# Can Anxiety & Depression Originate in Your Gut? (ft. Dr. Ted Achacoso) | SNH Podcast #71

An episode of [Health Optimization Medicine Podcast](https://invisiblenetwork.ai/podcast/1663974629), 15 May 2024, 53 min.

Audio: https://traffic.libsyn.com/secure/672d8edf-a640-45ce-ac61-cd5f898a7b27/SNH_71_Audio.mp3?dest-id=3824325

In this episode of the Smarter Not Harder Podcast, Dr. Ted discusses the profound connection between your gut and your brain. He reveals how the health of your gut microbiome can directly influence your mood, mental clarity, and even your risk of neurodegenerative diseases. *Join us as we delve into:* + The gut as a "second brain": Dr. Ted explains how your gut has its own nervous system, produces neurotransmitters, and communicates with your brain. + Gut dysbiosis and its consequences: Learn how an imbalanced gut microbiome can lead to inflammation, brain fog, and contribute to conditions like anxiety and depression. + Leaky gut and neuroinflammation: Discover the connection between a compromised gut lining and inflammation throughout the body, including the brain. + Optimizing gut health for brain health: Dr. Ted shares practical tips, dietary changes, and innovative therapies to improve your gut microbiome and support optimal brain function. This episode is for you if: - You struggle with mood imbalances, anxiety, or brain fog. - You're interested in the cutting-edge science of the gut-brain axis. - You want natural, proactive strategies to optimize your mental and physical health. - Get ready to learn how the health of your gut can unlock a healthier, happier you! *You can also find this episode on…* Youtube: https://youtu.be/NXcOFA8jPN8 *Find more from Dr. Ted Achacoso:* Facebook: facebook.com/drtedachacoso/ Instagram: instagram.com/tedace/ *Learn more about Smarter Not Harder:* Website: https://troscriptions.com/blogs/podcast | https://homehope.org Instagram: @troscriptions | @homehopeorg Get 10% Off your purchase of the Metabolomics Module by using PODCAST10 at https://www.homehope.org Get 10% Off your Troscriptions purchase by using POD10 at https://www.troscriptions.com Get daily content from the hosts of Smarter Not Harder by following @troscriptions on Instagram.

## Transcript

[0:05] Hi.
[0:09] Good morning.
[0:11] See, there were people there who said
[0:13] hi, and those people said good morning.
[0:15] Because in health optimization medicine
[0:17] and practice, as you heard yesterday,
[0:18] hi is always a four letter word.
[0:21] Today we're talking about the
[0:23] enderic microbiota gut brain
[0:24] axis in the context of health
[0:26] optimization medicine and practice.
[0:29] Now, I'd like to disclose that I'm the
[0:31] founder of both of these organizations,
[0:33] Health Optimization Medicine and
[0:34] Practice, which is a non profit.
[0:36] We teach physicians health optimization
[0:39] medicine and non physician healthcare
[0:41] practitioners health optimization
[0:43] practice on how to do health optimization.
[0:46] And The products off descriptions LLC,
[0:49] which is now held a company held by
[0:52] smarter, not harder is actually to help
[0:56] clinicians deal with more acute symptoms.
[0:59] During a patient or client
[1:01] care for example, anxiousness
[1:03] and sleeplessness and pain.
[1:06] And we are essentially the
[1:08] main donors to Home Hope.
[1:10] So that's a disclosure for me.
[1:13] The general schema of everything
[1:15] that we talk about is this,
[1:16] is a enteric microbiota with
[1:19] a bidirectional communication
[1:20] with the gut and a bidirectional
[1:22] communication with the organs.
[1:23] So it's enteric microbiota
[1:25] gut organ communication.
[1:27] I actually created this slide
[1:28] because I was made to lecture
[1:30] on enteric microbiota gut lung.
[1:33] Access during the beginning of
[1:35] COVID and as you can see here there
[1:38] is the common theme is that all of
[1:40] these organs actually have malt.
[1:44] And I don't mean whiskey because
[1:47] in health optimization, we
[1:48] have better drugs and alcohol.
[1:51] So MALT stands for what?
[1:53] Mucosa associated lymphoid tissue, right?
[1:56] So you could see here whereas before
[1:58] the other systems we should thought were
[2:00] sterile, like the ureters, et cetera,
[2:01] and placenta, they actually have a,
[2:04] Microbiota now, as we have found out.
