TRANSCRIPT & APPLICATION GUIDE OF 7...

TRANSCRIPT & APPLICATION GUIDEOF 7-EPISODES AND Q&A 1-2

EPISODE 3THE MICROBIOME:

WHERE HEALTH AND DISEASE BEGIN AND END

Betrayal•Episode3-TheMicrobiome:WhereHealthandDiseaseBeginandEnd

Dr.TomO’Bryan:[00:03:03]Patient:

Inthelastepisode,episodetwoofourseries,welearnedhowautoimmunityisintricatelytiedtowhathappensinthegut.Wedeeplyexploredhow,ifwecanhealthegut,wecanreverseandarrestautoimmunedisease.Fromsymptomslikechronicfatigue,brainfogandjointpaintoillnesseslikefullblownautoimmunediseasesMSandRheumatoidArthritis,wenowknowthatitALLbeginsinthegut.Episodetwoisyourstartingpointtounderstandingthatprocess.WealsolookedatthemiraculousroleofvitaminDinhealingandhowvitaminDdeficienciesaremonumentalandcausetheultimatebreakdownofvitalbodilyfunctions.Ihopeyoutookcopiousnotesforthelastepisodebecausethatinformation–thesecretsofvitaminDanditsvitalroleinhealth–andthegroundbreakingfoundationalinformationonthegut–aretwokeybuildingblocksinwhathappensfortherestofyourlife–andforthoseyouloveandcareabout.Inthisepisode,wedeepdiveintothemicrobiome.Themedicalcommunityhaslongviewedmicrobesassomethingtodestroy.Whyisthat?Ourunderstandingaroundmicrobeswasborninillnessandsearchingforcuresforthingslikeinfluenza,measles,smallpox…buttheideathatbacteriaarebadandholdonlyoneroleinourecosystemisnotonlyamisunderstanding,itisactuallydangeroustousasindividuals–andasaspecies.ItwasLouisPasteurthefatherofthegermtheorywho,onhisdeathbedsaid,“Themicrobeisnothing,theterrainiseverything.He’stalkingaboutthemicrobiome.Wearemoreandmoreaware,asscientificandmedicalcommunityleaders,thatmicrobesKEEPushealthyandcontrolourabilitytowardoffdiseaseanddosimpletaskslikerundigestionandimmunity.Nurturinghealthybacteriaisofparamountimportanceinthisnewmillennia.Infact,newgenerationsofmedicationsarebeingdevelopedthatkillharmfulbacteriaandleavethefriendly,GOODbacteriaalone.Andinotherarenas,bacteriaarebeingexploredandusedascarryingagentstocureillnesseslikecancer.Ihavebeenaskedmanytimesovertheyears…”IfthereisonethingI’mgoingtodoDoc,justonething,whatisit?”Andtheansweristhesame.Fixthemicrobiome.Themostimportantthingyoucando.Theinformationyouwillhearonthisepisodeis,inmanycases,brandnewandutterlylifechanging.THISiswhereyoulearnwhatcanbuild–orcompletelydestroygoodbacteriaandhowtocreateahealingprocessthatbeginsinthemicrobiomeandspreadstoyourentirebody–andimpactsonyourentirelife.Becausehealthiswealthanditstartsatyourverycore,themicrobiome.IwouldprobablysayallmylifeIthoughtIwasareallyhealthyperson.Exercised,atewell,didalltherightthings.ThenwhenIhitmy40's,mybodyliterallystartedfallingapart.Ihadshingles,Ilostatooth,andthenIwentintothisseriousfatiguewhereIjustneededanapeverydayat3:00,andIknewsomethingwaswrong

Idecidednottoseeatypicaldoctor,aregularMD,becauseIwasworriedthatIwouldbeprescribedsomekindofpillorsomething,soIwaslookingfortheright


doctor,afunctionalmedicinedoctor.

Ifoundonethroughagirlfriend.WhenIsawhim,hetoldmethatIwasglutenintolerant,andthatexplainedeverythingthatwasgoingonwithme,allthechangesinmybody.Itwasjusttremendouspain,andIhadarash.Itaffectedthenerves.Iwasputonamedication,antibiotics,andthattookcareofit.ButwhatIwasfindingwasthatIwasstillweak.Iwasstilltired.At3:00or12:00,sometimeintheafternoon,Ijustwantedtogobacktobed.

Iwasn'tabletofunction.Iwasn'tabletostayandtakecareofmyfamilyanddothethingsIneededtodoforthem.

JonathanOtto: How'dthataffectyou?

Itwashorrible.Itwashorrible,becauseasamotherwhenyouhave3youngchildren,youwanttotakecareofthem.Ididn'tknowwhatwaswrong.Thentherewasamysteryofwhatiswrongwithme?

[00:04:31]LizLipski,PhD:

Eachofushasamicrobiomeofourskin,ourlungs,oureyes,ournostrils,andgenitourinarytract,andreallyeveryorganhasamicrobiomeofitsown.Infact,they'resodifferentthatIcouldhave70%differentmicrobesonthishandthanthishand.

Dr.TomO’Bryan: Really!Wow.LizLipski,PhD:

Yeah.That'sprettyfascinating,isn'tit?Ithinkthat'sthatleft-handed/right-handedthing.Wehavesomewherebetween2and6poundsofmicrobesinourgut,andtheyreallymodulateourimmunesystem.Theyareus.Weliketothinkofthemasseparate.There'sfungi,there'sbacteria,andthere'sviruses.Theviruseshavephages,whichareactuallyvirusesthateatbacteriaandkeepthemundercontrol.

Dr.TomO’Bryan:

Sovirusesaren'tallbadforus.

LizLipski,PhD:

They'renotallbad,justlikebacteriaaren'tallbad.Infact,thesemicrobesactuallyterraformtheplanet.They'rethereasonwebreatheoxygenandwhyplantsbreathecarbondioxide.Theyareineverycellinourbody,manyofthelittleorganellesinournucleiineverycellactuallyarebacterialsymbiotes,themostimportantonebeingthemitochondria,whichareenergyfactoriesineverysinglecellthathelpusturnfoodintoenergysowehaveheatinourbody.

Wehearthatthey'renotus,butthetruthisthatwe'rethisonebigsymbiote.Theyhaveanintelligenceaboutthem,andtheyliveinbigcommunities.Whenthesecommunitiesgetoutofbalance,wegetillness,likeautoimmuneconditions.Wegetdiabetes,obesity,mentalhealthissues,cancers.Itgoesonandon.


[00:06:50]JeffreyBland,PhD:

Youhaveliterallythousandsofdifferentorganismsthatwilllivewithinourintestinaltrackthathavetheirowngenetics,theyhavetheirowngenes,they'renotthesameasourgenes,andthey'realldifferentonefromtheotherbaseduponthespeciesoftheirlineage.Youstartsaying,"Well,aren'tmostofthosefriendly?"Well,itistruethatifyoulookat1gramofstool,that'snotatopicmostpeoplewanttotalkabout,butwe'llquicklytalkaboutit.1gramofstoolhasmorebacteriainitthantherearestarsintheknownuniverse.Nowthat'sprettyprofound,right?

Dr.TomO’Bryan: Thatisprofound.JeffreyBland,PhD:

Likemorethan10tothe13thbacteriain1gramofstool.Ofthat10tothe13thbacteria,howmanyofthemarehostiletothebody?Wewouldnormallysayinahealthyperson,veryfewofthem,maybe10tothe3rdor10tothe4th,1,000to10,000outof10tothe13th.It'saroundingerror.Youwouldn'tevenknowthemtobethere.

Dr.TomO’Bryan:

They'recompletelysurrounded.They'reoverwhelmed.Theycan'tpufftheirchestand...

JeffreyBland,PhD:

Precisely.They'vegotallthesewhatarecalledsymbioticbacteriaorcommensalsthatholdthemincheck,justasyouweresaying,butifyougetadisruptionofthatbalance,anditdoesn'trequirethemtobecomethedominantbacteriawithintheirgut,butjustahighervoiceinthesymphonyofallthesecampersthatareinourintestinaltracts,nowsuddenlytheoldmeetingaroundthecampfireisnotsofriendlyanymore.Nowyourimmunesystemseesthosebacteriaandtheirdebris,becausetheydied,andtheyreleasedtheircontentstothegutmucosa.Theycanbethingslikelipopolysaccharides,whicharepartoftheirgutwallstructurethattheninducetheimmunesystemtosay,"Oh,foreigners.Webettercallouttheguardsandstartdoingbattle."

Yourpointaboutthegutandthemicrobiomeisbeingamajorcontributortohowourimmunesystemisworkingeitherwellorinastateofhostilityisavery,veryimportantpartofthiswholeemergingstory.Thatgivesusanotherplacethatwecanintervene,whichistodothingstomaketheenvironmentofthegutfriendly.

[00:09:02]Dr.TomO’Bryan:

Doyouseehowimportantyourmicrobiomeis?Whenyou'vethoughtaboutbeinghealthyoreatinghealthy,haveyoudirectlytiedthatoutcometohavinghealthycommunitiesinyourmicrobiome?It'soutofthisworld,isn'tit?Butit'scriticallyimportant.Manyofushavealotofdamagetorepairaswe'veblastedourmicrobiomethroughtheantibioticswe'vetakenandtheotherharmfulenvironmentaltriggerswe'vebeenexposedto.

Iadmit,IgrewuponMountainDewandHostessapplepies.Notagoodthing.Thegoodnewsisthatthebodiesareforgiving.Youcanrestoreyourmicrobiome,andwe'regoingtobecontinuallysharingwithyouthemostcuttingedgeinformationonhowtodothatthroughoutthisentireseriesfromthispointforward.


Nowlet'shavealookatautoimmunediseaseinthedevelopingworld,alsoreferredtoastheThirdWorld.LookingatthehealthchallengesthatwefaceintheFirstWorldscenarios,wouldyouexpectthedevelopingworldtohavebetterorworsegutbacterialsituations?Theanswermightshockyou.

[00:10:05]Dr.DavidBrady:

Ifyoulookatautoimmunedisease,itreallyisadiseaseofthewesternindustrializedworld,ordiseaseclass.Becauseifyougototheunderdevelopedworld,ortheThirdWorld,ifyouwill,abigdifferencebetweenusandthemistheyliveincomparativefilth.Theydon'thavethekindofpublichygiene.They'reoftenlivingupstream,takingwateroutoftheriver,cookingwithit,goingtothebathroominit,puttingwasteinit,andthenthevillagedownstreamistakingthewateroutoftheriverthat...

