Do Probiotics Really Work, The Carnivore Diet, How To Heal Bacterial Overgrowth, Is Fiber Necessary, Melatonin For A Leaky Gut & More!
asters degree in physiology bio mechanics and human nutrition, I've spent the past two decades competing some of the most masochistic events on the planet from seal fit cocoon of Sardana ago. Gee in the world's toughest mater, thirteen ironman triathlons. Brutal bowlen's adventure races. Spearfishing plant foraging, free, diving bodybuilding and beyond. I combine this intense time in the trenches with a blend of ancestral, wisdom and modern science searched the globe for the world's top experts in performance, fat loss recovery got hormones, brain, beauty and Braun to deliver. You this podcast everything you need to know to live in adventures joyful and fulfilling life, my name is Ben Greenville enjoy the ride. Folks, then greenfield here, I have Dr Michael Rasheed show can't say his name without trolling yards baby on the show today. One of my favorite guys when it comes to all things gut. We didn't mention this during the show. So I figured I mention it now all of his his products, not only is books, but also all the things that he recommends to his patients for things like the elemental diet that we talk about in this show things to fix IBS small intestine bacterial overgrowth, he's cutting all of my listeners a discount. So I'm going to put that over in the show notes. If you go to the show for this podcast. Those are been greenfield finis dot com slash healthy gut. Speaking of discounts yesterday was Friday. So I guess you call today black Saturday if yesterday was black Friday, I don't know. But either way I have a bunch of really good stuff for you over a kion for black Friday, foreign handsome, unity better. Avary faster muscle gain faster, fat loss. We've put together a bunch of bundles and then vastly marked them down. We have a coffee bundle. We have a recovery. Bundle with a mean owes with flex with fish oil. 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They're gonna give you some free. You get six gains wave treatments. The throw another one on the house. If you get twelve the thirteenth for free to do that, just go to gains wave dot com slash Ben. That's gains wave dot com slash Ben to find a provider near you. When people ask me, the number one book, I recommend for all things got related. It is hands down a book called healthy, gut healthy, you healthy gut healthy, you it's written by Dr Michael rougeau. He's been a guest on my podcast before we did a big podcast on how to differentiate between all the different types of carbohydrates, and what type of carbohydrates were good, and what type of carbohydrates were bad and a high carb diet, low carb diet, he also came on. And did a big podcast with me a few months ago about why healthy people in particular, get broken guts, and what to do about it. And I'll wait to both of those in the show notes for this episode, which is going to be over. At Ben greenfield, fitness dot com slash healthy, gut. That's been greenfield fitness dot com slash healthy, gut. And the reason that I brought Dr show back was because the time I recorded those two he hadn't yet released this book. He sent me the book. And I read it, and I've just been recommending right and left to pretty much everybody who well who has a a small testing and large intestine and asshole spleen and liver. So if you have if you have digestion, you should read the book, and I actually have a few things, you know, whenever I interview somebody about a book, I don't like to just give you guys, you know, exactly what's in the book. But take a deeper dive into some of the things in the book and kind of explore them and unpack them so to speak. So that's what Dr Rubin I are up to today and and doctor shows practices in northern Cal. You're in which which city are you in? I forget it's walnut creek right in what we you've had on Judson Brandeis. And so his his pump kind of male health enhancement clinic in walnut creek as is a cryotherapy center. So we got some stuff to do next time your on. No crazy. Why walnut creek don't even know why what seems to be such a hot spot for I guess suburb outside of? San Francisco if you're looking to get out of the city, but not too far and have kind of like a nice affluent area that's clean in. Well, kept a lot of people end up in walnut creek GATS. Why there's so many things that you lot of rich board people that make sense. I wanna do to penis injections and sit and cryotherapy chambers. So I'm going to speak anyways, though. So there's there's so many places in the book that we could start. But where I'd like to start is this concept of bacterial overgrowth, it's probably one of the least understood areas of digestion for a lot of people who get gas, imploding and think they've got whatever, you know, parasites or yeast or fungus or something going on in the colon. But it turns out in some cases, it is this thing called bacterial overgrowth. So can you define that? And then I also would like to hear specifically about how that affects the thyroid because that that was a little known fact me in the book. So can you get in into into CBO or bacterial overgrowth what it is? And then specifically its effect on the thyroid. Yeah, there there's a lot there unpack which which I think is super interesting in very actionable for people. So how the inception of kind of mine. Foray into the importance of small intestinal bacterial growth dates back to maybe five years ago. When I think we really saw the initial burst of interest in the micro Bada, this is when you start hearing all this cool research being published where African hundred gatherers had more diverse bacteria in their guts, and that seemed to correlate with healthier. You know, people in general, and so there's a lot of excitement regarding the first healthy intestinal bacteria, and the potential utility that we may be able to garner from taking sick people and improving the health of their bacteria. So that was great. But. What you what can happen is? When you're looking at things observational, those observations don't always clearly translate into what you do in the clinic. And so what you were seeing being suggested in terms of inferences were pretty much the opposite of what any experienced clinician would recommend do from those patients until I was confronted with this. Quagmire where some of the microbial research was suggesting we need to undergo all these interventions to increase bacteria. Get I was seeing so many patients who clearly did not do well with that type of approach and actually only seem to improve when we underwent interventions ironically that would decrease bacteria, and this is one of the things I talk about in the book when you make delineation between the large intestine and small intestine you actually start to sort out where some of these discrepancies. Come from essentially, the long story short is we go to Africa. We do these stool samples of hunter gatherers, and they have really rich, large intestinal diversity. But what I suspect is being missed. There is the impact of the small intestine which is much harder to assess. And although yes, there's a correlation between large intestine on the small intestine. I don't think we really get a good read on what's going on