Hello, health enthusiasts, and welcome to Rev Up Health, your go-to podcast for all things wellness. I'm Dr. Mark Hechler, and I'm Tandi Hechler. Together we're here to fuel your health journey with the best of functional medicine and holistic well-being. Each episode, we'll dive deep into topics that matter to your health, bringing you the latest insights, research, and inspiring stories. Whether you're on a quest for vibrant health or just looking for daily health tips, we've got you covered. So let's embark on this journey together and transform the way you live. So, Tandi, what's on our wellness radar for today?
Hello, hello, and welcome to the Rev Up Health Podcast. I'm Tandi, and I'm Dr. Mark, and today we're going to be talking about gut health. This is something Dr. Mark has been talking with a lot of patients about recently, and he's done a lot of extra research, kind of taking a deep dive. So let's get to it.
Your Gut Microbiome: A Symphony You Conduct
We'd like to talk about what makes up our gut microbiome. I like to use the analogy that it's like a sophisticated symphony orchestra, made up of all kinds of different things — strings, horns, woodwinds, percussion — and all of these individual instruments have to play a part with each other and get along perfectly to have a beautiful song come out. You can also think of the fact that you are the conductor of this symphony. You get to choose what happens; you get to choose how good the sound and the music are going to be by what you do or expose yourself to, whether it be environmental toxins or, of course, what we eat.
These gut microbiomes are basically just trillions of microorganisms, made up of combinations of good bacteria and bad bacteria, and then we've got viruses, fungi, and archaea. How all these little fellas get along and live in a symbiotic relationship will determine how healthy you actually are. These bacteria are basically just digesters, so they'll digest our complex carbs and fiber — nutrients that are indigestible by humans — and make it so our gut can actually absorb them for nutrients, which is kind of crazy.
Dysbiosis and the Immune System
If there's an imbalance, that's what we call dysbiosis — the imbalance of this gut microbial community. This affects 70 million Americans per year, which is kind of incredible. These little guys are immune regulators; they help educate and modulate our immune system by training it to distinguish between good and harmful things. Harmful stuff can lead to autoimmune diseases — it's a whole symphony-triggered cascade of events that leads to that. About 70 to 80% of your immune system is in your gut, called the gut-associated lymphoid tissue, and they're the regulators of how well you get along with the outside community.
These bacteria will also lead to the synthesis of certain vitamins — vitamin K, biotin, folate, even B12. They take fiber and break it down into short-chain fatty acids, which have been known to be an anti-inflammatory agent as well as a boost to our immunity.
Energy, Metabolism, and Mitochondria
These bacteria have a lot to do with our energy and metabolism. They help with our insulin sensitivity, our glucose homeostasis, and even our lipid metabolism. They also aid in mitochondrial biogenesis, done through signals of nutrient availability and demand for mitochondria. But dysbiosis will essentially lead to a lot of chronic inflammation from various cytokines and metabolites secreted into our immune system, and that impairs our mitochondrial function.
Chronic Diseases Linked to Gut Dysbiosis
There are a lot of chronic diseases that are caused or worsened by gut dysbiosis. It's linked to numerous chronic health conditions, including inflammatory bowel diseases like Crohn's or ulcerative colitis, and irritable bowel syndrome, which includes symptoms like abdominal pain, bloating, and stool changes. Metabolic syndrome is also related to this dysbiosis. How you know you have metabolic syndrome is an increased waist size — greater than 35 for females, greater than 40 for males — elevated LDL over 150, low HDL under 40, high blood pressure, fasting glucose higher than 100, type 2 diabetes, cardiovascular disease, and NAFLD, which is non-alcoholic fatty liver disease. There are also allergic and atopic conditions like asthma, eczema, and food allergies. Dr. Mark already talked about the autoimmune diseases and how dysbiosis plays into that, and there are neurological disorders too — Parkinson's, Alzheimer's, MS, depression, and anxiety.
The Gut-Brain Connection
That leads us to discuss the gut-brain connection, which is a big topic these days. Our gut health influences your mood and hormone balance. It affects your cortisol levels, your insulin sensitivity and resistance, and the hormones that deal with our satiety and hunger, which are leptin and ghrelin, as well as serotonin, dopamine, and GABA, plus these short-chain fatty acids. All of these influence our mood, and that certainly affects your anxiety, depression, stress, and even your cognition. There's even talk about how the tenth cranial nerve, the vagus nerve, is affected from a rest-and-digest standpoint with our parasympathetic nervous system.
