The Gut Health/Autoimmune Disease Connection with Dr. Tom O’Bryan: Rational Wellness Podcast 270

Dr. Tom O’Bryan discusses the Gut Health/Autoimmune Disease Connection with Dr. Ben Weitz at the Functional Medicine Discussion Group meeting on July 28, 2022.

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Podcast Highlights



Dr. Tom O’Bryan is a Doctor of Chiropractic, a best-selling author, and an internationally recognized speaker focusing on food sensitivities, environmental toxins, and the development of autoimmune diseases. His 2016 book, The Autoimmune Fix won the National Book Award and the docuseries he released the same year, Betrayal: The Autoimmune Disease Solution They’re Not Telling You  has been seen by over 500,000 people worldwide. He also organized The Gluten Summit – A Grain of Truth. His website is www.theDr.com  His second book You Can Fix Your Brain: One Hour a Week to the Best Memory, Productivity, and Sleep You’ve Ever Had was also a best seller.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.


Podcast Transcript

Dr. Weitz:                            Hey, this is Dr. Ben Weitz host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates, and to learn more, check out my website, drweitz.com. Thanks for joining me, and let’s jump into the podcast. If you do listen to the Rational Wellness Podcast, please give me a ratings and review on Apple Podcast.


So our sponsor for this evening is Integrative Therapeutics, and so I’m going to read a little bit about a few products from Integrative Therapeutics. Integrative Therapeutics is one of the few professional brands of nutritional supplements that we carry in our office.  So one product is a Physician’s Elemental Diet, this is an aggressively hypoallergenic short term gut boost or reboot for any kind of autoimmune flare up related to permeability, and it works excellent for SIBO and most other gut problems. It’s typically a two week deal, but it’s been shown to be as effective as Rifaximin or the other leading strategies for SIBO. Another excellent product that we use a lot is Theracurmin, and this is their water soluble curcumin, and it has the highest bio availability and studies show you end up with the highest blood levels of all the forms of curcumin on the market, and there’s actually been quite a number of scientific studies using this particular product, and another great thing about it is, the therapeutic dosage is two capsules a day, and then one more product from Integrative is Glutamine Forte, and this product contains five grams of glutamine per scoop with Theracurmin added as well, and it’s a great tasting powder that allows for dosage flexibility.



Dr. Weitz:                            Our speaker for this evening, Dr. Tom O’Bryan, is a doctor of chiropractic, a bestselling author, a professor for the Institute of Functional Medicine and an internationally recognized speaker who focuses on gluten, food sensitivities, environmental toxins, and development of autoimmune diseases. His 2016 book, The Autoimmune Fix won the National Book Award and the docu-series he released the same year, Betrayal: The Autoimmune Disease Solution They’re Not Telling You, has been seen by over half a million people. He also organized the highly successful, The Gluten Summit. His website is thedr.com. His second book, You Can Fix Your Brain: One Hour a Week to the Best Memory, Productivity and Sleep You’ve Ever Had, was released in 2018, and it was another huge hit. Tom, thank you so much for joining us tonight.

Dr. O’Bryan:                        Thank you, Ben. Thanks so much, it’s really a pleasure. And thank you all for being here, I know it’s been a long day at work, probably, and appreciate your taking the time for this. I have found that my entire life, where I have shined the best is at a catalyst and in thinking about a bigger picture and in my practice, it was always that way, and that’s where I got the most juice, and certainly tonight’s going to be another example of that. I’ve got some ideas here to share with you that I think may not be new, but may have been put in the back corner of our awareness and I want to make sure they’re right in the front for everyone. Dr. Weitz, I need to be able to share my screen.

Dr. Weitz:                            Oh yes. Sure.

Dr. O’Bryan:                        And I’ve got way too many slides, I’m told that…

Dr. Weitz:                            Oh.

Dr. O’Bryan:                        I’m told that I speak faster than Jeff Bland and have more slides.

Dr. Weitz:                            Oh boy.

Dr. O’Bryan:                        So, sorry about that. And we’ll pause at some point, but put your questions in the Q&A, as Ben suggested, and we will get to them and I’ll stay with you guys as long as you want, or until my voice goes. So, here we go, let’s just get started. Fire in the hole, that’s a term that just resonates for me, that when you read the science on so much of what we’re dealing with from the gut and it’s contribution just across the board, I remember the old combat television show and other shows where they say, “fire in the hole”, and everybody dives down really deep, that’s what we’ve got going on in chronic inflammatory diseases.

I’m going to show you this. I’m just putting a clicker here on my computer, so I don’t have to keep hitting the button all night, it’ll take just a moment to get that up and running and see here if I can make it work. So let’s just move on here. Lots of gratitude to Ben for doing this, by the way, whoever the sponsor is tonight, the company that Ben referred to, he’ll put the email address for the rep for that in the chat room, could everyone just take a moment and copy it, paste it into your email box, send the guy a little thank you, “thanks for doing this, I really appreciate your company doing this.”

I mean, those people are working hard just like we are and they’re a business and they want to know that their investments make a difference, and I’m really grateful for Ben and the thankless job of what he does to host these events and people that do this all over the world, and I come to these events and give my time and really happy to do that because a rising tide lifts all boats, lifts all ships that as we all learn some of these topics, we can make an impact on humanity. So the sales rep for this company is doing it in his way, Ben’s doing it his way, I’m doing it my way, you’re doing it your way, but take a moment and just send a little thank you to that rep, it’ll surprise them and they’ll be happy with that.

All right, let’s move on here. This is my first mentor, Dr. George Goodheart, the founder of Applied Kinesiology and I had over 450 hours with George by my second year in practice, when I was still in school I began studying with him and we called him, The Great Wazu, that his knowledge base was just jaw dropping for us, and his presentations, his 10 hour weekends were at the Marriott Hotel at the Detroit Airport. So, people fly in from all over the world and we’d just hang out all weekend and celebrate, and the stage that George would stand on was a wooden stage in the room, and he would do this so many times in a weekend, he would lift up his right leg, cock his right leg up in the air, lift his right arm, and he would slam his foot down, “why doctor?”

And he’d slam his foot on that wood stage, and we’d all get startled by it. Some of you who may have seen one of his events will remember that, that was his signature. “Why? Why does the patient have what they have?” And he’d say, “you have to look with eyes that see, listen with ears that hear”, and I was a young stud and I’d say, “yeah, whatever”, I didn’t know what it meant, now I know what it means. That as we look a little deeper and as we look at the contribution of the mucosal lining of the gut in the development of rheumatoid arthritis or multiple sclerosis or Parkinsons, it doesn’t matter what disease you talk about, and if you put your consciousness inside the lumen of the small intestine, you do an OMG, it’s like, “oh my God, all of that is going on. Wow. That explains why…”

And there’s just more understandings that come up. Why was the question again and again, and again, look with eyes that see, doctor. Listen to the patient with ears that hear what they’re saying, and it formed my way of looking at patient mechanisms, where did all this come from? So between Dr. Goodheart and I attended my first Jeff Bland talk in Chicago in 1978, it was his first talk in Chicago, and I’ve been listening to Jeff ever since. So between George Goodheart and Jeff Bland, that formed my consciousness about asking questions internally, “why is this happening to this person? Where’s it coming from?” So what’s the most prevalent pathology at the root of practically every disease? Well, one of the most important medical discoveries of the past two centuries is that, it’s the immune system creating inflammation not just for a few select disorders, but for every chronic inflammatory disease, the immune system gets activated.

So the question is, what is it trying to protect you from? If your immune system is the armed forces in your body, the army, the Navy, the Air Force, the Marines, the coast guard, IGA, IGG, IGE, IGD, IGM, and then the innate immune system with all the cytokines, if it’s the armed forces trying to protect you, what is it trying to protect you from? Chronic inflammatory diseases are recognized as the most significant cause of death in the world today, and they dominate present day morbidity and mortality. Yes, okay. We know from the CDC that 14 of the 15 top causes of death today are chronic inflammatory diseases. Everything except unintentional injuries is a chronic inflammatory disease, which means, when you go down and when I go down, it’s going to be because of a chronic inflammatory disease, most likely.

