November 6, 2025 • 48 mins
What if adult acne isn’t hormonal after all, but an inflammatory signal from the gut asking for help?
In this thought-provoking episode, naturopath Asha Evertsz unpacks the gut–skin–brain axis and reveals why most adult acne is less about hormones and more about systemic inflammation, microbial imbalance, and stress. Drawing on years of clinical experience treating complex female acne, Asha reframes the condition as a terrain issue, not a topical one, where digestion, bile flow, and microbial diversity determine how the skin behaves.
You’ll hear how chronic stress, impaired digestion, and microbiome disruption from antibiotics, the pill, and Roaccutane alter immune pathways and ignite the mTOR signalling cascade that fuels breakouts. Asha walks through the stool markers that matter, including secretory IgA, zonulin, SCFAs, and Akkermansia, and explains the overlooked roles of bile, stomach acid, and pancreatic enzymes, her “guardians of the gut.” She demystifies the H. pylori connection, showing how low stomach acid and disrupted FOXO1 and IGF-1 pathways link directly to acne through poor absorption, excess sebum, and inflammation.
From there, we get practical. Asha outlines her phased gut-repair framework: fortifying mucosal defences, feeding the microbiome with fibre and polyphenols, introducing strain-specific probiotics, and only then layering in antimicrobials like berberine, a clever mTOR modulator. She shares clinical pearls on using bovine immunoglobulins to rebuild IgA and barrier function, timing omega-3s once bile flow is restored, and using zeolite, curcumin, and green tea to bind and calm the system during detox. From the outside in, she explains how corneotherapy protects the skin’s acid mantle and microbiome with topical pre-, pro-, and postbiotics, ditching harsh actives that create “leaky skin.”
Whether you’re a practitioner ready to move beyond surface-level acne care or a clinician refining your gut-first protocols, this conversation offers a test-led roadmap for rebuilding both inner and outer barriers, turning chronic flare-ups into calm, resilient skin.
Connect with Asha: Acne Naturopath | Asha Evertsz | Home
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_01 (00:12):
This is Wellness by Designs, and I'm your host,
Andrew Whitfield Cook.
And joining us today is AshaEverett and we'll be discussing
skin and the gut brain access.
Welcome to Wellness by Designs,Asha.
How are you?
SPEAKER_00 (00:24):
I'm excellent, thank you, Andrew.
Lovely to meet you.
SPEAKER_01 (00:27):
Lovely to meet you too.
Now tell us a little bit abouthow you practiced and how did
you become like, or how did youchange your focus to be an
expert in this area of skin andgut brain access?
SPEAKER_00 (00:43):
Yeah, absolutely.
So, you know, I had a personalhistory with acne, and that's my
passion.
So I guess I'm known for mytreatment of complex female
adult acne.
And I think we always can dowhat we know, you know,
personally.
And so it was very much the casefor me.
When I was well into mynaturopathy studies, I realized
(01:05):
that there was more to treatingskin than from the inside out.
So I went on a journey where Iwas studying skin from the
outside in, and that's exactlyhow I practice today.
I work from the inside out andthe outside in with my female
adult acne clients.
And of course, uh the gut skinaccess is a big focus of the
(01:27):
work I do.
So lots of stool testing aswell.
SPEAKER_01 (01:31):
Cool.
Can you take us through thedifferent types of acne and how
you assess these in theirclient?
Because, like some people say,oh, you know, the high acne, the
low acne, the chin acne, it'snot quite as defined as that, is
it?
SPEAKER_00 (01:46):
It's not.
It would be a lot easier if itwas.
But you know, I've I've seeneverything, and there's no
definitive pattern,unfortunately.
There is there are some generalpatterns, and there definitely
is becoming more awareness ofinflammation as the biggest
driving factor.
So we're steering away fromhormones.
Um we're not saying thathormones don't play their part,
(02:09):
but what we're saying in adultacne cases, and adult acne being
women that are over 25, thatonly about 3% of them are going
to be solely hormonal acne.
So we definitely take that intoconsideration.
So when we're looking athormonal acne, um that's quite
straightforward because we canpick that up in testing.
We can see that kind of U shapein the face where it's appearing
(02:30):
along the jawline, the chin, thelower cheeks.
Um, and that's quite adefinitive area.
Typically, the women who see me,that would have already been
picked up because that's fairlystraightforward.
So then we've got the othertypes that we see, which is very
much the stress connection.
So chronic stress elevatingcortisol, which increases that
(02:51):
sebum production andinflammation.
That can appear more randomly,but you can hear your patients
say things like, I went onholiday and my skin cleared up.
Um, we've got post pill acne,again, a very clearly defined
one when women are discontinuinghormonal contraceptives, and a
lot of time there's a lot offear, and then the stress acne
(03:11):
contributes to that.
Um, and they all interplay.
You know, we can't say thatthere's just one in isolation
because, for example, withpost-pill acne, we're going to
have the stress componentbecause they're fearful of
coming off the pill and havingthat post-pill acne.
There's going to be a gut andliver involvement because of
what that medication has done tothose organs.
And so it's all interconnected,which is why it makes it quite
(03:34):
complex to treat.
But what I do love treating inclinical practice is the
gut-related acne.
So that connection to gutpathogens, parasites, H.
pylori, SIBO, foodsensitivities, leaky gut, all
this stuff that we're going todive into today.
Um, and a lot of our patients,so 90%, will do stool testing,
(03:56):
even if they've got no symptoms,because there's such a strong
connection between the gut andthe skin.
The other interesting ones thatwe can see are the connection
between mineral disturbanceslike copper excess and zinc
deficiency.
Um microbiome overgrowthmimicking is acne.
And what I mean by that isactual overgrowths in the skin
(04:17):
microbiome that mimic acne, butthey're not acne.
They need to be treated verydifferently from the outside in.
And then our mold, mycotoxins,heavy metals, and environmental
allergens, which over the courseof my career I've seen increase
more and more and more.
SPEAKER_01 (04:36):
So let's dive into the gut, forgive the pun, um,
and and explore those processesat play in the body.
You know, you mentioned certaininfections.
H.
pylori was really interesting tome.
Um, but can we dive into that abit and talk about how you
assess and what sort ofvariations, if you like, in
(04:56):
treatment you you or how youtweak treatment?
SPEAKER_00 (04:59):
Yeah, absolutely.
So I guess when we're looking atthe skin gut connection, we know
that it's undeniably there.
And if someone is having skinissues, then it's very likely
that this is stemming from thegut.
So when we're looking at signsthat aren't gut connected when
they're not presenting withovert gut symptoms of bloating,
(05:21):
constipation, diarrhea, youknow, those kind of things,
we're starting to look at um isthere malabsorption?
You know, do they have low iron,low B12, zinc?
And do they say that this hasalways been the case for them?
And no matter what, they can'tbring it up.
Um, do they have unrelentingfatigue that can't really be
explained?
(05:42):
Do they have acne that can't beconnected to the menstrual
cycle?
Um, is there a big stresscomponent?
Um, have the hormones beentested and they're within range?
Um, and those are the kind ofthings that I'm looking at.
But like I said, we we do testabout 90% of our patients.
So when we're looking at the gunskin connection and acne, what's
(06:04):
really fascinating to me is howinterconnected these systems
are.
So the intestinal microbiotaisn't just sitting there
passively, it's activelyinvolved in acne formation
through several key mechanisms.
Um, so I like to think about itthis way that both of our gut
and our skin are incrediblyvascularized and innovative
(06:27):
tissues, and they're bothperforming complex
neuroendocrine and immunefunctions, which means they're
constantly communicating witheach other.
It's like they're having thisongoing conversation through the
nervous system, our hormones,and our immune pathways.
So, where it gets reallyinteresting for practice is that
(06:50):
essentially we know that the gutmicrobiome is our first line of
defense, and so is our skin.
Um, but it's determining how ourbody responds to everything
we're consuming.
So when the microbiome isbalanced, we get proper immune
tolerance.
But when it's disrupted, westart seeing inflammatory
cascades related to immunitythat can manifest as acne.
(07:12):
Um, we know some of the thingsthat are disrupting this, right?
So the Western diet is a majorculprit, um, throwing off that
delicate balance betweenbeneficial and pathogenic
organisms.
But something I find that'srelevant is that stress has a
big impact.
So stress will have an impact onour friendly bacteria,
(07:33):
particularly the lacto and thebifido.
It'll have an impact on our uhsecretory IgA, so our immunity,
and it will have an impact onour gut permeability, so
creating leaky gut as well.
So we know that the gut andthese bacteria and intestinal
health markers are incrediblystress-sensitive.
(07:55):
And when we're chronicallystressed, these microorganisms
can actually switch from beingprotective and anti-inflammatory
to producing inflammatoryneurotransmitters.
Um and then the real protectivemechanism that I work strongly
with is that a healthymicrobiota produces short-chain
(08:17):
fatty acids, including thepropionatic acid, which is
actually protective againststaph aureas and the C.
acne's bacteria in the skin.
So, you know, the research inthis area is still emerging.
We're often working clinicallyahead of where the research
stands, but it is it is comingand there's more and more
(08:39):
exciting research at play.
But the short chain fatty acidsdirectly affect the skin in a
few mechanisms.
So it's really important tofocus in on those.
SPEAKER_01 (08:51):
And so talking about gut inflammatory markers, which
markers do you find of mostclinical benefit for you?
Like, for instance, a medicomight use something like Cal
Protectum when they're lookingfor inflammatory bowel disease.
Do we go that uh, you know, do Iwhether you gross or do we have
to use it more more nuancedinflammatory markers?
SPEAKER_00 (09:13):
Yeah, it's a really good question.
And I would definitely say thatwe need to be more nuanced.
And in seeing so many reportsfor acne, and I'm definitely
going to talk about SIBO and H.
pylori in a moment, um, but whenwe're looking at the first thing
I look at in a report is theintestinal health markers.
And so I'm very much looking atthose as the protective
(09:38):
mechanisms of the terrain or theenvironment.
And yes, the cow protectin oneis a big one, but we know
there's going to be a hugeamount of inflammation generated
if zonulin is present.
Um, and also um looking at thosegluten antibodies and looking at
the secretary IgA.
