Episode Transcript
[00:00:05] Speaker A: Welcome to Anti aging unraveled with Dr. Lori Gerber. The body is one of the most complicated systems in the universe. Dr. Gerber and her guests explore integrative medicine and cosmetic dermatology, combining traditional medicine, alternative health practices, new innovations and technology which work together to help you look and feel natural and age gracefully. Now here is your host, Dr. Lori Gerber.
[00:00:30] Speaker B: Hi everybody. This is Dr. Lurie. Welcome back to Anti Aging Unraveled. And I am very lucky to have with me today Mark Brown. He is my guru for Ortho Molecular. That's what I'm going to call you today for Pennsylvania and Delaware. Right.
And he's actually my representative who helps me figure out what products I'm going to bring onto my line and in all honesty knows more about the topic we're talking about today than, than I do for sure. And we're going to bring a topic to you that I think many people either have heard the words or the an acronym but don't really know what it is. And that is called sibo, S I B O and it's Small Intestinal Bowel overgrowth. And we're all so used to saying we don't have the right gut microflora and these big words, but really this is a disorder that became popular a long time ago actually and the anacronym was coined a while ago from a post surgical gut issue patient and now has really become a little bit more mainstream when we realize some of the pathophysiology that's similar between those patients and basically a regular person. And I would say, and I don't know, you can correct me if I'm wrong, Mark, but I think this is probably one of the most under diagnosed disorders, if you will, in medicine, to be honest. So we're going to talk a little bit about that, right?
[00:01:58] Speaker A: Yeah, absolutely.
[00:02:00] Speaker B: So sibo, Small Intestine Bowel overgrowth. So the anachronym is exactly what it sounds like. It's your bowel basically having these bugs that are overgrowing in your small intestine. Right. And I guess what I want to pick your brain about is, is one, why, why has this not been kind of talked about more? And what, what is this, what exactly is happening when we say that these bugs are overgrowing? Why are they overgrowing in our small intestine?
[00:02:31] Speaker A: Yeah, there's a lot of reasons why this can happen. A lot of them can be related to autoimmune diseases which are plaguing our country. I did a presentation a couple of years ago, where there's 50 million Americans at that time were diagnosed with an autoimmune disease. And the equivalent to that is like taking the state of Texas and Florida and putting them together. That's how many people have an autoimmune disease in our country. And they're two of our. Some of our biggest states.
In addition to that, motility is probably one of the most leading causes to people having some form of sibo create.
Basically, lack of motility will lead to this boost buildup of, like a playground for this bacteria to overgrow and be pushed up into your small intestine. And that gets into a more specific conversation of this thing called your migrating motor complex. Sounds like a really fancy word. Took me a while to learn, so I like to say it.
But it's basically these small peristaltic movements that help push waste out, These parallel static movements. Just think of it as like, if you've ever fasted for a long period of time, you start to hear that grumble in your stomach. That's your migrating motor complex working. And that is one of the therapies we do recommend for people with lack of motility is intermittent fasting, but with decreased migrating motor complex function. You again, you start to build this playground for bacteria to overgrow and gently work its way up into the small intestine, where you start to develop sibo, small intestinal bacterial overgrowth.
[00:03:58] Speaker B: Now, doesn't the small intestine already have bugs in it? I get that question all the time. It's like, well, if my large intestine has a certain amount of bugs, shouldn't my small intestine have that same amount of bugs? Or is there a line that differentiates one between the other?
[00:04:16] Speaker A: Yeah, it's the type of bacteria that you'll find within those different regions. And sometimes you have people in the wrong neighborhoods and they create problems for you. It's kind of the definition of sibo, where you just get these. These people who aren't familiar with their territory, and they're acting differently than they should be in that specific area. And they're creating a lot of problems like gas, bloating, diarrhea, et cetera.
[00:04:38] Speaker B: Okay, so I'm gonna. I'm gonna go back a little bit. So, yeah, have these bugs, and let's just say someone's been to six different doctors before they end up with me, which usually happens. And they've been on probiotics, they've been on other digestive enzymes, they've been on all these things.
Are these the People that were trying to say maybe possibly have sibo.
[00:05:02] Speaker A: Yeah, it's definitely worth exploring. SIBO went typically very undiagnosed until, like, 1994. I think it was one of those things that didn't have a name, so it got put into the IBS catch. All of you have a syndrome.
I even remember I was in the army for a few years and I had terrible GI issues. I was also eating MREs every day, but packaged food that's supposed to last forever.
But I remember going to a traditional doctor and them scoping me and getting their paycheck, and then they were like, hey, there's nothing wrong. You got some small inflammatory issues. And it wasn't until I found ortho that I found they had a lot of larger issues. But, yes, sibo is something that typically just isn't talked about a lot, but it's coming more and more to the forefront of the functional medicine community, which is great because it's. It's really helping a lot of people. You know, the person you just described is a lot of people that walk into your office specifically is, I've been to this doctor and that doctor, and nobody can tell me what's going on. And, yeah, SIBO is becoming one of the most highly diagnosed things in our community today.
[00:06:07] Speaker B: So what? So you talked about motility, and there's two things in my brain. Again, I need to break this down into simple things, guys. I'm not act like I'm smart, but I motility. Okay? You can't get food for everything to pass through. What is dysbiosis or what does it mean when your gut is dysbiotic? I think people hear that all the time. And I would say that, to me, is the other arm to sibo. And you can correct me if I'm wrong, but what is dysbiosis? What does that mean? What does it mean when you have a dysbiotic bowel?
