WEBVTT - How to tackle midlife gut issues – testing, treatments and restoring balance 0:00:00.720 --> 0:00:03.160 Why is it so hard to get real answers about 0:00:03.200 --> 0:00:06.560 your health? If you've been told that everything looks fine, 0:00:06.760 --> 0:00:08.800 but you know that something is off, well, you're not 0:00:08.960 --> 0:00:12.800 imagining it. That's why I created Vitality three sixty to 0:00:12.880 --> 0:00:16.080 help you better understand what's going on inside your body 0:00:16.200 --> 0:00:19.040 so that you can take the targeted action needed. With 0:00:19.120 --> 0:00:22.639 a functional health approach plus testing, we go beyond the 0:00:22.720 --> 0:00:26.480 guesswork to uncover the root causes of your symptoms. I've 0:00:26.520 --> 0:00:30.720 teamed up with Doctyesmina, an incredible integrative GP and together 0:00:30.800 --> 0:00:33.880 we will help you decode your body's signals and answer 0:00:33.960 --> 0:00:38.040 questions like why am I always exhausted? What's really causing 0:00:38.040 --> 0:00:42.159 my stubborn weight? Am I inflamed? Insulin resistant? Or maybe 0:00:42.159 --> 0:00:45.560 missing key nutrients? Because when you understand your body better, 0:00:45.800 --> 0:00:48.920 you can transform your health. Visit v three sixty dot 0:00:49.000 --> 0:00:52.400 health or check out the show notes for more. For 0:00:52.479 --> 0:00:55.920 a time, after having each of my kids, when they 0:00:55.960 --> 0:01:00.640 were really newborn, I seem to go through the short 0:01:00.760 --> 0:01:04.880 term bout of ibs and I have this really clear memory. 0:01:05.319 --> 0:01:08.520 In one particular occasion, it was with angus so baby 0:01:08.600 --> 0:01:11.479 number three, and I was sitting at the library one 0:01:11.560 --> 0:01:13.440 day ironically studying. 0:01:13.000 --> 0:01:15.920 My masses of nutrition, and I had. 0:01:15.920 --> 0:01:19.399 Him in the purpoose snoozing, and I was working on 0:01:19.440 --> 0:01:22.480 my laptop and I'd just eaten something and then suddenly 0:01:23.280 --> 0:01:28.520 that gut gurgle happened and I literally had to run 0:01:28.920 --> 0:01:31.720 through the middle of this library. I left my laptop 0:01:31.760 --> 0:01:35.560 at the desk with this poor bouncing baby in the papoose. 0:01:35.600 --> 0:01:37.160 I hope I didn't give him whiplash. 0:01:37.400 --> 0:01:41.000 I had to bolt to the bathroom and I literally 0:01:41.280 --> 0:01:44.440 just made it and it was not pretty and it 0:01:44.520 --> 0:01:45.000 was just. 0:01:45.000 --> 0:01:45.600 It was awful. 0:01:45.600 --> 0:01:47.680 And after that, I was really I had a lot 0:01:47.720 --> 0:01:50.120 of anxiety around going out, and I had a lot 0:01:50.120 --> 0:01:54.000 of anxiety around what I could eat. Anyway, I went, 0:01:54.080 --> 0:01:56.520 and you know, I did some investigation, I did some 0:01:57.040 --> 0:01:59.840 in depth testing, kind of got to the bottom of 0:01:59.840 --> 0:02:02.400 what it was, went through a bit of a protocol, 0:02:02.480 --> 0:02:03.560 and it resolved itself. 0:02:03.600 --> 0:02:04.960 And now I've got guts of steel. 0:02:05.120 --> 0:02:08.680 So I've certainly been through my own gut journey, and 0:02:08.720 --> 0:02:10.760 I have to say that when you're in the thick 0:02:10.800 --> 0:02:25.360 of it, it ain't pretty at all. This is healthy 0:02:25.400 --> 0:02:29.160 her with Amelia Phillips. If you're a woman in midlife, 0:02:29.280 --> 0:02:33.359 chances are you've noticed some gut and digestion changes happening, 0:02:33.600 --> 0:02:36.280 with the most common symptoms that we hear about being 0:02:36.320 --> 0:02:40.640 things like bloating, constipation, diarrhea or sometimes a mix of 0:02:40.760 --> 0:02:45.840 both a combo abdominal pain, reflux, heartburn, gas, and often 0:02:46.200 --> 0:02:48.960 new food sensitivity is popping up as well. But some 0:02:49.040 --> 0:02:52.280 of the other symptoms we might not associate so much 0:02:52.360 --> 0:02:55.280 but are or can be related, are things like low 0:02:55.360 --> 0:02:59.760 mood and anxiety, which can sometimes be linked to gut health. 