in the small intestine with the stool test because. It's right in the middle of everything's gonna hawk are to get to. And by the way, I mean that was like a study just a couple of weeks ago that showed that the bacterial status of the large intestine in no way, reflects what's going on the small intestine, which kind of sucks for a lot of these Baion tests that are testing stool and not getting a reflective evidence of what's going on up in the small intestine. Exactly, exactly. So that's one of the main premises. I developed in the book is. A lot of the previous gut advice was very large intestine Centric. But the problem is the small intestine represents over fifty six percent. So the majority of your intestinal tract. It's the most prone to leaky gut. It's the most immuno active. It's where ninety percent of your calories are absorbed. So it's a huge miss to miss the importance of the small intestine is a huge mess. And here's what kind of bottom lines to you can twist observations to support almost any hypothesis where the bullets hit really gets called is when you go to the interventional or clinical trials, and this is why I really harp on the importance of clinical trials because you can you can cherry pick and mislead with operation data and with mechanism data. But when the rubber really hits the road is when you say, okay, we have a group of one hundred people they are sick. We're going to do this in half. We're not gonna do that in the other half. Give them up a CBO. And then see what happens and when. If you look at the outcome data you start leaning back toward the interventions that seem to favor the small intestine so long prelude here to the answer. What is that till overgrowth most, namely, small intestinal bacterial overgrowth, which is what I think is the most relevant is where you have either an overgrowth of or the wrong type of bacteria in the small intestine. There should be some not nearly as much as there is in the large intestine, and what can happen is you can have an overgrowth of bacteria in the small intestine and again, sometimes it's native bacteria, sometimes bacteria from the large intestine rowing upward into the small testing. Sometimes it's oral bacteria from the nasal for NGO cavity that gets down into the large intestine or sometimes it may even be the native small intestinal bacteria that just simply over grow. But the point is that this is not something like a parasite, which is I think a lot of the older. After like last generation, gut advice was tests for parasites and get rid of parasites in. There was some truth to that. And I'm an example of that I had a parasite, but I think it's much more common now is an overgrowth of activity that are native to your system. It's just they've gotten decompartmentalise or they are in the correct compartment. But there's just too many of them in that compartment. So essentially, what CBA was now the tie-in to the thyroid, I think is fascinating. And a just say this very plainly that there may be a lot of people who think they have a thyroid condition who actually don't and I'll come to studying a moment that actually found that sixty percent six zero of people who had a ambiguous thyroid diagnosis when they were re-checked sixty percent of them actually were not hypothyroid. And I think this is because the symptom. Of not only small intestinal bacterial overgrowth, but problems in the GI in general can manifest as symptoms that look like hypothyroidism and just as one example. There was a study looking at patients with IBS so edebali's syndrome gas bloating, dumb will pain altered mental function and they found a significantly higher. Incidence of fatigue, depression and anxiety in that cohort now fatigue and depression, oftentimes tributed to hypothyroidism, so we certainly can see that problems in the gut may manifest as what looks like a thyroid problem. But specifically there's a couple of key points that have been published over the past maybe two years one only about six months ago study. I believe it was in Russia. It was either in Russia earn pulling and essentially found that patients with CBO small tesla bacterial overgrowth had about three times higher the level of TPAO antibodies, which are the antibodies of underlie hush among those now, I also should be careful in saying three times sounds like a lot. But this is where I don't want to contribute to some of the overzealousness a functional medicine. I wanna be a little bit too starting. So the control group had a level of thirty nine which is considered just above normal user, the cutoff for teeth peo- antibodies to steroid autumn unity is about thirty five. So the control group. The none CBO group had. I'm sorry. So the control group had a value of six and in the CBA group had a value of either thirty nine to ninety four. So it's actually more than than than a threefold. But here's what the details do matter while that is a significant elevations of thyroid antibodies in the CBO group. I wouldn't say it's a huge elevations. Because when you look at thirtieth bodies in my experience, they have to really be over five hundred and there's some literature that supports this to really the note a clean a clinically meaningful elevation. So yes, there is evidence showing that one may have worsened fired autumn unity situation, if they have small intestinal bacterial overgrowth, and that's something you can act on in may help. But I don't want people to think that this is a huge leeann packed full issue. At least not from diploma. Mary literature. So it's one thing that can help. But I wouldn't lose sleep over it per se and the mechanism. There may be that when Beccaria in the small intestine over grow they seem to sue quest selenium, and if they're using selenium at the expense of you the host, we know that selenium does dictate thyroid out, immunity, so what may be happening again, this is more. So my speculation than the reasoning solid evidence to support this. I don't think there's really an answer those questions. So I'm just inferring base opponent b do know. But what may happen is that you have someone with a genetic predisposition to thyroid autumn unity? They develop small intestinal bacterial overgrowth that small bacterial overgrowth start to sensually binding to their selenium making someone a bit selenium insufficient and in that may exacerbate the thyroid autumn unity, so that's one mechanism. But here's what I think is is the most important data. We have regarding. Third autumn unity in CBO. There was one study looking at over eighteen hundred patients, and they were looking to see what were the most associated conditions too, small intestinal bacterial overgrowth. So a group of researchers looked at eighteen hundred and nine patients specifically, and they were looking at immunosuppressive drug use asked lowering medication use prior intestinal surgery. And they're expecting one of these two really associate to increase the risk for CBO what they found was very surprising. The two most correlated conditions associated with CBO were being hypothyroid or being lowered medication. So there's clearly a high association between CBO and small intestinal bacterial overgrowth in then just to finish this thought. And this is something that I've seen in the clinic patients come in, and they're