WEBVTT 00:00.031 --> 00:01.435 [SPEAKER_01]: to the Aquaman podcast. 00:01.635 --> 00:03.680 [SPEAKER_01]: This is an exploration of woman kind. 00:03.841 --> 00:08.453 [SPEAKER_01]: Here we discover and him to create a bounty of health for the body, mind, and spirit. 00:10.365 --> 00:11.005 [SPEAKER_01]: Hello Kelly. 00:11.065 --> 00:13.506 [SPEAKER_01]: Thank you so much for joining us on the podcast today. 00:13.526 --> 00:14.886 [SPEAKER_01]: I really appreciate your time. 00:14.926 --> 00:22.187 [SPEAKER_01]: Do you mind introducing yourself and talking to us about who you are and what led you to become a doctor of naturopathic medicine? 00:22.347 --> 00:22.887 [SPEAKER_00]: Sure. 00:23.467 --> 00:28.888 [SPEAKER_00]: So initially, what led me to pursue naturopathic medicine was my interest in nutrition. 00:29.108 --> 00:33.449 [SPEAKER_00]: And I knew that in the conventional medical setting, there isn't a lot of nutritional 00:38.310 --> 00:45.012 [SPEAKER_00]: other methods of treatment and how to tie nutrition to foundational health and chronic disease. 00:45.612 --> 01:01.576 [SPEAKER_00]: So when I discovered naturopathic medicine was kind of the best of both worlds between conventional diagnostics and learning about the body the same way that conventional colleagues do, but a whole different set of tools in the toolbox, including herbal medicine, supplements, 01:07.518 --> 01:15.804 [SPEAKER_00]: a root cause approach in a holistic approach to health, which really intrigued me, and I've loved practicing in Chicago for the past 15 years. 01:16.044 --> 01:17.025 [SPEAKER_01]: Wow, it's amazing. 01:17.145 --> 01:24.790 [SPEAKER_01]: And you were just telling me previously that you started in bioengineering, and then you moved over to an airport trip off the, and you don't know of anyone who's made that. 01:25.130 --> 01:50.865 [SPEAKER_01]: And I guess when you're doing bioengineering and when you're training to make these tiny little machines that can work in hearts and valves and all of these other things, it doesn't seem in that community that the natural progression is in a proper theory, but I guess for you doing lots of math and biochemistry, it is a dark moment, of course, because in a proper theory is almost the modern iteration of holistic medicine and understanding all of these really complex mechanisms in the body, how they're all interconnected, 01:51.305 --> 01:55.108 [SPEAKER_01]: which is in of itself kind of biochemistry and is bioengineering as well. 01:55.148 --> 02:06.397 [SPEAKER_01]: You're just bioengineering with herbs and supplements and doing really personalised lab testing and figuring out what the health looks like for this individual person which is wonderful and I think just seems like a natural progression. 02:06.597 --> 02:10.501 [SPEAKER_01]: We're talking about the gut today and talking about systems in the body. 02:10.521 --> 02:15.224 [SPEAKER_01]: I think it was in 2012 everyone became really obsessed with the gut and so you probably saw that. 02:15.264 --> 02:16.285 [SPEAKER_01]: You've been practicing for 15 years. 02:16.305 --> 02:16.645 [SPEAKER_01]: So he's 02:17.366 --> 02:23.552 [SPEAKER_01]: You're probably like, yep, everyone came into my office in 2012, 2013, wanting to do gut microbiome testing. 02:23.932 --> 02:31.860 [SPEAKER_01]: Do you mind introducing in a nutshell what the gut microbiome is, which is a huge ask of you because you're probably like, where do I start? 02:32.160 --> 02:41.489 [SPEAKER_01]: But do you guys do you mind giving us just the nutshell of what it is before we get into the needy gritty of the gut microbiome in relation to women's hormones and hormone health over the last van? 02:42.390 --> 02:43.050 [SPEAKER_00]: Absolutely. 02:43.270 --> 02:47.872 [SPEAKER_00]: So it's fascinating that our gut is home to trillions of microbes. 02:48.352 --> 02:52.793 [SPEAKER_00]: And collectively, we call that whole community, the microbiome. 02:53.153 --> 03:05.556 [SPEAKER_00]: So that's the good, the bad, the gray area, and how your liver processes things, how your body absorbs nutrients from food, and how your gut actually 03:07.517 --> 03:08.037 [SPEAKER_00]: on its own. 03:08.317 --> 03:12.578 [SPEAKER_00]: So one of the things patients sometimes ask me is, do I have to take a probiotic? 03:12.959 --> 03:16.860 [SPEAKER_00]: Well, no, we actually have a mechanism for making our own good bacteria. 03:17.280 --> 03:23.481 [SPEAKER_00]: So essentially, it's the community that lives inside of you that actually out numbers are human cells. 03:23.662 --> 03:24.582 [SPEAKER_00]: It's really fascinating. 03:24.842 --> 03:25.082 [SPEAKER_01]: Yeah. 03:25.362 --> 03:29.285 [SPEAKER_01]: And there's more DNA as well because we have a diversity of the gut microbes there as well. 03:29.305 --> 03:31.587 [SPEAKER_01]: And we want as many different types as we possibly can. 03:31.627 --> 03:41.595 [SPEAKER_01]: And I think just gut mapping through ancestry and looking at how gut microbes have changed throughout history and for different even different races of people is also really fascinating. 03:41.635 --> 03:44.798 [SPEAKER_01]: I feel like I could just go down a huge rabbit hole with that. 03:45.098 --> 03:47.080 [SPEAKER_01]: And I think what you just explained is really important. 03:47.280 --> 03:48.381 [SPEAKER_01]: Do I just take a probiotic? 03:48.401 --> 03:49.682 [SPEAKER_01]: That's under the assumption that 03:50.062 --> 04:01.326 [SPEAKER_01]: everyone's got microbes are the same and everyone will benefit from the same microbes but your body knows exactly what it needs and if we give it the right tools and the right environment you'll be able to maneuver it's got microbiome for our own personalised health. 04:01.926 --> 04:05.247 [SPEAKER_01]: So let's get into the gut hormone access and female health. 04:05.367 --> 04:12.430 [SPEAKER_01]: So could you illuminate some key ways in which estrogen, progesterone and testosterone shape the landscape of our microbiota? 04:12.750 --> 04:18.133 [SPEAKER_01]: And in 10, how does this microbiol community orchestrate the metabolism and availability of these hormones? 04:18.233 --> 04:20.414 [SPEAKER_01]: Huge question, but I'm sure you nail it. 04:20.975 --> 04:22.175 [SPEAKER_00]: Yeah, yeah. 04:22.375 --> 04:25.657 [SPEAKER_00]: Interestingly, well, I guess I'll start with some basics. 04:26.037 --> 04:34.402 [SPEAKER_00]: And I always go through this discussion with patients when they're in the office or being seen remotely is just thinking about the cycle in these two halves. 04:34.762 --> 04:37.844 [SPEAKER_00]: So of course, the first is a follicular phase before ovulation. 04:38.204 --> 04:40.505 [SPEAKER_00]: Estrogens, the main driver, helping that follicle 04:42.146 --> 04:46.948 [SPEAKER_00]: and then after ovulation, that's where progesterone steps up to prepare the unit lining. 04:47.588 --> 04:52.270 [SPEAKER_00]: So both of these hormones just made by specific cells in the ovaries with signals from the brain. 04:52.610 --> 05:00.113 [SPEAKER_00]: So testosterone is a little bit different, it's not made just in the ovaries, also made in the adrenal glands and doesn't have any cyclic fluctuation. 05:01.583 --> 05:08.507 [SPEAKER_00]: There isn't such a linear relationship between each of those hormones and specific bacteria. 05:08.848 --> 05:13.491 [SPEAKER_00]: The one I guess that has the most specific relationship is estrogen. 05:13.831 --> 05:21.215 [SPEAKER_00]: Estrogen gets recycled in the body and broken down into various metabolites, known as the estroglom. 05:21.436 --> 05:23.497 [SPEAKER_00]: But aside from that, you know, basically 05:23.897 --> 05:30.752 [SPEAKER_00]: We're just thinking about this community and how the hormones are talking to the bacteria and vice versa. 05:31.093 --> 05:33.979 [SPEAKER_00]: The bacteria talking to the hormones. 05:34.297 --> 05:58.461 [SPEAKER_01]: Yeah and I guess could you also say that there are some things happening in the gut that predispose to different hormones being made like cholesterol for example and would you also say that maybe the gut hormone access might impact our reproductive hormones via insulin signaling and insulin sensitivity which we know has a huge connection to the gut as well, especially for testosterone with PMOS individuals, would you say that there's a little bit of a connection there? 05:58.721 --> 06:01.562 [SPEAKER_00]: Exactly and that means we think of the two big families. 06:03.742 --> 06:05.664 [SPEAKER_00]: for macudies and bacteriocities. 06:06.064 --> 06:12.189 [SPEAKER_00]: Those are big families of bacteria for macudies when that's high relative to bacteriocities. 06:12.650 --> 06:18.475 [SPEAKER_00]: That's more associated with insulin resistance and diabetes and PMOS. 06:18.815 --> 06:25.220 [SPEAKER_00]: So that's where we get into the relationship of insulin and metabolic factors related to the gut. 06:25.400 --> 06:26.061 [SPEAKER_01]: Yeah, perfect. 06:26.421 --> 06:31.005 [SPEAKER_01]: You did mention before the Astroblom, which I think is one of the most fun words to say. 06:31.025 --> 06:33.787 [SPEAKER_01]: Do you mind explaining what the Astroblom is? 06:33.987 --> 06:37.330 [SPEAKER_01]: And why this concept is so central to understanding women's hormonal health? 06:37.410 --> 06:44.835 [SPEAKER_01]: Does the current evidence actually tell us anything about dispayosis linked to disruptions in the Astroblom and how it relates to women's hormonal health? 06:47.137 --> 06:52.139 [SPEAKER_00]: think of when your body handles estrogen, it has to be detoxified. 06:52.400 --> 06:57.062 [SPEAKER_00]: And so as that starts with your liver, think of your liver is like the bounce or at the door. 06:57.102 --> 06:58.162 [SPEAKER_00]: It's going to see everything. 06:58.302 --> 07:04.565 [SPEAKER_00]: It's going to see your caffeine, your alcohol, your medicines, your supplements, and even your own hormones. 07:04.925 --> 07:10.748 [SPEAKER_00]: So then as things move through the liver pathways like methylation and conjugation, 07:11.368 --> 07:18.854 [SPEAKER_00]: happen to those various substance, including estrogen and estrogen gets metabolized into many different byproducts. 07:18.874 --> 07:21.476 [SPEAKER_00]: So there's not just one estrogen, there's many. 07:21.837 --> 07:26.560 [SPEAKER_00]: And so then these metabolites travel through the gut and that's where the microbiome stops in. 07:26.901 --> 07:35.207 [SPEAKER_00]: And so depending which bacteria they're out, depending on which bacteria are there and how they behave, the estrogen can get recycled 07:36.408 --> 07:40.109 [SPEAKER_00]: bloodstream and some of it gets cleared out through regular bowel movements. 07:40.450 --> 07:43.811 [SPEAKER_00]: So there's a lot of bacteria involved in that process. 07:44.471 --> 07:49.873 [SPEAKER_00]: Some are famously known for producing an enzyme called beta glucoronidase. 07:50.293 --> 07:55.416 [SPEAKER_00]: which essentially flips estrogen back into an active form and it gets reabsorbed. 07:55.716 --> 08:02.961 [SPEAKER_00]: When estrogen gets reabsorbed, it can bind to those same receptors that estrogen that would normally be made also binds to. 08:03.341 --> 08:12.207 [SPEAKER_00]: So this can lead to things like estrogen linked conditions, whether that's fibroids or cancers, other types of growths. 08:12.827 --> 08:15.569 [SPEAKER_00]: So we want to keep our estrogen flowing 08:16.109 --> 08:19.611 [SPEAKER_00]: through our liver and being detoxified through our gut. 08:19.832 --> 08:24.435 [SPEAKER_01]: Yeah, better to click her on today's is turned off by calcium degluderate as that correct. 08:24.975 --> 08:32.740 [SPEAKER_01]: And that type of estradiol, it's that 16 estradiol, it's highly associated with the development of breast cancer fibroids and demetriosis. 08:32.780 --> 08:34.661 [SPEAKER_01]: So we do really want to get rid of this. 08:34.961 --> 08:40.825 [SPEAKER_01]: So the relationship between the gut and mood is increasingly well documented in the context of women's hormonal cycles. 08:40.845 --> 08:43.107 [SPEAKER_01]: What's the specific link that you know of between 08:45.368 --> 08:50.634 [SPEAKER_01]: And just anecdotally, I remember how to client a while ago and she had quite severe PNDD. 08:50.714 --> 08:53.217 [SPEAKER_01]: She had very severe suicidal ideation. 08:53.257 --> 08:54.739 [SPEAKER_01]: She would want to break up with her boyfriend. 08:54.799 --> 08:59.304 [SPEAKER_01]: She would want to quit her job as soon as she had ovulated, like very, very intense PNDD. 08:59.664 --> 09:03.028 [SPEAKER_01]: And she told me a month after I had seen her and she applied all these changes. 09:03.148 --> 09:03.789 [SPEAKER_01]: Hi, took! 09:04.089 --> 09:06.591 [SPEAKER_01]: and antibiotic and my PMDD symptoms have gone away. 09:06.611 --> 09:10.314 [SPEAKER_01]: And I'm not saying to anyone listening to this, go and take an antibiotic, your PMDD will go away. 09:10.634 --> 09:11.935 [SPEAKER_01]: But I said, that's really fascinating. 09:11.955 --> 09:15.578 [SPEAKER_01]: And to me, really spoke to the gut access with our hormones. 