation andrelaxation, that I personally
felt being in one of thesesessions, just the

(39:05):
non-psychedelic part was alreadyso so wonderful that I would go
back there even without any uhingestion.
So here's where we live, there'sa lot of experience, also
teachers, and but in many placesof the country that wouldn't be
the case.

SPEAKER_03 (39:22):
Right.
Definitely not in New England, Idon't think.

SPEAKER_01 (39:26):
But maybe depends on the parts.
Yeah, it depends on the parts.

SPEAKER_03 (39:30):
So let's switch gears a little bit.
So we've talked mostly, well, toboth of you, but with an
emphasis on Dr.
Mayer.
And I want to kind of switchgears to the work that you've
done, Dr.
Mani, really looking atneurogastroenterology,
psychology, brain gutconnection.
You've started this study atMass General, which is really
where I personally learned aboutpsilocybin from you.

(39:52):
And so let's get into somequestions.

SPEAKER_02 (39:56):
Again, we've been talking about psilocybin now for
a little while, but how might itreset our brain gut connection
in someone with IBS?

SPEAKER_01 (40:06):
Yeah, well, first thanks, Kate, for taking my cold
email to talk about thissubject.
I think that that speaks a lotto your open-mindedness and I
really appreciate you beinginterested in this.
And to answer your question,Megan, I want to kind of walk
back a little bit from some ofthe hype that I think
psychedelic research can getcaught up in.
So I think I would say thatreset is maybe too strong of a

(40:27):
word because I think it kind ofimplies that psilocybin is a
one-time or a few-timetreatment, and then almost by
magic, you take the drug andeverything is fixed.
Everything is reset.
And I think that it has a coupleof problems.
One is that it makes theperson's subjective experience
almost like secondary, like itdoesn't really matter what the

(40:47):
person's experience is, they'rejust a passive recipient of this
medicine, and then things arefixed.
And also, I just don't thinkthat that's really how it works
or how really psychedelicresearchers sort of think about
the kind of unfolding processthat is started, hopefully, by
these medicine sessions.
And I think that's true whetheryou're talking about using
psychedelics for IBS ordepression or what have you.

(41:10):
So I think what we've seen inour study is that psychedelics
are very powerful neuroplasticagents, and this has been seen
also in other studies withstrong like neuroimaging
components, as Dr.
Mayer mentioned.
We see that classicalpsychedelics, which includes
psilocybin, are serotoninagonists, and so they bind
throughout the body and in thebrain to the same parts, the

(41:32):
same receptors that serotoninbinds to.
And what neuroplastic reallymeans is that psychedelics seem
to open up kind of this windowin the brain where new neural
pathways can be formed, and thatthe brain can become much more
malleable to how it approachesproblems and sort of in your
day-to-day life, how youapproach ways of being in the
world, but also how the brainapproaches interpretations from

(41:54):
the body in terms of chronicpain or how it sort of interacts
with the peripheral, you know,nervous system.
And as we mentioned earlier, wedon't really know yet if
psychedelics also createneuroplasticity at the level of
the gut, but again, the gut isfull of neurons, the gut is full
of immune cells that are allbeing acted upon by serotonin.
So I would find it verysurprising to find out that that
was not the case.

(42:15):
So I think that there areprobably changes being elicited
in the gut as well as the brain,really throughout the body.
And so, really, we think ofpsychedelics as like a catalyst,
kind of or like a boostingagent, and that it's really not
just the psychedelic, but as Dr.
Mayer also keeps mentioning,it's really the psychedelic
assisted therapy itself.
And so our study also actuallyhas a lot of therapy.

(42:36):
So we have, just to give alittle bit more context about
the framework that our studytakes, which is similar to
studies that have beenundertaken for like PTSD or
depression.
We have two therapists that areassigned to a patient.
And in our case, they're allpsychiatrists, one music
therapist actually, but they'reall, you know, sort of PhD level
therapists.
And they are paired with thisperson throughout their whole

(42:57):
journey.
And they start with apreparation session.
These are like two sessions thatare 90 minutes to two hours
each.
So again, already a lot oftherapy, already a lot of
getting to know a person's lifehistory, how they're living
currently, how they managestress, et cetera.
And then explaining how thepsychedelic dosing days will
actually go and kind of helpingthe patient role-play different
ways that they might manageparts that feel scary or

(43:19):
uncomfortable, sort of how tokind of trust, let go, and be
into the process.
And then on the dosing daysthemselves, the person takes in
our study 25 milligrams ofpsilocybin, which is equivalent
probably around to like three,three and a half grams of dried
mushrooms, which is for mostpeople enough to elicit a
quote-unquote psychedelicexperience where they have, you
know, visual changes, but alsochanges in perception, also kind

(43:42):
of an openness to exploring likeautobiographical material within
their mind that might come up.
And the dosing day is reallyinwardly directed.
So we're not, the therapists arenot like, think about your IBS
right now.
You know, it's like nothing likethat.
It's just sort of that theperson has music, they're
internally processing andthey're having a variety of
experiences mostly on their own.

