FIX YOUR GUT To Prevent Autoimmune Disease TODAY! | Mark Hyman & George Papanicolaou

you know so many millions of people suffer from this and what we understand about the microbiome what we understand that food is medicine you can get better so from your experience george what are the top things you think about when you're seeing a patient with inflammatory bowel disease uh well the first the first thing i think of is disordered microbiome i just think of uh i and then i think of all of the components that go into that from their diet specifically their lack of foods that are prebiotic and probiotic i think about the types of foods they eat that would be disruptive to the gut microbiome like grains that have glyphosate sprayed on them if you're not eating organically i i that's where i really begin to to dig down and dig deep i look at stress you know i will tell you that it's whenever one of my ulcer colitis patients or crohn's patients call suddenly with you know a a exacerbation it's come on and they're in a panic and they they want help eight times out of ten stress is triggered you know and the role of stress in triggering this disease and driving it and causing exacerbations and making it even more difficult to get under control so i think about lifestyle i think about stress i think about the role of exercise because exercise does play a role in controlling inflammatory bowel disease i mean stress and exercise have been studies have shown controlling stress getting your exercise i mean and altering your diet those are three things that can make a big difference so i think about those when a person's coming to me that that lights up um what the causes are you know they're you know there's obviously a genetic you know predisposition for people uh and so we think about that there's not a lot i can do to change the genetics at this point in in in medicine i think about the again i go back to the immune system we know that there's an immune sugaring that goes on and we know that the gut and the microbiomes very specifically is the gateway to the immune system and that's why i think about it first because we need a healthy gut microbiome to have a healthy gut lining or that mucosal lining because that mucosal lining plays a very important role of providing very concise and precise communication between the gut bacteria and the immune system because the gut and the immune system work very closely together to make sure that we are protected from outside danger things that aren't us and when that when that gut microbiome those bacteria aren't healthy then they're gonna you know that mucosal lining breaks down and now toxins and bacteria and viruses heavy metals can get back into our system and recirculate increasing our toxic load further damaging our immune system further creating inflammation to trigger or maintain that inflammatory process that we call collided ulcerative colitis and crohn's disease yeah what's great now is we're learning so much about the microbiome and so much about how to work with it and how to optimize it and how what harms it george is also the diet's such a key thing for most people and it's not only you know eating an anti-inflammatory diet it's not only getting rid of the food additives the emulsifiers and things like the carrageenan and other things that can cause damage to the gut lining but it's also thinking about how do we reduce all the potential inflammatory factors in the diet and all the potential food allergens and there's been some interesting research done on what we call an autoimmune paleo diet that's been shown to be effective for crops and colitis in in trials and i think it's really been overlooked for the most part but can you talk about what is an autoimmune paleo diet and how does it work for crohn's and colitis yeah so you know as i said earlier the the microbiome is the gateway to the immune system and we know that there is a strong immune component to inflammatory bowel disease the autoimmune paleo diet um i gotta put my glasses on so i can see you better and so the autoimmune paleo diet basically is going to eliminate foods from your diet that can trigger your immune system to have that autoimmune response and to create that inflammatory response and it's going to allow the the gut lining to heal um and so uh there are foods that are fought to really what do they take out what what is an autoimmune paleo diet what do they take out they're gonna take out grains legumes nuts seeds nightshades um eggs and dairy all of these have inflammatory components to them and so then you know yeah so that's the main things and you feel like grains and beans and nuts and seeds and eggs are supposed to be healthy so right so they are how does that your system begins to break down then those foods can tend to have you know trigger the immune system to have that you know an increased autoimmune response uh because what happens with some of those foods is that you develop the the mucosa breaks down so it can't do its job number one it can't break foods down so you're not gonna get your nutrients that you need number two that mucosa now this this very uh finely designed uh gate system is broken and these foods when they're not broken down into the smallest peptides possible can actually they don't have to be because the gates are broken so now you have these larger peptide forms and these particular foods their proteins are inflammatory to the immune system when they're larger and the immune system can't recognize them so the immune system begins to create the autoimmune response in the inflammatory response so that's why these particular foods are taken out and it includes alcohol coffee it includes processed oils you know corn oil canola cotton seed you know you want to not have those oils in your diet as well absolutely and so you're getting all that stuff and one of the kind of results you're seeing with those patients well with an aip diet uh we see very you know we see very good results you know we because a lot of folks when they've come to us they've never been told that you can eat a certain way to improve your symptoms so when we take these foods away for you know six to eight to 12 weeks it gives the the the intestine and the immune system opportunity to rest and now you can get healing of the gut because you are still eating very nutritious foods that are healing to the gut um we're able to once the symptoms begin to you know to um be vanquished um they're able to tolerate more foods we can get more fiber in we can get more probiotics in and then the healing process really begins and you know by 12 weeks we're seeing you know people with you know all symptoms are gone um and they feel great and that's leaving eip with with probiotics that's incredible i mean really when you think about the fact that this is such a debilitating disease that it's such a difficult challenge for patients that the drugs are so potentially toxic and harmful that you know so many millions of people suffer from this and that what you're saying george is in functional medicine we have a map to figure out why we have a approach to improve the microbiome to treat them with an anti-inflammatory diet and to reset the gut microbiome