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Fermented foods (like sauerkraut) and the bidirectional relationship between anxiety/depression and gut function

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fermented foods

Today’s blog is to whet your appetite (pun intended) with some snippets from my interview – Anxiety: Gut-Brain Communication & Diet – with Dr. David Perlmutter, author of Grain Brain and Brain Wash. In this interview we talk about fermented foods (like sauerkraut) and a study that highlights mechanisms underlying the  bidirectional relationship between anxiety/depression and gut function.

With anxiety at an all-time high and the ever-evolving research on the gut-brain connections we are relaunching the Anxiety Summit 5: Gut-Brain Axis summit on November 8-14, 2021. This interview is featured during the summit and is meaty (you’d expect nothing less from Dr. Perlmutter.)

The two-way connection between the gut and brain is powerful and needs to be explored and addressed if you have anxiety. Diet, fermented foods, reducing inflammation, addressing leaky gut (or intestinal permeability) and neurotransmitter support with amino acids are some of the ways that make a difference.

For the summit relaunch we have 4 incredible new guest expert interviews on sugar addiction, thiamine deficiency, trauma and the freeze response and safe tapering of SSRIs. And I have a new deep dive interview on glutamine, DPA and tyrosine for anxiety and sugar cravings/addiction. I’m excited to share it all with you!

For now, save the date and look out for the registration link in a few weeks. We’re in edit mode for the videos and transcripts, and getting all the backend setup done.

This is the first question I ask Dr. Perlmutter: I’d like to start with the microbiome and the fact that there is a bidirectional relationship between mental health and gut function. There’s a paper titled, Fermented foods, the gut and mental health: a mechanistic overview with implications for depression and anxiety published online late 2018 in The Journal of Nutritional Neuroscience. It highlights this important bidirectional relationship and the role of fermented foods. Can you share a little bit more about this and why this is important?

Before I share Dr. Perlmutter’s response, let me share a few quotes from the abstract of the paper:

  • Mental disorders including depression and anxiety are often comorbid with gut problems, suggesting a bidirectional relationship between mental health and gut function.
  • Several mechanisms might explain this comorbidity, such as inflammation and immune activation; intestinal permeability; perturbations in the hypothalamic-pituitary-adrenal axis; neurotransmitter/neuropeptide dysregulation; dietary deficiencies; and disturbed gut microbiome composition.
  • The potential of modulating the microbiome-gut-brain axis, and subsequently mental health, through the use of functional foods, is an emerging and novel topic of interest.
  • Fermented foods are considered functional foods due to their reputed health benefits.

The paper goes on to discuss food fermentation and summarizes how these foods “act biologically in the gastrointestinal tract and have the ability to modify the gut microbiota, influence translocation of endotoxins and subsequent immune activation, and promote host nutrition.” They are exploring their theoretical potential to improve symptoms of depression and anxiety in humans, saying more research is needed.

Dr. Perlmutter highlights various section of the paper and starts by sharing more about fermented foods and that we’ve been actively fermenting for thousands of years:

I think it’s first instructive to recognize that we’ve been actively fermenting foods for thousands of years as humans as a technique to preserve them, and allow us to travel with a food source. But beyond that, our ancestors prior to that would eat fermented foods. Fermentation is actually what happens to food when it’s left outside and is exposed to bacteria and begins the process of, dare I say, rotting. I don’t want that to be off putting to people who are going to hear the later part of our discussion dealing with eating fermented foods, because we have wonderful fermented foods that we eat these days.

He goes on to elaborate on what the paper terms functional foods. What this means is that these fermented foods have far-reaching health benefits for optimal health and for making us resistant to disease (i.e. improving our immunity):

The point is that the process of fermentation is basically a process of enrichment of food sources with bacteria. And what a notion that is, where we’re looking at the idea of eating a food that’s teeming with bugs, with germs, if you will. I say it that way, because it has such a negative connotation, but it really is what we want to do. These bacteria are involved in so many processes that deal with our health, and nurture our health, and our resistance to disease.

Some common examples of fermented foods are kimchi, sauerkraut, kefir (dairy kefir and water kefir), kombucha, and yogurt. Keep in mind, you can ferment many different vegetables. One of my favorites is cauliflower.

The paper also mentions inflammation as one possible mechanism for the bidirectional relationship between anxiety/depression and gut function, and Dr. Perlmutter discusses this in great detail, in the context of chronic health conditions. And he ties it all back to the microbiome:

From my perspective, of course, that has to do with the functionality of the brain, the way the brain remains healthy, and disease-free moving forward. And there are multiple mechanisms that relate to what’s going on in the gut to the brain. When we think of disease processes, most of what we are concerned about is the notion of inflammation, at least, in terms of a mechanism that relates to so many of the chronic degenerative conditions of the brain; be it Alzheimer’s, Parkinson’s, or even a non-chronic degenerative condition, which is autism is not necessarily considered to be progressive, but nonetheless at its heart, is in fact an inflammatory disorder.

So beyond that, of course, all of the chronic degenerative conditions that plague our planet, including heart disease, cancer, diabetes, the autoimmune conditions are at their very core, primarily inflammatory.

And let me be very clear that chronic degenerative conditions are ranked by the World Health Organization as the number one cause of death on planet Earth.

So we have to pay attention to anything that’s involved in the regulation of inflammation in the human body. And front and center right now in terms of gaining the spotlight, is the health of the gut bacteria, as well as its metabolites and it’s gene expression, collectively, we call that the microbiome.

The paper mentions intestinal permeability as another mechanism. Dr. Perlmutter covers the importance of the gut lining integrity and why it’s so important when it comes to anxiety, depression and the chronic diseases he mentions:

So we realize that the gut bacteria have a very important function, and that is to maintain the integrity of the gut lining.