And if it’s a chronic inflammatory disease, and I keep saying it that way for a reason, but if it’s a chronic inflammatory disease, chronic means it’s going on for a long time, and if you’ve heard me talk before, if you’ve read my books, you understand that you can identify the mechanism of rheumatoid going on 14 years before a person gets diagnosed with MS, and Hashimoto’s, seven years before they get a diagnosis, they’ve got elevated antibodies. With diabetes, 11 years, 11 to 14 years with diabetes, and that’s called predictive autoimmunity and read my book, The Autoimmune Fix and you’ll say, “oh my God, I didn’t know that”, and that was the formation of Cyrex Labs. I was privileged to be a part of the initial team at Cyrex, that’s why I moved from Chicago to California in 2010, was to open Cyrex.

And we talked about all of the markers to use and which one should be on which test and why this one and why that one and Cyrex Array number five, the autoimmune panel looks at 24 different antibodies to self, and when you get these elevated, and I did this test myself in 1999, when it was still in the research phases and I got my test results and I called the lab, I said, “what is this? This is a mistake”, because I was in my early forties doing triathlons and scoring the top 10% of the 30 to 35 year olds, I thought, “I’m a stud, I’m healthy”, but my test came back and I had three antibodies elevated to my brain, myelin basic proteins, cerebellar peptides and gangliosides, and I called them and I said, “this is a mistake.” “No, it’s not.” “To do it again.”

“We did. We know it’s you. We did it again. Sorry.” And that’s when I learned about predictive autoimmunity and that these mechanisms go on for decades sometimes before you ever have any symptoms, killing off cells, killing off cells, killing off cells. So a chronic inflammatory disease is chronic. By the time they get symptoms, the body can no longer compensate for the insult and the inflammation killing off cells, killing off cells, killing off cells. I love this drawing, because at the center of every chronic inflammatory disease is systemic chronic inflammation, well, that makes sense. So what’s turning the wheel of systemic chronic inflammation? Well, it’s disbiosis and obesity and physical inactivity and chronic infections, bacterial and viral and food selections and chronic stress and stress hormones, lack of sleep, xenobiotics, that turns the wheel of the chronic inflammatory cycle that manifests wherever the genetic weak link is for the person. Type two diabetes, non-alcohol product liver disease, cardiovascular disease, the list goes on and on, but it’s not just the genes, don’t ever say genes cause disease. No, they don’t. You pull it a [inaudible 00:15:10]

There are some like cystic fibrosis and down syndrome, those are unfortunate, and if you carry those genes, it’s a really difficult one to quiet down, but with all of the other genetic vulnerabilities, the goal is to dim down those genes from expressing themselves, you do not turn genes on or off, so please stop saying, “let’s turn those genes off for [inaudible 00:15:35] four for Alzheimer’s”, they don’t turn off. They operate on a dimmer switch and you can dim down that function and ramp up the genes of anti-inflammation. So tell your patients about dimmer switches, and every time they cheat, they’re ramping up the genes of inflammation, and that helps them to understand and be more successful in applying the recommendations that you’re giving to people.

So what present complaints in your practice are not inflammatory? Well, accidents, they’re the only ones that are not chronic inflammatory conditions. Shifts in the inflammatory response from short to long live cause a breakdown of immune tolerance and lead to major alterations in every tissue in organ, as well as normal cellular physiology, which increase the risk for various non-communicable chronic inflammatory diseases.

Understanding both the internal and external processes that foster chronic inflammation may provide important insights into why people develop their chronic inflammatory diseases, and I put that in here because many of us forget about the endogenous triggers of chronic inflammation, the heavy metals, the pesticides, the insecticides, the list goes on and on, you have to explore that with every patient that’s got a chronic inflammatory disease, of course their diet, everybody knows, you put them on a gluten free diet and they start feeling better some way or another, usually that happens, but what’s inside has to be addressed also, all of the organal phosphates, the altered microbiome, you have to address that also. A complex balance exists in the intestinal ecosystem, highlighting is mine, that if disrupted, compromises the function and integrity of the intestinal ecosystem and is the trigger for chronic systemic inflammation. So, if 14 of the top 15 causes of death are chronic inflammatory diseases, when do you think the chronic nature of the inflammation begins for the person that’s presented in your office with symptoms? It’s years and sometimes decades before they develop a symptom.

So chronic inflammatory disease develop over time. I’m just going to breeze through this, I’m sure most of this is quite familiar to all of you, and for those that are not, it’s elaborated on in great detail in my book, The Autoimmune Fix, but here is the paradigm shifting article by Melissa Arbuckle in the New England Journal of Medicine, in 2003 we knew this, she went to the VA and she looked for people with lupus. She found 132 people with lupus in this one VA center. Now she knew that if they’re in the VA center, they’re veterans, if they’re veterans, they were in the armed forces, if they’re the armed forces, they had their blood drawn many times over the years when they were in the armed forces and healthy. What most people don’t know is that the government’s been saving almost all of their blood since 1978, they’ve got tens of millions of samples of our service people’s blood frozen.

Well, Melissa Arbuckle knew this, so she went back and asked for permission to look at the blood in storage of the currently diagnosed lupus patients when they were healthy in the Marines or the Navy, she got permission, and what’d she find? That auto antibodies for lupus, and there are seven antibodies to lupus, there’re all elevated years before there’s ever a symptom, and that the elevation follows a predictable course, and this is the drawing that she did, these are the seven antibodies to lupus and the zero line is the normal reference range, not that they don’t have any, but that they’re within the normal range, anything above the zero line means they’re elevated.

And you see every single antibody is elevated five years before they ever have a symptom, and some of these antibodies were elevated 11 years before they ever had a symptom, and there’s a predictable course of elevation every year that occurs, killing off cells, killing off… By definition, if you’ve got elevated antibodies, that means you’re killing off more cells than you’re making, that’s what elevated antibodies means. So when you get a test back that looks at 24 tissue antibodies, and you’ve only got three that, “oh, don’t worry, Mrs. Patient you’ve only got three”, nonsense, you can’t have any elevated, because you’re killing off more tissue than you’re making.

And this was a summary that she did that six years beforehand, every one of these antibodies were began at 50% above normal range, and then they just went up, up, up, up, up, and she did this bar graph or this drawing and she made it up, you have a normal level of antibodies, if you do a thyroid antibody test, why is there a normal level of TPO antibodies? When is it normal to have antibodies to your own tissue? Well, it’s because for cellular regeneration, “you have an entire new body Mrs. Patient every few years, every cell regenerates.” How does that happen? You have to get rid of the old and damaged cells. How does that happen? By antibodies, and by cytokines, they get rid of the old and damaged cells, so there’s a normal range of antibodies, but when you have elevated antibodies, you’re killing off more cells than you’re making.

So Dr. Arbuckle shows here, the normal level of antibodies, then they have what she referred to as benign auto immunity, it’s not benign, they’re just no symptoms, but it’s killing off cells, and then you have pathogenic because now you have symptoms and then you finally get a diagnosis.

And she identified the environmental factors and genetics were the two triggers that determine the progression of this cascade, and she was right on the money, this was back in 2003, almost 20 years ago. And this is the prodromal period where you can turn this around pretty easily usually, it’ll take time, but if you’re comprehensive, you can arrest the development of autoimmune diseases, and that’s what the book’s all about, and that’s what the scientists say, they use the word, arrest. So the prodromal period means before symptoms, it comes from the Greek word prodromal, which means precursor, and this is the prodromal period in the development of chronic inflammatory diseases across the board, and individuals at risk to developing autoimmune diseases should be advised to refrain from activities and lifestyle that endanger their health and quality of life, that’s our job, is to advise them, so to identify the activities and the lifestyle.