0:03:00.000 --> 0:03:03.240 So what is causing these not so nice symptoms making 0:03:03.320 --> 0:03:06.720 us more sensitive to foods we used to tolerate well and 0:03:06.919 --> 0:03:09.760 possibly taking some of the joy out of eating. To 0:03:09.840 --> 0:03:12.960 help us understand why this is happening and how to 0:03:13.040 --> 0:03:16.240 get to the root cause through testing plus the best 0:03:16.280 --> 0:03:20.240 strategies for restoring optimal digestive health, I am joined by 0:03:20.280 --> 0:03:25.160 gastro entrologists doctor Paul Frooms. Doctor Paul is Board certified. 0:03:25.400 --> 0:03:28.400 He treats patients with gut issues in both the public 0:03:28.600 --> 0:03:33.400 and private practice and is known as the microbiome doctor, 0:03:33.520 --> 0:03:35.480 which I really love and I want to drill into 0:03:35.480 --> 0:03:39.480 the microbiome today. He also trains other doctors and practitioners 0:03:39.480 --> 0:03:43.880 in IBS management through his microbiome treatment program, which is 0:03:43.960 --> 0:03:47.600 called Best Gut Medical Doctor. Paul, thank you so much 0:03:47.640 --> 0:03:49.000 for joining me on Healthy Her. 0:03:49.160 --> 0:03:51.320 Oh, You're welcome to me. It's very nice to be 0:03:51.440 --> 0:03:52.200 asked to join you. 0:03:52.760 --> 0:03:55.360 I just love talking gut health, and I love your 0:03:55.400 --> 0:04:00.320 positioning being a gastroentrologist but also a microbio I am 0:04:00.440 --> 0:04:04.040 specialists as well, which I'm super keen to drill into. 0:04:04.800 --> 0:04:08.160 Now I've just listed off some of the top symptoms 0:04:08.320 --> 0:04:09.720 that I hear of. 0:04:10.000 --> 0:04:10.520 What are you. 0:04:10.600 --> 0:04:14.680 Seeing in your clinic, particularly for women in midlife around 0:04:14.720 --> 0:04:18.719 that perry and menopause transition, and maybe those five years 0:04:18.760 --> 0:04:20.040 post menopause as well. 0:04:20.279 --> 0:04:23.360 Well. The volume of women that I see in their 0:04:23.400 --> 0:04:27.440 forties and fifties presenting with new onset gut symptoms or 0:04:27.480 --> 0:04:30.800 worsening of gut symptoms has significantly increased, I have to say, 0:04:30.839 --> 0:04:33.080 in the last decade, probably because of my interest in 0:04:33.080 --> 0:04:37.640 the microbiome, and probably because they really struggle to actually financewers. 0:04:37.800 --> 0:04:40.320 And so what's striking is a lot of these women 0:04:40.400 --> 0:04:44.160 have had, you know, perfectly normal guts, good digestion, not 0:04:44.200 --> 0:04:46.800 too many food intolerances in their twenties and thirties, but 0:04:46.880 --> 0:04:51.719 then often around postpartum as so after pregnancy things change 0:04:51.760 --> 0:04:54.279 suddenly the different there. So what they complain of is 0:04:54.320 --> 0:04:57.200 they bloat with food whereas they didn't. Bow have its 0:04:57.279 --> 0:05:00.640 change and they can swing either way. Constipation diary, they 0:05:00.680 --> 0:05:04.839 get gas distinction, nausea, reflux, and this is often happening 0:05:04.920 --> 0:05:06.960 for the first time, and they're going, what is wrong 0:05:07.000 --> 0:05:10.760 with me? And they've been seen by GPS, they've been 0:05:11.279 --> 0:05:15.440 tried various dants, told that there's nothing really wrong, and 0:05:15.760 --> 0:05:19.000 yet these symptoms are still persisting. So I see a 0:05:19.000 --> 0:05:21.039 lot of these sort of you'd sort of call it 0:05:21.120 --> 0:05:26.400 IBS symptoms emerging or quite often in that middle age group, 0:05:26.440 --> 0:05:30.480 all the postpartum patients, and they also come with other symptoms, 0:05:30.520 --> 0:05:34.919 so a company and gut symptoms are also that is 0:05:35.400 --> 0:05:40.240 gut brain axis problems. So they always complain of enough 0:05:40.279 --> 0:05:41.880 and say this to them without them even asking, do 0:05:41.920 --> 0:05:46.000 you also have fatigue, brain fog, low mood, anxiety, poor sleep, 0:05:46.400 --> 0:05:47.920 aches and pains, and they go, how did you. 0:05:47.880 --> 0:05:50.040 Know that perfect storm? Isn't it? 0:05:50.279 --> 0:05:52.640 You got it? So I'm seeing both of those sort 0:05:52.680 --> 0:05:58.040 of groups of symptoms or clusters of symptoms in my practice. 