(44:04):
And then the very next day afterthe dosing session, they return,
talk about it with thetherapists.
And then the next week, moreintegration, more figuring out,
oh, this came up for you.
Like, how do you think thismight be connected to things you
struggled with over time?
How might you want to moveforward differently?
So those integration pieces areso key to take advantage of this
neuroplastic state, you know?

(44:24):
If a neuroplastic state's openedup and then you just do exactly
the same things, is like alittle bit of a waste.
So we really want to take thetime to kind of maximize and
really build on thoseexperiences.
And yeah, what we're finding isthat like rather than sort of
resetting IBS in the patientswho this therapy is really
working the best for, it'speople who are able to, after

(44:47):
this therapy, see their IBS andsee their life in a different
lens and to maybe see the earlylife roots, as Dr.
Mayer mentioned, of kind ofwhere this all started from, or
to see, you know, in the presentday how their partner or their
stressful job or their life orjust other things like outside
of the gut ostensibly areimpacting their gut.

(45:08):
And then also people have oftenthese like very beautiful and
enjoyable experiences and theyfeel really safe and happy in
their bodies in a way that theymaybe haven't before.
And that experience can also bekind of like reparative.
We have had interestingly, a fewpeople who have done very well
with this study and have hadtheir IBS disappear, reset, I

(45:29):
guess, in this case.
I'm thinking of two participantswho had these like very
beautiful and profound visualsthat then they were able to they
they write about theirexperience after the dosing day,
and we we read them and arestudying those kind of for
qualitative themes.
And the people who really likehold on to these experiences,
they often have these strongvisuals that they can then like
hold on to and bring forwardinto their life.

(45:50):
And then patients often, again,who who have success from this
will make big changes followingthe experience.
So they might make dietarychanges that they have not
really been had success stickingto in the past, or do kind of
any number of other things thatreally like keep the work of the
psychedelics going.
So that might include like yoga,journaling, meditation, things

(46:12):
that I think it's easy to likesort of pay lip service to
before.
But I think this experience canreally help people feel that
these practices might be callingto them in a different way and
really like bring it forward ina more solid way.
And so, yeah, we think that thissort of relaxes these previously
held rigid beliefs and opens upthis neuroplastic window.
And that may be why people areable to actually stick to these

(46:34):
things that, like, of course,they might say, I tried yoga
before, it didn't help me.
But now maybe other therapiesthat have been suggested to them
before, they're more open to andthat they feel more engaged
with.
So, yeah, so I think that wasvery long-winded.
But basically, I don't thinkthat psilocybin on its own like
resets everything because thedynamics of a brain gut disorder

(46:54):
are just so complex.
But I think it's just this verypowerful tool that can help
rewire the brain, help rewirethe peripheral nervous system as
well, and help people understandtheir symptoms differently and
feel safe in an embodied way andkind of carry hopefully those
changes forward with them afterthe dosing.
And and we often tell people,you know, you might not feel
like cured by one dose.

(47:16):
Don't expect that.
That's not a that's not ahelpful way to go into things,
but this might start a processof change for you that could
last the rest of your life.

SPEAKER_02 (47:24):
Who knows?
Amazing.
So I think you're highlightingthe fact that, you know, for all
of us looking for that magicpill, that magic cure, that
magic reset, it's not there.
Really good IBS research isshowing us how there's a
retraining.
And we talk about that withgut-directed hypnosis, that it's

(47:45):
a retraining of the way thesubconscious thinks about the
functioning of our gut andexperiences.
And I've heard Dr.
Mayer now talking about it andyou talking about it.
It's almost in some of thepsychedelic research, we hear
people saying it's like arebirth, a re-emergence, a re-an
opportunity to explore again howyou want to go about living your

(48:09):
life.
So it's truly, it's trulyfascinating.
And the way you describe givingpatients the safe experience,
the importance of amultidisciplinary team, that
again, this is not a one-offsituation that's taking place.
It's really a journey as youexplained it.

SPEAKER_03 (48:29):
Exactly.
I would like to know, like justsome of the I know you did like
IBS symptom severity scores andsome visceral hypersensitivity
scoring in this study.
Can you give us a littlesnapshot on that data from your
study?
Is it free to share?