[00:06:41] Speaker A: Sure, it definitely plays a role in the creation of sibo, like the early stages, I would say. So all these things are like domino effects. One, it's a trigger, and then they. And they fall. But dysbiosis is very simply put of if you've ever been on a seesaw, it's kind of like you want to create balance that seesaw. So two things are in the middle. When you have dysbiosis, you're taking your bad bacteria, and it's greatly starting to outweigh your good bacteria, and you have all these bad actors. So as your immune system is starting to reach up through the dendritic cell, which are basically these things that will come up through your GI tract, they'll pull things down, they'll present them to your immune system. The more bad actors you have, it's going to start really ramping up your inflammatory respons. And that's how you start to develop these syndromes or other conditions, autoimmune diseases. This is the basis of all those things. So when we talk about gut brain connection or gut joint connection, it all starts there. And it typically starts with dysbiosis. And that's why things like probiotics, some of the products we'll discuss later are so highly recommended because all you're trying to do is again, create that good balance between good and bad bacteria.
[00:07:47] Speaker B: And I think that's really important, guys. And you hear me talk. One of my favorite, what I call triangle is the gut immune brain triangle. And the. He's talking about these, I call them finger cells, but the dendritic cells that actually they present these, these things from your gut to your body. Right. And that is the root cause of the gut immune connection. Right. It's literally the presenting cells. It says, hey, here's a red flag. This is the bug, right? Or this is the infection or this is whatever.
And that's where these autoimmune phenomenons start. And that's so important to understand. People think, well, I don't understand how the gut and the immune system are linked. It's a huge lymphatic organ. The gaunt and the Malt, right?
[00:08:28] Speaker A: Yeah. 70% of your immune system is found within your GI tract.
[00:08:34] Speaker B: And actually I just found a really cool stat, which I didn't know, not to this extent, that 95% of the body serotonin is made by gut bacteria.
So I thought that was completely impressive. So we go back again to the brain part of it. Yes, there's other reasons for brain inflammation, but if your gut bacteria is off and you're not making appropriate amounts of serotonin, just think about what happens.
[00:09:01] Speaker A: Yeah, yeah. It's a huge chemical imbalance. I mean, not to get too far off the beaten path, but when you look at a lot of these neuro issues as far, even like autism is a big one. When you can start to reregulate gut function, you have huge improvements in symptoms with patients who suffer from some form of autism as well.
[00:09:18] Speaker B: Yeah, no, agreed. Obviously not everybody, but it definitely plays a component for sure.
All right, so we have this gut autoimmune immune connection. We have this motility lack Thereof. Right. So you're getting. Things are getting stuck. Right. It's almost. So my. My question always was, why diarrhea and not constipation? The overriding symptom, guys, at least one of them is diarrh.
And I think that really, I don't know. And again, correct me if I'm wrong, but I think that goes back to lack of digestion and lack of the ability to absorb your nutrients. Yeah, an electrolyte shift.
I always thought it was kind of fun in my brain. It tells me constipation. But what I want to put out there is 90. If you're going to have one diarrhea or constipation with this, it's 99% of the time. Diarrhea.
[00:10:10] Speaker A: Yeah.
[00:10:12] Speaker B: So let's kind of shift gears a little bit and let's talk about the. What do you find? What do. Like, what do I find when I'm looking for labs? What am I looking for to treat. To find something in this patient? If I'm not doing some of the gut testing, what am I looking for in blood works? Let's start there.
[00:10:32] Speaker A: Yeah, it can be presented a few different ways. More commonly, there's a new test, looks like igm, igg and IGA sc, and that gets into a very complicated conversation about cdts.
So as you have this present of trying to think of a way to explain this a little more simply, as SIBO starts to present itself, you start to get this release of something called cytolethal distending toxins. And as they start to disrupt your epithelial lining, you'll start to have this higher amount of release of IGGs, IGAs and IGMs.
[00:11:08] Speaker B: Just so you know. Okay, I'm just helping you out. Antibodies.
[00:11:13] Speaker A: Yeah, these antibodies to help fight off this, not an infection, but fight off what is. What is occurring. So that's one way they can do it. Very typically, breath tests are how it's traditionally done, and they can be very hit or miss, too. They take a long time. Some people don't want to sit there for two to three hours and do a breath test.
Most. Most diagnosis that I see with my clinicians are more subjective.
And so a lot of gas and bloating is one of the most common signs you'll find with a lot of patients don't respond well to typical probiotics.
Constipation, diarrhea being another one.
Hypochlorogia is another one. So PPI users as well. So there's.
[00:11:57] Speaker B: What is that?
[00:11:59] Speaker A: Stomach acid issues.
But yeah.
There are a few other ways you can kind of start to start to narrow in on what SIBO is and if a patient has it.
[00:12:11] Speaker B: So just so you guys know, when I. And again, this is a new. To me, this is a newer diagnosis. I think it's been out there for a million years. And I used to say, hey, I always thought IBS is a wastebasket diagnosis. It doesn't tell you anything other than you have problems in your bowel.
So to me, I would venture to say probably, and I'm gonna just throw out a number. Probably 80% of IBS people either have a lack of digestive enzymes or they have sibo or both. And that's just. You know, again, there's probably. How many other disorders can there be? Probably a lot that we don't know. Right. So, you know, when I look at a patient, I end up getting labs first and a story, and the story of usually bloating, cramping, lots of food sensitivities or intolerances, and usually a feeling of feeling really full after eating or bloating. That's the key.