0:05:57.760 --> 0:06:01.840 More and more what is happening mechanistically or what is 0:06:01.880 --> 0:06:06.760 happening inside our bodies that is triggering these changes and 0:06:06.839 --> 0:06:07.919 therefore these symptoms. 0:06:08.360 --> 0:06:11.000 There's a few things, but fundamentally, it's a change in 0:06:11.040 --> 0:06:15.440 the composition of the microbiome that then affects their bodies 0:06:15.480 --> 0:06:18.839 and their guts on multiple levels. So firstly, post pregnancy 0:06:18.880 --> 0:06:23.520 and midlife, there's a definite reduction in both microbial diversity 0:06:23.600 --> 0:06:27.720 and the biomass. So the populations of gut bacteria, which 0:06:27.760 --> 0:06:31.120 are so important and critical for gut function and physical 0:06:31.160 --> 0:06:34.479 and mental well being. Through the gut brain axis, they 0:06:34.600 --> 0:06:39.920 change from healthy probotic populations to what we call disbotic populations. 0:06:40.279 --> 0:06:44.240 And you add to that the overall biomass of the microbiome, 0:06:44.320 --> 0:06:47.279 so the size of it shrinks, so it's smaller, it's 0:06:47.320 --> 0:06:51.880 become inflammatory, it's less probiotic. That then triggers inflammation or 0:06:51.920 --> 0:06:55.080 what you call gut barrier changes, and then that spreads 0:06:55.120 --> 0:06:57.120 through the gut and the gut brain axis. 0:06:57.400 --> 0:06:59.880 What is driving those changes. 0:07:00.160 --> 0:07:04.200 Hormonal fluctuations is one, So as you many of your 0:07:04.200 --> 0:07:10.400 listeners will understand, the hormone fluctuations prepregnancy, pregnancy postpartum are 0:07:10.480 --> 0:07:16.200 massive and there's a subset of gut bacteria, probotic bacteria 0:07:16.280 --> 0:07:21.720 that significantly impact estrogen and progesterone metabolism. It's collectively it's 0:07:21.720 --> 0:07:26.720 called the estrabolome or the progesterbolome. So these bacteria change right. 0:07:26.920 --> 0:07:29.280 What they do is they produce an enzyme it's called 0:07:29.280 --> 0:07:34.280 a gleucuronidase or a beata glucuronidase enzyme. It deconjugates estrogen 0:07:34.360 --> 0:07:38.160 and progesterone in the gut, so that allows reabsorption of 0:07:38.360 --> 0:07:44.320 estrogen progesterone, and so that helps balance out and modulate 0:07:44.920 --> 0:07:49.240 a normal cyclical estrogen progesterone cycle in women. And that 0:07:49.400 --> 0:07:54.200 changes when the microbiome changes, so that alters normal hormone regulation. 0:07:54.960 --> 0:07:58.760 That then, of course feeds back into all these many 0:07:58.920 --> 0:08:03.800 or many of these symptoms because estrogen progesterone both modulate 0:08:03.880 --> 0:08:07.360 gut motility, so you can swing from one to the other. 0:08:07.480 --> 0:08:11.480 So if your estrogen falls, you often experience leaky gut, 0:08:11.880 --> 0:08:17.320 which drives bloating, food sensitivities, inflammation, aches, pains, and progesterone 0:08:17.320 --> 0:08:20.600 when it drops, removes its relaxing effect on smooth muscles 0:08:20.600 --> 0:08:23.120 of the gut, so then they get constipated. If they're 0:08:23.160 --> 0:08:26.320 just fluctuating all the time. Then of course the belle 0:08:26.680 --> 0:08:28.280 and the digestion become very erratic. 0:08:28.600 --> 0:08:31.680 Yeah, it's very destabilizing, I can imagine very much. 0:08:31.720 --> 0:08:35.480 So then they get stressed. So the gut microbiome is 0:08:35.520 --> 0:08:38.960 supposed to produce a lot of lovely precursor amino acids 0:08:39.000 --> 0:08:43.520 that your brain uses to make neurotransmitters like dopamine which 0:08:43.520 --> 0:08:47.280 makes you happy, serotonin which makes you calm, melatonin helps 0:08:47.280 --> 0:08:51.160 you sleep, acettle, coline good memory. So you often lose 0:08:51.240 --> 0:08:57.920 those critical nutrients. Plus there's inappropriate activation of the vagus nerve, 0:08:58.000 --> 0:09:01.200 which connects your gut to your brain that sends messages 0:09:01.280 --> 0:09:03.520 straight to your stress centers in the brain. So you 0:09:03.600 --> 0:09:09.000 get quite a lot of cortisol, surging, stress, anxiety, all 0:09:09.040 --> 0:09:13.760 of that steaming from dys biosisycle it of the gut microbiome. 