Probiotics, Cold Plunging, & Lab Testing

May 18, 2024

From podcast: https://bengreenfieldlife.com/podcast/best-of-gut-health/

[00:00:00] Introduction

[00:00:46] Coleen Cutcliffe and alternatives to GLP-1 weight loss drugs

[00:11:15] Dr. Hanaway and microbiome testing

[00:21:54] Raja Dhir from Seed Health and supporting children’s microbiome

[00:36:08] Lauryn Lax and her book on gut health

[00:55:39] Ben’s ad for his house

[00:57:18] Joel Greene and cold exposure for fat loss

[01:06:45] Closing the Podcast

[01:07:11] End of Podcast

[01:08:11] Legal Disclaimer

Ben:  Fitness, nutrition, biohacking, longevity, life optimization, spirituality, and a whole lot more. Welcome to the Ben Greenfield Life show. Are you ready to hack your life? Let’s do this.

Welcome to the “Best of Gut Health.” I have assembled in today’s show the best of the best of my snippets from some of the coolest gut health podcasts that I’ve ever recorded. If you go to BenGreenfieldLife.com/guthealthpodcast, you’ll be able to access the shownotes and take a deeper dive into any of these episodes which you’re going to hear the best of the best from. 

We’re going to start off today with Pendulum‘s Colleen Cutcliffe. And she introduced me to alternatives to GLP-1 weight loss drugs like Ozempic but alternatives that are natural and safe and effective including how you can stimulate GLP-1 with specific forms of bacteria. This was a fascinating podcast. I’ve been experimenting with some of the peptide she sent me based on this GLP-1 agonism and it’s incredible. So, let’s jump in and hear what Colleen Cutcliffe has to say. 

And, I’ve got this blood glucose monitor and I can hold my phone up to it. It’s a Freestyle Libre. It’ll tell me my blood glucose in real time. And, I was thinking about the fact that gosh when I test this, this is measuring the sugar in my blood, but how the heck do you make the connection from a bacteria in my gut to the sugar in my blood? I think that it would be really helpful for me to wrap my head around this whole gut metabolism axis if you could describe how this actually works, what I eat, specifically the bacterial content in my food or the biome in my gut. It actually influences something like blood sugar.

Colleen:  Yeah. I think, at first, it’s sort of non-obvious how your gut bacteria might be influencing your blood glucose spikes. And, I actually also wore a continuous glucose monitor to understand what impact the products were having on my own blood glucose spikes. But fundamentally, everything we eat first goes into your stomach, you have all these stomach acids and they kind of break down your food to some extent. But, more importantly, as your food parts go down the digestive tract, they hit the gut microbiome. And, this is where the real metabolism of all of your food is happening. And, one of the things that we all know is that a high-fiber diet is really good for us. We’re supposed to eat lots of fruits and vegetables. And, one of the reasons why a high-fiber diet is good for us is because when those fibers get to the gut microbiome, they get metabolized into small molecules called short-chain fatty acids. One of the most important is called butyrate. And, those small molecules that the microbiome creates after metabolizing our fibers actually stimulate GLP-1 production. And, a lot of people don’t know this, GLP-1s are certainly starting to become more well-known but a lot of people don’t know that GLP-1 is actually triggered in the gut microbiome.

Ben:  What’s GLP-1 stand for?

Colleen: GLP-1 stands for glucagon-like peptide. And essentially, it is a small molecule that stimulates insulin response. And, it actually does more than that. So, on the one hand, it stimulates insulin response to help clear out the sugar in your blood after you’ve eaten a meal, but it also appears to have a very strong tie to our brains and our cravings and our food cravings. And so, people who take these GLP-1 drugs, which are designed for people with type 2 diabetes, not only see that their sugars are metabolized in their blood more effectively by releasing insulin but they also find that they have increased satiety. So, they just really don’t crave foods as much. And so, that combination leads to kind of a really nice positive cycle in which you are metabolizing sugars better and then you’re also craving less of the foods that kind of cause these high sugar spikes. And so, GLP-1, drugs like Ozempic and things like that, that’s how they function and they’re extremely effective in helping to lower blood glucose spikes and lower food cravings.

Ben:  Would you ever take those, I think they call them semaglutide peptides because now I know why I’ve heard that term GLP-1 before because everybody’s dropping that is the way that these drugs or peptides if you want to call them like Ozempic actually work. What do you think of those?

Colleen:  I personally would not take them. And, the reason is because, first of all, they were designed for people with type 2 diabetes who are people that are actually unable to produce the right amount of GLP-1 in order to manage their blood glucose spikes. So, you’re talking about people that have a disease that a drug was designed for. And, if you’re a healthy person and you’re able to make GLP-1, kind of adding a drug on top of that in general, there’s going to be side effects that you’re going to experience. But, maybe more importantly is physiologically what GLP-1, how it’s supposed to work. So, how it’s supposed to work is that you eat food, your microbiome digests that food and it tells your body, “We just ate a bunch of food, we need to the glucose out of the blood.” So, it stimulates GLP-1, GLP-1 gets released, it tells your body to release insulin, you clear the sugar out of your bloodstream.

So, actually, the levels of GLP-1 in your blood go like this, kind of similar to blood glucose spikes. When your body eats food, GLP-1 gets spiked in your bloodstream to tell your body to metabolize that sugar, and then it goes away. And then, when you eat again, it does the same thing. And so, you’re supposed to have this cycle of GLP-1. What the GLP-1 drugs do is they increase GLP-1 consistently. So, you no longer have this cycle that your body is supposed to have, it’s just high levels of GLP-1 all the time. And, while that can result in really nice immediate results, it’s not the way your body is supposed to physiologically work. And so, when you disrupt cycles like that in your physiology and all kinds of other biochemical systems get disrupted, and so for me, since I don’t have diabetes, I wouldn’t personally take them.

Ben:  So, if you had the GLP-1 constantly being stimulated by these semaglutide peptides, would you have constantly high insulin levels or low insulin levels?

Colleen:  You would be high. So, basically, your body is constantly trying to metabolize all the sugar in your bloodstream even when you haven’t eaten.

Ben:  So, you could almost induce kind of chronic hyperinsulinemia with these?

Colleen:  Not only that but these beta cells which are producing insulin, you’re constantly stimulating them and having them going. And so, eventually, those betas–and, this is actually quite well known for people with type 2 diabetes. When you keep stimulating those beta cells that produce insulin, over time, the drugs become less effective because you’re basically, it’s like if someone were yelling in your ear all day long, in the beginning, you might have a reaction but after a while you’re going to start to tune it out. And, our cells have a similar feedback loop which is to say that under constant stimulation, eventually they become less responsive. And so, that’s what you’re doing to your body, you’re overstimulating a process all the time that’s not supposed to be turned on all the time.

Ben:  Well, I mean, even though obviously being overweight or obese might have more risks than something like this peptide might present, it sounds to me like we would have to see a lot better long-term safety debt on something like pancreatic function or insulin sensitivity before saying that the average, I don’t know, fitness enthusiast who wants to lose a few pounds or one of this anti-aging enthusiast who wants to keep blood sugar regulated effectively should use something like this.

Colleen:  100%. I mean, the long-term effects and safety of long-term use of the drugs in healthy people really hasn’t been explored. They were developed for people with diabetes.

Ben:  Yeah. And, in contrast, it’s my understanding that a lot of these so-called blood glucose disposal agents that a lot of people talk about like berberine or bitter melon extract or apple cider vinegar or I suppose a pharmaceutical metformin, those are acting differently, right? Those are triggering, from what I understand, the cell surface receptor, the glute transporter that would allow for glucose to be taken up into something like muscle rather than hanging around the bloodstream. It’s a different mechanism of action, isn’t it?

Colleen:  Well, to be honest with you, even though metformin has been out for a long time, I think there’s still things being uncovered about it. And actually, there’s a pretty strong set of hypotheses around metformin impacting the gut microbiome, and that being one of its mechanisms of action too. And actually, a lot of people theorize about apple cider vinegar as having kind of a similar thing. So, you’re introducing something more acidic into the microbiome, you’re potentially changing the composition of the microbes that are there. But ultimately, the microbiome is your natural way to metabolize these fibers and to help your body metabolize sugars and carbs by stimulating GLP-1 that that’s kind of the natural system. And so, that’s where the microbiome becomes really interesting because what people found is that people with obesity and type 2 diabetes are low or entirely missing these microbes that stimulate GLP-1. And so, that’s where you start to have really interesting intervention opportunities.

Ben:  So, rather than taking GLP-1, you’re actually allowing the bacteria in your gut to naturally produce GLP-1 all on its own. What kind of bacteria would actually do that?

Colleen:  Well, there’s actually only one strain so far that’s been known to do that. So, as I mentioned, there are these short-chain fatty acids like butyrate that get produced by the microbiome, and there’s been evidence suggests that butyrate can stimulate GLP-1 production. There’s actually only one bacterial strain that’s ever been shown to directly be able to stimulate GLP-1 and it’s a strain called Akkermansia muciniphila. And, this is a strain that you’re really not going to see on labels and certainly probably most people haven’t heard of it, but it is emerging as a keystone strain in the gut because it is the only strain that we know of right now that literally lives in your gut lining. And, its job all day and all night is to keep that gut lining regulated and it also is the only strain that is known to be able to stimulate GLP-1. And so, it really is becoming clear that this strain is super important. And, maybe I would say moreover the way Akkermansia started to make its way into this keystone string status is because there are a wide variety of diseases in which people are low in Akkermansia. So, there’s obesity, type 2 diabetes, type 1 diabetes, bipolar disorder, inflammatory diseases, immune diseases. So, you start to say, well, gee, all these diseases that people have and they’re also low, they’re correlatively low in Akkermansia, why would that be? And really, what’s starting to emerge is that Akkermansia is just playing a really core role in the gut lining as well as a production of GLP-1. And, that’s how it’s having all these outsized effects when you don’t have enough of it.

I hope you enjoyed that snippet from Colleen.

Next up. I’ve got Dr. Hanaway. Dr. Hanaway is responsible at Genova Diagnostics as the expert behind their GI effects 3-day stool panel. So, we get into microbiome testing, what a test result will reveal, what steps to take from a functional medicine standpoint when you test your gut. We even go into psychobiotics, the manipulation of bacteria gut-brain signals. So, if you want to learn how your bacteria and your intestinal inflammation affect your mood, your health, your longevity, and a whole lot more tune in to this episode with Dr. Hanaway. Again, all the shownotes are at BenGreenfieldLife.com/guthealthpodcast. 

I used to always recommend folks, and this is right up your alley, use something like a Genova Diagnostics GI Effects Stool Profile, usually like a three-day profile where you’re getting a sampling over several days, which I understand to be a little bit more accurate than the single day panel. And that is a panel that advertises itself as being able to detect most of the common parasites, and then yeast and bacteria, and I believe inflammatory markers as well, like calprotectin, for example. And I think some people might be confused about whether or not getting a test like that would be redundant with getting something like a Onegevity gut biome test that’s looking at the actual microbiome of the gut. Do people need to get both, or can you get just about everything that you would get out of a GI Effects panel from something like a gut bio?