Dr.TomO’Bryan:

Doingthesamething,right?

Dr.DavidBrady:

Yeah.Thatcanbebad.Youcanhaveoutbreaks.Youcanhavedysentery.Youcanhavebadstuff,butthey'reusuallyacutethings.Youeitherlivethroughit,yousurviveanditresolves,oryoudon't.Youcertainlylearnhowtodealwithyourenvironment.Yourimmunesystembecomesprobablystrongertothethingsthatarereallyathreatthatyouhavetoreactto,butitbecomesmuchmoretoleranttoalargearrayofthingsthat...Yourimmunesystemisalmostsayinglike,"Listen.Ican'treacttoallofthis.It'sjustnotpossible.Ihavetosizeitup,andIhavetopickmybattles."

We'reexposedtosolittlenow.Weliveintheselittlesemi-sterilethingswecallhouseswithcarpetanddraperies,off-gassingtoxins.Mom'safraidtoletthebabycrawlinthedirtorgetdirtybecausethat'sbad,andsothey'rescrubbingthemwithallthissoapalldaylong.Theyjustdon'tsampletheirenvironment,sosoonerorlaterthey'regoingtorunintothesethings,andiftheirimmunesystemdoesn'tknowhowtosizeitupright,they'regoingtotendtobeover-reactivetoeverything.

[00:11:41]KiranKrishnan:

Becauseweknowbacteriamutategenerationtogeneration.They'resosupremelyadaptedtoliveonthisearth.Ourancestorswhowerehunters,gatherers,foragers,atedirt,livedamongthedirt,andactuallygothugedosesoftheseguyseveryday,sowedevelopedthisamazingsymbioticrelationshipwherewegivethemahomeandtheyprotectthehome,andtheyprotectthehomeinsomanydifferentprofoundways,it'sevenhardtoimagine.Justeverythingfromevendigestingyourfood.

[00:12:10]Dr.MichaelAsh:

IfwelookattheHadzatribe,whichisahuntergatherertribethatliveinTanzania,orAmerindiansinSouthAmericaandcomparetheirbacterialcompositionaldiversitytosomebodyinaEuropeancity,whichhasbeendoneinacoupleofstudies.Weseeabouta60%reductionindiversitycomparedtonearesthuntergatherercousins.Youhavetoaskthequestion,"Whatisitthatthey'redoingthat'ssodifferentcomparedtowhatwe'redoing?"


Dr.TomO’Bryan:

It'srarethattheyhaveautoimmunediseasesintheAfricancultures.

Dr.MichaelAsh:

You'reexactlyright,Tom.Youseeachange,ashiftintheirriskforreducedlifespan,tendtobebytraumaorinfection.Ourriskforreducedlifespantendstobebyautoimmunediseaseorwhat'scallednoncommunicablediseases,whicharediabetes,heartdisease,cancer,upperrespiratorytractandrespiratorytractdiseases.

Obviously,thequestionthattendstorunthrougheveryone'smindis,isthereasetoforganismsthataremissingthatweresoabsolutelyessentialtoprotectusthatwecanreplace?Orisitthewaythatwelookafterthem,asyou'vebeenindicating?Isitsomethingthatwe'redoinggenerationaftergenerationthat'sremovingthisdiversity?

[00:13:27]Dr.AntonioMarinho:

ImaginethatyouliveinAmerica,NewYork,forexample,orinChicago,andyouaregoingintoyourlate20'stoMalaysia,ortoAfrica,toAngola.It'sunlikeyoutodevelopautoimmunedisease.

Dr.TomO’Bryan:

It'sunlikely?

Dr.AntonioMarinho:

It'sunlikelytoyoutodevelopanautoimmunedisease,butifyouput,ontheotherside,ifyouputfamilyinanothercountry,ifyouputanAfricanfamily,anAfro-AmericanfamilyinAmerica,inthesecondandthethirdgeneration,you'llstarttohaveautoimmunedisease,andsevereones.Theyaregoingtostarttobelessexposed.Thatwillhappenlikethat.

Dr.TomO’Bryan: Sotheirprotectionisreducedthenextgeneration,theirprotectionisreduced.Dr.AntonioMarinho:

Ofcourse.Yes.It'smoreaburdenandatheoryforourlifestyle.Ournowadayslifestyleismoreaburdenofantigenexposerthatisthepossibleexplanationofthat.It'squitebeautiful,becauseit'sinfinite,thepossibilitytorecognizeforeignantigens.

Dr.TomO’Bryan:

Ourimmunesystems,we'vebeendevelopedwiththeabilitytorecognizesomanyforeignantigens,andinthiscountry,wearenotexposedtothat...I'msorry,intheUnitedStates,orinanyindustrializedcountry,we'renotexposedtoasmany,sothatitmakesusmorevulnerabletodevelopingtheautoimmunemechanisms.

Dr.AntonioMarinho:

Mechanisms.Yes,ofcourse.


Ihaveyoungkids,andIwalkthroughtheirelementaryschoolandeverysingleclassroomhaswarningsignsonit.Inthisroom,childallergictopeanuts.Childallergictocorn.Childallergictodairy.It'snojoke.Theyhavelikeanaphylacticlevelreallyseriousstuff,life-threateningstuff,soit'snotjusthypersensitivitytotheideathatkidshavefoodsensitivities.It'sreal.Thesearechallengingtimes.Kids'immunesystemsareeffectivelyofftherails.They'renotbehaving,evenlikewhenwewere


kids,atall.

There'salotofveryinterestingdataemerginginthemedicalliterature,particularlyintheimmunologyliterature,lookingatthedifferenceinimmuneresponsebetween,let'ssay,kidswhoarelivinginanunderdevelopedcountryversuskidsthatliveinawesterndevelopedindustrializedcountry.Evenbeyondthat,theyparseitmuchmorethanthat.

Theylookatkids,let'ssayintheUnitedStates,wholiveincities,kidswholiveinsuburbs,kidswholiveonfarms,orurbanversussuburbanversusruralenvironment.Theirimmunesystemsactverydifferently,andtheyhavemuchdifferentprevalencesofautoimmunediseases,anddiseasesparticularlythatwewouldconsideratopic.Thingslikereactiveairwayasthma,urticaria,allthosedermatitis-typeofthings,thesevery,veryreactivethings,andbasicallykidswhogrowuponfarms,particularlysmallerfarmswheretheycomeintocontactwithlivestock,lotsofdifferentanimals,particularlyifthey'redrinkingrawmilk,ifthey'reeatingalotofthingsrightlocallyoffthefarm,theirimmunesystemsaregenerallymuchmorebalanced,muchmorehealthy.

TheirGImicrobiotaismuchmorediverse,andtheydon'thaveautoimmunedisease.Theydon'thaveasthma.Theydon'thavehayfever.Theydon'thaveallthesethingsthatmostkidsinthesuburbsandcitiesnowarerackedwith.


It'ssuchaproblemthatourchildrenfacelivinginthesuburbs.There'sclearlysomethingtobelearntfromthechildrenwithhealthygutbacterialivingonfarms.Wecangainalotfromseeinghowthechildren'sbehaviorisconnectedtotheirguthealth.Thekeyisthatwhateverthecircumstancewelivein,wehavethetoolsavailabletocreatethebestpossibleenvironmentwithinourbodieswiththechoiceswemake.

Now,let'shavealookattheimmunesystem.Theimmunesystemisvitalasweallknow.Ahealthyimmunesystemkeepsusfightingcoldsandflusandseriousdiseasessuchascancer.Weallgetcancercells.Everyday,wegetcancercells.It'sjustaquestionofwhetherourimmunesystemcantakecareofthemornot.It'ssomethingweallknowweneedtohaveintact,butdidyouknowthatthere'sadirectconnectionbetweenthemicrobiomeandtheimmunesystem?

Thisisakeymissinglinkwhichisthereasonpeopleoftenfailtohaveeffectivefunctioningimmunesystems.


Partofitisthatourimmunesystemisquiteabitundercontrolbytherestofthegoodbacteriainthegut.Theimmunesystemisalmostnaïveinaway.Ialwaysexplaintopeople,theimmunesystemislikethisbigarmywithalotofcapabilitiesbutnogeneral.Theydon'thaveaplan.Theydon'thavealistofbadguystoattack.Weusedtohavethoselistsofallthedifferent...Thetop10badguys,orwhatever,toattack.


Dr.TomO’Bryan:

TheFBI's10mostwanted.

KiranKrishnan:

10mostwantedlist.Theydon'thavethatlist.Theyactuallyrequirethegoodbacteriawithinyoursystemtotrainthemtofigureoutwhothebadandgoodguysare.Weactuallyknowofbacteria,forexample,thespore-basedbacteriathatIworkwithalotinresearch,thatcansitnexttoabadbacteriainyourgutandactuallyflagitfordestructionbytheimmunesystem.Itcanactuallygoasfarassaying,"Hey,immunesystem,here'sabadguy."

[00:19:14]TomMalterre,MS,CN,CFMP:

Youhearalotaboutbiodiversity.Youneedallthesedifferentstrainsofmicrobestocalmdowntheimmunesystem,butveryfewpeopleknowwhythishappens.Itturnsoutthattheactualhumanbodyhaslittlereceptorsthatsitonourintestinalcells,andwhenwehavecertainspeciesofmicrobesaround,thedeadfragmentsfromthesemicrobeswillbindthesereceptorsandsendasignaltoourbodiestocalmdown.

Ourimmunecellsareliterallytrainedbymicrobes.Whenmicrobesarepresent,theytellourimmunesystemhowtobehave.Ifwe'regoingtohaveatonofthesemicrobesaround,we'regoingtohaveadiversewell-trainedimmunesystem.Sobiodiversitymeanslowerinflammation…calmtheimmunecells.

[00:20:09]JeffreyBland,PhD:

Thisrelationshipthatthegutbacteria,theso-calledmicrobiome,haswithourimmunesystemcaneitherbewhat'scalledtropic,whichispositive,itcanstimulatetheimmunesystem,itcouldbeintheappropriatebalanceofrecognizingtrulyforeigners,anditcanbeavigilantpartofourgoodhealth,orifyougettoomuchofthemessageofforeignersonboard,thenitshiftsthatimmunesystemoverintostartingtohavecollateraldamagetoourtissuesitself.