SPEAKER_01 (48:46):
Yeah, it's free to share.
And I gave a presentation atPsychedelic Sciences earlier
this year, which was in June inDenver.
Amazing conference.
Highly recommend it if anyone'sinterested in this space.
Like no conference I've everbeen to, with people, you know,
the VC pharma people walkingaround in suits and then other
people walking around dressed asmushrooms.
And it's like really an eclecticmix of a really wonderful

(49:09):
experience.
And I presented sort of ourinterim results there.
And I'm also happy to likeprovide those slides to you,
Kate, if anybody wants to seethem visually.
But I think the overall liketakeaways, one is that our
study, this is the first studyin in the US, or I think in the
world, that is looking atpsychedelic assisted therapy
targeting a GI indication.
So mainly the outcomes thatwe're sort of powered for, or

(49:31):
not are not even powered for,but the things that we were
looking for are just safety andfeasibility.
So that's the main things thatwe can report on.
And we did find that theintervention is generally safe,
but we did have one patient whodeveloped suicidal ideation.
So I did want to highlight thatbecause I think this shows that
psychedelics are not for everyperson and they're not without
some risks.
And it does highlight the needto kind of think about these

(49:54):
agents in a supportive,structured setting.
But the patient, the suicidalideation resolved, and she's
plugged in with her own therapynow outside of the study.
But I did want to just mentionthat.
And then in terms of like theactual dosing day itself, we
found that most participantsexperienced the dosing days as
very intense, and we measuredthat on this mystical
experiences questionnaire, andalso have a challenging

(50:15):
experiences questionnaire to tryto get a sense of like how the
day was for people.
And so what we found is I thinkby the time I prepared these
slides, I think we had dosedlike six people, and I think
four of six or so had had likepretty intense experiences,
maybe not fully mystical, butpretty high scores on those on
those questionnaires.
And then the experience betweenthe two dosing days within the

(50:37):
patient were pretty much thesame or very similar, but
between patients, as Imentioned, can be totally
different.
Like we did have one patient whoonly did one dose in the study
and then dropped out because hewas like, I didn't really feel
anything.
I didn't really like the waythat fell.
Okay.
And then other people were likeblown away.
So it was just kind of likeeye-opening to us because we're
like, as you know, physicians,it's hard to give a drug that

(50:59):
could have like such completelydifferent effects on different
people.

SPEAKER_00 (51:02):
I just want to go back to something that you said
earlier.
I think it's it's it's reallyimportant.
So typically, you know, thetreatments for IBS, the
traditional treatments, and Imean, our center was involved in
many of these attempts of thepharmaceutical industry in the
80s and and and 90s to developyou know receptor-targeted
interventions, gutreceptor-targeted interventions.

(51:23):
And I would say pretty much noneof them really came out with
something that has changed thefield.
Soin therapy is completelydifferent.
You know, it's not a pill thatyou pop in the morning and then
that's it.
That's all you do.
You have to do the active workboth with your therapist, but
also the ongoing process.

(51:44):
It's changing more than some gutfunctions.
You know, it changes theparadigm that you evaluate, you
know, the world around you andyour symptoms.
And I think this is thefundamental difference.
It's not the pharmaceuticalmagic pill.
And I mean, we see this now withdifferent medications.
I mean, it's the same with theGLP1 agonists, that it's not

(52:06):
just getting the shot, you know,it's implementing all kinds of
other lifestyle modifications atthe same time.
It's definitely a new paradigmfor developing treatments for
chronic medical problems.
I think you have to combine itwith more than just the pill.

SPEAKER_01 (52:24):
Yeah.
Which is so exciting to be likea young physician starting now,
because this is exactly how Iwant to practice.
This is exactly how most of thepeople I know want to practice.
And I think, you know, patientsand physicians are just like not
really satisfied with thisapproach of seeing someone for
10 or 15 minutes prescribing amedicine and seeing them back in
three months and being like, didthe medicine work?

(52:46):
Like, no, that's not howanything works.
If only it were that easy inlife, you know, to make actual
deep changes to the way you liveand the way you relate.
But on the counterpoint, it'sjust exciting to see that there
is more openness to these kindof interventions that do take
more time.

SPEAKER_03 (53:02):
I just want to step back, but on one of your slides,
because you did share them withme, one of the participants had
sort of this vision of turningtheir IBS pain inside out and
pushing the pain out likefeathers were kind of flying or
something like that.
And using an imagery like that.
I think of gut directed hypnosisusing imagery and just replaying

(53:25):
that in their mind, like how itwas an image that came to them
and seemed to help goingforward.
So it I just wanted to sharethat if that's okay.