Patrick:  Well, that’s a great question and I think the answer on that is still to be determined. I’ve worked as a medical director, chief medical officer at the Genova for 10 years. Markers like calprotectin and pancreatic elastase were tools that actually was the one involved in getting FDA approval and getting CPT code status for them. So, I’m very familiar with them and have published on each of them. They’re great individual biomarkers looking at inflammation and looking at digestion. They also, the GI Effects has different ways of being able to look at the gut microbiome. It uses culture methodology that’s been around for 50-plus years. It’s been using the 16S probes that we talked about that are going to help us get an idea of diversity and what’s going on, but they aren’t going to give us all the details and they’re not as sensitive.

And they also have some markers of directly measuring the metabolomics, the metabolic byproducts of the bacteria. Now, what the GutBio test does is it’s able to give us everything that’s going on there. So, I can look at and say, “Well, I have 198 species. Here are the species in here. Here is how much is there, and that is exactly what’s in me. And I can get an understanding of what’s going on virtually because they’re looking at the genes of what’s happening with the bacteria in my gut metabolically.” Those are very useful pieces of information that are not available on a test like the GI Effects.

But the individual biomarkers looking at inflammation or digestion like calprotectin, which is a validated tool or pancreatic elastase, which is a validated tool, those would need to be done separately. You can get some inference on the GutBio test about an inflammation score based upon the machine learning that Joel Dudley has helped put together. You can get an understanding of what’s happening with digestion based upon who’s living in the hood that are helpful with digestion, but you don’t get an exact answer.

Ben:  Interesting. So, at this point, if you wanted the best of both worlds, you’d have to get both tests. It sounds like that would be appropriate. If you wanted to see everything that was going on in the gut, you’d have to get like a GI Effects panel and a GutBio panel?

Patrick:  Or you can get some of the individual biomarkers like pancreatic elastase and calprotectin from just about any laboratory in the country and then look at the GutBio test to really get an understanding of the gut microbiome. There’s no better test for the gut microbiome than what Onegevity Health has put together.

Ben:  Oh, that’s a powerful statement. Okay. The GI Effects panel then, like you mentioned, you probably could save some money by just getting like calprotectin and pancreatic elastase and a few of the things you wouldn’t be getting, or something like a GutBio. Do you think that in the future, some of these microbiome tests like the GutBio would also be able to offer those type of markers on the panel?

Patrick:  I’m hoping we can get there.

Ben:  Yeah. That would be cool to only have to fiddle around with one.

Patrick:  Yeah. And part of it, Ben, is that they’re going to be working on doing the comparisons to see, can you actually predict exactly what the calprotectin level is going to be? That’s what the beauty of what Joel Dudley’s work is and the machine learning is. To be able to make those comparisons, we don’t know that yet. For example, there is a low-level inflammation that we have a pretty good idea is happening for a lot of people that’s based in the microbiome. And we don’t see changes in inflammatory markers of the gut yet. And we don’t see changes in CRP, but we know that there’s something that’s going on with inflammation. We look at these millions of people with autoimmune disease and we’re not actually able to pick up where is the inflammation. We know there’s something going on with the immune system and it’s our hope that we’re going to be able to characterize that with the GutBio test, and metagenomic sequencing, and machine learning, and virtual metabolomics. So, that’s to me where the puck is going.

Ben:  Okay. Got it. And again, kind of boots on the ground, can you give me an example of something that you might see, or perhaps even as you just alluded to with the case of inflammation, something you see repeatedly on something like a GutBio in many people and what steps from a functional medicine standpoint you would then take to address something like that?

Patrick:  Well, with the GutBio test, where I’m going is, I’m looking at some of the scores that are put together where we’re going to look at a microbiome-based inflammation score. And that’s going to tell me, “Okay. So, here’s an inflammation that’s going on. Now, I need to work with some specific agents and they may be fish oils and omega-3 fats, they may be using turmeric and various formulations of turmeric at therapeutic doses, 500 to 1,000 milligrams twice a day, they may be using Boswellia. I’ve got a whole series of kinds of things and tools that I work with that I’m able to apply when I know that there is an inflammatory issue that’s going on. Or if I see that there’s a permeability issue that’s going on, then that I can tell from the GutBio test. So, with each of these factors, I’m getting deeper into an understanding.

Now, where they’re going is being able to take that not only to look at the system, but to more deeply look at digestion to understand where your fiber needs are, but also being able to look at the enteric nervous system and the whole brain-gut microbiome connection, which is fascinating. We see this whole idea of psychobiotics and prebiotics that are going to help the bacteria that will have an effect on your mood, on depression and anxiety. And this to me is really a whole fascinating new field that we’re going to be looking at the gut to treat patients who have depression and anxiety, and mental health, and neurological disorders. That’s really fascinating.

Ben:  That’s interesting. And not many people have used the term psychobiotics on the show before, but I know it’s been supple years now since articles have been appearing on PubMed about this idea that probiotics when ingested can confer beneficial effects to the central nervous system and regulate the HPA axis and the glucocorticoid stress response. It’s very interesting that these things in a way are almost like mini-psychedelics.

Patrick:  Well, you can think of them that way or you can think of them–I’m actually more interested in what are the foods and what are the prebiotics that help your bacteria to grow to be able to bring balance back to the system overall. Let me give you an example of how sort of the, if you will, the oddness of my thinking, but how these pieces fit together is that we know that through the gut, it produces cytokines that may be pro or anti-inflammatory. It produces metabolites. There are more metabolites that come from our gut than there are circulating from our own cells. There’s information that is stimulated from the vagal nerve going back up to the brain. There are neurotransmitters like serotonin. Ninety-five percent of the serotonin in the body is in the gut. All that information is going up into the brain, 10 times more information going in that direction than in the other direction.

Now, where it goes is it goes first to the amygdala, which is involved in our emotional relationship to the world and gathers information from our memory, and it goes to another place called the insular cortex. And our insular cortex is a small, little area that helps to define our own sense of self. So, from there, that information then goes to the HPA axis and determines what’s going to happen hormonally. It goes to our whole reactivity. It connects to our emotions.

So, to me, like, okay, so what I’m taking in from the environment, the dog that I’m touching, the water that I’m drinking or bathing in the food that I’m eating, every environmental input is being related to or filtered through my gut microbiome and it’s sending signals to my brain. That helped me to understand who I am and how do I relate to the world and what is the emotional connection. Well, that to me is super fascinating because it now puts us in direct relationship where the microcosm of what’s happening in our gut is related to the macrocosm of what’s happening in our world and the diversity of the microbiome. And it connects to our own sense of self and relationship to the world. Well, that’s a pretty big view, and that’s a view that systems like Ayurveda and traditional Chinese medicine have talked about for a long time of how those elements fit together. That’s what I’m interested.

Next up, I had a fascinating discussion with Seed Probiotics, Raja Dhir. We talked about how he cares for his young 5-month-old with Bifidobacterium infantis and the right way to support a young growing child’s microbiome. We talked about food sources for reinventing your own gut bacteria, how your microbiome is made, how it informs your lifelong health. If it’s true that babies born via C-section have inadequate gut bacteria, you’ll be surprised at his reply and a whole lot more. So, if you want to learn how to help your body make its own natural anti-depressants using specific gut health strategies, you’re really going to enjoy this conversation with Seed’s Raja Dhir. 

If you are not born vaginally, if you’re born via C-section I should say, there’s a lot of people who say that your gut is not really adequately populated with beneficial bacteria the right amount of bacteria for years later on in life until you’re–I’ve seen figures like 7 or 8 or 9 years old. Is there anything to that? Is that true or is that just kind of a myth floating around the internet?

Raja:  Yeah, that’s not entirely true. So, a better way to think about it is that the mode of birth, vaginal versus C-section, the mode of feeding, breastfeeding versus non-breastfeeding, and the presence of antibiotics are kind of three equally and varyingly powerful lever chairs of the of the stool. So, try to get as many of those right as you can. And, if you’re able to do so, you’ll have a very good chance at what is considered an optimal infant microbiome, which is dominated by a few different strains of Bifidobacterium infantis. Making way for other bifidobacterium to slowly start to build with diversification and acidify the gut as the rest builds on top. So, you’ll have that if you follow those three. 

There are studies where people are born non-vaginally but there’s no antibiotics and there’s breastfeeding and a little bit of luck that the right strains found their way there and they ended up with all known markers with a totally fine microbiome at six months and on.

Ben:  Okay. What are the three strategies again did you say?

Raja: Vaginal birth, breastfeeding, and no antibiotics.

Ben:  Okay. So, if you aren’t born vaginally but you’re not exposed to a lot of antibiotics and you breastfeed, arguably you’re still going to have a decent biome as an infant or your child is going?

Raja:  I mean, if there really is no bifidobacterium that finds its way there, you could kickstart the process by making sure that that infant has exposure to a few different strains of Bifidobacterium infantis. But, it could be there, it could not be. The data is inconsistent on how B infantis actually gets to infant guts in the first place.

Ben:  Okay. Yeah, I was just curious the extent to which the vaginal flora makes a significant impact or I guess even like the fecal matter that they say that the child is exposed to going through the birth canal if that really is as significant as a lot of people say.

Raja:  I mean, I think it is important for other reasons. A perfect infant microbiome like, let’s say, two weeks or three weeks out from being born should be dominated by Bifidobacterium infantis, one bacteria. And, you know why? Because it takes HMOs, it takes the prebiotic fibers and breast milk. It engulfs them entirely and it leaves nothing else for any other pathogen to grow. There’s nothing left over. It entirely metabolizes HMOs internally. So, when B infantis is there, it’s not allowing any potential pathogens in that early period of life to take hold. Secondarily, it trains the immune system to promote tolerance. And so, it’s a very big driver of minimizing what’s called that atopic march, those conditions of allergy, asthma, sensitivity, inflammation, excessive inflammation. That tolerance we believe is taught from that bacteria. So, for infants that are getting that bacteria initially from fecal content or very rarely a reservoir vaginally, that contact is very important. For others, maybe it finds its way in a different way but if you want an optimal microbiome out of the gates, those are the conditions you need.

Ben:  So, are you saying that the–what do you call it Bifidum infantis? 

Raja:  Bifidobacterium. That’s the genus. It’s a very interesting genus even in our research for many different stages of life. That’s a very good one. And, the species is called infantis. I think it’s a subspecies of longum, but it’s Bifidobacterium infantis. That’s the Latin name of the bacteria.

Ben:  Okay. So, are you saying that Bifidobacterium infantis is the only important strain in a young human being up to a certain age?

Raja:  I mean, at least one strain. There are other different strains that have different benefits, but as a baseline, Bifidobacterium infantis is. In fact, the healthiest infants in the world are dominated by almost exclusively Bifidobacterium infantis until diversification.

Ben:  And, at what age does diversification usually occur?

Raja:  That depends on when you bring foods into the mix. So, as long as you’re exclusively breastfeeding, you’re pretty much going to be dominated by Bifidobacterium infantis in an optimal state.

Ben:  Okay, I got. And, these HMOs, that’s human milk oligosaccharides, right?

Raja:  Yeah, that’s coming from mom’s milk.

Ben:   Is there a benefit to consuming HMOs after you finished breastfeeding? Let’s say for me, for an adult who wants a healthy gut, is consumption of human milk oligosaccharides something as beneficial?