And why would I, as a neurologist, give a hoot about the integrity of the gut lining? Quite categorically it’s because that is where inflammation in the body, in the long term, has its genesis. So, meaning we’ve got to have a strong gatekeeper at the lining of the gut to keep various gut-related proteins and other chemicals from making their way into the rest of the body, and challenging the immune system, upregulating the production of inflammatory chemicals that then do damage.

Dr. Perlmutter ends by discussing neurotransmitter dysregulation (also mentioned in the paper):

We know that our gut bacteria are involved in the manufacture of various neurochemicals, various neurotransmitters, serotonin, for example, dopamine, norepinephrine, epinephrine, [GABA], etcetera, that are primarily manufactured in the gut.

As a matter of fact, when it comes to serotonin, which certainly gains the spotlight; 90% is manufactured in the gut, another 9% is manufactured in the blood platelets, meaning that only 1% is actually manufactured in the brain, though, we call it a brain transmitter, a neurotransmitter. That said, the availability of the precursor for serotonin; the amino acid tryptophan, the availability of that even to the brain, is in fact controlled to a significant degree by actions of the gut microbes.

He wraps up by bringing in the microbiome, inflammation, chronic health conditions, anxiety and depression, and our lifestyle choices and diet (which includes foods such as fermented vegetables):

If we simply recognize that our gut bacteria are playing a massive role in regulating inflammation in the body, that’s enough, because our mission for the prevention of chronic degenerative conditions in the brain and out of the brain is controlling inflammation.

And it’s through the lens of the microbiome that we realize the detrimental or effectiveness of our food choices, and other lifestyle choices that can act to increase or balance inflammation. So it becomes extremely important.

The paper does discuss perturbations in the hypothalamic-pituitary-adrenal axis but we didn’t get into this during this interview. However, we do cover this in Dr. Peter Bongiorno’s interview on the summit.

Some of the recent research on specific fermented foods and mental health

Here is some of the recent research on specific fermented foods and mental health, where some or all of the above mechanisms may be a factor:

Some simple changes you can make

Here are some simple changes that be incorporated when you have anxiety or depression:

  • Include fermented foods and beverages in the diet (ideally on a daily basis). If you decide to include sauerkraut, you can make it yourself or buy it from the store. If you buy it ready-made, always make sure it’s raw and found in the refrigerated section. Vinegar should not feature on the label but do look for salt as this is used in the fermentation process. In the example I share above, the added ginger helps with digestion even further and is very delicious!
  • Eat a real whole foods diet with quality animal protein, healthy fats and organic vegetables and fruit (there is much research supporting dietary changes for improving mood and easing anxiety i.e. nutritional psychiatry)
  • Avoid inflammatory foods like gluten, sugar, processed foods/fast foods and foods that you have a sensitivity to
  • Address intestinal permeability if necessary (glutamine is my go-to nutrient for this and I take a deep dive into this amino acid in one of the new interviews on the summit)
  • Use targeted individual amino acids such as GABA to boost GABA (for physical anxiety symptoms) and tryptophan or 5-HTP to boost serotonin (for worry-type anxiety). You can do this while you are addressing underlying gut issues and making dietary changes. Keep in mind that these amino acids help you quit sugar, gluten and junk food at the same time as easing anxiety!

Resources if you are new to using the amino acids as supplements

If you are new to using the amino acids as supplements and want to know more, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable.

Do join us on the summit relaunch of Anxiety Summit 5: Gut-Brain Axis summit on November 8-14, 2021. Registration details coming soon.

And if you’d like to learn more about Dr. Perlmutter’s book, Brain Wash: Detox Your Mind for Clearer Thinking, Deeper Relationships, and Lasting Happiness (written with his son Dr. Austin Perlmutter), here is my review. In our interview on the summit, he shares about disconnection syndrome (and loneliness) and how our decision-making abilities have been compromised.

Are fermented foods and beverages included in your diet (and your family’s diet) on a daily basis? And what are your favorites?

Do you make your own fermented vegetables?

Have you observed mood and/or digestive improvements since including fermented foods in your diet?

If you are a practitioner, do you recommend fermented foods and discuss this bidirectional communication between the gut and the brain with your clients/patients?

Feel free to post your questions too.

MegaSporeBiotic™: A spore-based probiotic for leaky gut, IBS, anxiety, depression, liver health and colitis

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megasporebiotic

MegaSporeBiotic™ is “a 100% spore-based broad-spectrum probiotic shown to maintain healthy gut barrier function” i.e. leaky gut. Research and clinical results show it is promising for irritable bowel syndrome (IBS) or SIBO (small intestinal bacterial overgrowth), recovery from liver injury caused by acetaminophen, and is protective in ulcerative colitis (an inflammatory bowel disease). Given the gut-brain connection and the fact that the majority of serotonin is produced in the gut, it’s not surprising that spore-based probiotics may also help ease anxiety and depression.

Here are some of the studies supporting this spore-based probiotic for gut issues:

The key findings of the present study is that oral spore-based probiotic supplementation reduced symptoms indicative of “leaky gut syndrome”.

The results demonstrated that patients treated with MegaSporeBiotic, compared with those treated with rifaximin followed by nutraceutical or low-FODMAP diet, had similar severity scores and rectal volume sensation test results for all parameters tested and statistically significant improvement in measurements of quality of life.

This is important because “Acetaminophen  is one of the most used analgesics [pain-reducing] and antipyretic [fever-lowering] agents in the world. Intoxication with acetaminophen is the main cause of acute liver toxicity in both the US and Europe.”

Pretreatment with probiotic spore-forming Bacillus strains and a supplement of amino acids in combination with immunoglobulins exhibited anti-inflammatory and antioxidant effects in an AA-induced rat model of ulcerative colitis.

In one study, Bacillus coagulans (one of the spore-forming strains in MegaSporeBiotic™), when used alone was shown to help ease depression and gut problems in IBS patients. It was a randomised, double-blind, placebo controlled, multi-centre, pilot clinical study and:

The improvement in depression and IBS symptoms was statistically significant and clinically meaningful. These findings support B. coagulans MTCC 5856 as an important new treatment option for major depressive disorder in IBS patients.