pursuing what they think is the cause of their symptoms. So they might be depressed a bit overweight their cholesterol's a little bit high, and they're fatigued, and they may or may not have digestive symptoms because you don't always have digestive symptoms that accompany, gut inflammation. Sometimes the information is silent and only manifesting in other non intestinal symptoms. Right like like neurological, fatigue or brain fog. Right. Exactly. Exactly. So these patients come in. And they may be they may have been on legal wrongs for six months, then they tried to leave Iraq simplicity mouth. So you have your teeth re plus on your four plus t three. So it's more like a custom medication, and they may even have gone and tried armor or WPA thyroid or or whatever, and they never really got the traction that they were looking for. And so what I've been saying now. For close to a year is I been criticizing that in the progressive realms of natural medicine, functional medicine, whatever you wanna call it. I think we're doling out hypothyroid diagnosis too quickly, and certainly not with near the level of circumspection that we should using. And when I've gone back and actually checked I found that some of these patients were never hypothyroid, and you may have been able to nitpick and say, well, they're TSA JR. Is an optimal their teeth fours optimal. That's a big difference from being hypothyroid and the clinicians. Probably in. Unintentional way. Didn't clearly explain this to the patient that they were not hypothyroid yet. There may have been a little bit of functional low thyroid status, nevertheless, they went on a vacation. And they come to see me five years later. And when I checked their initial lab work. It's clear they were never hypothyroid. They never felt fully improved from the medication yet. They've been on it for five years. This leads me to this. Most recent study that looked at inside from being long winded here. But this is this is super interesting. So this study they documented exactly what I've been seeing in the clinic two hundred ninety one patients who didn't have a firm hypothyroid diagnosis were then tested at baseline taken author medication for six to eight weeks. And then retested sixty percent of those patients were not hypothyroid that is a huge deal. And the title of the study was. Intially hypothyroid a timely diagnosis meetings a diagnosis. Now that's in vogue. So it's being handed out more quickly, which it really shouldn't be in. So. A couple of mistakes. They're important that the antibodies nor someone's weight nor their time on medication dictated, whether they had a higher chance of actually being hypothyroid or if they were normal thyroid. So that's just some important context. Ultrasound findings did seem to be somewhat predictive. So that's something that someone may be able to use the kind of sort this out but said quite simply if you haven't had a definitive diagnosis of hypothyroid and you're on thyroid medication. You may want to speak with your doctor about revisiting this issue to double check if you are hypothyroid or not, and I would say, and I'm not sure how to say this tactfully as I'd like to. But if your diagnosis was made by someone not in the conventional medicine community, I would be more prone habit. Double check than a Inouye mean that to be disparaging of functional integrative or natural medicine. But I do think that there's been some misrepresentation of the data to this community where some of the conditions in this space. I think I've been led to believe that hypothyroidism is more common than it actually is. And so yes, there is this association between CBO in hypothyroidism in my experience. It's one of the chief causes of someone who thinks they have a thyroid problem, but actually don't in their symptoms are actually coming from the problem in the gut, and you may be able to get some people off of flowering medication and fix a problem in their gut and also from the point where throughout noted medication in their symptoms. Are now cleared that's super interesting now if somebody wanted to actually test and see if they had CBO do you have go to test because I know that there's been in the past some talk. I think you've mentioned this to me, many CBO tests might not be reliable. Yes. I should maybe back up and just say for. People who wanna run the firearm test. The what you wanna do is test your age and your free t four and what you're looking for is if you're TSA is in the conventional MoMA range and your team four is in the conventional normal range. Then there's a extremely high likelihood that you are not hypothyroid, and you don't need our administration. Now might be a minor problem with conversion sure, but is a solution to that lifelong administration of thyroid hormone, no the solution is diet stress. And I would argue in large part, your gut so just to get people the parameters there because this is this is one of the things that leads to the Iranians diagnosis of hypothyroidism is using these ranges at are too narrow, and that's whole nother conversation, maybe to get into some of the particulars regarding why some people say that you're TSA should be below two point five, but. That's when you're diagnosing the condition Sunsilk for now. So so, but that is one important thing just to give people a note on if they wanna run this test of their thyroid set us now regarding CBO there is some debate on what the best test is really. I think you have to practical options both are breath tests. One uses glucose the other uses lackey Las. You can make a case for either. And I think there's pretty good evidence to make a case either way the Rome foundation, the largest body gastroenterology in the world recommends glucose the North American expert consensus recommends Lahtchi Laos so you have to large well credential bodies recommending these two different tests. I think is long as you're using the lactose test. Just to clarify you drink a bunch of lactose or any of this other. These other sugars that you get sent with the test to your house, then you breathe into this tube and it tracks how much gas Factoria produce over few hours. Exactly bellsa. Yep. And so there's there's a bait on which test is the best one of the challenges is the lack yellows test may lead to false positives. Meaning you may see a positive on your test. But you may not actually have CBO if you make your interpretive time window from the start of the test to ninety minutes only look at that window with the Latinos, you seem to safeguard against those false positives. So there's a fairly easy way. At least in my opinion to get around that. But really either one can work either breath tests can work they're cheap. They're like two hundred dollars. Even if insurance doesn't cover them, many insurances will cover them, and they can give you some some data to move on cool. Now, one of the things that I know I've seen you recommend for CBO. And I've tried this died out, and it's actually pretty good. It's called an elemental diet and usually has some kind of mirror placement powder in I've done. It used thorn medically and blended it with stevia and ice and actual but of bone broth and thrown in a little bit of oil in their little bit extra. I mean acids, and you just like drink that for breakfast, lunch