When I look at the secretaryIgA, I like to also have a look
(10:01):
at um Acamansia, fecali, androseberrea because that's going
to give me an indication of thehealth of the mucosal lining.
And we know if the mucosallining is thin and fragile, that
there's going to be inflammationthere as well.
So having a look at all of thosemarkers in the context of
inflammation is reallyimportant.
SPEAKER_01 (10:25):
It'll be an interesting day when achomantium
immunisophilia is going to beavailable for clinicians, isn't
it?
It's available already overseas,I understand.
SPEAKER_00 (10:37):
Yeah, I do use the overseas one.
Yeah.
SPEAKER_01 (10:39):
Great.
SPEAKER_00 (10:40):
Yeah, as well as polyphenols and all of those
other great things.
SPEAKER_01 (10:44):
Um, I love what you're saying there about
feeding the bacteria.
Because, you know, in in theolden days, go ahead, um, it was
all about the bacteria, thebacteria, the bacteria.
And then we realize, you know,as soon as you stop, the effects
go away.
There's a lot of geneticimprinting stuff.
You need that um you know,beneficial effect to keep going,
(11:07):
you have to take more or more.
You know, and then we realizehang on, these things eat off.
Um, so it's just it's really aninteresting clinical facet to
explore with the diet and howthe dietary um inclusions of
things like polyphenols, fibers,etc., can influence the
(11:29):
microbiota.
Can you tell us a little bitabout that and your just your
clinical experience there whenyou're treating acne?
SPEAKER_00 (11:37):
Yeah, absolutely love to.
Um, so when we're treating acne,one of the things that we need
to, you know, keep in mind isthat most of our patients will
have been on pretty hectic acnemedication and not just for a
little while, like for a longtime.
And so that's the first thingI'm thinking when I start to
look at a report.
I'm like, okay, I know thisperson has done three rounds of
(11:59):
Raccutane, I know they've hadmultiple antibiotics and they've
been on the pill.
This is going to have haddecimating effects on the
microbiome.
What's really interesting is theclients that are currently
taking Racutane and looking attheir reports because the
literature is a bit wishy-washy.
Um, but when you look at anactual report of someone who's
(12:22):
on Roaccutane, it's quiteundeniable the effects that it's
having on those short-chainfatty acids and the mucosal
lining and the cow protectin.
Um, it's undeniable.
It's undeniable.
And it's often a little bit umsensitive to chat to people
about that when they're takingthose medications as well.
(12:42):
Um, but generally speaking, um,I will do a three or four-phase
uh gut protocol.
So the first phase is very muchabout addressing those
intestinal health markervulnerabilities, knowing that
we're going to have to supportthose for you know the long
term, um, but also addressingthe commensal bacteria through
(13:03):
probiotics, prebiotics, fibers,dietary aspect.
Um, one of the common thingsthat I see, you know, is the
bacterial phyla um beingdisordered.
And you'll say to someone, look,you know, how much fiber are you
eating?
And they'll say, I'm followingwhat you asked me to do.
(13:23):
I'm eating half a plate of umfruit and vegetables, like a
rainbow on my plate at everymeal.
It's linking back to, you know,digestion is a top-down process.
And so we've got to rememberlike what's happening from the
top down as well, and how muchis the gallbladder and the bile
and the liver impacting on that,yeah, on that commensal-friendly
(13:45):
bacteria as well.
So often I'll work a lot on thebile because that's like the
bile, the hydrochloric acid, thepancreatic elastase, you know,
they are the guardians of thegut.
And if we don't really honor andacknowledge them, we're just
going to be throwing probioticsat someone for a long time.
SPEAKER_01 (14:08):
I love what you're saying, the guardians of the
gut.
It's brilliant.
Um, you said you'd like todiscuss a little bit more about
H.
pylori and SIBO and that it's umlinked to acne.
Can we delve into that a littlebit?
SPEAKER_00 (14:20):
Yeah, absolutely.
Um, so actually, um, not sure ifyou're aware of Dr.
Julie Greenberg.
She's an um she's a naturopathfrom the States, and I've
followed her work for a longtime, and her work has been a
real game changer for me.
She did a clinical-based studyusing stool testing on organic
(14:42):
testing from her acne patients,and the numbers were staggering.
This is what started my piquedmy interest in H.
pylori and the acne connection,because what she found in this
clinical study was that 92% ofher acne patients tested
positive for H.
pylori.
Um, and that was just sosignificant to me.
(15:04):
Um, so when you start to delveinto that deeper, the research
is there for that outside ofthat clinical-based study.
So we know that what's happeningwith the H.
pylori is it's a very clever,sneaky bacteria that produces
urates.
And that job of the urese is toneutralize stomach acid because
(15:25):
it wants to create a nice uhalkaline buffer around itself to
survive the environment.
Um, so when we've got thateffect of the H.
pylori suppressing stomach acid,well, we know there's a direct
connection to acne andhypochlorhydria.
That's that's known.
Um, but we know as well that weget suboptimal digestion, so
(15:46):
we're not breaking down ourproteins, but then we're not
breaking down things like zincand ion that are crucial for
skin health.
Um, the stomach acid is a signalto gallbladder and pancreas,
which I'm very passionate about.
I do a lot of gallbladder andbile work in my practice.
And when that signal iscompromised, we're seeing that
poor fat digestion and enzymeproduction.
We might see that steadocritrise, um, which directly absorbs
(16:08):
the impacts the absorption offat-soluble vitamins that are so
crucial for skin, like youramegas, your vitamins A, D, E,
and K, all essential for skinintegrity.
So if someone is saying I can'tget my vitamin D levels up as
well, am I looking at the livergallbladder?
Yes.
But am I looking at H.
pylori as well?
Yes.
(16:29):
Um and then the third, and thebig one, is that we're losing
that killing power.
So the stomach acid as our firstline of defense against
pathogens.
And when we're seeing anovergrowth of the opportunistic
bacteria, the yeast, theparasites, then that first
guardian of the gut is, youknow, on its extended leave and
can't protect us.
(16:50):
Um, but this is this is wherethe research gets really
interesting with H.
pylori directly connecting toacne.
It doesn't just mess with ourdigestion, it actually induces
nuclear inactivation ofsomething called FOXO1 in the
gastric cells.
So FOXO1 is this transcriptionfactor that's like a master
regulator.
(17:10):
And when it's functioningproperly in the nucleus, it will
keep things like IgF1 and themTOR pathway in check.
And remember that that mTORpathway is a protein kinase that
plays a significant role in acnedevelopment.
But when H.
pylori knocks that FOXO1 out ofthe nucleus, we get this cascade
(17:31):
of increased sebum production,cell proliferation, inflammation
in the pyloserbaceous unit, andbasically that's causing acne.
So, you know, I say to mypatients that their acne might
just be a problem with lack ofFOXO1 in the nucleus.
It's um maybe a bit more of astraightforward way of
explaining how a gut infectioncan show up as acne.
SPEAKER_01 (17:54):
Um you're giving me so much to think about, Ash.
So can I just interject?
Um like talking about long-termusage of vitamin A, uh vitamin A
analogues, forgive me, um, likecryoac ketone.
Um and we're talking about theimbalance, if you like, or the
(18:17):
the uh uh contesting ofabsorption of of fatty um
fat-soluble vitamins.
Do you find things like youwell, you mentioned why can't I
get my vitamin D up?
And then what I'm thinking isyou mentioned the mTOR pathway
and the effect that fat-solublevitamins have on that, um, like
(18:39):
the FOXO1.
This is just this is blowing mymind.
I really need to go and readsome more books.
Can can I just get thepractitioner again?
What was it, Julie Greenwood?
SPEAKER_00 (18:49):
Dr.
Julie Greenberg.
SPEAKER_01 (18:52):
Greenberg, thank you.
SPEAKER_00 (18:53):
Yes, yes.
So we've known about mTOR for along time, but she was the first
person that talked about the Fox01 connection.
And then that just sent me onjust an absolute like, you know,
like spiral of research, andvery grateful for that because
we can't deny that the mTORpathway is one of the most
(19:14):
profound root causes of acne.
So it's it's driving all, youknow, um acne pathophysiology.
And um, we know that it's gotconnections to more sinister
health presentations as well.
Um, so we could look at acne asan early warning sign for those
(19:37):
more sinister healthpresentations, which is why I
love treating acne.
SPEAKER_01 (19:42):
Yes, that's where my mind was going too, Ashley.
Um I I this is just sointeresting to me.
I'm sorry, this is fantastic.
Can can I ask, you mentionedthat only 3% of women, was it,
that you see, um have hormonallyrelated acne.
Can we delve into that a littlebit?
(20:04):
How you tease apart those thathave a hormone component versus
like a major driver of thedisorder?
SPEAKER_00 (20:14):
Yeah.
Well, the 3% statistic came fromthe literature.
So that came from the literaturewith late onset acne, otherwise
known as adult acne.
And I was like, thank goodness,I'm not imagining this.
I'm not losing my marblesbecause hormonal acne has been
such a marketable term.
And a lot of our patients,they're frustrated because
(20:36):
they're they're thinking, youknow, I've got hormonal acne,
but it's not responding to anyhormonal treatments.
Um, and a lot of this is down tothe fact that the only
medications are hormonallyrelated apart from, you know,
Roaccutane.
And so it's been a very easy,like, black and white term to
(20:57):
use with connection to um acne,you know, it's hormonal.
Um so it's obviously a lot morecomplex than that.
And it is easy in to test forhormones, and I love that.
So one of the foundationalthings that I do is I run serum
pathology, I'm looking at anumber of things, not just the
(21:20):
hormones.
And when I talk about hormones,I'm not just talking about sex
hormones, I'm talking aboutinsulin, I'm talking about
cortisol.
It's very important that werecognize those.
Um, IGF 1.
IGF 1 is a really important toacknowledge as well.
Um so, um, like I said, if ifthe people who come to see me
have tried everything and I'mnot their first naturopath,
(21:43):
usually that hormonal stuff hasbeen picked up or a PCOS
diagnosis has been picked upbefore they see me.
So my clinical experience mightbe a little bit skewed because
of that.