During The Anxiety Summit 5: Gut-Brain Axis, I interviewed Kiran Krishnan who is a microbiologist, one of the founders of Microbiome Labs and a co-creator of MegaSporeBiotic™. He reminds us about the gut-brain connection and how anxiety and mental health issues come from the gut “because the vast majority of serotonin in your body – more than ninety percent of it – is actually produced in the gut” and not in the brain.

He talks about the type of cell in the gut that produces serotonin – the enterochromaffin cell – and the fact that “spore forming bacteria are some of the best stimulators of the enterochromaffin cell to produce serotonin.”

With low levels of serotonin you’ll experience the worry-type of anxiety with ruminations, obsessing, panic attacks, insomnia (often lying awake worrying). Other low serotonin symptoms include low mood/depression, late afternoon and evening carbohydrate cravings, pain, PMS, irritability, rage and anger, TMJ, low confidence, imposter syndrome and perfectionism. This type of low-serotonin anxiety is different from the low GABA physical/tension type anxiety.

These cells also play a crucial role in gastrointestinal regulation, particularly intestinal motility. We know low serotonin also contributes to digestive/IBS-type symptoms.

You can see a list of all the low serotonin symptoms here.

Brandy’s positive feedback on digestive issues and mental health

Brandy Oto, a marriage, couple and family counselor, incorporates  an integrative nutrition approach with her clients and she shares this:

MegaSporeBiotic™ makes a HUGE difference in my body! I have used every probiotic I can think of. Megaspore has not only resolved my digestive issues and allows me regular bowel movements, I find my mental health is much better! I have decided to use it in my practice as well now. Clients consistently report better mental health!

I asked her how quickly she notices an improvement when using MegaSporeBiotic™ and what aspects of mental health improve for her and her clients. She shares this:

I personally notice physical and mental anxiety decrease usually about 4-5 days, bowel movements easy within a couple days, ability to tolerate foods I was sensitive to after 6 or so months on them.

Clients report all types of improvements from anxiety, depression, to digestive issues improving. I have even heard from one client that when she gets off the probiotic symptoms of schizophrenia return.

In Brandy’s mental health practice, she does use amino acids to address neurotransmitter deficiencies too (for example tryptophan or 5-HTP to address low serotonin symptoms like worry, fear, panic attacks). She uses this spore-based probiotic to address underlying issues that cause those deficiencies.

It’s not one or the other – the probiotics and amino acids are part of a comprehensive plan.

Not everyone raves about this probiotic and some folks report it either does nothing for them or is too strong for them. So, as with everything, it’s very individualized.

How do spore-based probiotics differ from other probiotics?

During the Anxiety Summit interview with Kiran, he explains how they differ from other probiotics and why this is important for them to get into the gut:

These are organisms that have a unique capability of covering themselves in a thick calcified protein-like coating. So it’s armor, essentially, around the bacterial cell.

This allows these bacteria to come in through the gastric system, through the oral route, and survive the gauntlet that bacteria have to go through just getting through the process of digestion.

So the first step is the stomach acid. The stomach acid is called the gastric barrier and that’s because it acts as an actual physical barrier through the function of hydrochloric acid to try to kill off as many microbes that are trying to enter the system through food and other exposure.

If something gets past the stomach acid then the second piece of the gauntlet are the bile salts. Bile salts are released into the duodenum itself. Those are very strong antimicrobials and part of their function is to act as an antimicrobial to protect the system against a lot of bacteria coming in on a regular basis.

And then the last part is the pancreatic enzymes that help you digest your food – they also act as antimicrobials.

So there’s this really difficult gauntlet that the microbes that are entering the system through the oral route have to go through in order to make it past these initial systems to get to the site of action in the deeper part of the intestines where they’re supposed to function as a probiotic.

These spores have developed this unique, natural capability of covering themselves in this armor which allows them to survive through all of that.

This study, Survival and persistence of Bacillus clausii in the human gastrointestinal tract following oral administration as spore-based probiotic formulation confirms the above for one particular strain and concludes that “Bacillus clausii spores survive transit through the human gastrointestinal tract.”

Where can I buy MegaSporeBiotic™?

megasporebiotic supplement facts

These are the spore-based bacteria contained in the MegaSporeBiotic™ product: Bacillus Licheniformis, Bacillus Indicus HU36™, Bacillus Subtilis HU58™, Bacillus Clausii and Bacillus Coagulans.

You can purchase MegaSporeBiotic™ directly from Microbiome Labs once you have set up an account with them under my name. Use this link (and make sure the Direct2Patient™ Code says tscott).

You can also read more about the product on the Microbiome Labs site here.

If you already have an account with Fullscript, my online supplement store, you can purchase from there too.

If you don’t yet have an account with Fullscript you can read more about how to set up an account here.

Let us know if you’ve used MegaSporeBiotic™ with success and how it helped you with anxiety, depression and/or gut and liver health.

Let us know if you’ve used another spore-based probiotic and which one? Or do you have a favorite probiotic that is not spore-based?

I’m going to a product review like this once a month so please let me know if you like this format with research, feedback and mechanisms.  And let me know what other products you’d like me to review.

Feel free to post your questions here too.

[The above statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.]

 

Gut bacteria, pain and anxiety connections: Klebsiella and ankylosing spondylitis

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We know about the gut-brain connection where the health of our microbiome impacts how anxious or depressed we feel, but we often forget that there is a gut-pain connection too and how addressing dysbiosis and bad bacteria in the gut can have far-reaching benefits.

An old work friend recently reached out asking for help for her husband who had been diagnosed with ankylosing spondylitis, ulcerative colitis and gluten sensitivity, and was not seeing results with conventional treatment. I did some digging for them and a colleague mentioned that they had addressed Klebsiella when they discovered that her husband had genes predisposing him to ankylosing spondylitis. Read on to see what I’ve learned.

