Coronavirus Briefing – 11-29-2020

All right. So reducing inflammation and I know there’s something with gut health. Tell me, tell me one more time.


Using gut health to fight inflammation and auto-immunity okay.




Good morning. Hi. I see a lot of familiar faces out there today. Welcome everybody. Cynthia’s got her hair up today. Not the usual glamour due she’s she’s in, in model weekend. Look the pet fleas. All right. Good to see you guys. All right. So everybody, so here’s the deal. So we have something super exciting today, which I’m sure you guys all know, which is why you’re here. I’m going to ask if you don’t mind putting your camera on. We like to, we like to see faces, although if you’re in some kind of witness protection program or being sought after by a motorcycle gang or something like that, I don’t want to be responsible for you getting caught. So Beth, we can actually turn off the non video participants and my guest again, back by popular demand, repeat performance, not repeat performance, but this is going to be new ground. The role of gut health in reducing inflammation. And auto-immunity with my very special guest and new friend and new nutritionist who I congratulated today on me hitting my highest weight ever. Jill, Brooke, I didn’t follow, I didn’t start following any of her instructions yet, so I can’t put that on her. I’m looking forward to it. Jill, Brooke, welcome to the show. Thank you so much for being here again.


Oh, thanks for having me again. Like I always say your community is really special, so I’m honored to be here And today, as you might recall today was the stuff I was actually more excited to talk about. Because last week we talked about some things you can do to just kind of get by and manage some conditions and the stuff we’re talking about today. There’s some evidence and some theories that we can maybe do better than just manage that we can actually halt and reverse some inflammation and the damage that it causes. So


So that’s one exciting thing. The other exciting thing is, you know, last week I was, I was with you because I, I’m not a pulmonary specialist, I’m a dysautonomia specialist, but we were talking about how some forms of dysautonomia dysautonomia can have many different underlying causes. And I always am happy when I get a client who has auto-immunity as one of their potential underlying causes, because that’s where I have more things to offer. And a paper just came out two days ago from London suggesting that the dysautonomia that occurs after COVID they do suspect is auto-immune. So that is that’s good news. As far as if you’re going to have it, at least having that type of it. Nutrition does have some things that suggest may be able to




I know it’s hard to find a silver lining to that.


Awesome. So without further ado, if that’s how you say that word, let’s get it on. Ready to rumble. [inaudible]


So I’m going to share part of my screen if that’s okay. Of course. Oh, I think you need to, let me share my screen.


Good to go. There we go. All right. Okay. Are you seeing that? So we’re seeing it. It’s not quite in the middle for me. No, I think, I think it is. You’re good. That’s good enough. Yeah.


All right. So as Noah said I’m going to share some reigning theories today about how we can improve gut health to fight chronic inflammation and or auto-immunity. But first as before, this is meant as education, not advice, talk to your doctor before making significant dietary changes. I’m sharing theories today. Nothing in nutrition really has randomized placebo controlled trials behind it because nutrition just almost never gets that level of evidence. So just keep that in mind. And finally, this picture is me doing acro yoga, which I kind of have to do because I have trouble staying upright too long because I have auto-immune dysautonomia. So thank you for understanding if I recline or put my feet up while we talk.


Let’s just with a review


That inflammation is the body’s response to a threat or an irritant, the heat, redness and swelling are your body bringing blood to an area, attacking any pathogens and clearing out damaged tissue. And this is great and necessary if you have a broken ankle for example, or a virus. But the inflammation should ideally stop once the problem is solved. And we know that an inflammatory response does do a little bit of collateral damage to surrounding tissues, but that’s not a big deal. If the inflammation is brief if it’s acute inflammation, it gets in, it does its job and then it stops and that’s great chronic inflammation on the other hand, never shuts off. So the collateral damage to surrounding tissue can add up over time. And one particular type of chronic inflammation is auto-immunity. And that happens when the immune system specifically targets some of your healthy tissue.


Now why would it do that? One reigning theory is called molecular mimicry and it, it says it’s because sometimes you get unlucky and you have some bodily tissues that look a lot like a pathogen to your immune system. So the immune system can’t tell them apart and attacks both of them at the same time, both the legitimate threat and your innocent tissue that resembles it. So there are over a hundred different autoimmune conditions identified so far and they’re identifying more all the time. Each one depends on the different type of healthy tissue. That’s getting attacked by the immune system, but you don’t have to have a full blown auto-immune disease to have excessive inflammation causing harm.


This Washington post article summarizes it really nicely. The headline is chronic inflammation is long lasting, insidious dangerous, and you may not even know you have it. It discusses how scientists from 22 institutions recently wrote a paper warning that quote chronic inflammation is involved in not just a few select disorders, but a wide variety of very serious physical and mental health conditions. And indeed chronic inflammatory diseases are the most significant cause of death in the world today with more than 50% of all deaths being attributable to inflammation related diseases. So given that I think everybody should be interested in the emerging evidence about how gut health may be a huge underlying factor in chronic inflammation and better yet how we can do a lot to change our gut health for the better to fight chronic inflammation. Right. so as I was saying last time as somebody with an auto-immune condition myself, this is the part I wish I had known 20 or 30 years earlier because I think I could have prevented so much damage that my immune system did to my autonomic nerves, for example.


So today’s agenda. We’re going to talk about what is the gut, what does it do? We’re going to talk about two aspects of gut health. The first is called intestinal permeability. The second one has to do with the microbes that live in the gut. And then we’ll talk about how does gut health affect inflammation and autoimmunity. And most importantly, what can we do to improve gut health? So gut health means the functioning of our intestines and the trillions of microbes that live there. It’s so easy to think, nothing of this body part. And I know I never thought much about it until, you know, several years ago, but there’s really some amazing and important stuff that goes on there. So let’s get to know our amazing intestines there.


Can I just make one comment? Ladies and gentlemen, I just want to let you know that this is being recorded. There’s going to be a lot of information here, so don’t feel like you have to furiously you know, copy everything down or write everything down. It will be available to you. And we’re also going to ask just from an intellectual property perspective that you please don’t screenshot. Again, we will make this available to you on our website. But this is Jill’s work and we want to share. And but don’t feel like you have to catch everything. This is the kind of thing where you can watch it over and over again and learn something new every time you watch it. Thank you, Joe.


Yeah. Yeah, absolutely. I know some people are more into the details and some people just want sort of the big picture and whatever you get out of this. There’s a summary slide at the end where it kinda tells you every, all the takeaways. And so this, hopefully you can just kind of find it interesting and maybe motivating later on when you’re thinking about what to eat. But so our intestines are about 25 feet long and they’re a tube going from stomach to the anus. They’re a tube that gets filled up with all the food you eat so that nutrients and energy can be absorbed into the bloodstream. And that’s really important because technically the food in your intestines is not really inside your body yet it’s in that tube. That’s going through you from mouth to anus. And so it’s technically still the outside world.


Now, if it passes through the intestinal, then it will be inside you. So I like to take a minute to think about that one ton of food passing through that tube every year, that’s a lot of material to sort through, right? Your intestines need to process all of that sort, the trash from the treasurer and absorb the good stuff while the unneeded or harmful stuff. And that’s a lot of really important work, which might be why the gut is home to some really important things such as around two thirds or more of your immune system, more neurotransmitter production than in the brain. About a hundred million neurons, which is more than are found in the spinal cord or the peripheral nervous system. And the large intestine or the colon is home to trillions of microbes, making up the largest part of the human microbiome.