Um, I do want to mention thatour skin is an endocrine organ
and it has its own hormonereceptors, and we can't test for
(22:04):
that.
So you could theoretically betesting someone's serum
pathology for androgens, andthey all come back within the
functional medicine referencerange.
However, in the pyloserbaceousunits, their um hormone receptor
may be extra sensitive, andthat's the genetics of it, and
it's actually picking up a lotmore DHT than we would actually
(22:29):
know from any testing.
So there's that.
Um, but in my practice, I treatthe gut before I treat hormones
because there is such arelationship between hormonal
imbalances and gut health.
Um, so you know, we're finallyunderstanding, as I referenced
before, that acne isn't ahormonal condition as a systemic
(22:53):
inflammatory condition, um,where the gut skin hormone axis
plays an essential role.
So, you know, we can understandthat when there's a dysbiotic
gut, there's a cascade ofsystemic inflammation and we're
having decreased intestinalpermeability and leaky gut,
we've got LPS and bacterialendotoxins crossing into the
(23:16):
circulation.
But what we need to understandis that this is not only
triggering inflammatory pathwaysand other cytokines, but it's
directly influencing sebaceousgland activity and keratinocyte
proliferation.
So it's intersecting withhormonal pathways.
(23:41):
Um, and we know we know that thegut bacteria participate in
hormone metabolism, so theyproduce enzymes like
beta-glucaronidase that candeconjugate estrogens.
It's bigger thanbeta-glucaronidase, but it is
important.
Um and the PCOS connection isrelevant here because many of
our female acne patients willhave underlying insulin
(24:03):
resistance, and even if theydon't meet the full PCOS
criteria, if they've got insulinresistance and they've got
dysbiosis contributing toinsulin resistance, that's going
to increase their IGF-1 andsimulate sebaceous lens and
increase free androgens.
Yeah.
Um, so we know butrate is goingto help maintain insulin
(24:26):
sensitivity.
SPEAKER_01 (24:27):
Um, sorry, I cut you off.
Sorry.
SPEAKER_00 (24:31):
No, please.
SPEAKER_01 (24:33):
Yeah.
So what I was going to ask isso, you know, by treating the
gut, you you're really handlingthe enterohepatic circulation
and letting the hormones havingdone their job to get out of the
body, but there is thatcomponent of overproduction of
certain hormones, androgens,blah, blah, blah, PCOS, the
(24:53):
acne-related stuff there.
So do you do you solely um focuson the gut and let the terrain
help to manage itself?
And that do you do you find thatum once you get that terrain
balanced, it can sort ofself-manage itself backwards, or
do you have to at some stageuse, you know, hormonally
(25:15):
balancing herbs and things likethat?
SPEAKER_00 (25:17):
Yeah, it's a really good question.
And the way that I treat is thatI don't look at hormonal panels
in isolation.
Um, I think that if we don'tunaddress the underlying gut
dysfunction, we're missing acrucial piece of the puzzle.
Um, and you know, the theresearch is showing that the gut
(25:40):
microbiota plays an increasinglyrecognized role in hormone
metabolism, particularly withandrogens and estrogens, which
for me makes it the priority fora treatment.
So I say to my patients, give mesix months with your gut, and
then we will retest yourhormones because I only work on
(26:01):
one thing at a time, and um, thegut has to come first, and then
we'll see, we'll see.
And and usually, you know, thethe changes in hormones are
quite remarkable by working onthe gut, gallbladder, bile,
liver.
SPEAKER_01 (26:19):
Wow.
Naturopathic axiom, which wetend to forget, you know,
because we we want to changesomething.
We see it as that's out ofbalance, that's bad, rather
than, you know, this is whatwe're taught in naturopathy.
That might be the issue, but youhave to go back and look at the
foundations of health.
SPEAKER_00 (26:37):
I love what you're doing.
Thank you.
SPEAKER_01 (26:40):
I I'm so impressed.
Like it's almost like a rebirthof like, duh, Andrew.
You know, we can we well, wecould we tend to sort of, you
know, focus on quote unquote theproblem that presents rather
than the problem that caused theproblem that presents.
SPEAKER_00 (26:55):
Absolutely.
There has been thiswesternization of naturopathy
where we're tend to be, youknow, looking at it like that.
And I think that the the morethat we can go back to our roots
and we can be looking at thoseum fundamental things, including
nervous system regulation, um,the better the outcomes for the
(27:16):
whole person.
SPEAKER_01 (27:18):
What about external versus internal treatments?
You know, people want to feelgood, they want to look good,
they have to work.
I mean, I I I don't know ifanybody can see at the moment,
but I've got a couple of zitsand I've had to use concealer.
They were pronounced.
Um so uh gut much anyway.
(27:39):
Um so internal versus externaltreatments.
Can you take us through a bit,please?
SPEAKER_00 (27:45):
Yeah, absolutely.
So I I suppose that the gut theskin microbiome is one of my
biggest passions.
Um we we can't neglect it and wecan't ignore it.
It is the second biggestmicrobiome of the body, and I
think in the next five years theum research will explode and the
(28:05):
way that we're looking at theskin is going to change
dramatically.
So um it's a hugely missedopportunity not to be supporting
it from the outside in.
Um and it doesn't need to becomplicated, and we don't need
to be using very expensiveclinical treatments.
In fact, I think that that's aterrible idea if someone's skin
(28:27):
barrier and microbiome arecompromised.
Um I myself am a corneotherapistand I have been for a very long
time.
What does that mean?
Um, corneotherapy is similar tocorniobiology.
Um, I try to explain it topeople that it's a
rehabilitative skin treatmenttool that shares naturopathy's
(28:49):
principle of do no harm.
So we want to protect thebarrier function, repair um the
skin microbiome, and rather thanstripping or disrupting the
skin, corneotherapy works withyour skin's natural defense
systems to restore balance andfunction.
Because one of the biggestthings that I see is that people
(29:11):
are using topicals that aregoing doing the opposite of what
I just discussed.
They're using products that havegot ingredients that are
breaking down the skin barrierand the microbiome.
And what happens when it'sexactly the same as the gut,
when we have a leaky gut.
So when you don't have an intactskin barrier that's protecting
(29:35):
you from the outside environmentand it's housing your pH, so
your acid mantle, and your skinmicrobiome.
So your skin microbiome can'texist without your barrier, then
underlying that is immune cells,and exactly the same as the gut.
So if we have a leaky skin, thenthe immune system is constantly
(29:55):
getting provoked, and that'swhen we're seeing redness,
inflammation.
Damage, all of those things thatpeople are desperately wanting
to correct.
And so if we can just beaddressing those defense layers
and taking away anything that'shurting those, we can have
(30:16):
dramatic improvement in the skinfrom the outside in.
SPEAKER_01 (30:23):
Very interesting that even the most medically
minded, even the most orthodoxmedicine mind will be uh
recommending emollients forinflamed skin.
And that is indeed creating anextra barrier so that it doesn't
have to um uh interact with theoutside world, if you like.
Now, not to say that that'snecessarily good, but it's
(30:46):
really interesting, you know,that the interesting of the the
inventor of the petroleum jellycame from I think it was oil
miners or something working withGreece.
Um I think that's a reallyinteresting point that you're
making there.
SPEAKER_00 (30:58):
Yeah about the investment.
So they'll be relying like theacne clients will still well
clear of things like that, bitof film forming, but the eczema
clients, they're desperate forum like that um fake skin
barrier, and so they'll be kindof addicted to those products.
Um, and you know, it's actuallyundermining everything whilst
(31:22):
they're using them,unfortunately.
But it's one of those thingswhere we can't rehabilitate
until they go cold turkey.
SPEAKER_01 (31:30):
Let's go a little bit into treatment options here.
So we're talking about gutstuff, so obviously prebiotics,
probiotics.
Do you tend to use a broadspectrum?
Do you tend to sort of pick andchoose your probiotics?
And can you take us through somemore of the therapeutics which
you use to bring down theinflammation?
You know, perhaps um, I don'tknow, omegas, um certain fibers,
(31:52):
yeah?
SPEAKER_00 (31:53):
Yeah, for sure.
Yeah, for sure.
Um so um I won't prescribe untilI've seen testing, generally,
uh, unless someone's takingantibiotics and we're wanting to
support that.
Um, but some of my go-tos thathave I wanted to discuss the
things that have the mostprofound impact on people's
skin.
(32:13):
Um, so I am a huge fan of umbovine immunoglobulins, um,
dairy-free.
Uh, they can be used as binders,but they also have many, many
applications to uh obviouslyincreasing secretary IGA and
also but in the skin.
(32:33):
So there's been a lot ofresearch around that in the
realms of colostrum andlactoferin, and uh we see that
there's uh reduction in acnegrade, there's reduction in
sebum content, reduction ininflammatory lesions, um,
inhibits proliferation withinthe sebaceous gland, inhibits
mTOR, hello, um, enhances skinbarrier, stimulates skin
(32:57):
regeneration, and it canincrease the synthesis of
collagen and hyaluronic acid.
So there's nothing it can'treally do for the skin.
And I have to admit that it'sprescribed for almost every
single patient of mine withgreat results.
Um, fish oil, we know fish oilis very, very well researched.
(33:18):
I don't, I'm um a little bitrogue here in that I don't
actually prescribe fish oiluntil I understand someone's
capacity to absorb fats becauseit could be putting more
pressure on the system.
So I would prefer to have a verywell-functioning gallbladder and
bioflow before I'm going in withhigh-dose fish oil.
(33:39):
So it's actually not a firstchoice for me, but it definitely
needs to be in the mix at somepoint because it has so many
implications for acne and skin.
There was actually some reallysignificant findings from a 2024
German study, which has providedsome of our strongest evidence
to date.
So really demonstrating thatmany acne patients have an
(34:01):
omega-3 deficit and that theacne severity improves
significantly when that wasreplenished.
Um, so we know that it's gotanti-inflammatory effects,
including downregulation ofpro-inflammatory cytokines and
insulin-like growth factor, um,which is very, very interesting
(34:23):
to me.
So we do need to correct theomega-6 to three ratio in the
diet first and foremost.
That has to be addressed.
Um, but then yeah, we we reallywant to include that at some
point for overall skin health.