09:15.938 --> 09:18.801 [SPEAKER_01]: Could you speak to how PMDD connected to our gut? 09:19.081 --> 09:26.187 [SPEAKER_01]: And what that connection looks like and why that client might have seen that change just by simply changing her gut microbiome? 09:26.367 --> 09:26.667 [SPEAKER_00]: Right. 09:27.003 --> 09:33.545 [SPEAKER_00]: Well, let's start with some of the famous players, a neurotransmitter-wise, that are made in the gut. 09:33.805 --> 09:35.605 [SPEAKER_00]: Of course, we know about serotonin. 09:35.765 --> 09:37.946 [SPEAKER_00]: And serotonin is just one of a few. 09:37.966 --> 09:45.148 [SPEAKER_00]: We have dopamine, norepinephrine, epinephrine, gaba, and they all have various effects on the brain. 09:45.508 --> 09:51.609 [SPEAKER_00]: And so when the microbiome gets disrupted, the signaling of those mood chemicals can also be disrupted as well. 09:51.830 --> 09:53.290 [SPEAKER_00]: So the gut imbalance 09:53.970 --> 10:21.245 [SPEAKER_00]: isn't necessarily the problem, but sometimes it's also individuals are primed to anxiety or depression and then the hormones kind of amplify the imbalance going back to the normal fluctuations of the cycle, progesterine climbs and then drops sharply right before the period and the brain so sensitive to those hormonal ups and downs and then gut, you know, the gut is constantly talking 10:23.754 --> 10:29.737 [SPEAKER_00]: So we think about the chemical messengers, like the serotonin, and the gaba, the calm, and steady state. 10:30.058 --> 10:34.760 [SPEAKER_00]: And when those get out of balance, the hormonal shift is actually a heavier hitter. 10:35.121 --> 10:36.381 [SPEAKER_00]: And that's just inflammation. 10:36.421 --> 10:46.307 [SPEAKER_00]: So when we have the gut lining bacteria that might be abnormal, things like leaky gut or foods that don't agree with your system, that creates inflammation. 10:46.487 --> 10:51.330 [SPEAKER_00]: So then we know that sometimes in PMDD, inflammation is a big driver. 10:51.736 --> 10:53.058 [SPEAKER_00]: And the next is stress. 10:53.338 --> 10:59.125 [SPEAKER_00]: So hormones like cortisol can also leave your neurotransmitters out balance. 10:59.485 --> 11:08.116 [SPEAKER_00]: So that can be like the perfect storm between the chemical messengers, the inflammation, stress signals, and the PMDD is never just in your head. 11:08.156 --> 11:08.256 [SPEAKER_00]: The 11:08.676 --> 11:15.924 [SPEAKER_00]: brain is generally sensitive to those types of hormonal changes and the inflammation that could be happening in your gut. 11:16.144 --> 11:28.236 [SPEAKER_01]: Yeah, so a dispayosis in the gut means that you're not making serotonin in the day, which means you're not making melatonin at night, which can really mess up your circadian rhythm, you're not making dopamine, you're not making serotonin, therefore you don't have your happy drive hormones. 11:28.696 --> 11:37.440 [SPEAKER_01]: So you can feel really really anxious and then you can feel really, really depressed, it's just this roller coaster that I think women experience and I don't think a lot of women really know. 11:37.460 --> 11:50.487 [SPEAKER_01]: And even I remember speaking to a doctor, I think it was last year saying, hey, did you know that serotonin and melatonin of precursors in the gut and your gut has an access with your brain and she was like, no, it's not serotonin is not made in your gut and I just thought, 11:50.707 --> 11:51.047 [SPEAKER_01]: Wow. 11:51.247 --> 11:51.567 [SPEAKER_00]: Okay. 11:51.787 --> 11:54.768 [SPEAKER_01]: And as someone hasn't read the literature in about 13 years, cool. 11:55.789 --> 12:07.053 [SPEAKER_01]: But I thought that was really interesting that there is this huge connection with your gut, and that kind of goes back to what HIPOCRA T says that health really is defined and starts in the gut, and that couldn't be more true for PNDD. 12:07.673 --> 12:18.480 [SPEAKER_01]: Could you please help us differentiate between primary dyspiosis where the microbial structure is out of balance and secondary dyspiosis marked by dwindling metabolic activity and diversity? 12:18.981 --> 12:21.202 [SPEAKER_01]: And why is this distinction really important? 12:21.222 --> 12:33.171 [SPEAKER_01]: Because I think a lot of people understand dyspiosis in the gut is not good, but no one really understands that there's different types of dyspiosis and figuring out which type of dyspiosis you have is really critical to how someone treats you. 12:33.191 --> 12:33.711 [SPEAKER_00]: Yeah. 12:34.011 --> 12:37.514 [SPEAKER_00]: that is a really important and clinically useful distinction. 12:37.694 --> 12:45.119 [SPEAKER_00]: And so I'll use an analogy that I think helps us understand that distinction is that I think of your God as like guest suit a party. 12:45.319 --> 12:49.222 [SPEAKER_00]: And so primary dyspiosis is like a guestless problem. 12:49.382 --> 12:50.703 [SPEAKER_00]: It's like who shows up? 12:50.984 --> 12:52.385 [SPEAKER_00]: It's the wrong crowd. 12:52.925 --> 12:55.386 [SPEAKER_00]: They're not the people you want to be at the party. 12:55.646 --> 12:58.727 [SPEAKER_00]: And so the party doesn't go according to plan. 12:58.907 --> 13:01.727 [SPEAKER_00]: Secondary dyspiosis is something else going on. 13:01.767 --> 13:03.628 [SPEAKER_00]: It's like the right people are there. 13:04.108 --> 13:05.909 [SPEAKER_00]: They're not behaving how they should. 13:06.289 --> 13:08.629 [SPEAKER_00]: So there's something upstream that's driving it maybe. 13:08.649 --> 13:14.111 [SPEAKER_00]: There was a fight earlier, maybe there was something in the news that caused people's moods to be off. 13:14.471 --> 13:14.611 [SPEAKER_00]: So 13:15.258 --> 13:19.440 [SPEAKER_00]: It's about the community structure in primary dysbiosis. 13:19.800 --> 13:26.242 [SPEAKER_00]: And then secondary dysbiosis is about function in response to something else. 13:26.502 --> 13:35.405 [SPEAKER_00]: So primary dysbiosis, a great example of something that would drive that would be taking antibiotics, like you just spoke to, a bad infection. 13:35.605 --> 13:39.787 [SPEAKER_00]: Sudden extreme diet changes, prolonged fasting, 13:40.243 --> 13:41.083 [SPEAKER_00]: things like that. 13:41.444 --> 13:46.807 [SPEAKER_00]: And then secondary really shows up in the context of something that's pre-existing. 13:47.107 --> 13:54.972 [SPEAKER_00]: Like diabetes we talked about was different families of bacteria that can be influenced by insulin resistance or long-term medication use. 13:55.012 --> 13:57.373 [SPEAKER_00]: There's more upstream drivers. 13:57.573 --> 14:06.258 [SPEAKER_00]: And so it's important for treatment them because if someone tells me, you know, they haven't been well since they had C-diff, well we think, all right, it's the people at the party. 14:06.698 --> 14:07.479 [SPEAKER_00]: Whereas if someone 14:10.125 --> 14:12.926 [SPEAKER_00]: Okay, well, it's the metabolic issue that's systemic. 14:13.106 --> 14:16.247 [SPEAKER_00]: We really need to work on that will help regulate the gut. 14:16.447 --> 14:17.747 [SPEAKER_01]: That was so beautifully explained. 14:17.827 --> 14:20.528 [SPEAKER_01]: I love the bouncer in the liver, the people at the party. 14:20.548 --> 14:30.251 [SPEAKER_01]: I think that's really wonderful and it's really great to just visualize that if you have people in the party who are not making short chain fatty acids and they're drinking all the booze and they're bringing the vibe down. 14:30.471 --> 14:31.671 [SPEAKER_01]: That's a people problem. 14:31.691 --> 14:34.772 [SPEAKER_01]: You need to clear them out with an antibiotic and get the bounces in there and get them out. 14:35.012 --> 14:37.453 [SPEAKER_01]: that might have been that person with PMDD, right? 14:37.853 --> 14:43.156 [SPEAKER_01]: But if you're having a situation where the right people are there and you do a stool test adding more people into the party. 14:43.216 --> 14:45.357 [SPEAKER_01]: So going, okay, there's heaps of lack of a sealer sealer. 14:45.377 --> 14:46.937 [SPEAKER_01]: Let's just add more with a probiotic. 14:47.317 --> 14:53.640 [SPEAKER_01]: That's not going to fix the problem because it's not that maybe these people aren't drinking the glucose and they're not producing short-chain fatty acids. 14:53.660 --> 14:55.801 [SPEAKER_01]: I think that's a really great way to think about it. 14:55.821 --> 15:02.144 [SPEAKER_01]: And it really goes back to that original point that I made before that just taking you probiotic or just eating more fermented foods might not be the answer for you 15:04.905 --> 15:12.948 [SPEAKER_01]: And maybe you need to clear out the people, or add in the right people, or if it's we can maybe do some nonviolent communication training with the people at the party. 15:13.508 --> 15:15.448 [SPEAKER_01]: Get them to do their job, right? 15:15.808 --> 15:17.969 [SPEAKER_01]: Next, let's go into the reproductive year. 15:17.989 --> 15:19.250 [SPEAKER_01]: So let's cycling years. 15:19.330 --> 15:26.712 [SPEAKER_01]: So when you're having your period, so before you have so as you're having your first mincees, so you're first menac up to Perry menopause. 15:27.112 --> 15:30.133 [SPEAKER_01]: So estrogen and progesterone rise and fall throughout the menstrual cycle. 15:30.413 --> 15:35.394 [SPEAKER_01]: You've spoken about this before, but is there any inclination that the microbiota responds? 15:35.434 --> 15:40.576 [SPEAKER_01]: Do we see any consistent patterns in microbiome shifts throughout the cycle for women who are cycling? 15:40.976 --> 15:43.497 [SPEAKER_01]: Or is it kind of just a steady state that we're seeing? 15:43.517 --> 15:48.398 [SPEAKER_01]: We know we see a pretty distinct change in the vaginal microbiome, but do we see it in the gut microbiome? 15:48.478 --> 15:49.899 [SPEAKER_00]: Yeah, that's an interesting question. 15:50.139 --> 15:51.239 [SPEAKER_00]: And what I've 15:51.619 --> 15:58.964 [SPEAKER_00]: found is that there aren't big shifts throughout the menstrual cycle and studies that tracks stool samples across the cycle. 15:59.124 --> 16:08.089 [SPEAKER_00]: They didn't see any big swings across diversity and overall composition that would like to line up neatly with each phase of the cycle. 16:08.389 --> 16:15.053 [SPEAKER_00]: And so it is present certainly those sorts of shifts are present in the vaginal microbiome 16:19.596 --> 16:19.976 [SPEAKER_01]: wonderful. 16:20.637 --> 16:25.859 [SPEAKER_01]: So many women they report distinct GI symptoms across their cycle, like bloating, constipation and diarrhea. 16:26.279 --> 16:29.421 [SPEAKER_01]: I think the very common story for women is in their ludial phase. 16:29.661 --> 16:33.723 [SPEAKER_01]: It's a little bit of constipation and on day one of their period, they appear at poo. 16:33.743 --> 16:34.623 [SPEAKER_01]: So all the poo's said they're crying. 16:34.643 --> 16:38.624 [SPEAKER_01]: who would have had during their linear phase there, having on their period and it's a little bit overwhelming. 16:38.964 --> 16:42.345 [SPEAKER_01]: We could put that down to Prostaglandans, we could put that down to progesterone. 16:42.765 --> 16:46.766 [SPEAKER_01]: But the hormonal shifts, do you mind explaining what that is? 16:46.926 --> 16:57.708 [SPEAKER_01]: And so if it's not microbiome shifts, what is creating this change in GI symptoms, that I think a lot of women might connect to the microbiome, which we know isn't really the cause in this case. 16:58.588 --> 17:01.589 [SPEAKER_00]: Yeah, it's one of those upstream drivers, right? 17:01.709 --> 17:18.475 [SPEAKER_00]: So you mentioned prostaglandins that ramp up and suddenly, you swing the other way into diarrhea if, you know, towards the beginning of the cycle, those prostaglandins spill into general circulation and up, contraction. 17:18.515 --> 17:27.979 [SPEAKER_00]: So that doesn't neatly stay in your uterus when you shed your lining, but it also goes systemic, which is low-grade inflammation and altered immune signaling. 17:28.318 --> 17:39.776 [SPEAKER_00]: So, if your gut is already primed to those sorts of irritations and you layer on the hormone with jaws and the prostaglandin bursts, it's like throwing fuel on to the fire. 17:40.157 --> 17:43.081 [SPEAKER_00]: So, day-to-day symptoms might get magnified there. 17:43.722 --> 17:45.142 [SPEAKER_01]: What would you recommend for these women? 17:45.202 --> 17:49.864 [SPEAKER_01]: So prostate landings could be things like omega-3s and maybe more fiber. 17:49.964 --> 17:57.646 [SPEAKER_01]: Like what would you recommend to a woman presenting in your clinic who says, I've constipation for five days and then I've period poo's have all this bloating and GI distress. 17:57.666 --> 17:58.626 [SPEAKER_01]: Like what would you recommend? 17:58.646 --> 18:01.347 [SPEAKER_01]: Like what are the three things that you think most important in that case? 18:01.567 --> 18:04.948 [SPEAKER_00]: I think fish oil and omega-3s are so important. 18:05.088 --> 18:09.950 [SPEAKER_00]: EPA and DHA are my favorite anti-inflammatory tools. 