Interview with the Doc 10/28/22
(This is an edited version of an interview I was given by a college student for one of their classes. I thought you all might enjoy it as well, so I typed it up and posted it here. Enjoy)
-Ok let’s get started. First off, I know you like treating the gut, why did you get started with this as a chiropractor?
I knew about the effects the gut has on the body from before I was in practice, so somewhere around 2003-2004ish. The gut can be a major source of chronic low-grade inflammation in the body. The lining of the gut, for a variety of reasons, can become hyperpermeable known as “leaky gut”. When this happens, you will be in a constant state of low-grade inflammation. This stems from gut bacteria traveling around in your bloodstream to your body’s tissues. This is called “bacterial translocation” and happens when the gut lining wears down, becomes too porous, and allows bacteria in your gut to enter the bloodstream.
Certain bacteria that normally reside in the large intestine or colon, known as gram negative bacteria, can build up in the small intestine and wear away at the gut lining. These bacteria contain one of the most inflammatory toxins in their outer membrane, lipopolysaccharide (LPS), which causes us to have inflammation.
So, getting chronic pain from inflammation really must be treated as a gut problem in most cases that I’ve seen. There are so many meds and supplements that address inflammation, but I’d say in many if not most cases that inflammation really isn’t being addressed. Many meds temporarily lower inflammation while damaging the gut further. And that’s just one reason. You can get overgrowth of microbes in the gut, called a dysbiosis, and they release gasses by fermenting our food. Some of these gasses are highly toxic if they are being produced in the small intestine and being absorbed into the body. Plus, the bloating of the abdomen and distension can be a constant strain on the lower back as they back muscles will tighten up. With these people it doesn’t matter how many stretches, massages, adjustments, or pain killers they take, they have a gut issue to deal with. Then there are food sensitivities that can cause joint pains, also related to a hyperpermeable leaky gut. Essentially when the gut becomes leaky it’s not only microbes that get into the bloodstream, but food particles can also as well. The immune system will see these food particles and instantly react to them, creating a food sensitivity. This is only a small glimpse into the multitude of problems from having a leaky gut. Roughly 80% of our immune system resides in the gut, and issues there can alter our immune responses for the worst. This is why many autoimmune problems originate in the gut, allergies, and all types of chronic issues. When I started helping people with their gut to improve inflammation, I got a wide range of other symptoms and problems they were having resolve like acne, fatigue, allergies, headaches, and just simply feeling better getting out of bed in the morning.
-So you look to the gut to help inflammation?
Yes, if someone is inflamed, I’m thinking gut but also diet, adrenals, hormones, too many toxins needing to be detoxified, and also I look to the gut to improve healing. The toxins and inflammation from the gut, combined with all the junk people put into their bodies, hormones, stress hormones, and medications…they all need to be processed and detoxified. The nutrients the body uses for detoxification are also needed to rebuild connective tissue like tendons and ligaments, cartilage, and skin even. The body is smart and will prioritize detoxification to keep the body alive, so joints, tendons, and ligaments get put aside regarding healing and rebuilding. Often, I’ll make nutritional recommendations that aid in the detox and repair department.
-I didn’t know that
When you go to the gut to heal inflammation and speed up healing, you see all kinds of issues heal up on people. Skin problems, weight issues, fatigue, headaches, sleep, allergies, joint pains etc. I have always had gotten the best results with the patients who wanted to put in the effort to “heal from the inside out” so I enjoy working with them.
-Wow that’s a lot, let me ask you some follow up questions based on all that.
So bacteria get into our bloodstream from our gut?
Yes. It’s called bacterial translocation; it happens when the gut lining becomes hyperpermeable known as leaky gut. Bacteria, large food particles, and anything that happens to be in the gut can get into the bloodstream. Some bacteria have a potent toxin in their outer membrane which causes inflammation and will create low grade inflammation systemically – full body- so anything you do can create an “-itis” like tendonitis, bursitis, arthritis, dermatitis, etc. There is now evidence that shows gut bacteria can be found in arthritic joints and inside degenerated spinal discs. It’s a big problem and most of the time it’s not being treated. Most of the time different treatments are making it worse.
-What do you mean? How would a treatment be making it worse?
Well for starters if you take an NSAID painkiller or a steroidal like prednisone, they can straight up create a hyperpermeable leaky gut. They also will deplete the nutrients your body needs for healing many injuries. I have never once in what 13, 14 years now seen a doctor tell their patient what to take to combat these major detrimental effects.
Antacids can cause major bacterial overgrowth by elevating the pH of the gut which makes bad microbes overgrow and thrive. Antacids also cause you to not digest protein properly, and the waste products released from microbes eating your proteins are toxic to your cells, your DNA, and are cancer causing. Oddly enough most people who have “too much acid” really have a hiatal hernia, the muscular one-way valve is open allowing stomach contents to wash up into the esophagus. Why do they have a hiatal hernia? One method is the gasses the microbes release force the one-way valve open.
Opioids can cause major bacterial overgrowth by slowing gut motility, allowing microbes to take their time eating up your food and multiplying.