Um that I've been playing a lotwith recently is I mentioned
binders and using immune um umbovine immunoglobulins as
(34:49):
binders.
Um, but I have also been havinga bit of a play around with
zeolite recently, and there isactually quite a lot of evidence
for zeolite, not justinternally, but topically.
I haven't actually played aroundwith it topically at this point.
Um, we have to be very wellaware of the quality of the
(35:11):
clinoptilite, I can't even saythis clinoptilite and where it
comes from and what mind andstuff like that.
Um, but you know, it will swapout zinc and replace for toxic
elements.
So for me, if someone's havinguh die off in their gut protocol
(35:35):
and I've already got them on thebovine immunoglobulins, then I
will bring in the zeolites, uh,a quite high dose for that as a
binder, because it's not goingto steal minerals like charcoal.
It's actually got a cage ofminerals and it's gonna swap
them in return for toxicelements, which is very generous
(35:56):
of it.
Um, not just heavy metals, alltoxic elements, and it has other
supportive factors for the liverand things like that.
So, yeah, yet to try ittopically, um, would be curious
about that.
Um, but yeah, I do use it moreand more to bind toxins in the
(36:17):
GI tract.
Um, curcumin, yep, is a realgo-to.
Um, and I am using uh turmericstem cells topically at the
moment as well.
So that is exciting.
So internally using curcumin toreduce inflammation, but also to
support those as a polyphenol tosupport the commensols.
(36:42):
So we know that it willdownregulate inflammatory
targets, um, inhibitinflammatory cytokines, but it
also inhibits biofilm andreduces inflammation associated
with reactive oxygen species.
So it's very, very indicated forskin.
Green tea is a phase as ananti-inflammatory antimicrobial,
(37:05):
um, inhibits the bacterialmembrane on bacteria in the
skin, um reducesfibalpharoductase, um, and has
got a lot of research to back itas well.
Um, berberine, I'll use it inthe context of my antimicrobial.
Uh, don't just use it kind ofwilly-nilly, um, but we know
(37:28):
that it's got a lot of evidenceto support it as well.
Like some studies are showing45% reduction in four weeks, and
it's an inhibitor of um the mTORpathway as well.
So if you have someone who needsthat as an antimicrobial and
they have acne, it's a doublebonus.
(37:48):
Um, I'm going to talk aboutprobiotics in more detail, but a
couple of others that I usequite a lot in herbs are Rishi.
So Rishi is really fantastic forpromoting antioxidants in the
skin.
It's antiantrogenic, it's anadaptogen, it will reduce
redness in the skin.
Um, polysaccharides in it arevery hydrating for the skin.
(38:09):
It inhibits pigmentation viatyrosinase inhibition and it'll
increase those white blood cellcounts, which are often low in
people with acne.
Um, and then echinacea is quitea fave as well.
So that inflammatory pathway,plus it's um well researched as
well.
Um, but yeah, I can I can do abit more of a dive into
(38:30):
probiotics if you like.
SPEAKER_01 (38:32):
If you've got time, like I know that you've got a
hard stop because you've gotclients to see, but but mate,
I'll talk for three hours withyou if you I think it would be a
shame not to cover the probioticaspect.
SPEAKER_00 (38:43):
So um let's do that.
Um, so look, the research couldbe better in terms of um acne
and probiotics.
It's still limited given thescope of what it can do.
Um, but what we do have is veryencouraging.
So um there was a study where umthey used it in conjunction with
(39:05):
women who were takingmaminocycline, which is very
harsh on the gut, and they splitthem into three groups: so
probiotics alone, antibioticsalone, and then the combination.
The combination group had amassive synergistic
anti-inflammatory effect whenused together.
Um, and so it's demonstratingthat we very much need to
(39:25):
support our acne patients whenthey're taking antibiotics for
their acne or otherwise to getbetter outcomes.
Um, but there is some compellingin vitro work showing
antimicrobial effects.
So, sort of the strains we'relooking at are L.
Casey, L.
Pantarum, L.
(39:46):
gaseri, L.
lactis, because they'reeffective against those
pathogenic strains of the acnebacteria.
Now just remember that many ofthe strains of the C acne
bacteria are actually reallyessential for the microbiome,
and we don't want to kill all Cacnes.
We all have C acnes on our face.
It's the pathogenic strains thatare causing problems.
(40:06):
Um, so yeah, while it's earlydate, and they actually combine
these with conjac as well forgreat results, which is really
interesting.
Um there's been research intothe use of probiotics topically,
um, and that's certainlysomething I use with every
single one of my patients.
I use um prebiotics, probiotics,and postbiotic serum topically
(40:30):
to re-inoculate the uh skinmicrobiome.
Um, but that's that's veryinteresting because that that
actually has been demonstratedin the literature to help with
that negative C acne'sproliferation and staph aureus
biofilm production plus betterhydration and fewer porphyrins,
which can be part of the acnecascade.
(40:52):
Um and there's some strains thatthey've isolated from snail
slime, um, orally and topically,which is going really well.
So let's just like um keep aneye out for that.
Um, but I think I think thetakeaway for me in that is that
the evidence suggests probioticswork through multiple
mechanisms, um, gut skin access,direct antimicrobial effects,
(41:15):
immune modulation.
But what they can do really wellis modulate insulin-like growth
factor, with which we've talkedquite a lot about today.
Um we know that the IGF-1 isplaying a big role in acne
pathogenesis, and this is whereour dietary recommendations, but
(41:36):
also probiotic protocols, canmake um a lot of impact.
Um, so we know that certainfoods um, like the refined carbs
and dairy are associated withincrease in IgF1.
But from a probioticperspective, um, when the
researchers looked atsupplementing lactobacillus to
(41:57):
the fermentation of dairy, um,that the IGF levels were
fourfold lower than thenon-fermented skim milk.
So this is telling us thatprobiotics are not just working
locally in the gut, they'reactually modulating the systemic
levels of IgF1, which istherefore reducing acne.
(42:18):
And so talking to people aboutfermented dairy.
So we're talking about um thedistinction between uh
functional dairy and refineddairy.
Some can tolerate, some cannot.
It's a very individual thing inclinical practice, but a nice
(42:40):
coconut kaffir is always goingto be really helpful for that
aspect and supplementing withprobiotics.
SPEAKER_01 (42:50):
Um we could seriously, there's so much more
to delve into here.
Um I seriously would have lovedto talk to you for hours.
I could learn so much.
Uh you really are awakeningsomething that it's so easy for
us to forget, and that is thesebasic 10 A's of naturopathic
treatment.
(43:10):
Can I ask as a last question?
Once you've got your clientsacne under control, we've got
ongoing therapy, we've you know,you you might um eventually need
to intervene, as you said.
You know, you you get the thefoundation set up first, you
need six months to do that, andthen you might need to tweak
other aspects.
(43:30):
Tell me that flow, how that howdoes that normally present in in
your patients?
SPEAKER_00 (43:35):
Yeah, absolutely.
So I say to my patients, we needsix to twelve months because
this has probably been a longtime in the making.
You know, you've you've got thatanalogy of the bucket, the
internal bucket, and that's aninflammatory bucket, and into it
can go stress and poor dietarychoices and hormonal imbalances
(43:57):
and gut microbiota imbalancesand heavy metals.
And it's not until that bucketis in overflowing that we see it
come out in the skin.
Because people often say, Whydid I get adult acne?
How did this happen?
And I'll explain the bucketanalogy and I'll explain that
this was a long time in themaking, and that we have to
really empty out that bucket.
Um, and always, always, alwayswhat I'm doing, I do believe
(44:21):
that as clinicians, our job isto educate, and my job is to
educate people around um theirroot causes of why they
developed acne or a skincondition in the first place,
and then the tools to managethat.
So once we've done the deeperwork, so once we've done a gut
(44:41):
protocol, or once we've donethat liver gallbladder work, or
once we've even done like heavymetal work, then you know, my
job, I see it as been mainlydone, and during that process, I
should have helped that personenough to understand how to
(45:02):
maintain their skin and theirhealth, you know, moving forward
to that.
So none of my clients go back tothe diet the way that it was
before they see me.
None of my clients go back tothe skincare that they were
using before they saw me.
They will change as a result ofthe work that we do together.
(45:26):
And I I do explain to them thatin the beginning we do our
foundations, and then I'm gonnatake you on a journey of doing
that deeper detox drainagepathway work, and then you'll go
back to the foundations in yourdaily life, and that's how you
maintain your skin as a moreaware, connected, educated
(45:50):
person to create positive changefor a lifetime.
And I'm also very passionateabout functional detox and detox
in daily life.
So, along that path, we wouldhave discussed castor oil packs,
coffee enemas, dry skinbrushing, bar infrared sauna,
you know, all nervous systemregulation.
Like I'm doing my breathworkteacher training in November,
(46:13):
and it's a big part of what Ibring into clinical practice.
So, or sleep, you know, all ofthose things.
So if someone's skin isresolved, then you know, I say
to them, if you want to see mequarterly, you can.
Um, sometimes we've found biggerthings like heavy metals that we
need to keep going with.
Um, but other than that, theycan see me quarterly or they can
(46:34):
just see me as needed umafterwards.
SPEAKER_01 (46:39):
Asha, I have learned so much from our near our
together.
I I seriously, I I've I've wow,you've awakened, reawakened
something in me, which I'veforgotten.
Um and I might just say the waythat you give truly thoughtful
care, like everything that youdo has a reason for doing it.
(47:03):
And the the the instance I'mgonna just quickly um relay is
uh I remember a young lady thatcame to see me once and I was
for deep talking about it.
And um just bang, broke out likereally bad acne everywhere.
And I just went well back up, Ican't wait to in this scenario.
(47:26):
Um I just said, no, no, I reallywant to treat my philosophy.
It really surpassed me.
Um I need to to refer you on soI refer her on to Rusty, love
your work, Penelope.
Um, some people will know her.
Um which was taken care of in amore thoughtful manner, I might
add.
But it was a big lesson for mein going in too hard.
(47:48):
And I love how you say I willnot do that until I've done
this.
And the reason is because you'resetting up the foundations so
that your terrain is normalized.
And it's such an importantaspect that we lose sight of.