PART 1 OF 4 ENDS [00:23:04]

Dr. O’Bryan:                        … advise them, so to identify the activities and the lifestyle, which endangers our health and quality of life. And so many studies on this now, that we know, that if you have any of the antibodies to lupus elevated, you have a 94% to 100% positive, predictive value. You’re getting lupus in seven to 10 years. Scleroderma’s 100% within 11 years, rheumatoid 52% to 97%, 14 years. And you see for every one of the autoimmune diseases, how these manifest. Hashimoto’s, primary biliary cirrhosis, type one diabetes, Addison’s, Crohn’s, celiac, they all have the prodromal period. And this is the test that I referred to, that we came up with in 2010 and started testing people. And it’s jaw-dropping to see how many people have elevated antibodies to their own tissue.

And this is the Neural Zoomer Plus, which looks at 53 markers of inflammation to tissue of the brain and the central nervous system. So technology’s improved quite a bit, as we were saying before we started the presentation, but it’s the same concept, looking for the prodromal period before the development of a diagnosis of Alzheimer’s, or Parkinson’s, or schizophrenia, or bipolar, doesn’t matter, the diagnosis. That they have brain inflammation, chronic brain inflammation.

So, if we agree that chronic inflammation is the fuel in the fire for the vast majority of our patients, how critical is it to educate our patients? It’s bottom line, 101 critical. We have to educate them on the lifestyle that’s causing the problem. And just like we know cigarette exposure as a well-established cause of various health conditions, everyone explains that now, or everyone knows that now. But many, many different conditions have the accumulation of toxins creating endotoxin, this accumulated debris inside our body, that’s leeching out into circulation, creating this loss of tolerance that we get. We can’t tolerate it anymore and then our immune system gets called out to protect us. What’s it trying to protect you from? That’s the million dollar question. What is it trying to protect you from when you have an activated immune system? It’s not an immune system that’s gone crazy, it’s an immune system that’s trying to protect you.

So the question is, what’s it trying to protect you from? And eventually they lose tolerance and here comes the activated immune system, causing the collateral damage that it does as Arbuckle showed us, occurring years, 10 years or more, before they have any symptoms.

When the burden within an individual reaches a threshold, the immune system provokes a low grade systemic inflammation with substantial changes in the cytokine profile. I didn’t put the study in here, but I’ll just tell you this one as an example. This is just an example, and this is in JAMA, that they looked at couples going to assisted fertility centers and the editors of JAMA commented on the study. And they said, “This is an elegant study, with sophisticated biomarkers to prove their very sensitive point.” The editors of JAMA don’t do that very often. They’re giving their stamp of approval to this study. And what did they do? They looked at couples at assisted fertility centers. They’re spending tens of thousands of dollars trying to get pregnant and have a healthy pregnancy.

Well, they isolated all of the different factors that may impact on success and they isolated and compared people eating conventional fruits and vegetables and people eating organic fruits and vegetables, and they ruled out all the other factors. They divided them into fourths, the lowest, the second, the third and the highest four. And then they compared the two highest groups, the conventional to organic, eating the highest amount of fruits and vegetables, which we think is great. The Mediterranean diet. Oh, great, lots of fruits and vegetables.

Well, what they found when they compare the couples eating the highest amount of fruits and vegetables, conventional, versus the couples eating the highest amount of fruits and vegetables, organic. The couples eating the highest amount of fruits and vegetables conventional had an 18% less likely of achieving pregnancy, 18%. And they ruled out all the other factors. But if they got pregnant, it was a 26% less likelihood of having a live birth. Did you hear what I just said? Eating the highest amount of fruits and vegetables, but conventional, 26% less likelihood of a live birth, meaning the babies died or they miscarried.

But wait, they’re eating lots of fruits and vegetables. How could that be the factor? It’s the pesticides, the insecticides, the fungicides, and the rodenticides that are endotoxins accumulate in the body over years and change the microbiome, creating a chronic inflammatory microbiome. It’s like, what? You could do a PhD thesis just on that topic. But I throw it out here for you just to, as an example of how much there is to learn on this.

Where is the low grade systemic inflammation coming from? You have to educate your patients over the course of many visits on successful detox protocols. You do a little video series on your iPhone, “Hi, it’s Dr. Tom O’Bryan and this is episode number three of detox. I’ve got a list of things to tell you. You can’t learn them all at once. So let’s talk about number three today. Let’s talk about apple sauce.” And then you go to town and your staff, you just write it on the route slip. And the patient goes up to the front desk and the receptionist says, “Oh, I see doctor wants you to have video number three. I’ll be sending it to you to be in your inbox by time you get home.” And you just start working this out. You can’t keep talking about this to every patient. You don’t have time to do that. So use the tools at your disposal to get the education out to them.

This hypersensitive state magnifies and responds to inciting exposures with the re of a cytokine storm, these cell signaling and sometimes gene-regulating molecules, what do they mean? Well, how do you turn the dimmer switch up or down on your genes? It’s the environmental triggers you’re exposed to, whether it’s what’s on the end of your fork, or what’s already stored in your body that’s activating the genes of inflammation, or activating the genes of anti-inflammation. The abnormal immune … it’s not abnormal. It’s a normal response trying to protect you. Might be triggered by foods, inhalents, chemicals and even electrical incidents.

Everyone needs to know that if you’ve got patients with any type of brain dysfunction, any type of ear dysfunction, recurrent sinus infections, pink eye, sore throats, strep infections, anything in the head and neck area, you teach your patients how to clean their shower heads because of the biofilms of pathogenic bacteria that accumulate in all shower heads. Just read about it and it’s in my book, it’s in You Can Fix Your Brain, it’s in that book, and the studies, and how to clean the shower heads and all of that.

Application of appropriate interventions to avoid these triggers and facilitate elimination of the toxic burden, reverses the toxic induced loss of tolerance and consistently results in remarkable recovery from sensitivity-related illnesses. So, what are the mechanisms in the production of excessive endogenous and exogenous molecules? So let’s talk about our friend Alessio Fasano, who we think will win the Nobel Prize because he and his team are the ones that identified in 1997, the protein, zonulin and the mechanism in the creation of pathogenic, intestinal permeability. And he talks about the perfect storm in the development of chronic inflammatory diseases.

Dr. O’Bryan:                        This is so critical to understand. If 14 of the 15 top causes of death are chronic inflammatory diseases and there’s a perfect storm that creates chronic inflammatory diseases, do you have to understand the perfect storm as a physician? Well, of course you do. And there are five factors in the perfect storm. Your genetics, can’t do anything about that. Your environmental triggers that activate, have their hands on the dimmer switch of your genes. You can do a lot about that. Altering your microbiome, creating dysbiosis, you can do a lot about that. Creating intestinal permeability, you can do a lot about that. Allowing the macromolecules to get through the leaky gut, into systemic circulation, activating your immune system, to protect you from these macro molecules, creating systemic immune response.

Dr. O’Bryan:                        This is what they’re teaching at Harvard Medical School right now. So, the new gastroenterologists coming out will be very familiar with all of the minutia of this. You’ll need to understand the minutia. You need to understand the mechanisms here, the big picture of the perfect storm. And these are the three that, as clinicians, we have control over.

Dr. O’Bryan:                        Although there are dozens of environmental triggers that have contributed to the individual specific inflammatory state, what’s the big kahuna? Well, Professor Fasano tells us that it’s LPS and gluten, are the two most powerful triggers. Once again, this is what they’re teaching at Harvard Medical School. And that when zonulin gets activated, it’s to flushed out what it thinks is a bug, a bad bug. And so it impacts on the microbiome ecosystem.

Dr. O’Bryan:                        I underline this because it’s the ecosystem inside the gut. When you get down inside the gut and just envision … if you can give an elevator speech to your spouse of what’s happening inside the gut of your patient with MS, if you can do the elevator speech in everyday language, you’ve got this down. Until you can do that in your own language, everyday language, the elevator speech means you got 30 seconds to talk about the mechanism of where’s this person’s depression coming from? For every one message from the brain, going down to the gut, there are nine messages from the gut going up to the brain. It was Michael Gershon in 1999 that told us that from Princeton in his book, The Second Brain. So, you need to be able to do the 30 second elevator speech of what’s going on inside the gut with whatever chronic inflammatory disease they’re presenting with. And when you can do that, you’ve got this down.