0:09:14.120 --> 0:09:17.560 And that's changed because of the stress on the body 0:09:17.600 --> 0:09:21.000 of going through the aging process plus pregnancy. 0:09:21.120 --> 0:09:23.360 Yeah, I was going to touch on the aging process 0:09:23.400 --> 0:09:26.640 as well, because you were speaking around you know, those 0:09:26.679 --> 0:09:32.560 hormonal changes. How much of these symptoms can also be 0:09:32.760 --> 0:09:36.520 a process of aging. For example, things like our ability 0:09:36.559 --> 0:09:39.800 to digest food out that you know, the quality of 0:09:39.800 --> 0:09:44.640 our digestive enzymes, the integrity of our gut lining, you know, 0:09:44.800 --> 0:09:49.600 all of the neucosal membrane. Is there those factors that also, 0:09:50.720 --> 0:09:54.600 you know, play into this picture of gut dysbiosis. 0:09:54.800 --> 0:09:58.839 Yeah, it's a double whemy. So it's one. It's living 0:09:58.880 --> 0:10:03.360 in the West where the diet is pro despotic bacteria. 0:10:03.360 --> 0:10:09.599 It's way too high carbs, sugars, chemicals, preservatives, pesticide residues, 0:10:09.960 --> 0:10:13.360 chlorine in the water, antibiotic resides in meats. 0:10:13.840 --> 0:10:16.480 Gosh, when you list them like that, it's amazing that 0:10:16.520 --> 0:10:19.360 we're even sitting here with any gut microbiome. 0:10:19.600 --> 0:10:21.840 So it's pretty hard in the first place. So you 0:10:21.880 --> 0:10:25.400 see the deleterious effects of that on the microbiome anyway. 0:10:25.720 --> 0:10:27.680 But then you add aging to the picture, and the 0:10:27.720 --> 0:10:33.040 gut ages just like any other organ ages. So you 0:10:33.160 --> 0:10:37.640 see the ability the ability of the gut to secrete 0:10:37.720 --> 0:10:41.280 digestive enzymes, to secrete acid, both of which are absolutely 0:10:41.320 --> 0:10:45.280 critical to normal gut function, to secrete the neurotransmitters that 0:10:46.000 --> 0:10:50.160 promote regularity of the gut to make sure there isn't 0:10:50.160 --> 0:10:53.560 any altered gut permeability. You know, it's harder to maintain 0:10:53.640 --> 0:10:57.720 those nice tight junctions they're called that stop permeability. So 0:10:57.760 --> 0:11:01.920 that creates an inflammatory state, in depletion state, and you 0:11:02.080 --> 0:11:05.120 pair that with a microbiome that's already starting to take 0:11:05.200 --> 0:11:10.360 hit after hit. Then aging plus dysbiosis basically just keeps 0:11:10.440 --> 0:11:14.000 rolling on and makes it very difficult to have a 0:11:14.200 --> 0:11:17.120 very robust, healthy, strong gart and feel terrific. 0:11:17.480 --> 0:11:21.600 But the great news is that we can restore balance, 0:11:21.679 --> 0:11:24.760 and that you have seen in the work that you 0:11:24.920 --> 0:11:29.120 do and in your clinic that it's not a life 0:11:29.160 --> 0:11:32.559 sentence that we have to live with this poorly performing 0:11:32.640 --> 0:11:36.480 digestion and taking the joy out of eating. Is there 0:11:36.920 --> 0:11:41.560 a lot we can do to help buffer these effects 0:11:41.600 --> 0:11:44.440 of hormonal shifts and aging? Is there a lot that 0:11:44.480 --> 0:11:47.559 we can actually leave as we can pull to help? 0:11:48.040 --> 0:11:51.000 There is a lot you can do. You can actually 0:11:51.360 --> 0:11:55.920 alter the microbiome significantly and rejuvenate it so that the 0:11:55.960 --> 0:12:01.400 populations of toxic bacteria decline, Your probiotic populations can be restored, 0:12:02.040 --> 0:12:06.720 the permeability defects can be repaired, and so you can 0:12:06.880 --> 0:12:09.400 effectively if you work hard on it, you know what 0:12:09.480 --> 0:12:12.640 to do. You can diagnose it and you can then 0:12:12.720 --> 0:12:16.559 reverse most of these changes and then maintain them. So 