Thisisreallymediatedthroughavery,verycomplexandbeautifulregulatorysystem.Ifyouthinkoftheimmunesystemashavingsomanyvoices,becauseimmunecellsaredifferentiatedintoallsortsofdifferentfamilies,TH1,TH4,TH16,13,17,allthesedifferentpersonalitiesoftheimmunesystem,andthey'reorchestratedbykindofanupstreamexecutivecentercalledtheTregulatorycell.

TheTregulatorycellisincommunicationatthegutlevelwithwhat'sgoingonwiththemicrobiome.Ifyougetamessagefromthemicrobiomeasallishealthyhere,allisfun,wehavebrightsunnydaysdownhere,thentheTregcellsendsoutmessagestoalltheseotheroperativecellswithinourimmunesystemtosay,"Justkeepdoingyourjob.Don'tworry,"butiftheTregcellsgetsamessagefromthegutthroughthesereceptorsthataretriggeringthemessagesultimatelytotheimmunesystem,thentheTregcellwillsendoutadifferentsetofmessagesthatthenshiftsthebalanceintowhatwecalltheTH1response.Thishasawholedifferentfamilyofimmunecellsthataremoreoutthere.They'renowhypervigilant,onguard,andthey'relikelytostarthavingcollateraldamagetothetissueitselfthatwe'remadeof.



Didyouknowthatthemicrobiomeisn'tsomethingthatyoucanglanceovertoseeitshistory?Infact,thisissomethingthatgoesbackalongwayfurtherthanthat.Itgoestoatimewhenyoudidn'tknowtimeexisted.Perhapsallyouknewwasthatyouwereupsetthatyou'dbesnatchedfromwhereyoufeltsafeandcomfortable.I'mtalkingaboutyourbirth.

[00:22:01]Dr.JillCarnahan:

Whatwe'redoingiswearedestroying,we'rebombingourgutmicrobiome.We'relosingdiversitythatcanneverberegained.IfyoureadMartinBlaser'sworkandmany,manyothers,somanyofthethingswecanstartwithfrombirth,cesareansection,whichsometimeswecan'thelp,butwe'recolonizingourinfantswithskinfloraofthesurgeoninsteadofthemother'svaginalflora,whichisthenormalmicrobiome.Thenyougoontobreastversusbottlefeedingthathasaprofoundeffectonthemicrobiome.

[00:22:57]ProfessorAaronLerner:

Wearelivinginaworldofbacteria.Weareexposedtoalotofbacteria.However,ourimmunesystemduringevolutiondevelopedalotofmechanismtostopthebadguys,thebadbacteria,andtheyopenedthedoorforthegoodone.Infact,whenthechildisborn,inacoupleofhoursoracoupleofdays,he'sacquiredthemicrobiome.He'sacquiringitfromhismother,fromthefamily,fromthehouse,fromtheenvironment,fromthebirthcanalandwhatever.Inahealthyphysiologicalsituation,hewillcarrythismicrobiomeallofhislife.

However,sometimesformanyreasons,thatmaybewe'lltalkaboutit,thereisadisequilibriumwherebythedysbiosisistakingoverandfightingourmicrobiome.Thenmostprobablyaproblemisstartingtoappear.

Dr.TomO’Bryan:

I'veseensomeofthestudiesthatachildthatisbornnaturalchildbirth,thechildcomingdownthebirthcanal,iscoveredinmother'sbacteria.Thatbacteriagoesthroughthenoseandthemouthandtheears.

ProfessorAaronLerner:

Everywhere.

Dr.TomO’Bryan:

Thebabyisinoculatedwiththegoodbacteria.Someofthatbacteriacarriesmessagestohelpbabypreparefortheenvironmentthatbaby'scomingoutinto,butwhenababyisbornbycesareansection,asanexample,thenthebacteriathatmigratesintothebaby'sintestinesisthebacteriainthehospitalroomorwhereverthebabyisborn.

ProfessorAaronLerner:

You'retalkingaboutadifferentpopulationsof…

Dr.TomO’Bryan:

Differentpopulationsofbacteriathatgetin,andthatthosechildrenwhodonothavetheinoculationatbirth,theytendtobemorevulnerabletoatopicdiseasesorskindiseasesandallergiesandasthmaasthey'regrowingintotheirchildhood.


[00:25:31]Dr.SaraGottfried:

I'mabigfanofnaturalchildbirth.Irealizethatalotofwomendon'twantthat,butIalsowanttoadvocateforvaginalbirthsforwomenwheneverpossible.WehavearisingcesareansectionrateintheUnitedStates.There'ssomecountrieswherethecesareansectionrateisvery,veryhigh.It'sfunny,alotofwomenhavethisperception,it'salmostamyth,thatcesareansection'seasier.Theythink,"Oh,well,IcouldjustshowuponaWednesdayat8:00andgetmybabyout,"butthetruthisthatyouwanttohaveavaginalbirthforacoupleofreasons.

Oneisthatababycomingthroughthevaginalcanalgetsinoculatedwiththemicrobiomeofthemother,sothere'ssomeinoculationthathappenswhenthebabyisstillintheuterus,asyoudescribed,kindofthepassiveimmunityofthemother,butthere'sthisreallyimportantsetup,kindofafoundationforthebaby'smicrobiomethattheygetwhentheycomethroughthevaginalbirthcanal.

There'sthisexquisitekindoffinetuningthathappensbeforeawomangivesbirth,andwhenyouhaveacesareansection,basicallyyougetscrubbedandyou'renotabletocompletelyremoveallbacteria,butthere'sanattemptmadetomakeitassterileaspossiblewhenyouhaveacesareansection.Weknowthatit'snotjustaproblemwiththemicrobiomewhenyouhaveacesareansectioncomparedtoavaginalbirth.Weknowthatcesareansectionbabieshaveahardertimebreathing.Theydon'thavethesamesortofstressresponse.

Whenyougothroughthevaginalcanalandyou'rekindofallsquisheddownintoyourfetalposition,there'sthismomentwhenyougivebirththroughthevaginawhereeverythingiskindofsqueezedout,andyourlungsexpand,andyoutakeyourfirstbreath,andyoudon'tgetthatwhenyougothroughacesareansectionandincisioninthebelly.

There'sthemicrobiomeeffect.There'salsothisstressresponsethat'sgood.Thescientifictermforthisis'hormesis'.It'sagoodstressorforthebaby.

Tome,oneofthemostimportantthingsyoucoulddotokindofhelpwiththemicrobiomeistobreastfeed.It'sreallysimple.Breastfeedingiscruciallyimportantforsettingupthemicrobiomeandforhelpingthebabyjusthavethisfoundationfordigestionthatwillservethatbabyfortherestofitslife.

Ibreastfedmykidsforaboutayeareach.That'swhat'srecommendedbytheAmericanAcademyofPediatrics.Ithinkifyoucangoalittlelonger,that'sbetter.It'samazinghowitalsoimpactsotherissueslikeyourbodyweightlater,yourriskofobesity.There'ssomanybenefitstobreastfeeding,Ifeellikewecouldtalkforafewhoursaboutthat,butIthinkthatit'soneofthethingsthatyoucouldputintheextraeffort.


Letmebackupforasecond.Ithinkalotofwomenhavethebestintentionwhentheygivebirth.Theywantnaturalchildbirth.Theywanttohavethevaginalbirthand,forwhateverreason,theyendupwithacesareansection.OurC-sectionrate,evenifyou'reverycommittedtohavingavaginalbirth,issomewherearound15to20%.

[00:28:58]Dr.DavidPerlmutter:

IsaC-sectionabsolutelynecessary?Truthfully,theseproceduresaredoneasamatterofconvenienceattimes.Again,theyaremandatory.It'sbeenestimatedbytheWorldHealthOrganizationthatabout10%ofbirthsindevelopedcountriesarecomplicatedandwouldrequireaC-section.Ourrateistriplethat.Let'ssayachildisbornbyC-section.Whatcanyoudo?

There'swonderfulworkfromNewYorkUniversitybyDr.MariaDominguez-Bello.Shetakesitrightfromtheget-go,thatifaC-sectionishappeningandyouknowit'scoming,thatyoushouldputasponge,a4x4sponge,intothebirthcanalwhilemotherisinthehospitalandtakethatoutofthebirthcanalbeforethebabyisborn.It'scoveredwithgoodbacteriafromthebirthcanal.Thenthebaby'sbornbyC-section.Youusethatspongetocoveritsface,itsnoseandmouthinhopesofgivingittherightbacteria.

Nowtherehasn'tbeenalotstudyofthat,butIwantedtodiscussthat,becauseitisshowingthatresearchersarereallyfocusedontheimportanceofthismoment,birth,intermsofcreatingthatmicrobiome.Understandthatwhatisbeingtransferredatthetimeofbirth,yeah,it'sbacteriaandotherorganisms,butit'sinformation.That'swhat'skey.Understandthat99%oftheDNAinyourbodyisn'tthe23,000genesthatyougotfrommomanddadthatrepresentyourgeneticlegacy,it'sinyourgutbacteria.

[00:30:40]Dr.HylaCass:

We'veruinedourmicrobiomewithalltheantibioticswe'regivingrightfromtheget-go.Littlebabiesaregivenantibiotics,wipingouttheirmicrobiome,ortheydon'tgetamicrobiome,becausethey'rebornbycesareansection,andarepopulatedbywhatever'sonthehandsofthepersonwho'shandlingtheminthenursery.

Dr.TomO’Bryan:

Right.Thesurgeon.Thesurgeonorthenursethat'shandlingthemafterwards.That'sthemicrobiometheydevelopisthebacteriaonthesurfaceoftheskinofthesurgeons,notmom'sinternalbacteriathattheywerepre-programmedtoreceive,andthatbacteriaisthelibrary,ifyouwill,ofhowthatgutissupposedtodevelop.

Dr.HylaCass:

Itsmessages,itsinformation.Thisbabyisbornwithoutthatinformation,whichishorrifying.Themommaynothavesuchagreatmicrobiomeeitherbecauseshemayhavebeenonantibiotics,shemayhavebeenonallkindsofmedications,steroids,whatever.Shemayhavehadvaccineswithmarisolinthemthatwipeoutthegutbacteria,orstress.Stressisgoingtodothat.Cortisoldoesthat.We'reintrouble.