and dinner for for awhile up to thirty days. I don't know if I just bastardize the element diet. But ultimately, I'm curious if you can explain the elemental diet, and how would work for something like CBO, or inflammation or ID or anything else shirt. Now, I don't know if that application would would actually classify or qualify as elemental I think it'd be pretty close and could probably work the the elemental diet is essentially a hypoallergenic. So it's devoid of common allergens and gut. Healing me. Hill replacement shake and one of the things that this elemental diet will do is it absorbs in the first couple of feet of the small intestine. So the rest of the small intestine and the large intestine all get a break from digestion. And if there are over growths, those overgrowth don't have the fuel the food in your diet to help continue to fuel the over grow. So it affect will starve overgrowth. And this is why we see one clinical trial showing quite impressive benefits and small intestinal bacterial. Overgrowth a number of inability to decrease autumn, unity and inflammation in the gut in inflammatory ballot. Z's some evidence showing it can help with was known as Nick esophagitis or in the focus off, which is essentially inflammatory condition in throat and one study showing benefit with rheumatoid arthritis. So joint information, so it can be very. Very helpful. It's not actually is hard to do as it sounds. It. Sounds like liquid liquid only diet would be tough. I've done this exclusively for four days is a guy who is six one in two fifteen in fairly muscular needs a lot of food, and I wasn't hungry at all actually had great mental clarity and focus and make a lot of shakes tastes pretty good too. Yeah. Yeah. And I should also mention that the the older generations of elemental dine it's tasted kind of like postage stamp glue. They were just there horrid. And I say that someone can show it almost anything even I was like gosh that you know, these these are terrible. There's a newer generation of elemental formulas that are actually quite palatable one of which we have released him really proud of in the feedback that we've gotten from our patients and people who go to the book protocol has been fantastic are formulas called elemental. He'll and it's one of these newer generation formulas. This one thankfully is available without a prescription that actually tastes pretty good. And you won't feel like you wanna gag which is always nice. Hey, I want to interrupt today show that tell you about Birdwell beach britches bird well beach, britches also known as birdies what they do is they make board shorts. But these are not just any old board shorts outside magazine. 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And if you use my discount code their autumn going to donate twenty percent all the fire victims. So I think that's pretty cool. The discount code is Ben one zero percentage sign the stuff would be an amazing stocking stuffer actually just saying Ben one zero percentage sign get you ten percent off those go shes organics fine. Fine. Schupp lament. All linked to that in Shonno's. If people wanna try out this diet, I would recommend you don't just like willy nilly jump into triad. Probably better to do the, you know, the the breath test for CBO, for example, the doctor show is talking about. But it's it's kind of a simple clean easy way to to again. Like you mentioned kind of keep the bacteria from having something to feed on in. You had mentioned briefly, Michael the idea of these African hunter gatherers microbiology, and how might be different than the westernized diet. But there's also, you know, there's people like, you know, Jeff Leach, for example, was made famous not made famous, but he he became a little bit famous for his experiment where he did the fecal microbiology transplant of the stool of hunter-gathering hung himself. Upside down the middle village. I think it was in data and just basically replaced his colonic bacteria with that of hunter gatherer. And and then I. Often wrote an article on it. I'll see if I can find the story linked to in the show notes. But what what do you think about that? Because you talk a little bit about the micro Bayada, these African hunter gatherer tribes in the book. And I'm curious what would happen if we were to all do that go way back to our roots and just put the bacteria our ancestors into our current westernized bodies. Well, it's it's a it's a great question. And. I don't know exactly. What would happen? If we all did FM teas from an African population African hundred other Republican, but a lot of the mismatch between the research, or I should say the the observational inferences that was being taken from Africa. And what the actual clinical science says that that I kind of open conversation with came from this research in Africa, and these these cross cultural comparisons are always very challenging because it's really bad science in bad practice to take an entire culture that's different in a vast array of ways and try to excise out from that culture one thing, and then replicate that almost force that EDEM into a totally different population. And so the African hundred gatherer groups that have been studied. Really provide a compelling example of that where they eat in many cases, a fairly high grain diet, a high carb diet, Anna diet that usually about half the calories as many many of us in the west, and they have vastly different immune systems and vastly different lifestyles, many of these tribes are highly Parasad's. Meaning they have almost all of them have worm infections were learning that those worms may actually have benefit or even not be parasites because Secondly deficit of parasite has to be kind of opportunistic and feed oppsosed and even do dances. And a lot of these things that just kinda like, you know, as in in the west, it's called home ethic therapy. But you know, the a lot of people now will will use tapeworms whip worms that are safe to actually effect, for example, a more robust immune system. Yup. So is absolutely. And I do think we should be rethinking how label some helmets or some worms as potentially not truly parasitic. It's incredibly well said, but all that being said, it does appear that the microbial is of the Africans are adaptations in part to their environment. And when we see similar entertains in the west devoid of their environment. They actually might be pathogenic and Matthias Brevard, Dr Smith, which I expound upon in the book provides what I feel one of the best examples of this Matthias Brevard actors Smith is like a cousin toback Tyrians tending to classified as our Caja, and this organisms interesting in the sense that it slows down with much Hillary or the movement of food through the intestines and by doing so helps to extract more calories from the food in helps. With more robust breakdown and extraction calories from food. So in an African population. That's evening, highly dense, highly fibrous diet and also a lower calorie diet. This is a beneficial annotation. You slow down the rate at which this food moves to the intestines, and you extract more calories from it. So you have more of a chance to extract calories from this dense hard to break down food to begin with that works for the Africans. When we see this