The hypothesis is that the gut needs to be incredibly sophisticated because it is the largest border that our bodies have with the outside world. The intestines when stretched out, have a surface area of around one to two tennis courts, depending on the estimate. So that’s a lot of border to patrol, right? That means that the intestinal barrier has a supremely important job to do. It needs to decide what gets to enter into our bodies and what stays out. And the goal of course, is to let in the healthy nutrients, while keeping out the harmful viruses, bacteria, toxins, undigested, food particles, et cetera. And the intestinal barrier is only one cell FIC and our bloodstream is on the other side of it. So whatever crosses the barrier is now circulating in our body free to move anywhere in the body. And that’s a really big deal, right? So there are some little Gates in the intestinal wall that can be signaled to open or to close to either let things in or to keep them out. And these little Gates are called tight junctions. That word will come up again.


And there’s growing research about how our lifestyle and diet can make tight junctions be more open or more closed. What can happen in an unhealthy gut is that the tight junctions can be too wide, open too often allowing unwanted things into the bloodstream. And it’s sometimes called leaky gut. You’ve probably heard that term. So in this picture, you can see healthy, tight junctions on the left, where nothing much is getting through until the intestines to let something through and on the right, there are a few leaky, tight junctions, which might be allowing microorganisms through or undigested food particles, toxins, potential pathogens. And like we said, the bloodstream is right on the other side of that barrier. So once that type of junk is in the bloodstream, what do you expect? The immune system is going to do, give that a thought for a second, the immune system major start doing its job, right?


I E attacking anything. It deems potentially dangerous, right? And that creates inflammation. So if this happens all the time, because junk is constantly leaking in through the leaky gut, then inflammation is chronic and it can cause collateral damage to healthy tissues. Now in susceptible people, this could theoretically lead to auto-immunity. Right. We talked about the theory of molecular mimicry, which says that if our immune system is attacking something, say a virus and we just happen to have some bodily tissues that resemble that virus at a molecular level, then the immune system may attack both because it cannot tell the difference. So letting more junk into the bloodstream all the time means more opportunities for that to happen. Does that make sense?


Yeah. Okay. So, oops. So here are some things known to increase intestinal permeability, right? Infections is on there in a minute, you’ll see, there’s already a study out showing that COVID infection may play a role in that. You’ll see wheat gluten on there. It is believed that the reasons so many people feel inflammatory reactions to wheat, gluten, even if they don’t have a wheat allergy or celiac disease, it’s that gluten signals those tight junctions to open up more. It makes the little Gates in the intestinal barrier open up. So this allows more stuff to get in the bloodstream, right? And so the immune system might be reacting to any part of that junk. So going off gluten is one way to get tighter, tight junctions. And then we think that’s the reason so many people feel better when they go off gluten. The other things on there probably don’t surprise you dysbiosis. We’ll talk about cause that’s a big one. Now let me just say the exciting part of the leaky gut theory is that it suggests that if we stop letting in pathogens into our bloodstream, then the immune system won’t have so much to get riled up about if it’s not riled up all the time, there will be less inflammation.


Intestinal permeability is one very important aspect of gut health. And the other one which goes hand in hand is the community of microbes that live in the intestines, right? And these two things are highly related. As you see, as you’ll see, because the microbes do a lot of different jobs, but one of them is maintaining the health of that intestinal wall. The gut microbiome is the trillions of microbes that live in the colon in the last few feet of the intestines. And we only became aware of their enormous power relatively recently. And so this is the reason that I thought I was eating healthy for years, but really wasn’t


Because microbes


Change everything.




The gut, the gut microbiome consists of over 1500 different kinds of bacteria, yeast, viruses, fungi, other little critters, and most of them are friendly. Ideally they would all be doing different, beneficial things for us, but we can also get bad microbes that do harmful things. And we have when we have too many of the bad microbes, it’s called dysbiosis, you’ll see that word a lot. And the good and the bad microbes compete for space and resources. So having more good ones can help keep the bad ones from thriving. And it’s important to remember that more diversity of microbes is associated with better health, probably because every different type of microbe has a different, important job to do. So if we’re missing important micro diversity, then we’re missing out on the skillset of that species. So this is just a list of some things that they typically do in the body such as helping to digest food extract, nutrients, produce substances that the body can use for fuel or for healing helping to regulate the immune system and preventing pathogens from moving in. You’ll see that I circled one important thing that they do. They produce short chain, fatty acids, and those are the building blocks of a healthy intestinal wall. So our gut microbes are in charge of maintaining that gut wall, right. But spoiler alert, they can only create short chain fatty acids when we eat plant fiber. So we’ll come back to that later. They can only do their job, right? If we feed them. Right?




Microbes are so influential that researchers can look at the gut microbes in a baby’s first poop and predict their likelihood of getting asthma microbes are so powerful that researchers can make identical twin rats, either skinny or or obese just by implanting different microbes. Microbes are so powerful that researchers can manipulate behavior in rats, by changing their microbes. They can make the rats either more or less fearful and anxious or more or less social microbes are so powerful that researchers can make a rodent, either have no reaction to a pulmonary virus or have an extreme inflammatory reaction to a pulmonary virus just by putting different microbes into their intestines.


And here’s


The craziest thing to me, microbes are so powerful that they explain why babies born by C-section historically had higher risk for allergies, asthma, depression, obesity, and autoimmune conditions.


It’s because


We get the start of our microbiomes when we’re born. So while we’re traveling out the birth canal during birth, the mother’s gut microbes, get into the baby’s mouth and those microbes get swallowed and become the anchor tenants of the baby’s gut microbiome, which continues to


Evolve from there. So can you guess what happens differently in a C-section birth?


Think about it. What are the first microbes there


Are exposed to? Right.


So when babies are born by C-section, they don’t go through the birth canal or get the mother’s gut gut microbes in their mouths. Their first exposure to gut microbes is from the hands of the doctor, which are totally different microbes and with much less diversity. And this was discovered to be a huge disadvantage. So like I said, these babies grew up to have more allergies, asthma, depression, obesity, and auto-immune disorders, all conditions related to inflammation and be all because of starting life with a less diverse microbiome. So luckily they figured that out. And now in many hospitals, if a baby needs to be born by C-section, they’ll use a sponge to take some fluids from the mom’s birth canal and put it in the baby’s mouth and nose to try to get them the, the initial microbiome that needs


Intended. So hopefully,


Hopefully I’ve convinced you that microbes are super influential. I think we’re just at the beginning of learning, how


When it comes to inflammation, we know that good microbes maintain and repair a healthy intestinal. So that means the immune system has less to react to. And they also release anti-inflammatory metabolites right into the bloodstream, which signal the immune system to be more calm and relaxed when there’s no major emergencies going on and to be more appropriately aggressive when there are dangers that it needs to take care of on the other hand, bad gut microbes or dysbiosis has the opposite effect. Those microbes can create toxins, which leak into the bloodstream and trigger the immune system to be more inflammatory. They can also signal the immune system to respond inappropriately to all sorts of pathogens. Right. and you may be thinking, so how exactly would the gut send signals to other parts of the body? And this paper describes three different ways that the gut can do that. And the details aren’t really important right now for our purposes. So I’m not going to take time right now, but it just means that the gut has incredible influence beyond its local area. Right? So that explains why gut health appears to affect all health. Gut health has been implicated in the development of numerous diseases in every organ. It’s implicated in the development of heart problems, CLPD, depression, schizophrenia, renal failure, autism, chronic fatigue syndrome, intestinal disorders, skin disorders. And there’s more here.