Raja:  I mean, that’s an interesting question. I think that it could be but I think that if you have the right diet, it’s not necessary because you’ll still give plenty of oligosaccharide-like structures that you find in the food matrix. So, it’s preferential so it can, in periods of distress, probably tip certain communities in a more favorable way. But, my perspective is that a rich and varied oligosaccharide composition in your diet should overpower any additional effect that HMOs would have in adulthood.

Ben:  What are some other ways that you get nonhuman milk oligosaccharides, these other oligosaccharides that you mentioned from food?

Raja:  From food, I mean in virtually all plant, rough plant matter you’re going to find some version of them. I mean, they’re in many different fruits, they’re in many different vegetables. They’re concentrated very highly in tubers. You’re getting them. If you’re eating carbohydrates from plants, most generally come in the form of if they’re not sweet generally come in the form of variably digested oligosaccharides, varying chain-length prebiotics. That’s what you’re getting these types of fibers from your diet. Now, there’s some that are, again, easier to get, there’s some that are more useful in different periods of time versus others, but an optimal healthy microbiome at the adult stage should be able to tolerate and actually demands an extremely diverse portfolio of plant fibers.

Ben:  Okay. So, you’ve got your monosaccharides which are the single very simple sugars then things like polysaccharides. Are oligosaccharides longer chains of carbohydrates that you’d find in fiber or are they just varying lengths like you said? I don’t even remember what the word “oligo” means.

Raja:  That’s exactly right. So, the number of polymers, the number of the degree of polymerization isn’t one, it’s closer to six or seven or eight, up. And then, above 10, I believe, is characterized as a fiber.

Ben:  Okay. Alright, got it.

What do you think about the carnivore diet though? Are they getting oligosaccharides from meat in some way?

Raja:  Certainly not.

Ben:  Really?

Raja:  Yeah, certainly not.

Ben:  Is that a problem do you think?

Raja:  I think people could survive on a carnivore diet, but I think that every 100 out of a 100 academic microbiome scientists would answer that question by saying that you’re introducing a massive deficit to the host microbiota, a massive deficit and first. And, second that you probably dramatically shift it from a saccharolytic state, which means breaking down carbohydrates, to a proteolytic state, which is very adversely associated with metabolic and cardiovascular health outcomes just from the microbiome standpoint. No, I’m not talking about in the blood.

Ben:  Yeah, that’s interesting. I was talking with Dr. Steven Gundry who was poking some holes during our interview which might be released at the time that this interview comes out. Again, I’ll put the shownotes at BenGreenfieldLife.com/Seed2. He was bringing up some statistics on true long-lived populations or at least longer-living populations than some of the popular blue zones. And, he was talking a lot about the process of fermentation of meat, dry aging, wet aging. There’s even like on lifehacker.com, they’ve got recipes for speeding up that process via fermenting the meat in fish sauce and kombu. Would the fermentation process applied to meat help to skirt some of these issues with inadequate fiber?

Raja:  There’s no way. Fermentation can’t make a fiber. Spontaneous fermentation can’t assemble amino acids into a fiber-like structure. It just doesn’t work that way. I mean, fermentation can take a very long fiber and transform some chain lengths of that into different compounds. That’s basically the basis of fermentation is we break it down and convert it into other interesting compounds that your body might like. That’s how acetate is made, for example. So, there’s an interesting role for fermentation, but fermentation itself can’t take amino acid chains and make fibers out of them. Fibers have to start from carbohydrate. Actually, mucin and some of the intestinal sugars, some of the backbones of mucin, of the mucosa layer are actually more similar to that type of saccharide-based fiber structure. And, that’s why you see that mucin degrading bacteria. They like those fibers because they’re able to have all the environment that’s necessary to also adhere to mucin and to degrade marginally mucin. But, be careful, if you degrade too much mucin, that can also take you to a bad place.

Ben:  Steven Gundry in the book, by the way, he just wrote that I talked to about it’s called “Gut Check.” I think his main argument was that there are some potentially harmful sugars associated with chronic disease in meat. I believe they’re called Neu5gc, and the process of fermentation somehow deactivates or predigest those sugars. And, I don’t think he was making the argument that the fermentation somehow causes the non-existent fiber and meat to somehow benefit the biome. I think it was more the elimination of potentially harmful sugars.

Raja:  I’ve heard that hypothesis. I don’t have a definitive opinion on it, but it’s certainly plausible that subjecting meat to microbial fermentation could alter it in a way that could make it less harmful. That hypothesis could definitely be true.

Ben:  Now, a lot of people are sensitive to fiber. Way back in the day I interviewed this guy. You’d probably find him fascinating. He wrote a book called the “Fiber Menace.” And, his name was Konstantin Monastyrsky, something like that. Anyways, totally vilified fiber and talked about how it causes gastric distress in a lot of people. And, I think people who have had, for example, small intestine bacterial liver growth or SIBO have certainly reported having issues with the whole idea of resistant starches, inulin, green banana starch, et cetera, causing bloating and digestive distress. 

Even after I interviewed Konstantin, yeah, I was doing the giant blender bowls of kale. And, I learned this from Mark Sisson. I don’t know if he still does this, but big ass salads with just tons of nearly pounds of vegetables for lunch. When I began to reduce that amount of specifically raw fiber intake, my gut did feel a lot better with respect to bloating and indigestion, irritation, gas, et cetera. I think that a lot of people have kind of tuned into the idea that maybe excess fiber might not be that great, especially if you have those issues and some people have even cut out fiber quite a bit. Maybe not gone with the full carnivore diet, but they’re limiting fiber.

Now, what I’m wondering is this. If let’s say I’m traveling and I’m not eating as much vegetables and fruit and fiber or I’ve got digestive issues and I’ve decided to try lowering the amount of fiber that I take in, could using a probiotic actually allow for you to get all the benefits that you’re looking for in fiber? Like even if I was eating just meat, what if I were to just take a probiotic, would that replace a lot of what it is that I’m missing from fiber?

Raja:  I think reduction of fiber for people that have symptoms from it is fine. I’m not sure if that’s optimal. I think that may be speaking to microbes that are in regions of the intestinal tract that maybe not the best suited or are at the right place. I think that field is still developing, but that can also explain some of those symptoms is that there’s other organisms that are causing those symptoms that would normally be crowded out or in an optimal microbiome wouldn’t be there at all but have already been outcompeted. So, I think that’s an interesting area to explore; what are those organisms and how can you fix that. Why then would there be several studies where people take antibiotics and actually their ability to eat fiber goes up, right? So, there’s validation for this hypothesis that there’s a microbial component to fiber intolerance or to resistant starch intolerance.

I think that to dramatically cut down fiber without replacing it with a very biologically relevant amount of other substrates, so flavonoids, polyphenols, there’s certain carotenoids that structurally are also able to be metabolized by the microbiome also enrich for very interesting pathways and also keep that organ, that microbiome metabolically active in a positive way. And so, I think any dramatic reduction of fiber intake should be cautiously paired with something of that type. And, you have to take this seriously. I’ll give you one example. So, a paper came out in a leading scientific journal a few months ago in Akkermansia and it found that in the presence of a low-fiber diet, it went from protective to inflammatory and triggering food allergy. So again, it was a very well-designed. I think it was even a Nature paper, but it was an animal model. And so, it was a very mechanistic paper. But yeah, that was the takeaway, which is if you have Akkermansia or if you take Akkermansia should be paired with a high-fiber diet. Otherwise, my hypothesis is it’ll start to degrade your mucins, induce more inflammation at that local site, and actually increase the inflammatory signaling coming out of the microbiome.

Ben:  Well, that’s actually really good to know too because I interviewed Colleen Cutcliffe of Pendulum that makes an Akkermansia-based product and she brought forth some data that indicated that Akkermansia may assist with fiber digestion in people who tend to get some of these bloating and gas type of issues in response to a high fiber diet. So, I suppose it makes the case that if you’re going to use Akkermansia, A, don’t avoid fiber, and B, maybe be less scared of fiber because it might actually help you to digest it.

Raja:  I think there’s many bacteria that serve that function. So, there’s many Bifidobacterium, there’s many bacteroides, there’s many Lactobacilli. The interesting about Akkermansia is that it does do that but you don’t normally have a lot of it. There’s not a high abundance of Akkermansia normally. And so, when you think about rounding out your microbiome to be able to handle high fiber production, I would consider open the question of what is the best cocktail of organisms to actually accomplish that. You probably want a diverse cocktail and you probably want them all to have pathways for fiber degradation.

Ben:  Okay, that makes sense.

Want to backpedal for a second back to babies. Since the last time I interviewed you, you’ve sent me a few packets of this powdered, I don’t know if it’s a Synbiotic or a probiotic or how you would define it but it’s a pediatric product–is different than the one that I’ve been taking on a regular basis. What’s different about the pediatric product that you’re making and why?

Raja:  Sure. So, DS-01 is the adult product. And, that is a 24-strain mixture, but that’s not the most important part. The important part is that there’s multiple strains from within the same species in that composition. So, it’s what’s called a redundant consortia. So, it’s a very interesting transient probiotic consortia designed for adult consistent usage. That’s the intention of it and with activity across different organ systems, across many different biological systems within the body.

Ben:  Okay. And, I don’t want to derail you from the pediatric thing, I want to come back to that, but what do you mean when you say “transient”? Do you mean these probiotics just go through the gut, washed away and they’re gone?

Raja:  They’re transient in the sense of they don’t result in long-term chronic shifts of the composition of the native microbiome. So, they don’t displace or modifiably alter in a healthy state the native microbiome.

Ben:  Why is that important?

Raja:  I mean, the microbiome is an ecology which is quite varied between people. And so, certain organisms and certain microbes work in what we call networks. They work with other organisms that they’re used to working with. Akkermansia, just to drive that point, is part of a network of four or five organisms that when you look in people that have Akkermansia are typically colocalized and collocated with. So, the microbiome is a resilient yet also fragile ecology in the sense that there shifts from time to time. And, especially in periods of duress, after course of antibiotics in a condition that microbiome may play a role like IBS, those are two areas that we’ve studied. You have to be very careful and considerate about which microbes you’re introducing into that ecology and what you’re trying to do. 

So, transient can be good for the goal of that. If you’re trying to cure depression, you probably don’t want a transient consortia, you probably want to take very high amounts of coprococcus and dialister, different bugs. And, you’d want to take probably antibiotics first to wipe everything away so you have the best chance of making those new bugs actually take over and build a new ecosystem as a foundation of that ecological recovery. I mean, that’s how it works in drugs. 

If you have a C. diff infection, you take a course of antibiotics to wipe everything out, then you’re transplanted a stool, a whole stool from another person and then you let that try to recover. But, if you just take the stool from another person and you just put it in without the antibiotics, you have much lower engraftment and long-term colonization rate. So, it can be good, it can be bad, it depends on what you’re trying to do.

Ben:  So, if the transient product is designed not to disrupt the presence of an already arguably healthy microbiome, if I’ve got a healthy or good microbiome, why would I even take it in the first place? Specifically referring to the DS-01 that you guys make.