18:10.150 --> 18:10.830 [SPEAKER_00]: Additionally, I think 18:11.210 --> 18:38.142 [SPEAKER_00]: magnesium and there's different types of magnesium so you have to choose the right one one that kind of works with the body with muscle contraction like calming magnesium magnesium glycinate can be really helpful and then I always also think about maybe shifting nutrition a little bit towards the end of the cycle maybe ramping up soluble fibers so fibers that help absorb water things like psyllium or ground flax seeds are good examples of that 18:38.542 --> 18:43.365 [SPEAKER_00]: and that can help make up for the increase in the motility and absorb water. 18:43.425 --> 18:45.626 [SPEAKER_00]: So stools can become a little bit more formed. 18:46.486 --> 18:46.846 [SPEAKER_01]: Beautiful. 18:46.926 --> 18:50.508 [SPEAKER_01]: And would you also recommend perhaps blood sugar balancing as well? 18:50.608 --> 19:05.015 [SPEAKER_01]: So making sure you're eating fats, carbohydrates and proteins and equal variations and making sure you're eating a lot of fiber with carbohydrates sources to make sure that your blood sugar balance is happening as well because we know that blood sugar regulation problems can have an impact on the GI system as well. 19:05.055 --> 19:05.916 [SPEAKER_01]: Could you speak to that? 19:08.217 --> 19:12.360 [SPEAKER_00]: I like to share with my patients a visual and think of this divided plate. 19:12.441 --> 19:17.344 [SPEAKER_00]: So there's the 50% portion of the plate and then there's the two quarter sections of the plate. 19:17.765 --> 19:20.767 [SPEAKER_00]: The 50% portion should be vegetable fiber. 19:20.947 --> 19:30.235 [SPEAKER_00]: One of the quarter sections of the plate should be protein and then the last quarter section would be a carbohydrate, so like a potato or rice. 19:30.775 --> 19:35.199 [SPEAKER_00]: So that type of plate should keep your blood sugar really balanced. 19:35.540 --> 19:46.830 [SPEAKER_00]: Some individuals are more susceptible to grain sensitivity where they might have a higher spike and therefore require less servings per day, perhaps, or serving quantity of grains. 19:47.390 --> 19:53.235 [SPEAKER_00]: But the basic plate portions to focus on would be the vegetable fiber protein. 19:53.315 --> 19:56.998 [SPEAKER_00]: I didn't mention healthy fats, but those are important to have on each plate. 19:57.258 --> 19:58.019 [SPEAKER_01]: Yeah, absolutely. 19:58.399 --> 20:00.101 [SPEAKER_01]: Let's go back to PMDD. 20:00.121 --> 20:06.246 [SPEAKER_01]: And when it comes to PMDD, could dyspiosis act as both the trigger and the result of underlying inflammation and metabolic chaos? 20:06.686 --> 20:11.747 [SPEAKER_01]: What does the latest evidence reveal about restoring the microbiota as a potential therapy for PNDD? 20:11.767 --> 20:17.449 [SPEAKER_01]: So we touched on this lightly before, maybe we could go a little bit deeper into PNDD and its connection to the GAHIA. 20:17.549 --> 20:17.849 [SPEAKER_01]: Sure. 20:18.189 --> 20:29.072 [SPEAKER_00]: Well, this is really fascinating because I think that's one of the most exciting research frontiers in gut health is linking specific conditions to maybe specific bacteria. 20:30.072 --> 20:35.073 [SPEAKER_00]: So there are some nicely designed studies that are looking at specific 20:35.513 --> 20:36.313 [SPEAKER_00]: bacteria. 20:36.513 --> 20:47.758 [SPEAKER_00]: Some of the names are tricky to say, but one strain in particular called lactobacillus perigasary that can actually help improve PMDD symptoms. 20:48.418 --> 21:00.002 [SPEAKER_00]: So I think what's interesting is that hopefully we continue to learn how specific bacteria behave and then how they affect neurotransmitters being made in our gut. 21:00.162 --> 21:01.363 [SPEAKER_00]: So it's promising to see 21:05.044 --> 21:05.745 [SPEAKER_01]: Okay, amazing. 21:05.785 --> 21:08.287 [SPEAKER_01]: And so what would that look like for a woman with P.M.D.D. 21:08.307 --> 21:11.109 [SPEAKER_01]: for example, would she come in, have a stool test? 21:11.229 --> 21:19.275 [SPEAKER_01]: We can look at what her microbiome looks like, and then go, oh, there's actually gaps here that we see when we have low amounts of this or high amounts of this that's associated with this system. 21:19.676 --> 21:27.742 [SPEAKER_01]: And you can supplement in specific microbiome players like Laptopacillus, for example, like what you just said and see an improvement in her symptoms. 21:27.762 --> 21:28.883 [SPEAKER_01]: It has that being used or 21:29.483 --> 21:31.364 [SPEAKER_01]: They're just going, okay, this is a pilot study. 21:31.604 --> 21:38.788 [SPEAKER_01]: We've seen this a connection and then maybe the backup study after that would be applying that knowledge and seeing if that can be used clinically. 21:38.808 --> 21:42.290 [SPEAKER_01]: Do you think there's a possibility for that to be used for women with P&D? 21:42.390 --> 21:50.455 [SPEAKER_00]: Yeah, it's rarely a one-size-fits-all is the first thing and in research, you know, they like cause and effect and more linear relationships. 21:50.975 --> 21:55.518 [SPEAKER_00]: But I think it might be more multifactorial than just a single probiotic because 21:55.938 --> 22:06.240 [SPEAKER_00]: We have to think about the whole microbiome, and if we're not eating enough fiber-rich foods to make short-chain fatty acids, then maybe those probiotics won't work so well. 22:06.760 --> 22:17.182 [SPEAKER_00]: So I think it has to be a multifactorial approach where we're taking into dietary strategies, fiber, and supporting the gut as a whole, and then adding in some specific strains. 22:17.522 --> 22:19.702 [SPEAKER_00]: The limitation that gut microbiome testing 22:24.016 --> 22:26.418 [SPEAKER_00]: more are some of these strains commercially available. 22:26.878 --> 22:33.564 [SPEAKER_00]: So microbiome testing gives us a nice overview, but it can't always point to the specifics. 22:34.605 --> 22:35.005 [SPEAKER_01]: Wonderful. 22:35.145 --> 22:35.565 [SPEAKER_01]: Thank you. 22:36.086 --> 22:41.350 [SPEAKER_01]: PCOS now known as PMOS is closely tied to insulin resistance and chronic inflammation. 22:41.851 --> 22:47.495 [SPEAKER_01]: How does dyspiosis both fuel and stem the metabolic turmoil in PMOS? 22:47.515 --> 22:49.537 [SPEAKER_01]: And when I say metabolic turmoil, I say, 22:49.977 --> 23:02.405 [SPEAKER_01]: really ingrained insulin resistance that we see in about 95% of patients with PMOS, regardless of whether they are overweight or obese or not, and what does the gut microbiome play in managing these hydrogen levels as well? 23:02.425 --> 23:03.766 [SPEAKER_01]: So there are a few pieces to this puzzle. 23:03.786 --> 23:15.673 [SPEAKER_01]: We have a one-on-one with PMOS, and how do antigens and insulin play into the gut, and how does the gut play into these hormones that can cause all of these different hormonal cascades and symptoms that women with PMOS experience? 23:15.893 --> 23:16.173 [SPEAKER_00]: Yeah. 23:16.373 --> 23:25.921 [SPEAKER_00]: Well, the name PMLS is a much better name for the condition because it reflects that the ovaries aren't really the central problem. 23:25.961 --> 23:29.663 [SPEAKER_00]: They're a result of that metabolic issue that you just described. 23:29.903 --> 23:35.808 [SPEAKER_00]: And how I'll explain it to patients sometimes is thinking about you have diabetes in your ovary. 23:36.068 --> 23:41.352 [SPEAKER_00]: It's not always systemic insulin resistance or diabetes or obesity. 23:41.772 --> 23:56.958 [SPEAKER_00]: see a lot of women that are lean and don't have any metabolic markers that are abnormal, but we're still going to work on blood sugar regulation and insulin resistance as a part of any PMOS case. 23:57.158 --> 24:05.701 [SPEAKER_00]: So when we look at women with PMOS the main thing is that there's been shifts in microbial diversity which bacteria are present so 24:06.242 --> 24:10.084 [SPEAKER_00]: This might be a good example of the secondary dyspiosis. 24:10.224 --> 24:13.225 [SPEAKER_00]: There's an upstream driver in those metabolic changes. 24:13.565 --> 24:23.409 [SPEAKER_00]: So lower diversity in the gut can track with higher total testosterone and the classic signs of the Androgen dominance that we see in PMOs. 24:23.869 --> 24:33.033 [SPEAKER_00]: Also, when there's less diversity in the gut, the intestinal barrier can become weak, get more permeable, and information can become systemic. 24:33.407 --> 24:39.952 [SPEAKER_00]: So this low-grade inflammation can also interfere with how hormones are being signaled to be produced. 24:40.292 --> 24:47.558 [SPEAKER_00]: And then that feedback on the brain can further drive the dysfunction between what hormones are being made in the ovary. 24:47.798 --> 24:52.902 [SPEAKER_01]: And that's the thing that I think was really popular a few years ago with the rise of the obsession with the gut was like you got. 24:53.222 --> 24:55.384 [SPEAKER_01]: Do you mind explaining to us really quickly what this is? 24:55.624 --> 24:58.486 [SPEAKER_01]: I guess the official name for it is intestinal hyper permeability. 24:58.866 --> 25:06.551 [SPEAKER_01]: And what that might mean, because I think a lot of people go, okay, leaky gut inflammation, but how, for everyone listening, inflammation is a tool used by our white blood cells. 25:06.571 --> 25:12.914 [SPEAKER_01]: It might be from things like histamine's and cytokines, and they create these big storm to create space and do their job, basically. 25:12.954 --> 25:19.258 [SPEAKER_01]: But what does that mean when we connect the gut with it being a hearted permeable and also our white blood cells? 25:19.298 --> 25:21.439 [SPEAKER_01]: And what does that mean for women with PMOS? 25:21.779 --> 25:22.039 [SPEAKER_00]: Right. 25:22.560 --> 25:25.902 [SPEAKER_00]: So with leaky gut, basically what's happened is 25:28.720 --> 25:29.260 [SPEAKER_00]: permeable. 25:29.520 --> 25:37.384 [SPEAKER_00]: So that just means, you know, our nutrients, our vitamins, our minerals and amino acids should get through into our bloodstream. 25:37.524 --> 25:39.045 [SPEAKER_00]: Of course, that's how we get nourished. 25:39.385 --> 25:52.031 [SPEAKER_00]: But when it becomes inflamed, the gut lining becomes more permeable to toxins, to abnormal bacteria, medicines, you know, foods that might be more pro-inflammatory. 25:52.371 --> 25:52.651 [SPEAKER_00]: And then, 25:54.039 --> 25:56.881 [SPEAKER_00]: that can give rise to inflammation. 25:57.481 --> 26:02.765 [SPEAKER_00]: And when inflammation is present, that can affect the way that our body processes are food. 26:02.785 --> 26:12.251 [SPEAKER_00]: It might have a harder time responding to the insulin signal and using insulin to adequately metabolize glucose into the cell. 26:12.671 --> 26:13.952 [SPEAKER_00]: And so when that happens, when 26:14.552 --> 26:24.956 [SPEAKER_00]: glucose is stuck in a sense that can increase androgen levels in women with PMOs, causing that irregular follicular development and irregular ovulation patterns. 26:25.256 --> 26:25.636 [SPEAKER_01]: Wonderful. 26:25.676 --> 26:27.136 [SPEAKER_01]: You've played that so beautifully. 26:27.196 --> 26:27.716 [SPEAKER_01]: Thank you. 26:27.796 --> 26:28.977 [SPEAKER_01]: Let's move on to pregnancy. 26:29.657 --> 26:40.225 [SPEAKER_01]: I think this is where a lot of women start to see changes in their vaginal microbiome, but also in their gut microbiome, which I think is a little bit hard for women to figure out because they have a growing a big fetus and everything is changing. 26:40.946 --> 26:46.730 [SPEAKER_01]: Pregnancy brings these huge hormonal changes and research is revealing striking shifts in maternal microbiomes. 26:47.410 --> 26:51.192 [SPEAKER_01]: What drives these change and how do they impact the health of both mother and baby? 26:51.372 --> 26:54.613 [SPEAKER_00]: Yeah, well let's put these hormonal shifts into perspective. 26:54.793 --> 27:03.657 [SPEAKER_00]: So by the third trimester, estrogen can be roughly 20 to 50 times higher than the peak in any regular menstrual cycle. 27:03.897 --> 27:10.519 [SPEAKER_00]: So across a single present pregnancy, your body produces more estrogen during like all of your non-pregnant years combined. 27:10.940 --> 27:12.300 [SPEAKER_00]: So think then about how your 27:14.846 --> 27:15.967 [SPEAKER_00]: has a lot of work to do. 27:16.147 --> 27:23.330 [SPEAKER_00]: We talked about the estroblem and we talked about, you know, this ratio of two families for Mickey D's bacteria ways. 27:23.670 --> 27:30.314 [SPEAKER_00]: So what happens is that in pregnancy, to some extent, all women become insulin resistant. 27:30.514 --> 27:31.474 [SPEAKER_00]: And that's by design. 27:31.594 --> 27:34.996 [SPEAKER_00]: We want fuel for the baby, no matter what, feast or famine. 27:35.216 --> 27:42.680 [SPEAKER_00]: And so it is important to some extent that your microbiome actually shifts to accommodate that increased energy need 27:44.928 --> 27:54.335 [SPEAKER_00]: However, you know, if it tips too far, there's problems that can show up like distational diabetes or pre-clampsia or weight gain. 27:54.635 --> 28:04.203 [SPEAKER_00]: So in summary, it's somewhat unavoidable, but also there's a tipping point where it might lead to more problems with the microbial shifts. 28:04.581 --> 28:12.384 [SPEAKER_01]: The more I learn about pregnancy, the more I am just surprised and in awe of the power and the intelligence of the female body, it's just absolutely incredible. 28:12.404 --> 28:19.567 [SPEAKER_01]: Could go to the dyspiosis during pregnancy raise the risk of gestational diabetes preoclampsia or poor health outcomes. 