And more findings are coming out every week, connecting gut health to something new that seems like it should be completely non-related right. This is just a smattering of headlines that I found interesting. Because they link gut health to mental disorders recovery after a spinal cord injury, Alzheimer’s disease, obesity, diabetes, Parkinson’s neurological disorders in general auto-immune disease in general. And I was interested to see maybe you guys already knew about this, but there’s several mentions of the gut lung access as a new topic of research like at the Mayo clinic and elsewhere. And I knew that there was a gut brain axis discovering how much they’re describing how much the brain and the gut communicate and affect one another, but the gut lung access was new to me. So I kind of looked into it. And according to the Mayo clinic, the gut lung axis concept posits that alterations of intestinal microbes may have a profound effect on lung disease. Microbes may be recognized by host immune cells hosts. That means us, the humans host immune cells resulting in systemic cytokine release that’s inflammation, or in some cases, the bugs make drugs such that bioactive compounds are secreted by microbes absorbed into circulation and directly alter lung function. According to the Mayo clinic, pulmonary researchers are naturally interested in the microbes that live in the lung. However, the intestinal microbes may be even more important than the lung microbes in some pulmonary diseases.


So one more example of how gut health is just everywhere is in the considerable interest in the connection between gut health and COVID. I went on to pub and found a few papers already written and 23 clinical trials already registered to look at gut health in COVID patients. One of these papers already found that COVID changes gut health for the worse, and we’ll come back to that in a minute. But all of this is just to emphasize that gut health is more important than it may appear at first. And it seems that no matter where in your body, you may have inflammation, the gut may be relevant. These little bugs have reached far beyond their home in the colon. But speaking of their home in the colon, sometimes they sneak out of the colon, colon and location matters.


Jill, can I ask you a question? Where does P H N S city come into all of this? If it’s, if that’s way off track, we could get to it later, but you know, so much of what we’ve seen a with respiratory diseases and B with COVID long haulers has to do with increased acid reflux. And that seems to trigger inflammation, not just in the lungs, but also in the sinuses and, and other areas as well.


So so there’s a few interesting things that come to mind for that. One of them actually has to do with this CBO right here. CBO happens when the gut microbes that are supposed to stay in your colon in the last few feet of your intestines. When they sneak up North into your small intestines, then they can create a lot of problems. And one of the big ones they can create is more acidity in the body. They can also change your gut motility, and we know that some people get that reflux because their intestines are not moving the way that they’re supposed to moving. So, so instead of having food move through, it just kind of stops and sits there. And it isn’t flowing the right direction, so it can come back up. I think that as far as you know, so when, when that acid does come up into the esophagus and into the mouth that definitely can do some tissue damage because you’re not meant to have acid right there.


And in the, in the, in the airways as well.


Yeah. and in my world, what we try to do is focus on getting rid of the CBO the small intestinal bacterial overgrowth and helping the gut motility because once, once your your digestive system is moving everything through the right direction, nicely, again, you tend to have less of it less reflux.


So, you know, similarly to the heart and the lungs, like if, if you have, let’s say backflow from the left ventricle to the left atrium, like we know that everything kind of goes back like plumbing. So does, does the GI system behave in the same way that anything kind of further down can work its way back up?


Well, in theory, that’s not supposed to happen. You’re supposed to have these nice waves of Peristyle cysts that are always moving things South. We’re not supposed to really have things moving North, but we know that dysautonomia can cause nerve damage and it maybe some other issues as well that make those waves not happen the way they’re supposed to. And and so yeah, those people do encounter a lot of problems like nausea or vomiting or CBO where yeah. Things are moving the wrong direction. We know that one thing that can help is taking longer breaks from eating. And I know this goes a little contrary, like I know at least in the just Autonomia literature, everybody always says, you got to just eat little meals all the time, just to be constantly snacking. And so that you don’t overwhelm your digestive tract. And I think that has some good thinking behind it.


But from the gut health perspective, you actually do want to take breaks from eating because that’s the only time that you get the intestinal cleaning wave, it’s called the migrating motor complex. And it’s this nice cleaning wave that does a bunch of housekeeping. And it just pushes everything through, including any bacteria that might be climbing up the wrong direction. Other little things that, that might be moving the wrong direction, but in order to get that you need to go a good four or five without eating. And so so some people find, I know it’s kind of hard when you can’t eat very much at one time, how are you supposed to take five hours between, you know, bites of Cracker? So it’s kind of a, a delicate balance, but it’s something you can try and see if that helps keep things moving in the right direction more,


You know, it’s so interesting. Like everything that you talk about, it’s like, you know, every like 30 seconds you say something that like I’ve never heard before, or like you discuss diet nutrition in a way that nobody else discusses. And it’s like, I’m so happy that you’re here because I, I really think that so much of this is really linked to what we’re talking about in some of the problems that, you know, not just long haulers, but anybody with inflammation is, is really facing.


Yeah. And I think so many of our instincts are wrong. I mean, I always feel like I need to apologize for the history of nutrition, giving terrible advice for decades. And it’s so much like, especially before we knew about the gut microbes. Right. So think about how, okay. As soon as you lose weight and you can’t put weight on and you can’t really eat, what do you do? Oh, well you start living on milkshakes because that’s the way to get in the most calories or you live on pizza and burgers. I mean, I remember, you know I got sick. It was a couple of decades ago now, but I, I remember getting down to 80 pounds, not being able to really digest anything and thinking, well, darn it. If I, if I’m going to not gain weight or absorb any of this, anyways, at least I’m going to get to live on croissants.


Right. This is the one thing that makes me happy. And now looking back like, okay, what is that? That’s wheat, gluten wheat, gluten bombs, right. Not the best thing to get your gut health back. And just so many, I think so many of our instincts I think have been wrong because we didn’t know about gut microbes and a lot of what we, a lot of these things take a long time to change. And so I think that still, we all kind of have some of these old pre gut microbiome ideas in our heads and it makes it really easy to to do things that we think are helping that maybe aren’t,


But we’re all going to start over tomorrow. That’s right. So I’m glad you’re here. This is perfect timing.


Oh, good. So I just would like to mention quick about CBO because so many people in this space have it, there’s so many times that I’m talking to a client and they’ll be describing their their symptoms to me and I’ll be thinking, Oh boy, I think you might have CBOE. And the truth is that until you treat SIBO, if you have it, most other nutritional things are not really going to help you. So as I said, CBO, it stands for small intestinal bacterial overgrowth. And it happens when the microbes in your colon climate out go North. And they they take up residence in your small intestine where they’re not supposed to be, and it can cause a lot of bloating, gas, stomach aches, brain fog, diarrhea, or constipation or alternating, and they can speed up or slow down your digestion. The, the top CBO researcher at Cedars-Sinai hospital in Los Angeles, Dr.