Raja:  It’s a very good question. So, there’s two parts to think about what you want a probiotic to do. You want a probiotic to do things to other microbes in your microbiome like microbe interactions and then there’s things you wanted to do to the host. So, micro host interactions. 

Now, what we learned as we were progressing was that most of the microbe-host interactions actually don’t happen in the colon. The colon is a lot more protected. It has a much thicker mucosa. It has a much more dense community, but actually, there’s something different about ingesting, about that daily inoculation of microbes and their transit and passage through the body that we believe seem responsible for many of the host side effects, the microbe-host side of those two interactions. And, one good example is probably a lot of intestinal immunity is regulated there because the immune cells that reach out and sample it are big drivers of t-cell differentiation of immunity. And, other examples like the gastrointestinal barrier, the epithelial barrier is more permeable in the small intestines and the small intestines than you’d expect it to be in the colon because it actually bypasses that. So, it actually gets absorbed in the intestines on their path down. 

So, most of your microbiome or most of what’s already in your microbiome isn’t going to interact with those other parts of the gastrointestinal system on a day-to-day basis. And so, for that, you have to look more to probiotics. And, if their human native strains is just a different level–people have also, for some host side effect, tried to look to fermented foods if there’s a very interesting way to think about fermented foods as well, but you have to really dissect what you’re trying to look for and what you’re trying to deliver. There’s an independent benefit of daily microbial inoculation than what your microbiome is to begin with. That’s probably the most important part.

Ben:  Okay. So, when I take a probiotic even if I’ve got a good microbiome, what I’m doing is upregulating the function of things like the gut immune action, the mucosa lining, the potential of something like a permeable gut, and some of these things that just having a healthy microbiome might not be sufficient to allow for.

Raja:  Yeah. Well, that was actually the primary finding of our placebo-controlled trial on DS-01 after a course of broad-spectrum antibiotics. That was a clinical trial that we did. And, the first and strongest, and probably most striking finding was concurrent to antibiotics which actually disrupt the epithelial barrier. They disrupt the gut barrier. So, that was a very interesting finding. The second one was that DS-01 rescued that gut barrier disruption and almost 90% versus 10% to placebo. So, it was a very strong effect based on this lactulose mannitol test. And, the third thing was that that effect persisted out to two weeks after taking the original course of antibiotics. That’s kind of the host side of it. And then, if you ask about microbiome, there’s a lot of other findings, I think, are very interesting. But, I think that that framework for people might be interesting to think about.

Ben:  So, if I were going to use that strategy, if I were, God forbid to have to get on some kind of a hefty antibiotic regimen, would I begin to use the DS-01 Synbiotic during my antibiotics or would I wait until I’d finish the course?

Raja:  Concurrent.

Ben:   Okay, concurrent. Take it at the same time.

Raja:  That’s how the trial was designed.

Ben:  Okay, got it.

Now, I kind of derailed you as you were beginning to explain why the pediatric blend is different than the DS-01.

Raja:  Yeah. So, on composition, it’s different on outcome, it’s different. The pediatric product is fewer strains but also multiple strains from comprising different strains of the same species. So, more redundancy, more representation of the diversity within individual species and paired with a fermentable prebiotic. And so, the primary outcome for that was that when consulting pediatricians in designing the trial, we were told that this trial were it to address pediatric constipation or regulate the GI system of children would address the single most common reason for pediatrician visits, which is pediatric constipation. I think it’s one in three or one in four kids. See a doctor for it, have it.

Ben:  Yeah, useful for a parent sanity too because no parent wants to be waiting there 15 minutes to use the bathroom themselves when their kid is on the toilet.

Raja:  I’m sure, yeah.

Ben:  The age though. What’s the age at which you take or stop taking something like this?

Raja:  Well, that you could start as early as three. You should continue for as long as regulation of the gastrointestinal system is a primary benefit or goal that you have. And then, I think maybe even post-adolescent onwards. I don’t know what the official recommendation is, but from a biological standpoint, I would say as soon as you’re highly diverse and if you’re able to balance out your carbohydrate and your fiber intake in a somewhat meaningful way, you can switch over.

Ben:  Okay. Do you have kids?

Raja:  I do. I have one 5-month-old son.

Ben:  Okay. Knowing what you know, if you were to kind of have the gold standard feeding or probiotic or breast milk consumption or human oligosaccharide consumption, human milk oligosaccharide consumption for a young human being coming into this world to give them as many advantages as possible from a microbiome standpoint, what would it generally look like in terms of what you’d feed a young human being to optimize that?

Raja:  I mean, I think about this all the time now. So, I have as detailed and intricate answer as you want to that question. I think I’m very, very interested in the development of the gut and the brain, and they’re kind of related. There’s a lot of compounds that drive that, either comprise the structure of it or drive the development of it. I think for the first few months, as much as possible, one should exclusively breastfeed at least through four months. Try to get to six if you can, but at least through the first four months if there’s no Bifidobacterium infantis. So, I didn’t do a test per se, but I gave him early inoculation of Bifidobacterium infantis around week three or week four.

Ben:  Wait, wait. What do you mean early inoculation?

Raja:  I mean, I did it myself. I work with and grow a lot of different strains. So, I took two or three strains from our library of Bifidobacterium infantis and I put it on the tip of his tongue and then he breastfed right after.

Ben:  By the way, look at you, you got your library of probiotics. You have your gastro simulators. Jeez, everybody’s going to be envying your setup at home. So, you inoculated your son with those strains. What else do you do?

Raja:  Yeah. Well, that’s first, then you get to breastfeeding. When you get to diversification, you want to get carotenoids and N3 fatty acids. As early as possible you want to make sure that mom is taking very, very high dose at least DHA but ideally DHA and EPA. That’s going to directly pass through the breast milk. And, even during the breastfeeding phase, you want to make sure mom’s eating an incredibly diversified diet in carotenoids. Carotenoids are very unique and that they actually are stored in, are broken down in the gut along like polyphenols and flavonoids and some other plant-based compounds, but they also make their way directly into the eye and into the brain. And, that’s very interesting to me that there’s this very precious class of compounds that crosses the placenta. It crosses the blood-brain barrier. It’s allowed to aggregate in the brain of your offspring. And so, I’m very, very interested in some of these types of plant-based compounds.

Ben:  Yeah, going to sell a lot of mini carrots to pregnant and breast women with this. What other food sources are rich in carotene, by the way, that you like?

Raja:  Not just carotene, so I should clarify. The class are carotenoids and they’re a wide variety of compounds. There’s about 40 or 50 in the human diet that are found across the spectrum of color. Basically, they comprise color in certain vegetables by having an absorbing effect on the light spectrum and reflecting out others. So, their relationship, they function alongside chlorophyll as a relevant molecule in plant biology. That just turns out to be very interesting for humans too. I mean, we benefit a lot from them.

Ben:  So, just colorful vegetables.

Raja:  Yeah. As rich and deep. Most pigments in vegetables are driven by something in the carotenoid family or also in the marine environment things like astaxanthin or zeaxanthin. There’s few in the sea as well.

Ben:  Got it. Anything you go out of your way specifically for your son or that you recommend folks avoid?

Raja:  I mean, I’m pushing for him to get onto polyphenols as quickly as possible as well. So, blueberries, bilberries, just most of your bright relatively lower-sugar berries, I think. You’re just going to get so much of it. So much good stuff from that.

Ben:  Fantastic. You’ve just described the diet that my sons grew up on. So, I feel very good about that. And, I’ll still probably forward them this podcast in a few years. So, I’ve got healthy grandchildren, but yeah. Okay. Well, that’s great.

Raja:  I see them also probably drinking the oil of the fish straight out of Japan in addition.

Ben:  They’re not that extreme although I have to admit they probably get their fair share of chicken fecal matter from doing an inadequate job washing the eggs they go down and harvest every day from our chickens. So, they are getting an adequate microbiome. That and licking the goats.

Raja:  That’s it. In the first two years of life, you’ll see introduction of all kinds of things that kids eat. You’ll see everything that they eat. Show up but it doesn’t last very long, it just passes through and signals to the host to teach it tolerance. That’s the hypothesis behind early rich microbial exposure. And, its effect on the immune system is that you’re born inflamed. Microbes and certain ones are better at teaching your immune system tolerance. Over time that benefits you, that benefits your immune system. It makes it more calibrated.

I hope you’re enjoying today’s episode. Again, all the shownotes are at BenGreenfieldLife.com/guthealthpodcast. This next conversation was Lauryn Lax who wrote a fantastic book on supporting your gut, specifically a lot to do with the mind and the brain. But we get into a lot of practical stuff here too like what you can learn from your poop because who doesn’t love to stare at their dump in the toilet. What’s coffee withdrawal constipation, do eating disorders create gut disorders, and if so, what you can do about that. She has a great book and this conversation was just incredible. I got a lot out of it. Again, all the shownote is going to be at BenGreenfieldLife.com/guthealthpodcast. So, enjoy this conversation with Lauren. 

Do you think that eating disorders damage the gut because it seems kind of counterintuitive to me and maybe some other people? Because you think, well, anorexia, you’re just not eating very much. Wouldn’t that be easy on the gut? Maybe it’s hard on the joints and the hormones, et cetera, but does that make sense? Just playing devil’s advocate, it seems to me like sometimes eating less could help the gut. I even know some people with gut issues who get really skinny and almost look like they have anorexia just because they’re afraid to eat anything at all but it seems to help their gut. And so, do you think there’s a mechanism of action where anorexia or some other eating disorder could actually harm the gut?

Lauryn:  Oh, 100%. I think just in research alone we see 98% of those that have had eating disorders will develop a functional gut disorder. And, I think it’s super unaddressed both going through treatment and eating disorder life. And, you’re right, that which is once productive can become counterproductive. So, I think it begins on, first, where the gut begins when you are beginning. So, say I feel a little bit better when I’m adopting say a diet of not eating, fasting, but it really depends on the variables as well. Like, if you’re living on artificial sweeteners as I was like Crystal Light and all these diet foods that are super processed, that’s not going to make your gut feel good. And then, just all the dysbiosis, we would call insufficiency dysbiosis that’s created with anorexia, so you are basically starving out both the healthy and the non-healthy gut bugs, so you really just don’t have that life force in there. 

And, one in four women that have gone through anorexia or I just say women, but men are experiencing this as well will develop an autoimmune disorder as well. So, we just know how related that is to leaky gut and dysbiosis on the back end. And then, those that maybe are struggling with overeating, binge eating, I mean likewise, there’s dysbiosis being created. Dysbiosis being just gut imbalance because of just the certain things that you’re feeding the microbes and certain things you’re not and how you’re forcing digestion to happen. There’s a lot of stress created. And, that too being the number one driver would be stress, the perceived stress, the inflammation that’s going through that gut-brain axis.

So, great question, and yes, gut issues are very common in those that have struggled with disordered eating. And, I think, again, that threshold of if one goes on say a long-term fasting or just eating less diet, they feel better because perhaps they were starting at a threshold of a very dysbiotic gut to start. And so, they are starving out some gut bugs that aren’t serving them. 