Even certain probiotics, prebiotics, bone broths, and healthy foods can make an overgrowth situation significantly worse.
Not to pick on anyone’s treatment, there’s many ways to approach healing the body.
To me every treatment plan, diet, nutritional supplement, or program should begin and end with the gut in mind. There’s so much information in the natural health and nutrition world, but people seem to be lacking direction and priority.
-So you don’t believe people can have too much acid in their stomach?
Yes and no, one thing with working with many people is you learn that people are very similar and yet very different. For example, someone with high histamine levels, which is also rooted in gut problems, can have higher stomach acid levels. Someone who is dealing with stress, and is in daily fight or flight mode, will have lower stomach acid.
-How is high histamine rooted in gut problems?
A few ways. Traditionally the condition known as Histamine Intolerance is thought to be caused by having too low of the enzyme to break down histamine known as the Diamine Oxidase (DAO), like lactose intolerance where they lack an enzyme to digest lactose properly. Essentially you would eliminate high histamine foods and the symptoms would improve. Symptoms are very similar to gut issues like abdomen pains, bloating, but also headaches, skin issues, joint pains, breathing issues like asthma, wheezing or shortness of breath, even low blood pressure and passing out when the levels get high enough. Sleep problems and foggy brain are also common. The histamine levels being elevated exacerbate sinusitis and airborne allergens and they usually are always on allergy meds. In the natural health world, this would be treated by adding acid to the stomach, like taking apple cider vinegar or a supplement called betaine, and it works. Nowadays we know that certain microbes, even good ones, can convert the amino acid L-histidine to histamine, so treating that overgrowth is important. Making sure protein is being fully digested is also important. And the more up to date research demonstrates having a leaky gut allows rapid transport of the histamine being produced by the microbes to enter the bloodstream. Not to mention the enzyme needed to break down histamine is made in the lining of the intestine, so inflammation and overgrowth can interfere with the enzyme levels needed to break histamine down. So yes in a few ways having gut issues makes allergies worse.
-Wow that’s awesome. I have bad allergies, I never thought it would be a gut related problem
I know, this is why the gut is the foundation to health. I can’t think of a condition that won’t find benefit in a healthy gut.
-So you’re seeing overgrowth as a cause for leaky gut?
Yes overgrowth, is one major way. Diet is another. Lifestyle, alcohol consumption, having an illness, exercising too intensively...there’s many ways it can happen.
I’d say people who know they have a gut issue most likely have an overgrowth. They get pain after eating or get gassy, bloated, diarrhea or constipation. Sometimes they’ll have these symptoms for months or years. The imbalance of good to bad microbes is called dysbiosis and can make you very sick. With dysbiosis the microbes will eat your food and release gasses, and some of these gasses can be very toxic to us. They also will wear out the gut lining and gain access to the bloodstream. Once that happens the gut will be leaky. Candida is a yeast that can overgrow in the gut. Wherever it attaches to the gut lining will be hyperpermeable and leaky underneath.
It’s important to identify why there’s an overgrowth, so it doesn’t keep coming back.
-What do you find is causing overgrowths to occur?
Once again everyone is different. Diet can cause significant changes in the gut creating too many bad bacteria to overgrow known as dysbiosis. If large intestine or colon bacteria escape into the upper gut, the small intestine, that’s when many of the symptoms begin to happen like bloating, belching, pains, etc. There’s a valve that separates the large intestine from the small intestine called the ileocecal valve. If it spasms or gets stuck open, then the microbes can travel up into the small intestine and gain access to the body. There’s a simple massage technique to help the ileocecal valve that works great. Constipation is another major cause. As the stool contents sit in you microbes will multiply rapidly. Being stressed out possibly is one of the more common causes. Stress affects the Vagus nerve, and the Vagus nerve controls the intestinal movement of food. If you’re stressed, and the food is moving slowly through you because your trapped in a fight or flight mode, then you’re giving microbes more time to eat and multiply in your small intestine. Not fully digesting food, which can happen with age, stress levels, or medicines to name a few, will also give the microbes more to eat, ferment and grow.
-So, being stressed out creates the overgrowth?
It certainly is one of the ways! Basically, our body handles an acute stressor great. You wake up, see a home intruder, and instantly your adrenals activate, dump adrenaline into your body, creates sugar for energy, blood leaves your guts and goes into the muscles for fighting, or running from this guy. As far as your survival is concerned, digesting, going to the bathroom, making hormones, complex thoughts-all get put on the backburner. This is a good thing. However, with chronic stress the body behaves very similarly. It releases cortisol as its long-term stress hormone. Cortisol will have similar effects on the gut, hormones, and sugar levels. Unfortunately, we want and need our gut to digest food and eliminate it in a speedy fashion. We don’t need all that extra blood sugar, so it gets converted to fat. The gut microbes alter significantly, inflammation goes up, and the gut becomes leaky. So yes, not only does being stressed out create overgrowth, but it will also cause it to return. This is why when you work to improve your gut health, you usually also must improve your stress handling as well.
-How does diet affect the leaky gut?