through a whole host of interventions that we call the 5r program in functional medicine we've talked about that on the podcast before we also you know tend to look for other things that people don't look for like heavy metals or inhalating infections or other issues yeah and it's amazing what you'll find and what you see and it's so gratifying you know of all the conditions i love it when i get a patient with crohn's or oh yeah colitis because it's such a slam dunk and for me i had one of those cases that just was not getting better and so i always get the cases you know the worst whatever it is and then i have to figure it out and i figured it out and i think you know there's other treatments that can be helpful and i used ozone i used exosomes there's a lot of different things but it's quite amazing when you see the potential for this yeah and i want people to know that you know it's there are look you're really sick you're not feeling well and you're having bloody mucusy stools and you're having them 11 times a day and you're having pain and you can't eat you're desperate and you know and then you're going to be told well guess what we're going to put you we're going to eliminate all the foods that you like um well you know what sometimes unfortunately we don't even we don't even you have to you can't even start an aip diet you know because people when they come can be so debilitated that they can't even tell they can't tolerate food so to really give their gut at risk i'll use something called an elemental diet you know an elemental diet is basically medical food that has all the nutrients that you need but doesn't require your body your broken mucosa to break down the proteins and the complex carbohydrates and so we're able to use the elemental diet to really rest and really get all the symptoms calmed down then move on to aip you then add in our probiotics and then we then we have other things that we can do for long-term maintenance of a healthy state and that is some things that can boost the immune system modulate the immune system i commonly will use things like low-dose naltrexone which modulates the autoimmune response and i'll use cbd with thc blends that again can have a modulatory effect on the immune system decrease inflammation in the gut increase appetite and so there are a lot of things that we can do in functional medicine just as you've just pointed out and those are some of them in a little bit more detail wow thanks george well listen we're going to get right into it so inflammatory bowel disease how common is it what is it um what symptoms do people get and and tell us about what we know about the disease in terms of a traditional approach from you know traditional conventional medicine um what's the approach to this because you know it just seems like a vexing problem and and we just seem to you know made some advances but still it's it's not great yeah so you know it's it's very common there's about 300 3 million people have it per year in the united states of america that is actually up from two million in two thousand so there's a very steep in uh increase over the last several decades and the projections are that's going to increase an even more rapid rate over the next 20 years so ulcerative colitis crohn's disease which both are the are the two major inflammatory bowel diseases uh are frequent and common and are very very disruptive to the people that have they can really just completely upend their lives um you know depending on how quickly you want to get into this i can get right into i'm just thinking of all my patients and they're suffering i can tell you that when it's uncontrolled there is a lot of pain there's a lot of diarrhea um there's an inability to eat there's fatigue and weakness that keeps people from being able to weight loss weight loss you know all those symptoms um malnutrition can be included in there so there's a there's a lot of people that have it it's a growing problem and when you have it it's very disruptive and even when you are well you have to work hard at staying well yeah it's a huge problem and and you know it's basically an autoimmune disease of the gut it's amazing to me as in traditional gastroenterology i've talked to gastroenterologists and they're like oh you know what you eat doesn't really impact it i'm like wait a minute you're putting pounds of some foreign substance in your mouth every day that's going through your gut how could that not affect it right it's just so striking to me that there's just this complete almost ignoring of the role of nutrition and food in what's going on with gut disorders that's just kind of a meta a meta comment because obviously to me yeah but to make it to retort with another meta comment i would say that in our food yes but in that food are toxins and in our environment and we have medications and we have you know we have xeno we have endocrine disrupting hormones all of which end up in our gut in our in our gut microbiome and are very disruptive and if a person has a genetic predisposition to ulcerative colitis or crohn's inflammatory bowel disease in general then they're going to be at a high risk for triggering that gene and developing that disease they have a predisposition for it's our diet it's our environment it's the stress all of those can trigger your genetic predisposition absolutely absolutely because you have to ask yourself the question like why have we had you know such a rapid increase over the last several years what's going on and you know and this is you know this is your area that you just you know you're you are the the leading edge of the medical voice and understanding agriculture and food production in our country and how it is it is toxic and why it's toxic you know we don't have healthy soil and that's where it begins because if we don't have healthy soil we're not going to get the nutrients in in our gut soil to grow good bacteria and have a healthy microbiome so that our intestines can stay healthy and do their job for us yeah it's such a big deal and you know from a conventional perspective the treatments are really to shut down your immune system right oh yeah prednisone steroids chemo drugs tnf alpha blockers things that you know increase risk of cancer and infection um they're pretty extreme drugs and they can be very helpful and they can be life-saving and they can work for people but the question is is there an alternative yeah and do you know do we have to deal with this the same old way we've been doing with it and then of course for a lot of patients who have it sometimes they need surgery appear they need total colectomy for ulcerative colitis so they remove your entire colon or resect whole sections of your bowel with crohn's disease which doesn't really even cure the problem it's just a rough rough disease it is rough and i think you and i can bring people some really good news today that using functional medicine and what we understand about the gut microbiome what we understand about food is medicine you can get better and stay better without having to use the the kind of drugs you just mentioned that can lead to cancers down the road people on immunosuppressive drugs you know followed for 