But, I do see this in diet culture too. You don’t have to have an eating disorder to fall into the pigeonhole or the rabbit hole of a disrupted gut microbiome. And, I think any diet, it can be productive, so we say carnivore, keto, vegan, vegetarian, whatever people are adopting. The reason why they see that productivity is because it’s modifying the gut. And then, the reason why 95% of diets fail, say after the 30 days or three months or hit that plateau, it’s not just because they failed the diet or their willpower is down or the diet’s not working, it’s because of what’s happened in the gut microbiome. And, in my patient population, I see a lot of patients that don’t have overeating disorders, but they have a fear of food that has developed because they’ve pigeonholed themselves so much into a certain diet where they’re eating maybe five to 10 foods because it’s all their body can handle. They’ve developed histamine issues or they continue to linger in that state because even a carnivore diet, which I think can be very beneficial and therapeutic. But, I’ve had a lot of patients that have fallen into that’s all they can eat now. Because if they do introduce something back in–it was kind of like a Band-Aid. It was cover up because they took out certain foods that were making them unwell, but if they didn’t mind to heal the gut as well, didn’t just rely on the food and grow some healthy gut bacteria that could digest other foods, they may run into a wall. Does that make sense?

Ben:  Yeah, it does. It’s interesting because I was telling you before we started recording I’m supposed to interview Steven Gundry tomorrow. And, his whole book is about, he calls them, gut critters, but the idea of the microbiome and its importance in the gut-brain axis and the gut metabolism axis. And sure, if you over and spill over a bunch of say inflammatory lipopolysaccharides from the gut into the bloodstream or develop leaky gut or pockets of inflammation, diverticulitis, or the like, then that kind of makes sense because you’re just eating too much, you’re eating too much of the wrong thing. But, it sounds to me what you’re saying is that even if you’re not eating enough, you’re throwing off your microbiome, not feeding your gut bacteria, not populating your gut, and creating a host of other issues. And then, what I’m talking about is particularly relevant to not eating enough or excess dieting or anorexia nervosa or not eating wide enough variety of foods. I think it’s pretty intuitive for most people as something like bulimia would cause issues just because you’ve got so much acid imbalances and that results in poor digestive enzyme production and damage to the esophagus, et cetera. But, I was just thinking about that as you were talking that it is kind of interesting because you’d think, “Well, just don’t eat and everything will heal up.” But, you just don’t eat, and as you just noted, you throw the bacterial balance off in a pretty remarkable fashion.

So, I interrupted you though when you were talking about everything kind of coming to a head at one point.

Lauryn:  Yeah. So, everything in that journey really came to a head the morning that I stepped on the scale at 5:00 a.m. only to see a number I had not seen since I was that 10-year-old girl, only this time I was 23 and I was a full-fledged adult. And, I was living in Nashville at that time, about to enter my second year of grad school the next day. I was studying occupational therapy by this time. Long story, I’d gotten out of the news just because I wanted to get out of Little Rock, Arkansas where I was working in the news under my parent’s roof because I was so unwell that they had really wanted me to be close. So, I said, “I’ll go to grad school” and that I could live on loans. And so, I was there and woke up, and at this time, again being scared, there was no doctor standing over me telling me I was unhealthy anymore or my parents even there who had really fought for my life many times in and out of all these hospitals and treatment centers. And so, I remember getting into my car and driving to the gym. I had four or five gym memberships. I was working out eight hours a day at this time in my life and just praying out loud, “God, help me make a change today.” And, my spiritual journey had been a very big part of my eating disorder. I felt like it was really a spiritual warfare. And, to me, God helped me make a change, help me eat a tablespoon of almond butter more or help me work out 30 minutes less on my StairMaster today, just willpower.

And, when I got to the gym that morning, I got out of my car collecting my magazines, my fitness stuff to go into the gym and turned around and I heard not one but nine other strangers walk up and they said, “Good morning, Lauryn.” Whipped around nine other gym goers who stepped in and spoke up and said they wanted to help. And, not knowing anything about my backstory in my life, just seeing this girl for the past couple years every day [00:12:35] _____ on the StairMaster and they stepped in and spoke up and just said, “We don’t know what we would do if we ever saw you collapse in front of us.” And, just out of the kindness and the love of their hearts, they had all come together the night before and just plan this kind of intervention. They were all friends, about my parent’s age because that’s who works out about 5:00 a.m. in the morning, and they drove me to Vanderbilt Hospital and where nothing imminent had happened; no bullet wound, no car wreck and the doctors were like, “Why is she here?” But, they just knew in their hearts I was not well and my parents were by this time on their way down from Little Rock to come. 

And, within 48 hours, I found myself in the CCU with a heart rate in the near 20s and doctors saying I may not make it. And, I know without a doubt had they not stepped in that day I would not be here having this conversation with you at all. And, in that moment, flat on my back in a hospital bed as they’re screaming we may need to call code blue and talking about maybe putting a pacemaker into my heart, there was something a piece that came over me and it was just if God was saying, “Lauryn, this is not your time, you’re going to make it but buckle up, this is going to be a ride.” 

And, I spent the next four weeks on feeding tubes and heart rate monitors and IV fluids in the hospital. And, by the end of that four weeks, the doctors gave me one of two choices. They said you can stay here for another eight weeks and continue to be refed and bed rest or you can go back to treatment. You have no other option. And so, I chose to go back to treatment and said I’ll go for the minimum six weeks. And, I had done the treatment game many times. Again, Pop Tarts Pizza Prozac model. I knew what I was in for, and ended up staying about a year in Miami. And, on that six-week mark that I was supposed to leave, actually, I started to have all these chest pains I had not had since that day of that imminent moment. And, it was, again, as if God was saying, “Lauryn, I’m not done with you yet,” and wanted to ring out that eating disorder out of my system and out of my psyche. And, there was a lot of hard lessons learned that I wrote in a blog at that time just facing double bagel day or Egg McMuffin Fridays or Eggo waffle Tuesday, Thursdays like my nemesis. It was not really about the food by that time, it really was ringing out of my heart and my head. Treatment was no different. It was something in me had really changed though and decided when I get out of here life is going to be different on the other side. And so, I got out of treatment about a year later and I was learning to walk again and crawl, starting to do that in life and began to find my footing and actually was so thankful to stumble into an amazing church community, CrossFit community. And then, that was a gateway into functional medicine in paleo for me was that CrossFit community down there in Miami.

And so, I began to get really curious and interested in helping others heal. And so, yeah, I kind of began my functional medicine journey. I had no idea what I was going to do with my doctor in the occupational therapy, but it really is the job of helping people live life to the fullest is the ethos of that profession. And so, learned how to marry that with functional medicine training and nutrition. And, over the next decade, set out on this journey of learning not only in the classroom or in online learning kind of situations but also actually my body became my best teacher because I ended up developing these 13 incurable conditions over the next decade that had been a byproduct. You asked a question earlier about how the gut is disturbed during something like anorexia, and lo and behold, it really was. And, little did I know that all of these issues were related greatly to that disrupted gut-brain axis, but it really was this residual of the five autoimmune diseases: Lyme, mold, mast cell activation syndrome, hypothyroidism, cancer workup, stroke workups, brain tumor workups. It was just nuts. And, the doctors couldn’t explain it, Mayo Clinic turned me away, Cleveland Clinic turned me away. It was just one of those complex cases that I see a lot now in clinical practice as well. And really, there was not much hope for me other than symptom-based treatment according to both conventional and honestly a lot of the functional docs were scratching their head. 

And, that journey came ahead a decade later, literally almost to the date. I was 33. My Jesus year is what I call it. It’s just really a pivotal year in a lot of people’s lives, but I found complete healing and it was really through this mechanism called the gut-brain axis and rewiring the gut-brain axis that I was in a training. They didn’t even call it gut-brain axis, it was just limbic system type of work and NLP type of work that I was training from a coaching perspective, but it ended up helping my body do this complete 360. You oftentimes hear the body keeps the score or issues are in a tissues and mine certainly were, and I didn’t realize that. It was a much deeper work than I’d ever done in the 20-plus years of therapy. I’d been in just cognitively touching the 5 to 10% of the brain that is in the cognitive state; whereas, 90% of our thoughts are subconscious, which interestingly enough 90% of those thoughts come from the gut microbiome as well. And so, I developed this understanding of how the gut and the brain are connected. And, through healing my brain, I was already eating a healthy diet. I was already doing the supplements. I was doing everything physically and it all began to work when that gut and that brain got aligned. And, there was this stress release that had been there for so long in my body. And so, this is a lot of the work now that I do with clients is just marrying the two. It’s like the physical and the mental emotional because it’s just like a physiological state can produce a psychological reaction. So, something in the 3D world can make us feel anxious, for example, a news headline or something like that.

A mental emotional state can also produce a physical state and even more greatly if you can think about the water studies where we can change water with just loving thoughts versus angry thoughts where they look under a microscope and they see that. And, we’re 70% water ourselves as a body. So, I’m very passionate about helping individuals take their health back into their own hands. And really, my mechanism that I use is just a gut-brain reset. And, when I say the word “gut,” to me that is if you’ve ever seen “My Big Fat Greek Wedding,” they use Windex on everything. So, to me gut is not just digestion, constipation, and bloating, it really does touch multiple parts and facets of health. So, it’s a very broad term for what I mean like the root cause of health.

Ben:  Interesting story. I’ve never actually had to pray to God that I could eat more almond butter. If anything, I’ve had to pray that God would somehow keep me from eating the entire jar. But, I get where you were. And, it makes me think a little bit about the fact that back to your story when you were a kid in elementary school and coming back and looking at the Doritos, I mean people are encouraged to look at food labels now, Lauryn. I mean, for example, I just interviewed T, and the entire podcast was about look at this on the food label, look at that on the food label. How do you kind of marry the idea of intelligent approaches to knowing what it is that you’re eating and not freaking out about it or stressing out about it in such a manner that disrupts that gut-brain axis producing stress, leaky gut and anxiety around food? Does that make sense? How do you approach the whole food label thing?

Lauryn:  Yeah. I mean, I think we do live and it’s not heaven on Earth necessarily here. So, there’s a lot of chemical and toxins in our food. I think America’s food system compared to say Europe, it does not reflect a real food diet here. And so, I think that is something I’m cognitively aware and I still educate my clients on. And, that said, I also believe in something like the hygiene hypothesis with food that the little dirt never hurt mentality. And, we know hygiene hypothesis in immunology, it goes, the cleaner you are, the sicker you become. So, the more you sanitize your hands or the more you live like a bubble boy, the more when you’re exposed to the elements outside you’re going to become sicker. And, I think with the food and gut, it can be the same way. 

And so, kind of we were talking about or reflection, some of my sickest patients are those that are eating only five to 10 foods because they are avoiding everything or they’ve become so fearful of how food makes them feel, and yet I just said they’re the sickest patient still because they’re in this bubble, this container and their gut is not as resilient. Eating dirt, I guess, is something that we would say. But, yeah, I think there is a balance and a fine line in a way, but I was just at Whole Foods earlier today and I forgot to bring some liposomal vitamin C. I love it when I’m traveling. And so, just picked up one and flipped over a label. I mean, there’s all this food coloring in it and citric acid, and just some fillers and it’s just like, I think we do need to read labels from that perspective of toxicity. And, I think toxins are the X factor and chemicals are the X factor. Ideally, we’re eating a real food diet. Still, that mimics ancestral times.