Well done, Asha.
Really well done.
SPEAKER_00 (48:06):
Thank you.
Thank you.
That's really kind.
Thank you, Andrew.
SPEAKER_01 (48:09):
Um brilliant little speaker.
I want to see you're doing aseminar on this.
This is this is really this isthis is groundbreaking stuff
that we all need to know.
Just why you do things in acertain manner.
Brilliant work.
SPEAKER_00 (48:21):
I would I would be happy to, and I love sharing,
and thank you so much for havingme on the podcast.
SPEAKER_01 (48:27):
Absolute honour.
It really has been my honour.
You are a true guardian of thegut.
Well done.
SPEAKER_00 (48:34):
Thanks so, Andrew.
SPEAKER_01 (48:36):
And thank you all for joining us today.
Remember, you can catch up onall the show notes.
We will put as much as we caninto the show notes for this
podcast.
Um, and you can catch up on allthe other podcasts on the
Designs for Health website.
I'm Andrew Witchville Cook.
This is Wellness by Design.
This is Wellness by Designs, and I'm your host,
Andrew Whitfield Cook.
And joining us today is AshaEverett and we'll be discussing
skin and the gut brain access.
Welcome to Wellness by Designs,Asha.
How are you?
SPEAKER_00 (00:24):
I'm excellent, thank you, Andrew.
Lovely to meet you.
SPEAKER_01 (00:27):
Lovely to meet you too.
Now tell us a little bit abouthow you practiced and how did
you become like, or how did youchange your focus to be an
expert in this area of skin andgut brain access?
SPEAKER_00 (00:43):
Yeah, absolutely.
So, you know, I had a personalhistory with acne, and that's my
passion.
So I guess I'm known for mytreatment of complex female
adult acne.
And I think we always can dowhat we know, you know,
personally.
And so it was very much the casefor me.
When I was well into mynaturopathy studies, I realized
(01:05):
that there was more to treatingskin than from the inside out.
So I went on a journey where Iwas studying skin from the
outside in, and that's exactlyhow I practice today.
I work from the inside out andthe outside in with my female
adult acne clients.
And of course, uh the gut skinaccess is a big focus of the
(01:27):
work I do.
So lots of stool testing aswell.
SPEAKER_01 (01:31):
Cool.
Can you take us through thedifferent types of acne and how
you assess these in theirclient?
Because, like some people say,oh, you know, the high acne, the
low acne, the chin acne, it'snot quite as defined as that, is
it?
SPEAKER_00 (01:46):
It's not.
It would be a lot easier if itwas.
But you know, I've I've seeneverything, and there's no
definitive pattern,unfortunately.
There is there are some generalpatterns, and there definitely
is becoming more awareness ofinflammation as the biggest
driving factor.
So we're steering away fromhormones.
Um we're not saying thathormones don't play their part,
(02:09):
but what we're saying in adultacne cases, and adult acne being
women that are over 25, thatonly about 3% of them are going
to be solely hormonal acne.
So we definitely take that intoconsideration.
So when we're looking athormonal acne, um that's quite
straightforward because we canpick that up in testing.
We can see that kind of U shapein the face where it's appearing
(02:30):
along the jawline, the chin, thelower cheeks.
Um, and that's quite adefinitive area.
Typically, the women who see me,that would have already been
picked up because that's fairlystraightforward.
So then we've got the othertypes that we see, which is very
much the stress connection.
So chronic stress elevatingcortisol, which increases that
(02:51):
sebum production andinflammation.
That can appear more randomly,but you can hear your patients
say things like, I went onholiday and my skin cleared up.
Um, we've got post pill acne,again, a very clearly defined
one when women are discontinuinghormonal contraceptives, and a
lot of time there's a lot offear, and then the stress acne
(03:11):
contributes to that.
Um, and they all interplay.
You know, we can't say thatthere's just one in isolation
because, for example, withpost-pill acne, we're going to
have the stress componentbecause they're fearful of
coming off the pill and havingthat post-pill acne.
There's going to be a gut andliver involvement because of
what that medication has done tothose organs.
And so it's all interconnected,which is why it makes it quite
(03:34):
complex to treat.
But what I do love treating inclinical practice is the
gut-related acne.
So that connection to gutpathogens, parasites, H.
pylori, SIBO, foodsensitivities, leaky gut, all
this stuff that we're going todive into today.
Um, and a lot of our patients,so 90%, will do stool testing,
(03:56):
even if they've got no symptoms,because there's such a strong
connection between the gut andthe skin.
The other interesting ones thatwe can see are the connection
between mineral disturbanceslike copper excess and zinc
deficiency.
Um microbiome overgrowthmimicking is acne.
And what I mean by that isactual overgrowths in the skin
(04:17):
microbiome that mimic acne, butthey're not acne.
They need to be treated verydifferently from the outside in.
And then our mold, mycotoxins,heavy metals, and environmental
allergens, which over the courseof my career I've seen increase
more and more and more.
SPEAKER_01 (04:36):
So let's dive into the gut, forgive the pun, um,
and and explore those processesat play in the body.
You know, you mentioned certaininfections.
H.
pylori was really interesting tome.
Um, but can we dive into that abit and talk about how you
assess and what sort ofvariations, if you like, in
(04:56):
treatment you you or how youtweak treatment?
SPEAKER_00 (04:59):
Yeah, absolutely.
So I guess when we're looking atthe skin gut connection, we know
that it's undeniably there.
And if someone is having skinissues, then it's very likely
that this is stemming from thegut.
So when we're looking at signsthat aren't gut connected when
they're not presenting withovert gut symptoms of bloating,
(05:21):
constipation, diarrhea, youknow, those kind of things,
we're starting to look at um isthere malabsorption?
You know, do they have low iron,low B12, zinc?
And do they say that this hasalways been the case for them?
And no matter what, they can'tbring it up.
Um, do they have unrelentingfatigue that can't really be
explained?
(05:42):
Do they have acne that can't beconnected to the menstrual
cycle?
Um, is there a big stresscomponent?
Um, have the hormones beentested and they're within range?
Um, and those are the kind ofthings that I'm looking at.
But like I said, we we do testabout 90% of our patients.
So when we're looking at the gunskin connection and acne, what's
(06:04):
really fascinating to me is howinterconnected these systems
are.
So the intestinal microbiotaisn't just sitting there
passively, it's activelyinvolved in acne formation
through several key mechanisms.
Um, so I like to think about itthis way that both of our gut
and our skin are incrediblyvascularized and innovative
(06:27):
tissues, and they're bothperforming complex
neuroendocrine and immunefunctions, which means they're
constantly communicating witheach other.
It's like they're having thisongoing conversation through the
nervous system, our hormones,and our immune pathways.
So, where it gets reallyinteresting for practice is that
(06:50):
essentially we know that the gutmicrobiome is our first line of
defense, and so is our skin.
Um, but it's determining how ourbody responds to everything
we're consuming.
So when the microbiome isbalanced, we get proper immune
tolerance.
But when it's disrupted, westart seeing inflammatory
cascades related to immunitythat can manifest as acne.
(07:12):
Um, we know some of the thingsthat are disrupting this, right?
So the Western diet is a majorculprit, um, throwing off that
delicate balance betweenbeneficial and pathogenic
organisms.
But something I find that'srelevant is that stress has a
big impact.
So stress will have an impact onour friendly bacteria,
(07:33):
particularly the lacto and thebifido.
It'll have an impact on our uhsecretory IgA, so our immunity,
and it will have an impact onour gut permeability, so
creating leaky gut as well.
So we know that the gut andthese bacteria and intestinal
health markers are incrediblystress-sensitive.
(07:55):
And when we're chronicallystressed, these microorganisms
can actually switch from beingprotective and anti-inflammatory
to producing inflammatoryneurotransmitters.
Um and then the real protectivemechanism that I work strongly
with is that a healthymicrobiota produces short-chain
(08:17):
fatty acids, including thepropionatic acid, which is
actually protective againststaph aureas and the C.
acne's bacteria in the skin.
So, you know, the research inthis area is still emerging.
We're often working clinicallyahead of where the research
stands, but it is it is comingand there's more and more
(08:39):
exciting research at play.
But the short chain fatty acidsdirectly affect the skin in a
few mechanisms.
So it's really important tofocus in on those.
SPEAKER_01 (08:51):
And so talking about gut inflammatory markers, which
markers do you find of mostclinical benefit for you?
Like, for instance, a medicomight use something like Cal
Protectum when they're lookingfor inflammatory bowel disease.
Do we go that uh, you know, do Iwhether you gross or do we have
to use it more more nuancedinflammatory markers?
SPEAKER_00 (09:13):
Yeah, it's a really good question.
And I would definitely say thatwe need to be more nuanced.
And in seeing so many reportsfor acne, and I'm definitely
going to talk about SIBO and H.
pylori in a moment, um, but whenwe're looking at the first thing
I look at in a report is theintestinal health markers.
And so I'm very much looking atthose as the protective
(09:38):
mechanisms of the terrain or theenvironment.
And yes, the cow protectin oneis a big one, but we know
there's going to be a hugeamount of inflammation generated
if zonulin is present.
Um, and also um looking at thosegluten antibodies and looking at
the secretary IgA.
When I look at the secretaryIgA, I like to also have a look
(10:01):
at um Acamansia, fecali, androseberrea because that's going
to give me an indication of thehealth of the mucosal lining.
And we know if the mucosallining is thin and fragile, that
there's going to be inflammationthere as well.
So having a look at all of thosemarkers in the context of
inflammation is reallyimportant.
SPEAKER_01 (10:25):
It'll be an interesting day when achomantium
immunisophilia is going to beavailable for clinicians, isn't
it?
It's available already overseas,I understand.
SPEAKER_00 (10:37):
Yeah, I do use the overseas one.
Yeah.
SPEAKER_01 (10:39):
Great.
SPEAKER_00 (10:40):
Yeah, as well as polyphenols and all of those
other great things.
SPEAKER_01 (10:44):
Um, I love what you're saying there about
feeding the bacteria.
Because, you know, in in theolden days, go ahead, um, it was
all about the bacteria, thebacteria, the bacteria.
And then we realize, you know,as soon as you stop, the effects
go away.