overgrowth in westerners, it's accompanied by constipation, and it's been fairly highly associated to waking high cholesterol and high blood sugar so works for the Africans doesn't really seem to work. So well for us. So this is why we have to be careful in trying to replicate the diet of the Africans because they they had this whole environment. That's adapted to allow them to thrive on that diet and with that Beccaria ecosystem. So we have to be cautious in just replicating that and this is part of the scientific process, we see those observations, and then we formerly hypotheses, and then we test hypotheses and only after we've tested those policies in clinical trials should we act? Unfortunately, you know, there are the translation from what leeches doing to clinical practice isn't often made with caution, and you have people jumping from observation to clinical recommendations. And this is where you can seriously get yourself in Trump. So we should continue to watch this body of evidence. And learn what we can from it. But we want to be careful with how closely we replicate are are African hunter gatherer contemporaries Jasser to like a car high car prebiotics, super fiber rich diet works for Africans. But you're westerner. And you've got issues. That diet might be the exact opposite of what you need like at my feedback Tiriac, for example, if you have CBO or it might feed bacteria that you're mute system is attacking or create create more issue's, exactly. And and the higher carb. You know, obviously, if the haircut higher fibre, I think requires a little bit of contextual station, which is if someone's going from the standard American diet to any kind of healthy diet, they are likely going to increase their fiber in prebiotic intake. Just the question is how far you go on that spectrum for some people a low, carb paleo diet may be enough to make them feel totally fine. If they go to the extreme of going more proximal to a vegetarian diet, which is even higher in carbs and fiber in pre biotic, then they may start to have some serious problems with their gut. Now, one of the other things that you talked about, you know, in in regards to kind of like, you know, westernized versus non western societies is how non westernized societies have lessened. Slamma Taurean less autoimmune and less allergies because they're living in less sterile environment. So they might have stronger more robust immune systems. And I thought it was really interesting. How you outlined this with a modern day example of sir Denia can you explain what the Sardinians did? And how this affected their mean system. Yeah. This is an interesting story that I had heard anecdotal reports about and like many things in the book. I've really fact check them because one of the things I think is not helping the field of integrative medicine as great as it is is just parroting these things that we've been told in fact checking anything if you don't fact check than you never catch errors. And you're never able to get rid of the heirs in update. So I really did fact checked pretty much everything in the book, and you can tell by the referencing in the book, there's just under a thousand references. So I checked into the Sardinian issue because I wanted to make sure this wasn't just some kind of lower from. Natural medicine. It turns out that this does checkout, and I believe it was in the nineteen fifties. That Sardinia went through this anti malarial campaign because there's a fairly high incidence of malaria in Sardenia, and what ended up happening years after that was the incidence of multiple sclerosis in Sardinia started to go up to one of the highest in the world. And what the researchers who have been tracking? This are now positing is it was a or the the malaria was. A or I should say the star Deion immune system. Learn to evolve under the pressure of malaria and kind of required that little bit of tension in the immune system from the malaria for the Sardinians immune systems to be healthy. Once that was taken away, the Sardinian immune system that was always kind of used to having this little bit of tension with malaria once that was gone. It's almost to say these are immune system did not to do with it self. And it was so used to being a little bit turned on to guard against the malaria than when the malaria was gone. It was kind of like having a board army. Right. And then the soldiers get drunk going down start picking fights and you see this by standard autoimmune effect. And so sometimes things that we don't think are good may actually be good, especially if the immune system has evolved to pee in harmony with those in the same thing applies to. The helmets. As you alluded to earlier where helmets or warms are a fairly common part of the guts in those who are hundred gathers and one of the things that may lead or have led to the increased prevalence of autumn unity in the west is the anti worm campaign that was initiated in the US where now almost no one has worms. But those warms may have actually provided a little bit of background tension against our immune systems to prevent on unity. And now that they're gone the immune system tips into autumn unity. Yeah, I wrote an article about this a couple of months ago, I I actually inoculated myself with tapeworms in wick forms just to kind of experiment with how my moon system felt and and ultimately the biggest change I found was far less ability to getting sick. And it seemed even reduce the symptoms of jet lag. When I was traveling all all across the globe. So it seemed kind of modulate the immune system in some way all league at article in the show. He has to read it. I'll put it over at Ben greenfield finished dot com slash healthy, gut. But it's a perfect example. You know that this malaria eradication example of why we may want to keep our museum slightly challenged. Another thing that that I thought kind of reflected kind of good practical tip was this idea of increasing our our bacteria externally, especially like our skin bacteria and doing so with with naturally occurring plant life. So, you know, I've talked about the NASA cleaner study before my wife, and I have have placed house plants around the house that naturally clean the air based on many of the plants like English Ivy and peace lily that dented in in the NASA clean air study. But then you kinda take this to the next level as far as plant life. Can you explain what's going on? When we when we've plant in our home or surround yourself with plants. I think about a couple of studies in the book, and that were interesting most, namely, those one cohort study that looked at children growing up in environments where there is a high diversity of naturally occurring plant life around the home compared you children in environments where there was a low diversity or just a low amount of naturally occurring plant life around the home. And what they found was very interesting the diversity of plant life correlated with the diversity of bacteria on the skin of these children, which was inversely related to inflammation in the skin. So the higher the plant life the higher the bacterial diversity on the skin the lower, the inflammation in the skin and that led to a lower amount of things like eight topic dermatitis or just skin allergy of various sorts. So there