So I don't usually see people when they say there is a lot of terminology like malnutrition and that kind of thing. I don't see people getting to that point, at least not with what I do. But that is, I guess, in theory, what's going on is we're not absorbing enough nutrients. So when I look at their labs, it's really interesting. I call them poor absorbers because their B12 is low, their iron's low, their thiamine's low. You know, they sometimes have an anemia of sorts, low hemoglobin, and. But what's interesting is their folate is almost always normal, which. And again, folate. High folate is a part of bacterial synthesis. So when you have a bacterial overgrowth, they'll actually have high to normal folate, which, again, I didn't know until I started. Really interesting. Yeah. So I think that's really, really interesting that I can go back now and look at my patient population that I've treated for however many years before Ortho came out with some of this SIBO supplementation. And I'm like, wow, I was treating them this way for a long time, and they've still been persistently not getting better.
[00:14:12] Speaker A: Yeah.
[00:14:12] Speaker B: These are the people that I'm kind of now looking at their numbers and saying, wow, they were a massively poor absorber.
I haven't been able to get their D up without giving them 10,000 IUs of vitamin D. So that being said, I don't know that I would start doing breath testing. I did get that question, actually.
Someone was asking, do we do breath testing in the office? And it's not something that I think is necessarily worth the time because there is so much, a lot of time, it doesn't yield the results that you are looking for, and it is very time consuming. So I don't know how you feel about that.
[00:14:53] Speaker A: But my whole thing with testing, and it's amazing, I have a really cool position where I cover pretty much the entire state of Pennsylvania and Delaware, and each doctor has a different philosophy, and I tend to side with the practitioners or if you suspect sibo, you're going to treat it anyway, you're going to address that first. So as we get into more of the therapies of this, we talk about reconditioning your GI tract, which is important to do anyway. It's a starting point for you. So even if you're starting on these products, it may have a benefit if you were to be diagnosed with sibo, but it's also playing a vital role in setting you up for success in the future with other therapies you're going to do to be more specific to your treatment plan. Same thing with, like the. The GI triad we've discussed several times is you're coming in here, you have some form of intestinal permeability. It's a good chance that you do. So starting you on this therapy and getting you a great starting point is key. And testing is expensive and it's not always necessary can cause a lot of discomfort for patients. Stool testing especially. Many people aren't very keen on putting the whole pan in the toilet doing that game. So if you can save them that, they'll be thankful.
[00:16:06] Speaker B: Dirty game, but somebody's got to play it, right?
[00:16:08] Speaker A: Exactly. Yeah.
[00:16:09] Speaker B: Well, I mean, so I got a question. How do you know if you're at risk at sibo? And so I think we kind of covered a little bit of that, but I'll touch. I'll touch into that a little bit more. I think the people that are at risk for SIBO are those that have what we would call dysbiotic gut, autoimmune disease that are already, and leaky gut, if you will, they're just not behaving appropriately. And how do you know that? Well, I would say nine times out of 10, you're having some kind of reflux, gastric discomfort, GI discomfort, but you can be having the autoimmune things where you're getting sensitivity to new foods all the time, you're finding that you're having brain fog and you can't function from a mental state. So people on PPIs, which are acid reducers, guys, for the stomach, I think this is probably, probably one of the biggest ones, if you really ask me.
Proton pump inhibitors, which is. And without throwing out brands, it's the little purple pill. And you know, there are more of them. But now that that's over the counter, you know, you have to think about the downstream effects of that, of suppressing stomach acid. Well, the bugs that grow there are going to change, right? Things are going to change inside all these IBS patients, celiac, new and multiple food sensitivities. A big one is antibiotic overuse.
I think that is another one that people forget you're on. Especially with COVID right now. I feel like people are doing so well with boosting their immune system that the second they go on an antibiotic, I think even for any prolonged period of time, it actually. And then they forget, right? They forget. They have to keep working on their gut. They keep. It's like a. It's a slippery slope.
That is a big one. And I see a lot of chronic Lyme patients, so I do see a lot of SIBO with that type of overuse of or it's necessary, but there's a lot of antibiotics on board.
It used to be surgical, right? I mean, that was a big one too. You know, you had a. Had a bowel resection or injury to the small intestine of some kind.
[00:18:23] Speaker A: Yeah, yeah. It'll trickle over into like ulcerative colitis, Crohn's type patients. I have a family member who had a large section of their colon removed. And it was like a constant thing for this person. And we kind of like had to go back and forth with doctors. And I finally was like, hey, maybe why don't we try this on for size? And it's been a life changing experience for that person.
So, yeah, that taking out of the bowel and that would even result in some more extreme symptoms. When you mentioned brain fog, like instability, equilibrium issues, it can really get pretty dicey for that person if they're having this excessive bacterial overgrowth.
[00:19:03] Speaker B: This is a question I had as well, and this is a couple weeks ago from somebody. So if you have what I call a lack of absorption or poor absorption syndrome, like a sibo, would you show more osteoporotic tendencies because due to lack of absorption of your calcium?
[00:19:24] Speaker A: Yeah. I mean, in general. So bone building is a very complex thing that we start since from the day that we're born, and it kind of peaks at a certain point. So everything you do up to ages between the age of 32 and 36 are your bone building years. Especially for women, you have this very strong decline as you reach premenopause and postmenopause.
So things that elemental is too. Boron, selenium, strontium, all those things play crucial role in that bone matrix complex of building healthy bone. So calcium is another crucial one as well.
Yeah. So as you start to have these, everything is GI related at its foundation. If you're not addressing GI first, it's. You're not gonna. You're gonna be doing spot treatments continuously down the road. So GI first make sure digestive isn't intact, make sure you have eubiosis, which is the opposite of dysbiosis, and you don't have leaky gut. And that's when you can start there. You can start to really improve other areas of your life, whether it be mental, musculoskeletal, so on and so forth.
[00:20:31] Speaker B: Now, are GI docs still doing small intestine aspirates or any culturing do you know? Or kind of a way of the past at this point, but then.