There's a lot of geneticimprinting stuff.
You need that um you know,beneficial effect to keep going,
(11:07):
you have to take more or more.
You know, and then we realizehang on, these things eat off.
Um, so it's just it's really aninteresting clinical facet to
explore with the diet and howthe dietary um inclusions of
things like polyphenols, fibers,etc., can influence the
(11:29):
microbiota.
Can you tell us a little bitabout that and your just your
clinical experience there whenyou're treating acne?
SPEAKER_00 (11:37):
Yeah, absolutely love to.
Um, so when we're treating acne,one of the things that we need
to, you know, keep in mind isthat most of our patients will
have been on pretty hectic acnemedication and not just for a
little while, like for a longtime.
And so that's the first thingI'm thinking when I start to
look at a report.
I'm like, okay, I know thisperson has done three rounds of
(11:59):
Raccutane, I know they've hadmultiple antibiotics and they've
been on the pill.
This is going to have haddecimating effects on the
microbiome.
What's really interesting is theclients that are currently
taking Racutane and looking attheir reports because the
literature is a bit wishy-washy.
Um, but when you look at anactual report of someone who's
(12:22):
on Roaccutane, it's quiteundeniable the effects that it's
having on those short-chainfatty acids and the mucosal
lining and the cow protectin.
Um, it's undeniable.
It's undeniable.
And it's often a little bit umsensitive to chat to people
about that when they're takingthose medications as well.
(12:42):
Um, but generally speaking, um,I will do a three or four-phase
uh gut protocol.
So the first phase is very muchabout addressing those
intestinal health markervulnerabilities, knowing that
we're going to have to supportthose for you know the long
term, um, but also addressingthe commensal bacteria through
(13:03):
probiotics, prebiotics, fibers,dietary aspect.
Um, one of the common thingsthat I see, you know, is the
bacterial phyla um beingdisordered.
And you'll say to someone, look,you know, how much fiber are you
eating?
And they'll say, I'm followingwhat you asked me to do.
(13:23):
I'm eating half a plate of umfruit and vegetables, like a
rainbow on my plate at everymeal.
It's linking back to, you know,digestion is a top-down process.
And so we've got to rememberlike what's happening from the
top down as well, and how muchis the gallbladder and the bile
and the liver impacting on that,yeah, on that commensal-friendly
(13:45):
bacteria as well.
So often I'll work a lot on thebile because that's like the
bile, the hydrochloric acid, thepancreatic elastase, you know,
they are the guardians of thegut.
And if we don't really honor andacknowledge them, we're just
going to be throwing probioticsat someone for a long time.
SPEAKER_01 (14:08):
I love what you're saying, the guardians of the
gut.
It's brilliant.
Um, you said you'd like todiscuss a little bit more about
H.
pylori and SIBO and that it's umlinked to acne.
Can we delve into that a littlebit?
SPEAKER_00 (14:20):
Yeah, absolutely.
Um, so actually, um, not sure ifyou're aware of Dr.
Julie Greenberg.
She's an um she's a naturopathfrom the States, and I've
followed her work for a longtime, and her work has been a
real game changer for me.
She did a clinical-based studyusing stool testing on organic
(14:42):
testing from her acne patients,and the numbers were staggering.
This is what started my piquedmy interest in H.
pylori and the acne connection,because what she found in this
clinical study was that 92% ofher acne patients tested
positive for H.
pylori.
Um, and that was just sosignificant to me.
(15:04):
Um, so when you start to delveinto that deeper, the research
is there for that outside ofthat clinical-based study.
So we know that what's happeningwith the H.
pylori is it's a very clever,sneaky bacteria that produces
urates.
And that job of the urese is toneutralize stomach acid because
(15:25):
it wants to create a nice uhalkaline buffer around itself to
survive the environment.
Um, so when we've got thateffect of the H.
pylori suppressing stomach acid,well, we know there's a direct
connection to acne andhypochlorhydria.
That's that's known.
Um, but we know as well that weget suboptimal digestion, so
(15:46):
we're not breaking down ourproteins, but then we're not
breaking down things like zincand ion that are crucial for
skin health.
Um, the stomach acid is a signalto gallbladder and pancreas,
which I'm very passionate about.
I do a lot of gallbladder andbile work in my practice.
And when that signal iscompromised, we're seeing that
poor fat digestion and enzymeproduction.
We might see that steadocritrise, um, which directly absorbs
(16:08):
the impacts the absorption offat-soluble vitamins that are so
crucial for skin, like youramegas, your vitamins A, D, E,
and K, all essential for skinintegrity.
So if someone is saying I can'tget my vitamin D levels up as
well, am I looking at the livergallbladder?
Yes.
But am I looking at H.
pylori as well?
Yes.
(16:29):
Um and then the third, and thebig one, is that we're losing
that killing power.
So the stomach acid as our firstline of defense against
pathogens.
And when we're seeing anovergrowth of the opportunistic
bacteria, the yeast, theparasites, then that first
guardian of the gut is, youknow, on its extended leave and
can't protect us.
(16:50):
Um, but this is this is wherethe research gets really
interesting with H.
pylori directly connecting toacne.
It doesn't just mess with ourdigestion, it actually induces
nuclear inactivation ofsomething called FOXO1 in the
gastric cells.
So FOXO1 is this transcriptionfactor that's like a master
regulator.
(17:10):
And when it's functioningproperly in the nucleus, it will
keep things like IgF1 and themTOR pathway in check.
And remember that that mTORpathway is a protein kinase that
plays a significant role in acnedevelopment.
But when H.
pylori knocks that FOXO1 out ofthe nucleus, we get this cascade
(17:31):
of increased sebum production,cell proliferation, inflammation
in the pyloserbaceous unit, andbasically that's causing acne.
So, you know, I say to mypatients that their acne might
just be a problem with lack ofFOXO1 in the nucleus.
It's um maybe a bit more of astraightforward way of
explaining how a gut infectioncan show up as acne.
SPEAKER_01 (17:54):
Um you're giving me so much to think about, Ash.
So can I just interject?
Um like talking about long-termusage of vitamin A, uh vitamin A
analogues, forgive me, um, likecryoac ketone.
Um and we're talking about theimbalance, if you like, or the
(18:17):
the uh uh contesting ofabsorption of of fatty um
fat-soluble vitamins.
Do you find things like youwell, you mentioned why can't I
get my vitamin D up?
And then what I'm thinking isyou mentioned the mTOR pathway
and the effect that fat-solublevitamins have on that, um, like
(18:39):
the FOXO1.
This is just this is blowing mymind.
I really need to go and readsome more books.
Can can I just get thepractitioner again?
What was it, Julie Greenwood?
SPEAKER_00 (18:49):
Dr.
Julie Greenberg.
SPEAKER_01 (18:52):
Greenberg, thank you.
SPEAKER_00 (18:53):
Yes, yes.
So we've known about mTOR for along time, but she was the first
person that talked about the Fox01 connection.
And then that just sent me onjust an absolute like, you know,
like spiral of research, andvery grateful for that because
we can't deny that the mTORpathway is one of the most
(19:14):
profound root causes of acne.
So it's it's driving all, youknow, um acne pathophysiology.
And um, we know that it's gotconnections to more sinister
health presentations as well.
Um, so we could look at acne asan early warning sign for those
(19:37):
more sinister healthpresentations, which is why I
love treating acne.
SPEAKER_01 (19:42):
Yes, that's where my mind was going too, Ashley.
Um I I this is just sointeresting to me.
I'm sorry, this is fantastic.
Can can I ask, you mentionedthat only 3% of women, was it,
that you see, um have hormonallyrelated acne.
Can we delve into that a littlebit?
(20:04):
How you tease apart those thathave a hormone component versus
like a major driver of thedisorder?
SPEAKER_00 (20:14):
Yeah.
Well, the 3% statistic came fromthe literature.
So that came from the literaturewith late onset acne, otherwise
known as adult acne.
And I was like, thank goodness,I'm not imagining this.
I'm not losing my marblesbecause hormonal acne has been
such a marketable term.
And a lot of our patients,they're frustrated because
(20:36):
they're they're thinking, youknow, I've got hormonal acne,
but it's not responding to anyhormonal treatments.
Um, and a lot of this is down tothe fact that the only
medications are hormonallyrelated apart from, you know,
Roaccutane.
And so it's been a very easy,like, black and white term to
(20:57):
use with connection to um acne,you know, it's hormonal.
Um so it's obviously a lot morecomplex than that.
And it is easy in to test forhormones, and I love that.
So one of the foundationalthings that I do is I run serum
pathology, I'm looking at anumber of things, not just the
(21:20):
hormones.
And when I talk about hormones,I'm not just talking about sex
hormones, I'm talking aboutinsulin, I'm talking about
cortisol.
It's very important that werecognize those.
Um, IGF 1.
IGF 1 is a really important toacknowledge as well.
Um so, um, like I said, if ifthe people who come to see me
have tried everything and I'mnot their first naturopath,
(21:43):
usually that hormonal stuff hasbeen picked up or a PCOS
diagnosis has been picked upbefore they see me.
So my clinical experience mightbe a little bit skewed because
of that.
Um, I do want to mention thatour skin is an endocrine organ
and it has its own hormonereceptors, and we can't test for
(22:04):
that.
So you could theoretically betesting someone's serum
pathology for androgens, andthey all come back within the
functional medicine referencerange.
However, in the pyloserbaceousunits, their um hormone receptor
may be extra sensitive, andthat's the genetics of it, and
it's actually picking up a lotmore DHT than we would actually
(22:29):
know from any testing.
So there's that.
Um, but in my practice, I treatthe gut before I treat hormones
because there is such arelationship between hormonal
imbalances and gut health.
Um, so you know, we're finallyunderstanding, as I referenced
before, that acne isn't ahormonal condition as a systemic
(22:53):
inflammatory condition, um,where the gut skin hormone axis
plays an essential role.
So, you know, we can understandthat when there's a dysbiotic
gut, there's a cascade ofsystemic inflammation and we're
having decreased intestinalpermeability and leaky gut,
we've got LPS and bacterialendotoxins crossing into the
(23:16):
circulation.