SPEAKER_01 (53:37):
Yeah, no, I mean, exactly, exactly right.
Like, you know, we didn't buildany gut-directed hypnosis into
this therapy manual.
We wanted to, I kind of wishthat we would have.
But what's been interesting isthat even without that explicit
like guidance, people have sortof come up with their own
gut-directed hypnotherapy.
And then the people, like Imentioned, that have really

(53:57):
benefited the most, like hold onto these images and as you say,
like replay them.
And so, yeah, just to like wrapup, coming to the preliminary
results.
I just pulled up the slide so Ican remind myself too.
But when we looked at the IBSSSS, five out of the six
patients had the clinicallysignificant response of greater
than 50-point drop.
And it was durable up to sixmonths, or even improving up to

(54:18):
six months for most people.
And this patient, actually, thatyou mentioned that had this
strong visual, she started thestudy in what would be like the
moderate severe score for IBSSSS.
And at six months, the score waszero.
So I initially, when I made thisslide, I had to like go back
because I thought there was aproblem with the data, but it
was like, you know, literallyzero.
Like this patient has justcomplete remission of symptoms,

(54:41):
which is just like incredible tosee.
We saw some similar changes forvisceral sensitivity.
Basically, everyone's visceralsensitivity index improved.
That was also durable up to sixmonths, where we have the data.
One interesting thing was thatwe thought that a lot of this
would be mediated bypsychological flexibility, which
is a construct from acceptanceand commitment therapy, which is
sort of what our therapy modelis based on, trying to improve

(55:02):
people's ability to sort of bein the present moment, not kind
of push things away.
Didn't really change.
Again, just six patients, so whoknows?
But it almost seems like there'ssomething happening more at the
level of the gut.
It's more embodied in a way thatthey're having these symptomatic
changes without necessarilypsychologically feeling like
they're approaching thingsdifferently.

(55:23):
And then one of the metrics thatI found the most interesting is
that we have people, they havethis iPad and it has two circles
on it.
One circle, we say thisrepresents yourself, your whole
life.
And then this other red circlerepresents IBS.
And please drag the IBS circlewhere on the iPad it makes
sense.
And it could be partiallyoverlapping the yellow sense of

(55:44):
self, or it could be far away.
You know, people understand itlike right away what the task is
that you're giving them.
And the self-illness separationis the distance between those
two circles.
And so we know from other kindsof pain and other studies, not
necessarily IBS specifically,but having a larger separation
of self from illness isassociated with better outcomes

(56:05):
because then you're not sort ofsaying, I am IBS, but it's just
something that occurs sometimesin my life, but you have a you
know more balanced approachtowards it.
And the self-illness separationincreased for everyone, and that
was also durable out to sixmonths.
So amazing.
So these are interestingoutcomes, and of course they're
all kind of self-reported forthe most part, you know, but

(56:26):
this is like a subjectiveillness.
It's what people, it's thesymptom-based illness, right?
So if people tell you that theirsymptoms are improving, then I
think that's that's reallyexciting to see.
And how many people will youstudy?

SPEAKER_03 (56:37):
Is it going to be a larger cohort?

SPEAKER_01 (56:40):
Yeah, we're enrolling 14 patients.
We currently have 10 enrolled,so we're looking for the last
few people.
We are still recruiting.
So if anyone is listening tothis and is in the Boston area
and is interested, I can alsosend to Kate the contact to
reach out to.
But we do want people to belocal to Boston because as I
mentioned, it's a lot of therapyand it's in person.

(57:00):
So, but that's our goal is toget to 14.

SPEAKER_03 (57:02):
Perfect.
We'll put that link in the shownotes for anyone listening
that's interested and lives inBoston.

SPEAKER_00 (57:08):
One comment about the visceral sensitivity index
that you mentioned.
I mean, sensory sensitivity is amajor variable in this
psychedelic experience becauseyour sensitivity to visual,
auditory, olfactory stimulichanges pretty dramatically to
essentially experience adifferent reality.

(57:30):
And I I mean, we don't know,it's just a speculation, but
maybe it's a rebalancing onceyou come out of the actual
experience that it's arebalancing of the sensory
processing in your basal gangliaor somewhere at your higher
level that normalizes thevisceral hypersensitivity.
But in IBS patients, you know,we know in the meantime it's

(57:51):
it's not just the viscera.
I mean, they are if you askthem, it's auditory, it's
visual.
You know, most patients havemultiple increased sensitivities
and the rebalancing of thesesomething as simple as that
could be the major reason thatpeople you know get rid of their
IBS symptoms.
Interesting.
Potentially, you know, tospeculation.