Klebsiella as a precursor to ankylosing spondylitis

The paper shared with me: The relationship between Klebsiella infection and ankylosing spondylitis, discusses the HLA-B27 gene and the Klebsiella connection:

Klebsiella-reactive arthritis is the precursor stage occurring in the early and active phases of ankylosing spondylitis.

Let’s learn more about Klebsiella, ankylosing spondylitis, the anxiety connection and prevalence, the role of neuro-inflammation and genes, the problems of a high carb diet and the role the amino acids GABA, tryptophan and DPA play in pain and anxiety relief and being able to quit the carbs easily, plus provide sleep support.

In case you’re not familiar with Klebsiella, this excellent FX Medicine article describes it as follows:

Klebsiella pneumoniae (KP) is a type of gram-negative rod-shaped bacteria that can cause different types of infections ranging from pneumonia (lung), blood infections (septicaemia), wound or surgical infections, urinary tract infections, small intestinal bowel overgrowth (SIBO), ankylosing spondylitis, Crohn’s disease, ulcerative colitis and meningitis (brain).

Ankylosing spondylitis is an inflammatory disease of the spine

In case you’re not familiar with the condition ankylosing spondylitis (pronounced like this) the Mayo Clinic site provides this summary:

Ankylosing spondylitis is an inflammatory disease that, over time, can cause some of the vertebrae in your spine to fuse. This fusing makes the spine less flexible and can result in a hunched-forward posture. If ribs are affected, it can be difficult to breathe deeply.

Ankylosing spondylitis affects men more often than women. Signs and symptoms typically begin in early adulthood. Inflammation also can occur in other parts of your body – most commonly, your eyes.

They say there is no cure and the treatments include pain medications and physical therapy to ease symptoms (and surgery in some cases).

I’m all for physical therapy but you’ll notice there is no mention of gut health or Klebsiella. This is why we have to keep searching for root causes – and work with a functional medicine practitioner – no matter what the health condition, be it ankylosing spondylitis or anything else.

Prevalence of anxiety in ankylosing spondylitis

As with most physical conditions there is a connection with anxiety. This paper: Prevalence of psychological disorders, sleep disturbance and stressful life events and their relationships with disease parameters in Chinese patients with ankylosing spondylitis reports that

AS [ankylosing spondylitis] patients had more severe psychological disorders, sleep disturbance, and stressful life events.

Prevalence of anxiety, depression, and sleep disturbance was 31.6%, 59.3%, and 31.0% respectively.

We have to ask ourselves if we have anxiety, depression and insomnia because of the pain being experienced or because of one or more of the root causes that contribute to both pain and anxiety.

Microbiota disturbance, neuro-inflammation, and anxiety

Often the research focuses on the former but we know that there is Evidence for interplay among antibacterial-induced gut microbiota disturbance, neuro-inflammation, and anxiety in mice. In this 2018 animal study treatment with lactobacilli suppresses this neuro-inflammation.

Ankylosing spondylitis, Crohn’s disease, genes and a high carb diet

The above FX Medicine article shares the connection between ankylosing spondylitis, Crohn’s disease and ulcerative colitis, as well as the genetic susceptibility, together with the problems of a high carb diet:

Genetically susceptible people, such as those who have the HLA-B27 allelotypes and consume a high starch/carbohydrate diet, can trigger a growth in Klebsiella in the bowel, the starch becoming a main food supply for the Klebsiella.

The amino acids for pain, carb addition, anxiety and insomnia

The amino acids come into the picture again, helping to ease the pain, provide precursors for neurotransmitter production until the microbiome is balanced, and eliminate carbohydrate cravings so they can be given up without willpower.

As always figuring out your own imbalance and doing an amino acid trial is key. Here is a summary of how they may help in this instance, assuming you have low levels of GABA, serotonin and/or endorphins:

  • GABA helps with stress eating of carbs, eases physical anxiety, eases some pain.
  • Tryptophan helps with afternoon and evening carb cravings, eases mental worry-type anxiety and depression, and also eases some pain. Both GABA and tryptophan help with insomnia.
  • DPA boosts endorphins providing acupuncture-like pain relief and provides the emotional comfort that starchy treats often do.

The FX Medicine article has treatment and prevention tips for you to share with your functional medicine doctor, who will be able to run a functional stool test such as the GI-MAP offered by Diagnostic Solutions Lab.

Just because there are these gut bacteria, pain, anxiety, Klebsiella and ankylosing spondylitis connections, it doesn’t necessarily mean everyone with ankylosing spondylitis has Klebsiella or that everyone who has Klebsiella will go on to develop ankylosing spondylitis (as stated above) or even that everyone with ankylosing spondylitis will have anxiety. I’m simply connecting some dots so you can start to think outside the box.

I’d love to hear what has worked for you or a loved one with ankylosing spondylitis and/or if you’ve seen elevated Klebsiella on your stool test or have the genetic predisposition?

Have the amino acids and a low-carb diet helped the healing process and eased some of your anxiety while addressing the underlying Klebsiella infection?

The Broken Brain highlights: Trudy Scott interviews Dr. Mark Hyman

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I’m really excited to share my in-person video interview with Dr. Mark Hyman, MD. It’s an interview I arranged because I’m so excited about his Broken Brain docu-series which will start airing on January 17th. You may have seen it when they recently did a test launch but if you haven’t yet seen the series it is well-worth watching and is highly recommended! (Registration link here)

In this interview with Dr. Hyman we talk about root causes of anxiety, depression, dementia, Alzheimer’s disease and ADHD: medication side-effects, diet, the microbiome, nutritional deficiencies, brain chemical imbalances, heavy metal toxicities and more; he shares his personal mercury toxicity story and the why behind the Broken Brain series; we cover off-label medications, trauma, labels and functional medicine.

I love the term he uses to describe body-mind medicine (which is different from mind-body medicine): somatopsychic = mental symptoms caused by bodily illness i.e. all of the above root causes.