Mark Pimentel, he estimates that 70% of IBS is actually caused by CBO. And that’s important to know, because I think most people think IBS is not treatable. You just have to live with it. And CBO is treatable. And at least in my world of auto-immunity and dysautonomia and mast cell activation, like so few things are actually treatable with just 10 days of a pill. So when you get something like that, you take advantage of it. And so the important thing about CBO is to find a doctor who’s really familiar with it and who can treat it. A lot of doctors are not familiar with it because some of this is new information, but when you get rid of CBO, you can get rid of a lot of symptoms. We can come back to this later, if CBO is of interest, I kind of want to move on to the bigger picture, but but if CBO is your problem, I almost think that’s lucky because that one, you can just treat it and be done with it.


And it improves a lot of things. Okay. So moving on with the big picture, the microbiome is kind of like a huge army that can either work for you or against you in a lot of different ways. And with normous influence, if we can harness this thing to work for us, that’s great. If it turns against us, look out looping back to that autoimmune or inflammatory theory, there’s evidence suggesting that three things are necessary to perpetuate chronic inflammation or autoimmunity. And you’ll see here in this triangle it’s genetics, environmental factors and gut dysbiosis. So the good news is that researchers think that poor gut health is not only necessary for autoimmune or inflammatory conditions. But it’s reversible.


And the way that it would be reversible is by, by, by getting rid of the dysbiosis and re-establishing that intestinal barrier function. Right. so I found this interesting. It seems like COVID triggered a lot of people to have new inflammatory conditions. So I just found this article interesting. It suggests that having COVID can cause dysbiosis in this study, they took regular poop samples from hospitalized COVID patients and looked at the microbes in them to see if they changed over time. And I’ll just read from it. It says, quote, fecal microbiome from patients with COVID-19 had depletion of symbolic symbionts that’s friendly microbes and enrichment of opportunistic pathogens. That’s bad microbes, which persisted after clearance of SARS, Kobe to impact these findings indicate the prolonged effect of SARS cov two infection on the microbiomes of patients with COVID-19. So that’s interesting. Right. does it explain part of what’s happening to some people? I know some of you got inflammatory conditions that started with COVID and I don’t know if that explains it. But either way here is some really good




We have a lot of control over our microbial communities because they have to eat whatever we give them. We can feed the good microbes and starve the bad ones. When I say they eat what we eat, technically they eat whatever reaches the colon after we’ve absorbed a lot of our foods.




So that means they eat a lot of fiber, this figure it says it’s a schematic representation of how diet shapes the human gut microbiota and impact impacts on chronic disease risk unquote. So you’ll notice that the food pyramid that’s good for microbes is more Mediterranean and less of a Western diet. The Western diet is the one for dysbiosis and chronic disease.


So the friendly bacteria they call it microbiota symbiosis, that’s friendly bacteria. They thrive on fiber from whole plant foods, especially fruits and vegetables, but also whole grains, legumes, herbs, nuts, and seeds. And they do not do well with processed


Foods, especially


Processed foods containing anti-microbial ingredients. Right. That makes sense that anti-microbial ingredients are by design harmful to microbes. Right. but there are tons of anti-microbials in processed foods, such as preservatives high amounts of sodium antibiotics show up in a lot of foods herbicides and pesticides artificial sweeteners are also found to really disturb gut microbiome microbes a lot


Friendly gut flora in us, just like a whole lot of clean plant fiber which is why these food pyramids for friendly and unfriendly microbes have all the plant foods, not only promoting friendly bacteria, but also actively hurting the unfriendly bacteria. Right? So in theory, every time you be broccoli, you’re not only helping some friendly bacteria, you’re killing some bad bacteria because the good and the bad microbes compete for space and resources. So by supporting the good ones, we can help squeeze out the bad.


In addition to that


Actively starved the unfriendly bacteria by taking away their preferred fuel, which is sugar processed or refined carbohydrates, fatty cheap meat, and basically any unnatural ingredients.


So this is just some detail


Sales. You know, we talked about how the good microbes mostly live on fiber from whole plant foods. The us RDA for fiber is only 25 grams a day for women and 38 for men. And most Americans only get about half fat, but our paleolithic ancestors are estimated to have eaten more like a hundred grams of fiber every day, or even 150 grams of fiber every day. So that may be closer to what our microbes evolved for. Now obviously don’t go and tomorrow, like up your fiber intake by 90 grams, if you were going to up your fiber intake, you don’t want to do it gradually and let your microbes have time to adjust and make sure your your digestive tract can handle that. Cause that would be a pretty big shock to the system.


But it’s not just the quiet


Entity of fiber that matters, but the variety, right? So the way to get a diversity of good microbes is to give them a diversity of different whole plant foods, ideally colorful ones from every from every food group and every part of the plant. So that means eating plant foods that some that are seeds or roots or stocks or leaves or fruits or flowers, like every of the plant, because it all has good things to offer. For mented vegetables like sauerkraut and kimchi are also fantastic because they not only have fiber to feed the good microbes, but they actually contain their own actual microbes, those probiotics, which can do good things as they travel through the gut. And like we said, the foods to minimize are the sugar refined carbs excessive, salt, artificial sweeteners, chemicals, toxins and factory farmed animal foods that can be full of antibiotics and chemicals. So those are good to avoid too.


Jill, can I ask what the effect of cooking these things are? Like, for example, if you heat and cook sauerkraut, does that in any way detrimentally affect the, the, the value of it?


Yeah. In theory, you probably would kill a lot of the microbes and sauerkraut. So you probably get a lot more out of that if you eat it raw, when it comes to to just other plant foods though, it’s wonderful either way. The, the fiber will do good things in each of those microbes, whether it’s cooked or raw


Does putting it on a hotdog in any way, decrease it value.


Well, you know, I’ve heard that some people are now roasting carrots and eating them like hot dogs. I don’t know if that’s huge buzzkill


Oh, carrot instead of hotdog note to self. Thank you.


There are some people who have made quite an art out of making vegetables taste and feel like more exciting things, you know, like turning the cauliflower into risotto with the rice cauliflower or the zucchini noodles, making the zoodles, I’m a, I’m a big fan. I feel like that’s sort of the modern day alchemy, if you can turn your vegetables into more exciting things. But yeah, you know, unfortunately hot dogs are an example of something we’re about to talk about unless you’re getting a super high high quality swanky hotdogs factory farmed foods are kind of a big problem. And I think sometimes people are surprised to hear that animal protein isn’t always helpful. And it really depends on how the animal was raised because those pesticides and the hormones, and especially the antibiotics, those all bio accumulate up the food chain. So when we eat chicken or pork or whatever, full of antibiotics that, you know, by affects


The microbes in our guts


We actually, you know,


They’ve done studies, you can watch the inflammation spike within hours of eating factory farmed foods. And I know that the higher quality cuts of meat, the free range or the grass fed or the pastured or the wild cut, that all gets a lot healthier, but more expensive. But the good news is you, you probably don’t need to replace it. One for one, since most Westerners are way over eating animal protein anyways. And that’s a little hard on our kidneys at ages us. And so just cutting down on protein, on animal protein and eating more


Plant foods is a way to have your cake and have it be cheap too. Or I don’t know if that really,


That makes sense, but get the best of both worlds. So a few other ingredients that are known to be really bad for inflammation and autoimmunity are industrial additives, right? So this article explains how seven, seven different aspects of processed food cause leaky gut, how every one of these processing methods is growing in popularity year after year. There’s probably many other industrial additives that are bad too. These are just the ones they happen to have studied. But they think that this is actually largely responsible for some of our higher rates of autoimmune disorders and inflammation yeah.


Year after year.