[2:07] So after this lecture, you will be
[2:09] able to discuss knowledgeably about
[2:11] the fundamental structure functions
[2:12] and new perspectives of the M.
[2:15] G.
[2:15] B.
[2:15] Axis enumerate the bidirectional
[2:18] communication pathways of the E.
[2:19] M.
[2:19] G.
[2:20] B.
[2:20] Axis mentally formed a framework.
[2:22] Of HomeHope and its fundamental
[2:24] role in caring for the EMGB
[2:25] axis as a practitioner.
[2:27] Be familiar with the technique of
[2:29] detection and correction of imbalance
[2:31] of HomeHope versus diagnosis and
[2:33] treatment of disease of illness
[2:34] medicine as applied to the EMGB axis.
[2:37] Discuss knowledgeably about
[2:39] the enteric microbiota brain
[2:41] interactions, neuroinflammation,
[2:43] and identify what's missing in
[2:45] today's research on the EMGB axis.
[2:49] And be up to date with the latest
[2:50] developments in the EMGB axis.
[2:52] Now, let's take the first part
[2:54] of this, is the structure,
[2:55] functions, and new perspectives.
[2:57] You guys already can always Google
[3:00] the structure and function, right?
[3:02] What I'd like you to remember
[3:03] from this section are really
[3:04] the perspectives that you should
[3:06] carry when you are in the clinic.
[3:08] Let's take a look at a quick structure.
[3:10] Many of you have more expertise
[3:11] than I have in this area.
[3:13] This is distribution of
[3:14] microbial communities by weight.
[3:16] As you can see, 78 percent
[3:18] is in the GI tract.
[3:19] And here's the distribution.
[3:21] On the right side of the slide, where you
[3:22] could see where the colon has 10 to the
[3:25] 11, jejunum 10 squared, and 10 to the 8.
[3:30] So you could see where the
[3:31] distributions are of the gut microbiota.
[3:34] Now the important thing here is
[3:36] to visualize it in several layers.
[3:38] The gut microbiota actually
[3:41] pre process all of your food.
[3:43] Now, that's a key term here, is it pre
[3:45] processes everything that you swallow
[3:48] they try to pre process even non
[3:50] edible things that you try to swallow.
[3:52] So here after they pre process it
[3:55] and it passes through the liver.
[3:56] That's When you take an oral drug the
[3:58] liver tries to either activate or detoxify
[4:01] it however the drug is configured and
[4:04] then those raw materials are now then fed
[4:07] to the brain to the heart, the adipose
[4:10] tissue, the muscle, kidneys, and so on.
[4:12] All right, so the new perspective is the
[4:15] enteric microbiota is a post natal organ.
[4:18] Okay it's an organ that actually
[4:20] appears and grows after birth, right?
[4:23] It's seeded usually in spontaneous vaginal
[4:26] delivery through the vaginal canal.
[4:28] And as early as 2006, there
[4:31] were already some publications
[4:32] that is the forgotten organ.
[4:34] Now, don't forget microbiota
[4:36] is not foreign to you, right?
[4:38] It is part of what grows in
[4:40] you as an organ, except that it
[4:42] only grows after you're born.
[4:45] So here's a more recent, this is
[4:46] 2019 article, a representation
[4:49] of the gut micro biota in terms
[4:52] of prenatal, infancy, childhood,
[4:54] adolescence, adulthood, and aging.
[4:56] And you could see here on the lower
[4:58] part what they're actually doing
[5:00] right in helping to contribute.
[5:02] Doing now of course the second part
[5:05] that, that's your enteric microbiota.
[5:07] Remember in, in old textbooks,
[5:09] we just say gut-brain axis.
[5:10] That's already old, right?
[5:12] You have to specify enteric
[5:13] microbiota, gut brain axis, right?
[5:16] In order to be more specific, that the
[5:19] microbiota itself is an organ in the body.
[5:22] Now the gut is actually
[5:24] a brain in itself, right?
[5:25] It has the lumen, of course the
[5:27] like the ventricles in the brain.
[5:29] Myenteric plasters, which
[5:30] is the main nervous.
[5:32] system of the brain, which
[5:33] we call actually the enteric
[5:34] nervous system, right?
[5:35] And then there's semicosal
[5:37] plexus, and then the mesentery.