One of the big reasons I’m supporting The Broken Brain docu-sersies is that it offers solutions and plenty of hope!

Here is the interview and transcript.

(there are captions on the video – if you don’t see them be sure to click the CC on the bottom right)

Trudy: – Welcome, it’s Trudy Scott here, food mood expert, certified nutritionist, author of The Antianxiety Food Solution, host of The Anxiety Summit, and today I’ve got the pleasure of interviewing Dr. Mark Hyman, who is the creator and host of the new Broken Brain series, and I’m just really excited to be here. I’ve been such a fan of yours for so many years. I know my community knows who you are, and they’re really excited about the Broken Brain series. I wanted to get together with you, and give some highlights, and talk about firstly why you created the Broken Brain series, and you’ve got a story behind your passion about it.

Dr. Mark Hyman: – I do. I do. Thank you for having me. Yeah, so about 20 years ago, I went from being a very healthy young doctor to having a broken brain, and a broken body, and it turned out it was from mercury poisoning that I got when I was in China, and I just developed severe chronic fatigue, where I couldn’t focus, I couldn’t remember, I couldn’t think, I couldn’t pay attention, I was depressed, I couldn’t sleep, I felt just completely not myself, and through that journey, was able to discover this world of functional medicine, which I thought was fairly developed at the time, but was really just in its infancy, and through discovering functional medicine, I was able to repair my own system, and fix my broken brain. I began to apply this with patients, seeing all kinds of things, without really knowing what I was doing, I was just treating people’s physical systems, fixing their gut, helping their immune system, cleaning up their diet, optimizing their nutritional status, balancing their hormones, and all their mental problems would get better. Their anxiety would get better, their depression would get better, and I wasn’t actually treating the depression or anxiety. Autism, ADD, memory issues, dementia, all these things would start to get better, and I began to realize that the body was driving a lot of this brain dysfunction, and that if you fix the body, a lot of the brain disorders would get better, that it wasn’t a primarily a mental problem, but it was a physical problem. Just as there’s a mind body effect, which is real, there’s also a body mind effect and that hadn’t been really talked about, so I wrote a book called The UltraMind Solution 10 years ago, which outlined this model, and then really this has been an incredible 10 years of brain research that I felt needed updating, and so we created a documentary series online looking at the new research, and how this applies, and the things that I noticed 10, 15, 20 years ago are now becoming more and more accepted and understood as real, and so we’re able to actually work with people in a very specific and direct way to help heal their broken brains, and to help people recover from things that we thought were really irreversible, not just anxiety, depression, but ADD, autism, dementia, Parkinson’s, all sort of issues that affect the brain that have a very different approach that can be used to repair and heal.

Trudy: – That’s so powerful, and I love that you talk about this effect that the body has on the brain, because we know about mind body medicine, you talk about that in the series, about how we can use our mind to affect our health, but you use this term. Tell me what the term is that you use that talks about how physical issues in our body, nutritional deficiencies, imbalances, can actually affect the brain.

Dr. Mark Hyman: – You mean the body mind effect?

Trudy: – Yes.

Dr. Mark Hyman – Yeah.

Trudy: – You’ve give it a term, and it was called?

Dr. Mark Hyman: – Oh, somatopsychic.

Trudy: – Somatopsychic, yes.

Dr. Mark Hyman: – We think of psychosomatic, but there’s also a somatopsychic phenomena. I would say if you have mercury poisoning, or you have a thyroid problem, or you have abnormal gut flora, or you’re vitamin D deficient, or B12 deficient, it’s very hard to have a proper functioning brain. You can’t just say someone’s got depression, that’s what’s causing their hopelessness, and helplessness, and sadness, and maybe many other things, it could be psychological, it could be a trauma, but it also could be so many other factors, and they often are overlooked and ignored, and when I start peeling back the layers of what’s happening with these people, and looking underneath the hood, and looking through the functional medicine lens at the body as a system, and correcting the imbalances, it’s shocking to me what happens. I always remember when I start applying this, I was like, wow, you got better? I can’t believe it. You shouldn’t really get better, according to Western medicine.

Trudy: – Amazing, and you mention trauma. Even if someone has experienced trauma, if their nutritional status is good, they’re able to deal with it better.

Dr. Mark Hyman: – Right.

Trudy: – And maybe have less symptoms of post-traumatic stress.

Dr. Mark Hyman: – That’s right.

Trudy: – If they have a good nutritional status, and there’s a lot of good research supporting that.

Dr. Mark Hyman: – Absolutely.

Trudy: – You talk about that in the series as well.

Dr. Mark Hyman: – Yeah, absolutely. Your brain has the ability to be resilient, but if you’re nutritionally depleted, and if you’re having all sorts of inflammatory problems, if you’re eating foods you’re reacting to, or allergic to, your brain can’t work properly, so your baseline is going be much lower, but if you fix all those things, then your capacity to deal with your psychological issues, it’s not that they don’t exist, it’s that your ability to cope with them, to work through them, to heal and repair the more difficult things, which are early life traumas, or abuse, or addiction, these are much easier to deal with once you fix the basic constitution of the person.

Trudy: – Right. Now one thing that you talk about a lot in the Broken Brain series, which I really appreciate, is the fact that there’s so much over-medication.

Dr. Mark Hyman: – Yeah.

Trudy: – Can you talk a little about it today? And I know with your story, you also had anxiety, depression, and you were prescribed medications as well.

Dr. Mark Hyman: – Yeah.

Trudy: – So this is common.

Dr. Mark Hyman: – Yeah.

Trudy: – You talk about antipsychotics. You shared some pretty scary stats on the increase that we see.

Dr. Mark Hyman: – When you look at it, it kind of goes up and down, but psychiatric medication as a whole, is the number two or three most prescribed category of drugs in America, and increasing across the globe, and it’s being used instead of dealing with the real issues, and they don’t really even work that well. I mean, anxiety medications can work, but antidepressants have been shown really not to work that well for mild to moderate depression. For severe depression, they can be helpful, and they can be life saving for some people, but they’re not a panacea, and when I was a kid, there was that one kid in the class, Patty Ainsworth, who was a troublemaker. Now it’s like 10% of the class is on ADD medication. That’s a problem.