[00:20:42] Speaker A: Not something I've been exposed to. No.
[00:20:46] Speaker B: I just. I know that when I was looking at some of the history that that was one of the first diagnostic tests that they were using, and I didn't know if anybody was really still doing that anymore or not.
It's calling it the gold standard, but I would say that that's a pretty. It's a long road to get there. And maybe you reserve that for someone with like severe ulcerative colitis or something that you're still trying to figure out what.
Where to go with them. But I do have one patient who has severe Crohn's that has been flaring since pregnancy pretty significantly that I will be trying this protocol on who they just cannot get her under control. And again, I think we start to look at. If you're looking at the forest through the trees, right.
We start to focus so much on the inflammation and shutting that down. What are we. We almost are perpetuating it at times, right. The steroids, everything else. Because we're making the gut worse. What's happening is we're just driving the pathway towards further dysbiosis. Right. I mean, we're just making it more irritable, more irritated and raw. And all we're doing is Keeping the ph in an unhappy place. Right.
[00:21:58] Speaker A: Yeah.
To bring it back to sibo. I mean, the typical treatment is rifaximin, which is a pretty heavy dose antibiotic. And the recession. Not recession rate.
The rate in which remission rates. Thank you. It's after five. Not so sure. The. The remission rate of these people is like upwards of 80%. It doesn't really. And then you. You're just clearing everything of good and bad bacteria. There's no dissemination.
[00:22:27] Speaker B: Right.
[00:22:28] Speaker A: And you're creating unfavorable environments for bacteria to grow. Again. It's. It's a. A weird path that we go down for some reason.
[00:22:36] Speaker B: So we're going to spend the last 30 minutes or so, guys, talking about treatment protocols. And I think that this is something I'm launching big time right now, because I feel like now that we're all out of this Covid fog, if you will. And again, I hope the COVID fog continues to stay lifted. But I feel like we all need to take a look at what was happening with our immune system and our guts, because when you look at the data, and there is data on this, people that have a healthy gut and a healthy immune system and that aren't autoimmune, that aren't very pro inflammatory, didn't get very sick with COVID or didn't get Covid at all. And now that we have the time to kind of address, you know, the underlying concerns here, that may have put you at a higher risk for being on a ventilator, that may have put you at higher risk for this inflammatory cascade.
Look at SIBO and try to say, all right, let's get these people healthy. So I'm making a big push with orthomolecular and some of my branded product, and we're launching what I call the repair and restore line. And it's literally a group of products meant to heal Sibo and heal. I'm putting that in quotes. Sorry, Mark. Heal Sibo.
[00:23:51] Speaker A: Careful.
[00:23:51] Speaker B: It can say calm it down, restore, repair. But that's my big push. Because I think while we have the time, let's focus on what is the primary thing that is wrong in our bodies, and that is nine times out of ten, what we're eating in our gut. So let's talk treatment protocols.
You alluded to antibiotics, and it's probably my least favorite one, but I know that it is a necessity to some people.
And how long are people typically? Is it is a short course of antibiotics? Is it a long course of antibiotics? Do you know that answer?
[00:24:27] Speaker A: It Usually depends on the patient and the expression of symptoms, but I believe they usually try to do it. Well, first of all, our Faxman's a very.
Most insurances don't cover it, so it's very expensive.
But it's usually anywhere between half a month to a little bit over a month treatment for these people, they may experience some alleviating symptoms, but then they kind of fall right back into the gas and bloating, not feeling well, diarrhea, so on and so forth. So, yeah, to answer your question, about two weeks to a month and a half.
[00:25:00] Speaker B: Okay. And what else is out there? So if we. Let's just say we did a month of antibiotics and we're trying to avoid the relapse, if you will. We're trying to avoid that falling back into the same pathway. What are the things that people are going to do besides the supplements? We'll talk about. What are some of the things that people want to do to avoid that?
[00:25:22] Speaker A: Yeah, the biggest thing is lifestyle changes. So we talked a little bit about intermittent fasting earlier, but fodmap diets as well. So low fermentable foods that you would eat, things that would exacerbate symptoms as well. And this kind of gets into a confusing conversation about the use of probiotics as well. If you have sibo.
[00:25:42] Speaker B: Mm.
Might as well go there because I'm going.
That is the next point. So go for it.
[00:25:50] Speaker A: Yeah. So as we get more into the product specific things, there's different strains of probiotics that are available, but what we see with SIBO specific patients is that if you utilize traditional Lactobacillus or Bifidobacterium strains, you can actually exacerbate symptoms. So these bacteria that fall within the small intestine will feed on them and they'll create gas and bloating conditions to be even worse.
So it kind of puts you at a roadblock when treating these patients. And it's kind of a good thing in some ways where it could be an indication of, okay, maybe this person is leaning a little bit more towards sibo. We need to adjust to our approach.
[00:26:26] Speaker B: So it's almost diagnostic. I agree with you. I think it's a tool and a diagnostic indicator. If someone does not do well on a traditional probiotic and he threw out a bunch of big words there, but no, it's. I mean, I do it all the time. What we're talking about is really, if it doesn't say that it's a spore probiotic, essentially, then there's lots of different bugs that they put into probiotics. Those bugs become food. Essentially. They're feeding the bugs that are already there and create more and more and more gas and fermentation. Right. So the problem is we want to get those off of them and then put back something else. So, but what are the other things that feed it? I mean, there's lactose. Right. So dairy.
[00:27:15] Speaker A: Food will feed dairy. I'm trying to think of the acronym for fodmap. I say it so much, but I have it.
[00:27:23] Speaker B: It's ferment. I'm not going to, I don't have it memorized. Fermentable, oligosaccharides, disaccharides, monosaccharides and polyols.