The Triad of Metabolic Harmony: Gut, Thyroid, and Energy
Then we talk about this triad of metabolic harmony, as I like to call it — essentially the gut, thyroid, and energy trilogy. If you have thyroid problems, you can have issues with fatigue, weight gain, sluggishness, even constipation and bloating. This can all be related to hypothyroidism, which will also cause a decrease in motility. And it doesn't necessarily have to be a label of hypothyroidism — you can have suboptimal levels of your thyroid. You may have normal levels, but it's just not getting into the cell, whether from the sludge that gets around our cells or the receptors that get bound up, and that tends to reduce our thyroid optimization. Optimizing our thyroid will support your immune homeostasis and help reduce gut autoimmune diseases like celiac and inflammatory bowel disease.
Leaky Gut and Hormones
Intestinal permeability, also known as leaky gut, is a problem that allows bacteria and toxins to go straight into the bloodstream, triggering inflammatory processes and autoimmune diseases. A lot of the things we see from an autoimmune standpoint may be triggered by this leaky gut problem.
Then we've got the impact of the gut microbiome on our sex hormone production and levels. You've got a direct effect with estrogen — also known as the estrobolome, essentially. There are different types of enzymes that deconjugate estrogens in the gut, and that causes an increase in these estrogens in the bloodstream. The microbiome also has to do with the metabolism of your testosterone, and it can influence progesterone. It just causes an imbalanced regulation, and the endocrine system is quite sensitive — it can be disrupted even by antibiotics, steroids, and the toxins we get exposed to.
One thing I thought was very interesting was listening to someone talk about estrogen and estrogen dominance, and one of the ways that happens is with constipation. When you're in dysbiosis and you've got constipation, you've got all of these toxins — including all of these hormones that should be secreted to create balance throughout the body — and instead, now you're creating these disproportionate hormones, because you're not having a regular bowel movement.
How Do You Know If You Have Dysbiosis?
That leads us to the next part: how do you know if you have a problem with dysbiosis? Essentially, this is where we're talking about your bowel habits. Are you pooping regularly? What does your poop look like, and what should it look like? Essentially, we're looking for a smooth, sausage-like, brown poop — that's a good poop to have.
I recently heard a podcaster talking about how, if you have trouble with your dysbiosis and your bowels and what you eat — is it that you have logs and rocks, or do you have tea, or do you have snakes? That kind of hits home; it's descriptive, but you know what I'm talking about. These symptoms of dysbiosis take on all kinds of forms — constipation, diarrhea, bloating, gas, abdominal pain — they're pretty common issues.
Then also, looking at changes. We all know that everybody is different, so everybody's going to have a little different schedule and a different rhythm, but when you start seeing changes, that's a pretty good indication that there's a problem. Oftentimes, if you're really paying attention, you might be able to correlate what you ate or what you were exposed to that caused those changes. But I think a lot of people just think it's normal to have diarrhea every once in a while, or constipation — and the truth is, even though it's common, it's not normal.
Look at the situation for everybody: if you've traveled and gone anywhere for an extended period of time, or even an overnight deal, it's certainly something that will upset that biome — with what you eat, maybe a change in your activity, stress. All of those affect it. That's a simple sign of how dysbiosis happens, and to have that happen on a chronic, everyday basis starts to affect your overall health.
Testing the Microbiome
There are a few things we can do to test the microbiome. One would be a stool analysis — a test where we provide a kit, you take it home, do the collection, and send it off for testing. When you get it back, it will tell you which bacteria you might be low in or have too much of. There's also a food inflammatory test, a blood spot test you do at home and send in, and it will give you information about your microbiome too. It's about the sensitivity — it doesn't necessarily mean you're allergic to foods. People think, "I can't eat that because I'm allergic to it," but that's not necessarily true; it could just be more of a sensitivity. And what is that? Is it because your gut lining has some troubles and you don't tolerate these well, you don't make enough enzymes, or is there a genetic predisposition? Those are things we can go through and try to figure out.
Improving Your Gut: Start With Movement
Once you've identified that you have a problem with your microbiome, what are some things you can do to improve it? There are a lot of things, starting with exercise. When you increase your exercise, you improve your gut motility just from the fact that you're moving your body. That'll help reduce constipation without question, and it's going to help improve gas, bloating, and inflammatory bowel symptoms — those irritable things that happen. And it's just modest amounts of exercise, not excessive.