does seem to be some kind of benefit from having a diversity of plant life around your home. Whether we can replicate this by buying plants putting. In the home. I don't know that that's been shown, but I wouldn't think that would harm in any way and certainly could only be neutral to hopefully beneficial. Yeah. It was really interesting takeaway in and then you kind of get into the realm of probiotics. And this is a big one for a lot of people especially in light of that new research. I talked about earlier that found that I think the primary takeaways or large intestine bacteria, don't necessarily flecked what's going on in the small intestine. And even though all these microbiome tests testing, the large intestine the stool, and then I think the other takeaway was that many of these probiotics even though they seem to have some kind of an effect on things like IBS IBD depression, and in many of the things that probiotics have been studied to be somewhat efficacious for they don't appear to actually kind of seed or populate the gut. So there's a lot of confusion out there regarding probiotics, and you have some really good sections of the book on probiotics. But what's your take on them? I mean, do you use them you prescribe them? Do you think they even worked? They stay in the. Gut. I mean what what's going on with probiotics in that respect? You're right. One of the I think most. I guess intuitive things that is important to mention regarding probiotics. Is that most probiotics with the exception of a few do not colonize you. And this throws a monkey wrench in the previous philosophy of. Well, you need to like you said received the repopulate with healthy Bank area. And that doesn't really seem to be the way this plays out. I think a better way to think about probiotics is you have this bacterial colony in your gut and with stress with poor diets with environmental insults with the fact that we grow up in an environment that's fairly sterile. And if you were not breastfed, or if you were caesarian birth all these things are negative knocks against that bacterial community in your gut. What I think probiotics can do is. They can provide a a nudge to the microbiology that can help reset it to a healthy. Equilibrium. And if we pair that nudge with preate diet in lifestyle inputs into the gut than we can help that nudge to maintain this you bios or this balance in the longer term, so healthy diet and lifestyle foundation paired with a nudge from probiotics seems to be able to help reset the microbiome to a healthier equilibrium. And and so I I should mention that one of the things that probiotics do that. I think is under appreciated is or actually antibacterial antifungal and anti parasitic perhaps using the term parasitic loosely, but they do seem probiotics is to be able to combat things like small, tesla bacterial overgrowth and Candida. So a properly used probiotic can have a lot of benefit for reducing overgrowth and also helping to reduce inflammation repair leaky guts. In help with a number of symptoms. But it's not to say that they will repopulate you're with this missing beg curia. But rather again, if you have these imbalances, the probiotics can help to kind of dislodge some of these balances and reset you to a healthier equilibrium. Now, what about when to take them because you you mentioned the use of probiotics kids. My kids eat a wide variety of ferment foods around the house like him Chee and coconut yogurt and sauerkraut me. So and things like this. But they don't take a probiotic per se. I think they have like some of that like the smarty pants. Probiotics upstairs. And you know that access to my probiotics. But, but do you think it's beneficial for kids to be using products? Well, there there had been a number of studies showing that probiotics can be helpful for children. And one of the first things I wanted to look at was how early can we go with probiotics. 'cause is there some sort of time. We need to wait before we give probiotic and could a probiotic perhaps given to an infant bead detrimental in some way. And even if you look at children in the Nick you or Preterm infants there is a benefit derived from taking probiotics. In fact, one study found that administration of probiotics before twenty seven days of life decrease the incidence of type one diabetes, and if the probiotics administered after twenty seven days of life. There was no impact on type one diabetes, which is not immune condition. So that's just one study. But there does seem to be this trend into state at simply the earlier antibiotic is used the more detrimental it is. And the earlier probiotic us is used potentially the more helpful. It is now probiotic foods. You know, how do they interface in here? It's hard to say I would assume that probiotic foods or supplemental probiotics would have a similar. Impact? I don't know that we have great research yet looking at for minute foods in in, you know, infants toddlers we do have those studies with probiotics in reduc- benefit. I would assume the same thing happen with a probiotic. So. I would say for for a child you can use either. If you're if you're if you're pre food than obviously, a probiotic would be the way to get there, or at least the mother taking it so hopefully, get some crossover benefit into the child. And then as as growing up, I would say use either minute foods or probiotics or a little bit of both. Yeah. I mean, really probiotics would be almost more targeted delivery, though. Because you know, when you look at live microorganisms assume you're not eating like a like a heat pasteurised probiotic like a lot of these store-bought sauerkraut. For example, are you know, the thing is they might not be necessarily reliable as a source of beneficial effect of bacteria. If you're trying to target your body with a specific strain of bacteria, but if you want just kind of shock approach of a wide diversity of back during your system, I think that that regular use of those than targeted USA probiotic seem to be somewhat affective and. In terms of target user, probiotics there there is this concept of survivability, and whether the probiotic can actually survive the acidic journey through the digestive system and make it for example to the colon. And I've seen of seen some folks. Now talking about like newer probiotic strains that might actually see the God. That's even the name of of one of them that people are talking about is this company called seed. That's making probiotics that they say actually survived the acidic environment in the gut than in populate. The god. Have you looked into strains like God at all? That are having hand survivability. You know, I've looked to some extent into these enteric coated probiotics. And my thinking here is the consumer needs to be very careful with the claims regarding probiotics. I remain very open. But I think there is much more hyperbole than there is here, actually actionable or helpful advice. And I think we are going to see because probiotics market that many companies wanna get into you're going to see progressively more outlandish claims made to market a product because the more people are marketing, the more marketing claims are made now you have to Mark even harder you need newer more novel pathways and mechanisms to market, so I can tell