[00:27:33] Speaker A: There you go.
[00:27:34] Speaker B: Right, In English, fermentable stuff. Right. So anything that it can break down and ferment is really what you're avoiding. Right. So and what, I guess really what is that? And I would say like sugars, carbs, dairies, artificial sweeteners. Right. That's a big one.
[00:27:55] Speaker A: Yep.
[00:27:57] Speaker B: Oh, I was looking at the FODMAP earlier.
[00:27:59] Speaker A: Yeah. Cheese, grain based things. Nuts, seeds, very good.
They like green leafy vegetables can be good. Certain nuts and seeds that are high in fiber content would be adverse to what you're looking to accomplish.
[00:28:16] Speaker B: Okay. So you know, we're looking to. And then obviously I think a big part of this too is figuring out food sensitivities and what you're. And what you're sensitive to in general by doing those antibody testing kind of that we talked about earlier.
I think that's really important because there's certain things that your body's still gonna need to avoid because you're just making too many immune cells against it.
And until we calm it down, you're not gonna be able to tolerate them. So you're right. Diet. To me, diet changes. And it's really hard to tell someone to avoid all this stuff, but when they're really sick and they can't because everyone's like, oh, really? That's like everything. Right. It's like everything. I eat protein. Right.
You know, I think that if they're really uncomfortable that this is going to be a very, they're going to be very agreeable to do these things.
[00:29:06] Speaker A: Yeah. And there's a ton of resources out there for you as well. If you are a person who's experienced sibo, if you just type in low FODMAP diets. I mean it's becoming so much of a popular thing. Even some supplementations as far as like. So greens can be difficult for some people. Like cruciferous vegetables, breaking them down, especially if they're having digestive issues.
If they can find, for example, orthomolecular provides like a fodmap specific greens. So you can still get your fruits and vegetables in without having to experience that gas and bloating. I know I'm an apple lover and apples for me are very gassy foods.
[00:29:45] Speaker B: I can't do apples because one thing that I'm so sensitive to that I haven't been able to get rid of. So I am with you on that one. It's a cross reactor with a lot of pollen, so too. So it's a super highly sensitive fruit for a lot of.
[00:30:00] Speaker A: Yeah.
[00:30:01] Speaker B: So let's talk a little bit about my favorite. What is a.
For probiotic? What does that mean? And some people call it a soil based probiotic, right? Yep. What does that mean, soil based? We're eating dirt. And what is that.
[00:30:22] Speaker A: Kind of. Yeah, it actually has like a fascinating story leading all the way back to World War II, I believe, where people, they were growing in like camel dung and people were using it to fight off Dysteria, where they were getting like massive infections. And then America kind of came to this crossroads where they decided of, do we utilize these spores which can kind of identify the environment they're in and respond accordingly, or do we just use antibiotics, which at the time had become very popular and we can kill everything and, well, obvious what route we went down.
But yeah, in nature, once they're exposed to certain nutrients, basically the endospore that is the spore based probiotic will go into a vegetative state and loses its resistance to environmental stress.
But within our GI tract, they do this thing called quantum sensing, which is.
[00:31:14] Speaker B: Kind of cool if you guys follow the terminology. It's cool.
[00:31:19] Speaker A: Yeah. If you have a second, just YouTube quorum sensing, it's kind of fascinating. It's very similar. I always use the example of adaptogens for more mental health, but they can adjust to the environment in which they're in.
[00:31:32] Speaker B: Yeah, I like that story. Yeah, yeah, go for it. I like that story. It's a good.
[00:31:39] Speaker A: Yeah.
It really sets the scene of identifying how these will work for the SIBO patients. So we're constantly, for the last half hour, been talking about bacteria being in an environment in which it's not supposed to be. So how these spores kind of work is they will move into this environment and kind of go by the basis of separate and conquer. So they're Constantly manipulating the environments in which they're in. So as they fall into the small intestine, they will create unfavorable environments for the bacteria that are there and push them back into an environment where we kind of want this battle to take place, which is the large intestine. So once reaching the small intestine, they will release certain proteins, enzymes, back to size, which are very similar to like a mechanism of an antibiotic, and gently push these fragments back into the large intestine once they reach the large intestine and become more of this, more of a pro force in this way, or a positive thing where they're helping create an environment for good commensal or good healthy bacteria to flourish.
That's one of the unique things of these spores and how they kind of differ from regular probiotics. So I think that's important to kind of hit on is regular probiotics are transient beings. We're constantly trying to, if you have two cups on a scale, we're constantly trying to fill up the better beverage so it's healthier. Bacteria is crowding out the bad bacteria and they last seven to ten days. That's important. I always get like, oh, probiotics are changing the bacteria. It's not quite how it works. They're transient beings, so typically seven to 10 days, whereas spores can remain dormant for up to a month. So they're constantly having this positive impact on the environment in which they fall.
Yeah, it's always amazing how these things work. And given the back history, how people figure out how they work is even.
[00:33:34] Speaker B: More interesting, I think, just to, just to put this out there for you guys, since he knows a lot more than we do, there's a bug. The spore that they use is bacillus. Right. So bacillus is a bacteria that is known for laying, I should say laying, but creating these spores that are dormant. So it's still a bacteria. It's just sitting there quietly and it's, it's alive. It's just not, I would say it's not activated. It's almost like it's in a shell. That's the best way I can think about it.