20 years or you know they're already at very high risk they're already increased risk with implant inflammatory bowel disease for you know colon cancer and then if you put them on a a uh an immune suppressive drug and followed them for 20 years you know they have increased rate of skin cancers by about 40 percent uh and so you know and and during that period of time they've increased rates of infection they have side effects to the medications they have to come on and off them they have to try new medications um and and and but by and large you know they're they're moderately effective and sometimes not effective at all for some people for sure and i you know i think that um people suffer a lot from this and it can manage the disease but it often doesn't go away or it's not curable but from a functional medicine perspective it can be really curable and i can tell you so many patients that i've had i mean i just actually how i got the job and probably how i got the job job at uh at cleveland clinic was because i met someone to the ceo who um whose niece had severe colitis was tried all the medications wasn't working was about to have her total entire colon removed at 32 years old and i said look just have her come to me no promises but no it's worth trying before she rips out her entire colon which is irreversible right and i think she was skeptical uh she was from new orleans and probably wasn't the healthiest you know lifestyle down there and she agreed to do what i told her to do but she was quite skeptical but i changed her diet i reset her gut microbiome you know did sim simple things simple things and six weeks i talked to her she said um i'm perfect i'm fine i'm on no medication and i'm like what literally six weeks and they were gonna take her colon out and she's symptom free and offer medication and i can tell you story after story like that another young kid was 25 years old same thing about take his colon out just some simple dietary lifestyle changes and and getting the gut microbiome straight and resetting the gut with the functional medicine for our five-hour program is so key so i think well it's it's it's we had talked earlier as we were preparing for this and one of the one i think with the first things that happened and you can correct from wrong but you met with dr rogerio who is a gi doc clinic you know to you know work with functional medicine and traditional and conventional forms to treat um ulcerative colitis inflammatory bowel diseases and that that sounds like a phenomenal um partnership absolutely it really is and i think there's a real openness to understanding there's there's really room for this including with everything it's not either or yes how do we how do we create the best conditions for a patient to get to health and i think i just in terms of causes let's sort of dive into that because from a functional medicine perspective you know we really look at root causes and today i was you know going through my medical research that i do every day and just sort of looking at what's new and i was sort of shocked to see this well not really shocked she kind of expected it but i was shocked to see it sort of published so prominently in in a medical journal really really discussing the uh way in which food sensitivities i mean that's right food additives and ultra processed food will drive changes in in people's gut so when you look at this data it was quite interesting they looked at uh mice and people and they basically showed that high sugar processed food diet affects the gut and in a harmful way we also know that there's a lot of emulsifiers and atoms in food like their thickeners even things like microbial transglutaminase which is a like a gluten product that's put on purpose in food to make it stick together because gluten makes it glue makes it stick together and and uh and so we we have to sort of think about when we take care of these patients what their causes are and you know and i and i've seen all sorts of cases of of crohn's and colitis and you know i i i just share another story of a guy who i saw years ago who had severe colitis was really losing weight struggling i tried all the normal functional medicine stuff reset his gut microbiome did the 5r elimination diet you know tried everything the right supplements it just wasn't getting better and so i went back to the principles first principles that i learned from sid baker which is what could be bugging this person that needs to be gotten rid of is there something else that i'm missing and what am i missing is there's something i'm missing yeah so i went back to the drawing board as my medical detective had on and and found out this guy had really high levels of mercury and it wasn't until i chelate his mercury that he was able to correct his colitis and it's now symptom-free um i personally had a different cause you know i was i was somebody who was mostly had a healthy gut most of my life and then i developed mercury poisoning and that messed up my gut i didn't get colitis but i had really bad irritable bowel and bacterial overgrowth and all sorts of issues that i cured but then a few years ago about five years ago i got a confluence of events where i ended up having to take an antibiotic for a bad tooth and and a root canal and it was clindamycin and this antibiotic is known to cause c difficile which is a really common intestinal infection that causes death in about 30 000 people a year and all of a sudden i started getting not just you know diarrhea and this and that from it i started getting really severe pain nausea i'm going to the bathroom 20 times a day bloody bowel movements was just it was miserable i literally was in bed five months running back and forth to the bathroom and turned out i had developed colitis from the c difficile and then continued even after we cured the infection the colitis continued and so i had to really go back to the drawing board to think about what do i do because i had mold exposures and i had all these imbalances i had low echomancy so i learned a lot about on a personal level which i really didn't want to learn that way but i learned about what the symptoms are what it does and how to actually start to think about fixing it differently yeah and for me i did a number of things i used a cocktail of i called gut food which is a cocktail of components that have i think not really been put together too often including prebiotics probiotics polyphenols and immunoglobulins and things that really helped the body to reset the gut and i also dealt with the mold that i had in my house and i also used ozone to help boost my immune system and kill infections and it was really amazing within a very short time i was able to really recover and i think a lot of us sort of struggle without really knowing what to do and even sometimes when you do an elimination diet if you have colitis you don't necessarily always get cured because there may be something else going on and maybe yeah like what i had maybe there was um you know c death or maybe there was mercury or maybe you know there was something else going on but you can you can really help these patients so much crohn's is often a little more challenging but we do a lot of