There'ssomewomenwhoendupgettingantibioticswhenthey'reinlabor,eithertheyhaveasignofinfection,liketheiruterusgettinginfected,orthey'recolonizedwithGroupBstrep.That'swhereyouwanttostartbeingreallycarefulabouttheuseofantibiotics.Youwanttobecarefulatparturition,whichiswhenyou'reinlabor.Youalsowanttobecarefulwithyourinfant.

Sometimesit'slifesaving.Theyhavepneumonia,theyhavetohaveantibiotics,buteverytimeyougiveanantibiotictoababyortoachildandanadult,you'reaffectingthediversityoftheirmicrobiome.

There'ssomesituationswhereIthinkantibioticsarenotneeded,andthat'sareallyimportantplacetofocuson.Alotofkidshaveotitismedia.Theyhaveanearinfection.Physicianstendtogiveantibiotics,it'sawayofdealingwith40patientsadayandkindofrunningthemthrough;whereas,it'softenavirusthat'scausingtheotitismedia,sowewanttojustbereallythoughtfulandhavethiskindofhighbarforwhetherwegiveantibiotics.

Dr.TomO’Bryan:

Isawastudybackinthelate80'sthatover70%ofrecurrentearinfections,otitismedia,over70%ofthemwerenotabacterialinfection,andtheyidentifiedafungusorayeastthere.Whenyougiveantibiotics,ithasnoeffectexceptmaybetoallowtheyeasttogrowmore,becauseyoureducethecompetitivebacteriainthegutthat'ssupposedtobethere.

Dr.SaraGottfried: Exactlyright.Dr.TomO’Bryan:

Sometimesantibioticsareneeded.Absolutelytheycanbelifesavingandlifeprotecting,butthere'stheindiscriminateuseofthemasafirstoptioninsteadofasalastresort.

Dr.SaraGottfried: We'reatatippingpointwithlookingatthediversityofthemicrobiome,andweknowthatpeoplewhohaveamorediversemicrobiomearehealthier.

[00:33:53]Dr.MarkMenolascino:

AlotofpeoplehavebeentoNepal,toAsia,toAfrica,averywell-traveledoutdoorgroup.Theymayhavegottenaninfection,hadittreatedwithantibioticsorherbals,andthebugisgone,butthesignaturedamageisstillthere,andthatsignaturedamageisleakygut,intestinalpermeability,alteredmicrobiomeflora,andthere'ssomesoundbytesthatIusewithmypatientstocatchtheirattention.

There'smorebacterialcellsinyourbodythantherearehumancells.Thatshockspeople.HalftheDNAinyourbodyisnotyours.That'showcomplicatedthemicrobiomeis.Mostoftheserotonininyourbodyisnotinyourbrain,it'sinyourgut.

Oncewecankindoflookatthesemechanismsthatareproveninmedicineandapplythemtotheuniqueindividual,what'stheirstory?What'stheirpattern?What'stheirpredictionofwherethey'reheading?Andtryingtochangethecourseofthatnaturalillness.Weseeitwithrheumatoidarthritis.There'sseveralbugsthat


havebeenidentifiedaslinkedtorheumatoidarthritisinthemechanismofthebugcausingdamage,allowingfoodparticlestointeractwiththeimmunesystemintheblood.Theythengotoauniqueenvironmentwheretheimmunesystem'sneverseenthem,anditattacksthem.

Oneofthecommonautoimmunetestsisrheumatoidfactor,whichisnotjustwithrheumatoidarthritisbutwithmultipleautoimmunedisease.Whatistherheumatoidfactor?It'swhat'scalledanIgMmolecule.It'sanautoantibodytosomething,andwe'renotreallyquitesurewhatitdoes.Itmaybeareactiveantibodytomultiplethingsthathavecreatedanabnormalenvironmentinthebody,andthebody'stryingtorespondtoit.Ithinkwe'rejustinourinfancyofunderstandingautoimmunedisease.


Ihopeyoucanseeclearlytheassaultsthatareonyourimportantgutbacteriaeveryday.I'mgladyou'veseentheclearandsimplestepsthatyoucanimplementtohelpstoptheonslaughtoftoxinsandtriggerstoyourpreciousgutmicrobiome.Also,I'mgladyoucanseehowyoucantakesimplestepstorebuildthemicrobiomeinyourgut.Maybeyoufeellikeyouneedsomemoreinformationonhowtodoit,solet'sdivedeeperintothis.

[00:36:00]Dr.MarkHyman:

Thismicrobiomehastobeinbalance.There'sanextraordinarybookcalledTheEpidemicofAbsence,thedetails,thehistoryofthechangesinourmicrobiome,theeliminationofparasitesandworms,andhowthathasactuallyledtothisdisruptioninourimmuneresponse,anditsoverreactiontoourbody'sowntissues.Whereweusedtoactuallyrespondtoparasitesandwormsandkeepanequilibrium,they'renotthereanymore,andourbodysometimesgettriggeredintothisautoimmuneresponse.

Ithinkthatthere'salotofthingsthatdisruptourgutmicrobiome.There'sourincreasingrateofC-sections,breastfeeding,changesinourfoodsupply,lowfiber,highsugar,GMOfoodsmayalterourgutmicrobiome,theoveruseofgut-bustingdrugslikeantibiotics,anti-inflammatories,antaciddrugs,hormones,steroids,allthesedrugsalterourgutmicrobiomeinwaysthatleadtoimbalances.

Whenyouendupdisturbingthegutmicrobiome,itcanalsoleadtoaleakygut.Itcanalsoupregulateinflammationinthebody.Dealingwithananti-inflammatorydietandahypoallergenicdietandoptimizingthegutflorathroughthefunctionalmedicineapproachorthe5-Rprogramwhichistoremovethebadthings,replacethenutrientsandenzymesthatareneededandprebiotics,reinoculatewithhealthybacteria,repairthegutliningwiththingslikeglutamine,zinc,fishoil,andsoforth,andrestorethebody'sequilibrium.Theseareallverystraightforwardprocessesweusewithgreatsuccessinautoimmunedisease.


Letmejusttellyouabout1particularclientwhohadanundiagnosedautoimmunecondition,probablylupus.Itwasearly.Shewashavingalotofnumbnessinherarm,botharms,butmostlyon1side.ShehadslightlyelevatedSmithantibodiesandANAantibodies.Hermemorywas,asshedescribedit,goingdownthetubes.


Shewasunderhugeamountsofstress.Whatwedidwaswechangedherdiet,andbychangingherdiet,wechangedhermicrobiome.Bygivinghermorelivefoods,takingawayfoodsthatwereinflammatoryoutofherdiet.Itwasreallyremarkable,becausewithinacoupleofweeks,itwasallstartingtoresolve.

Within3months,shehadlost20pounds.Shegoes,"Ilost20poundswithouttrying."Igo,"Yeah,youjustchangedeverythingaboutthewayyoueat."

Dr.TomO’Bryan:

Changedthemicrobiome.

LizLipski,PhD:

Youchangedthemicrobiome,andalsoyourested2hoursaday.Wedidalittlebitofproteinpowderthathadsomenutrientsthatupregulatedphase1andphase2liverdetoxification.Shewasayogateacher,sosheknewhowtoactuallyrelaxprettywell,andIsaid,"Youjustneedtostop2hourseveryday,"becauseshewasinasituationwhereshewascompletelyoverwhelmed.RememberIsaidit'sthatoverreaction,andshewasoverwhelmed.Within3months,allofherautoimmuneconditionsymptomswere100%gone.

Dr.TomO’Bryan:

Amazing,isn'tit?Restoreyourmicrobiomeandwatchyoursymptomsgoaway.Youheardthatright.Within3months,allofherautoimmuneconditionsymptomswereahundredpercentgone.Gone.That'sthedayofpeacewhenthewarhasfinallyendedinsideherbody.

Wouldyouliketoknowwhatthefirststepistocheckthegut'smicrobiome?Here'swhatyoudo.

[00:39:45]Dr.MarkMenaloscino:

Themoreyouworkonthegut,themoreindividualizedyou'reabletodoit,butyou'vegottoremovetheoffendingbugs.You'vegottorestorethemicrobeenvironment.You'vegottoreplacetheflorawithgoodbacteria,andit'sreallyaremovalandrestoration.Itellmyclientsit'skindliketheAmazonRainForest.Ifallyou'vegotistrees,youdon'thavethebiodiversitythatyouneed.You'vegottohavealltheorchidsandalltheferns,andyou'vegottohavethatincrediblediversitythatyouseeintherainforest.

Ikindofseethegutasaninternalrainforest.Youhavetopickwhatindividuallytheyneed,usetheadvancedtestingthat'savailabletoidentifywhattheproblemis.


Wetrynottogetrealhunguponwhatthediseaseorthepathologyis.Werundownthefoundationalelements,andoneis,inautoimmunedisease,particularlyiftheyhaveastrongfamilyhistory,wehavetostraightenoutthegut.Ithastoberight.I'llusesortofamolecularDNA-basedtesting.It'sastool-basedanalysis,andwemaptheGImicrobiome.WedoaGImapthatlooksatthebacteria,theprotozoa,theviruses,thefungi,andwecanevendotheviromenow,likeIsaidwithDNA,andwecanlookatwhat'sthere.Thegoodguys,thebadguys,andtheonesinbetween.Theopportunist.


Wecanlookattherelativebalancesofthose.We'redoing2things.We'retryingtonudgethemtowardwhatwewouldconsideranacceptablemicrobiota,anormalbalance,andgetridofanyovertpathogens,butwiththeopportunist,we'relookingparticularlyfortheones,theseorganismsthatweknowintheliterature,todayalreadyhavebeeneitherassociatedwhentheyovergrow,orthere'smoreDNArecoveredthannormal.They'reassociatedwithmuchhigherincidencesofthesevariousautoimmunediseases.

Iftheyhaverheumatoidarthritisintheirfamilyhistory,I'mlookingforklepsiellaovergrowth.I'mlookingforcitrobacterovergrowth.I'mlookingforProteusovergrowth.

[00:41:49]Dr.KaraFitzgerald:

Yeastcanmakeusfeellousy,nottomentionreallyusherinmoresugarcravings.Thisisawholeotherconversationaroundhowgutmicrobiomecaninfluenceourtaste,anddysbioticfloracancauseustocravefoodsthatreallyaren'tgoodforusatall.