So they have, they have a much longer half life, if you will. They last a lot longer in the system. And they don't, again, they don't create this nidus or this area for the other bugs to feed on because they're this dormant rock. Like they're literally just like this. And then they, they can, like you saying, migrate the bacteria down to where it's supposed to be. I almost like when you say that story. I almost think it's like moving the war. It's like moving it to, let's just say like, you know, the middle of the winter where you don't want to be somewhere that's really unfavorable or it's a more favorable environment for them. But they can't really fight back there. Right. Because they're back with their homes. Yeah, they should be.
So, you know, to me this makes sense because now you're, you're moving the bugs and changing the ph. Right. So it does help to improve the ph. So if you've been on PPIs or these acid producers for a long time, it increases short chain fatty acids too. Right.
[00:35:07] Speaker A: In, in smaller amounts. As we get a little bit through more of the, the, the products we'll discuss in the future, like the, the phytopri that's more specific to increasing short chain fatty acids.
[00:35:19] Speaker B: Okay, so let's, let's go there. Let's start to talk about, you know, we talked about spores, we talked about probiotics. Let's talk a little bit about the product. So we've heard about prebiotics, we've heard about probiotics. What is the difference between a. You have a product called phytopree, right?
[00:35:37] Speaker A: Yep.
[00:35:38] Speaker B: And I do carry Phytopree. What is the difference between phytopree and a probiotic?
[00:35:43] Speaker A: Yeah. So as we mentioned previously, probiotics are again, these transient beings. So you're already taking the Lactobacillus either just of the bacteria, you don't need to remember these words, but there's several strands of these Lactobacillus and Bifobacterium strains that we take. If you ever look at the back of a bottle, some will have one or two. If you're getting it from Dr. Laurie, you'll notice that there's six of them, including Saccharomyces boulardi. But basically what we're doing is trying to create a good population of bacteria by just adding it directly to the GI tract. Whereas prebiotics are helping your body produce its own good commensal bacteria internally. So endogenously, through the use of feeding them. Traditionally, it's done with fiber based things. You may have heard the word inulin. Inulin fibers, very common. One of the most common types of prebiotics that are out there. And there's others like guar gums and things of that nature that can help grow good commensal bacteria. The hurdle that we Face is kind of what we just discussed earlier with your SIBO patients. You can't give them fermentable things. It's going to create their symptoms to be worse, exacerbate their symptoms. So this is where phytoplate is one of my favorite products to talk about because it's a truly innovative product in our space where we use these phytonutrients to help create good commensal bacteria that relate in things like short chain fatty acids, specifically butyrate.
They help drive down some lab markers that practitioners are constantly looking at associated with like leaky gut, like calprotectin.
They have this direct effect within our GI tract where they can help flourish good bacteria, which is a hurdle that practitioners face when treating sibo because as we mentioned earlier, you can't use traditional probiotics. So we're taking like a, like a back, back door approach to, to repopulating good commensal bacteria.
[00:37:38] Speaker B: So pomegranate fruit is not.
It's not, it's. It's a. It's, I guess in the FODMAP diet. It's. It's not going to ferment. It's.
So it's a. And it's citrus based. Right. So. Yep, I would think, I guess maybe. Well, I have to look that up now. I actually would have thought, all right, well, citrus base, that would still ferment. It probably would be off limits. But that's, That's a really cool thing. So you guys use pomegranate fruit extract, which is your active ingredient, as opposed to inulin or the other things that would create basically more food. Right. It would actually enhance the other ones, would enhance the bacteria that are already in there. As opposed to, I should say it would exacerbate SIBO in the small intestine. As opposed.
[00:38:21] Speaker A: Exactly. Yeah.
[00:38:22] Speaker B: As opposed to giving you the opportunity to make your own bacteria the way they're supposed to be.
[00:38:28] Speaker A: Yeah.
It's really fascinating.
If your listeners have a second, if you just Google pom x P O M X versus inulin. There's this great graphic they did where they show a live culture and they actually compare inulin to pomex over a 24 hour period and you can see the aggregation or the growth of lactobacillus in this petri dish, for lack of a better term, but how it influences change within the GI tract. So you're seeing this growth of bacteria occurring even as, I mean, for years inulin has been really the only thing that people have used. So to have this New tool in your tool belt. You know, it's a really great thing for practitioners.
[00:39:12] Speaker B: And I do measure calprotectin in some patients and it's interesting I didn't think about remeasuring it after phytopree, so that might be something that I actually kind of take on then. That's only the first step to me in really getting your body back on track. But we're giving you the pre, literally the precursor to be able to make your own. So let's go back to that soil based probiotic mechanism. Let's talk about a product that I actually call Sporify.
But it's spore technology, right, For Sibo type patients. And we talked about that bacillus bug. So let's talk a little bit about how that works just in general and why it's different than others on the market. Because I think that Sporify is unique in a couple different ways.
[00:39:59] Speaker A: Yeah, that's, that's a great way to set it up. So there are a lot of bacillus based products available to practitioners and clinicians, but they're specifically bacillus strands. And there's one crucial part that a lot of practitioners miss on. And I kind of touched on this a little bit earlier with the antibiotic piece is when you're killing off or pushing back these bacteria in the small intestine to large intestine. Large there. Think of it as I always use the example of drywall. I was to take a hammer to the drywall behind me. There's going to be these small fragments that are left over. And that gets into this conversation that I touched on briefly, which is cdts. So as you start to break a large, these large gram negative bacteria, just think of gram negative as bad as you start to break those down and they fall within the large intestine and start to reach your epithelial lining, they'll actually create these huge holes within your epithelial lining, basically giving good, bad, all bacteria like a hyper, a super highway to your immune system which is going to over activate it. So you'll hear very commonly patients will experience what we call a Herxheimer type reaction where they have this overabundance of die off and then it creates this worse feeling than they felt before.