Dr. O’Bryan:                        So, it’s the internal environment of the microbiome ecosystem that sets the stage for zonulin activation and the gateway to systemic inflammation. Yes, big, big picture here of minutia, which then gives you the paradigm to talk to your patients, and they stay with you long term because you don’t rebuild a gut in two weeks. It’s going to take a year to two years to turn around a gut that’s developed over 30 to 40 years.

Dr. O’Bryan:                        Let’s take a look at the LPS contribution to this microbiome ecosystem. This study just had us drooling back in 2010, when we were putting the test together at Cyrex. This study was so incredible because the macaque monkey, I’m not sure if I’m saying that correctly, but the macaque monkey has a similar gut to humans. So, lots and lots of studies on medications, pharmaceuticals, physiology uses macaque monkeys to understand human disease. But they had a problem, that the pigtailed macaques always had like leaky gut, always, that it seemed endemic to them. And they didn’t know why at the time, they found out why, but they couldn’t use pigtail macaques for healthy guts because they didn’t have them.

Dr. O’Bryan:                        What did they find? Let me back up. Yeah. Uninfected pigtail macaques have increased damage to the tight epithelial barrier and high levels of LPS in the lamina propria, meaning it’s gotten through the tight junctions, into the submucosa. In order to determine if these breaches in the tight junctions of the epithelium correlated with the observed increase in microbial trans location, meaning LPS, they studied the colon sections of these monkeys. And what did they find? That the monkeys, the macaque monkeys, had increased levels of LPS compared to the rhesus macaque monkey. The pigtail macaque monkey is the one, they’ve always got intestinal permeability, and this is what it looks like. The rhesus macaque doesn’t.

Dr. O’Bryan:                        Now you can give them intestinal permeability, but you can’t use a pigtail macaque to see what causes permeability, because they’ve already got permeability. That was really interesting, but they looked at these monkeys and they stained to see how much LPS has migrated from the lumen inside the tissue. And what they found was that 13% of the pigtail macaque monkey was composed of LPS, 13% of the tissue. Whereas in the rhesus macaque monkey that didn’t have intestinal permeability, it’s 0.274%.

Dr. O’Bryan:                        13% of the tissue is saturated with LPS. What do you think that does to the immune system? So, this is what it looked like in terms of the numbers. 13% in pigtail macaque monkeys, when they’ve got intestinal permeability, LPS migrates into the system, and they found LPS in the peripheral blood mononuclear cells, in the spleen, in the axillary lymph nodes, in the inguinal lymph nodes, in the mesenteric lymph nodes, the duodenum, the jejunum, the iliums, the cecum. The monkeys were saturated with LPS through their entire body.

Dr. O’Bryan:                        Damage to gut epithelium results in systemic, microbial translocation that correlates with immune activation. The term bacterial translocation is the passage of viable indigenous bacteria from the GI tract to extraintestinal sites, like the mesenteric lymph nodes, the liver, the spleen, the kidney, the peritoneal cavity, the brain and bloodstream. It’s known that bacterial translocation often leads to a progressive and catastrophic condition known as multiple organ dysfunction syndrome. The systemic inflammatory response triggered by bacterial endotoxin affects many organs and leads to death.

Dr. O’Bryan:                        Once again, this is way back in 2010 we were talking about this, and why it’s so important to test for LPS, and of greater importance are the infectious complications that in that may be initiated by LPS getting through a leaky gut. Whatever the source, exposure to endotoxin induces a systemic inflammatory response that involves many interconnected cellular and plasma mediators. They may be self-limiting or the cascade can proceed to shock, organ failure and death.

Dr. O’Bryan:                        And I love this drawing because this is the development of systemic, chronic inflammatory diseases. Some of you know, 1.7 million people a year are diagnosed with sepsis in the US, of which over 250,000 die. It’s the number one cause of death of elders in hospitals, is sepsis. And this is the mechanism in the development of sepsis.

Dr. O’Bryan:                        First, you have a healthy gut, then you get intestinal permeability. So, you get bacterial translocation, let me back up. Bacterial translocation into systemic circulation. Then you get the systemic inflammatory response syndrome. Then you get sepsis, then you get shock or multiple organ dysfunction, and then you die. And this is going on in systemic chronic inflammatory diseases.

Dr. O’Bryan:                        That’s why when you test with the Wheat Zoomer, they also put in there the markers for intestinal permeability, which include antibodies to LPS, translocation of microbial products and the resulting immune activation of not only consequences within the GI tract, but are also associated with systemic dissemination of LPS. When microbial products translocate from the lumen of the colon into lamina propria, it can result in local and systemic immune activation. These data define the degree to which microbial translocation can stimulate the immune system locally and systemically.

Dr. O’Bryan:                        And if you can imagine us in 2010 with this article, sitting around the table, just drooling at how important it is to get this information out to clinicians, that this is the mechanism in the development of systemic chronic inflammatory diseases, of which 14 of the top 15 causes of death are systemic chronic inflammatory diseases and this is the mechanism. We were so passionate to get this information out to the world. And as you can tell, I’m still passionate because most of us can’t do the 30 second elevator speech as to where their lupus came from, or where their rheumatoid came from, or where their chronic depression came from. We can’t do the 30 second speech and we’ve got to practice that to get it down.

Dr. O’Bryan:                        This increased microbial translocation correlated with high levels of immune activation and frequency with IL-17, here comes the autoimmune cascade. This data highlights the relation between mucosal damage, microbial translocation, and systemic immune activation and underscored the importance of microbial translocation. That’s why Fasano, who is so careful about everything he says, published the paper I showed you in the beginning two years ago, all disease begins in the gut and it’s number three of the five categories of the perfect storm.

Dr. O’Bryan:                        Number three is dysbiosis. That’s where you can make the greatest impact, change the environment inside the lumen of the gut. Next month’s talk is really important about SIBO, you have to change the … You need to get down inside that lumen of the gut and understand everything that’s going on in there. All the inflammation and be overwhelmed, like the miniature man in those movies, just tiny little guy. So, you get down in there. You’re looking, “My God, look at the look … Wow, wow. Look at all that klebsiella over there. Wow, that’s why my stool analysis says I’ve got klebsiella pneumonia. Wow and that’s causing … Oh, there’s so much more leaky gut there, so much inflammation. There’s so many more tears in the cheesecloth there, that’s … Wow, I get it now. Oh, the yeast over there, they can’t … Yeah, I got to get to that too.”

You have to be able to get in there to understand all of this if you’re wanting to address systemic, chronic inflammatory diseases. LPS activates Toll-like receptor 4, lowers protein … I put an example in here for you of one tissue in the body, outside of the gut, and that’s your muscle. This is where sarcopenia comes from. And here’s the drawing in this article, of LPS and its deposition and chronic inflammatory conditions that develop, eating away at the muscle. Massive infection of CD4+ T cells, which is our immune response to LPS early in antigen infections is directly associated with inflammation and breakdown mucosal integrity. This allows microbial products to translocate from the lumen of the GI tract into peripheral circulation. And the effect on healthy aging of this bacterial translocation? I just found this study in my notes today and I said, “Oh, I’ve got to throw this one in here too.”

So, look at the title, “Serum zonulin and endotoxin levels in exceptional longevity.” These are people that live over 100, centenarians. Translocation of LPS from the intestinal lumen into circulation can occur through transcellular or paracellular pathways with the ladder being regulated by zonulin, okay? Following specific stimuli, such as LPS …

PART 2 OF 4 ENDS [00:46:04]

Dr. O’Bryan:                        … following specific stimuli such as LPS and the wheat protein gliadin. Zonulin reversibly disassembles tight junctions leading to increased permeability. We’ve all read The Blue Zone, if you haven’t, you have to read The Blue Zone. That’s where the pedal hits the metal. That’s the groups all over the world that live into their 90s, over a 100, and they have no diagnosed diseases, and they’re not on any medications. I’m going to show you a reason why here.