Processed foods, high unhealthy fats, high carb, high sugar diets like in the US is a major culprit. The high fat and processed foods can cause inflammation along the gut lining and induce a leaky gut that way. Certain bacteria are attracted to inflammation and will thrive there. High fat/high sugar will cause a dysbiosis overgrowth, it’s been demonstrated over and over in research. Alcohol effects the gut in a few different ways, all of which result in it becoming leaky. Microbes love to eat sugars and carbs. But they can adapt and eat proteins as well.
-What about the carnivore diet or keto? High protein and high fat?
Glad you asked. Yes, there are weight loss benefits to the keto and carnivore diet, as well as blood sugar and metabolic. Because carbs, sugar, and fiber feed microbes so well often diets that exclude them help to reduce bacterial numbers. In the short term this is great, but in the medium to long term you will want to add certain foods like fruits and vegetables, or even soluble fiber to aid the growth of healthy microbes.
-Why is that?
Microbes need dietary fiber to eat, ferment, and release short chain fatty acids (SCFA’s). SCFA’s are produced by the microbes of the gut and are one of their most important aspects. SCFA are needed to keep the intestines healthy and uninflamed, protect the gut lining from becoming leaky, the blood brain barrier strong, cells utilize them as a source of energy, they kill off bad overgrowth, amongst many other positives. A diet that consists of very few carbs will have very few SCFA production, very few good microbes, and a greater chance of microbes eating protein and releasing their waste products.
-So, what diet do you do?
I personally probably eat a modified Mediterranean diet if you were going to label it. That “style” of diet eliminates processed foods, added sugars, and has you eating a variety of fruits and vegetables. However, many people don’t have a gut healthy enough to jump right into that, so don’t take that as advice for someone with gut overgrowth issues. If you have overgrowth that needs to be dealt with first and so you might need to modify your diet accordingly.
-How does that work?
Well, you will have to limit healthy foods like fruits, carbs, sugars, and fibers. Microbes will more than happily eat these and ferment them. If you have bacteria that migrated into your small intestine you must starve them out first, then build a healthy gut. And it’s not always so simple. Microbes can create a biofilm, which is like a slimy protective barrier. Often that biofilm needs to be dealt with or the failure rate will be high. The stress system is another major system that must be addressed. Having adrenal fatigue or overly stressed adrenals will continuously wreck the balance of the gut. If you’re constipated or have slow motility that needs to be addressed or the overgrowth will keep returning. Keto has shown promise with a variety of neurological conditions. If you have adrenal fatigue, you might need to go heavier on the fats and salt. Ultimately people are different, but you want to get to a place where you have a healthy gut, and everything that’s involved to get there.
-That sounds complex.
Well, it is and it isn’t. I’ve had quite a bit of trial and error, and I’ve worked with many people. Most people are quite easy, I treat their adrenals and gut simultaneously. Some people from being stressed for so long, or suffering an illness simply wipe out their immune system, so sometimes you must investigate that too. Starting with is the stomach producing adequate acid to fully digest food, is the body eliminating foods efficiently and in a timely manner, what are you eating and taking, are you getting gassy, do you get sick often or easily or recovering from a major illness, do you have adrenal fatigue etc. etc. There’s a bunch of things to look at, but it all ties together.
-It seems like many people online talk about the gut and autoimmune, what are your thought s on this?
Ok, there are some conditions a leaky gut can straight up cause. You would need to have a gene for the condition that gets turned on. Celiac disease for example requires a person have the gene, have a leaky gut, and the bloodstream gets exposed to gluten. Many conditions like autoimmune arthritis’s have roots in a damaged gut lining. Also, though sometimes we don’t know what came first, the autoimmune condition or the leaky gut. Healthy microbes like Bifidobacterium help regulate T regulatory cells, they are like the conductors in our immune system orchestra. So healthy gut microbes can assist in keeping our immune system from attacking us. Also, there’s molecular mimicry, so when food enters the bloodstream, and the immune system attacks it, it can also attack anything that looks like that in our body. Different dairy proteins, corn, and soy proteins are common ones I find.
-OK to wrap up this interview, what would be the number one thing a person should do to have a healthier gut?
It’s difficult to say what would be the one thing. It greatly depends on where you are at. Some people have so much inflammation and overgrowth they need some time to focus on repair and rebalancing the microbes. Nowadays people are so stressed out, so focusing on improving that is vital. If we are talking about a hypothetical “healthy person” I’d say watch the sugar, processed foods, additives, unhealthy fats, alcohol, and medications. Eat balanced with a variety of color in your fruits and vegetables. This is what evidence shows to have the healthiest microbes, and they are running the show inside of us. To shamelessly promote myself, I’d say find someone, like myself, who has helped many people heal their gut and listen to your coach. Age and stress effect stomach acid levels, and low stomach acid levels begin the process of harming our gut, creating overgrowth, and malabsorption of most minerals and nutrients, I’d probably say look to the breakdown of food in the stomach as well.
-Thank you so much for the interview and your time, I learned so much, and I needed this for my final grade.
No problem happy to help!