So with these bacillus strains, while they are effective, there has to be something to kind of mitigate or attach to this release of cdts or catching the small fragments from my drywall. I'd be like putting a towel under it or something on the floor and that's where we get into the conversation of sbi protect or serum bovine immunoglobulins, which is probably one of the most innovative products, one of the most well studied, I should say, nutraceuticals that are available. So there's actually 46 human clinical trials associated with SBI Protect. It actually is available by prescription as a medical food for most GI doctors to treat diarrhea. But in this setting it has a very specific mechanism of kind of like a safety net that's catching all those cdts that are being broken up and binding to all these pro inflammatory organisms that would create additional disruption down the line.
So you kind of get this, this push pull mechanism where you're not only killing off the bacteria, but you're also binding to and help passing through before they have the opportunity to create additional damage. So one of the best feedbacks I get from a lot of clinicians who were using other spore based probiotics before is that they're not, they're having a much lower rate of Herxheimer types reaction with their patients who suffer from sibo. That's probably one of the most crucial parts about that product that no other product has, is that it has the killing mechanism, but also the catching mechanism.
[00:42:51] Speaker B: Yeah. So I'm a huge user of bovine immunoglobulins in general. So to me I find that they have such a wide reaching use and the fact that it's put into this product is huge because he's right. Everybody or 95, 99% of the people that you're treating in this world or realm, you're right. They have holes in their drywall. Right. They're so leaky, their gut is so disrupted that they literally are seeing everything as foreign. They have all of these, again, we talked about those antigen presenting cells, those cells that kind of say, hey, this is like bad stuff here, come and fix me. And then all of your body, your body sends in all this defense mechanism. Well, this is basically kind of shutting that down. It's saying, all right, I'm taking care of this guys, I'm going to get it out of your way for you. And then your body really start to heal and do what it's supposed to do. So I find immunoglobulins in general and especially serum bovine immunoglobulin to be really, really interesting because you can shut down autoimmune response. You can help with, you can help with people that have this severely leaky gut and lack of absorption and avoid I actually use it in my Lyme patients as well to help with the Herxheimer, because it really does help to shift that reaction the other direction when we talk about that reaction. Just to kind of give you an idea, guys. It's really almost like when you kill something off in your body that's not supposed to be be there, it releases its contents. When it releases its contents, it makes everything in your body kind of go crazy. So it's almost like fighting a fire that shouldn't be there, and it makes you feel lousy. And the problem with feeling lousy before you get better is you lose trust in the system. Right. Like, you got to trust the system. I think we. Hopefully the Sixers, we might be almost there. You have to trust the system. No one wants to trust the system. We just want to feel good. So in order to do that, these immunoglobulins are key.
I think it's one of the coolest things that's come out probably since I've been in med school, to be completely honest.
[00:45:00] Speaker A: Yeah.
It's really fascinating to read through all the different material. Even though they're smaller patient population sizes, it just has such a wide array of abilities, from ulcerative colitis patients to Crohn's and very severe Crohn's patients.
It's such a key ingredient for rebuilding it. And just to give a little bit more explanation on it, it works specifically in the lumen, which is like this. Try to break it down. It's like this gap outside of your. Yeah, it's like a circle. And then every.
[00:45:30] Speaker B: So you can. You can.
[00:45:31] Speaker A: Yeah.
Everything else around that is, you know, the last stretch before your immune system, and it's just picking off these things that can create this additional inflammatory response, and it's just binding to them. It's like, I use this analogy, and I hope people. Have you ever been to a concert? I personally never have, but I know how they work.
I know I got to get out more conversation after the last, but think of your GI tract, your immune system, as a concert where you have this population of people in the crowd that are your bacteria. You have this wall lining that is before your immune system that would be like the security gate between the crowd and the main stage, and then the main stage being your immune system.
Probiotics crowding out all the bad members, or the irate people who drank a little too much before the show and they're trying to rush the stage. That lining being your epithelial lining and doing things like the GI triad and then SBI is like sending bodyguards into the crowd to bind to these bad members to take them out. It's really easy way to think about it.
[00:46:46] Speaker B: You've never been to a concert.
[00:46:50] Speaker A: I've heard things.
[00:46:52] Speaker B: Oh, goodness. I'm not sure. Well, I don't know what he's been doing, but military is one of them. So. All right, let's talk about to me, one of the second to last products and that would be motility pro. So we talked about how the, the lack of mobility kind of might initiate this, right? It actually might kind of hold the bacteria, if you will, up in the small intestine and not allowing them to go to where they're supposed to go. I've just started using motility probe recently and I'm not personally, but a little bit more in my practice and I find especially with actually a lot of my post COVID patients, which I think is really interesting, that the increasing the motility of the gut is key because what happens is these people aren't absorbing their nutrients. So when you check their nutrients in their serum, imagine if your body doesn't have the stuff that it needs. What do you think is happening? You're getting all these short circuits, right? Your metabolism's not working, your brain's not working. So let's talk about how Motility pro. And it's actually different than a lot of them on the market as well. But tell me how that works. What is it doing? What is it made of?
[00:48:01] Speaker A: Yeah, yeah. So it's artichoke, ginger and bitters. It's actually a patented rolling gradient called pro digest that is basically made up of those different things.
And it's basically like a kick in the rent for that migrating motor complex we talked about earlier where it creates like these small parallel static or like tiny explosions just to help kind of remind your body of we need to, you know, expand, contract, help push out this waste that's there and it creates regularity. I mean, there are some more nuclear options that you can do like cape aloe oil and things of that nature to really help evacuate the bowels. But this is stimulating this constant movement of waste. So you don't have. It works very well in people who complain of constipation outside of sibo or reoccurring sibo patients. So you can have this constant stimulation of these peristotic movements to just keep, keep moving along.