Dr. O’Bryan:                        So they looked at three groups, these are Italians. Disease-free centenarians, non-diabetic patients less than 40 years old who’d experienced acute myocardial infarctions. These were sick people, and healthy young volunteers matched to those that had an MI for age and sex. All subjects were Caucasian whites of Italian descent in Northern Italy. Disease-free centenarians had significantly lower levels of zonulin and LPS than the healthy young people who had, had a heart attack and lower concentrations of LPS than the healthy young people that were healthy. You’re over 100 years old, but you have less zonulin. That they’ve got healthy guts, and here’s the numbers. I’ll give you a moment to look at that.

Dr. O’Bryan:                        That’s my goal, to be over 100 years old and have the poop that I’m going to sell for fecal transplants. How’s that for a goal? All the centenarians were free of major age-related diseases. They didn’t have cognitive impairment, clinically evident cancer, coronary heart disease, renal insufficiency or severe physical impairment. LPS levels significantly lower in disease-free centenarians and healthy young controls. Zonulin levels significantly lower in centenarians. Intestinal permeability may cause endotoxemia which in turn leads to inflammation, insulin resistance, atherosclerosis, hypercoagulation.

Dr. O’Bryan:                        Our data suggests that serum levels of zonulin and LPS emerge as potential novel biomarkers of exceptional longevity. Our data coupled with the fact that aging per se is typically associated with elevated zonulin, endotoxemia, inflammation, insulin resistance and atherosclerosis suggests that measures taken to decrease permeability and LPS translocation may help to reduce the risk of coronary heart disease and contribute to a healthy lifespan. This is really where the pedal hits the metal. Everybody wants this. That’s the LPS contribution to the microbiome ecosystem.

Dr. O’Bryan:                        What about the gluten contribution? Gluten’s misinterpreted by zonulin pathways, a potential harmful component of a bug. This is a paper from Fasano. Look at the title of the paper, All Disease Begins in the Leaky Gut, so let me back up to that for a minute. So the protein structure of peptides of wheat, poorly digested wheat, the protein structure looks like the protein structure of the surface of pathogenic bacteria. Gliadin activates the zonulin signaling pathway in normal intestinal epithelial cells. The cellular response observed only a few minutes after gliadin exposure characterized by cytoskeleton reorganization with the redistribution of actin filaments. Look at the date on this paper. We knew this 20 years ago, that gliadin does this. And then in 2006 in the Scandinavian Journal Gastroenterology, they told us again, gliadin activates zonulin resulting in immediate reduction of intestinal barrier function.

Dr. O’Bryan:                        This process is independent of any genetic predisposition. This is not celiac, this is non-celiac wheat disorders. Every human has this happen when they eat wheat, and this is what it looks like at the actin level, in the scaffolding of our cells in the gut. This is what happens when you’re exposed to wheat. And Maureen Leonard at Harvard, famous gastroenterologist, did a literature review in 2017 and published it in JAMA. Look at the title, Celiac and Non-Celiac Gluten Sensitivity, and she says, “Previous studies have shown that gliadin in wheat causes immediate transient increase in permeability. This process takes place in all individuals who eat wheat, all humans irrespective of how they feel. That’s why every new patient needs to do the Wheat Zoomer. It’s the most accurate test out there, and it includes the markers for LPs and intestinal permeability because this occurs every time they eat wheat. Gliadin has been identified to activate toll-like receptor 4.”

So I just put a couple of slides in here so you understand the mechanism by how does all this occur. Toll-like receptor 4, they’re throughout our body to identify any bugs they get in pathogens, and in the proximal part of small intestine, their screening all the food coming out of the stomach. And they look at it, “Oh, look over there. It’s a bug. It’s a bug.” No, that’s gliadin from wheat. “Oh, look over there. It’s a bug. It’s a bug.” No, that’s amylase trypsin inhibitors from wheat. But Toll-like receptor 4 gets activated because the amino acid sequence of these peptides of wheat look like the shell of pathogenic bugs, so Toll-like receptor 4 gets activated, and this happens within five minutes, so watch what happens in this video. This is a video of five minutes worth of still shots in the gut when people are exposed to wheat, and these were failures to… And you see the white coming out towards the surface, this is a camera inside the gut looking in at 1 o’clock you see that the dye is leaking out into the gut and more that’s occurring when exposed to wheat.

And this occurs within five minutes of wheat coming out of the stomach into the proximal part of the small intestine. This is leaky gut in reverse. This is exactly what it looks like, and that happens within five minutes of wheat and it happens to all humans. So it’s LPs and wheat that activates zonulin, so who would you not test for LPs and a loss of tolerance to wheat? If they have present with a chronic inflammatory condition, who would you not test? Where to begin and feeding a healthy microbiome? So over the past few decades, let me check my time here and see where I am. Over the past few decades, thousands of studies have talked about fruits and vegetables and our friend Deanna Minich coined the term, the rainbow diet, and she’s guided us in this. And the ability of these polyphenols in our vegetables to produce clinical effects may be due to a bidirectional relationship with the gut microbiota.

These polyphenols feed the probiotics in your gut, critically, critically important to encourage the good guys to become dominant. They impact the composition of the gut microbiota independently associated with health benefits and gut bacteria metabolized polyphenols into bioactive compounds that produce clinical benefits. And Deanna’s handout or not her handout… Her article, we give this to patients on the rainbow diet. There’s three pages. We tell them to print it out, put on the refrigerator because these are all the fruits and vegetables they need to be reminded to include in their diet, and because people don’t think about it. And the goal is to develop the lifestyle habit for 50 different foods a week. It’s not hard when you start, it’ll take you a month or two months to do this, but you just start slowly, and this is page two and it’s 50. That’s the goal Mrs. Patient. Right now, you’re at 12 according to your diet recall that we looked at for the last week, and we want to bump that up quite a bit. So we just give them the handout.

You can download it, just Google Deanna Minich rainbow diet, and the article’s there. Give it to your patients, just email it to them and let them put it on their refrigerator as a reminder. At IFM, we started giving this handout out in 2011, 2012, and we’ve updated it a few times just to encourage our patients to get more colors into their diet. This may be gluten free, but it sure as hell is not healthy. This is a whole other ballgame, and this is the kind of direction we want to go in with our food for everyone. That’s a nice breakfast or a component of your breakfast. So I put these studies in, this one in here about akkermansia. That it’s a critically important probiotic in the gut. It’s depleted in people suffering with a variety of diseases, obesity, metabolic syndrome, diabetes. It often is not even identifiable, and when you’re low in akkermansia, you get intestinal permeability because you get a dysbiotic gut.

And here’s the study on black raspberries, on how they increase akkermansia dramatically, so that’s one of the foods you include, Mrs. Patient is black raspberries. Because akkermansia increases butyrate production, and butyrate helps to heal a leaky brain, and you’ve got depression. So we want to heal the leaky brain, and so including black raspberry, and patients get this and they’ll start. But this is where you have… And all this is in my book, You Can Fix Your Brain, all these studies and the foods are in there, that you can use and fasting mimicking diets. Fasting mimicking diets increase stem cell production in the gut, so you increase and regenerate, healthier younger cells. So you have to learn about fasting mimicking diets.

Now, I love this, that it’s a myth. You’re supposed to eat three meals a day, and unfortunately, how we’ve been raised since infancy with this concept is that we’ve become dependent on it, and so our blood sugar is so way out of balance and our insulin resistance is high because of all the carbs and garbage we’ve eaten over our childhood, teenage, young adult years, that we need to feed ourselves more often to keep our blood sugar stable. But over the course of time, as you educate your patients, they need less food and their blood sugar will stay more stable. They’ll develop more insulin sensitivity, and they eat more complex food so that it lasts longer and gets into the bloodstream slower. But I just wanted to throw this in here that three meals a day is not what our genetics encourage at all.