0:12:16.600 --> 0:12:19.480 it's certainly possible to impact it in a very positive way. 0:12:20.160 --> 0:12:23.120 Yes, And I want to really put that message of 0:12:23.200 --> 0:12:25.880 hope out there for people, because you know, whether you're 0:12:25.920 --> 0:12:28.840 sitting here with a lot of gut issues and you 0:12:28.880 --> 0:12:31.480 know it can be really debilitating for you, or whether 0:12:31.520 --> 0:12:34.120 you're just sitting here and you're not in going Oh, yes, 0:12:34.160 --> 0:12:38.200 all those things doctor Frune just spoke about around hormonal 0:12:38.320 --> 0:12:41.120 changes in aging. It's more about I want to optimize 0:12:41.120 --> 0:12:43.440 and I want to either prevent or just you know, 0:12:43.559 --> 0:12:47.679 minimize the amount of negative impacts. And so you mentioned 0:12:47.679 --> 0:12:50.760 the word diagnosis a moment ago. Yeah, And I really 0:12:50.800 --> 0:12:53.360 want to drill into testing because I know that you're 0:12:53.960 --> 0:12:59.120 super experienced and knowledgeable and being a gastroenterrologist that also 0:12:59.200 --> 0:13:04.200 deals with all the big structural issues of our gut health, 0:13:04.679 --> 0:13:08.400 but that's also very knowledgeable in the microbiome and testing. 0:13:08.720 --> 0:13:13.160 Before we talk about microbiome mapping and what you like 0:13:13.200 --> 0:13:16.760 to test for, I think it's wise to talk about 0:13:16.840 --> 0:13:20.360 the important things to kind of rule out the dangerous things. 0:13:20.520 --> 0:13:22.920 So as a gastroin turologist, if someone comes to you 0:13:23.000 --> 0:13:23.920 and you know they've got. 0:13:23.800 --> 0:13:27.160 Some gut issues. What do you rule out the big things? 0:13:27.280 --> 0:13:30.560 And then let's get into your more detailed microbiome testing. 0:13:30.760 --> 0:13:33.400 So generally, the first thing we do when someone comes 0:13:33.440 --> 0:13:35.959 with chronic gut symptoms is that we do rule out 0:13:36.000 --> 0:13:39.840 the big things. So we check for undiagnosed celiic disease 0:13:40.040 --> 0:13:44.880 with blood testing, we look for a basic pathogen panel, 0:13:45.200 --> 0:13:49.319 which is a pretty standard stool PCR test. We usually 0:13:49.400 --> 0:13:53.120 do a gastroscopy and colonoscopy because it's incredibly important to 0:13:53.200 --> 0:13:54.920 rule out structural pathology. 0:13:55.280 --> 0:13:58.120 What do you mean by that? For an everyday person, 0:13:58.400 --> 0:13:59.000 you've got to make. 0:13:58.920 --> 0:14:02.480 Sure that they don't have something like inflammatory bowel disease, 0:14:02.840 --> 0:14:07.800 Crohn's disease, ulcer of colatis. There's another thing called microscopic colidis, 0:14:07.840 --> 0:14:10.640 which you can only rule out by taking biopsy's. You 0:14:10.679 --> 0:14:14.400 want to rule out refluxusophage artis highness, saying he's peptic 0:14:14.440 --> 0:14:18.920 ulcer disease, celiac disease. So those sort of structural things 0:14:19.000 --> 0:14:23.120 it's very important to first rule out before you go 0:14:23.200 --> 0:14:24.720 down the microbiome pathway. 0:14:24.840 --> 0:14:27.320 All right, So let's say that that all has been 0:14:27.400 --> 0:14:30.120 ruled out, or if they have something they're well aware 0:14:30.120 --> 0:14:33.640 and they're managing it. Let's now talk about the store testing. 0:14:33.680 --> 0:14:35.600 First of all, I think you have a test that 0:14:35.680 --> 0:14:38.840 you like to do. What are you measuring in this test? 0:14:39.040 --> 0:14:42.480 So essentially I like to do two tests in most patients. 