SPEAKER_03 (58:11):
But all right.
So I'm gonna switch gears.
I think we'll do our speed roundbecause we're wrapping, we're at
one hour, so I hope you can dothis really quickly with us.
So we're just gonna ask a fewrapid questions, one word, one
sentence answers, just to kindof get your level of expertise.
So I'm gonna start with Dr.
Mayer.

(58:32):
What are your top five must-havefoods for gut health?

SPEAKER_00 (58:36):
General answer all the foods that increase short
chain fatty acid production inthe gut, which have
anti-inflammatory effects.
So these are oats, cereals,complex carbohydrates.
I would list them at the topbecause you have this second one
is naturally fermented foods,which is not something that we

(58:57):
add to our diet.
It's something that humans havelived with for thousands of
years and have mechanisms torespond to it.
So I would say the combinationof foods containing complex
carbohydrates and naturallyfermented foods are the two key
ingredients.

SPEAKER_02 (59:13):
Love it.
And Erin, what's your favoritemorning ritual for gut brain
health?

SPEAKER_01 (59:20):
I guess I would just say general like stress
management.
So for me, that the main biggestthing that I've started doing
recent months is reading a fewpages of a book rather than
looking at my phone first thingin the morning.

SPEAKER_03 (59:30):
Oh, I love that one.
Okay, Dr.
Mayer, which impacts the gutmore, stress or diet?

SPEAKER_00 (59:37):
Obviously, we know today that both of these factors
are perforations or stressors ofthe gut.
Yeah.
I would say, you know, and andthat's not 100% based on
science, but really on my careerpath that influences from the
brain the chronic stress, notany kind of stress.
Chronic persistent stress hasthe more Profound negative

(01:00:01):
effect on the gut.

SPEAKER_02 (01:00:02):
We'll take that.
Dr.
Mani, what's one thing you wishmed school would have taught you
about the gut?

SPEAKER_01 (01:00:09):
I think we got into this a little bit in the
podcast, but I would say that,you know, medications like PPIs
and antibiotics, they have aplace for the short-term
improvement of symptoms, butmaintaining improvements really
requires deep changes tolifestyle for most people, and
that our health system is justdeeply broken and not really set
up to support this kind of deepchange generally.

SPEAKER_03 (01:00:30):
Agree.
All right, Dr.
Mayer, what gut health trend doyou wish would disappear?

SPEAKER_00 (01:00:36):
Well, the obsession with gut health.

unknown (01:00:41):
Yeah.

SPEAKER_00 (01:00:44):
If you really so why all of a sudden there's an
explosion of that obsession withgut health?
I mean, some people say it's youknow, it's the anxiety, it's
it's uh you know, a lot ofdifferent things.
I I think talking about thingsmore specifically, yeah, a
balanced interaction between thenervous system and the digestive
system is would probably be amuch better way of focusing our

(01:01:07):
attention.

SPEAKER_02 (01:01:09):
Okay.

And then one final question: intermittent fasting for gut (01:01:10):
undefined
health, yes or no, Erin?

SPEAKER_01 (01:01:17):
I think yes for some people, and I think it's a place
that's really fertile forself-experimentation.
So I think the science is prettycompelling that there's a lot of
beneficial things happeningunder the hood in terms of you
know mitochondrial autophagy andjust a lot of other things
happening that can be beneficialwith intermittent fasting or
time-restricted feeding.
But I do think, like withanything, it's not for everyone.

(01:01:39):
And there's people with ahistory of eating disorders or
poor metabolic health or peoplewho are gonna just end up
breaking their fast with venges.
And in that case, I think it'sprobably not worth it.

SPEAKER_02 (01:01:48):
Great answer.
Mean.
So yeah, it's great.
And with you know, all thisinnovation comes lots of
complexity.
Thank you so much for doing ourspeed round.
And really, Dr.
Mayer, Dr.
Moani, for your time today.
This has certainly been aprovocative conversation that I
think are going to get ourlisteners excited.

(01:02:11):
But as we know, no quick fixes.
There's a lot of still ongoingresearch, safety concerns,
ethical concerns that we have tobe considerate of when we think
about the potential ofpsychedelics.
But we hope you'll join usagain.
And to all of our listeners outthere, thank you for supporting
our gut health community.
Thanks again to both of you.

(01:02:32):
We really appreciate it.
Thank you for joining us as wegrow this gut health community.
We hope you enjoyed this episodeand don't forget to subscribe,
rate, and leave us a comment.
You can also follow us on socialmedia at the Gut Health Podcast,
where we'd love for you to shareyour thoughts, questions, and
experiences.
Thanks for tuning in, friends.

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