Trudy: – It is.

Dr. Mark Hyman: – And when we see one in four people have depression in their lifetime, and if the knee jerk reaction is medication, it just sort of gives people a sense of numbness, but it doesn’t really deal with the issue. So I think we are way over-medicated, and on top of that, there’s pushing of medications for off-label use, which means that they’re not approved for those indications. So they’re doing this for kids with antipsychotics, and they’re actually been sued. So the pharma companies have been held liable for promoting these drugs for off-label uses, which they’re not allowed to do, for kids. They get fined billions of dollars, but they don’t care because they’ve made umpteen more billions, and they just see it as a marketing expense. So it’s really discouraging to see what happens to the pharmaceutical use in this space, because even for example, ADD is so fixable by dealing with the root causes, and most of us not are not even trained how to think that way.

Trudy: – That’s why I love the Broken Brian series, because it offers a message of hope, offers some practical solutions, and it empowers the person who’s suffering from the brain disorder, whatever it is, anxiety, depression, dementia, you name it, empowers them with solutions, and I think the other thing is it’s going to give curious practitioners who are not on board with this functional medicine approach some insights into what the future may hold, which I think is very promising.

Dr. Mark Hyman: – Yeah. It’s very powerful. I remember this guy who read my book, The UltraMind Solution, which is really what the Broken Brain series is based on, and he was a doctor, and he had a kid with autism, and he said, “We’re so desperate. Our kids was five, he wasn’t talking. We just started with the diet. We just got him off gluten, casein, and a few days later, all of a sudden, he started talking in full sentences,” and this is a skeptical physician who witnessed this, and I see this all the time. Patients, for example, have Alzheimer’s, or dementia, or diagnosed with dementia, and it turns out they have other issues. They have heavy metal poisoning, or they might have Lyme disease in the brain, or they might have severe nutritional deficiencies, or they might be insulin resistant with high levels of sugar in their diet that are affecting their brain, and you can fix those things. There may still be issues left over, but it’s going to be much easier to deal with those after.

Trudy: – Get to the root cause, and address those root causes.

Dr. Mark Hyman: – That’s right. That’s the purpose of functional medicine, which is a medicine of why, not what, and we have all these labels, but you know, if someone comes into my office, and they’re hopeless, and helpless, have no interest in life, can’t focus, can’t sleep, don’t want to have sex, I know what’s wrong with you. Depression, but depression isn’t the cause of those symptoms, it’s the name of the symptoms. It doesn’t tell you what’s really wrong with that person. It’s could be a host of things, from low thyroid, to gluten, to mercury poisoning, to vitamin D deficiency, to B12 deficiency, to insulin resistance. All these factors can lead to depression. Same syndrome, but different causes. So I’m much more interested in addressing the causes, then you don’t have to use the medication.

Trudy: – And some people have an issue with gluten, and have autism symptoms, and someone else can have depression or anxiety or dementia.

Dr. Mark Hyman: – That’s right.

Trudy: – So it can affect different people in a different way.

Dr. Mark Hyman: – That’s a very good point. So in functional medicine, we see that one disease can have many causes, but on the other hand, one causative factor can create many diseases. For example, heavy metals may cause dementia, or autism, or depression, or anxiety, or insomnia, or gut issues can cause all these various things that are not one disease, or for example gluten, like you mentioned, can cause autoimmune disease, can cause cancer, can cause diabetes, can cause osteoporosis, can cause anemia, can cause depression, can cause even dementia. So how do you begin to think about it? Our current naming of diseases doesn’t make any sense. So all the labeling, if you look at the diagnostic criteria, we have something called the DSM-5, which is the diagnostic and statistical manual that categorizes and catalogs all the psychiatric disorders, and they’re all categorized by symptoms. So it’s all descriptive. It’s says if you have these five symptoms, you have this, but it doesn’t tell you why, and it doesn’t really help you, other than giving you a label, which doesn’t mean anything about helping you understand what’s really going on.

Trudy: – And then you’re on a medication that’s going to give you side effects, and not actually get to the root cause of the problem.

Dr. Mark Hyman: – Right.

Trudy: – And yeah, just make some nutritional changes, addressing the thyroid, getting off gluten, addressing the gut – big session in the Broken Brain series.

Dr. Mark Hyman: – Yeah, it’s huge.

Trudy: – The gut brain connection.

Dr. Mark Hyman: – I mean, we’re just learning about this. For example, for years one of the main ways I treated the brain was fixing the gut, and that means optimizing the flora, getting rid of bad bugs, helping heal leaky gut, and we just did it, we didn’t really have a deep understanding other than we knew the microbiome was important, but now we know, for example, that there are more bacterial molecules in your blood than your own molecules, that you have 10 times as many bacterial cells in you as your own cells, 100 times as much bacterial DNA, and that DNA is all producing proteins, and all those proteins, you have 20,000 genes, there’s two million genes of bacteria in you, and they’re all producing molecules that are entering your blood stream, and driving all sorts of biological reactions, that aren’t even human molecules. So we have to begin to sort of how do those affect the brain and what’s going on? And it’s very powerful.

Trudy: – And so much research in this area, it’s just growing and growing.

Dr. Mark Hyman: – Yeah.

Trudy: – So you mentioned earlier that you wanted to do this because of all the new research. There is so much research on the gut brain connection, nutritional psychiatry. Dr. Drew Ramsey talks about this recent study on depression, and just getting people onto a real whole foods diet, and how 30% saw remission of symptoms, just changing their diet.

Dr. Mark Hyman: – Of course.

Trudy: – Not even going gluten free. So it’s powerful. These small changes can have powerful effects.