0:14:42.520 --> 0:14:45.320 So we like to rule out what's called CEBO, which 0:14:45.360 --> 0:14:48.920 is small intestinal back to overgrowth, because that is very 0:14:48.960 --> 0:14:51.800 common and its major syentom is bloating and just about 0:14:51.880 --> 0:14:55.560 everybody complains of a lot of bloating, and that's bloating 0:14:55.560 --> 0:14:58.280 that decurves quickly. So we do a breath test to 0:14:58.320 --> 0:15:01.440 look at that, and we're looking at breath hydrogen methane 0:15:02.080 --> 0:15:04.400 after ingesting a sugar, So we rule out CEBO with 0:15:04.400 --> 0:15:07.960 a breath test, and we also do microbiome mapping, so 0:15:08.040 --> 0:15:11.440 this is detailed mapping of the composition of all the 0:15:11.520 --> 0:15:14.880 microbes that make up the microbiome from a stool test. 0:15:15.040 --> 0:15:19.440 And so they use PCR or sixteen S RNA technology 0:15:19.480 --> 0:15:23.760 now and there's even DNA higut sequencing they do, which 0:15:23.800 --> 0:15:29.680 will measure specific bacterial species to detect parasites, pathogenic bacteria, 0:15:30.160 --> 0:15:35.160 and then these what are called dispotic bacteria or facultative pathobions. 0:15:35.160 --> 0:15:37.760 There's lots of different names for them. These are bugs 0:15:37.760 --> 0:15:39.760 that if they are allowed to get into a state 0:15:39.800 --> 0:15:43.080 of overgrowth, cause problems like chronic ibea. 0:15:43.560 --> 0:15:45.640 So these are kind of like the opportunists. 0:15:45.960 --> 0:15:49.280 They're the opportunistic pathogens. Yep, they get a chance, they'll 0:15:49.320 --> 0:15:51.840 take over and start to cause absolute habit And we 0:15:51.880 --> 0:15:54.080 can look at all of those, look at whether there's 0:15:54.160 --> 0:15:57.400 inflammation with what's called a calprotect and we can measure 0:15:57.480 --> 0:16:01.240 zoonulin to see if the pulp there's permeability issues. You 0:16:01.240 --> 0:16:05.880 can look at measures or estimates of digestive enzyme dysfunction. 0:16:06.280 --> 0:16:07.200 That's really interesting. 0:16:07.280 --> 0:16:09.600 So when you're not just measuring you know, when you 0:16:09.640 --> 0:16:13.280 talked about the microbiome, you've got the pathogens, which are 0:16:13.320 --> 0:16:18.480 the baddies. You've got the opportunists, which maybe are not 0:16:18.760 --> 0:16:23.200 so bad in low levels but you know, small amounts, 0:16:23.200 --> 0:16:25.560 but if they proliferate, that can cause so they're kind 0:16:25.560 --> 0:16:27.640 of sitting on the fence. Then you've got the good, 0:16:27.800 --> 0:16:31.840 healthy gut bugs. But you're also looking at other things around. 0:16:32.000 --> 0:16:35.680 We spoke about aging a moment ago, so digestive enzymes, 0:16:35.720 --> 0:16:38.520 gut permeability, integrity of the gut lighting that. 0:16:38.920 --> 0:16:39.640 So you're measuring. 0:16:39.720 --> 0:16:42.160 You're looking at it at it quite holistically, You're not 0:16:42.440 --> 0:16:43.600 just looking at the bugs. 0:16:43.640 --> 0:16:44.160 Is that right? 0:16:44.520 --> 0:16:48.080 That's right? Yeah. There are other as I mentioned, biomarkers 0:16:48.120 --> 0:16:53.520 of gut function, permeability, digestive enzome function that sort of 0:16:53.520 --> 0:16:55.760 give you a cluest to just how compromised and how 0:16:55.800 --> 0:16:59.640 severe the the effects of dys biosis are, which might 0:16:59.760 --> 0:17:03.920 zero you went onto extra treatment protocols depending on what you. 0:17:03.920 --> 0:17:06.680 Find, And tell me do you find? 0:17:06.880 --> 0:17:09.720 Is there a really common theme that you see for 0:17:09.800 --> 0:17:16.000 our ladies in perimenopause and menopause? Is there like, oh yeah, 0:17:16.040 --> 0:17:19.040 like I can just look at ten results and before 0:17:19.160 --> 0:17:22.080 even I can tell that's a perimenopause a woman or 0:17:22.119 --> 0:17:24.320 is it extremely. 0:17:23.600 --> 0:17:25.200 Unique for each individual. 0:17:25.480 --> 0:17:28.320 So there's some very common things you see, and then 0:17:28.359 --> 0:17:31.040 there's some very unique things you see that are individual 0:17:31.160 --> 0:17:38.240 because everybody's microbiome is very similar, but it's completely unique, 0:17:38.720 --> 0:17:41.720 so they're as unique to you as your retina is 0:17:41.840 --> 0:17:45.800 or your fingerprint. So while we share a great many similarities, 0:17:45.840 --> 0:17:51.760 everyone's microbiome is actually specific to them. So classically we 0:17:51.840 --> 0:17:57.280 see reduced microbiome diversity, so there's fewer spee numbers of species. 