And, back to the 80/20, the little dirt never hurt is being able to go with the flow. And, if you are in Rome, eat the pasta on your birthday, have a treat, and just move on. At Thanksgiving, enjoy whatever your mom made you. Like the traditional things, I’ve had some patients, like I said, with that five to 10 foods, one of that comes to mind. She had mast cell activation syndrome had mold illness, was eating practically I think chicken and chicken for every meal, and maybe a little bit of, I don’t even know what vegetable she was eating, not much, anything. But, all that to say, she went home during a Thanksgiving and just being around family and feeling loved and not on her own in the journey, she actually ate foods that she hadn’t eaten in years and she felt fine. And, I remember her just messaging me the next day and say, “Dr. Lauryn, I don’t know how this happened,” but that goes back to how that gut and brain work.

And, one of my favorite studies is the milkshake study. Crum is the doctor’s last name I think it’s Alice or Alison Crum.

Ben:  Okay.

Lauryn:  And, they take two groups and they give them a milkshake, and they want to see what happens to them metabolically. One milkshake is a 600-calorie milkshake and one milkshake is a 140-calorie diet shake, so the healthier shake. In actuality, both groups got the exact same milkshake, a 300-calorie milkshake. So, they had no idea though and they drink the milkshake. And, what they found is a completely different metabolic response. So, those that drank the 600-calorie milkshake that were like, “Hey, this is one and done. This is for the study. I’m going to just enjoy this, savor this,” they actually had a healthy metabolic response. Whereas, those that drank the diet shake went into kind of that starvation mode, they were hungrier. Their Ghrelin scores, which is a hunger hormone went up three more times than the other group. And, this was all based on perception not on the actual calorie shake or the milkshake. 

So really, our perception plays a huge role in our diet. And, you can even think about a food dessert versus yuppie culture in downtown Austin where I live. Everything’s gluten-free, animal-based, and you can get all the free things at whatever restaurant you go. They don’t look like you have a third eye. But, if you go to a food dessert, I mean they’re eating the Dorito diet, but they’re not thinking about even anything related to their health a lot of times and they’re just living on this every day. They’re not thinking about how the food’s affecting them because their totem pole of what they’re stressed about is completely different and maybe more in that survival mode state or on what’s happening with baby daddy. It’s just a different threshold of where our directed focus goes. And so, I think the more sometimes we’re hyperfocused on food, the more we can either stay intolerant to foods or we react to foods.

And, when I was reintroducing foods back from so much restriction, one of the things that helped me the most is speaking positive into my mind and the food I was actually digesting. So, my body is strong, I’m resilient, it knows how to digest this food. And, I’ve reintroduced every single food that I was reacting to, all the histamines and the autoimmune paleo diet kind of foods that I wanted to reintroduce with that principle.

Ben:  Yeah, the brain certainly is pretty powerful. It’s kind of related to you feeling great because you feel as though you got a fantastic night of sleep and then checking your wearable and finding out your sleep score isn’t that great. And, all of a sudden, you feel tired. Or, back to the calorie thing related to the milkshake study, sometimes I’ll just be awake at night and I’ll think I’m full and I’ll think, “Gosh, why do I feel hungry, restless, et cetera?” I’ll sometimes check my blood glucose and it’ll be low and then I’ll lay there. This isn’t every night, but I’ll think, “Well, gosh, I had that packet of oatmeal and that was 350 calories, and that shake was maybe 600 calories,” and then lunch seemed really filling and it was maybe 300 calories, whatever. And, once I add it all up, I realize, “Oh, I ate a thousand fewer calories than my body needs tonight that’s why I’m hungry.” But sometimes, if you think you’re eating a whole bunch of calories, you feel full when you’re really not and then the hunger can kick in later on. So, I’ve experienced that in a few different ways.

And, as far as the food labels go, correct me if I’m wrong, but I don’t think you’re endorsing eating crap. I think you’re endorsing not being so stressed out and myopically orthorexic about your diet that you’re actually not doing your gut any favors. For me, I think that if you’re if you’re exercising, if you’re physically active, you can certainly get away, I think, with a little bit more from a dietary standpoint. But, I’m honestly more concerned about big egg, about monocropping of agriculture, about poor soil practices, about abusive animals with non-regenerative farming and just supporting that entire scenario. I’m much more concerned about that than, “Hey, this grain-fed steak is going to just screw me for weeks on end then destroy my gut and make me fat or whatever people think.” So, I think it’s kind of an art and a science, it’s about being a responsible consumer, who knows, and is educated about the physiological and environmental impact of what you’re eating, and then also checking yourself and not stressing out about it too much because, as you’ve outlined, that can have a pretty significant impact on the gut.

But, I’m curious, because you talked about limbic training and NLP, what’s that even look like? Can you give me an example or if somebody’s listening in, an example of if they are stressed out or if they do have an eating disorder, what a practice or what a sample routine or whatever from that style of training actually looks like?

Lauryn:  Yeah, totally. I think first starts with awareness. It’s all about getting awareness of the subconscious mind, which is again 90% of our thoughts being subconscious. So, just thoughts that we’re not aware of. And interestingly, they say statistically 80% of people’s thoughts are repeat or negative thoughts they’ve had before. So, it’s like opening up this onion layer of thoughts and I think around health would be a great example to workshop here. And, if people have whatever symptomology is, say you have bloating all the time or maybe someone has PCOS or maybe someone has an acute UTI right now, whatever it is, it’s first gaining awareness around what is the mindset connection to this symptom. And so, symptoms, I, a lot of times, have found are metaphors for the body or for the brain, like a stressor perceived stress. We talked a little bit about toxins. I think they can be the X factor. So, say you go to Mexico, you drink the water, get a parasite or a gut infection. That’s overtly toxicity happening. However, something internally or at a mental mindset level can prime tissues for disease or symptomology to show up for different people in different ways. So, I’ll give you a really just simple example.

Say little Johnny, he’s 8 years old, he eats peanut butter and jelly every single day for lunch and he has for years and he loves it. And then, one day, out of the blue, little Johnny begins to develop these skin rashes, a little bit of hives as well as gut symptoms around his PB&J. And so, he go to the doctor, the doctor says, must be a gluten and peanut intolerance. So, cut those out, see how he does. Little Johnny’s doing better. Well, when little Johnny comes to me, we do a little bit of work and I asked him or really his mom what was happening in little Johnny’s life prior to the onset of these symptomologies, and come to find out little Johnny was eating a PB&J, at the same time, he witnessed his parents have an all-out fight in the kitchen. That led to his dad walking out that day and eventually their separation and divorce. And, the way that the gut-brain axis works is it locks that in or the limbic system which traps and stores memories.

And so, now, when little Johnny sees this trigger, subconsciously he’s not thinking about the fight, the divorce, the stress, the indigestible conflict that he felt in that moment not able to figuratively digest or swallow. The body and the limbic system are correlating this trigger or this sandwich with that trigger and that stressor. And, this is all happening at a very subtle level.

Ben:  Yeah. And, by the way, this would be similar to, for example, me having a little bit of a disagreeable association with the way that pizza impacts my gut. But, maybe it’s because most of the pizza that I ate for five years was combined with massive amounts of tequila, vodka, gin, and being hangover and eating it cold from the refrigerator. And so, now, when I see pizza, I just associate it with feeling like crap.

Lauryn:  Yeah, exactly, or people may have experienced this even with just food poisoning in general. If they remember like it was that Chinese restaurant, they never want to go again because that would be now a conscious stressor that they’re aware of. And, that’s being a gut and food-related, but this really goes deeper to all sorts of symptoms.

And so, for example, my mom, she had developed a UTI the other day. I was talking to her on the phone and she was like, “Gosh, I haven’t had one in several years.” I don’t know. Well, knowing just what I know about mapping the body and what symptoms are connected to certain stressors, a UTI is connected to a territorial conflict, like territory is down there. And, I was like, “Well, mom, has there been any, I said, “territorial conflict, like you feel someone’s infringing on your territory? This can be sexual. This can also just be in our environment. It doesn’t have to be.” And, she’s like, “Yes.” I was like, “Well, what is it?” And, lo and behold, my sister had just moved back home from Alabama with her husband. They’re kind of homeless looking for a home. They have three kids all under the roof. And, my parents are in their golden years of retirement life right now and it’s just been a lot of energy and influx and being on. 

And so, she had escaped to go to their–they have a lake house. And, when I was talking to her, and a lot of times the way symptoms arise is when you’re out of the acute stressor is where they onset because you’re now in the phase two of disease onset. Stress is happening sympathetic, so we’re not feeling the symptoms when we’re running from a bear. We’re not feeling the sprained ankle. We’re not feeling the scab on our knee that we just got, we’re just trying to get away. But, when you’re away is when you feel the sprained ankle or the scab. Same thing with symptomology, and so at an onset and a lot of times with awareness around health-related challenges of what are some of the root cause stressors that were happening, not just physical stressors can be really healing and alone. Because it’s if you’re standing in the ocean and a wave keeps hitting you from behind, you keep falling forward and then you turn to face the wave, what happens? You’re able to stand stronger and not be knocked down as much. And so, it’s the brain takes back its power with this awareness, so it’s not sending that same inflammatory signal to those tissues where the inflammation is.

So, for a lot of people, I write about this in my book and kind of map out certain symptoms and what they could be connected to from a stressor perspective. And, it’s super unique for every individual. I think COVID is a great example as well. So many people had different symptoms with COVID, and some people have had guts, some people had no symptoms, some people had all sinus, some people had lungs, and a lot of that from this gut-brain connection perspective would be how they were perceiving the stressor. So, when people are say watching the news and hearing about COVID, “Oh, my gosh this is so indigestible, I cannot swallow this information, this is a lot,” it could show up in the gut. Whereas, if there’s this death fright conflict like I could lose my life, and we see this a lot with the Baby Boomers and older generations, it would show up as lung or heart. And again, all in a matter of a split-second perception of how that can result in certain symptomologies.

Ben:  Yeah, that’s super interesting. And, it makes me think about this joke I sometimes tell when I’m out and about at a restaurant, the food comes out and I tell everybody, “Wait, wait, wait, let’s pray.” And then, I pray over the food and bless it to our bodies and everything like a good little Sunday school boy does.

Lauryn:  Yes.

Ben:  And then, I’ll open my eyes say amen, and say, “Okay, now the food won’t poison you or now you can eat as much vegetable oil as you want, it’s not going to hurt you.” But, on a more serious note, when you look at this idea of limbic training in the gut-brain axis, would an example of managing that be something like prayer or three deep releasing breaths or gratitude before a meal? Because I’ve read and heard that that actually has a significant biological impact on incretin hormones and satiety, digestion, absence of leaky gut, et cetera.

Lauryn:  I’m so happy you’re mentioning that. And, that is a principle, one of many techniques that is very powerful for, again, kind of taking back the reigns over whatever the stress is, whether it’s present in your frontal lobe or if it’s a stress in your body like the symptomology. And, I mean, I think that biblically as well, what a principle, like God just kind of created this principle of Thanksgiving and gratitude, and even in the Lord’s Prayer and I think for a great reason, and I mentioned a little bit earlier the study of the water and how water responds to the energy that we send it. So, it is that about face and that energy that you send it. Or, if you think about say Victor Frankl who the man search for meaning and with purpose and vision and just thinking more positive thoughts is really what he credits his survival from like Nazi Germany or the concentration camps.