28:20.167 --> 28:26.390 [SPEAKER_01]: And what does the latest research indicate and are there any particular microbes or metabolic markers linked to these risks? 28:26.470 --> 28:29.351 [SPEAKER_01]: You just talked about gestational diabetes and preoclampsia. 28:29.791 --> 28:34.313 [SPEAKER_01]: What about other pull-out comes and do these possibly pass on to the fetus as well? 28:34.493 --> 28:34.853 [SPEAKER_00]: Yeah. 28:35.053 --> 28:46.098 [SPEAKER_00]: So on gestational diabetes, I think the insulin resistance is the driver, the reduced diversity, altered bacterial ratios, and those bugs that really want to harvest energy. 28:46.318 --> 28:51.621 [SPEAKER_00]: And so with pre-clampsia, the lower diversity can be associated with inflammation. 28:51.821 --> 28:56.483 [SPEAKER_00]: And so then with inflammation, you know, can come the leaky gut that we talked about. 28:56.843 --> 29:03.225 [SPEAKER_00]: more prone inflammatory and more toxic to the blood vessels, making them less responsive to normal signaling mechanisms. 29:03.445 --> 29:12.388 [SPEAKER_00]: And poor birth outcomes, you know, um, oral, and vaginal and even gut microbiomes had been linked to preterm birth, grocery restriction, this carriage. 29:12.608 --> 29:24.832 [SPEAKER_00]: And particularly in women with PCOS, some of the metabolic markers can be associated with premature aging of the um, uterine lining in pregnancy. 29:25.032 --> 29:25.152 [SPEAKER_00]: So 29:25.572 --> 29:33.176 [SPEAKER_00]: It's really important to address the gut microbiome for all those reasons and to think of the gut as treating the gut as being prevention. 29:33.496 --> 29:47.303 [SPEAKER_01]: And treating the gut as a part of our metabolism, I think a lot of people think of the mitochondria, everyone's obsessed with the mitochondria at the moment, thinking about the liver, thinking about the pancreas, but no one really takes into account the gut and how important it is as an insulin resistance prevention tool. 29:47.923 --> 29:52.726 [SPEAKER_01]: And if we look at the gut in pregnancy, it can also help to prevent gestational diabetes 29:55.047 --> 30:02.893 [SPEAKER_01]: I think they're becoming more and more common, which means that more and more people are used to it, but I don't think we should normalise dysfunction in any sense of the word, especially during pregnancy. 30:03.373 --> 30:14.402 [SPEAKER_01]: Speaking about mood changes, there's a common during pregnancy and after birth, to what extent do these shifts in the microbiota and inflammation from dyspiosis be responsible for these emotional ups and downs? 30:14.442 --> 30:21.067 [SPEAKER_01]: Or would you say it's mostly that huge hormone or shift going from that huge amount of progesterone and estrogen, and then after the birth of 30:22.768 --> 30:25.910 [SPEAKER_01]: Do we see any interaction with the microbiome, yeah, and in the gut? 30:26.071 --> 30:27.031 [SPEAKER_00]: Yeah, I think you're right. 30:27.111 --> 30:29.453 [SPEAKER_00]: I think that that is probably the main driver. 30:29.513 --> 30:44.083 [SPEAKER_00]: These huge shifts in hormones from pregnancy to postpartum, coupled with, you know, sleep is changing, your diet changes, you know, antibiotics that may or may not present during delivery. 30:44.423 --> 30:50.207 [SPEAKER_00]: So it can be a perfect storm of change for the microbiome. 30:51.388 --> 31:04.518 [SPEAKER_00]: I think that the important thing to do is think about how we can correct for those big swings through nutrition, thinking about gut health in the simplest terms is going back to 31:05.025 --> 31:13.813 [SPEAKER_00]: healthy nutrition, regular movement, protecting your sleep as much as your new baby allows and avoiding antibiotics if you can. 31:14.153 --> 31:17.756 [SPEAKER_00]: That's part of protecting the resilience factor after birth. 31:18.156 --> 31:21.860 [SPEAKER_01]: Do we see any huge shift with pregnancy and then off to birth? 31:22.280 --> 31:28.906 [SPEAKER_01]: And is the microbiome of say, hey, if I feel pregnant right now, would my microbiome before being pregnant and then off to being pregnant? 31:29.326 --> 31:31.046 [SPEAKER_01]: and giving birth be different. 31:31.447 --> 31:38.588 [SPEAKER_01]: Do we see any changes with like microbiome shifts with women after their pregnancies and after they've given birth that might relate to fetal health? 31:38.688 --> 31:54.032 [SPEAKER_00]: I think that is fascinating and I think it has to and I think that it goes back to that multi-factorial cause that could be related to not only the hormonal shifts but also everything else that goes along in the postpartum state. 31:54.372 --> 31:58.233 [SPEAKER_00]: So yeah the the the differences might be very 31:59.346 --> 32:11.055 [SPEAKER_00]: But I think women, when they go back to their baseline, as far as post breastfeeding, cycling normally again, that the microbiome is probably similar. 32:11.596 --> 32:20.563 [SPEAKER_01]: And then for women who are planning a pregnancy or already expecting, which proven dietary supplement or lifestyle strategies best note show the microbiota and promote healthy outcome? 32:20.603 --> 32:22.144 [SPEAKER_01]: What are you repeating? 32:22.184 --> 32:23.826 [SPEAKER_01]: Are you saying, South crowd a lot? 32:23.906 --> 32:25.387 [SPEAKER_01]: Are you saying, so you will fire by? 32:25.407 --> 32:27.288 [SPEAKER_01]: What are the things that you're recommending to these women? 32:28.149 --> 32:43.253 [SPEAKER_00]: So pre-conception planning is so important, so I think that's a under-recognized tool of how to prepare women not only for conception, but also this translate to health throughout the lifespan of the child. 32:43.653 --> 32:49.314 [SPEAKER_00]: So it's not something to just gloss over and say here take a prenatal vitamin and call it a day. 32:49.594 --> 32:55.536 [SPEAKER_00]: So the things that I say over and over again are to eat a diverse and fiber-rich 32:57.726 --> 33:01.948 [SPEAKER_00]: So diverse just means don't eat the same things over and over again. 33:02.228 --> 33:05.970 [SPEAKER_00]: Try and buy new foods each week, eat seasonally. 33:06.610 --> 33:14.194 [SPEAKER_00]: And because a diet should be mostly plant-based, to me that means that 50% portion of the plate filled with vegetables at every meal. 33:14.494 --> 33:16.655 [SPEAKER_00]: We still want include proteins and carbs. 33:17.016 --> 33:19.797 [SPEAKER_00]: And then minimally process, think of foods like, 33:20.208 --> 33:25.453 [SPEAKER_00]: foods without a sugar, alcohol, caffeine, as treat foods. 33:25.673 --> 33:29.537 [SPEAKER_00]: As far as like fermented foods, those can also be really helpful. 33:29.958 --> 33:35.403 [SPEAKER_00]: Things like yogurt, miso, kefir, sauerkraut, kimchi, 33:35.750 --> 33:37.591 [SPEAKER_00]: I think there's kind of a tipping point there. 33:37.771 --> 33:43.375 [SPEAKER_00]: I've seen and practiced that sometimes people over consume those food groups, thinking they're so good for you. 33:43.936 --> 33:48.059 [SPEAKER_00]: And then might end up with some digestive troubles as a result. 33:48.479 --> 33:57.906 [SPEAKER_00]: So it's good to have some exposure to those foods, but not over exposure, and maybe your gut will tell you if there's a issue with how much you're consuming. 33:58.226 --> 33:58.546 [SPEAKER_01]: Awesome. 33:58.686 --> 33:59.007 [SPEAKER_01]: All right. 33:59.347 --> 34:01.909 [SPEAKER_01]: I'm really surprised that pregnant women can overdo it. 34:01.949 --> 34:04.291 [SPEAKER_01]: I think that's the first thing at least for my friends. 34:04.771 --> 34:07.934 [SPEAKER_01]: That experience pregnancy is that the last thing they want to eat is sourcrow out. 34:08.214 --> 34:08.575 [SPEAKER_01]: Yeah. 34:08.735 --> 34:10.656 [SPEAKER_01]: I don't want to force themselves. 34:10.896 --> 34:15.100 [SPEAKER_01]: I've seen my friends block their nose and force themselves to have their spoon of sourcrow out daily. 34:15.120 --> 34:17.942 [SPEAKER_01]: It's so surprised that women have been overdoing it. 34:18.282 --> 34:19.664 [SPEAKER_01]: Let's go into the metaphors. 34:19.884 --> 34:23.467 [SPEAKER_01]: So do you mind quickly just explaining what menopause is for our listeners? 34:23.507 --> 34:26.169 [SPEAKER_01]: Because I still think in the zeitgeist of women's health, we don't actually 34:27.890 --> 34:32.271 [SPEAKER_01]: And then we can stop talking about what menopoles is in relation to the got micro biome. 34:32.431 --> 34:37.433 [SPEAKER_00]: Yeah, I think that's really important because the terminology is confusing and it gets mixed up. 34:37.593 --> 34:43.254 [SPEAKER_00]: So starting with carry menopause, that's the time period leading up to the pause. 34:43.274 --> 34:48.456 [SPEAKER_00]: So maybe it's five to ten years before you have your last period. 34:48.676 --> 34:50.656 [SPEAKER_00]: So then comes the menopause. 34:50.976 --> 34:56.738 [SPEAKER_00]: It's technically that one year period after your final period, it's the waiting. 34:57.019 --> 34:59.461 [SPEAKER_00]: Are you going to get another period and my done. 35:00.401 --> 35:04.142 [SPEAKER_00]: And then the postmenopause are all the years that follow. 35:04.962 --> 35:05.602 [SPEAKER_01]: Okay, wonderful. 35:05.862 --> 35:07.483 [SPEAKER_01]: And they say that menopause is one day. 35:07.723 --> 35:12.124 [SPEAKER_01]: It's the day that after a year of you not having a period, you have entered menopause. 35:12.584 --> 35:18.925 [SPEAKER_01]: So we're talking to you women listening who are in menopause and you've passed that year where you haven't had a mincee. 35:18.985 --> 35:25.427 [SPEAKER_01]: So when this arrives, this one singular day in beyond and estrogen levels plummet, how does the microbiota react? 35:25.507 --> 35:27.647 [SPEAKER_01]: Does dyspiosis become more common or severe 35:30.488 --> 35:31.529 [SPEAKER_00]: Yeah, absolutely. 35:32.150 --> 35:50.287 [SPEAKER_00]: It's interesting because the microbiome becomes less diverse in response to the absence of estrogen, and it actually starts to look more like a male microbiome, which can be associated with central obesity, hypertension, more inflammatory, 35:50.727 --> 35:51.968 [SPEAKER_00]: or metabolic markers. 35:52.308 --> 35:54.309 [SPEAKER_00]: And of course, there's the vaginal microbiome too. 35:54.389 --> 35:56.489 [SPEAKER_00]: We know that that's influenced by estrogen. 35:56.729 --> 36:03.972 [SPEAKER_00]: And so the aftermenopause, the lower estrogen doesn't just affect, you know, hot flashes and mood. 36:03.992 --> 36:05.493 [SPEAKER_00]: It really does reshape your gut. 36:05.833 --> 36:13.596 [SPEAKER_00]: Less diverse fewer species that are more protective and more that promote inflammation insulin resistance and therefore weight gain. 36:13.616 --> 36:15.057 [SPEAKER_00]: Sometimes women will tell me that 36:15.437 --> 36:25.806 [SPEAKER_00]: you know, they've been the same weight, their whole lives, and now they're on a new diet, and new exercise plan, and they just can't quite crack the code on what to do. 36:26.166 --> 36:38.716 [SPEAKER_00]: And so, I think that thinking about the microbiome in this context can be really important, and how do we get the microbiome back to more looking like you are in your pre-menopausal years. 36:39.517 --> 36:54.219 [SPEAKER_01]: Going on from that, you just spread out pop flashes, mood swings, memory changes, and metabolic shifts like weight gain and a higher heart health risk, which are really concerning and I think a lot of women with perimenopause and menopause go, oh, you know, I'm just having another half hot flash or I can't sleep tonight. 36:54.659 --> 36:56.220 [SPEAKER_01]: I don't think we should normalize this dysfunction. 36:56.260 --> 37:01.783 [SPEAKER_01]: These are really serious symptoms that need to be taken very seriously, just because throughout history we haven't taken them seriously. 37:01.803 --> 37:02.964 [SPEAKER_01]: It doesn't mean we shouldn't now. 37:02.984 --> 37:09.568 [SPEAKER_01]: How much does this biosis explain or worse in these symptoms, especially as estrogen's influence on the microbiota fades? 37:09.608 --> 37:17.193 [SPEAKER_01]: And I would also say we're seeing more influence from insulin resistance and possibly high IGF1, and we know that that can increase inflammation. 37:17.673 --> 37:19.014 [SPEAKER_01]: in the gut specifically. 37:19.355 --> 37:24.319 [SPEAKER_01]: Do you mind answering that question just on like how these are connected to the gut specifically? 37:24.339 --> 37:24.800 [SPEAKER_00]: Mm-hmm. 37:25.020 --> 37:29.464 [SPEAKER_00]: Yeah, so the estrogen drop changes the microbiome composition. 37:29.804 --> 37:33.768 [SPEAKER_00]: And so a disrupted gut doesn't necessarily cause the symptoms. 37:34.008 --> 37:36.110 [SPEAKER_00]: It acts more like an amplifier. 37:36.470 --> 37:42.516 [SPEAKER_00]: So when those imbalance microbiome changes in the hot flashes, the mood, the way 37:44.185 --> 37:46.027 [SPEAKER_00]: it can affect the gut brain signaling. 37:46.687 --> 37:50.090 [SPEAKER_00]: And so I think that there's a few things to pick apart here. 37:50.210 --> 38:01.019 [SPEAKER_00]: So first on like mood and brain fog with the lower diversity, the that can influence serotonin, GABA production, and inflammation. 