different approaches so traditional medicine is pretty cut and dried so what are the kind of things we find um that work the best and and talk about from a dietary approach and then sort of drill down into the other aspects of our treatment for for colitis and crohn's disease right so the you know neck and neck it's diet and we've got microbiome right so it's really neck and neck and i will say you know with the gut microbiome um it's very intriguing because i there's more and more research being done into the differences between a healthy gut microbiome and the gut microbiome of a person that has inflammatory bowel disease and there are significant differences and in there in a person that has inflammatory bowel disease one of the you know key bacteria as you mentioned earlier is acromancia yeah acromancia plays a role in keeping the the mucosa of the gut lining the goblet cells really healthy it breaks down the mucin and then when it breaks that down it turns it into short chain fatty acids and we know that short chain fatty acids are the you know that's the honey of the the the you know the colonoscite it just loves you know its short chain fatty acids and that keeps it really healthy people who have inflammatory bowel disease tend to have really low levels of acromancia and it's not uncommon for me to find that they're not even detected when i when i do the complete diagnostic stool analysis on the patient so replacing acromancia you know has has been shown to have you know an important role in helping the gut mucosa heal there is a study that i had come across in preparing for this it was in the european journal of inflammation 2020 and it basically uh in this study they took by phytobacterium another another strain of bacteria that is found to be really low in patients with inflammatory bowel disease and they took a specific strain by fetal bifidobacterium lactase and they combined it with xyloglucan which is a non-digestible fiber source so they had a prebiotic antibiotic together in a patient with ulcerative colitis and they followed you know all of the patients um in the study and control groups and they found that there was at six weeks the study group um had significantly more healing and resolution of their symptoms more healing of the gut mucosa and um healing and resolution of their symptoms and this is just they had no other therapy this is just a prebiotic and a probiotic and that they use and so using probiotics you know to control and to resolve an exacerbation can be really critical and i think we're learning more and more about how they work there are other probiotics or there are other bacterial species that are missing or are low concentration in patients with inflammatory bowel disease including lactobacillus gg sarcomyces boularde and when you replace these you find huge benefits so i use probiotics pretty quickly in a patient i also will use there's a probiotic called vsl number three a lot of people know about that because it's frequently used um and it's really powerful it has all the screens of lactose bacillus and bifidobacterium that are low and very and are also very helpful in healing that gut mining mucosa and just by using that i've been able to help people start to feel better and see their symptoms resolve so as you can tell the microbiome using probiotics um are really a big part of how i'll treat my patients um but that has to be balanced about what you can tolerate and where they are in their disease um because the diet then becomes really important sometimes i can't give probiotics right away sometimes i've got to get this person eating i've got to get them feeling better before they're there they can actually tolerate the addition of the probiotics what what are the kinds of diagnostics you'd see us using with these patients to figure out what's going on with them well traditionally you're you know first you're going to get there i always like to go back to the basics you know you've got to remember that we're doctors are cognitive beings we are medical detectives we like to think so i think you need to make sure that you're listening to the patient's story hearing all instruments and doing a really good examination and making sure you do that part because that's where you get you find those predispositions you find those triggers and you find those mediators that are so important because that begins to those are the categories you think in to solve the mystery okay so once we've you know i've done that piece and i have a really good idea of what the predispositions are i have a really good idea of what the potential uh triggers are because those triggers can give me an idea of how i'm going to help them get better and control it down the road and some of the mediators and perpetuators um you know that could be you know stress or they could be their diet once i have those pieces then i say okay you know what i'm pretty sure you have ulcerative colitis you know how do we how do we know for sure um we can check inflammatory markers like something called calprotectin which will be very elevated in people with inflammatory bowel disease and then we can also visualize and it's it's the gold standards to visualize with the colonoscopy the intestines and you can you'll probably do both in upper and lower and you'll see that with crohn's disease uh it can involve the entire intestinal tract whereas with colitis it typically just involves the very end or the distal part of the large intestine the rectus sigmoid and the first third of the uh or the last third of the colon and that would be that we'll visualize it uh through colonoscopy so those are that's the conventional way and then yeah once they once they land in my lab after you know being frustrated um by just not getting better or finding that their diet's really restrictive and they're constantly having symptoms and they're not finding any answers in the places they're looking in the conventional medical world then i i immediately you know go into action and i'll look at you know the complete diagnostic stool analysis where we will get a full complete picture of your digestive processes are you making enough gastric acid pancreatic acids um do you have markers of inflammation is your detox system in your gut working correctly is your immune system responding over responding under responding and it will also tell us very specifically the diversity and abundance of your gut microbiome and so it's one of the it is the first test that i'll get but i'll also look for other things and we should have mentioned this earlier but i'll look for sibo which is small intestinal bacterial overgrowth i will look for food sensitivities particularly to gluten i'll look for a leaky gut and i'll also look for those cross-reactive foods foods that act like that can create inflammation if you're sensitive to gluten and then be a trigger for your ulcerative colitis so those are those are some of the tests i'll do an ion profile or a micronutrient it's a functional evaluation of all the most important biologic processes that your body does and it allows us to determine which systems are or aren't working and if they're not what nutrients are you missing do you have particularly