Ben:  Choose your contentedness no matter the GMO nature of the corn that you’re consuming and it’s less likely to cause you damage.

Lauryn:  I do believe so. I think just having been in that place of like being in a place of no cure for what I was struggling with and being at sub 90 pounds not in an anorexia state but in a catabolic state as an adult and just feeling like, “Man, is there going to be a way out?” The way that gave me that jet fuel was through the mind. And, I’ve just seen it so much with the most chronic of patients and it’s why I think foundationally–I mean, I build it up together because the physical is going to inform the mental as well. Our physiology will inform psychology. And so, I think the healthier choices we can choose, but that said, I still believe that the mind can greatly trump where the body’s at in our 3D reality. And so, I think it can be a dance if you are going to choose to eat a diet of Doritos for the rest of your life. I mean, that’s just your prerogative. And, that said, we all know a 90-year-old Uncle Joe who eats Spam sandwiches, orange soda, smokes cigars every day, sits in his La-Z-Boy, but live to be 99 years old. And, that was my grandma. And so, I think there is something merit of just the perception of stress and how that really does play a role.

So, I have a three-step process that I teach my clients and it’s tune into your gut, take care of your gut, and trust your gut. So, I talked about the tuning in and that’s just understanding where you’re at today and then getting a bit of vision for, well, what do you want. Because if you’re blinders are down saying a health perspective because this can apply to any area of your life, by the way, like the mind and how that can trump your 3D reality whether it’s money or whether it’s with relationships or you go on but in the health context. So, say I got vision in that hospital bed like, okay, I want to be well. Lauryn’s going to be recovered. I’m definitely not recovered in this 3D state right now. But, getting vision and basically just tuning into to where are these symptoms coming from.

Next. Number two is take care of your gut. And so, there’s a physical inside and out. So, the outside would be I teach my five gut love habits and the foundations of building back a healthier microbiome from a physical stand front. And then, on the tuning in or taking care of your gut rather, it’s really speaking gut love over your body into yourself. And so, getting a vision of that higher version of you. And, this is where the I am statements become like, “I am strong. I’m resilient. The mold can’t hurt me. I’m strong. I’m resilient. The mold can’t hurt me.” I helped my clients to find three mantras to start. That would just be core statements. And, these can change, but where you could rampage with these. If you can imagine a cartoon character where they hit it over the head with a bat, it gets those dizzy stars and spins. It’s kind of the same way for the subconscious mind. The more that we program something that is the anecdote to maybe, “I’m not good enough, I’m not good enough, I’m not good enough,” or “I’m scared, I’m scared, I’m scared,” or “I can’t digest this,” or whatever the story is. The more we can reprogram a new story, it begins to neutralize where that old story actually becomes like we forget the old story. So, that taking care is really about speaking gut love or speaking that into your life.

And then, the last is just trusting your gut. So, living in the knowing state. And, ways that we do that is through thanks and gratitude. Give thanks in advance. That’s a principle Rick Warren talks about all the time on his podcast is thank God in advance for what he’s already done in your life, but it’s just giving gratitude for being where you are and seeing yourself as if you are already there and living out of that as if state is a trusting state. And, it’s also the law of detachment. It’s like the more we’re focused and clinging to a goal, the more resistance happens. You’ve probably seen this, Ben, you’ve worked in the fitness industry forever with those that really want to lose weight for example. And so, they focus so hard on the scale, on the size of their jeans or whatever, and a lot of times there’s this resistance that’s created. But, when they jump into like, “Oh, what would healthy me do?” And, being the healthiest version of themselves and just acting as if they are already that 20 pounds down or 10 pounds down, there’s this resistance that lessens. We also see this in love and relationships. Love finds you when you least expect it. Or, with money, it’s already acting as if you have the millionaire mindset versus living in scarcity and checking your bank account or being so fearful of debt because the body senses that anxiety and that stress. So, trusting your gut is all about living in the knowing state and that it’s already been fulfilled and thanking God for the health that you’re going to have, that you have.

Ben:  Yeah, I love that.

And, it seems this question I want to ask you is on the extremities of the paradoxical because it involves hyper-analyzing a component of your diet in a manner that might actually stress a lot of people out. But, you have this poop chart in the book on page 64. I think I wrote to you and asked if we could put it in the shownotes too, so people could see what the golden poop chart is like. So, shownotes are going to be at BenGreenfieldLife.com/Lax. But, I was over at my buddy’s house last week and he showed me this black box. He’s like, “Dude, this is the most powerful one-day cleanse ever.” So, I actually because I to guinea pig this stuff, I ordered it and it comes with this guide on how to interpret the color and the length and the activity of your mucoid plaque, these things people mistake for parasites that wind up in the toilet bowl. And, while I’m not going to put you on the spot to interpret mucoid plaque, it did get me thinking as I was reviewing it just this morning over breakfast, over my green smoothie, looking at pictures of mucoid plaque, I thought I should ask Lauryn if she looks at her poop. And, if so, what she or somebody listening in could learn from that.

Lauryn:  Oh, yeah, definitely. It’s your daily report card and it’s just people are tracking their blood sugar nowadays or their Oura ring score or whatever, the monitors they’re using. It is something that ideally and hopefully we’re doing daily now. I have a lot of conversations and how’s your poo or tell me your habits, it’s normal. Define normal, please, because everyone’s level of normal is a bit different. But, the ideal normal poo would be daily if not twice a day as well as a well-formed complete SRC-shaped, easy-to-pass, and one or two passes kind of poo. That would signify a golden poo. And, if it’s anything other than that, then we just get a little bit questionable as there’s multiple factors that can contribute to different types of poo, and mostly being our eating habits and stress levels. But, that said, I do use this golden poo chart to kind of help people really assess where they’re at and get a better understanding of poo.

Ben:  Yeah, ribbons, pebbles, rocks. I get the big dump. I mean, I fill the toilet bowl every morning, not to gross people out, but then you ride in there big dump could indicate chronic constipation, which I get sometimes, by the way, low stomach acid enzymes, dysbiosis from stress, regular eating habits, low vagal nerve tone, and then the last one was a little bit of a head-scratcher for me, megacolon. What’s megacolon?

Lauryn:  Megacolon would be a toxic colon or for some people, toxic colon, some people it’s just a very enlarged colon. So, they just like are holding a lot of poo at once compared to those that are not. Just a smaller container. Kind of like a person that has a larger stomach versus those that don’t. And so, if it’s like your motility is a little bit slow or sluggish, then that could be a piece of the puzzle from a megacolon. I mean, I was diagnosed with that as a kid. They looked at an x-ray, it’s like you have a very large colon, Lauryn. And so, I was having a lot of constipation at that time.

Ben:  Congratulations.

Lauryn:  Thank you. And, just managing that is just–I mean, diet was way different than it is now, but there’s also certain supplements and digestive supports that helped me with kind of in the stage of coming out of a constipated state. Sometimes when people are say they’ve been on a train of not eating for a certain time of day and then eating more later in the day, I mean there’s just more bulk in the stool that could be creating a big dump scenario. Or, if again they are taking maybe a supplement such as a gallbladder support, that’s going to release more bile at once or help with stimulating that release right there. And so, my rule of thumb, number one is better off than in. And so, any type of poo being better than no poo because at least we’re clearing and then that I think is probably more indicative. I don’t know if you do intermittent fasting right now or what your eating time frames are.

Ben:  A little bit. Yeah. By the way, I’m so lean. I don’t worry about it that much, but I generally have 12 to 16 hours. I go overnight until breakfast that I don’t eat.

Lauryn:  Yeah.

Ben:  And, part of that is just because I don’t like to do sauna and cold pool and workouts and stuff after I’ve had a smoothie or eggs or breakfast, so I just wait until I’m done with all my things and then I have breakfast. And, by the time that rolls around, it’s been 12 to 16 hours.

Lauryn:  Yeah. Well, Ben, I teeter between that, and just straight-up golden poo is what I would call it. And, another thing I have found that’s kind of a trigger and it’s helping my body at least with the motility and bulk is I tend to eat more starch at night if I do do starch. I don’t really do much starch during the day from a blood sugar perspective, but I am obsessed lately with kombucha squash in particular. And, I find when I have something that is that soluble fiber and bulky, it is gel-like in nature. So, it is showing up as bulk in the stool in that way.

Ben:  Yeah, with some almond butter and honey and sea salt and the squash. Oh, it counts as dessert too. It’s amazing.

Lauryn:  Nature’s candy.

Ben:  You can pray God for more almond butter if you have a few extra kombucha squashes around.

So, the constipation thing is interesting because you talk about a form of constipation in the book that I’m guessing a lot of people have dealt with as they take advice to cut down on stimulants and energy compounds and coffee. You talk about coffee withdrawal constipation. I’ve never seen that in a book before. What’s coffee withdrawal constipation?

Lauryn:  Yeah. Well, since coffee is a natural digestive bitter, so it’s a bitter is going to poke the gallbladder. And, the gallbladder, why that’s important, that’s the most underrated organ I think in the body, but it’s what’s not only stimulating enzyme production and the breakdown of fats, is what people most correlated to and also just the release of bile. Bile is being released when that gallbladder is stimulated. So, if you can imagine a organ or closing your fist, ideally when a digestive bitter like coffee or a fat touches that fist, you get a nice pump, get that pump that muscle up and going squeezes out the bile to then stimulate a bowel movement. Well, if people are stripping the coffee out and maybe they’re even drinking two to three cups like the average would be or maybe it is just that morning cup, it’s just that extra little nudge-nudge that helps with that release. And so, that constipation can happen in that way.

Coffee, also as we know, is a stimulant. So, there is some caffeine release or adrenaline release that is helping with some motility for some people as well. But, the agent I find or the mechanism I find most prevalent for people is that gallbladder. And so, when we support the gallbladder say with some digestive bitters or even bile salts with meals for a time, not always and forever, even apple cider vinegar which can also have some of that gallbladder stimulating effect there, [00:48:01] _____ effect, then we can help with regulating some poo. We also know that coffee is a natural dehydrator, so it’s also kind of zapping up the hydration, being one of the number one supports for healthy motility, and a lot of folks are just underhydrated in our modern day.

Ben:  Yeah. My hack for that is I just drink more coffee because I figure the excess liquid helps to overtake the dehydration effect. That’s my logic and I’m sticking to it.

Your section on constipation was crazy. I mean, just to give you guys a little bit of a preview of Lauryn’s book. I mean, the part on constipation alone is use magnesium or buffered vitamin C, chew your food until fully liquefied, and slow down. Sea moss, one to two spoonfuls daily. I’ve used that before. It’s a really good source of fiber. I forget. Is that the soluble fiber that the sea mosses?

Lauryn:  Yeah, yeah. It’s gel-like.