Dr.TomO’Bryan: Dysbioticflorameanstoomuchofthewrongkindofbacteria,andsoyoustartcravingfoodsthatfeedthebadbacteria.It'sareallygoodexamplewithyeastandcravingsugar.Aretheresomeotherexamples?Whatotherfoodsfeedundesirablebacteria?

Dr.KaraFitzgerald:

Sugars,simplecarbohydrates.

Dr.TomO’Bryan: Simplecarbohydratesmeansrefinedgrains,likewhiteflour,whitebread,whiterice,thingslikethat.

Dr.KaraFitzgerald:

Thingsthataregoingtoturnintosugarquicklyinthebody,yes.Thatwillfeedthebadbugs.What'sreallyinterestingaboutthesebugsthatwe'relearningisthatthebugscanactuallyproducesomeoftheneurotransmittersthateithermakeusfeelgoodormakeusfeelbad.


Whatwe'redoingrightnowisdoingclinicaltrialonthesespore-basedprobioticsthatweworkwithforreducinggutpermeabilityorleakygutisacommonterm.Inordertodothat,whatwe'redoingiswe'refindingstudentsthathaveleakygut.Thesestudentsareyoung.They'rehealthy.Theyhavenosymptomology.Likeyousaid,there'sthatperiodoftimewherethingsarehappeninginthebodysettingitupfordisease,butthere'snosymptomology.

Dr.TomO’Bryan:

They'venotkilledoffenoughtissueyet.

KiranKrishnan: Exactly.They'venotkilledoffenoughtissueyet.Theinflammationisthere,buttheinflammationisstartingtobuildandcreatemoreandmoredamage.Wearefindinginscreeningthesestudentsbygivingthemacertainchallengemealthatwillinduceleakygut,we'refindingabout65%ofkidsareexperiencingleakygut.Thisisinresponseto1singlemeal.Ittakestheirbody14daystorecoverfromthe


inflammationfromthat1meal.

Themeal,ofcourse,we'regivingthemisaMcDonald'sbreakfasttostimulatethatleakygut.Thesesame65%ofkids,they'reintheirearly20's,mid20'smaybe.Theyareseeminglyhealthy,buteverysingletimetheyeatfood,especiallythebadfoodandthingslikegluten,you'regettingthishugetoxicresponseinyourbodythatyoudon'tfeel.Youfeelfine,butit'sdamagingtissue.It'smessingupyourimmunesystem.It'sconfusingtheimmuneresponse,andeverysingledayofdoingthatoverthenext10to15years,setsyouupforeverykindofautoimmunediseaseinyourmid30's,40's,and50's.


Wehaveastoolsamplesentin,andwewillgetmeasurementsofthepredominantmicroflora,sothemainplayersthatlivethere,andwecanlookandseewho'sinbalance,who'soutofbalance.Wecanlookandseewhetherornotsomeofthoseautoimmunetriggerbugsarepresent,andwecanseeifthereareanypathogens,arethereparasites,andonandon.Arethereinflammatorycompoundsthatthegutproduces?Thingslikelactoferrinorcalprotectin,eosinophilproteinX,aretheseelevated?

Thenwegointherecarefully.Iwilldesignaprotocolthatwillhelptodropthebadguys,raisethegoodguys,quenchtheinflammation,andbyandlarge,I'musingbotanicalstodothat,soantimicrobialbotanicals.We'vegotthisfabulousarsenalofherbsthatwork.

Dr.TomO’Bryan:

Theseareherbs.

Dr.KaraFitzgerald:

Yep.I'musingherbs.Longhistory,decentresearchontheirefficacy,andyoudon'tgetthefalloutthatyoudowithantibiotics.Onceinawhile,I'lluseantibioticsforcertaincircumstancesbut,byandlarge,Ithinkwecandoasgood,ifnotbetter,withherbs.Yes.

Dr.TomO’Bryan:

Arethereanyfoodsthatyourecommendtohelpbuildthemicrobiome?


Ohyeah,absolutely.There'satreasuretroveofprebiotic,prebioticfoods.'Biotic'meaningbugs,'pre'meaning,well,beforethebug,orwhatthebugeatstoproliferate.Therearemanygreatprebioticfoods.Arguably,everythingweeatisaprebiotic.Everythingisgoingtobefeedingourbugs.Arewefeedingthemhealthy?Arewefeedingourbugswhattheyneedtobeeatingsotheystaybalancedandhappy?Orarewefeedingourbugs,sotheguyswedon'twantaroundareproliferating?


Foodcanaffectourmicrobiome.Whatweeatdoesmakeadifference.Iknowyou'vebeenthroughtheconfusion,whatdoIeat?Whatdon'tIeat?Thenthere'sthediscouragementoffeelinglikenomatterwhatyoueat,theoutcomewillstillbebad.Well,thetruthisyoucangetbetter,feelbetter,andbeontopofwhateverchallengeyoumightbefacing.Whatfoodsdoyouavoid?Whatfoodsaremosteffective?



Probablythemostimportantfactorsarefood.Aswelosewhole,reallivefoods,whichfeedthemicrobiomeandwe'reeatingprocessedfastfood,Iwon'tmentionanynames,orprocessedpackagedfoods.YouthinkaboutthekidsthattaketheLunchablestoschool.Whatkindofamealisthat?Thatisnotfeedingthemicrobiome.Whatwe'redoingiswe'relackingthefoodsthatfeedourmicrobiome.We'renotjustfeedingus,we'reactuallyfeedingourgutbugs.Ifwedon'tthinkaboutthat,dietiskey.


Ithinkreallyoneoftheevenmoreimportantpiecesiseatingprebioticrichfoods.Thesearesolublefibersthatwefindinfoodslikeasparagusandonionsandgarlicandrootvegetablesandjicama.Thesearethefoodfortheprobioticsforallthebeneficialbugsinourgut.

Wefocusalotonprobiotics,andprobioticsarereallybydefinitionbacteriaorfungithathaveaspecificstrainthat'sknowntohaveaspecifichealthbenefitinthehumanbody.Whenthey'reactuallyinourmicrobiome,they'recalledprobiants,andtheyliveinbigfamilies.

Wefocusalotonprobioticsandprobioticsupplements,andIthinkthey'reprettyfascinating,andIthinkthattheresearchisgoingtoexplodeinthisarea,andIthinkthatwe'regoingtofindthattherearecertainprobioticsthataregreatforcertainhealthconditionsforcertainpeopleatcertainmomentsintheirlives.

Ithinkwheretherealmagiccomesisintheprobioticswegetinfoodandalsointheprebiotics,whicharefoodsthathavesolublefibersinthem.Thesesolublefibersthatwefindinthingslikeasparagusandonionsandgarlicandrootvegetableslikeyamsorthingslikejicama,bananas,mostfruits,beans.Theseprebioticfibersaresoimportantinsomanyways,becausetheyfeedtheprobiantsinthebody.Theyfeedthemicrobiota.

Asthemicrobiotagobblethemup,theseprebioticsgetactivatedandthepolyphenolsgetactivatedsothattheycanworkdoingwhatevertheydotoreduceinflammationandsendourgenesmessagesandsay,"Hey,calmdown.Everything'sreallyokay.Whyareyousoupset?"Primitivepeoplesreallyatealotoftheseprebioticfoods.


Oneofthethingsthatweknowaboutencouragingmoreofthebeneficialbacteriaisfiberfromvegetable.Theinsolublefibersfromvegetable.Oneoftheconceptswe'veoftenrecommendedisvaryingthevegetablesthatyoutakeinwilldeterminewhichofthegoodbacteriayou'regoingtobefeeding.

KiranKrishnan:

Absolutely.

Dr.TomO’Bryan:

Arethereanyvegetablesthatfeedbadbacteria?

KiranKrishnan: Oneoftheunfortunatethingsisthatfiberingeneralcanfeedbadbacteriaaswell


ascanfeedgoodbacteria.That,infact,isoneofthecausesofwhyalotofpeoplehavesensitivitytofiber.Alotofpeoplewilleatcertainvegetablesandactuallygetalotofgasandbloatingandcramping,andthat'sbecausetheunfavorablebacteriaisactuallyconvertingthatfiberintomethanegas,orhydrogengasinsteadofthegoodthingslikeshortchainfattyacidsthatreallyhelpthegut.

Badbacteriacanfermentfiberaswell,butingeneralifyoueatadiverseamountoffiber,7,8differentversionsoffiberfromvegetablesourcesprimarilyratherthansupplements,you'llactuallyallowfortheregrowthofenoughgoodbacteriathattheycanactuallysuppressthebadbacteriathemselves.Diversity,again,iskey.

Oneofthelecturers,bothyouandIspokeatashowyesterday,butoneofthelecturers,Dr.BenBrown,talkedabouthowourancestorsusedtoconsumeupwardsofathousanddifferenttypesoffoodsinanannualbasis.Wenowconsume20,22foodsmaybe.OnethingIalwaysrecommendtopeopleisit'sreallyhardtogetadiversityinyourdietifyou'regoingshoppingatWholeFoodsorJewel,oroneofyourregulargrocerystores.WhatItellthemisgotoanethnicgrocerystore.GotoanAsianmarket.GotoanIndianorPakistaniorLebanesemarket.You'llfindrootsandtubersandvegetablestherethatyouwon'tfindatyourregulargrocerystore,andyoudon'thavetoeatalotofit.Youjusthavetoeatasmallamountofiteveryotherdayjusttogetthediversity.

Dr.TomO’Bryan:

Aretherecertainfamiliesofvegetablesthatseemtobeofbetterorhigherimpacttotheprobioticsthanothers?

KiranKrishnan:

Yeah,actuallythat'sareallygoodquestiontoask,becauseforthemostpart,resistantstarchesandresistantfiberstendtobebetter,sorootsandtuberslikeyoumentioned,rootsandtuberstendtohaveahigherdegreeofmoreresistantpolysaccharidesinthem.Polysaccharidesisbasicallyjustlongchainsofcarbohydrates.Someofthemaremoreresistanttobreakdowninthesmallintestinesandgettothelargeintestine,becausethat'swhereyoureallywantittogetto.That'swhereallyourfermentationishappening.That'swhereallthegoodbacteriaaretryingtofeedoffthefiberandproducethingslikeshortchainfattyacids,whichlowersinflammation,sealsupthegut,doesallthesewonderfulthingsforyou.