So periodic fasting and fasting mimicking diets promote a rejuvenation process in tissues, organs and cells. There’s a lot of great science on this now. You just have to take the time to learn about it. It doesn’t happen overnight. And our microbiota is much reduced size and diversity in comparison with our ancestors and indigenous tribes that still live closer to the earth than we do. We must focus on rebuilding a non-inflammatory protective microbiome. That is the key to every chronic inflammatory disease. It’s not the only thing you do, but you sure as hell better include this anytime you’re dealing with a diagnosed disease. Now, about wheat, not everything in wheat is bad for you. It makes up about 80% of the prebiotic in the average Western diet. Now, a preliminary study, they took 10 healthy people, they did on microbiome analysis. They put them on a gluten-free diet for a month, and then they did another microbiome analysis.

Every single one of them had dysbiosis, a reduction in the beneficial bacteria on a gluten-free diet, an increase in pathogenic bacteria on a gluten-free diet and an altered microbiome creating dysbiosis. Why? Because they did what most of our clinicians do, is encourage people, “Well, it’s okay to have the gluten-free pasta. It tastes pretty good nowadays. It’s not like it used to be. It doesn’t taste like cardboard anymore, and here’s a recipe or here’s some really good gluten-free cookies,” that we encourage people to eat this garbage, to buy this white pace that is not enriched. It has no prebiotics at all.

So if 80% of the standard American diet gets their prebiotics from wheat and you take wheat out of their diet which is a really good thing to do, but you don’t guide them in how to substitute with healthy alternatives, and they eat gluten free crap and they develop dysbiosis. You’ve made them worse, and that’s why mortality is increased on a gluten-free diet. You see the science that drops your jaw. Everyone needs to take my course. I’ve got an online course called Certified Gluten Practitioner.com, Certified Gluten Practitioner.com. And you’ll learn, you put people on a gluten-free diet, you increase their mortality within a year. 86% increase risk of dying from a cardiovascular incident in the first year after diagnosis with celiac disease. 3.84, no 3.87 fold increased risk of death in the first year from a malignancy after diagnosis with celiac disease.

Why? Because these people are put on gluten-free diets. What else? Nothing. So they’re eating gluten-free garbage, and so when you take away the source of prebiotic and you don’t replace it with healthy sources, you starve the probiotics in the gut because they’ve become dependent on wheat. And when you starve them, you reduce their numbers and the pathogens rear their ugly head. Now, you’ve got a huge dysbiotic problem in the gut, and you increase mortality within year. I’m writing a paper right now on this topic, and you see the studies on this, it just drops your jaw. That’s why everyone needs to take the CGP course. I’ll talk a little about that later. When the growth of beneficial bacteria is not supported due to reduced supply of their main energy source, for people it’s been wheat their whole lives, other bacterial groups, opportunistic pathogens overgrow leading to dysbiosis.

So if it’s necessary to eliminate wheat, you have to give them highly fermentable carbohydrates to replace that, to feed the good bacteria. And Mrs patient for a few months, I want you to take a supplement of prebiotic while you’re changing your eating style just for a couple of months so that we don’t miss out here because we want to increase the good guys in your gut, and giving a prebiotic does that. And I love this drawing because it’s the prebiotics that are nondigestible that feed the good bacteria in your gut, and the good bacteria and your gut produce these short chain fatty acids. Now, we know that 36% of all the small molecules in the healthy human blood are the metabolites of the microbiome. It’s the exhaust of the bacteria in your gut. That’s 36% of everything in healthy blood. They’re the messengers that go to your brain and to your heart and to your lungs and to your liver to get them to function normally.

They’re the guiding posts. They have their hands on the steering wheel of how your body functions, 36% of everything. Now, you put them on a gluten free diet and you cause dysbiosis, and then now, you start to understand why mortalities increase after a diagnosis of celiac disease. So the beneficial bacteria, you feed them, and then their exhaust gets into the bloodstream and it goes to the targeted organs to increase insulin sensitivity, decrease inflammatory markers, decreased lipogenesis, increased tight junctions. And the result of all of that, you decrease glycemia, insulin resistance, fat mass, all of it. You guys can read this and you know much of this already.

So here’s a pearl, Mrs. Patient, I want you to eat… When you go shopping, buy a couple of every root vegetable in the store. Always buy organic, but get turnips and rutabagas and parsnips and carrots and sweet potatoes… Not too many white potatoes because of the glycemic index but everything else. And you eat one root vegetable every day, and if you don’t know how to cook turnips, just look online. They’re so easy to do, and everybody’s been to a nice restaurant where they shave radishes, raw radish and put it on your salad. It’s not hard. You just have to try it. In my books I’ve got great recipes for all that stuff, and then go on Google and type out list of prebiotic foods. Or better yet Doc, make a list for them and have your front desk send it to them, and every day you have two from the list.

A banana’s prebiotic. Garlics are prebiotic. Onions are prebiotic. You have two from the list and one root vegetable every day, and here’s an example. This one dropped my jaw when I saw this, that this guy came from China, he got a PhD in Microbiology, focusing on the microbiome, but he gained a lot of weight because he didn’t take care of himself and ate a bunch of fast food garbage. And so he remembered his grandmother told him about bitter melon and Chinese yams. He started eating bitter melon in Chinese yam every day, and his blood pressure, heart rate cholesterol levels all came down, he lost 20 kilograms. Fecal bacterium which is supposed to be 14.5% of the total gut bacteria, was undetectable when he began this, and he kicked it back up over two years, he lost 20 kilograms, that’s over 40 pounds.

Dr. O’Bryan:                        He lowered his cholesterol, he lowered his heart rate, he lowered his blood pressure just by eating a little Chinese yam and bitter melon every day. And look in two years, this is what’s happened by adding a prebiotic into his diet. You put people on a gluten-free diet and you starve the probiotics. Now, you understand where mortality comes from because this is mortality in reverse, a much healthier guy right now. And give them a supplement of prebiotic for a couple of months because there’s lots of benefits to it, and we recommend this one, but there are many good ones out there that you can use. Next, rebuilding, a healthy protective mucosa. Mrs. Patient one cup of bone broth every day. Why? Because bone broth is high in gelatin tannate which forms a protective barrier in your damaged gut, so when you’ve got leaky gut, it looks like this.

When you take in bone broth, you put like a bandaid over the leaky gut to protect it. The gelatin tannate does that, which helps it to heal quicker, and the result is, you get a healed intestine. Bone broth helps to heal a leaky gut. Next, Mrs. Patient, here is a supplement you take for a couple of months while you’re transitioning into this whole process. Next, Mrs. Patient, to increase the diversity of the good guys in the gut, I want you to eat tablespoon of fermented vegetables every day, so buy five different types of fermented vegetables. Get kimchi, get sauerkraut, get miso, get fermented beets, get curry flavored, whatever you like. But every day you have a tablespoon, just every day a tablespoon. Because fermented food, their microbiota is so enriched with so many good guys, one of them is conjugated linoleic acid.

I’d learned it long time ago, you take a little CLA every day and you lose one pound of fat a month within a year, about 12 pounds in a year of fat, your body mass index change because of CLA. Well, CLA is produced by the fermentation of vegetables in your gut… I’m going to skip the CLA stuff. The largest study of the association between fermented food consumption, the human gut microbiome, 7,000 individuals over a hundred individuals across four weeks of sampling. Consumption of fermented foods not only provides macronutrients, it also delivers large numbers of potentially beneficial microorganisms to the GI tract. When you do a tablespoon a day, you increase a number of good guys that you’re putting into your gut 10,000 fold over the average diet. So you’re inoculating your gut with the good guys, and this is a great book to read on the topic. I wrote the Forward to this book, and so when I said these bacteria sound like something out of star wars-

PART 3 OF 4 ENDS [01:09:04]

When I said, “These bacteria sound like something out of Star Wars,” with names like Akkermansia, Allobaculum, eubacterium, Clostridium, you don’t know whether to feed them or to shoot them. Are they saying, “We come in peace,” or have they come to conquer? It’s foreign language to patients so you laugh with them about it. But you give them this book, tell them to get this book, because Susanne Bennett is seventh generation Korean healthcare practitioner. So it is in her genes about kimchi and how to make kimchi. It’s just a great, great food to eat.