And so that kind of goes in hand. It’s not only the industrial attitudes


In food


Chemicals from other sources matter too. So this article is in the journal nature. It’s about chronic inflammation as a cause of disease across the lifespan. And it says each year an estimated 2000 new chemicals are introduced into items that individuals use or ingest daily, including foods, personal care products, prescription drugs, household cleaners, and lawn care products. And research has demonstrated that numerous chemicals to which people are commonly exposed, greatly alter molecular signaling pathways that underlie inflammation and inflammation, unrelated


Disease risk, right?


That’s why it can be really helpful to change your soaps, shampoos, cleaning products, et cetera, to things that use more natural ingredients.


I know that I didn’t know this until I got into this world, but I don’t think most people realize that all of these new chemicals, these 2000 new chemicals that get introduced into our products every year, they’re not really usually required to have any safety testing performed before they’re allowed in products. New chemicals are basically considered innocent until proven guilty. And I know that with, you know, 2000 new chemicals entering our personal products every year, I imagine it’s not that easy to determine which ones are causing our invisible inflammation. So if you’re trying to fight inflammation, you might just err on the side of avoiding a natural chemicals.




But getting back to food. Okay. So starving the bad microbes. It means cutting back on processed foods or foods with really dense carbohydrates like sugar and doing this might be hard because when you starve the bad microbes, they may put up a fight. Now I think that this is absolutely hilarious and intriguing and Noah tomorrow, when you start, when you start eating clean, see if you notice this. So this is an article called his eating behavior manipulated by the gastrointestinal microbiota and the authors write quotes like microscopic puppet, masters microbes may control the eating behavior of hosts. That’s us through a number of potential mechanisms, unquote. So these authors believe microbes evolved to have the power to control our eating habits because the ones who could do that thrive tomorrow. So they believe that they can produce neurotransmitters. They can make toxins to make us feel cranky until we eat the food that they want us to. They think that the microbes can change our taste buds and our, or alter our reward systems. So I think that’s just amazing


Last cup of coffee, last one right here. So I’m both depressed and encouraged, but it does explain why I feel the way I do.


Right. I mean, I find this so amazing because it’s like all these years we’ve been imagining that mind control was going to like come from the Russians or from aliens or something. And the true, the true mind control is coming from the microscopic bacteria in our own colons. And they just want us to eat some junk food


Literal enemy within.


Right. yeah, but I like to, every time I’m having a junk food craving, I like to tell myself that it’s just the feeling of a bad microbe, trying to boss me around and it makes it a little easier to resist. Now one big problem of course, is that when we are sick, it’s not always realistic to eat high fiber or to eat fresh foods. And so this pomegranate, this, this is me, a picture of me and this pomegranate is saying to me back when I was really sick, you know, look, you can’t stand up long enough to see me and you can’t digest well enough to eat me, move along I’m way out of your league. So I know what that feels like. And many people that I work with are unable to grocery shop to stand up long enough to prepare food, to tolerate heat in order to cook anything, they have troubles digesting.


And so that kind of is the main challenge. And so much of my work with clients is figuring out the best plan to, you know, do what we can and to build back up to being able to eat more real foods again. So then there’s a factor. But the ultimate goal for gut health is to basically not be an American. The standard American diet is thought to be a major problem for inflammatory disease. And so these photos show one week of food for families in four different cultures. And I bet you can guess which one has skyrocketing rates of chronic inflammatory disease. And in some cultures with, you know, like quote unquote primitive diets, they don’t even have auto-immune disease. They don’t even know what that is. And so kind of, as I mentioned before, one final thing that’s wrong with the standard American way of eating is that we tend to always be eating one study, found that it’s not uncommon for Americans to eat 15 times per day. And so that means that the intestines don’t get their time off to do their cleaning wave, which is also important for gut health. Because remember whenever we go about five hours without food, our intestines can stop digesting and do some house cleaning and that helps keep the dysbiosis away.




Just that summary slide I was talking about it just kind of mentions everything that we went over. If you wanted to take a a screenshot of sort of the, the overarching, you know, list of things you can do, this would be it. And don’t feel overwhelmed because you don’t have to do all of these things to see results in my, in my experience. Oftentimes even just a few baby steps in the right direction can make a big difference. I’ve seen people who feel much better just from giving up sugar or artificial sweeteners, for example I’ve seen people who all they do is they replace their factory, farmed chicken with antibiotic free chicken, and they start feeling much better. And so I think some people are lucky and they can do a couple things and see a radical difference. Other people are less luckily lucky and have to, you know, do a really deep dive and do everything.


But the good news is that gut health can start changing really fast, right? Cause a generation of microbes only lives about 20 minutes, right? So that means that microbial empires can rise and fall can rise and fall very quickly. So studies have shown that dietary changes lead to gut microbiome changes in just a few days, but that goes in the good direction and the bad direction. So you have to maintain your new habits if you want to maintain the good, better microbes. And the other good news is that gut tissue is among the fastest healing tissue. Right. So those of us with nerve damage wish that our nerves would heal half as fast as intestinal tissue. So this is why there’s a lot of optimism. Gut health is not the only thing that affects inflammation, but it’s a big one.


And there are large communities of patients out there who work on their gut health and who see huge improvements in their symptoms. So if you’re looking for those communities or for more information here are some good books and websites that I recommend. This first one, the walls protocol in particular has a really large community around it with a physician who used these principles to come back from severe Ms. Which typically isn’t thought to be reversible. She was in a wheelchair, but now she can bike 20 miles. And she’s leading a lot of great research in this area and has a whole detailed protocol, cookbooks, everything. Her program is pretty detailed and hardcore. If you want a gentler introduction to improving gut health, I recommend the book, the autoimmune fix by Dr. Tom O’Brien. And even if you don’t have an auto immune disease, it’s all the same principles for stopping inflammation right. Inflammation and autoimmunity. You’re kind of in the same buckets when it comes to this. Paleo is a great blog. The author is a serious scientist. Even though she calls herself a paleo mom and finally I contain multitudes is considered one of the best books on the microbiome if that’s of interest.


So that’s everything I wish I had known much earlier. I hope this information can serve you well. And I hope that if you ever take up acro yoga, it’s only because you think it’s super fun. So that’s all I got.


Jill, thank you so much. That is an incredible amount of information. And so enlightening. Just a question, I don’t know if you know the answer to that, is that the same ed young from the New York times?


Yeah, yeah. Yeah. He always writes us amazing science.


So incidentally ed young is doing a ton of work right now on on COVID as well. And COVID long haulers, so I’m sure that’s, that’s going to be heavily informed. Jill, so I hate to deprive you of a Sunday, but do you have time for a few questions? Oh, sure. Yeah. Okay. So Beth, if we could give people the opportunity to unmute, but ladies and gentlemen, I just want to point out, we don’t want to answer like specifically your this is not a console, so please keep the questions as general as possible. And Jill is available for consultations. Of course Jim and and, and that’s it for now? So, so Beth, are we good to go? Does, and if Jill, you can stop screen sharing so we could see more. That would be great. And then we can see who’s talking. All right. Good question for Joe. Yes, sir. Yep. Hi Joe, just, just, just a quick one. Does all inf inflammation or inflammatory markers show up in standard ESR or CRP tests that you might get from your doctor from a blood test? Great. Are we going to have to delve deeper?