38:01.199 --> 38:06.043 [SPEAKER_00]: And that disrupts the gut, um, the neuro-transmiller signaling access. 38:06.503 --> 38:11.028 [SPEAKER_00]: So dysthiosis then is generally linked to higher anxiety and depression. 38:11.348 --> 38:20.458 [SPEAKER_00]: And then on weight gain and heart risk, post-menopausal women with that more male-like gut, that's what can contribute to the insulin resistance and the astral below. 38:21.467 --> 38:29.474 [SPEAKER_00]: can become especially more important after the ovary stop making estrogen, your gut's handling of estrogen matters more than ever. 38:29.814 --> 38:36.620 [SPEAKER_00]: So we want the dysbiosis so that we want the bacteria to handle estrogen appropriately. 38:37.040 --> 38:39.062 [SPEAKER_00]: so that that estrogen gets recycled. 38:39.382 --> 38:53.896 [SPEAKER_00]: And then so it's back to supporting gut health through fiber, diet and management of sleep and stress, especially with women that don't want to go on hormone replacement because sometimes that is a really good fix. 38:54.356 --> 38:56.618 [SPEAKER_00]: It can help restore the gut microbiome 39:01.683 --> 39:07.645 [SPEAKER_01]: That was my next question was, okay, what about if people go on hormone replacement therapy and what does that do to the gut microbiome? 39:07.665 --> 39:19.450 [SPEAKER_01]: So you're saying that very menopause and menopause we're seeing the gut having all these changes that are a little bit more inflammatory and not associated with good health outcomes and also associated and looks closer to a male gut microbiome which is fascinating. 39:19.910 --> 39:32.697 [SPEAKER_01]: And then when we take that woman or that person, and we put them on home and replacement therapy, which might be a combination of testosterone and progesterone, but most importantly, Esther Dio, you're saying that we're seeing the microbiome shift back to a premenopausal state. 39:32.797 --> 39:33.338 [SPEAKER_00]: That's correct. 39:33.718 --> 39:37.360 [SPEAKER_00]: Yeah, so there's a lot of benefits for hormone replacement, not only 39:37.780 --> 39:43.646 [SPEAKER_00]: doesn't help with the symptoms of menopause, but also bone loss, cardiovascular risk. 39:44.086 --> 39:48.030 [SPEAKER_00]: So it's the most direct way to address the microbiome changes. 39:48.230 --> 39:52.234 [SPEAKER_00]: There also is some really good evidence of dietary changes. 39:52.554 --> 40:01.002 [SPEAKER_00]: One specific study I was reading was looking at low fat, plant-based diets, a higher-end soy-based foods, and that helps shape the microbiome as well. 40:02.263 --> 40:08.028 [SPEAKER_00]: that study highlighted that 80 to 95 reduction in moderate to severe hot flashes. 40:08.369 --> 40:19.198 [SPEAKER_00]: So maybe the driver of that is those estrogen-like phytoestrogens found in soil foods that can help feed the gut microbiome that were once there, get them back on board. 40:19.539 --> 40:24.283 [SPEAKER_00]: So between diet and either in hormone therapy, those are good approaches. 40:25.390 --> 40:33.174 [SPEAKER_01]: which is wonderful and I think there's still a lot of fear and it leads to the holistic women's health world around HRT and I'm such a huge, strong proponent for hormone replacement therapy. 40:33.194 --> 40:36.356 [SPEAKER_01]: I saw my mum go through men's pores really early and it saved her life. 40:36.476 --> 40:46.481 [SPEAKER_01]: It saved so many different elements, but I never once thought about how fighter estrogens in soy could have a positive outcome on post-mintopausal women's health via the gut. 40:46.922 --> 40:51.164 [SPEAKER_01]: Because that's the whole thing that's going online at the moment are fighter estrogens safe. 40:51.604 --> 40:57.965 [SPEAKER_01]: is soy, safe, is flax, safe, and we're seeing this huge benefit for populations of perimenopausal women and menopausal women. 40:57.985 --> 41:05.707 [SPEAKER_01]: There's a reason why a Japanese women don't actually have a word for menopause because they're always eating this phytoestrogens and their gut is being exposed to it. 41:05.727 --> 41:06.827 [SPEAKER_01]: That is so fascinating. 41:07.647 --> 41:16.189 [SPEAKER_01]: How would you assess and manage a post-menopausal woman who develops new GI symptoms, mood changes or metabolic issues with a focus on her microbiome? 41:19.090 --> 41:24.440 [SPEAKER_01]: a lot in your clinic and you feel like you could put on a record and just pop it on repeat in your clinic waiting room. 41:24.700 --> 41:25.582 [SPEAKER_00]: That's a good question. 41:25.682 --> 41:29.569 [SPEAKER_00]: So I think the first is a detailed history period. 41:29.770 --> 41:30.291 [SPEAKER_00]: And also, 41:30.827 --> 41:31.507 [SPEAKER_00]: food history. 41:31.727 --> 41:43.372 [SPEAKER_00]: And what I found is that with women that go into Perry menopause and menopause with the healthy balance, protein, and plant-rich diet, they tend to have an easier transition. 41:43.712 --> 41:53.376 [SPEAKER_00]: And I mentioned that women that have never had to think about nutrition suddenly, having to in menopause, I know that it's time for a nutrition makeover. 41:53.716 --> 41:58.558 [SPEAKER_00]: So that's always a pillar of our discussion points when working with 41:59.338 --> 42:00.918 [SPEAKER_00]: post-menopausal gut. 42:01.058 --> 42:07.159 [SPEAKER_00]: So food first, that's always my approach, and that diversity, reinforcing diversity and variety. 42:07.220 --> 42:12.160 [SPEAKER_00]: So it's not just what's on your plate, but the variety that goes there as well. 42:12.501 --> 42:24.523 [SPEAKER_00]: So specific foods, you know, we think about foods that tend to be more anti-inflammatory, those high-end Omega-3s, things like polyphenols, like berries, and olive oils, green tea. 42:24.583 --> 42:25.043 [SPEAKER_00]: I recommend 42:25.955 --> 42:30.397 [SPEAKER_00]: regular or D-ca through the anti-oxidance and ground flag seed. 42:30.517 --> 42:32.758 [SPEAKER_00]: I do tend to recommend that a lot as well. 42:33.558 --> 42:34.198 [SPEAKER_01]: Okay, amazing. 42:34.498 --> 42:39.140 [SPEAKER_01]: Let's move on to clinical integration forward looking into the science, which is super nerdy. 42:39.400 --> 42:46.423 [SPEAKER_01]: From your clinical experience, which are the following fetal microbial composition tests or short chain fatty acid levels. 42:46.623 --> 42:46.863 [SPEAKER_01]: So, 42:47.243 --> 42:48.924 [SPEAKER_01]: Zonulin, for example, might be good. 42:49.024 --> 42:56.630 [SPEAKER_01]: Like, what are the ones that you say in your clinic when you say, say, for example, someone who's preventing, with primary or secondary dyspiosis? 42:56.870 --> 42:57.510 [SPEAKER_01]: What do you go? 42:57.590 --> 42:58.811 [SPEAKER_01]: I can't get an order this test. 42:58.871 --> 43:02.334 [SPEAKER_01]: And I'm going to get a good reading for example. 43:02.394 --> 43:03.675 [SPEAKER_01]: Like, what are the ones that you go to? 43:03.715 --> 43:04.535 [SPEAKER_01]: And you trust a lot? 43:04.555 --> 43:06.277 [SPEAKER_01]: And think quite important clinically. 43:06.377 --> 43:06.717 [SPEAKER_00]: Yeah. 43:07.237 --> 43:13.582 [SPEAKER_00]: So I think fecal microbiome tests are really helpful in showing us that bacteria. 43:14.079 --> 43:16.660 [SPEAKER_00]: what's beneficial, yeast, parasites. 43:16.960 --> 43:26.543 [SPEAKER_00]: They all tend to be just a tiny snapshot in time though, so they don't always paint the whole picture, but I do feel like they give a good roadmap of where to start in rebalancing the microbiome. 43:26.743 --> 43:37.026 [SPEAKER_00]: I would also say that test that measure inflammation, markers like cow protectin or lactoferin, those can be really helpful, and then pancreatic function. 43:37.166 --> 43:41.967 [SPEAKER_00]: So the pancreas makes enzymes that help break down and assimilate our food. 43:42.432 --> 43:46.474 [SPEAKER_00]: So stool markers like the last taste are also very helpful. 43:46.815 --> 43:50.817 [SPEAKER_00]: Some tests add in the short chain fatty acid measurement as well. 43:51.037 --> 43:57.301 [SPEAKER_00]: And basically what short chain fatty acid test tells us is the functional output of your microbiome. 43:57.321 --> 44:03.204 [SPEAKER_00]: So you're inputting all these fibers and maybe even probiotics, but what is your body doing with that? 44:03.604 --> 44:08.947 [SPEAKER_00]: Is your body actually then making on its own more of those probiotics? 44:09.408 --> 44:11.549 [SPEAKER_00]: So with the short chain fatty acid assessment, 44:11.893 --> 44:18.215 [SPEAKER_00]: we can reliably tell patients, here it is, on paper, you need more fiber, you need more diversity. 44:18.555 --> 44:21.076 [SPEAKER_00]: So that can be a really helpful marker as well. 44:21.657 --> 44:27.199 [SPEAKER_00]: You know, Samuel, that's a good marker of increased intestinal permeability or leaky gut. 44:27.559 --> 44:33.621 [SPEAKER_00]: There's another test called the Lactulose Manitol test that seems to be a little bit more clinically validated. 44:34.061 --> 44:39.885 [SPEAKER_00]: But I found that using either of those can be really helpful, and I think it's very practitioner-dependent as well. 44:40.205 --> 44:52.934 [SPEAKER_00]: So we often get into our little boxes as I like this test, and when you consistently see patterns in a certain way in practice, then you just get comfortable with addressing the things that are found in your specific method of treatment. 44:53.240 --> 45:00.227 [SPEAKER_01]: Yeah and your practitioner needs to know how to read those as well and I guess everything is different in different countries and even states as well. 45:00.927 --> 45:05.952 [SPEAKER_01]: What is the latest evidence say about using prebiotics and probiotics and postbiotics? 45:06.132 --> 45:08.494 [SPEAKER_01]: First of all, can you please explain what those are? 45:08.835 --> 45:09.675 [SPEAKER_01]: What is a prebiotic? 45:09.695 --> 45:11.757 [SPEAKER_01]: What is a postbiotic and what is a prebiotic? 45:11.797 --> 45:17.843 [SPEAKER_01]: Because I think people use these interchangeably and they're kind of all similar but they're not they're quite distinct and they have different 45:18.238 --> 45:19.660 [SPEAKER_01]: impacts on the gut microbiome. 45:20.141 --> 45:21.623 [SPEAKER_00]: They are very distinct. 45:22.084 --> 45:27.652 [SPEAKER_00]: And so on prebiotics, think of prebiotics is like food. 45:28.039 --> 45:29.339 [SPEAKER_00]: for your gut microbes. 45:29.539 --> 45:37.161 [SPEAKER_00]: And for my perspective, I don't really see a need for prebiotic supplementation because that's where food comes in. 45:37.461 --> 45:43.762 [SPEAKER_00]: There's some cases where I've seen prebiotics from a supplements make certain conditions worse. 45:43.882 --> 45:47.763 [SPEAKER_00]: Small intestinal bacterial overgrowth is a good example of that. 45:47.963 --> 45:53.244 [SPEAKER_00]: So it usually don't suggest spending a lot of supplement dollars on prebiotics and then on 45:58.022 --> 46:02.606 [SPEAKER_00]: supplement with and many probiotics supplements are on the market these days. 46:02.666 --> 46:07.970 [SPEAKER_00]: Some of them are lactobacteria, bifidobacteria, acrimansia, bacillus. 46:08.310 --> 46:13.054 [SPEAKER_00]: There's a whole spectrum of probiotics available. 46:13.795 --> 46:15.977 [SPEAKER_00]: I found that there's no one size fits all. 46:16.377 --> 46:21.121 [SPEAKER_00]: Some patients will tell me this didn't work or I reacted negatively to this. 46:21.201 --> 46:23.783 [SPEAKER_00]: It gave me more diarrhea or more bloating. 46:24.182 --> 46:28.963 [SPEAKER_00]: So it can take a while to find a combination that seems to suit the person well. 46:29.323 --> 46:36.285 [SPEAKER_00]: The other thing that I would say about that is when we're adding microbes into the system, we shouldn't always take the same things. 46:36.605 --> 46:45.708 [SPEAKER_00]: So if you've landed on a probiotic that works for you, think about changing that up and trying something new every so often, maybe that's six months or a year. 46:45.888 --> 46:47.328 [SPEAKER_00]: And then postbiotics, so 46:47.798 --> 46:51.120 [SPEAKER_00]: That's basically leftovers from your good bacteria. 46:51.140 --> 46:53.961 [SPEAKER_00]: So this is where short chain fatty acids come in. 46:54.041 --> 47:03.426 [SPEAKER_00]: So after your bacteria make the short chain fatty acids, they make vitamins, they keep your gut lining healthy and strong. 47:03.746 --> 47:09.429 [SPEAKER_00]: So that's not something necessarily that we take, but rather that we make internally. 47:10.449 --> 47:15.513 [SPEAKER_01]: So, prebiotics are what feed the people, the people's outcome and kind of, I guess, fart. 47:16.814 --> 47:27.842 [SPEAKER_01]: And I guess it is a post-consumer waste, really, for our probiotics, short-chain fatty acids is waste products that our body finds really, really useful and we use things like beauty rates throughout the entire body, for example. 47:28.262 --> 47:32.047 [SPEAKER_01]: Okay, so going back to that, what does the latest evidence say about using these? 47:32.087 --> 47:35.331 [SPEAKER_01]: So prebiotics, probiotics, and postbiotics in women's health? 