when it comes to mitochondria do you have uh compounds or toxins that might be impairing those functions like with you you had mercury um uh elevations that probably were impairing your mitochondria probably impairing your immune system and on top of the other conditions you had may have you know typically took you over and made you more susceptible to the the adverse outcome with a antibiotic so we're looking at all those things and those are the tests that i look at and i you know i may do you know some um well yeah i usually will stop there in my first tier i usually get most of all the information i need with those tests yeah it's true i mean i do look at food sensitivities look at the gut look at heavy metals and and those can often be so helpful in figuring out what's really going on with people and then you end up being able to sort of customize their treatment based on what you find and you know there are some dietary approaches but you know when you get you don't deal with the root causes and figure out what you're doing initially it's a problem that's really what we do at the ultra wellness center we map out what's going on with people at a much deeper level i mean look at things that most traditional physicians just don't look at like who's measuring acromancial levels what we do because we know what this particular bacteria does right we want to know what your nutritional status is we want to know whether gluten is an issue we want to know what's going on with your gut is it leaky i mean we do all these things and then we then we implement a plan do you wanna know my secrets for living a long and happy and healthy life well all you have to do is check out my weekly newsletter mark's picks where i share my favorite tips for health longevity well-being and lots more check it out and the link below there's not a patient that comes to me that even if they're coming for one thing that we don't end up talking about their gut it seems like gut issues are epidemic it's huge huge it's huge and ulcerative colitis and crohn's disease i think are at the apex of the severity of what can happen when you have you have a poor diet you have a disordered microbiome and now you have an immunity you have a an immune barrier that's broken and now your immune system's you know under you know under you know siege and it can't respond appropriately yeah well i'm telling you george this is one of the areas in functional medicine that i've found over the last 30 years has been such a gratifying area because people really suffer the traditional approaches are kind of limited and the potential to heal the gut through restoring the microbiome changing diet and some simple measures is just huge it's huge and so i'm excited about having you know having this podcast with you because i think you know when we see when we see these interventions in functional medicine working out the way they do it's just such a life-affirming thing for me as a physician to know that i'm helping someone and i've been there like i've had all this i had 20 bloody painful balance today i was nauseous and pain for five months i was just yeah it was in bed like all i could do was go bed bath bed bath it was like it was terrible and and now i think you know um we have such a clear road map to how to fix this and there's some other weird things that people are doing like using worm therapy and other things helmets helmets i don't use that that often but it can be helpful so there's a lot of tricks in the functional medicine tool kit um and george you've been really great helping us understand inflammatory bowel disease tell us first what is leaky gut yeah so so many people are like saying the word leaky gut leaky gut but officially right the official medical term is increased intestinal permeability and i love to draw a picture for all my patients when they come in to really show them what we mean by increased intestinal permeability yeah i failed art in the eighth grade so i just show up on google images i don't know that's good that's good i don't know i'm still drawing it each time i go to google images that's very smart so we know there's this one cell layer right there's that one cell layer the end of the of the endothelium that divides the inside of the intestine right so where the food is and all sorts of other things your gi tract is a tube literally outside of your body right i mean it's a protective tube that you put food in all the stuff goes in it comes out the other side and it's literally like uh not really part of your body in the sense that it right the stuff inside isn't yet in your body right right so but there's that cell layer that has to determine what should come into my body right and what shouldn't what's been properly digested food you know has this has this protein been broken down enough yet um should this come in should they should i absorb this or should this stay out so that very like a filter it's like a coffee filter you don't want the grounds getting into your coffee but you want the good stuff getting it and that's sort of how your gut is supposed to work that's that's great yeah and when it does it's like you have holes in your coffee filter and stuff leaks through right and why is that a problem right because that that stuff leaking through that might be a food particle that's not digested enough yet or it could be a bacteria or a bug a fungus or some something that shouldn't be getting into the body some of the not so good bacteria and and when when those things that they get into the body when they're not supposed to then they can trigger all sorts of other symptoms in the body and that might be symptoms of inflammation so somebody might feel like joint pain or asthma congestion it may trigger and there's been a lot of studies to show this it can trigger autoimmunity yeah right allergies autoimmunity asthma all kinds of fibromyalgia yeah but we know what's interesting is that most diseases that are chronic diseases are inflammatory diseases yes right heart disease cancer diabetes alzheimer's stroke i mean these are all inflammatory diseases even depression yes is an inflammatory disease of the brain add is inflammation the brain autism is inflammation of the brain and so you know what's really interesting about this gut issue is that when the barrier breaks down and you're basically like a an area the size of a tennis court if you laid your intestines out flat and it's like you know one cell thick so you're basically one cell away from a sewer you know on the other side an important cell right yeah it's like and and that can get damaged and when that does things leak in like you said and you've got 60 of your immune system right under that layer which then reacts to whatever's coming through that's not supposed to come through yeah so your body's actually doing its job creating the inflammation yep it's just that your gut's leaky and the stuff getting in you shouldn't be getting in right and then and then you start to not feel so good yeah right like you mentioned fatigue or brain fog or or joint pain or swelling in the body we see a lot of people holding onto water or or swelling or congestion or asthma and then that whole cycle of autoimmunity also