But what we need to understandis that this is not only
triggering inflammatory pathwaysand other cytokines, but it's
directly influencing sebaceousgland activity and keratinocyte
proliferation.
So it's intersecting withhormonal pathways.
(23:41):
Um, and we know we know that thegut bacteria participate in
hormone metabolism, so theyproduce enzymes like
beta-glucaronidase that candeconjugate estrogens.
It's bigger thanbeta-glucaronidase, but it is
important.
Um and the PCOS connection isrelevant here because many of
our female acne patients willhave underlying insulin
(24:03):
resistance, and even if theydon't meet the full PCOS
criteria, if they've got insulinresistance and they've got
dysbiosis contributing toinsulin resistance, that's going
to increase their IGF-1 andsimulate sebaceous lens and
increase free androgens.
Yeah.
Um, so we know butrate is goingto help maintain insulin
(24:26):
sensitivity.
SPEAKER_01 (24:27):
Um, sorry, I cut you off.
Sorry.
SPEAKER_00 (24:31):
No, please.
SPEAKER_01 (24:33):
Yeah.
So what I was going to ask isso, you know, by treating the
gut, you you're really handlingthe enterohepatic circulation
and letting the hormones havingdone their job to get out of the
body, but there is thatcomponent of overproduction of
certain hormones, androgens,blah, blah, blah, PCOS, the
(24:53):
acne-related stuff there.
So do you do you solely um focuson the gut and let the terrain
help to manage itself?
And that do you do you find thatum once you get that terrain
balanced, it can sort ofself-manage itself backwards, or
do you have to at some stageuse, you know, hormonally
(25:15):
balancing herbs and things likethat?
SPEAKER_00 (25:17):
Yeah, it's a really good question.
And the way that I treat is thatI don't look at hormonal panels
in isolation.
Um, I think that if we don'tunaddress the underlying gut
dysfunction, we're missing acrucial piece of the puzzle.
Um, and you know, the theresearch is showing that the gut
(25:40):
microbiota plays an increasinglyrecognized role in hormone
metabolism, particularly withandrogens and estrogens, which
for me makes it the priority fora treatment.
So I say to my patients, give mesix months with your gut, and
then we will retest yourhormones because I only work on
(26:01):
one thing at a time, and um, thegut has to come first, and then
we'll see, we'll see.
And and usually, you know, thethe changes in hormones are
quite remarkable by working onthe gut, gallbladder, bile,
liver.
SPEAKER_01 (26:19):
Wow.
Naturopathic axiom, which wetend to forget, you know,
because we we want to changesomething.
We see it as that's out ofbalance, that's bad, rather
than, you know, this is whatwe're taught in naturopathy.
That might be the issue, but youhave to go back and look at the
foundations of health.
SPEAKER_00 (26:37):
I love what you're doing.
Thank you.
SPEAKER_01 (26:40):
I I'm so impressed.
Like it's almost like a rebirthof like, duh, Andrew.
You know, we can we well, wecould we tend to sort of, you
know, focus on quote unquote theproblem that presents rather
than the problem that caused theproblem that presents.
SPEAKER_00 (26:55):
Absolutely.
There has been thiswesternization of naturopathy
where we're tend to be, youknow, looking at it like that.
And I think that the the morethat we can go back to our roots
and we can be looking at thoseum fundamental things, including
nervous system regulation, um,the better the outcomes for the
(27:16):
whole person.
SPEAKER_01 (27:18):
What about external versus internal treatments?
You know, people want to feelgood, they want to look good,
they have to work.
I mean, I I I don't know ifanybody can see at the moment,
but I've got a couple of zitsand I've had to use concealer.
They were pronounced.
Um so uh gut much anyway.
(27:39):
Um so internal versus externaltreatments.
Can you take us through a bit,please?
SPEAKER_00 (27:45):
Yeah, absolutely.
So I I suppose that the gut theskin microbiome is one of my
biggest passions.
Um we we can't neglect it and wecan't ignore it.
It is the second biggestmicrobiome of the body, and I
think in the next five years theum research will explode and the
(28:05):
way that we're looking at theskin is going to change
dramatically.
So um it's a hugely missedopportunity not to be supporting
it from the outside in.
Um and it doesn't need to becomplicated, and we don't need
to be using very expensiveclinical treatments.
In fact, I think that that's aterrible idea if someone's skin
(28:27):
barrier and microbiome arecompromised.
Um I myself am a corneotherapistand I have been for a very long
time.
What does that mean?
Um, corneotherapy is similar tocorniobiology.
Um, I try to explain it topeople that it's a
rehabilitative skin treatmenttool that shares naturopathy's
(28:49):
principle of do no harm.
So we want to protect thebarrier function, repair um the
skin microbiome, and rather thanstripping or disrupting the
skin, corneotherapy works withyour skin's natural defense
systems to restore balance andfunction.
Because one of the biggestthings that I see is that people
(29:11):
are using topicals that aregoing doing the opposite of what
I just discussed.
They're using products that havegot ingredients that are
breaking down the skin barrierand the microbiome.
And what happens when it'sexactly the same as the gut,
when we have a leaky gut.
So when you don't have an intactskin barrier that's protecting
(29:35):
you from the outside environmentand it's housing your pH, so
your acid mantle, and your skinmicrobiome.
So your skin microbiome can'texist without your barrier, then
underlying that is immune cells,and exactly the same as the gut.
So if we have a leaky skin, thenthe immune system is constantly
(29:55):
getting provoked, and that'swhen we're seeing redness,
inflammation.
Damage, all of those things thatpeople are desperately wanting
to correct.
And so if we can just beaddressing those defense layers
and taking away anything that'shurting those, we can have
(30:16):
dramatic improvement in the skinfrom the outside in.
SPEAKER_01 (30:23):
Very interesting that even the most medically
minded, even the most orthodoxmedicine mind will be uh
recommending emollients forinflamed skin.
And that is indeed creating anextra barrier so that it doesn't
have to um uh interact with theoutside world, if you like.
Now, not to say that that'snecessarily good, but it's
(30:46):
really interesting, you know,that the interesting of the the
inventor of the petroleum jellycame from I think it was oil
miners or something working withGreece.
Um I think that's a reallyinteresting point that you're
making there.
SPEAKER_00 (30:58):
Yeah about the investment.
So they'll be relying like theacne clients will still well
clear of things like that, bitof film forming, but the eczema
clients, they're desperate forum like that um fake skin
barrier, and so they'll be kindof addicted to those products.
Um, and you know, it's actuallyundermining everything whilst
(31:22):
they're using them,unfortunately.
But it's one of those thingswhere we can't rehabilitate
until they go cold turkey.
SPEAKER_01 (31:30):
Let's go a little bit into treatment options here.
So we're talking about gutstuff, so obviously prebiotics,
probiotics.
Do you tend to use a broadspectrum?
Do you tend to sort of pick andchoose your probiotics?
And can you take us through somemore of the therapeutics which
you use to bring down theinflammation?
You know, perhaps um, I don'tknow, omegas, um certain fibers,
(31:52):
yeah?
SPEAKER_00 (31:53):
Yeah, for sure.
Yeah, for sure.
Um so um I won't prescribe untilI've seen testing, generally,
uh, unless someone's takingantibiotics and we're wanting to
support that.
Um, but some of my go-tos thathave I wanted to discuss the
things that have the mostprofound impact on people's
skin.
(32:13):
Um, so I am a huge fan of umbovine immunoglobulins, um,
dairy-free.
Uh, they can be used as binders,but they also have many, many
applications to uh obviouslyincreasing secretary IGA and
also but in the skin.
(32:33):
So there's been a lot ofresearch around that in the
realms of colostrum andlactoferin, and uh we see that
there's uh reduction in acnegrade, there's reduction in
sebum content, reduction ininflammatory lesions, um,
inhibits proliferation withinthe sebaceous gland, inhibits
mTOR, hello, um, enhances skinbarrier, stimulates skin
(32:57):
regeneration, and it canincrease the synthesis of
collagen and hyaluronic acid.
So there's nothing it can'treally do for the skin.
And I have to admit that it'sprescribed for almost every
single patient of mine withgreat results.
Um, fish oil, we know fish oilis very, very well researched.
(33:18):
I don't, I'm um a little bitrogue here in that I don't
actually prescribe fish oiluntil I understand someone's
capacity to absorb fats becauseit could be putting more
pressure on the system.
So I would prefer to have a verywell-functioning gallbladder and
bioflow before I'm going in withhigh-dose fish oil.
(33:39):
So it's actually not a firstchoice for me, but it definitely
needs to be in the mix at somepoint because it has so many
implications for acne and skin.
There was actually some reallysignificant findings from a 2024
German study, which has providedsome of our strongest evidence
to date.
So really demonstrating thatmany acne patients have an
(34:01):
omega-3 deficit and that theacne severity improves
significantly when that wasreplenished.
Um, so we know that it's gotanti-inflammatory effects,
including downregulation ofpro-inflammatory cytokines and
insulin-like growth factor, um,which is very, very interesting
(34:23):
to me.
So we do need to correct theomega-6 to three ratio in the
diet first and foremost.
That has to be addressed.
Um, but then yeah, we we reallywant to include that at some
point for overall skin health.
Um that I've been playing a lotwith recently is I mentioned
binders and using immune um umbovine immunoglobulins as
(34:49):
binders.
Um, but I have also been havinga bit of a play around with
zeolite recently, and there isactually quite a lot of evidence
for zeolite, not justinternally, but topically.
I haven't actually played aroundwith it topically at this point.
Um, we have to be very wellaware of the quality of the
(35:11):
clinoptilite, I can't even saythis clinoptilite and where it
comes from and what mind andstuff like that.
Um, but you know, it will swapout zinc and replace for toxic
elements.
So for me, if someone's havinguh die off in their gut protocol
(35:35):
and I've already got them on thebovine immunoglobulins, then I
will bring in the zeolites, uh,a quite high dose for that as a
binder, because it's not goingto steal minerals like charcoal.
It's actually got a cage ofminerals and it's gonna swap
them in return for toxicelements, which is very generous
(35:56):
of it.
Um, not just heavy metals, alltoxic elements, and it has other
supportive factors for the liverand things like that.