people that with the simple three category probiotic system that I use with the three probiotics that I recommend on the book, which are good clean probiotics. That have the appropriate ingredients in the proper dosing. But with those we haven't able to take. People who have positive candied in CBO in their labs. And the only thing they've needed to do is to use the appropriate protocol. And this does make a difference. I I remember most singly or just think with rob wolf he had done all types of gut protocols. I was because rob wolf knows everybody. And he he finally pulled me aside and said, hey, you know, you have anything to try so I gave him this probiotic protocol. And there was two categories of probiotics in three categories system that he hadn't tried and that was a huge game changer for rob not using the newest novel probiotic, which he was doing. I think for a while and getting pulled into the bells and whistles and just understanding that it's important to present the gut with this diverse array of probiotics using all three of the categories, and that was able to make a substantial impact. So I'd be I'd be cautious. Because this is something that you're gonna see more and more of and I watched a literature. And if there is something. Significant there that that needs to be acted on. I'll be one of the first people to adopt. But I am highly suspicious that the consumer is going to be just animal bombarded with all these different claims. Yeah, I think with that seed company they're using some kind of like a they're using LG as delivery mechanism. I think there's some how coating the bacteria with algae. And they say that it survives transit through digestion. But I don't know. I was just curious if you'd use any anything like that. But the other thing you talk about is is also this deal with using E coli as a probiotic, and that's a prize me. Because a lot of people think he call is just, you know, found bad hamburgers, and is gonna make you sick. But you actually talk about he coli as therapy is gut therapy. Where does he coli fit in when it comes to probiotic supplements? Asian great great question and very interesting 'cause there are pathogenic E coli tarot hemorrhagic coli, but also a fairly prevalent member of your healthy commence back tibia. Are different types of e-coli. And an so I mentioned earlier to three categories this probiotics while they're technically is a fourth which I mentioned in the book, but for most conversations like this. I don't discuss the fourth because the fourth isn't really available in the US for for weird. Regulatory reasons that I don't quite understand. While these probiotics are available in Europe in many other countries there for some reason not available in the US. Even though there have been a number of trials showing benefit. There's one that trained trade names as beautifully which is a choline isel one nine one seven, and it's it's a strain of coli, and it's been shown have quite impressive benefit like the other probiotics. I think all good probiotics of category one through three or this category. Four can be highly beneficial. So for someone who hasn't tried in coli probiotic. It's something that consider. And yes, there are healthy strains of coli that can be beneficial. And there have been a number of trials mostly inflammatory bowel disease, showing benefit with some of these e coli bass pro Alex interesting, and you can actually look on the label, and you can actually find coli ingredients on the label. Yep. Interesting. And so when people get a gut tests, and it says that they have coli those could actually beneficial strains of coli oftentimes, that's what you see. And it it's helpful to understand that E coli is a natural resident of the gun. And so unless it's dentist pathogenic E coli many times, this just tells you that you have lack just like lactobacillus Biffi bacterium, you have coli growth in your gut, which isn't a bad thing. Now, you also say in the book that we would be surprised about what you found in your research for the book about dietary fiber be surprised about dietary fiber. What what is it? The people be surprised about when it comes the dietary fiber. Well, I guess say it. Concisely the the benefit of dietary fiber, I think has been vastly overstated, but we have to paint one. I think important background nuance, which is a low fiber diet that's high sugar high in trans fat and high in processed foods is not healthy. But when you leave that sad, I which I'm sure no one listening to this has done probably a long time when you leave the standard American diet and go to pretty much any healthy diet from low carb all the way through a healthy budget, -tarian diet, you're probably okay in terms of your fiber intake, and there there's a fairly large swing in terms of the fiber intake from a low carb diet all the way through a bitch -tarian diet, but it doesn't really seem to matter. And this was the most of part of the book to write 'cause I was presented with one hundred sixty seven pages of abstract summaries on the research regarding fiber. I this was the point of the book where? Literally almost gave up. It was just it was so much data and having to try to parse through the data in a century say, okay, here's one hundred sixty seven studies we have to wait these by importance, and we have also divide. These by studies that show fiber has a health impact compared to fiber has no health impact. And that was quite difficult, but after going through that daunting process, the conclusion emerges is fairly clear, which is there has been no consistent benefits shown from a higher dietary fiber intake, and even some studies using diets that are relatively lower in fiber to some of the studies that they've been compared against and showing actual benefit for example, one they looking at a paleo diet next to a Mediterranean diet in the prevention of colorectal adenomas showed similar ability to prevent the currents of those now in your when you're saying high fiber versus low fiber. What are we talking here? Terms of number of grams of fiber. Well, that's the actual convenient thing. Which is it doesn't seem that you. We have to be highly prescriptive with this recommendation. Because it doesn't come kit. You have sought able fiber compared insoluble fiber. You have fiber from fruits you fiber from grains, you of hyper from vegetables. So it's been looked at in all different ways. But the trend that emerges in people want the deeper dive, you know, they they can read the book to kind of go through this on our study by study level, but the trend that you see is that higher fibre intake. There are some studies showing benefit from higher fibre intake, which is what a fiber enthusiast will cherry pick incite when they're trying to support the argument that you must eat a lot of fiber. But they will leave out the other evidence showing that higher fibre. And this will this will vary in terms of how much fiber in the type of fiber. But numerous studies also show no benefit from a higher fiber diet. So that's important factor. In also will meet look at studies that compare something like a vegetarian diet to a paleo diet or a prediction. Type diet compared to maybe a low carb type diet you actually see equivalent results in even specifically for metabolic conditions. A