Youwanttouseunder-cookedandlongchainpolysaccharides.Thingslikesweetpotato,forexample,ismuchbetterthanaregularpotato.Sweetpotatotendstohavemoreresistantstarchesinit.Celerytendstobeveryhardtodigestintheupperbowel.Thetypesofcelluloseandallthatisreallyisfermentedwellinthelowerbowel.Ingeneral,rootsandtuberslikemacaroot,thosethings,anythingthat'sarootortubertendstohavebettercarbohydratesinitthanyoursimplefruitsandvegetables.


Let'stalkabouthowwemightencourageadevelopmentofamorebeneficialanti-inflammatorymicrobial.Youarerenownedforoneofyourrecommendationsthatyouconsistentlytalkaboutyearafteryeartoourhealthcarepractitionersinyour


lectures,andthat1inclusionisaboutapples.Canyoutellusaboutapples?

Dr.MichaelAsh:

Sure.Applesprettymuchknowntoeverybodyasahealthyfood,eat1appleadaykeepsthedoctoraway.It'salwaysbeensomethingI'veknownfromprimaryschool,anditwasveryexcitingtome,probably10yearsago,todiscoverthatinamousemodelinitially,givingtheequivalentof2applesadaytothesemice,youcaninducethesamelevelofinflammationcontrolasaround10to15milligramsofasteroid,oralsteroid.Thisimmediatelytranslatedtomeishowdoweutilizethatinformation?

Dr.TomO’Bryan: MayIjustpausethereforamomentjusttoprocesswhatyoujustsaid?Theequivalentof2applesadaywillgiveyoutheanti-inflammatoryeffectof10to15milligramsofthemostpowerfulanti-inflammatorydrugs,thesteroids,thatourdoctorsusewhentheyhavenootheroptions?

Dr.MichaelAsh:

Correct.

Dr.TomO’Bryan: 2applesaday.Dr.MichaelAsh:

Whendeliveredtomicethathadcolitisatthetime.Thesemiceweregivenasulfatedextranwhichisasugaringproducttomaketheliningofthegastrointestinaltractgetveryinflamed.Whentheysplitthemoutbetweenthecontrol,theappleandthesteroidgroup,theappleandthesteroidgrouproughlymatchedoutat2apples,sobetween10and15milligrams.

Howdowetranslatefromlittlemiceintohumanswasmynextquestion?Itrackedapplestudiesforquitesometime,andyou'llbeamazedhowmanyyoucanfindcomingoutnow.Abigclueforthisisthatapples,whenthey'repreparedcorrectly,andit'snoteatingthemraw,butcookingthem,andwedothatbybreakingthemdown,tryingtokeepsomeoftheskinon,becausetherearechemicalsinthatskinthatarealsouseful.Wesoftenitup.InEngland,wecallitstewedapples,andinAmerica,youcallitapplesauce,butit'snottheapplesaucethatyoubuyinthesupermarket.

Youcook,breakdowntheapplesuntilthesurfaceoftheapplebeginstobecomeviscousandshiny.That'saproductcalledpectin.Pectinmimicstheliningofourgastrointestinaltract'sproductionofnormalmucopolysaccharides,whichisahealthyfluidthatwecoverourselveswithsowedon'tgetdirectcontact.

Whenyoueatapplesthatarebeingpredigestedforyoubybeingcookeddown,thenweaddsomecinnamon,becausecinnamonhasapowerfulanti-inflammatory[inaudible00:52:48],andweaddafewraisinssoit'snottoobitter,becauseweusecookingapples,andyoueatthatroughly2applesaday,peoplewithinflammatorybowelconditionsordifficultymaintaininginflammationcontrol,iftheycantoleratethat.Somepeoplefindtheyhavetostartmuchmoreslowly.Youwillreducenotonlylocalbutsystemicinflammationaswell.


Dr.TomO’Bryan: Whatmightbesomeofthereactionsthatapersonmighthavethatwouldencouragethemtotakeitalittleslowerthan2apples?

Dr.MichaelAsh:

Becauseapplesareacarbohydrate,theyhavesomesugarsinthere,somepeoplemayfindthattheygetabitwindy.Theyfeelabitbloatedortheyfeelabitliketheywanttoburp,becauseofhavingittoofast.Normallywhatwedoissuggestthattheytakesomenaturalyogurt,that'snonsweetenedornonflavoredyogurt,preferablyofanorganicorigin,andtheytakealittlebitofthatwithitandalsoperhapsaprobioticthat'sbeenrecommended.Aprobioticisacapsuleorapowderthatcontainsorganismsdeemedtobehelpfultohumanhealth.

Therearedifferenttypes.There'sanotherwholediscussion,buttherearelotsofdifferenttypes.Youmightjustwanttostartoffwith3or4teaspoonsonday1,thenday2doubleit,day3doubleit,andjustseehowquicklyyoucangettothepositionwhereyou'recomfortable.Ittakesabout10to21days.Theaveragestudyis28daystochangethepopulationofbacteriainsideyourgastrointestinaltract.Thatfavorananti-inflammatoryresponsethatimpactslocallyandthentransfersthatinflammationthroughouttherestofthebody.


Ilearnedfrommygreatgrandmotherthatyoudon'tfindtheanswertohealthinthebottomofapillbottle.Ithinkthat'struewithsupplements,too.Sometimessupplementscanmakeabigchange,canbeasmallhingethatswingsabigdoor,butforthemostpart,yourfoodissomuchmoreimportant.Ithinkafoodfirstphilosophyhereiscrucial.

Weknowthatthey'regoodforyou.Evenifwelookedatmyfridge,I'vegotabout20differentprobioticfoodsinthere,andI'vegotabout10differenttypesofsauerkraut.Ilovemiso.Ilovetempeh.There'smanydifferentfermentedfoodsthataredelicious.It'snotassimpleasjustjackingyourselfuponprobiotics.Itdoesn'tstickwhenitcomestoshiftingthemicrobiome,andreallythegoalhereistohavediversityofthemicrobiome.

You'regoingtohavemorediversityfromeatingfermentedvegetablesandfermentedfoodsthanyouarefromtakingaprobiotic.Itjustdoesn'tstick.Itdoesn'thavethestickfactorthatwewishitdid.Eatingthingslikeresistantstarch,havingprobioticfoods,Ithinkthoseareamuchbetterstrategy.


Whatwe'relookingfor,whatmostofthestudieshaveshownwithregardtoguthealthisyouwanttohaveagreatdiversityofbacteriawithinyourgut,sothemorediverseyourgutis,themorefunctionsitperforms,thestrongeryourimmunesystemis.Withthat,theideaofoverloadingyourgutwiththesame3or4strainseverysingleday,ifwhatyou'retryingtodoisrecedethegutwiththosestrains,whatyou'redoingisjustkindofoverloadingthosesamestrains.You'renotimprovingthediversitymuch.

Attheendoftheday,everystudythat'scomeoutofthehumanmicrobiomeproject,andpeoplemightnotbefamiliarwiththat,butthat'sahugeNIHstudy


thatwaslaunchedin2007.TheUSgovernmentspentabout$160,000,000instudyingthegutitselfandthebacteriawithinthegut,soalotofinformationhascomeoutaboutthegutwithregardstothat.Whatwelearnfromallofthatworkisthatthediversitywithinthemicrobiomeissoimportant.

Thewordmicrobiome,maybeyoudon'tknowwhatthatis,butmicrobiomeisthedescriptionoftheentirepopulationofbacteriaandallthegeneticelementswithinthehostitself,andtypicallywe'retalkingaboutthedigestivetract,butyou'vegotamicrobiomeonyourskin,youreyes,virtuallyeverypartofyourbody.

Again,thediversityisreallywhatwewanttogofor,soweneedsomethingthatisabletogointhereandimprovethediversityofthegutratherthanjusttryingtore-seedthegutwiththesame2,3strainseveryday.

[00:59:56]Dr.PatrickHanaway:

There'sanotherpartinrelationshiptothefood.Evenwhenyou'reeatinggoodfood,ifit'snotdigested,wellsomeofitmaymovethroughbecauseofopeningorleakiness.Therestofitisgoingtogodownstreamandisgoingtofeedthebacteriadownstream.They'renotsupposedtobeseeingwholevegetablesandwhole...

Dr.TomO’Bryan:

Bigclumpsofroastbeef.

Dr.PatrickHanaway:[00:57:30]

Exactly.Theygetthat,andsoweseethatthebacteriathataregoingtousethatasfeedbegintogrowandovergrow.Thishasseveralimplications,thebiggestoneofwhichwestillareinvestigatingtounderstandthehow,butthereisalow-gradeinflammationthatisdriventhroughthatprocessoftheimbalanceofthisterm'gutmicrobiome',thiswordthatyouandIheardaboutit15yearsagowhenitwasfirstestablished,butnowit'sallover.TheWhiteHouseistalkingaboutitasofyesterday.

Themicrobiomeisaltered,anditcreatesthisinflammatoryprocess.RememberthatIsaidnotonlydoweseeageneticpredispositionandanenvironmentalexposureandimpermeability,butalsothisinflammatoryprocess,thefoodsthatweeatandthethingsthatwe'reexposedtoarecreatingalow-grade,sometimesahigh-gradeinflammationthatmakesthosefiresburn,andtheimmunesystemdrivesoffofthatfire.

Dr.TomO’Bryan:

Withthat,Irememberbackintheearly70's,wewerechewingbrownrice30times.Doyourememberthat?Inthemacrobioticworld,theywouldtalkaboutthat,andifyouevertriedchewingbrownrice30times,justcountit...

Dr.PatrickHanaway:

1,2...Itgetsold.

Dr.TomO’Bryan:

Itgetsoldanditgetssweet.Itgetsreallysweet.Thatwasstartlingtometorealize.Ididthatonceandthatwasenough.Ineverdidthatagain,butitwasagoodexperiment,butitdemonstratesthatwhenyouchew,thejuicesinyourmouth,thesalivasinyourmouthhelptobreakdownthefood,getitstarted,andtheycarry


signalsthatgodowntosay,"Okay,makesomeaciddownhere."Ifyou'reabletomaketheacid,thenyoustarttobreakitdownevensmaller,sobythetimeitcomesoutofthestomach,it'salmostreadytobeabsorbed.Youneedalittlebitmoreenzyme,butit'sready.Evengoodfoods,ifwedon'thavetheapparatusworkingcorrectly,canstillcontributetothemechanismofautoimmunity.