[5:38] This is an old book that
[5:40] actually popularized the idea
[5:42] that it's the second brain.
[5:43] For many people, in fact, it is the first
[5:45] brain because evolutionarily, the brain is
[5:47] actually a later development in evolution.
[5:50] You had the gut first.
[5:51] So the functions would be nutrient
[5:54] absorption and immune defense, right?
[5:56] And you could see here underneath
[5:58] the intestinal lining, there
[6:00] is the payers patches, right?
[6:01] And there is the M cell or the micro
[6:03] fold cell that proceeds it and of
[6:05] course there's a lymphoid tissue
[6:06] underneath and this is called the
[6:10] induction path induction patch, right?
[6:12] This is where most of the immune
[6:14] system actually interacts with anything
[6:17] that's in the gut lumen, right?
[6:21] Now the new perspective that I'd
[6:22] like you to take home with you is
[6:25] that it's the largest immune organ.
[6:27] When you were in med school,
[6:28] it was a bone marrow, right?
[6:30] But we have, in the last 15 years, we now
[6:32] know it's the largest immune organ, right?
[6:35] And you could see here the
[6:36] distribution and with apologies
[6:39] for those who love Ayn Rand, who is
[6:42] GALT gut associated lymphoid tissue.
[6:44] This makes up 70% of
[6:46] the immune system now.
[6:49] Let's go to the brain the third part
[6:51] of the axis the brain we we we should
[6:54] always take a look that we have two
[6:56] brains and a single body, right?
[6:58] Let's take a look at
[6:59] the second brain first.
[7:00] It has glial cells, 500 million neurons,
[7:02] 14 neurotransmitters that are identified
[7:05] and produces 50 percent of all dopamine
[7:07] and 95 percent of all serotonin.
[7:10] Now, remember, these are not for the
[7:12] brain in the central nervous system.
[7:13] This is for its own use.
[7:15] As a brain in itself, right?
[7:17] So it's time for you to forget
[7:19] the fact that, oh, are these
[7:21] going to be used by the brain?
[7:22] No, this is going to be used
[7:23] by your second brain, right?
[7:25] It is a brain in itself.
[7:27] So these are its own neurotransmitters.
[7:28] These are what it produces for
[7:30] itself in order to function.
[7:32] That's why I said it requires a
[7:33] really, a shift in perspective
[7:35] to treat it as a brain, right?
[7:36] The other brain actually has
[7:38] about 86 billion neurons.
[7:39] And for those of you who are
[7:41] curious, really 65 billion of those.
[7:44] are contained in your cerebellum,
[7:45] so you have really only very
[7:47] few that are in your neocortex.
[7:49] Now the the finding, of course this
[7:52] was in, I think 2012, is that there's
[7:55] a glymphatic system in the brain.
[7:56] We used to think that there was no
[7:57] lymphatic system in the brain at all,
[7:59] and it turns out that the glial cells
[8:01] actually form a perilymphatic space
[8:05] or a perivascular space around the
[8:08] blood vessels and actually cleans out
[8:10] your brain, especially during sleep.
[8:12] So this is a Nobel worthy development
[8:16] that they actually saw that there is the
[8:18] brain has actually a lymphatic system.
[8:21] Now, the structure of the brain all of
[8:24] us talk about the blood brain barrier as
[8:26] if it were the only barrier of the brain.
[8:28] It is not, right?
[8:29] There are barriers at the surface of the
[8:31] brain the arachnoid barrier There's a
[8:33] blood CSF barrier closer to the cavities
[8:36] of your brain called the ventricles.
[8:38] And of course, there's
[8:39] the blood brain barrier.
[8:40] So all of these are actually significant
[8:43] in what we're discussing today.
[8:44] So when someone says blood brain
[8:46] barrier, do you mean just the blood
[8:47] brain barrier or do you mean the blood
[8:49] cerebrospinal fluid barrier or the
[8:51] barrier at the surface of the brain?
[8:53] These are very important
[8:54] distinctions to make.
[8:57] Now the function of the brain is for
[9:00] cognition and emotional regulation.
[9:02] And is actually interesting.
[9:04] Psychedelic research find the ego
[9:06] exists in the default mode network.
[9:07] This is a network that looks
[9:09] like a butterfly like this.
[9:10] It's composed of the posterior
[9:12] cingulate gyrus, the prefrontal
[9:14] cortex, angular gyri.