0:17:57.680 --> 0:17:58.920 So that's a less resiliant. 0:17:59.119 --> 0:18:01.320 Okay, So these are the common things. This is there 0:18:01.480 --> 0:18:04.879 if we let's look across the board generally speaking for 0:18:04.920 --> 0:18:09.000 this cohort Okay, reduction in the species. So our Amazon 0:18:09.119 --> 0:18:12.440 jungle has just now gone down to Central Park site, 0:18:14.160 --> 0:18:17.040 a lot of squirrels, but not much else. 0:18:17.160 --> 0:18:21.040 Okay, Yeah, And so the overall biodiversity is much smaller, 0:18:21.160 --> 0:18:25.080 the biomass is smaller, and we typically see reductions in 0:18:26.480 --> 0:18:34.040 overall in lactobasaur species and biffidobacteriumicibacterium. They're the sort of 0:18:34.040 --> 0:18:36.160 commonest things you see. But then there's all these other 0:18:36.880 --> 0:18:40.879 very specific abnormalities that might be individually. 0:18:40.720 --> 0:18:43.760 Based, and that's more around like the pathogens or the 0:18:43.800 --> 0:18:44.920 opportunists that might be. 0:18:46.240 --> 0:18:49.520 That's around the pathogens that's looking at which the sort 0:18:49.520 --> 0:18:54.320 of a collective or phylotype is called proteobacteria. But within 0:18:54.400 --> 0:18:59.840 that there are multiple different facultative or pathobionts or opportunists 0:19:00.280 --> 0:19:03.359 that differ amongst people. So we drill down into those. 0:19:03.840 --> 0:19:06.680 I want to ask you just on the pathogens about 0:19:06.720 --> 0:19:09.120 one in particular which can be quite a common one 0:19:09.160 --> 0:19:11.639 where I live, which is called dian to meba and 0:19:11.680 --> 0:19:15.200 Funnily enough, my eight year old so different cohort who 0:19:15.240 --> 0:19:17.959 had some tummy pains recently, just did the standard PCR 0:19:18.040 --> 0:19:21.199 test and she came back with that particular parasite. And 0:19:21.560 --> 0:19:24.680 I know that, like I've never had her gut tested 0:19:24.800 --> 0:19:28.560 when she was healthy. What I'd love just as a 0:19:28.560 --> 0:19:30.800 little side because I know this is quite a common one. 0:19:31.200 --> 0:19:32.000 Is that one? 0:19:32.400 --> 0:19:35.399 Do you classified that as a nasty pathogen or is 0:19:35.400 --> 0:19:37.439 that more one of those opportunists? I know there's a 0:19:37.440 --> 0:19:42.000 bit of kind of you know, discussion around dian to MEBA. 0:19:42.720 --> 0:19:45.680 Yeah, Look, it's probably the most underrecognized cause of ib 0:19:45.800 --> 0:19:50.639 AS symptoms there is. It's common, but it confuses people 0:19:51.000 --> 0:19:55.119 because some people can be exposed to it, contracted and 0:19:55.840 --> 0:19:59.359 asymptomatic and just get rid of it themselves. Other people 0:19:59.440 --> 0:20:01.959 will have a sh short lived mild gastro from it 0:20:02.119 --> 0:20:04.560 and get rid of it. But then there's a group 0:20:04.600 --> 0:20:07.879 of people that have chronic carriage of dying to MIBA, 0:20:08.640 --> 0:20:14.359 and this little protosaur is responded can certainly cause symptoms 0:20:14.640 --> 0:20:18.760 in those people. So if the clinical picture is they're symptomatic. 0:20:18.920 --> 0:20:22.240 So some loose stool bloating, tummy pane, nausea fatigue, or 0:20:22.240 --> 0:20:26.080 any combination of those. Plus you've got don to MEBA. 0:20:26.560 --> 0:20:30.119 The literature says that you can't call an IBS until 0:20:30.160 --> 0:20:35.200 you've eradicated that parasite because it can directly cause those symptoms. 0:20:35.400 --> 0:20:37.199 But there's a bit of confusion around it because of 0:20:37.240 --> 0:20:38.639 the other two presentations. 0:20:38.720 --> 0:20:42.320 All right, well, let's talk about digestive enzymes in our 0:20:42.359 --> 0:20:45.840 age group as well as kind of integrity of the 0:20:45.840 --> 0:20:49.800 gut lining. Do you see quite commonly a reduction in 0:20:49.840 --> 0:20:51.760 the quality of our digestive enzymes. 