Don't take a home, but you can't stay here kind of thing. Just keep going, keep going.
So you can, you don't have to worry about this. This constant buildup that will eventually lead down the road to cpo.
[00:49:08] Speaker B: Yeah, to me, it's like the traffic light, right? It's like it's going to direct your traffic and make sure it's going in the right direction.
So when I think about it and I put this kind of into what I called the repair, restore and repair, repair and restore. I feel like you have to keep it moving. And by the way, if you guys can hear his baby screaming, he's got a new one. Sorry to let you guys know.
Although I'm glad it's not mine.
But it really just keeps everything going along in the right direction. And we have about four minutes left. So that brings me to one of my, honestly, one of my favorite products. But I think that if you keep it moving, right, we've done that. You get the prebiotic on there, you're making sure your body can make some more of its own. You're getting the sibo, what I call a spore probiotic on there so that we're not feeding the system and we're actually leading the bacteria in the right direction. Right. And then you really need to heal. And then you have the IgG, which is the antibody, the immunoglobulin, that's really kind of directing again, it's really directing that traffic in the right direction, keeping you from feeling sick and ill and keeping your immune response to a minimum. Then we got to heal it, right? We got to heal up this, what I call permeable membrane, this gut lining that's become poked with holes, like you like to say from your drywall. And this is where I kind of started and got my bread and butter, really. And this is probably one of the first products that I pulled almost 12 years ago, probably from orthomolecular. And it's got calm in my world. But really what it is is high dose glutamine, right? So it's a calming agent. It's what I like to call the eczema cream for the stomach. And that's my little no more. But it's got aloe, it's got licorice. What else does it have? Zinc. So what does that do for you? Again? It's kind of like diaper cream, guys. I think about it like that coating. It's like that Pepto Bismol commercial. You take it and just coat coats the lining of the stomach. And if you don't ever take that step to me and heal up the lining, we're doing this, we're literally going around the hamster wheel because you're going to reintroduce foods or something's going to happen that's going to restimulate the cycle. Whether it be non sibo or sibo.
It's going to keep going around in circles. You're going to eat foods that irritate you, you're going to get a bug that's going to bother you, you're going to go out and have a binge drinking, right? And then you're going to be in trouble, whatever.
So for me, this is my last step to the puzzle. So I don't tell me. You can tell me why, Mark. Why does this work better than any of my other ones that I've.
[00:51:49] Speaker A: It's an orthomolecular product.
[00:51:52] Speaker B: Why? Why? What's the deal with the gluten? The way. And actually, I know it has something to do with the zinc, if I'm not mistaken, but. Yeah, but it just works so much better. I don't know if it's the particle size and I like it as a powder. It's got to be a powder in my book. It's got to coat that lining of the stomach and really heal it up.
I don't know. Do you know the answer to that?
[00:52:14] Speaker A: So I think one of the things with ortho is we don't try to shy away from. Like you said, co factors is part of it, but we understand that the science perspective of it, knowing that glutamine is this essential amino acid, it's going to help rebuild that intestinal lining. Once you start to have strong intestinal fortitude, a lot of your problems subside. And this can be accomplished through lifestyle changes. Gutcom for you is a key product, and it is in 80 to 90% of my offices because it plays that vital role of repairing the GI lining, which is ultimately what we're trying to do. We're trying to prevent unnecessary interactions with our immune system. We do that by repairing the GI tract. We talked about autoimmune disease earlier, and the three things you have for autoimmune diseases are intestinal permeability, mitochondrial dysfunction, and then a trigger. And if you can address those two things, first you have. You can limit the amount of exposure you're going to have down the lining. So it's. That's why that product works so well for you.
[00:53:17] Speaker B: Well, I love it. I mean, we have a couple minutes left, so I'm gonna. I'm gonna just put you on the spot and ask what products you use. For your gut with the last few minutes.
[00:53:26] Speaker A: Yeah. I'm currently training for a half ironman and I read this fascinating paper. I'm sure you guys have heard the stories of these long marathon runners and such dying of heart attacks. So I do a heavy gi. Yeah, a heavy GI protocol of sbi Protect Inflammacore, which contains glutamine, vitamin D, Arabic, lot of these immune supporting products that help repair the GI lining as well. And then I do a mixture of high dose probiotics depending on how I'm feeling that day. And then the last thing I add to it, and this is a product that Dr. Laurie carries as well is Mitocore. I believe your name's a little bit different for it, but yeah. So mitochondrial health is one of the most important things. It helps carry out all the functions from our brain, liver, heart, so on and so forth. And if you don't have healthy mitochondria, you're going to suffer, I will say.
[00:54:25] Speaker B: From a triathlon perspective, healthy gut, healthy athlete. Because if you support your gut lining, you are not going to be able to tolerate the workouts. And I'm learning that firsthand right now because I'm trying to everything right now and get back on track, guys. So listen, if you want to start any of these products and the repair and restore line, you can go to mydrlori.com m y-r l o r I.com and you can also shoot me an email. I do have some Facebook questions that I did get. So I will email you guys back or message you guys back on Facebook. And Mark, thank you so much for being with us today. We will bring him back on to talk about more inflammatory gut because it is my favorite topic and like I said, he knows way more than I do. Big words that I don't even try to use anymore.
Thank you guys for joining us. And we'll see you next week with Anti Aging Unraveled. Have a good night.
[00:55:24] Speaker A: Thank you for tuning in to Anti Aging Unraveled. Be sure to join Dr. Laurie Gerber again next Wednesday at 3pm Pacific Time and 6pm Eastern Time on the Voice America Health and Wellness Channel. We'll talk again next week and keep you aging gracefully.