I’m going to skip the rest of this on kimchi, it’s just another great food to eat. Once again, 36% of all the molecules in your bloodstream are the metabolites of your microbiome in the gut. That’s why it’s so important. And we include a spore-based supplement for a couple of months. We tell patients, in rebuilding your microbiome as a patient, as you develop the lifestyle habits, a couple of months of taking the supplements is good. So it’s going to protect you from having any complications or problems that come up with this. Yeah, we’ll skip about this spores, everybody knows about the spores.

And in terms of supplements, vitamin D is critical. And when you look at the kissing joints of … Let me back up to this drawing, this is really important. On B here, that’s a photo of a tight junction between two cells. MV means microvilli. And when you blow up that circled part of the tight junction, this is what you see, the kissing joints. This is like the Suez Canal or the Panama Canal, that what happens is the tight junction strand opens, zonulin opens the tight junction strands at these kissing joints, and it allows … Here’s the kissing joints. And one opens up, the gates open up, the food particles go down between, the gate closes, the immune system checks it out. The next kissing joint opens, the tight junction strands open by zonulin and few other proteins, and the food goes down. The gate closes, the immune system checks it out.

Well, what I want to show you about all of this is vitamin D controls the opening and closing of the gates. That’s why it’s so important that you have adequate levels of vitamin D. And because of that, we recommend a vitamin D that is … Here’s all the different components of the tight junctions that vitamin D regulates. This is like, what? So when you’ve got this visual and you start to understand it, you understand how important it is. And I give a capsule or a tablet of vitamin D for this, I don’t do the liquids. I do the liquids when I want systemic increase in vitamin D, but I want the vitamin D around the tight junctions. So we make sure to give them 5,000 units of vitamin D a day when we’re working on healing a leaky gut.

And I’ll skip that science. Curcumin, we give curcumin. And you guys know all about curcumin. I’m running out of time so I’m just going to go past this. All of the benefits of curcumin that we’ve all heard about many times before. And this is the dosing on different studies for curcumin between one to four grams a day, 100 milligrams daily in another study. And you see all the benefits that occur when you include curcumin as part of your anti-inflammatory profiles.

And these are all of the genes that are regulated to turn on or turn off to create an anti-inflammatory index with curcumin. And these are all the diseases that benefit from curcumin. And these are all the ones that are autoimmune. Oh, I have to do that one again, because you see the sluggishness there of the thyroid trying to get up there. I always have to create a little joke here. I mean, that slide took over an hour to make. But when would you not include curcumin?

And glutamine, we all know about glutamine, how important it is. And 30 grams a day of glutamine reverse ulcerative colitis in every, every patient, but diseases exasperation return when they stop the treatment. Why? Because glutamine deficiency is not the cause of ulcerative colitis. If you don’t stop throwing gasoline on the fire and deal with the environment in the inside of the lumen of the gut, the microbiome and the dysbiosis, giving them glutamine is temporarily going to help, but it’s not going to fix anything.

And fish oils, we know the anti-inflammatory index of fish oils is very high, activating genes to calm down inflammation and maintain the integrity of the intestinal epithelium. Good studies on including fish oils in there. And you can see what happens when you don’t have enough fish oils. LPS producing bacteria increase, mucus layers decrease, more gram-negative bacteria, and fish oils help to reverse that. And here’s the drawing of … The Omega-3s will favor the beneficial bacteria. And you know all this about … I’m going to skip through this geeky stuff here.

And enhancing the function of the gut barrier, increasing intestinal alkaline phosphatase, arguably the most important enzyme in the gut, IAP. And it’s why an apple a day keeps the doctor away, because intestinal alkaline phosphatase is produced in the apical membrane of the inner lining of the gut. It detoxes LPS, it activates genes of anti-inflammation. It activates genes to heal the gut, and it modulates beneficial bacteria.

It prevents bacterial translocation, we’ll skip that one. And I like the drawings, pictures always help. And the higher your IAP level, the lower LPS infiltration and into your gut. I like this one, it’s really simple. You see that when you’ve got enough IAP, LPS just goes out with the poop. It doesn’t get to toll-like receptor 4 to activate toll-like receptor 4. But when you don’t have enough intestinal alkaline phosphate, LPS gets down on the surface of the inner lining of the gut, activating toll-like receptor 4 and here comes the entire inflammatory cascade.

And alkaline phosphatase will reduce a hundred-fold reduction in the toxicity of LPS. That’s like, what, what? And why am I telling you about LPS? Because it significantly increase with apples. Apple sauce, the pectin in apple sauce. So we tell patients to start making apple sauce, because it’s one of the phenols that have such a beneficial impact on creating a healthy gut environment. So this slide, I just like going through it again, but now we’re looking at it from apple sauce.

Dr. O’Bryan:                        Now, the other thing is that apple-derived pectin modulates gut microbiota and replaces the fructans from wheat-derived arabinoxylan oligosaccharides. So including apple sauce when you give a gluten-free diet is an important tool, because the arabinoxylans in wheat that their microbiota became dependent on, the oligosaccharides from wheat, are replaced by the pectin in applesauce.

Dr. O’Bryan:                        So Mrs. Patient, you take 10 to 15 apples, chop them up, wash them. Always organic. Get rid of the seeds. Throw them in a pot and whatever the height of the apples in the pot, add water to about a third that height. Throw those cinnamon in there, a handful of raisins if you want. Turn it on high, boil for 11 to 15 minutes. You got apple sauce. You don’t peel it because a lot of the pectin’s in the peels. I like to, or my wife does, I don’t do it. My wife puts it in the blender and blends it up so it’s really creamy. I like it a little rougher because I like the fiber taste, but either way.

Dr. O’Bryan:                        And you have a tablespoon a day of homemade apple sauce. The commercial stuff won’t work, it has to be the homemade. And it’ll last you four or five days. And have your kids help you make and that way they’re really interested in eating it. Apple-derived pectin modulates gut microbiota, attenuates metabolic endotoxemia and inflammation, suppresses weight gain and fat accumulation. And of course organic, because the phenols in there are 34 to 54% higher than conventional. Always organic. Okay. And so we’ll skip all that. One tablespoon of homemade apple sauce a day.

Dr. O’Bryan:                        Mother Nature’s way of healing intestinal permeability is colostrum. Nothing activates healing intestinal permeability like colostrum. It activates more genes than in any other product possible. It recolonizes with the bowel with friendly bacteria. There’s nothing that is as powerful as colostrum. And for those that have a dairy sensitivity, what we say to them, “Mrs. Patient, we just found out you have a dairy sensitivity.” There’s no lactose in here. There’s about 0.6% casein, and most colostrums have two to 6%. This one has 0.6%. You’ll find it on my website.

And it is the colostrum that three countries of Africa licensed as their treatment of choice when a patient’s diagnosed with HIV because it calms down the inflammatory cascade in the gut. It’s just an incredible product to use. It’s the best known remedy. It contains growth factors, hormones to repair damage to the lining, restore a gut integrity. There are numerous One Milk products lighting the shelves of health food stores to stimulate the immune system and heal the gut, only colostrum plays the entire symphony.

I will tell patients, to Mrs. Patient, “I’m going to recommend you try some colostrum for a couple of months. Now if you have any symptoms like bloating or gas or diarrhea or cramping, anything at all, just stop the colostrum right away. But it’s worth a try ,because if you don’t have any symptoms, then let’s do it for a couple of months so that we can get all of those benefits that outweigh any other product that’s out there. And then we’ll get the colostrum out of there, but let’s see if your body will take it.” This colostrum is the most sensitive of all that I’ve ever found.