Dr. Mark Hyman: – Profound, profound effects

Trudy: – Well, thank you so much.

Dr. Mark Hyman – Thank you.

Trudy: – For your wonderful work that you do. And for making time today. I highly recommend the Broken Brain series with Dr. Mark Hyman, all the wonderful experts.

Dr. Mark Hyman: – Oh, so many. We’ve got 57 experts.

Trudy: – Amazing, some of our favorite functional medicine practitioners.

Dr. Mark Hyman: – Yeah.

Trudy: – Thank you.

Dr. Mark Hyman: – Thank you.

(I’m a tad disappointed that there is the background noise of people talking – and apologize – but I am hoping the great content overrides this and it’s not too distracting.)

Save the date for the 8 -part Broken Brain docusersies, hosted by Dr. Mark Hyman – and register here. It airs January 17-25th

Here’s a list of ALL the episodes, to showcase just some of what you will have access to. Each episode will be available for 24 hours, at no-cost!

  1. The Broken Brain Epidemic / My Story (January 17)
  2. Gut Brain Connection: Getting to The Root of a Broken Brain (January 18)
  3. Losing Your Mind (Alzheimer’s, Dementia, MS, and More) (January 19)
  4. ADHD and Autism (January 20)
  5. Depression & Anxiety (January 21)
  6. Traumatic Brain Injury: Accidents, Sports, and More (January 22)
  7. 7 Steps to An UltraMind (Part 1) (January 23)
  8. 7 Steps to An UltraMind (Part 2) (January 24)

I hope you enjoy it and get as much out of it as I did!

I actually flew from Sydney to LA for this opportunity to meet and interview him, and share more about the Broken Brain series, and I’m so glad I did! It was the first time I’d met Dr. Hyman in person and it truly was an honor to be in the company of this great man who is doing so much in the functional medicine world! Again, here is that link to register

Please share if any of this resonates with you – what solutions you have found have helped you and/or what you are working on addressing now?

AN UPDATE: there has been some feedback on the term “broken brain” being too negative and even scary so I gathered some feedback and share it in this blog: Is the term ‘broken brain’ hopeful and real or too negative and scary? I really want to hear your thoughts if you are offended by the term broken brain.  I also want to share Dr. Hyman’s apology.

Gut Hormone Connection with Dr. Jolene Brighten: Better Belly Project 2.0

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Dr. Jolene Brighten is one of my favorite women’s health experts and her Gut Hormone Connection interview with Summer Bock on the Better Belly Project 2.0: is fascinating. Here are a few snippets for you to enjoy about the connection between your thyroid, digestion and SIBO (small intestinal bacterial overgrowth) specifically:

In the case with hypothyroidism, this is something that’s a really interesting phenomenon. Your thyroid can be functioning perfectly well, but you can still be hypothyroid because it’s not about just the thyroid function but the conversion of T4 to T3. T3 helps your mood, it’s what helps your menstrual cycle, it’s your metabolism. It does so many wonderful things. Every single cell needs that active T3.

Well, your gut and your liver are major sites of activating that T3. If they are unhealthy they’re not going to convert your T4 to T3. Then, you get into a loop because if you don’t have enough T3, now, you don’t stimulate hydrochloric acid. If you don’t stimulate hydrochloric acid production, then, none of the other gastrointestinal organs are going to work as well. Your gallbladder is not going to contract. You’re not going to have pancreatic enzymes, which sets up a perfect environment for SIBO.

She goes on to share how T3 also affects motility, which is a major factor when it comes to SIBO.

Adrenal issues and high cortisol issues are common with the clients I work and Jolene shares more on this topic too, and how this can play a role in anxiety (and insomnia):

If the gut is inflamed, so if you’ve got gut infections going on, then, those adrenal glands are going to kick into hyperdrive. We can see they’ll try to secrete cortisol so that we can drop that inflammation. In addition to that, they’ll start spiking epinephrine and norepinephrine over time, which when those hit the brain, we’re going to feel anxious and panicked.

She also covers orgasms, and so much about birth control pill concerns like the impacts on the microbiome and an increased risk of Crohn’s disease. It’s an interview that is not to be missed!

Summer Bock, one of the leading gut health experts, is interviewing 49 experts who are leaders in the field of digestion, nutrition, and health in this huge, week-long virtual conference called Better Belly Project 2.0: Crushing the Critters, Plugging the Leaks, & Balancing the Biome for Your Best Body Ever

Summer’s goal is to create a great resource with a few different tracks to make it easier for you to navigate the information:

  1. Gut Health Basics
  2. Gut-Brain Axis (my interview “Low zinc, social anxiety/pyroluria and the gut” is in this track)
  3. Wellness Professional
  4. Fermentation
  5. Microbiome & Probiotics

This online event will provide exceptional value, knowledge, and truly life-changing insights from authors, professors, scientists, fermented foods experts, and wellness practitioners who have an understanding on how you can improve your digestive health amidst all the processed foods, antibiotics, stress and lack of probiotic-rich foods in the diet.

The dates are December 8-14th and there’s no charge to attend when you register in time for the live event. You can see the event schedule and register here for Better Belly Project 2.0

I hope you enjoy it and get as much out of it as I plan too! I learn new information at all these online events too!

Do you have thyroid issues and digestive symptoms? Feel free to leave your questions and comments below.

Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth (SIBO)

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Despite the fact that this paper was published in 2014, it’s still very relevant and I’m just behind in sharing it via a blog post: Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth

Patients with small intestine bacterial overgrowth (SIBO) have chronic intestinal and extraintestinal symptomatology which adversely affects their quality of life. Present treatment of SIBO is limited to oral antibiotics with variable success. A growing number of patients are interested in using complementary and alternative therapies for their gastrointestinal health. The objective was to determine the remission rate of SIBO using either the antibiotic rifaximin or herbals in a tertiary care referral gastroenterology practice.

I’ve also decided to post this study now because I’ve been dealing with chronic SIBO for some time and am in the middle of doing the Metagenics herbal protocol (more information on that below).