So I’m going to answer this as a patient, not as a medical professional, because I, I I don’t know how a medical researcher or a doctor would answer that question, but I can tell you from my own experience that it took, it took 20 years of seeing many, many doctors for me to figure out that my problem was auto-immune because all of my tests were coming out as inconclusive for 20 years. And and so I know that at least as an N of one, it is possible to have inflammation and autoimmunity as your problem, even when all of the typical tests for those things are coming back normal.


Okay. Thank you. And, and ESR eosinophil SED rate CRP are really general markers of inflammation that, you know, can come from your gut. They can come from your abdomen, they can from your lungs. They can, they can come from any other way. So a lot of times people will have high numbers there, but then you have to go deeper than by system and with COVID, it’s, it’s so challenging because there’s inflammation in so many different areas.


Thank you so much for your information. I’m just curious about artificial sweeteners are sweeteners like Truvia or Sila tol. Okay. Are they also not so good?


So that’s a great question. What we know so far is that Splenda is definitely bad. Nutrasweet is definitely bad. Saccharin is definitely bad. There’s no evidence that I know of yet that the newer ones such as the urethra tall or the Stevia are bad for gut health. And so I guess the only thing I’d say is that, that as much as I love sweets myself, I feel like the, the law of nutrition has always unintended consequences in anytime. Something seems too, too good to be true. It historically has been. So my guess is that small amounts of those things are fine. And my guess is that in another 20 years, they’ll discover some problem with some of these artificial things, even if they were, you know, processed from natural ingredients. Because just that is the trend that always seems to,


I just use it in my coffee.


Sure. So my guess is that a little bit is is likely not, I’m a big believer that everyone only has so much willpower to spend on their diet. And so yes, if that makes you happy, I wouldn’t worry about spending willpower to avoid it.


Vaughn, don’t worry. You’re going to be giving up coffee tomorrow also.


No way. Thank you, Noah and Jill, this was absolutely incredible. My question is, so is it like COVID that is impacting like COVID itself, that’s having this impact or is it like all the, the entire kitchen sink, including, you know, antibiotics and HCQ and all the medicines and vitamins that we, that we take during COVID that are resulting in this, because it’s almost like, I feel like now when I watch a presentation, I’m like, Oh, like it’s all the stuff that I took, the reason I’m having this, this experience of like the brain fog and all these other things.


That’s such an interesting question.


My, my feeling, my answer to that question would be the same as 90% of other questions about COVID, which is, I don’t think we know. And there’s a whole bunch of like swallowed the spider to catch the fly in this, which came first, the chicken or the egg. And it, I don’t know my gut feeling, no pun intended, like, and I’m now seeing close to 200 patients individually is that COVID is like a virus scan COVID is good at getting into your body, finding your weakness and exploiting it in every way possible. And I also think that every person is different. I don’t know that’s what do you think, Joe?


Yeah, definitely. And I, I, you know, viruses and infections are on the list of things that can hurt gut health, but so are antibiotics. And and so I think these are really interesting questions. I hope we get the answer to them someday. Thank you.


I think if nothing else, you know, like rather than an actual roadmap here, I think that this is great information to kind of, you know, with, COVID also, like, I think there’s zero roadmap. We’re trying to kind of dig away brush, but it’s like when you hear a noise, like, okay, these are some of the things we should be thinking about, you know, like if we’re in Brooklyn, like the first thing you think of is not probably draft, but, you know, I think these are things that we at least have to keep on the radar and consider. So Shelly, did you have a question,


Mary, Mary Flynn? I have a question.


Okay. Can you hear me? Yeah. Shall I go ahead? And then we’ll go to Mary, Mary, Mary.


That was fantastic. Jill, really? I’m curious, do you have any recipes or shopping guides that you can share with us?


So let’s see. So I would say as far as you’ll, you can go online and find a whole bunch of different resources for this. The, the word that you would look for, if you were looking for sort of a guide would be paleo auto immune protocol, and you will find tons of tons of resources there. What I usually do is just go to the grocery store and look and see what looks fresh and try to eat something that I haven’t eaten in a while to get that variety. I kind of play a game with myself to see how many different plant foods I can get into a meal. So pre microbe aware me might be happy with oatmeal and blueberries post microbe aware me is now going to also add in cinnamon and nutmeg and shredded coconut and ground flax seed and almonds and walnuts, and every plant that I can find, because I know that each one of those different types of plant fiber is supporting a different species of microbe that is going to do something probably pretty valuable for me. So I just kind of turned it into a game plants.




I think I’d better get out of here


Kind of an easy and easy short, but the go-to kind of, I would say super meals when it comes to this are going to be like stir fry, right? Get a bunch of different veggies in there. Pick your protein and put it over, maybe some grain of some sort vegetable soup ballads veggie grain bowls. And I tend to not really look for recipes so much as just see what is looking fresh at the grocery store.


That’s great. And don’t worry, Jill may not know this yet, but she’s not going anywhere. We’re we’re, we’re about to go into hardcore recruiting mode. Diane Cusick. Do you want to ask a question and then we’ll go to the please. Yeah, go ahead.


Quick. Is there a measure for what would be a brief inflammation as opposed to turning into chronic? Oh, that’s a good question. You mean, I’m sorry, what was that?


You mean by time or some kind of


Like, what would be concern? Like, I don’t know if I keep playing around, I definitely the food drives my symptoms. Like how do I think that’s, it’s hard to know if something is temporary as opposed to forever.


Yeah. That’s a great question. That’s a great question. My, my feeling is with COVID I’m not ready to call anything permanent. I hear a lot of people who say, Oh, you’re going to have permanent lung damage. You know, there was big talk at the beginning about pulmonary fibrosis and COVID and this idea was, is there going to be a whole new crop of lung transplant recipients? You know, w I know it feels like a long time and it has been a long time. Okay. It’s, you know, nine months, it’s like, you know, it’s a long time to not feel well. But there’s still improvements happening with COVID. And a study just came out that showed that a lot of what was thought to be pulmonary fibrosis before looking at ground glass opacity is actually just inflammation that’s resolving over time. So I would be really hesitant. And that’s why when I hear people say, Oh, this is going to be permanent damage. It’s, it’s premature, in my opinion. I mean, I see a lot of people like the average person who I believe it, or not, probably 80% of the people that I see now were infected in March. And that’s where people are starting to get, you know, people are starting to get better. We’re seeing nice improvements in people. So papeles,


So my question for Jill is about intestinal cleaning


Wave that you talked about, and that fasting contributes to it like four to five hours without fail. My question is, does that not happen every night for us when we’re sleeping? Or is there something about being asleep that doesn’t allow that to happen? My understanding is that it, it happens during sleep, but that ideally you’d have, it happened more times per day, like between every major meal. And so so I work with a lot of people who have to graze all day. They can’t eat very much. And so some people get along fine with just with just the cleaning wave that happens at night. Other people, their CBO will come back if they don’t take off hours between eating. So I think it’s one of those things where you can see what your body needs.


Jill, is it reasonable to kind of think of it in terms of priority? Like if gut motility is your biggest problem? Well, then fasting would be more beneficial to you, but like if weight loss is your biggest problem, like if you, if you lose too much weight, because for example, one of the issues that we see with a lot of respiratory patients is that because they’re working so hard to breathe, it’s very hard for them to a take in adequate calories because it then affects mechanics of breathing. And also, you know, because they’re working hard to breathe, they’re burning a lot of calories. So how do you balance that?