So add a colostrum product, and this is the one we use, GS Immuno PRO. It’s just incredible. My friend, Dr. Andrew Keech, was born and raised on a dairy farm. And he learned right away, if you don’t give those calves colostrum they die. You can’t give them milk, they die. Then he learned that when humans got sick, they drank some of the colostrum, they all got better. So he dedicated his life to making the best colostrum in the world, and he’s done that. And so that’s the one that we recommend.

And so in rebuilding a healthy gut, fasting [inaudible 01:21:13] diet, rainbow diet, strict avoidance of all wheat exposure, absolute necessity of working with a certified gluten-free practitioner, registered dietician, nutritionist, trained health coach. Rebuild the microbiome with a comprehensive gut restoration program. They have to work with the coach or a CGP because you don’t have time to talk to him about all this stuff, about food selections. So you want someone to do it who knows what they’re doing.

Rebuilding gut restoration with a daily applesauce, bone broth, numerous prebiotics, probiotics. Supplementation for a few months with prebiotics, spore-based probiotics, colostrum, vitamin D, glutamine, turmeric, Omega-3s. These are just the basics, there’s a whole lot more you can do. This is all outlined in detail in my book, You Can Fix Your Brain. And for those of you that don’t read English, you can get in any of these languages if you want.

And with that, please, please, please rebuild the diverse, healthy microbiome as a first response to any and every chronic inflammatory condition. Please consider the Certified Gluten Practitioner program. It’s online, it’s about eight to 10 hours. You’ve got three months to do it. You take a quiz after each section. If you don’t pass the quiz, it comes up and say, “Go back and look at slide 48 again.” And they say, “Oh right, okay.” And then you go back, and then you answer it and you’re fine. You don’t have to memorize this stuff, I just want you to be familiar with it.

And I give all of my CGPs new articles every month or two months that I think are important. I send them a clean copy and a highlighted copy, because most people don’t have time to read the articles. So here’s the bullet points, like the cliff notes. And they get PowerPoints of my presentations. It’s a really nice community, and they’re all over the world now, so please consider this. And if you do consider it, use this code, a promotional code, because you’re functional medicine practitioners. And I want a world of you out there that just have all this information in 30-second elevator speeches that you can deliver. So use this code, CGP Gift, for it.

Thank you all so very much. Take care of yourselves. Make sure to tell those important to you how much you love them, and thank you for your kind attention. And now we will go to the questions.

Dr. Weitz:                            Dorothy, you have some question or several questions about wheat. Why don’t you unmute yourself and ask Tom.

Dorothy:                              Hi, Tom. That was really amazing. And I don’t know how to get my video back on, but anyway. The study out of Harvard said that everybody reacts to wheat gliadin.

Dr. O’Bryan:                        Right.

Dorothy:                              What is the purpose of this Zoomer test? And also, you had mentioned that one of the Blue Zones, the Italians who lit the longest, I mean they are eating pasta every day. So explain this to me if you could.

Dr. O’Bryan:                        You bet, of course. So the test is the Wheat Zoomer. It comes out of Vibrant Wellness. How is it that the Italians who eat pasta … Their microbiome is healthy. That when you look at Maureen Leonard’s literature review from Harvard that all humans have transient intestinal permeability, the key word there is transient. That their gut heals, because they’re exposed to something that causes permeability, but their microbiome is a healthy, diverse microbiome.  It certainly is possible to eat wheat and thrive, it’s possible. But when you think of the JAMA study and at assisted fertility centers, people eating whole lots of fruits and vegetables, 26% less likely of a live birth. Why? All the pesticides and insecticides and rodenticides and fungicides that are in their gut have created this pathogenic microbiome that developed over 25 years. Nobody’s going to change that microbiome in two weeks. It takes years to rebuild a healthy microbiome that developed over 30 years. Years. Show me the evidence of anything other than that. Yes, of course symptoms go down because you activate an anti-inflammatory protocol, but it’s going to take a while.

So these Italians, they didn’t have pesticides, insecticides, rodenticides. Now see, I think what’s happening, and actually we’ve seen some preliminary evidence of these Blue Zone cultures, that the numbers of people living to those old ages is going down rapidly. That these papers came out 10, 15 years ago, most of them. Or the centenarians now, they’re born 100 years ago. They haven’t been exposed to all of these toxins that we’re exposed to. So I think that we’re going to see a drastic reduction in these cultures.  The answer to your question is, it’s the healthy, diverse microbiome that heals the transient intestinal permeability that you get when you’re exposed to wheat.

Dr. Weitz:                            Tom, I want to mention. Among the great clinical pearls you mentioned tonight, one was that if you wanted to take a vitamin D supplement and you wanted to act locally in the gut, better to use a capsule or tablet rather than a liquid. A lot of people like to use liquids because they hate swallowing pills. But for this purpose it makes a lot more sense.

Dr. O’Bryan:                        Yeah, yeah. And we use Micellized liquid vitamin D as a supplement when I want to boost levels. I use liquid because it’s absorbed really well and it has five times better increase in blood values than emulsified. But when I’m dealing with the gut, I want it down in the gut. I will give systemic also, but I want it down in the gut.

Dr. Weitz:                            And, Bernie, you had some questions about what testing that Tom recommends.

Bernie:                                 Yes. What’s the best test to show one’s inflammation level?

Dr. O’Bryan:                        Well, that’s really a good question. And in my experience, we don’t have a panel. Although Vibrant has come out with an inflammatory panel. I’m sorry, I have to correct myself there. They’ve got an inflammatory panel now that’s most comprehensive one that I’ve seen.  Cyrex has a nice panel looking for the effectiveness of natural killer cells and a few others. Vibrant’s panel, and I don’t remember the name of it because I don’t use it myself, but it would be a valuable test to do, that’s the one that I would look at, is from Vibrant.

Bernie:                                 And also, Dr. O Bryan, you didn’t talk about foods and immunity and immune responses to foods, based on the other Vibrant tests.

Dr. O’Bryan:                        Right, right. That’s all in the CGP program. I had 90 minutes, so there’s only so much I can talk about. Yeah, the Vibrant tests are incredible, and rarely are people sensitive to just one food. It’s very, very common. I mean the studies say celiacs, 50% of celiacs have molecular mimicry with dairy. And we find it’s more than that with wheat-related disorders.  That’s why we put everybody on a gluten-free, dairy-free, added sugar-free diet on day one. And then when their test results come back, we may tweak it a little bit, but we always include dairy-free. But corn’s extremely common. That’s why there are people out like my friend, Dr. Peter Osborne, that talks about grain-free diets, because so many people have cross-reactivity and sensitivity.

Bernie:                                 Okay, thanks.

Dr. Weitz:                            Yeah. The other thing, Bernie, you can get a stool test that will include fecal calprotectin. And that’s a good measure for inflammation in the gut.

Dr. O’Bryan:                        That’s correct.

Bernie:                                 Okay. Thank you.

Dr. Weitz:                            Okay. Any further questions? Tom, thank you. That was incredible. Awesome, awesome presentation.

Dr. O’Bryan:                        Thank you, Ben. It’s really a pleasure. And thank you all. Come back on screen to say goodbye so I can see who I’m dealing with. Oh, thank you. Thanks, Lori. And thanks everybody. It’s nice to see you all.

Dr. Weitz:                            Okay.

Dr. O’Bryan:                        And thanks for taking the time. And God bless to all of you.

Dr. Weitz:                            Thank you, Tom, and thank you everybody. We’ll see you next month.




Dr. Weitz:                            Thank you for making it all the way through this episode of the Rational Wellness Podcast. And if you enjoyed this podcast, please go to Apple Podcast and give us a five star ratings and review. That way more people will be able to find this Rational Wellness Podcast when they’re searching for health podcasts. And I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica Weitz Sports Chiropractic and Nutrition clinic. So if you’re interested, please call my office, 310-395-3111, and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz. Thank you, and see you next week.



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