47:35.411 --> 47:39.335 [SPEAKER_01]: Are there any particular strains or formulas that you found especially effective? 47:39.415 --> 47:40.877 [SPEAKER_01]: I mean, for me, I can speak to this. 47:40.897 --> 47:46.424 [SPEAKER_01]: I went to Southeast Asia two years ago, and I got really sick and I had to take a bunch of antibiotics, came home to destroy analysis. 47:46.744 --> 47:48.507 [SPEAKER_01]: and I had no lactobacillars. 47:48.647 --> 47:55.177 [SPEAKER_01]: I had no bifurdo bacterium, and so that told me, okay, I need to go and take a supplement with bifurdo bacterium and lactobacillars. 47:55.237 --> 48:02.488 [SPEAKER_01]: Would you say that that's kind of how you use gotstall tests to look in the microbiome and go, okay, you're down in buterate, we need to feed this specific 48:02.828 --> 48:07.410 [SPEAKER_01]: probiotic, and we need to use this specific food for that, or different types of soluble fibers. 48:07.430 --> 48:12.252 [SPEAKER_01]: Do you mind mapping out what that might look like for you and clinic when you get someone's stool analysis back? 48:12.352 --> 48:12.652 [SPEAKER_01]: Sure. 48:13.113 --> 48:23.177 [SPEAKER_00]: Yeah, so stool analysis is sometimes limited in the commercially available strains that are highlighted there, so use two really common examples, electobacillus, and the bifidobacteria. 48:23.587 --> 48:34.292 [SPEAKER_00]: And so since those are so prevalent, those are pretty easily sourced commercially and probiotic strains and varying strengths, the other thing I say is it's good to look at patterns. 48:34.672 --> 48:41.576 [SPEAKER_00]: So if it's like generally everything is low or you know, there's certain families that are off. 48:41.976 --> 48:49.540 [SPEAKER_00]: We can think about, do we need the actual strains or do we need what I like to call, like the fertilizers for those strains? 48:50.820 --> 49:06.494 [SPEAKER_00]: That goes into the different types of probiotics of the lactone bifidoburses like spore-braised probiotics or spore-braised probiotics aren't any of those things that we would see on a test, but the spores are primarily like planting a seed and then allowing the good bacteria to go. 49:06.694 --> 49:12.439 [SPEAKER_00]: Grow, whereas in the other approach you're taking those specific strains like the lactone bifidobacteria. 49:12.799 --> 49:36.517 [SPEAKER_00]: So overall trends are important to look at, sometimes rather than just the few specific strains that might be off, although I do see a lot of times a specific strain called acromancia is tending to be low in a lot of my patients microbiome stool analyses, and there's some good research between metabolic health and acromancia, and luckily that one is commercially available. 49:36.938 --> 49:39.039 [SPEAKER_00]: So I'm curious if the mechanism by which we could 49:42.602 --> 49:47.705 [SPEAKER_00]: I'm not clear on that, but I do tend to recommend apprehmancia as a single strain quite often. 49:48.065 --> 49:57.311 [SPEAKER_01]: It's an amazing research linking acumencia supplementation and improvements in metabolic syndrome outcomes and health for women with PCOS or PMOS, especially as well. 49:57.331 --> 50:02.614 [SPEAKER_01]: I talk about that in my book that supplementing without if you can take one probiotic for about three months. 50:02.654 --> 50:05.736 [SPEAKER_01]: You will see huge improvements specifically in insulin resistance. 50:05.776 --> 50:07.117 [SPEAKER_01]: It's a pretty amazing little microbe. 50:07.757 --> 50:16.019 [SPEAKER_01]: What are the biggest myths that you see about the gut hormone connection and what do you wish every woman understood about this vital relationship between her whole monobody and her gut body? 50:16.639 --> 50:34.602 [SPEAKER_00]: So, I think that one of the biggest myths is that you have to have gut symptoms to investigate further and so I think that this whole discussion points us in the direction is that the gut is the backdrop for a lot of things hormonally but also systemically. 50:34.945 --> 50:44.388 [SPEAKER_00]: So I think that, you know, just asking about gut health and a very detailed manner, and if there's nothing there, still taking into consideration. 50:44.488 --> 50:49.869 [SPEAKER_00]: The gut health is really part of your healthy foundation, and it's required to heal. 50:49.929 --> 50:55.751 [SPEAKER_00]: That was part of my philosophical training in naturopathic medical school was that health starts with the gut. 50:56.011 --> 50:58.152 [SPEAKER_00]: So we're always taking that into account. 50:58.472 --> 51:01.473 [SPEAKER_00]: I would say another myth is that you have to take probiotics. 51:01.913 --> 51:07.456 [SPEAKER_00]: we talked about ways that you can help support a diverse microbiome just through food variety. 51:07.916 --> 51:11.218 [SPEAKER_00]: And also that the gut is sometimes an afterthought. 51:11.658 --> 51:18.221 [SPEAKER_00]: That's another big myth is sometimes I'll go through an intake with a patient and they'll tell me all about their problems and 51:18.591 --> 51:24.474 [SPEAKER_00]: You know, we get to asking about gut health and they'll tell me they're only having a bowel movement every three or four days. 51:24.914 --> 51:27.436 [SPEAKER_00]: I'm like, wait, now this is problem number one. 51:27.716 --> 51:28.897 [SPEAKER_00]: We're gonna start there. 51:29.337 --> 51:32.158 [SPEAKER_00]: And then we'll go back through the rest of your list. 51:32.478 --> 51:46.906 [SPEAKER_00]: So I think that every woman should really understand that this is a vital part of not only her monofunction, but every day function in your sleep, your energy, you know, your inflammation. 51:48.682 --> 51:50.823 [SPEAKER_00]: always starts with the gut, absolutely. 51:50.923 --> 52:00.488 [SPEAKER_01]: And ending on an exciting note, like, what are some things in the research or things that have just come out, or you've just seen an RCT that's being published? 52:00.888 --> 52:03.949 [SPEAKER_01]: What is something that you're really excited about in the gut health space? 52:03.989 --> 52:09.432 [SPEAKER_01]: What's something that you think will actually be really applicable or you just think is fascinating for women's health in the gut? 52:10.112 --> 52:14.054 [SPEAKER_00]: So I think that my answer to this question is a little bit more broad, but 52:14.694 --> 52:18.395 [SPEAKER_00]: It kind of goes back to what I was saying that we always take the gut into account. 52:18.756 --> 52:27.298 [SPEAKER_00]: And I think that the more studies that are being done on specific dysbiosis scenarios and other conditions. 52:27.639 --> 52:38.582 [SPEAKER_00]: So what I mean by that is, you know, a pathogen that's maybe connected to an autoimmune disease or perhaps a skin disorder showing these disturbances in the gut. 52:43.824 --> 52:45.926 [SPEAKER_00]: bigger picture problems. 52:46.126 --> 53:00.700 [SPEAKER_00]: So I think the research that points to the gut is being a more necessary part of treatment across a huge range of conditions, not just the ones that are showing up as a gut associated. 53:01.103 --> 53:01.603 [SPEAKER_00]: problem. 53:01.764 --> 53:17.616 [SPEAKER_00]: So I spoke to that a little bit when we were talking about that specific strain of bacteria for PMDD to me that's so fascinating because that highlights how there might be one gut intervention that really leads to a big change in someone's experience of mood disorders. 53:17.956 --> 53:25.102 [SPEAKER_00]: So as that research continues to evolve with any type of systemic condition, I think that will be very fascinating. 53:25.922 --> 53:28.744 [SPEAKER_01]: Well, thank you so much, and where can people find you online? 53:28.964 --> 53:45.111 [SPEAKER_00]: Hmm, yeah, so my website is the best source of information about me, KellySinsND.com, and there I have information about my background and my practice, and I also do some regular blogging there. 53:45.231 --> 53:47.312 [SPEAKER_01]: Alright, well thank you so much for joining us today. 53:47.332 --> 53:48.773 [SPEAKER_01]: I really appreciate your time. 53:49.253 --> 53:50.094 [SPEAKER_01]: Yes, thank you. 53:50.194 --> 53:50.975 [SPEAKER_01]: Hello everyone. 53:51.015 --> 53:53.858 [SPEAKER_01]: Hopefully you enjoyed that interview with the amazing doctor Kelly. 53:54.439 --> 54:03.149 [SPEAKER_01]: I just wanted to close up with a few specifics because I know that a lot of people come here for specifics and that interview was really amazing so you can get the baseline understanding of the microbiome. 54:03.710 --> 54:06.513 [SPEAKER_01]: But I'd like to leave you with some tests that you can do. 54:06.853 --> 54:13.620 [SPEAKER_01]: with markers to look for what they represent, and how to kind of read a gut microbiome analysis or find someone who can. 54:14.321 --> 54:19.106 [SPEAKER_01]: Just to give you a bit of understanding and some tests at the end of it in three different regions. 54:19.126 --> 54:27.394 [SPEAKER_01]: So US and Canada, in the North America, Australia and New Zealand, and it also going to give you a test for EU and UK. 54:27.694 --> 54:30.117 [SPEAKER_01]: If you have any suggestions for gut microbiome maps, 54:30.777 --> 54:40.501 [SPEAKER_01]: In your country or region that you'd like to recommend, please contact us on Instagram or you can contact us through the contact form of our website so you can recommend it to other women. 54:41.121 --> 54:46.103 [SPEAKER_01]: So let's get into what a good microbiome test actually tests and what you should be looking for. 54:46.903 --> 54:51.205 [SPEAKER_01]: So just to give you a bit of a segment map, so we can understand what we're going to be looking at here. 54:51.825 --> 54:59.089 [SPEAKER_01]: We're going to be talking about why this section is really important, what makes the test worth trusting and what it makes a good test and a bad test. 54:59.689 --> 55:05.772 [SPEAKER_01]: What primary dyspiosis markers are secondary dyspiosis markers are and reading this as like a story. 55:05.872 --> 55:12.055 [SPEAKER_01]: So looking at your gut microbiome test to look at the history of what your gut microbiome has been through, what it represents now. 55:12.175 --> 55:17.359 [SPEAKER_01]: So let's get into the first section of like what actually makes a good microbiome test. 55:17.599 --> 55:22.944 [SPEAKER_01]: So firstly is the sequencing method and there's a few different methods that are being used. 55:23.304 --> 55:26.286 [SPEAKER_01]: The first one is the 16S sequencing RNA. 55:26.707 --> 55:27.427 [SPEAKER_01]: This is older. 55:27.688 --> 55:33.212 [SPEAKER_01]: It's also more affordable and it only reads one gene segment of each of these different bacteriodes. 55:33.392 --> 55:35.814 [SPEAKER_01]: It only resolves bacteria to a genus 55:38.296 --> 55:51.910 [SPEAKER_01]: So just like us, we have homo sapiens, homo neanderthals, we have a genus, homo, and then we have these species sapiens, for example, and we have that in bacteria and virus fungi. 55:52.110 --> 55:54.752 [SPEAKER_01]: So it can data and then is it albicans? 55:54.973 --> 55:59.077 [SPEAKER_01]: So 16S RNA sequencing only looks at one part of that gene sequence. 55:59.557 --> 56:01.979 [SPEAKER_01]: and it doesn't actually tell you what specific species are there. 56:02.019 --> 56:03.360 [SPEAKER_01]: So it's not a very specific test. 56:03.700 --> 56:06.021 [SPEAKER_01]: It can be really good for getting an overall look. 56:06.081 --> 56:12.225 [SPEAKER_01]: What your gut is looking like and what genus is there and you can make some conclusions from that but it's not so specific. 56:12.786 --> 56:17.929 [SPEAKER_01]: Which can be good if you're generally a good health and you're just noticing some weird changes in your gut microbiome. 56:17.969 --> 56:18.389 [SPEAKER_01]: That's great. 56:18.710 --> 56:24.013 [SPEAKER_01]: So you're 16 S RNA sequencing can be good, but if you have IBS, if you have 56:24.497 --> 56:24.917 [SPEAKER_01]: Cibo. 56:25.118 --> 56:30.462 [SPEAKER_01]: You were going to want more specific, you know, you don't want a rough diversity snapshot. 56:30.982 --> 56:35.526 [SPEAKER_01]: You need something really specific and that's what shotgun metagenomic sequencing is. 56:36.447 --> 56:39.249 [SPEAKER_01]: That reads the entire genetic material in the sample. 56:39.529 --> 56:43.392 [SPEAKER_01]: It resolves organisms to species and often at strain levels as well. 56:43.452 --> 56:48.937 [SPEAKER_01]: So it's ultra specific and it can also pick up fungi and other viruses that 16S misses entirely. 56:49.517 --> 56:52.079 [SPEAKER_01]: That's the depth you want if you have got microbiome issues. 56:53.500 --> 56:58.203 [SPEAKER_01]: If you're just looking for a general checkup, like I did recently, that 16S sequencing is really great. 56:58.563 --> 57:05.207 [SPEAKER_01]: But if you want something more specific that metagenomic sequencing is going to be what you want and loan behold, it's more expensive. 57:05.387 --> 57:06.908 [SPEAKER_01]: By far, it's more expensive. 57:07.248 --> 57:09.510 [SPEAKER_01]: But if you have ongoing issues, it's worth the investment. 57:09.610 --> 57:11.271 [SPEAKER_01]: There's also DNA and RNA. 57:11.451 --> 57:14.033 [SPEAKER_01]: So DNA is what's inside of ourselves. 