Dr.PatrickHanaway:

Exactly,andyouremindedmeofthiskindofepiphanythatIhadoneday.MichaelPollanhasawonderfullittlebookcalledFoodRules,andinthereare64rules.Eachoneisabouthalfapage.Iopeneditup.Iwouldgiveittopatients,butonedayIopeneditupanditsaid,"Eatatatable...Adeskisnotatable."Asapracticingphysician,I'moftenlike,"Well,I'mgoingtohavelunch,andI'mgoingtositdown."I'vegotmygoodfood,andI'vebroughtitfromhome,andit'sfresh.I'vewarmeditup,notinamicrowave,andI'meatingit,butI'matthecomputerandI'mlookingatchartsandI'mdoingthingsandI'mansweringthephoneandI'matmydesk.Vagaltone?AmIrelaxed?Noway.Eventhebestfoods,soyeah,you'rerightonit.


Justlikeourhealthisdependentonthequalityofthefoundationalbuildingblocks,themicrobiome,inthesameway,thequalityofthefoodweeatisdependentontheenvironmentinwhichit'sgrown.Watchthis.


Someofthestudiesshownowaswell,weusedtouseprobioticsadnauseam.Istilldo.Theyhaveanimportantclinicalplace,butwecanactuallycontributetothemonocultureofourgutbygiving1strainofprobioticforlongterm.Backtofood,becausethatincreasesdiversityversusjustprobioticstrains,andbacktothingsthatactually,eatingfoodoutofthesoilwithoutmaybealwayswashingitoffaslongasyougetitfromagoodsource.Ithinkthat'sagreatidea.

Ifwego1stepfurther,thehealthofthesoil,whichislackingseverelyintheUS,isareflectivemarkerofwhat'sgoingtohappentoourmicrobiome,becausethefoodcomesfromthesoil,ourmicrobiomeisactuallyveryconnectedtothesoil,andaswe'reusingthesepesticidesandchemicalsonthesoils,weareobliteratingthesoilmicrobiomeand,ofcourse,thatinturnaffectsusbecausewe'reeatingfoodfromthesoilthat'slackinginnutrients,lackingindiversity,lackinginthemicrobesthatweneedtocolonizeourgut.

[01:04:42]StephanieSeneff,BS,PhD:

Wehavesoilsthatarepoisonedwithglyphosateandyoucan'tevengroworganicinthemuntilyouwaitseveralyearstogetridoftheglyphosate.We'vegotahugeproblemrightnow.Evenifweweretostopusingitrightnow,we'dhavetowaitalongtimebeforeitdisappearsfromourenvironment.Glyphosatehasbeenshowntopreferentiallykillthegoodbacteria.

Wehavestrongcorrelationsbetweenintestinalinfectionandinflammatoryboweldiseaseandceliacdisease,allofthoseverystronglycorrelatedwithglyphosateusageoncornandsoycrops.WecangetthatdatafromtheUSgovernment.It'sfreelyavailableontheweb.I'velookedatallthesedifferentdatasets.I'macomputerscientist,soIcanprocessdata.


Thegutisdefinitelybeinghithardbytheglyphosate.Thesoil,samething.There'sbacteriainthesoil,andthey'resuperimportantforallowingtheplantstopullupthenutrientsjustasthebacteriainthegutaresuperimportanttosupplyuswithnutrientsand,infact,thepathwaytheglyphosatedisrupts,whichistheshikimatepathway.That'sthepathwayglyphosatedisrupts.Actually,itdoesalotofotherthings,butMonsantofocusesisonthatpathway,andtheysay,"Look,wedon'thavethatpathwayourselves,don'thavethat."It'sabiologicalpathway.

Dr.TomO’Bryan:

Humansdon'thavethatpathway.

StephanieSeneff,BS,PhD:

Yeah,soluckyus,we'resafe.That'stheargument.It'safalseargument,becauseourgutmicrobesdohavethatpathway,andtheyuseittoproduceincrediblyimportantnutrientsforus.Thisincludes,forexample,folate.Itproducesthearomaticaminoacids,thispathway.Soifthemicrobescan'tproducethosearomaticaminoacids,wecan'tgetthembecauseourcellscan'tmakethoseaminoacids.

Dr.TomO’Bryan:

WeknowthatthegoodbacteriainourguthaveastronginfluenceonproducingenoughoftheBvitamincalledfolate,orfolicacid,asmostpeoplehavehearditinthepast,andthatglyphosateandperhapstheotherinertingredientsinthere,butspecificallyglyphosatewillinterferewithourgut'sabilitytoproduceenoughfolate.

StephanieSeneff,BS,PhD:

That'sright.

[01:06:36]Dr.MichaelAsh:

Thesoilandussharesomedegreeofcommonalityinthatthesoilhasaphytobiome.Thatreferstoamixoffungianddifferentorganismsandbacteriathatsharethespaceofthesoil.Healthysoilmakesahealthyplant.Moreimportantly,thebacteriainthesoiltransfersinformationforenzymaticreleasetotheplant'simmunesystem,andtheplanthasaninnateimmunesystem,thatlikewewerebornwithasystemthat'spre-encodedtorecognizecertainchallenges,theplanthasthesame.

Thehealthierthesoil,themorevibranttheplant'simmunesystemis,whichmeansitcanresistdisease.Itcanresistinfectionfromdifferenttypesoforganisms,anditcanhelpdefenditselfagainstdifferentinsects.

Nowyoumightbethinking,"Whywouldaplant'simmunesystemhaveanyrelevanceformeasahuman?"Plants,whentheyhaveahealthyimmunesystem,producelotsofchemicalswhicharecalledphytochemicals,orplant-basedchemicals.Themorediversethosechemicalsare,themorenutrientdensetheplantbecomes.Moreimportantly,thatmessagegetsconveyedtouswhenweconsumeit.

Dr.TomO’Bryan:

Whenweeattheplant.

Dr.MichaelAsh: Correct.Here'saverysimpletakeaway.Switchingtoapredominantlyplant-based


diethasthesameinstanceofbenefitasgivingupsmokingintermsoffuturehealthrisk.Statistically,ifyoumovetowardsadietthatcontainsabout80%plantsourcedasopposedtomeatandfishbased,fromapureriskperspective,you'veroughlyachievedthesamelevelofreductionofriskasifyouweregivingupsmoking.That'saverypowerfulmessage.

Obviously,there'slotsofquestionsthesedaysbecauseofdifferenteatingstylesastowhetheraplant-baseddietorameat-baseddietorafat-baseddietshouldbeutilized.

Let'sjustgobacktotheseplants,becauseIthinkthatthephytobiome,thewaywelookafteroursoils,thewaythatwenourishoursoils,producesthefoodthatweultimatelyconsume,ortheanimalsthatwe'regoingtoeat,willconsume.Theycomewithmolecularmessages,likelittlekeys.Whenweconsume,wereleasethosekeysbybreakdowninthestomach,andtheyenterthegastrointestinaltractwheretherearelocks.

Ifthesekeysfittherightlock,itswitchesonacascadeofresponsethat'ssobeautifullyelegant,thatthereshouldbeasongwrittenaboutit.Insimpleterms,certaintypesofvegetablescontainsomethingcalledarylhydrocarbonligands.It'salongcomplicatedname,butiftheplantiscruciferouslikecabbage,cauliflower,broccoli,oronions,andtheystillhaveabittercontent,thatmeanstheimmunesystemisstillquiteactive.

Thatbittercontentisseparatedbyenzymes,anditfitsalockinsideourgastrointestinaltractandswitchesonawholerangeofhealingmechanisms.Itmakesimmunecells,itstopsthegastrointestinaltractfrombeingleaky,itfacilitatesappropriatecompositionalchangesinthemicrobiometofavorananti-inflammatoryratio,itimprovesperistalsisitreducesriskforconstipationandmakespeoplefeelmorecomfortable.Itchangestheproductionofhydrogensulfate,whichisagasthatbacteriaproducewhichinsmallquantitieshasanincredible...

Mitochondria,whicharelittlepowerhousesthatliveinsideourcellslookforhydrogensulfateinsmallquantitiestoswitchoffgenetictransferfrommitochondriatothecellnucleuswhich,inturn,diminishestheriskforcancerofthegastrointestinaltract.


Iftheyaskme,andlet'ssayyou'reataparty,andthishappenstousallthetime,"Whatdoyoudo?"Theyfigureout,andeverybodywantsfreeadvice,right?Iftheysaid,"Well,Ihaveautoimmunediseaseinmyfamily,"orwhathaveyou,"WhatcouldIdotobeproactive?"Somethingasbasicastakeaprobiotic,eatrealwholefreshfoods.Don'teatjunkyfoods.Beveryprudentaboutyouruseofantibiotics.Beprudentaboutyouruseofnonsteroidalanti-inflammatories.Hopefullyyoudon'thavetousethematall,butanythingthatcausesleakygut:excessivealcoholintake,likeIsaid,poorqualityprocessedfoods.That'sallgoingtohelptheGIenvironment.It'sgoingtohelpleakygut.It'sgoingtohelptheecologyinthegut.


Eatingfermentedfoods.Allthethingsthatweknowaregoodforguthealthis1thing.

Iwouldencouragethemreallytogofurther,andthatistotestwhichfoodstheirimmunesystemdoesnotlike.Ifyoureallywanttobehealthy,yougottogetbeyondthisdiseasereactivecaremodel,becauseourhealthcaresystemisnotahealthcaresystem.It'sadisease-reactivesystem.Ifyoureallywantahealthcaresystem,yougottofindproviderslikeyourself,likemyself,andmanyothersnowthatcanbeyourcoach,basically,tokindofhelpyouthroughthis.

Beproactive.Findoutwhatisuniquetoyouasanindividual,andworkwithsomeonethatcanhelpmodifyyourbehaviors,essentially.Thisislifestylemedicine.That'sthekeytofixingallthischronicdiseaseepidemic.It'snotthenextmagicpill.It'snotthenextdrug.

I'mgladthatthere'salotofmedicationsoutthere.Iwouldn'twanttoliveinaworldwheretheyweren'tavailableasanoptionifyou'reatthatpoint,butthiswholefantasylandthatwe'regoingtocomeupwiththesemagicdrugsthataregoingtocureallthesechronicdiseases,it'safunctionofhowwe'relivingandourenvironment,andwehavetodealwithitthere,asinconvenientasitmaybeformanypeopleandformanycommercialinterests.That'stheonlywaywe'regoingtoturnthisaround.