0:20:52.040 --> 0:20:56.000 Yeah, we have indirect ways of measuring it, so we 0:20:56.040 --> 0:20:59.280 have you look at the stool pancretic a lass dase, 0:20:59.280 --> 0:21:02.560 which is a reflection of how well your pancreas is 0:21:02.640 --> 0:21:07.200 secreting it your own digestive enzymes. Quite frequently that is low. 0:21:07.520 --> 0:21:10.880 And then the stool test also can look at what's 0:21:10.920 --> 0:21:14.200 called the stadecurate. It can look at whether there's undigested 0:21:14.240 --> 0:21:17.560 fats in excess in your stool. So that's another measure 0:21:18.200 --> 0:21:22.560 of maldigestion mal absorption because your digestive enzymes aren't doing 0:21:22.560 --> 0:21:25.080 the job they're supposed to. That's quite hot. I see 0:21:25.119 --> 0:21:28.119 that a lot too. The other component of that of course, 0:21:28.200 --> 0:21:31.919 is the microbiome, because it turns out your gunt bacterior 0:21:32.000 --> 0:21:36.639 do a lot, almost well, a high percentage of the digestion. 0:21:37.400 --> 0:21:42.760 For example, take carbohydrates. Now, pancreas secretes probably I think 0:21:42.800 --> 0:21:46.480 it's about eight or nine different enzymes to break down carbohydrates. 0:21:46.520 --> 0:21:51.480 They're called alderlasers. But your microbiome secretes something like one 0:21:51.560 --> 0:21:55.520 hundred and thirty of them. So who's doing the digestive 0:21:55.560 --> 0:21:58.639 work here? Yeah, we're doing a bit yep for sure, 0:21:58.680 --> 0:22:00.440 but our microbome's doing a lot of. 0:22:00.400 --> 0:22:01.520 It, a lot. 0:22:01.600 --> 0:22:04.840 So when we see that reduction in diversity and just 0:22:04.960 --> 0:22:20.320 overall size, it's going to make a difference. Why is 0:22:20.359 --> 0:22:22.960 it so hard to get real answers about your health? 0:22:23.240 --> 0:22:26.280 If you've been told that everything looks fine, but you 0:22:26.440 --> 0:22:29.359 know that something is off, you're not imagining it. That's 0:22:29.400 --> 0:22:32.439 why I created Vitality three point sixty to help you 0:22:32.480 --> 0:22:35.679 better understand what's going on inside your body so that 0:22:35.760 --> 0:22:38.920 you can take the targeted action needed. With a functional 0:22:38.920 --> 0:22:42.800 health approach plus testing, we go beyond the guesswork to 0:22:42.920 --> 0:22:46.199 uncover the root causes of your symptoms. I've teamed up 0:22:46.240 --> 0:22:50.400 with Doctyesmina, an incredible integrative GP and together we will 0:22:50.440 --> 0:22:54.080 help you decode your body's signals and answer questions like 0:22:54.359 --> 0:22:55.760 why am I always exhausted? 0:22:56.080 --> 0:22:58.120 What's really causing my stubborn weight? 0:22:58.400 --> 0:23:02.760 Am I inflamed in and resistant? Or maybe missing key nutrients? 0:23:02.920 --> 0:23:06.040 Because when you understand your body better, you can transform 0:23:06.080 --> 0:23:08.960 your health. Visit V three sixty dot health or check 0:23:08.960 --> 0:23:20.359 out the show notes for more. And when you just 0:23:20.359 --> 0:23:26.240 spoke about undigested fats and malabsorption, if someone's presenting with 0:23:26.960 --> 0:23:30.800 low nutrient levels like chronically, you know, low iron levels 0:23:30.920 --> 0:23:33.760 or some of the vitamins and minerals they're being tested 0:23:34.040 --> 0:23:38.360 just always low, even though they've got a healthy diet. 0:23:38.880 --> 0:23:40.800 Can that malabsorption? 0:23:40.920 --> 0:23:44.560 If those markers show of some malabsorption, can that be 0:23:44.600 --> 0:23:48.000 a really strong clue as to why these nutrient markers 0:23:48.000 --> 0:23:49.200 are consistently low. 0:23:49.520 --> 0:23:52.720 Yeah. Absolutely. By the time it gets to nutrient deficiency, 0:23:53.000 --> 0:23:58.760 clearly you're not You're not able to digest foods to 0:23:58.880 --> 0:24:01.600 the stage where you can and absorb them properly, so 0:24:01.640 --> 0:24:07.880 you're effectively partially digesting them, but you're rendering yourself nutrient deficient. Unfortunately, 0:24:07.960 --> 0:24:12.879 because you don't forget, you can only absorb nutrients or 0:24:12.960 --> 0:24:15.880 foods that have been broken down all the way down 0:24:15.920 --> 0:24:20.080