yeah so it's really uh you know one of the most prevalent problems and so why are we having all this leaky gut oh right that's a great question right and it's so much because of our crummy food supply what do we know about that yeah listening to me that's all i talk about so our crummy food supply that we've been putting a bunch of you know pesticides and antibiotics into which is just shifting our microbiota and i mean it's glyphosate from yes the roundup the weed killer that's on almost all our gmo foods and even wheat products is one of the biggest damagers of your microbiome forget that it causes cancer whether you can argue that or not but it does disrupt your microbiome right right and you know we of course are trying as physicians not to prescribe as much antibiotics for our patients but so many of us have taken unfortunately too many antibiotics and then our food supply right you know we're using so much antibiotics in our food supply to grow bigger cows for example and that's just shifting our whole that whole microbiota in our gut it's true i read a paper recently about emulsifiers in food which is using all processed food to make it thick or you know solidify it hold it together and and these emulsifiers like carrageenan and xantham gum and they even have this thing called microbial translutaminase which is basically bacteria made gluten if you can believe that and the reason it's called gluten is because it's like glue so it makes things stick together makes the food stick together right but it's highly damaging to the gut and so you've got all these processed food ingredients in food that are linked to autoimmunity yep right so it's not even and then of course the starch and the sugar the processed oils all damage your gut and then of course the lack of fiber the lack of phytochemicals in our diet the lack of food foods prebiotic foods probiotic foods like i had sauerkraut for lunch yesterday i mean we don't need that stuff and it's so important and we've seen so much damage to our gut because of all of these various factors in our diet and then of course there's the acid blockers that we take for everything right antibiotics as you mentioned hormones can mess up your gut bacteria you know steroids can do it and so you end up with antibiotics obviously end up with this horrible cascade of people with gut issues it's the number one reason people go to the doctor so much of it now it's it's crazy isn't it i mean it's so many people are coming in with with digestive issues with um and and symptoms of inflammation in their body but it's it's it's really common even if people are coming to us for other reasons yeah we're seeing okay it's the gut and we've got to start with the gut and and pay attention to what's going on there you know functional medicine has been thinking about this for decades and uh you know now there's a microbiome revolution everybody's talking about it there's huge industry development around it was talking about probiotics and this that and and we've been focusing for decades on the simple fact that most of our chronic illnesses start in the gut yes and whatever the name of the problem you have whether it's migraines or whether it's depression yeah or whether it's diabetes or obesity i mean arthritis or autism or whatever you got to start with the gut yeah and and traditional medicine like leaky gut is not a thing like you go to the doctor if you have arthritis they're like how's your gut right you're going to cardiology how's your gut like even though there's so much research showing the connection you don't get trained and so right there's this huge gap right now where the science has advanced so far but the practice hasn't right and in functional medicine we've been really great at actually getting the memo that the gut is at the center of our health right so for years right we we've learned about that 5r program with function functional medicine and and and how helpful that can be to heal the digestive system and then and then heal all these symptoms or diseases that somebody has yeah i mean it's amazing i was talking to the ceo of cleveland clinic recently and was telling me about studies that he had heard about that had used fecal transplants in autistic kids yeah and taking the poop out of a healthy kid and put him in an autistic kid and the kids autism goes away it's phenomenal i mean that's not true for all kids with autism but it's phenomenal yes it's amazing or they're doing transplants from people who are thin to people who are diabetic and their blood sugar gets better right i mean i had a guy once who was a really great patient and he was very poorly controlled diabetic on lots of medications and we worked on his diet it helped a lot took it down from like 200 to like the 120s or so but we never could get it all the way down it was a really good diet and exercise and he was telling me he had a bunch of digestive issues and so i said you know why don't you take some charcoal and do this and do that and and he called me back he says i don't know what happened but my blood sugar went to 90. right so we absorbed all the toxic crap in his gut that was causing inflammation that was causing his blood sugar imbalance and these are the kinds of things that we do every day in functional medicine but that are not part of traditional care and people are missing out on right right when we're saying why is that why is this going on how do we get to that underlying root cause for that individual person so so you've got some um amazing cases uh and i think i'd like to sort of get into it because you know people don't understand how so many of our issues come from the gut and how easy it is to diagnose it and treat it and we use tests that traditional doctors just don't do like we have a different set of uh lenses a different set of of filters that we can sort through information and data and ask questions that traditional doctors can't like how do you measure a leaky gut how do you look at the microbiome in the gut how do you look at the digestive function in the gut how do you actually start to treat it in a different way and your your first case is just so rich with uh a story that is so common that i i just love you to share this because i think i think everybody's gonna resonate with this story and by the way i've never seen this patient as you're patient but i have i've literally seen the same story a hundred times or maybe five hundred times or a thousand times in my practice the same freaking story right so tell us about this so he's a 24 year old gentleman who came in to see me and was really struggling over the last year with his digestive system he was having a lot of bloating and gas pain in his stomach every time he ate he was having diarrhea and sometimes he was getting constipated and um he he went to his traditional uh gi doctor and they told him you have irritable bowel and um but he he wasn't getting any better right and he was just really he was because he was having so much stomach pain he had lost some weight so he wasn't you know he um was on the thin side to begin with but because he was having stomach pain when he ate he wasn't able to eat as much and he was even losing more weight he was