SIBO symptoms and conditions

Here is a summary of some of the chronic intestinal symptoms: Abdominal bloating (gas), belching, flatulence, abdominal pain, cramps, constipation and/or diarrhea, heartburn (reflux or GERD), nausea and food sensitivities.

Here is a summary of some of the extraintestinal (outside the intestinal system) symptoms and conditions that have been linked to SIBO and/or dysbiosis: disorders of mood and behavior (including anxiety), diabetes, obesity, cardiovascular disease, rosacea, restless legs syndrome, pain, anemia, interstitial cystitis, and other pelvic conditions such as vulvodynia and proctalgia fugax (rectal spasms), chronic prostatitis and polyneuropathy.

During season 3 of The Anxiety Summit, I interviewed Dr. Allison Siebecker on Small Intestinal Bacterial Overgrowth and Anxiety. We talked about the SIBO Questionnaire I use with my clients and she gave me permission to share my modified version. You can find this SIBO questionnaire here. Please check out Dr. Siebecker’s site siboinfo.com for a wealth of information about SIBO.

The herbal treatments in this study

In this study, one hundred and four patients who tested positive for newly diagnosed SIBO by lactulose breath testing were offered either 1200mg rifaximin a day or one of two herbal treatments for 4 weeks. Lactulose breath testing was done again at the end of the treatment.

These are the two herbal treatments that were offered:  

Dysbiocide and FC Cidal (both by Biotics Research): take 2 capsules twice daily of each of these products

or

Candibactin-AR and Candibactin-BR (both by Metagenics): take 2 capsules twice daily of each of these products

The ingredients in each of the products
(from the paper: Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth)

Study conclusion

The study concluded that these herbal therapies are at least as effective as rifaximin for resolution of SIBO. It also states that the herbal products also appear to be as effective as triple antibiotic therapy in patients who don’t respond to rifaximin.

Adverse effects

With regards to adverse effects, they were reported as follows: in the rifaximin treated patients there was 1 case of anaphylaxis, 2 cases of hives, 2 cases of diarrhea and 1 case of Clostridium difficile; in the herbal group only one case of diarrhea was reported.

A comment about bioindividuality

You’ll notice that the only herb that is in both sets of herbal protocols is Red Thyme Oil or thymus vulgaris and yet both herbal protocols offer a solution. I’ve heard Dr. Siebecker share that of all the different approaches for SIBO (including the elemental diet), at least one approach works for everyone. So, if you’ve tried an approach and it hasn’t worked, don’t give up and move on to the next approach. This points to bioindividuality, and there being no one size fits all approach.

Dr. Siebecker lists the above combination herbal protocols together with the herbal protocol her and team use on her site, which, again, is different from the above: 1-3 of the following herbs x 4 weeks per course, at highest levels suggested on product labels.

  • Allicin from Garlic (the highest potency formula is Allimed)
  • Oregano
  • Berberine- found in Goldenseal, Oregon Grape, Barberry, Coptis, Phellodendron
  • Neem
  • Cinnamon

My protocol and experience

As I mention above, I also decided to post this study because I’ve been dealing with chronic SIBO for some time and am in the middle of doing the Metagenics herbal protocol. I’m 14 days into a 28-day protocol.

I’m actually doing 1 capsule of Candibactin-AR, 3 times a day away from food and 2 capsules of Candibactin-BR, twice a day, and about 10 minutes before food. I landed on this protocol, so I would have enough of each for a 4-week protocol.

When I started on the products I immediately observed the typical SIBO bloating and almost quit but quickly figured out it was from the microcrystalline cellulose and hypromellose in the Candibactin-BR.

It turns out that these are soluble fibers (dispersible in water) and are more easily fermented than insoluble fibers. This fermentation in the small intestine can trigger IBS/SIBO symptoms. Adding 2 capsules of a product with cellulase (an enzyme that breaks down cellulose) has helped.

Pain, gas and GABA

I also remembered that Dr. Siebecker shared on the SIBO SOS I summit about how SIBO patients can have visceral hypersensitivity where their pain can be due to the pressure of the gas that is produced and the muscles in the digestive system actually contracting against this pressure. It got me thinking about how effective GABA is for relieving muscle tension. I use GABA with my clients all the time for relief of their physical anxiety and stiff and tense muscles. And GABA helps me and many others with proctalgia fugax (rectal spasms)  which seems to be related to IBS/SIBO.

Over the last week I’ve tried sublingual GABA a few times to ease the pain and pressure and it’s been amazing. I’ve used it as soon as I notice the bloating starting AND even the next morning when I wake with the bloated ache in my belly.  I’ve been using the NFH GABA-T SAP opened on to my tongue. This product contains 300mg GABA and 150mg of theanine.  

I’m going to keep this in mind in case of a future flare up of my IBS/SIBO if I’m accidentally exposed to a food I can’t tolerate – assuming this protocol doesn’t clear it up for me. I suspect, as Dr. Siebecker reports, and based on the fact that I have chronic SIBO, that I’ll need a few more rounds anyway.

There is research supporting why this works: there are GABA receptors all over the gut and GABA is important for motility. (Stay tuned for a detailed blog post on this topic).

As well as the initial bloating and pain, I’ve also experienced some die-off symptoms like brain-fog and feeling blah, together with some sleep issues a few nights. The GABA helps with this and so does the tryptophan that I’ve also added.

If you’ve used GABA for this purpose or medications like Gabapentin or others to achieve similar results, I’d love to hear from you.

I’ll share more as I progress through the protocol. I’m also going to be speaking on SIBO SOS summit (the 3rd one) hosted by Dr. Allison Siebecker and Shivan Sarno. I will share more about my SIBO journey then, as well as all my results with this herbal protocol and any other challenges I face along the way.

Please also share if you’ve had success with any of the above herbal protocols or other approaches for your SIBO.

And feel free to post any questions below.