So, yeah, yet to try ittopically, um, would be curious
about that.
Um, but yeah, I do use it moreand more to bind toxins in the
(36:17):
GI tract.
Um, curcumin, yep, is a realgo-to.
Um, and I am using uh turmericstem cells topically at the
moment as well.
So that is exciting.
So internally using curcumin toreduce inflammation, but also to
support those as a polyphenol tosupport the commensols.
(36:42):
So we know that it willdownregulate inflammatory
targets, um, inhibitinflammatory cytokines, but it
also inhibits biofilm andreduces inflammation associated
with reactive oxygen species.
So it's very, very indicated forskin.
Green tea is a phase as ananti-inflammatory antimicrobial,
(37:05):
um, inhibits the bacterialmembrane on bacteria in the
skin, um reducesfibalpharoductase, um, and has
got a lot of research to back itas well.
Um, berberine, I'll use it inthe context of my antimicrobial.
Uh, don't just use it kind ofwilly-nilly, um, but we know
(37:28):
that it's got a lot of evidenceto support it as well.
Like some studies are showing45% reduction in four weeks, and
it's an inhibitor of um the mTORpathway as well.
So if you have someone who needsthat as an antimicrobial and
they have acne, it's a doublebonus.
(37:48):
Um, I'm going to talk aboutprobiotics in more detail, but a
couple of others that I usequite a lot in herbs are Rishi.
So Rishi is really fantastic forpromoting antioxidants in the
skin.
It's antiantrogenic, it's anadaptogen, it will reduce
redness in the skin.
Um, polysaccharides in it arevery hydrating for the skin.
(38:09):
It inhibits pigmentation viatyrosinase inhibition and it'll
increase those white blood cellcounts, which are often low in
people with acne.
Um, and then echinacea is quitea fave as well.
So that inflammatory pathway,plus it's um well researched as
well.
Um, but yeah, I can I can do abit more of a dive into
(38:30):
probiotics if you like.
SPEAKER_01 (38:32):
If you've got time, like I know that you've got a
hard stop because you've gotclients to see, but but mate,
I'll talk for three hours withyou if you I think it would be a
shame not to cover the probioticaspect.
SPEAKER_00 (38:43):
So um let's do that.
Um, so look, the research couldbe better in terms of um acne
and probiotics.
It's still limited given thescope of what it can do.
Um, but what we do have is veryencouraging.
So um there was a study where umthey used it in conjunction with
(39:05):
women who were takingmaminocycline, which is very
harsh on the gut, and they splitthem into three groups: so
probiotics alone, antibioticsalone, and then the combination.
The combination group had amassive synergistic
anti-inflammatory effect whenused together.
Um, and so it's demonstratingthat we very much need to
(39:25):
support our acne patients whenthey're taking antibiotics for
their acne or otherwise to getbetter outcomes.
Um, but there is some compellingin vitro work showing
antimicrobial effects.
So, sort of the strains we'relooking at are L.
Casey, L.
Pantarum, L.
(39:46):
gaseri, L.
lactis, because they'reeffective against those
pathogenic strains of the acnebacteria.
Now just remember that many ofthe strains of the C acne
bacteria are actually reallyessential for the microbiome,
and we don't want to kill all Cacnes.
We all have C acnes on our face.
It's the pathogenic strains thatare causing problems.
(40:06):
Um, so yeah, while it's earlydate, and they actually combine
these with conjac as well forgreat results, which is really
interesting.
Um there's been research intothe use of probiotics topically,
um, and that's certainlysomething I use with every
single one of my patients.
I use um prebiotics, probiotics,and postbiotic serum topically
(40:30):
to re-inoculate the uh skinmicrobiome.
Um, but that's that's veryinteresting because that that
actually has been demonstratedin the literature to help with
that negative C acne'sproliferation and staph aureus
biofilm production plus betterhydration and fewer porphyrins,
which can be part of the acnecascade.
(40:52):
Um and there's some strains thatthey've isolated from snail
slime, um, orally and topically,which is going really well.
So let's just like um keep aneye out for that.
Um, but I think I think thetakeaway for me in that is that
the evidence suggests probioticswork through multiple
mechanisms, um, gut skin access,direct antimicrobial effects,
(41:15):
immune modulation.
But what they can do really wellis modulate insulin-like growth
factor, with which we've talkedquite a lot about today.
Um we know that the IGF-1 isplaying a big role in acne
pathogenesis, and this is whereour dietary recommendations, but
(41:36):
also probiotic protocols, canmake um a lot of impact.
Um, so we know that certainfoods um, like the refined carbs
and dairy are associated withincrease in IgF1.
But from a probioticperspective, um, when the
researchers looked atsupplementing lactobacillus to
(41:57):
the fermentation of dairy, um,that the IGF levels were
fourfold lower than thenon-fermented skim milk.
So this is telling us thatprobiotics are not just working
locally in the gut, they'reactually modulating the systemic
levels of IgF1, which istherefore reducing acne.
(42:18):
And so talking to people aboutfermented dairy.
So we're talking about um thedistinction between uh
functional dairy and refineddairy.
Some can tolerate, some cannot.
It's a very individual thing inclinical practice, but a nice
(42:40):
coconut kaffir is always goingto be really helpful for that
aspect and supplementing withprobiotics.
SPEAKER_01 (42:50):
Um we could seriously, there's so much more
to delve into here.
Um I seriously would have lovedto talk to you for hours.
I could learn so much.
Uh you really are awakeningsomething that it's so easy for
us to forget, and that is thesebasic 10 A's of naturopathic
treatment.
(43:10):
Can I ask as a last question?
Once you've got your clientsacne under control, we've got
ongoing therapy, we've you know,you you might um eventually need
to intervene, as you said.
You know, you you get the thefoundation set up first, you
need six months to do that, andthen you might need to tweak
other aspects.
(43:30):
Tell me that flow, how that howdoes that normally present in in
your patients?
SPEAKER_00 (43:35):
Yeah, absolutely.
So I say to my patients, we needsix to twelve months because
this has probably been a longtime in the making.
You know, you've you've got thatanalogy of the bucket, the
internal bucket, and that's aninflammatory bucket, and into it
can go stress and poor dietarychoices and hormonal imbalances
(43:57):
and gut microbiota imbalancesand heavy metals.
And it's not until that bucketis in overflowing that we see it
come out in the skin.
Because people often say, Whydid I get adult acne?
How did this happen?
And I'll explain the bucketanalogy and I'll explain that
this was a long time in themaking, and that we have to
really empty out that bucket.
Um, and always, always, alwayswhat I'm doing, I do believe
(44:21):
that as clinicians, our job isto educate, and my job is to
educate people around um theirroot causes of why they
developed acne or a skincondition in the first place,
and then the tools to managethat.
So once we've done the deeperwork, so once we've done a gut
(44:41):
protocol, or once we've donethat liver gallbladder work, or
once we've even done like heavymetal work, then you know, my
job, I see it as been mainlydone, and during that process, I
should have helped that personenough to understand how to
(45:02):
maintain their skin and theirhealth, you know, moving forward
to that.
So none of my clients go back tothe diet the way that it was
before they see me.
None of my clients go back tothe skincare that they were
using before they saw me.
They will change as a result ofthe work that we do together.
(45:26):
And I I do explain to them thatin the beginning we do our
foundations, and then I'm gonnatake you on a journey of doing
that deeper detox drainagepathway work, and then you'll go
back to the foundations in yourdaily life, and that's how you
maintain your skin as a moreaware, connected, educated
(45:50):
person to create positive changefor a lifetime.
And I'm also very passionateabout functional detox and detox
in daily life.
So, along that path, we wouldhave discussed castor oil packs,
coffee enemas, dry skinbrushing, bar infrared sauna,
you know, all nervous systemregulation.
Like I'm doing my breathworkteacher training in November,
(46:13):
and it's a big part of what Ibring into clinical practice.
So, or sleep, you know, all ofthose things.
So if someone's skin isresolved, then you know, I say
to them, if you want to see mequarterly, you can.
Um, sometimes we've found biggerthings like heavy metals that we
need to keep going with.
Um, but other than that, theycan see me quarterly or they can
(46:34):
just see me as needed umafterwards.
SPEAKER_01 (46:39):
Asha, I have learned so much from our near our
together.
I I seriously, I I've I've wow,you've awakened, reawakened
something in me, which I'veforgotten.
Um and I might just say the waythat you give truly thoughtful
care, like everything that youdo has a reason for doing it.
(47:03):
And the the the instance I'mgonna just quickly um relay is
uh I remember a young lady thatcame to see me once and I was
for deep talking about it.
And um just bang, broke out likereally bad acne everywhere.
And I just went well back up, Ican't wait to in this scenario.
(47:26):
Um I just said, no, no, I reallywant to treat my philosophy.
It really surpassed me.
Um I need to to refer you on soI refer her on to Rusty, love
your work, Penelope.
Um, some people will know her.
Um which was taken care of in amore thoughtful manner, I might
add.
But it was a big lesson for mein going in too hard.
(47:48):
And I love how you say I willnot do that until I've done
this.
And the reason is because you'resetting up the foundations so
that your terrain is normalized.
And it's such an importantaspect that we lose sight of.
Well done, Asha.
Really well done.
SPEAKER_00 (48:06):
Thank you.
Thank you.
That's really kind.
Thank you, Andrew.
SPEAKER_01 (48:09):
Um brilliant little speaker.
I want to see you're doing aseminar on this.
This is this is really this isthis is groundbreaking stuff
that we all need to know.
Just why you do things in acertain manner.
Brilliant work.
SPEAKER_00 (48:21):
I would I would be happy to, and I love sharing,
and thank you so much for havingme on the podcast.
SPEAKER_01 (48:27):
Absolute honour.
It really has been my honour.
You are a true guardian of thegut.
Well done.
SPEAKER_00 (48:34):
Thanks so, Andrew.
SPEAKER_01 (48:36):
And thank you all for joining us today.
Remember, you can catch up onall the show notes.
We will put as much as we caninto the show notes for this
podcast.
Um, and you can catch up on allthe other podcasts on the
Designs for Health website.
I'm Andrew Witchville Cook.
This is Wellness by Design.
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