Ben:  Okay. Yeah, gel-like, exactly. Probiotics like lactobacilli plantarum, Squatty Potty, I love that except when I travel, I don’t have it. Sit up straight during the day. Take a pro kinetic in the morning and evening. Eat food with breakfast instead of a liquid. Sip Smooth Move tea. That sounds fantastic. What else? Water and minerals, of course. Avoid drinking out of plastic water bottles because it causes gut inflammation. No laying down or intense exercise directly after eating. Avoid raw veggies and raw salads. And, by the way, Lauryn, that was transformative for me when I quit filling the blender bowl and my plate with giant piles of kale and spinach and the like. Avoid high FODMAP foods, digestive bitters. Like you noted, coffee enemas. I actually still do those once a week. Chlorella tablets, jumping up and down in place or rebounding. Tabletop position stretch. Squeeze your colon acupuncture point. Oh, right hand, the inner web of the right hand. Abdominal massage and hypnosis for digestion and meditation. That is a pretty comprehensive list.

When it comes to all of these different things that somebody can do to get stuff moving along, it makes me think, well, there’s got to be some things that cause that in the first place that pop up over and over again. What would you say are the primary leading causes of constipation besides not just drinking enough water?

Lauryn:  Yeah. I mean, I think overtly stressed. And, stress is such a broad term, but if you can imagine just clinching your fist, even a little kid that’s just so frustrated, they got to go, poo. It’s just like when you’re clinching your gut or you are shortening your breath, a great telltale sign for people to do or a check-in would just be pause for a minute and count the number of breaths you take in a minute. And, just to get some feedback for yourself and ideally, we were at rest or you’re moving a little bit here so your breath rate would be a little bit different at a minute, but if you’re just chilling out, do this exercise. And ideally, you want to have a four to seven breaths per minute rate if you’re in that rest and digest parasympathetic mode that the vagus nerve loves for motility. So, the average I found is 12 to 20 breaths per minute for most people. If you think, again, rest and digest meditative state in a way, it’s pausing to pray and breathe before a meal. The reason why I think prayer is also helpful for digestion is just because it’s that natural art of pause that was created for humans prior to eating food and just jumping in and plowing in for that rest and digest. But, 12 to 20 breaths is what I would say I find the average breath rate.

If we’re on the higher end of that, say if you’re in the 15, 20–I’ve had a woman, she was at 47 breaths a minute, she had no idea she was hyperventilating and she could not figure out for the life of her why she had this chronic SIBO methane-based and she couldn’t lose the last 10 pounds. And, that exercise alone was so impactful for her. The body doesn’t know the difference in running from a bear versus I just pulled up my Instagram feed and I’m comparing myself to my business rabbits that I’m chasing or to the girl that I want her body. The way that the heart is changing and the breath rate is changing. And so, that is, I think, just to show kind of how stress just residual, we don’t think we’re under stress. Exercise is a stressor, like you said, to the body. It can be a hormetic stressor. But, kind of that yin and that yang, other causes of constipation I think just going back to that gallbladder, it is so inundated, it kind of is the net that catches all these toxins and gets congested over time. 

And so, especially with females that I work with that have had birth control pills is a huge stress to the gallbladder. But then, just like plastics by and large for humans as well, long-term use of drugs like SSRIs or Tylenols, Advils, NSAIDs, obviously toxins in the food, seed oils, et cetera. If your gallbladder is just inundated, your cup gets full over time, that’s going to cause some digestive backup from a gut perspective. And, it’s also, I think, one of the leading causes of things that are downstream. So, say a SIBO or just chronic bloating and then the constipation.

Ben:  Yeah, that’s super helpful. Probably one of the most underrated tactics that you have on there is the abdominal massage. I even have a miniature massage gun. It’s made by Power Plate. It’s one of the really small ones that TSA doesn’t freak out about, and I travel with it. And, sometimes if I get traveler consultation, I’ll lie on my back on the bathroom floor and just follow the path of the colon; ascending, transverse, descending over and then kind of over the ileocecal sphincter and just do about two or three minutes of that, transformative for traveler’s constipation. I mean, it worked at home too obviously. But, abdominal massage with a percussive gun set on a really light frequency, that’s a game changer.

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Next up is some information from probably one of the most popular two-part episodes I’ve ever recorded on nutrition with the great Joel Greene. You should listen to the entire two-part podcast series but in this section, we get into whether or not cold thermogenesis is an effective weight loss strategy and how to amplify and hack cold thermogenesis using a few tricks that Joel has up his sleeve. We get into how to shrink fat cells to keep yourself from regaining fat after you’ve lost weight. As well as what happens to Akkermansia when you do cold thermogenesis. A lot of surprising stuff in this episode so I think you’re really going to dig it. So, here we go. Let’s go talk to Joel. 

This is a strategy that I began implementing after noticing the profound impact it had on blood glucose control when experimenting with this and a continuous blood glucose monitor, and that’s cold. Why not just like take a cold shower or go for a brisk walk in the cold weather rather than eating all these random things before and after the meal? Do you incorporate cold thermogenesis much at all as part of the strategy?

Joel:  Okay. So, this gets to a what, when and how question, and order of operations, and structure-function kind of question, and it’s just super, super fascinating. So, here’s the thing with cold. Cold is a foundational toolset to do a lot of things. So, what I want to do is move us from listening into the, “Cold is good thing,” and move us into, “Cold works here, cold works here, cold works here, and here’s when you do it.” Okay? So, the first thing about cold, to understand, is that it seems to potentiate macrophages, which are–I built my book around two concepts, an immune cell called a macrophage and then a protein called hypoxia-inducible factor, and they’re both related.

What cold seems to do is, particularly in adipose mass, is it flips macrophages from the inflammatory state, I call them the red team, to the non-inflammatory state, the blue team, not the halo. Okay. And so, when we apply cold to adipose mass, there’s a bunch of things that happen. So, we can use cold very strategically timed to periods of fat loss for very specific effects. Okay. A couple things to know before you start. One is that cold induction is one-to-one related to proliferation or inverse proliferation of Akkermansia. So, the reason Eskimos are fat is that cold induction drives down Akkermansia, and it makes sense. From a survival perspective, if you’re enduring a lot of cold, like if you look at people who live in northern climates, northern latitudes, you need to make more energy. So, the body has a mechanism built in that makes you make energy, and that is cold induction spins up beating, spins down Akkermansia, increases the surface area of the gut. So, Akkermansia goes down.

But the other thing that cold induction does, particularly in adipose mass, is it induces on coupling. And the really interesting thing that it does is it induces FGF21. So, FGF21 is fibroblast growth factor 21. It’s a starvation enzyme made by the liver. And FGF21 is neither good nor bad. It’s useful. It’s extremely useful in certain places. What FGF21 does is it seems to adapt the body to starvation, adapt the body to fasting, and it can induce what’s called a futile cycle in adipose mass, meaning that it can potentiate both the release and the storage of fat mass. And so, if you map it out over time in the short-term, it’s fantastic, and the long-term, it’s bad. But where this gets great is at the end of a period of fat loss, one of the–what we’ll get into later, I’m sure, one of the problems that you’re up against is that the–I called this in the book the fat loss paradox, the act of shrinking fat cells potentiates long-term weight gain through a number of mechanisms. So, we have to hack those mechanisms. One of the ways we hack those mechanisms is to hack FGF21 at the end of a fat loss period. And the way that we do that is through timing cold induction to the end of a fat loss period for a certain period of time and timing that to the production of Akkermansia. So, at the end of a fat loss period, you want to induce cold in adipose mass, specifically. And what this is going to do–

Ben:  And by the way, to jump over, when you say, “at the end of a fat loss period,” let’s say someone has done like a cleanse or a fast or gone through a period of calorie deprivation or something like that.

Joel:  That would just reduce their body fat substantially.

Ben:  Okay. Or exercise, yeah.

Joel:  Right, yeah. If you don’t want it to come back, there’s a series of steps you have to do. Okay?

Ben:  Okay. That’s going to be super important for people because we know that–and you get into this in your book, the shrinking of fat cells can trigger changes that cause a regain of that fat pretty readily unless you do what you’re about to explain.

Joel:  Right. So, one of the emerging ideas in preventing weight regain after a period of fat loss is to induce FGF21. And also at the same time, to flip types of immune cells from the red team, the inflaming guys, the killers to the healers, the blue team. Okay? So, cold induction kind of checks all the boxes. So, post that loss, you got where you want. You need a week of cold induction targeted specifically to fat mass. And what it’s going to do is it’s going to flip macrophages in your fat mass to the anti-inflammatory kind. So, it’s going to help resolve the injury that fat loss induces, which we’ll get into. At the same time, it’s going to drive FGF21 right when you need it.

Now, what you don’t want to do is continue this, like for–the research seems to suggest right around between 7 to 10, 12 days. You don’t want to keep doing it like for 30, 40 days because what happens is you’re going to spin down Akkermansia, you’re going to increase surface area of the gut, you’re going to increase energy intake, you’re going to aid the weight regain. But this is a specific example of taking cold induction as an idea and then applying it in an extremely targeted, extremely efficacious way for a specific functional outcome.

Ben:  So, the cold then would be something that you do for a brief period of time after you’ve lost weight, but then you’re not a fan of continuing the cold on a regular basis?

Joel:  I think it’s very good strategically. I don’t think that it’s something you should do all the time. What I have seen is that people who do cold induction all the time is they get this barrel chest look going on. They get weight concentrated kind of–

Ben:  The polar bear swimmer, high amounts of brown fat deposition on the collarbone, shoulders, et cetera, type of look. Yeah. But we should clarify too, like that’s some pretty hefty cold thermogenesis. Those are like 10 to 20-minute doses on a daily basis. My own strategy is quick. Jump in a cold pool before I start my day or quick cold shower. And I’ve found that to be fabulous for maintaining a lean body, but I have found not only endocrine disruption and some kind of significant sympathetic activation, and even like mild, what you might call some adrenal exhaustion or some symptoms of adrenal fatigue from people who overdo the cold thermogenesis. But these longer bouts of cold thermogenesis or cryotherapy chambers or something like that would be appropriate for a short period of time following something like a weight-loss protocol. After which, you’d want to dial it back.

Joel:  Yeah. I think you really hit it on the head. So, what you brought up is you brought up the duration, you brought up the timing, and you brought up very important things that it’s neither good nor bad, it’s the order of operations, the way you do it. The other way that I find that’s just incredibly powerful is really very similar to what you’re doing. And in my own sort of lexicon of how I do things, it’s on day two of the two-day pattern in my program where you’re amplifying fasting signals, then cold induction before the workout, on the day you’re doing sprints, on the day–the more you can replicate the ancestral dawn hunt, the better. And I think I talked about this one in the book, like it’s the hardest one to do. People are game for everything else until it comes to the cold induction at dawn, they’re like, “No, I’m not doing that.”

Ben:  Yeah. You get used to it. And you actually have a hack to amplify the effect of the cold thermogenesis, and it’s like–is it a menthol type of topical cream or lotion?

Joel:  Yeah. What you find is that you’ll get a similar effect. You’ll get [01:37:37] _____ by topical application of menthol where adipose mass is, which is really one of the places you really want it. And so, by adding the two, adding all three, actually, adding fasting, adding early morning time of day, cold induction and menthol all in one spot, it’s kind of–there’s this new word in the science called combination therapy. Okay? And it’s just like the smart word for just throwing everything at it, but the kitchen sink, and it’s kind of that.