feeling really weak and tired and sad depressed right and so for him the time well for everyone the timeline is so important right that's what we we learn we learn in functional medicine is that gathering that information learning about that individual patient's story seeing so we start we start we start with a history with the mother and her pregnancy right and the birth and where they breast fat and when they took antibiotics whether they were sick as a kid what happened when they were introduced to food when they got gluten when they got dairy we ask all these questions so when someone comes in with irritable bowel the average gi guy is not asking all these questions right so why do we ask all those questions so you know because because for this gentleman for example you know he really didn't have stomach pain before a year ago but what we found out is that when he was a kid he had ear infections so probably because he was eating dairy probably right so it's such a common connection i remember being in the er liz and i this uh patient came in and this little boy kept coming back and like the toddler was coming back over and over to the er with ear infections and yeah just so inflamed and i said how was he like like did you breastfeed yeah so when did he start getting the ear infections when we started formula and dairy and milk and i'm like oh okay and this is even before i knew about functional medicine i know and i was like well maybe you shouldn't eat dairy yeah yeah the kid was fine you know right that's such a such a common connection i mean even my son with when he started dairy he got asthma and um eczema it was it's it's unfortunately such a common connection so for this child he had a lot of ear infections and um and and and eczema and so he was on antibiotics about once or twice a year in his childhood and he really didn't think that was very much yeah he's like that's not you know that wasn't too much but you know it makes a huge impact on the microbiome as we're learning and then he started to have acne as a teenager maybe because of dairy more right um or or some of the in the imbalances in the microbiome right when you screw up the gut with antibiotics or a c-section or lack of breastfeeding then you get often more acne yeah you know we treat acne on the from the from the top in as opposed to the inside out which is actually where it works much better and this this gentleman was given uh low-dose antibiotics for two years so then he took even more antibiotics and so this history of antibiotics sort of set him up and about a year ago he had some sort of stomach bug so some probably viral stomach infection and then since that time he started to have all these digestive issues and was losing weight and so this is a common story people are so they're sort of smoldering a bunch of insults over the course of their life you know maybe they're a c-section they're antibiotics as a kid they took acne antibiotics they got you know they were eating a crappy diet whatever and all of a sudden something happens and then boom the body right can't take it anymore and it creates some kind of disease yeah but if you look at the story you can often map out exactly how this happens that connection with his acne with his asthma with his digestive issues with those antibiotics that's that story we we often see and we're not making this up there's so much science that shows that your gut microbiome plays a role in acne and eczema and asthma that it plays i mean we're we're actually doing this at cleveland clinic now we're studying asthma and looking at how the microbiome plays a role and how it affects inflammation all these various factors that most doctors don't pay attention to right so with him as we do with most of our patients we do food first right so we said okay we've got to really focus on this person's diet and help him start feeling better right away so he can start to eat more and regain some of his strength so we pulled away inflammatory foods we took them off of gluten and dairy while we were waiting for tests to come back um you know sometimes we will do some tests that look at of course we'll test for celiac disease um or which is a big cause of leaky gut yep that's for sure probably the number one and he didn't have that but by the way you don't have to have celiac disease to actually have a problem right you can have they call it non-celiac gluten sensitivity yeah i would estimate it probably affects 20 percent of the population and i think if you look at the antibody levels you can get a clue which most doctors don't look at and i read a study that autistic kids and schizophrenic patients often have 20 of them have antibodies to gluten yeah and it may not be full blown celiac absolutely and and even you know irregardless of even if it people are negative totally for celiac um if they have increased intestinal permeability they start reacting to a lot of different foods yeah so then you start to see with that with that leaky gut as we talked about before right the coffee filter and things are coming through then the body's reacting to lots of foods that it maybe never reacted to before so they're not true allergies they're more like sensitive sensitivities and because of and the real thing is it's because of this increased intestinal permeability so our job is we have to heal that increased intestinal permeability so that they don't have to be so restrictive with their foods i mean we still always want them to be on a healthy diet but but we want to we want to relax those restrictions over time we most of the time we can yeah and so so it's part of the approach of functional medicine we start them on the elimination diet so eliminating all the inflammatory [Music] into each of those because they're really important but the the the the next step is also there's other things we may need to remove there's a test we need to do so what kind of tests would you look at as a functional medicine doctor that you wouldn't see at a traditional doctor's office that give us a roadmap of how to treat these patients right so we did a stool test that looked at his microbiome and what we noticed is that there was an overgrowth of unhealthy bacteria and unhealthy yeast so he had this you know probably because of years of antibiotics he developed this dysbiosis this imbalance in the bacteria and yeast and so there was an overgrowth of the unhealthy things it's like wheat having a lot of weeds in your garden yeah right right it's not it's it's not always like one of those do you think of a stomach infection and you're getting really really sick you're throwing up or having diarrhea this is this it's a it's an imbalance and it's called dysbiosis but that imbalance causes a lot of symptoms in people when you have the wrong bacteria and the wrong yeast levels you can get a lot of bloating after you eat you can get a lot of fatigue after you eat you can get those symptoms of constipation and diarrhea and and that causes this inflammation in the digestive system so all of your digestive enzymes don't work well so you're not breaking down your food well you're not absorbing your nutrients well and it becomes this vicious cycle that people are dealing with