[01:12:24]Patient:

Ikindofclosedoffandwasmyownisland.Itdefinitelyaffectedmymarriageandmytimewithmychildren.Itmademesad.Myoldestsonwouldaskmeeverydaythathesawme,ifIwasdying,becauseIlookedatpeoplearoundmeandIdidn'tseeotherceliacsstrugglingtothepointthattheyhadulcersintheirintestines,andI'vehad9surgeriestotalfromceliac.

JonathanOtta:

Didyouwanttogiveup?

Patient:

Yes,Idid.Iwantedtodiealot.Whenyouhaveulcersandyouhaveceliac,theyprettymuchconsiderthatlikeaprecancerousstate,andit'sapoorprognosiscancer.It'slymphoma.Peoplediefromit.I'mbacktofunctioning,andIactuallyambacktoknowingwhatit'sliketoenjoylife,justtohavehobbiesandthingsotherthanmedical.Mylifewasjustinandoutofdoctors'offices,andnowIcanactuallylivelifeandnothavetobaseeverythingarounddoctors'appointmentsandbeingillallthetime.

[01:13:29]Dr.HylaCass:

Hi.I'mDr.HylaCass,andIinviteyoutowatchthisreallyveryinformativedocu-seriesonautoimmunity,itsroots,howtodetectit,andwhattodoaboutit.It'sallfree.Iinviteyou,havealook,havealisten,enjoy.


Inthisnextepisode,you'regoingtolearnaboutthechallengingdigestivediseasesthatmakeupalotofthesufferingthatpeoplearegoingthrough.You'regoingtowitnesstheamazingtransformationsofpeoplesharingtheirheart-breakingstoriesthatcametoanamazingturnaround.Thesepatientssufferedfrom,andreversed,


colitis,type2diabetes,andglutensensitivitywithorwithoutceliacdisease.

You'llalsolearntheconnectionofautoimmunediseasewithglutensensitivity.You'llseethewaystotestandseeifyourdigestivesystemishealthyornot.You'llalsofindoutthestepsfortreatingthedigestivediseasesaswellascomingtounderstandthathydrochloricacid,it'smadeinyourstomach,isessentialforgooddigestion.

Finally,you'llfindtheanswerstoquestionsweallwanttheanswersto,whichiswhattoeatforahealthygut.


EPISODE 3—THE MICROBIOME: WHERE HEALTH AND DISEASE BEGIN AND END SUMMARY AND ACTION ITEMS Allergiesarerunningrampant.Skindisordersaremorecommonthanever.Andyet,nooneisconnectingthedotsthatyourguthealthistiedtoyourimmunesystem.Youareoutnumberedbymicrobes10to1.Microbesproduceover150timesmoregenesthanyoudo.Itturnsoutthatmicrobesliterallytrainyourimmunecells.Whenwehaveahealthypopulationofmicrobesinourbodies,wecanlowerourratesofautoimmunediseases.AwonderfulreferencebookonthissubjectiscalledEpidemicofAbsencebyMoisesVelasquez-Manoff.Fromlookingatthirdworldcountries,weseethatpopulationsthathaveawidearrayofmicrobesintheirintestinaltractsdonotsufferfromtheautoimmunediseasesthatmoreindustrializedcountriesdo.Inthisepisode,wehearthetermbiodiversityusedquiteoften.Thisreferstoharboringawidevarietyofmicrobesinyourbodytocalmdownyourimmunecells.Howdowedothis?Inthreeprimaryways.1.Weexposeourselvestolotsofmicrobes.

a.NaturalbirthvsC-section(swabbingifC-sectionisnecessary) b.Lotsofsiblings,closefriends,andpetsinchildhood c.Eatfermentedfoods d.Playinthedirt2.Wefeedthesemicrobeswellwithprebiotics. a.Breastfeed(sugarsorHMOs(humanmilkoligosaccharidesinbreastmilkfeedsmicrobes) b.Eatlotsofstarchyvegetables(esp.rootvegetables). c.Consumeprebioticrichfoodslikebananas,blueberries,apples,dandeliongreens,sweet

potatoes,acaciagum,baobabpowder,andgarlic.

Note:IfyouhaveIBSand/orSIBO,youmaywanttolimityourconsumptionoftheseuntilyourFunctionalMedicinepractitionerassistsyouinbalancingoutyourmicrobiome.

3.Welimittheexposuretothingsthatwouldwipeoutourmicrobecolonies. a.Antibiotics(ReadMissingMicrobesbyMartinBlaser) b.Antisepticproducts(soaps,lotions,creams,cleaners) c.Chlorinatedwater(filterscantakechlorineout) d.Pesticidesinourfood(ie.glyphosateherbicideslikeRoundup)Whatfruit,ifeatentwicedaily,couldlimitinflammationsimilartopainmedication?A.Bananas B.BlueberriesC.Apples D.SweetPotatoesNamewhichiteminhibitspropermicrobiomedevelopment.A.C-Sections B.Medications(antibiotics,anti-inflammatories,antacids,steroids,hormones)C.LowFiber D.GMOfoodsE.AlloftheaboveANSWERSinthebelowquotesfromtheepisode.


Dr.MichaelAsh:Sure.Applesprettymuchknowntoeverybodyasahealthyfood,eat1appleadaykeepsthedoctoraway.It'salwaysbeensomethingI'veknownfromprimaryschool,anditwasveryexcitingtome,probably10yearsago,todiscoverthatinamousemodelinitially,givingtheequivalentof2applesadaytothesemice,youcaninducethesamelevelofinflammationcontrolasaround10to15milligramsofasteroid,oralsteroid.Thisimmediatelytranslatedtomeishowdoweutilizethatinformation?...Howdowetranslatefromlittlemiceintohumanswasmynextquestion?Itrackedapplestudiesforquitesometime,andyou'llbeamazedhowmanyyoucanfindcomingoutnow.Abigclueforthisisthatapples,whenthey'repreparedcorrectly,andit'snoteatingthemraw,butcookingthem,andwedothatbybreakingthemdown,tryingtokeepsomeoftheskinon,becausetherearechemicalsinthatskinthatarealsouseful.Wesoftenitup.InEngland,wecallitstewedapples,andinAmerica,youcallitapplesauce,butit'snottheapplesaucethatyoubuyinthesupermarket.Youcook,breakdowntheapplesuntilthesurfaceoftheapplebeginstobecomeviscousandshiny.That'saproductcalledpectin.Pectinmimicstheliningofourgastrointestinaltract'sproductionofnormalmucopolysaccharides,whichisahealthyfluidthatwecoverourselveswithsowedon'tgetdirectcontact.Whenyoueatapplesthatarebeingpredigestedforyoubybeingcookeddown,thenweaddsomecinnamon,becausecinnamonhasapowerfulanti-inflammatorycomponentandweaddafewraisinssoit'snottoobitter,becauseweusecookingapples,andyoueatthatroughly2applesaday,peoplewithinflammatorybowelconditionsordifficultymaintaininginflammationcontrol,iftheycantoleratethat.Somepeoplefindtheyhavetostartmuchmoreslowly.Youwillreducenotonlylocalbutsystemicinflammationaswell.…Becauseapplesareacarbohydrate,theyhavesomesugarsinthere,somepeoplemayfindthattheygetabitwindy.Theyfeelabitbloatedortheyfeelabitliketheywanttoburp,becauseofhavingittoofast.Normallywhatwedoissuggestthattheytakesomenaturalyogurt,that'snonsweetenedornonflavoredyogurt,preferablyofanorganicorigin,andtheytakealittlebitofthatwithitandalsoperhapsaprobioticthat'sbeenrecommended.Aprobioticisacapsuleorapowderthatcontainsorganismsdeemedtobehelpfultohumanhealth.Therearedifferenttypes.There'sanotherwholediscussion,buttherearelotsofdifferenttypes.Youmightjustwanttostartoffwith3or4teaspoonsonday1,thenday2doubleit,day3doubleit,andjustseehowquicklyyoucangettothepositionwhereyou'recomfortable.Ittakesabout10to21days.Theaveragestudyis28daystochangethepopulationofbacteriainsideyourgastrointestinaltract.Thatfavorananti-inflammatoryresponsethatimpactslocallyandthentransfersthatinflammationthroughouttherestofthebody.Dr.MarkHyman:Ithinkthatthere'salotofthingsthatdisruptourgutmicrobiome.There'sourincreasingrateofC-sections,breastfeeding,changesinourfoodsupply,lowfiber,highsugar,GMOfoodsmayalterourgutmicrobiome,theoveruseofgut-bustingdrugslikeantibiotics,anti-inflammatories,antaciddrugs,hormones,steroids,allthesedrugsalterourgutmicrobiomeinwaysthatleadtoimbalances.


Whenyouendupdisturbingthegutmicrobiome,itcanalsoleadtoaleakygut.Itcanalsoupregulateinflammationinthebody.Dealingwithananti-inflammatorydietandahypoallergenicdietandoptimizingthegutflorathroughthefunctionalmedicineapproachorthe5-Rprogramwhichistoremovethebadthings,replacethenutrientsandenzymesthatareneededandprebiotics,reinoculatewithhealthybacteria,repairthegutliningwiththingslikeglutamine,zinc,fishoil,andsoforth,andrestorethebody'sequilibrium.Theseareallverystraightforwardprocessesweusewithgreatsuccessinautoimmunedisease.

“I have seen too much suffering. And it’s unnecessary suffering. After traveling the globe and interviewing some of the brightest medical minds on the planet, it is clear that there are simple options that can reduce and sometimes end the struggles of millions of people. It has been my dream to bring

these simple solutions to you and your loved ones so you can live long and vibrant lives filled with joy and hope. Thank

you for making this dream a reality.” Dr. Tom O’Bryan

Dr. O’Bryan is considered a ‘Sherlock Holmes’ for chronic disease and metabolic disorders. He is a clinician par excellence in treating chronic disease and metabolic disorders from a Functional Medicine Perspective. He holds Adjunct Faculty positions with the Institute for Functional Medicine and the National University of Health Sciences. He has trained thousands of practitioners around the world in advanced understanding of the impact of food related disorders and the development of individual autoimmune diseases.

Dr. Tom’s 2016 critically acclaimed ground-breaking book, ‘The Autoimmune Fix’ outlines the step-by-step development of degenerative diseases and gives us the tools to identify our disease process years before the symptoms are obvious.

TOM O’BRYAN, DC, CCN, DACBN

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