Right. And that’s a really good point because when you’re telling people to eat more fiber, that is kind of easy for the people who want to lose weight. All of a sudden you’re eating a lot of foods that are very calorie, non dense. The harder thing is to eat an anti-inflammatory diet that is also very high in calories. And so that’s where you really want to lean into the healthy fats because the fats are calorically dense, but they’re still anti-inflammatory. So instead of going for like the Haagen does and the pizza, which is nice and high calorie, you would be doing more things like olive oil and coconut milk and salmon and the grass fed butter or the the bone broth or avocado all of these things that sort of fit in the healthy fat category.


I don’t say this to point out an error. I’m just a question I want to clarify. Did you mean coconut oil or coconut milk?


Oh, they can both be good


Coconut milk also. Okay, great. Let’s go to Liz H and then Mona, and then Marie and Jill, just, just give me a signal. Like [inaudible], when you’re ready to call it a day for Sunday. So we so appreciate you being here. Liz H


This has been great. I I’d appreciate some clarification and lots of have been talking about mass


Cell activation syndrome, and there are two of us who are long haulers here, but what I’m finding is that looking at that as a diet is really, really massively restrictive. And I can’t see how to broaden the spectrum of what you eat and at the same time achiever, a low histamine diet. So anything you can suggest.


Yeah. So when it comes to mass cell activation syndrome so that’s the syndrome where your mass cells, which are immune cells that are responsible for allergic type reactions. They tend to be too easily set off or set off to inappropriate things, and they can kind of have a domino effect. So you can be kind of constantly in a flare set off by all kinds of things that should be should be no problem. And so the diet for that is called the low histamine diet. And the thinking is that if you take in fewer dietary histamines, like we know that histamine can help set off and perpetuate that chain reaction of mass cells being activated. And so the low histamine diet is super in inconvenience because everything needs to be fresh because the main thing that creates histamines is aging food, food that has been dead longer.


But the other thing is that all of the, all of the lists online that talk about what foods are high histamine or low histamine. There’s a lot of disagreement between those lists. And so a lot of people end up just avoiding everything that shows up on any list as high histamine. And I’ve been there, I’ve done that. And that is a quick way to drive yourself nuts and have nothing to eat. And so the, the expert consensus at this point is to do it as an elimination diet, where you start out by eliminating the most high histamine foods. And that tends to be the aged meat, the aged cheese, any fermented foods, including sauerkraut. That’s the bummer, right? Sauerkraut is so good for your gut health, but it’s also high in histamines. And when you cut out all of those high histamine foods, if you have mass cell activation syndrome, then there’s a good chance.


You’re going to feel a lot better. Now, if you don’t feel better, then you can just forget about it. It’s not going to help you. And you’re just needlessly restricting your diet, but at least most of the patients that I talked to with mass cell activation syndrome, they do feel better on a low histamine diet. So then the trick becomes to start adding in foods one at a time to see if they will cause you a problem or not. And it’s a very laborious elimination diet because a mass cell reaction can happen immediately, or it can happen up to 72 hours later. So you have to be very scientific. You have to keep a good food journal with all of your symptoms, because if you do have a reaction, you want to be able to, you know, figure out, was it something that you ate 10 minutes ago or something that you ate 48 hours ago?


So that’s why you only reintroduce one new food every three or four days, if it doesn’t cause you a problem, then that’s back on your list. Even if the lists claim it’s high histamine, if it works for you, I would include it back in your diet because you know, part of what we’re talking about today is dietary diversity, dietary diversity buys you microbial diversity, which buys you immune tolerance. And the whole goal of this is to have a more tolerant immune system. And so so I know it’s not easy with mass cell activation syndrome but I don’t know of a better way to do it than to do the elimination diet, add things back in and see which see how many foods you can get back into your life. Keeping in mind that non dietary histamine triggers are also going to be contributing.


So for example, we know that stress is a huge mass cell trigger. And there’s interesting articles that can show you the exact mechanisms of how, how stress makes your mass cells activate. But it’s kind of a bummer because it means that just the time when you’re having the most stressful time in life, it also means you’re going to have the most reactions to your food. But to the extent that you can identify the non-edible mass cell triggers and avoid those that can buy you more space in your diet to eat more high histamine foods.


Joe, can you just clarify for us please? So is it that we’re ingesting the histamine in the food itself? Is it that certain foods will cause certain individuals greater histamine responses or is it a combination of both?


So then there’s kind of a trio and I always feel bad talking about this because it’s such a raw deal for meself patients. It’s really, it’s really, almost unbelievable that first of all, you can just eat histamines. So anytime you eat a food that is aged, overripe mature fermented and then there’s a few others besides that, like the tomatoes, spinach you’re just eating histamines and eating the histamines can trigger more muscles. So that’s number one. Now there’s some talk as to foods that are histamine liberator’s and it doesn’t really have good research behind it, but so it’s unclear whether this exists or not. But for example, citrus fruits are the ones that lots of patients claim that even though there’s not a lot of histamines in citrus fruit that citrus fruit will release histamines and set off the, the the domino effect. And then the third thing, which is the most unfair is that eating itself can be a mass cell trigger and release histamines. And so there are some people aware, no matter what they eat, it’s doing it.


So I’m guessing when I go out to my car after a couple of days and finished the coffee, I left there with half and half artificial sweetener in the garage. Right. That’s probably not so good. Okay. That’s that’s bad. Mona,


Hi gel. Do you hear me? Okay, thank you. I just, I have a couple of little seatbelt questions, is that okay? Sure. Okay. I started having got problems like in August, 2018, and they will make a long story short in January. When I started losing in January, 2020, when I started losing weight, we did a test and I, you know, it came back, we did the breath test and I had Seba. Okay. I took, cause I faxed it two weeks and after it, it helped so much and then make a long story short and then it started getting worse again, and my symptoms started getting worse and he the two gastroenterologists. So I’ve been seeing, you’ve told me more than they ever tell me yourself, active for that. But anyways, someday upset that, you know, you couldn’t take it again for like three months. So we have to do three months. I took good again, and that was in may and it’s still not gone. So I just took another test at home yesterday. So we’re waiting to see if I still have it. But my other question is, since I was diagnosed with the CBO foods tastes totally, totally weird. That was one of the symptoms you had on your saying, is that from the CBO or is that from something else?


That’s interesting. I have not heard that before from the CBO, but it does remind me of that article that I mentioned that gut bacteria can control eating behaviors. And one of the ways they do it is by changing taste buds. So that surprise me so much. But about reoccurring CBO. Yeah. Some people do have a lot of recurring CBO and oftentimes oftentimes if you find a physician who really is very familiar with CBO, what they will do is they will combine the Xifaxan with some other drugs or herbs that are shown to help and, or they will also combine it with a promotility drug such as low dose naltrexone and there’s others and ones that help keep the gut moving. Because we do know that if your gut is not having those nice movement and Paracelsus, then it is quite, you know, it is a risk factor for the CBO to just keep coming back.


One other thing that can be done in combination with the treatment is the low FODMAP diet. And that is a diet that is designed to not give those bacteria anything that they live on. And so it’s fermentable carbohydrates. And so so if they’re not getting anything to live on, then the thinking is that it makes it easier for the Xifaxan to kill them, or maybe they just starve to death. Some people stay on that diet longterm, but it’s, it’s not really recommended to be a super long-term diet because you are, you are robbing yourself of healthy foods. And so ideally that would just be a temporary tool to help get rid of the CBO. But sorry, sorry, Joe. Oh, I would just say if if you feel like you’re not having success with the doctors that you’re working with now, there are some doctors who really, really specialize in CBO and are so good with CBO. And I think that it’s worth it to find one of those doctors,


You know, there was a, a cafe next to our old office called CBO and it make me second thoughts about eating there anymore. Marie Marie.