57:14.153 --> 57:17.675 [SPEAKER_01]: RNA is kind of like another strand of DNA. 57:17.755 --> 57:19.056 [SPEAKER_01]: It's one half of the DNA. 57:19.076 --> 57:19.816 [SPEAKER_01]: It doesn't have a dual 57:22.058 --> 57:22.958 [SPEAKER_01]: And they're a little bit different. 57:23.479 --> 57:31.787 [SPEAKER_01]: So DNA-based testing in your microbiome mapping tells you if a microbe is present, it does not tell you whether that microbe is active. 57:32.247 --> 57:39.314 [SPEAKER_01]: So when we have RNA, that's where basically splitting that DNA in half, we're taking a copy of that DNA and that's RNA. 57:39.874 --> 57:47.419 [SPEAKER_01]: So when RNA is around, and we do RNA based testing in your microbiome, this measures gene expression, which is really important in the gut. 57:47.499 --> 57:53.844 [SPEAKER_01]: It actually gives you a snapshot of what the microbiome is actually doing at the time of the sample. 57:53.944 --> 58:01.329 [SPEAKER_01]: So the DNA is telling you what's there, what microbes are there, or some we know, but we don't know what they're doing, and that's what RNA still considering is really, really great for. 58:01.569 --> 58:06.253 [SPEAKER_01]: because it's telling you, okay, you might have Bifuero bacterium, but we're not seeing any RNA for it. 58:06.513 --> 58:09.416 [SPEAKER_01]: So the Bifuero bacterium is just sitting there, not really doing much. 58:09.656 --> 58:12.498 [SPEAKER_01]: So it's there, but it doesn't have any RNA, for example. 58:12.919 --> 58:15.661 [SPEAKER_01]: And so that's that primary and secondary dyspiosis, right? 58:15.761 --> 58:19.184 [SPEAKER_01]: So that primary dyspiosis that's telling you, okay, Bifuero bacterium is here. 58:19.544 --> 58:22.786 [SPEAKER_01]: But if there's no RNA, it's telling us it's not transcripting. 58:23.046 --> 58:25.908 [SPEAKER_01]: It's telling us it's not doing anything in the gut. 58:25.928 --> 58:27.288 [SPEAKER_01]: So that's that secondary. 58:27.509 --> 58:28.829 [SPEAKER_01]: So that's what that is for, right? 58:28.849 --> 58:32.191 [SPEAKER_01]: So DNA is kind of an primary dyspiosis marker. 58:32.211 --> 58:35.033 [SPEAKER_01]: And RNA is telling us a secondary dyspiosis marker. 58:35.387 --> 58:38.908 [SPEAKER_01]: So you can have completely fine primary symbiosis. 58:38.948 --> 58:41.349 [SPEAKER_01]: So you have all of the right bacteria there. 58:41.389 --> 58:44.410 [SPEAKER_01]: We don't have any opportunistic bacteria or the under control. 58:44.470 --> 58:44.931 [SPEAKER_01]: That's awesome. 58:45.471 --> 58:51.173 [SPEAKER_01]: If we don't have any RNA of our beneficial microbes, then that secondary dyspiosis for an example. 58:51.253 --> 58:54.234 [SPEAKER_01]: Another thing is it needs to be processed in an accredited lab. 58:54.574 --> 58:56.675 [SPEAKER_01]: And most pathology labs are accredited now. 58:57.015 --> 59:01.237 [SPEAKER_01]: especially if they're looking at stool-based analysises, at least in Australia and New Zealand. 59:01.537 --> 59:08.240 [SPEAKER_01]: You don't want an unregulated lab because that's going to really negatively impact the reproduced ability of those results. 59:08.340 --> 59:10.841 [SPEAKER_01]: Okay, so let's get into primary dispiosis markers. 59:10.961 --> 59:12.441 [SPEAKER_01]: So remember what Kelly was saying? 59:12.762 --> 59:13.362 [SPEAKER_01]: Who is there? 59:13.942 --> 59:14.202 [SPEAKER_01]: right? 59:14.283 --> 59:17.166 [SPEAKER_01]: So we want diversity and richness in the microbiome. 59:17.446 --> 59:23.773 [SPEAKER_01]: The single most load bearing result on your microbiome stool test is going to be the diversity. 59:23.793 --> 59:25.916 [SPEAKER_01]: So how many different microbes do we have in your gut? 59:26.136 --> 59:26.997 [SPEAKER_01]: And are they beneficial? 59:27.077 --> 59:28.499 [SPEAKER_01]: Are they making short-chain fatty acids? 59:28.619 --> 59:31.222 [SPEAKER_01]: Our diverse ecosystem has redundancy built in. 59:31.662 --> 59:34.764 [SPEAKER_01]: If one species drops out, another can cover its function. 59:34.864 --> 59:36.265 [SPEAKER_01]: So that's why we want diversity. 59:36.465 --> 59:39.206 [SPEAKER_01]: Load diversity in of itself is a marker. 59:39.566 --> 59:47.871 [SPEAKER_01]: Independent of any single organism being high or low, it signals the gut ecosystem is more easily tipped by antibiotics, illness, or a rough month of eating. 59:47.931 --> 59:49.192 [SPEAKER_01]: So what are we looking for here? 59:49.232 --> 59:51.333 [SPEAKER_01]: So we want beneficial commensals. 59:51.413 --> 59:54.414 [SPEAKER_01]: So these are the organisms you want to see present and abundant. 59:54.574 --> 59:57.296 [SPEAKER_01]: So remember, Akamanzia, we was speaking about before, 59:57.720 --> 01:00:04.125 [SPEAKER_01]: This is the mucus layer specialist and this is really great for prevention of intestinal hyperpermubility, aka leaky gut. 01:00:04.185 --> 01:00:06.387 [SPEAKER_01]: It's often called the Centennial of the gut. 01:00:06.427 --> 01:00:12.912 [SPEAKER_01]: It supports gut barrier integrity, helps to modulate the immune response and enriches other muterate producing bacteria. 01:00:12.932 --> 01:00:16.635 [SPEAKER_01]: So it doesn't really produce a lot of muterate itself, but it supports its other friends that do it. 01:00:16.795 --> 01:00:22.360 [SPEAKER_01]: Also, fake hally bacterium, one of the largest single contributors to beauty rate production in a healthy gut. 01:00:22.720 --> 01:00:27.424 [SPEAKER_01]: It's sometimes accounting for over 5% of total bacteria in store, which is massive. 01:00:27.845 --> 01:00:31.227 [SPEAKER_01]: And beauty rate is the primary fuel source of colon lining cells. 01:00:31.808 --> 01:00:36.652 [SPEAKER_01]: So remember, epithelial cells in our colon, they use beauty rate as an energy source. 01:00:36.692 --> 01:00:37.533 [SPEAKER_01]: So who don't have, 01:00:37.953 --> 01:00:44.318 [SPEAKER_01]: short-chain fatty acids like buttery being made, out epithelial cells don't have an engine, and they can't hold those tight junctions together properly. 01:00:44.398 --> 01:00:48.061 [SPEAKER_01]: When we have low levels of either of these, that signals to investigate. 01:00:48.161 --> 01:00:49.722 [SPEAKER_01]: It's not a diagnosis on its own. 01:00:49.842 --> 01:00:56.887 [SPEAKER_01]: Also, Bifurdo bacterium, sacromycies, and lactobacillus species, or really beneficial, and we should be seeing pretty high levels of these. 01:00:57.007 --> 01:01:00.990 [SPEAKER_01]: Let's go on to opportunistic organisms, and they're not necessarily bad bacteria. 01:01:01.030 --> 01:01:07.035 [SPEAKER_01]: They're just overrepresented, and they can start to cause problems or be associated with problems in the gut microbiome. 01:01:07.695 --> 01:01:19.299 [SPEAKER_01]: If you see low beneficial microbes and then higher opportunistic, these are organisms that exist in small numbers in most healthy guts and only become a problem when they expand beyond their normal share of the ecosystem. 01:01:19.499 --> 01:01:22.240 [SPEAKER_01]: Usually because something else has been displaced and really 01:01:22.640 --> 01:01:28.765 [SPEAKER_01]: important to come back to that word opportunistic, that word is doing a lot of work here to explain the situation here. 01:01:28.865 --> 01:01:38.153 [SPEAKER_01]: It means the organism took an opportunity created by a disrupted environment so they don't cause the problem, they're just associated with the problem, they're the canary in the coal mine. 01:01:38.273 --> 01:01:41.296 [SPEAKER_01]: So what are some types of opportunistic bacteria you might see? 01:01:41.476 --> 01:01:47.541 [SPEAKER_01]: So the whole genus, I would say of interior caucus is a pretty opportunistic bacteria, mucoid, ecolai, 01:01:49.523 --> 01:01:53.647 [SPEAKER_01]: and the entire genus of strep basically that you see in the gut. 01:01:53.707 --> 01:01:55.629 [SPEAKER_01]: You can also see some staff here as well. 01:01:55.749 --> 01:02:00.753 [SPEAKER_01]: So these are, I know when you probably hear staff and strep in the gut, you think you've got that's a really big problem. 01:02:01.074 --> 01:02:07.079 [SPEAKER_01]: Yeah, it can be, they can be pretty problematic, but they are generally under the opportunistic label. 01:02:07.159 --> 01:02:09.501 [SPEAKER_01]: Next we have your gram negative load. 01:02:09.561 --> 01:02:13.245 [SPEAKER_01]: So these are bacteria that are broadly classified by their cell wall structure. 01:02:13.685 --> 01:02:15.486 [SPEAKER_01]: a gram-positive or a gram-negative. 01:02:15.946 --> 01:02:19.367 [SPEAKER_01]: And this is one of the most genuinely useful ways to read your report. 01:02:19.567 --> 01:02:22.008 [SPEAKER_01]: Gram-negative bacteria carry LPS. 01:02:22.028 --> 01:02:34.233 [SPEAKER_01]: Remember how we were speaking about LPS before in your gut that can get past your epithelial layer and can cause problems that can trigger a lot of TNF alpha into look and eight into look and 18 and then CRP and HSCRP down the load. 01:02:34.573 --> 01:02:35.814 [SPEAKER_01]: That's a lot of inflammation. 01:02:35.854 --> 01:02:38.815 [SPEAKER_01]: So it's associated at triggers a lot of inflammation in the body. 01:02:38.875 --> 01:02:40.175 [SPEAKER_01]: So gram-negative bacteria 01:02:41.616 --> 01:02:43.897 [SPEAKER_01]: outside of their membrane. 01:02:43.957 --> 01:02:45.498 [SPEAKER_01]: And LPS is an endotoxin. 01:02:45.558 --> 01:02:56.104 [SPEAKER_01]: It's not dangerous while it stays inside the gut lumen, but it becomes a really big problem once it crosses the epithelial layer and then it can trigger off a huge cascade of inflammatory events inside of the body. 01:02:56.204 --> 01:03:04.168 [SPEAKER_01]: And over a representation of gram-negative organisms raises the total LPS burden and the gut barrier has to contain it and it's really hard to contain those. 01:03:04.268 --> 01:03:09.671 [SPEAKER_01]: And LPS and gram-negative bacteria is kind of the bridge into secondary dyspiosis. 01:03:09.791 --> 01:03:12.814 [SPEAKER_01]: Gram negative isn't the scary label on its own. 01:03:13.255 --> 01:03:15.137 [SPEAKER_01]: It is a part of the cell wall structure. 01:03:15.497 --> 01:03:20.903 [SPEAKER_01]: And the question with LPS and Gram negative bacteria is how well your gut is holding up. 01:03:21.283 --> 01:03:23.565 [SPEAKER_01]: So is there a lot of LPS in your stool? 01:03:23.806 --> 01:03:24.066 [SPEAKER_01]: Cool. 01:03:24.346 --> 01:03:25.708 [SPEAKER_01]: But is it passing through? 01:03:26.268 --> 01:03:27.229 [SPEAKER_01]: the gut barrier. 01:03:27.329 --> 01:03:30.371 [SPEAKER_01]: And one of the best ways we can look into that is something like Zonulim. 01:03:30.711 --> 01:03:34.053 [SPEAKER_01]: So let's get into the second part, which is secondary dispayosis markers. 01:03:34.113 --> 01:03:36.094 [SPEAKER_01]: And what it's really doing and what it's really showing you. 01:03:36.174 --> 01:03:37.235 [SPEAKER_01]: Number one is Zonulim. 01:03:37.255 --> 01:03:39.056 [SPEAKER_01]: This is quite popular and for good reason. 01:03:39.136 --> 01:03:40.296 [SPEAKER_01]: It's the barrier marker. 01:03:40.376 --> 01:03:42.077 [SPEAKER_01]: So Zonulim is a human protein. 01:03:42.238 --> 01:03:43.218 [SPEAKER_01]: It's not a microbe. 01:03:43.618 --> 01:03:46.520 [SPEAKER_01]: And it regulates the tight junctions between the gut lining cells. 01:03:46.880 --> 01:03:52.223 [SPEAKER_01]: Think of this protein as the gatekeeper for how permeable that lining at any given moment is. 01:03:55.185 --> 01:03:57.928 [SPEAKER_01]: with highs on your land that points to a compromise gut barriers. 01:03:58.249 --> 01:04:02.013 [SPEAKER_01]: So the Zonulin isn't staying in the tight junction of the cell in your colon. 01:04:02.293 --> 01:04:04.215 [SPEAKER_01]: It's falling out and it's coming out in your stool. 01:04:04.255 --> 01:04:07.259 [SPEAKER_01]: So high amounts of that means higher amounts of leaky gut. 01:04:07.379 --> 01:04:09.781 [SPEAKER_01]: Alongside Zonulin is also calprotectin. 01:04:09.801 --> 01:04:14.567 [SPEAKER_01]: So this is the inflammation marker that you should be looking out for in your gut microbiome test. 01:04:14.867 --> 01:04:19.852 [SPEAKER_01]: it's a well-established indicator of gut inflammation, and it's really relevant if you have inflammatory bowel disease. 01:04:20.092 --> 01:04:33.686 [SPEAKER_01]: It helps distinguish genuine inflammatory activity from functional gut symptoms and it's an important line to draw before assuming every symptom is just IVS and we didn't talk about IVS in this podcast and I have a bit of a gripe with it and I think a lot of people 01:04:34.266 --> 01:04:37.989 [SPEAKER_01]: in health do as well, because IBS is just kind of this unparalleled term. 01:04:38.249 --> 01:04:40.051 [SPEAKER_01]: It doesn't actually tell you what's going on. 01:04:40.431 --> 01:04:44.275 [SPEAKER_01]: It's just a term that basically the medical industry has created to go. 01:04:44.475 --> 01:04:45.676 [SPEAKER_01]: Your gut has problems. 01:04:46.897 --> 01:04:49.799 [SPEAKER_01]: We don't know what they are, so we're just going to give you this label of IBS. 01:04:50.420 --> 01:04:53.663 [SPEAKER_01]: Maybe try a stool test and maybe do this and maybe do that. 01:04:53.703 --> 01:05:00.448 [SPEAKER_01]: Maybe try and have some metamus or, you know, I'm going to do a whole podcast one day on IBS with someone. 