slate favoring for benefits in metabolism from a moderate to lower fiber intake. So there's not a specific Graham that one needs to shoot for to say that high fiber, moderate, fiber or lower fiber. But rather I would say whatever diet you feel best on anywhere from low carb, which tends to be a little bit lower in fiber all the way through high carb, which tends to be a little bit higher in fiber feel okay about that. Because there's no consistent evidence showing that you need to be eating higher fibre to have a healthier colon or just be healthier overall. You hear that a lot from people now who are following the carnivore diet, you know, eating a lot of meat and granted mean has a little bit of fiber in. But they're they're not eating a lot of fiber yet seeing in some cases reversal of a lot of guys, shoes, and inflammation. And I be d-. Have you looked into the carnivore diet at all or thought about that? When it comes to fiber. You know, I've had some patients who have fooled around with it. Some have done very poorly on it and some have done really well on it. And my thinking is that the carnivore diet is almost like an extreme limitation diet because we know that plant foods contain a number of things that can be noxious lecterns Sapin. Ines oxalate s- some Sofer Fahd maps and even just fiber in and of itself, especially vegetable fiber, insoluble fiber can all be irritants to the guts in. So what I think is happening is in part. This is just like taking everything or not everything, but many things that could be problematic to the gut and just wiping them all off the table in one fail swoop. When you go in the carnivore diet. So I I like it from I don't know if I was like it. But I I see the plausibility of it as an initial elimination diet and then one should. he'll after a while on that. And then try to move to the broadest diet possible. Have I've Osama opinion, by the way, I I don't I don't think that it has anything magical to do with eating copious amount of meat every day. I think it's the fact that you've just simplify the diet to the extent where you just aren't eating barely anything that could cause gut inflammation. But at the same time, I you know, this might offend some people. But I think it's almost like a lazy diet, you know, kind of similar to the elemental rights. I'm gonna same thing for breakfast, lunch, and dinner and screw food food. Prep cooking learning more about the wonderful world around me eating a whole foods diet like kind of a western prices diet where you know, you're you're actually learning and building a relationship with food versus like throw another slab of meat on the grill for breakfast, lunch and dinner. I just think it's it's almost like a little bit of a myopic overly restrictive diet. That's kind of like a a lazy way out. But that ultimately if you eat that way your entire life. I suspect you get pretty bored. Most people have talked to about it. They're like love her by. But after a month or two just like, I'm getting tired, and I agree. And I I would be prone to think that this would show some type of deleterious impact in the long term. Just like, you know, we we in the kinda paleo-ish camp or one in the paleo-ish can't loves to criticize the vegetarian diet for the potential nutrient deficiencies, I think the same logic applies here that a diet that's too extreme in what it limits opens the door increases, the likelihood of some type of neutral deficiency in the long-term. Yeah. I wanted to ask you one other question. And this was just like a little anecdote from your book that I found very interesting, and it was this idea of melatonin actually being something that could help with a leaky gut. And I'm curious if that is literally like just supplementing with melatonin, or if it is more related to sleeping, more or sleeping better. Or what? The deal with that would definitely say that the the optimum choice would be to have your sleep be adequate and quality to try to goose the melatonin pathway for gut health, but there has been at least one trial showing inability to improve IBS symptoms with supplemental melatonin and melatonin does seem to have an anti leaky guts mechanism to it perhaps due to its antioxidant capacity. So it I mean, it's certainly something that you could tinker with it's not something I use for the application in the clinic. If someone's having a hard time sleeping than I think Milton is is definitely a supplement to consider because it has secondary health benefits. So I see it having applicable there. But if someone's having a hard time sleeping, I would say look into the health of your gut because it has been fairly well identified that inflammation in the gut can lead to insomnia. So there's there's kind of this this closed loop circle. Where problems in the gut may lead to insomnia that insomnia may decrease melatonin melatonin may make gut worse than they're stuck in this self feeding cycle. So yes, melatonin can't help with leaky gun. Any of those studies? Remember how much melatonin was being used? You know, I don't I'm assuming it's probably anywhere from five milligrams a day to ten to ten probably the somewhat standard o- slow bit on the higher side there. But it's it's not something. I would say use a probiotic way before you use melatonin for for healing that he got interesting. I thought that that was kind of a cool anecdote was the USA melatonin. So all I'll linked to some of the research on this. And also everything we talk about if you just go to Ben greenfield, fitness dot com slash healthy, gut. That's been Greenville finis dot com slash healthy, gut. We kind of only scratched the surface in terms of the actual book. But I consider this to kind of be, you know, to a certain extent almost like a cookbook for if you have like gas constipation, bloating. Cbo you've noted something on your gut test results that you want to take a deeper dive into the book is a really good resource almost like a coffee table resource for your guts. And Dr Ruth show also has. Cast. That's really good. That has a lot of really good research base science on the gut which is what I really appreciate about. Michael is he he actually has researched back everything up like there's a thousand different studies just reference in this book alone. Any also puts out a newsletter. That's pretty good. When it comes to kind of keeping your gut dial in and getting access to the latest research on the gut. So the book is healthy, gut healthy, you I'll link to it and everything we talked about over Ben greenfield, Venice dot com slash healthy, gut and Michael thanks for. Thanks for coming on for three peat on the podcast. Yeah. They have me. But a lot of fun. Awesome, folks. While I'm on Ben greenfield with Dr Michael rougeau, sign out from Ben Greenville, finished dot com. Have an amazing week. While more go to Ben greenfield, fitness dot com. Where you can subscribe to my information packed and entertaining newsletter and click the link up on the right hand side of that webpage says Ben recommends you'll see a full list of everything ever recommended to enhance your body and your brain finally to get your hands on all of the unique supplement formulations that I personally developed you can visit the website of my company kion at get K I O N dot com. That's get K I O N dot com.