I think that's key — that it's regular movement on a regular basis. I heard Dr. Casey Means talking the other day about how our current thought on exercise is, "I've got to go to the gym and get my workout in, and then I'm good for the day." But the truth is, our bodies were made to move all day long. So although it's great to get that one workout in — and I'm not saying don't do that — make a point to get up and move your body several times throughout the day, even if it's just standing next to your desk and doing some squats, or, even better, taking a walk, because then you're getting a break from sitting and looking at the walls of your cubicle.
All this exercise is going to help improve your good bacterial microbiomes — the good guys that help protect our linings. It decreases our gut permeability, which is eventually going to improve your nutritional absorption and help your overall health and wellness.
Yoga and Meditation
Then, kind of a second stage, yoga is a great way to exercise and move the body. It really does work the gut, but it also reduces stress, which is another great thing to help improve your gut health. Meditation kind of goes hand in hand with yoga, and both of those would be really good to help.
Meditation is really key. A lot of folks just don't do it, and that's okay, but you need to take time to have a way to reset and reduce stress, even if it's just doing three box breaths — sit down in a nice quiet environment, take some big deep breaths, and blow out the steam, no pun intended.
Nutrition: Fiber, Fermented Foods, and Eating the Rainbow
The next thing is nutrition and how you're going to feed your body to improve it. Dietary and lifestyle support comes with a diverse, rich, high-fiber diet — those good bacteria love that fiber, and that's basically our prebiotics and probiotics. There are a lot of different types of probiotics on the market, but there are also fermented foods — various types of sauerkraut and kimchi and things like that, kombucha, kefir — lots of ways to get fermented food. And then there are the polyphenols, which are a variety of different-colored foods, vegetables, and fruits. What we want to avoid are the sugars, starches, and all these processed carbs — those things just feed the bad bacteria.
Just a quick note on the polyphenols: the idea is to eat the rainbow, so make sure you're eating a wide range of colors of vegetables, and that will help make sure you're getting everything. You need to think of trying to get your fruits and vegetables as more of a whole food, instead of getting it out of a can. That's going to help maintain that good-quality microbiome we need. We need to make our fruits and vegetables more of our main course, instead of an afterthought, something to add to our food source.
Avoiding Toxins
We also have to avoid the pollutants and toxins, especially the toxins from some plastics, and glyphosate — basically the herbicides that are in a lot of things. Your cattle are eating the grasses we're putting these herbicides on, so that stuff gets into our system too.
Supplements and GLP-1
There are also different supplements you can take to help. We talked a little about the pre- and probiotics. We recently started taking Akkermansia, and we've really felt like that has helped us a lot.
Another part of that is GLP-1 production, which is really key. Obviously, there are the GLP-1 agonists like Ozempic that are out there, but your gut wants to produce GLP-1 on its own. So what do we need to do to encourage that? That's taking care of our good gut bacteria. GLP-1 has anti-inflammatory effects, and in these smaller doses, it reduces your appetite, improves your insulin sensitivity, and also improves your gut barrier integrity — that leaky gut permeability we don't want. And as far as medications, there's also been some evidence that metformin could benefit the gut microbiome and gut barrier function as well.
Wrapping Up
As you can see, there are a lot of topics here, and a lot of things our gut is vitally important for — it's a major contributor to our health. As the conductor, you've simply got to do what you can to conduct your symphony orchestra to produce the best outcome. What you can do as a human to help your own GI tract is going to help improve your quality of health and your overall mental and physical health.
I think that's a good place to stop for today. If you have any questions, please reach out at revelationhealthandwellbeing.com, and keep following us. Let us know what you want to hear more about. We appreciate you listening. Have a healthy day.
Thank you for tuning in to another episode of Rev Up Health. We hope you're leaving with some valuable insights to supercharge your health journey. Don't forget to follow or subscribe to Rev Up Health wherever you listen to your podcasts, and if you enjoyed today's episode, please leave us a rating and review. Have a topic you want us to explore? Reach out to us on our social media channels — we love hearing from our wellness community. Until next time, keep thriving, and remember: your journey to health is a journey to a better you. Stay well, and we'll connect with you again soon. This is Tandi, and this is Dr. Mark, signing off from Rev Up Health. Take care.
The information provided in this podcast is for educational purposes only and is not intended as medical advice. The content is designed to support, not replace, the relationship that exists between a patient and their healthcare provider. Always consult with a qualified healthcare professional before making any changes to your healthcare regimen, including diet, exercise, or treatment plans. The views and opinions expressed in this podcast are those of the hosts and guests and do not necessarily reflect the official policy or position of Revelation Health and Wellbeing.