01:05:01.229 --> 01:05:01.889 [SPEAKER_01]: Hang tight on that. 01:05:02.630 --> 01:05:07.012 [SPEAKER_01]: But the next one we want to be talking about is secretory IgA, also known as SIGA. 01:05:07.552 --> 01:05:12.114 [SPEAKER_01]: It's a pancreatic eleste, SIGA reflects frontline gut immune function. 01:05:12.474 --> 01:05:15.235 [SPEAKER_01]: Your mucusal depends system doing its job. 01:05:15.536 --> 01:05:21.098 [SPEAKER_01]: Pancreatic eleste is reflects digestive sufficiency, so whether you're actually breaking food down, 01:05:21.738 --> 01:05:23.079 [SPEAKER_01]: before it reaches the colon. 01:05:23.259 --> 01:05:36.146 [SPEAKER_01]: Together, help protect and also SIGA, they can be really, really helpful in answering the question people rarely think to ask, is this bloating a microbial problem or is it simply undigested food problem? 01:05:36.206 --> 01:05:40.688 [SPEAKER_01]: So that's a thing that your stool should be picking up as well is undigested food. 01:05:41.088 --> 01:05:46.571 [SPEAKER_01]: So it will be looking at the amount of fat, protein and carbohydrates and fiber in your stool as well. 01:05:47.091 --> 01:06:00.334 [SPEAKER_01]: And for example, if you have a low bio flow, you won't be able to digest fat soluble vitamins like A, D, E in the K. So that'll come out in your stool and your test will come back and say, you're not digesting fat properly. 01:06:00.394 --> 01:06:01.835 [SPEAKER_01]: So you need to work on your bio. 01:06:02.255 --> 01:06:04.155 [SPEAKER_01]: And you're not digesting fiber properly. 01:06:04.295 --> 01:06:08.156 [SPEAKER_01]: So maybe you don't have a lot of beneficial microbes that can break down that insoluble fiber. 01:06:08.256 --> 01:06:11.637 [SPEAKER_01]: And as IGA gives you a bit of a snapshot on how you're digesting food, 01:06:12.057 --> 01:06:17.280 [SPEAKER_01]: and whether it's a micro problem, whether it's a digestion problem, whether it's something happening upstream or downstream. 01:06:17.380 --> 01:06:19.102 [SPEAKER_01]: Next is Bader Glucoronodase. 01:06:19.322 --> 01:06:25.486 [SPEAKER_01]: Not a lot of stool tests actually look at this, and if you have estrogen dominant symptoms, I think it's really important to look at this enzyme. 01:06:25.846 --> 01:06:27.227 [SPEAKER_01]: It's a hormone crossover maker. 01:06:27.427 --> 01:06:30.349 [SPEAKER_01]: So this enzyme is produced by certain gut bacteria. 01:06:30.429 --> 01:06:34.791 [SPEAKER_01]: It's involved with de-conjugating metabolites, including hormones like estrogen. 01:06:34.831 --> 01:06:37.013 [SPEAKER_01]: So basically, the liver does this amazing thing. 01:06:37.393 --> 01:06:39.074 [SPEAKER_01]: Let's use estrogen as an example. 01:06:39.374 --> 01:06:40.135 [SPEAKER_01]: It conjugates. 01:06:40.595 --> 01:06:41.055 [SPEAKER_01]: estrogen. 01:06:41.236 --> 01:06:46.359 [SPEAKER_01]: It kind of adds something to it, so it can't be used and it can't attach itself to receptor sites. 01:06:46.980 --> 01:06:59.549 [SPEAKER_01]: Once it gets into the gut, beta-glucoronidase that's been made by different microbes in the gut can take this conjugation off, de-conjugate it, and push it back into circulation so it can be reabsorbed. 01:07:00.150 --> 01:07:08.936 [SPEAKER_01]: And so that's why if someone is in having a poo every single day and she has high estrogen, we know that beta-glucoronidase might be working over time 01:07:10.477 --> 01:07:11.578 [SPEAKER_01]: and figure out what's going on. 01:07:11.778 --> 01:07:19.081 [SPEAKER_01]: That's why calcium deglaterate works because it turns off beta glucauronidase and it actually allows the conjugated estrogen to leave the body. 01:07:19.101 --> 01:07:22.223 [SPEAKER_01]: But that's with other hormones as well, like testosterone, for example. 01:07:22.343 --> 01:07:26.125 [SPEAKER_01]: Another secondary dyspiosis marker that we can look at is short-chain fatty acids. 01:07:26.165 --> 01:07:34.229 [SPEAKER_01]: Remember, the byproducts of all of our beneficial microbes, beauty rate, propyleneate, and acetate, for example, they're really, really useful in the body. 01:07:34.489 --> 01:07:36.950 [SPEAKER_01]: And we can test how many are in our stool, 01:07:37.370 --> 01:07:41.113 [SPEAKER_01]: and the diversity of them and then we can match that two different microbes in the gut as well. 01:07:41.153 --> 01:07:44.375 [SPEAKER_01]: And so we can have a look at primary and secondary dyspiosis. 01:07:44.475 --> 01:07:45.456 [SPEAKER_01]: First up is beauty rate. 01:07:45.516 --> 01:07:50.039 [SPEAKER_01]: Remember that's the primary fuel source of the cells of the lining in your colon. 01:07:50.359 --> 01:07:54.282 [SPEAKER_01]: It promotes gut integrity and it reduces inflammation directly. 01:07:54.922 --> 01:08:04.813 [SPEAKER_01]: Low or raw short-chain fatty acids are a functional red flag pointing to reduced microbial diversity and then not functioning properly because they can be there but maybe they're not functioning properly. 01:08:04.853 --> 01:08:09.958 [SPEAKER_01]: Maybe you have a low fiber diet and they can't do the work they need because they don't have the energy they need to do their job. 01:08:10.038 --> 01:08:11.680 [SPEAKER_01]: Okay, so let's get to the test. 01:08:11.820 --> 01:08:14.204 [SPEAKER_01]: Let's start with Australia and New Zealand. 01:08:14.344 --> 01:08:15.485 [SPEAKER_01]: I really like ice cream. 01:08:15.505 --> 01:08:17.308 [SPEAKER_01]: I'm just on their website now having a look through. 01:08:17.869 --> 01:08:21.434 [SPEAKER_01]: I did their microbiome check, which is 32 tests included. 01:08:21.875 --> 01:08:23.177 [SPEAKER_01]: It's pretty great. 01:08:23.437 --> 01:08:25.260 [SPEAKER_01]: I would say I was really impressed with it. 01:08:25.420 --> 01:08:26.542 [SPEAKER_01]: I was in Southeast Asia. 01:08:26.942 --> 01:08:39.029 [SPEAKER_01]: And I did this test when I got back because I got really sick of it there and I needed to take an antibiotic and I came back and I had very little bit of bacterium and lactobacillus and I started to have some weird symptoms and then I was like, okay, cool. 01:08:39.069 --> 01:08:40.750 [SPEAKER_01]: So this is primary dyspiosis. 01:08:40.830 --> 01:08:44.873 [SPEAKER_01]: So the people aren't there making the short-chain body acids and doing all of these other things. 01:08:45.413 --> 01:08:49.737 [SPEAKER_01]: So I'm going to go and find a probiotic that are rich in bifurdo bacterium and lactobacillus. 01:08:49.757 --> 01:08:52.720 [SPEAKER_01]: I'm going to eat fermented foods that I know I really, really high in these microbes. 01:08:53.180 --> 01:08:55.002 [SPEAKER_01]: I haven't retested, but I need to do it again. 01:08:55.122 --> 01:08:56.303 [SPEAKER_01]: I really like ice cream. 01:08:56.824 --> 01:08:58.205 [SPEAKER_01]: They send you the test kit. 01:08:58.625 --> 01:09:06.673 [SPEAKER_01]: Let me tell you, it's a real bloody humbling being in your bathroom and putting your stool in three different solutes mixing it together. 01:09:06.733 --> 01:09:10.416 [SPEAKER_01]: And then it's super weird putting in the post post box. 01:09:11.457 --> 01:09:19.161 [SPEAKER_01]: It's really weird, but I got my results back in about 10 days, which I was really impressed by, and it's really easy to read through as well. 01:09:19.221 --> 01:09:26.464 [SPEAKER_01]: They look at parasites, potential autoimmune triggers, yes, they also look at all your opportunistic pathogenic and beneficial bacteria. 01:09:26.844 --> 01:09:30.966 [SPEAKER_01]: They also look at your digestive and metabolic markers as well, your microbiome snapshot. 01:09:31.186 --> 01:09:38.848 [SPEAKER_01]: and they also look at fecal macroscopy, which is your store color, store form, mucus, and fecal occult blood, which is really, really helpful as well. 01:09:38.948 --> 01:09:40.209 [SPEAKER_01]: So that's ice cream. 01:09:40.329 --> 01:09:44.410 [SPEAKER_01]: Next for my North American girlie, so Canada in the U.S. is Viom. 01:09:44.490 --> 01:09:47.551 [SPEAKER_01]: They have a few different gut tests that you can do. 01:09:47.951 --> 01:09:52.492 [SPEAKER_01]: They have the gut intelligence test, the 4 body intelligence test, and the oral health intelligence test. 01:09:52.912 --> 01:10:04.822 [SPEAKER_01]: You can just go over the gut intelligence test and they have a fourth of July stale on today so you can save about 70 US which is about $100 Canadian dollars if you order it kind of soon and they look at a bunch of different things. 01:10:04.842 --> 01:10:06.183 [SPEAKER_01]: They look at gut health insights. 01:10:06.203 --> 01:10:11.127 [SPEAKER_01]: They look at your food recommendations as well and something on food recommendations. 01:10:11.147 --> 01:10:12.147 [SPEAKER_01]: I don't back this. 01:10:12.387 --> 01:10:19.173 [SPEAKER_01]: This test is pretty good for the test they look at for your gut but I do not ever recommend paying any attention 01:10:21.274 --> 01:10:26.856 [SPEAKER_01]: They are based on IGG food and sensitivity tests that are not backed, they're not evidence-based. 01:10:27.436 --> 01:10:36.699 [SPEAKER_01]: It's just something that I think a lot of these companies add on because they, I think they think it adds value and IGG food and sensitivity tests are pretty cheap to do. 01:10:36.719 --> 01:10:41.540 [SPEAKER_01]: I don't, the traffic light system for foods and stuff like that, it doesn't work that way. 01:10:41.840 --> 01:10:44.521 [SPEAKER_01]: It just tells you the food you're eating a lot of. 01:10:45.361 --> 01:10:48.143 [SPEAKER_01]: It's not actually telling you how you're reacting to that food. 01:10:48.383 --> 01:10:53.105 [SPEAKER_01]: There are tests for that that you can do with the dietitian or a doctor and they're called allergy tests. 01:10:53.465 --> 01:10:58.228 [SPEAKER_01]: And so if you think that you're reacting to a food, go and do those allergy tests with the health provider. 01:10:58.748 --> 01:11:01.450 [SPEAKER_01]: Food and sensitivity tests done in this way, I don't back. 01:11:01.570 --> 01:11:02.610 [SPEAKER_01]: So I'm just going to say that. 01:11:03.090 --> 01:11:05.972 [SPEAKER_01]: But the rest of this is pretty good and they recommend 01:11:06.552 --> 01:11:10.534 [SPEAKER_01]: what you're low in and what you can bring up and what foods are rich in that, for example. 01:11:10.594 --> 01:11:12.215 [SPEAKER_00]: So volume is pretty good for that. 01:11:12.295 --> 01:11:17.658 [SPEAKER_01]: And finally, for the women listening in the EU and UK, biome site is pretty good. 01:11:17.758 --> 01:11:22.521 [SPEAKER_01]: They have a gut microbiome snapshot and then you can also get three tests of the same test. 01:11:22.541 --> 01:11:26.863 [SPEAKER_01]: So you can get one test or three tests, which I think is pretty great and you get a big discount. 01:11:26.903 --> 01:11:35.168 [SPEAKER_01]: So I think if you get three tests, it's usually about a thousand pounds, but if you just get the three in one go, it's about 700. 01:11:35.188 --> 01:11:35.628 [SPEAKER_01]: So you can say 01:11:36.148 --> 01:11:37.469 [SPEAKER_01]: I don't know. 01:11:37.489 --> 01:11:39.591 [SPEAKER_01]: 300 to 400 pounds, but it's pretty good. 01:11:39.631 --> 01:11:45.395 [SPEAKER_01]: It gives you a good insight into what bacteria, probiotic, and what commensal bacteria you have. 01:11:45.655 --> 01:11:49.838 [SPEAKER_01]: It also looks at all your short chain fatty acids, it looks at toxin and neurotransmitter produces. 01:11:50.258 --> 01:11:53.181 [SPEAKER_01]: It also looks at how you're synthesizing vitamins and things like that as well. 01:11:53.221 --> 01:11:54.542 [SPEAKER_01]: So it's a pretty good test. 01:11:54.982 --> 01:11:58.585 [SPEAKER_01]: If you want all of the links for all of these, I'm going to hyperlink them all below. 01:11:58.605 --> 01:12:01.006 [SPEAKER_01]: If you're watching on YouTube, then it's going 01:12:04.769 --> 01:12:08.510 [SPEAKER_01]: But all of them are there for you if you wanted to do a gut microbiome test. 01:12:08.650 --> 01:12:19.934 [SPEAKER_01]: I did one this year and I really loved it I think it's something that we should just be doing every single year, especially if you have any gut microbiome issues Especially if you're dealing with any symptoms Always look into the gut. 01:12:20.114 --> 01:12:24.376 [SPEAKER_01]: It's really important to consider the gut as a part of your overall health and well-being 01:12:26.477 --> 01:12:30.779 [SPEAKER_01]: Thank you so much for taking the time out of your busy day to listen to this episode. 01:12:30.859 --> 01:12:35.201 [SPEAKER_01]: If you loved it, please remember to like, subscribe and send to a loved one. 01:12:35.581 --> 01:12:46.266 [SPEAKER_01]: If you want to learn more from our quorum and please check out the website at arquorum.com.au where you can find a pothora of offerings like charts, master classes, courses, and organic clothing. 01:12:46.666 --> 01:12:53.590 [SPEAKER_01]: You can also head over to patreon.com slash archwomen or substack.com slash archwomen to join the community. 01:12:53.830 --> 01:13:00.294 [SPEAKER_01]: I hope you have a really beautiful morning, afternoon or evening wherever you are in the world and I will see you on the next episode.