Okay. Hi, thank you so much. No. And Jill for doing this, I hope you can hear me. I’ve I already, I get the big picture and the small picture, and I really appreciate the way you’ve cited so many medical articles that are specific to what we’re going through. I think like the madness of this is sometimes not having the expertise to do it yourself. So that’ll be great. Thank you. The question I have is I get that the best thing is a diverse diet to, well, you know all of that, but you also mentioned vitamin B and D and I wondered if you could talk about that supplementation or also how you feel about probiotics


And three bags while you’re at it, please.


Sure. Yeah. So just like our bodies are sensitive to nutrient deficiencies. It turns out that gut microbes can be also, and so they need some B vitamins, they need D and so if we can get those through diet, that’s wonderful. If you can not get them through diet then supplementing I think is the, not the next best thing in particular vitamin D is found to be huge for inflammation, I think partially through the gut microbiome and partially just through other avenues. You know, my understanding is that vitamin D controls the the can flip the switch on over a hundred different genes. And that’s just a super incredibly important. The Omega threes are also found to be really important for that intestinal permeability and for gut health. The, the way to get those naturally would be through things like the cold water fatty fish or supplementing can also be a way to get it when it comes to probiotics.


This is where I think, like, I wish that research could just be sped up at 20 years because I expect that in 20 years, they’ll be able to look, they’ll take a fingerprint of your gut microbiome, figure out what you have too much or too little of there’ll be able to, you know, replace it and give you a perfect gut microbiome and, you know, life will be great. Right now I think there’s some studies showing that for some inflammatory conditions, certain, certain probiotics can help. And every time I work with a client, I recheck the data on that for whatever their condition is, because the stuff is coming out so fast, like every week, there’s new, exciting stuff about that. As far as like probiotics in general, in the absence, if there is no study that can guide us. My suggestion is to start with things like sauerkraut and kimchi first, because a you get way more diversity than you ever, then you get in any of the supplements.


B we know that when you eat your, your probiotics on fermented vegetables, they survive the trip to your colon because they have that fiber to cling to. And it kind of serves as a little life raft. A lot of the, a lot of the probiotic supplements that we take are they just die in our stomach acid and they never even get to our colon anyways. And so I guess I, I think that probiotics are super promising. I think they’re probably gonna find that it’s one of those things where it’s not one size fits all different people see different results with different probiotics. And I just don’t know if there’s enough guidance right now for most people on which one to try or which one to take. There’s a couple that have a lot more research than others for safety, and that would be like VSL number three, and visit biome. And they have some good research for helping with certain things. So if I was going to just kind of like take a stab in the dark and start with a couple of those would be the ones that I’d start with.


Awesome. My gastroenterologist also said VSL three is one of like the, it’s almost like a medical food. And it’s, it’s been super tested with great results. Last question from Suzanne B and then I’m just going to ask one question from the chat, and then we’re going to let you go. I feel like you should have a residency here sort of like Celine Dion in Vegas, but but all right, Suzanne, go for it.


I think this may have been answered, so I’ll start with a big, great, great big, thank you for doing this. It’s been extremely helpful and valuable. But you started off telling us that that it can be auto immune caused by the virus essentially. And somebody had asked about temporary versus permanent, and I know we can’t obviously answer that over this point, but is there a chance that it won’t just go into remission, but that if it is an auto-immune that it would actually resolve itself?


Yeah. So that’s the big optimistic thing about the reigning theory of this, right? So so Alessio Fasano is this great researcher at Boston children’s hospital, somewhere in Boston. And he is this great researcher on the gut barrier. And he’s the one who has figured out that those little Gates in the, in the gut barrier, the that open up and close that he believes that in order for auto-immunity to perpetuate, you need to have that dysfunction in that gut barrier, that your little Gates are too open too often. So that garbage is getting into the bloodstream through the gut and keeping your immune system overly riled up and his theory, and he’s accumulate. He’s accumulating research that keeps supporting this. So that’s very exciting is that if you can fix the dysbiosis so that those gut microbes do their job and heal the gut lining so that you no longer have leaky gut and you no longer have garbage pouring into your bloodstream from your intestines.


His his theory and his evidence so far is suggesting that if you do that, then the immune, the immune system stops being so on guard and that the auto-immune damage can stop. So I can tell you that with the clients that I see the people who have the huge improvements, who completely turn around to their health are the ones who pay attention to gut health. It’s not the people who decide that they’re gonna lose weight. It’s not the people who decide they’re going to go keto. It’s not the people who decide they’re going to perfect, their ratio of carbs to protein, to, to fat. It’s the people who really pay attention to gut health through food. And also remember, it’s not just food, it’s like chemicals from your shampoo and your soap and your cleaning products too. But those are the people that I see having their auto-immune disorders go away. And if you look in some of those communities that I mentioned, you’ll see tons of examples of people who find the same thing. So I guess that’s like, I don’t, I don’t feel medically qualified to tell you that, yes, I guarantee you that your auto immune system or that your auto-immune disease can be halted, but I can tell you that a ton of people out there feel that this is working for them, and that they’re seeing the results


That makes so much sense. I mean, it’s really like the fertility of the soil in which you grow your plants or your trees. So I have just one more question, speaking of fertility. So I want to just ask so many of the long haulers that we see are young women, and we find that a lot of them report a worsening of their symptoms or an exacerbation, or kind of experiencing a setback during their periods. So is there anything nutritionally that can help support in that area?


So that’s a great question. And boy, I don’t know if it’s a coincidence that that is exactly what you see in dysautonomia and pots too. And so I can tell you that we, we know that ginger is one thing that can help prevent PMs pain and PMs symptoms. Can it change like, you know, I don’t, I don’t, I don’t know what’s going on with all of this stuff and menses and hormones. But, but if it is related to a thing, you know, I guess ginger would be my best guess is to, to see if the things that help with PMs might also help with this.


And, and in what form would you get that ginger


Tea is the easy way, but if you’re


A good cook and you want to make some ginger stir fry or put some ginger into your Curry, I’m lazy. I do. I just do tea. Gotcha. Gotcha. All right, guys, I know we could sit here for another eight to 12 hours listening to this Gil. I feel like we should say we’re not worthy. Really phenomenal fascinating and complete and kind and so beneficial. And we have to talk because this cannot be the end. Ladies and gentlemen have a great weekend and Beth, we could unmute everybody so that we can we can’t unmute everybody. Okay. So we’re going to have to do some, some performance art without sounds or unmute yourself. And we want to show Jill like a wave, everybody. [inaudible]. Thank you so much. Everybody have a great weekend. Very soon. Feel good, everybody. Thank you for hosting. Thank you so much. Thanks. Thank you. Awesome, Jill, you so much. Thank you. You guys have a beautiful thing going here. This is, this is so great to see. Thank you. Thank you. But we’re just friends. Just kidding. I, it wouldn’t be a webinar of mine if I didn’t say something inappropriate. So I’m glad I got to squeeze that in. Have a great day. Everybody.