and we see all the time yeah it's so it's so powerful so so you know you know when i see this patient i'm like okay you don't do all the tests but sometimes if you get stuck you look at you know various tests that look at the antibodies against things that that are in the gut that determine a leaky gut right you can call it cyrex ii testing which is a test you can get through function right is there you can test to see if there's leaky gut i love that test too because it's a great way for us to follow up and see how much we're seeing seeing improvement right are we doing enough right um are we seeing improvement in in in their leaky gut or increased intestinal pressure then we look at poop testing like you know where we do thousands and thousands of these tests and it's so helpful and it doesn't just look at the microbiome it actually looks at the function of the gut yes like whether there's malabsorption whether you have no digestive enzymes whether there's inflammation whether there's overactive antibodies in there whether you have uh imbalances and what we call the short chain fats which are the the food for the colon that are produced by bacteria eating the right kinds of fiber and if they're low it means there's an imbalance then we look at the microbiome we look at what grows we look at parasites and then we we target and micro target the things that are out of balance for that person and it's different for everybody then we might look at food sensitivity testing we might look at at um and even things like heavy metals or other things which can also cause it i had a patient with ulcerative colitis once and i did everything right i did the whole 5r it wasn't working but i forgot the first part of the r which was remove and i thought well maybe you know heavy metals can cause autoimmunity maybe it's a problem and so i tested him and he was like wasted away and he was like it was terrible he actually had high levels of mercury we treat his mercury and his colitis went away so it's phenomenal yeah yeah so i think it's it's so powerful this case is so important because it really describes how a patient you know goes traditional doctor is diagnosed with the disease irritable bowel syndrome by the way anytime you hear syndrome it means doctors know what that's going on it's just a collection of symptoms that we agree we're gonna put in this bucket and if you have those symptoms you have this disease but it's not really a disease right and and so that's what functional medicine sort of looks upstream to figure out what the root causes are and and and personalize the treatment for everybody and there's common things that we do like the 5r but it may be different r's for each patient right right right so for him we removed you know the inflammatory foods and we removed the bacteria and yeast i actually treated him with an uh an antibiotic a non-absorbed antibiotic and an antifungal um so i treated him with a prescription medication a weed killer so that was the remove right and then the replace because he was underweight and because of that inflammation in his digestive system i gave him some digestive enzymes for a short period of time just to help him help it so the food wasn't as inflammatory for him and to help him absorb more nutrients um and then we then we worked on re-inoculating right so after we we gave him some good probiotics put in the healthy bacteria put in the healthy bacteria some good prebiotics right so we know that what are probiotics prebiotics are the are the things that help feed the good bacteria so they're the food for the probiotics which is usually what like like fibers fibers are amazing prebiotics we know a lot of phytonutrients are prebiotics so this i think is really exciting research when we're looking at our phytonutrients you know we know that phytonutrients right so i know it's amazing right so so our food has has minerals in it it has vitamins but it also has these things called phytonutrients which are these components in our plant foods that um have this amazing health benefits for us so that can include things like elagic acid that we see in pomegranate that can feed some of the good bacteria that acromancia that we know can lower inflammation we know that um just just to back up on that necromancy thing so when we look at the poop we can tell if there's like good levels of different bugs one of them we look at is akkermansia and it turns out that that is so important for protecting your gut it helps you keep your biofilm or that little coating over the gut so you don't have a leaky gut and it's involved in so many autoimmune diseases in response to cancer therapy and metabolic issues and weight and it's such an overlooked thing and you can't take a probiotic of it at least not yet right but you can feed it the good guys we can feed it we can feed it with all these amazing phytonutrients like the what's in pomegranate um the electric acid and also we know that sulfurophane from our cruciferous vegetables feeds the good bacteria yeah you know so broccoli collards kale but not juicing right brussels sprouts all those good ones um we know that green tea you know that has good phytonutrients in it that's good for the digestive system so we always say to people you know get something from every color of the rainbow every day you know you'll get some plant foods from every color of the rainbow every day get some good red foods like the pomegranate or cranberry get something orange and yellow and green blue purple white tan you know those all those good healthy plant foods um that we you know like our vegetables our fruits our spices our teas our coffees really actually are impacting our microbiome which is is fascinating so great and you know just a great anecdote from a colleague of mine dr lee who was on our podcast talking about eat to be disease his mother had stage four uterine cancer and being the smart doc he is he understood from the research that if you have low acheromancia patients don't respond to the immunotherapy what they call the checkpoint inhibitors which is this new form of cancer therapy that helps activate your immune system so if your gut isn't healthy you can't actually get the cancer cells to die with the immunotherapy right so basically you die unless you have good bacteria in your gut and so his mother was had stage four uterine cancer and was gonna die and wasn't responding and he gave her pomegranate cranberry green tea all these phytochemicals got her acromancial levels up and she was cured of her stage four cancer within a month that's a phenomenal story it's an incredible story and i think that just shows the power of these plant foods of the plant foods and of getting focused on the gut yes hey youtube if you like this video you're gonna love the next one click on it to check it out today and our diet also uh plays a huge role in the growth of good or bad bacteria so you can feed it certain things and it makes it worse and other things and it makes it better so talk about that yeah so so i always tell patients that when you're eating food you

Channel: Mark Hyman, MD

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Length: 59min 24sec (3564 seconds)

Published: Mon Aug 16 2021