[9:16] And you can see here that you should
[9:18] keep in mind, we're talking about,
[9:19] gut microbiota here, and the thing
[9:22] that you could think about is your
[9:24] ego is actually getting controlled
[9:25] by your gut microbiota sometimes.
[9:28] The other thing is that the brain circuit
[9:30] for spirituality has been identified
[9:32] and it's the periaqueductal gray.
[9:35] And for those of you who administer
[9:37] anesthesia at one point or the
[9:38] other, this is an opiate rich
[9:40] center that gets you high.
[9:42] And so there is your brain circuit for
[9:45] spirituality, and it's also in the brain.
[9:48] And so this is also being
[9:51] affected by your microbiota.
[9:53] I wonder if anyone here would
[9:54] sequence the gut microbiota of
[9:55] highly spiritual people and see
[9:57] what they get in terms of organisms.
[9:59] Now, then the new perspective that
[10:02] I'd like you to go home with is that
[10:03] the brain is not immune privileged.
[10:05] It has a neuro immune system.
[10:07] You guys are actually
[10:09] very familiar with this.
[10:10] This is the capture, rolling,
[10:12] activation, adhesion, this is all
[10:14] white blood cell activity, right?
[10:16] And it actually can insinuate itself into
[10:20] the neurons via the perivascular space.
[10:24] You could see here there's a
[10:25] neuroimmune crosstalk, right?
[10:27] There's a healthy brain
[10:28] and the diseased brain.
[10:29] You could see in the diseased brain
[10:31] or the unhealthy brain, right?
[10:32] There's a reactive astrocyte
[10:34] and activated microglia.
[10:35] Remember that astrocytes are just,
[10:38] what, special types of microglia.
[10:41] So let's take a look at the
[10:42] bidirectional communication
[10:44] in the tripartite axis, right?
[10:46] So there's neural, endocrine,
[10:47] immune, metabolite signaling,
[10:49] and vesicular, right?
[10:51] Here you have the neural mechanism.
[10:53] Here's the the neural mainly
[10:55] mediated as we as is often
[10:57] referenced as a vagus nerve, right?
[10:59] And then the endocrine is via the
[11:01] HPA axis with a cortisol affecting,
[11:04] gut motility, the immune system with
[11:06] the cytokines metabolite signaling.
[11:08] And one more here's the bi
[11:10] directional communication.
[11:12] We all know about the vagus nerve
[11:13] vagus actually slows down intestinal
[11:16] motility, and that's a signal.
[11:17] But what you should not forget is they're
[11:19] communicating with the enteric neurons.
[11:22] That's important.
[11:22] We all think it's just
[11:23] coming from the brain.
[11:24] Your second brain is actually
[11:26] communicating with your first brain
[11:27] in terms of its own enteric neurons.
[11:30] Okay.
[11:31] Now there's a bidirectional
[11:33] communication via the endocrine system.
[11:35] You have the hypothalamo pit axis, of
[11:38] course, the cortisol release and so on.
[11:40] And those actually report basically
[11:44] affect your microbiota and what your
[11:46] microbiota do actually produce metabolites
[11:49] that then are sent back to the brain.
[11:52] If you take a look here you have
[11:54] your we only think again this is
[11:57] what I'm going to emphasize here.
[11:58] You always think that it's
[11:59] coming from the brain.
[12:00] But the gut itself has its
[12:02] own enteroendocrine cells.
[12:04] It means it produces its own hormones,
[12:07] like GLP 1, PYY, CCK, these are all
[12:10] enteroendocrine hormones that are produced
[12:13] by the enteroendocrine cells in the gut.
[12:16] As I said earlier this is
[12:18] a separate brain in itself.
[12:20] So it has its own neurohormones, it
[12:23] has its own hormones that affect it and
[12:26] that affect the first brain in itself.
[12:28] The third is bi directional
[12:30] communication using the immune system.
[12:33] Of course, here are the
[12:34] immune cells, right?
[12:35] They produce the inflammatory cytokines
[12:38] and they affect the brain if they are
[12:40] inflammatory cytokines, of course,
[12:42] then you will begin to have something
[12:44] like neuro inflammation, right?
[12:47] It says here that the LPS
[12:48] activates an inflammatory response.
[12:50] You all are familiar with LPS.
[12:53] And one of the things I'd like to say
[12:55] here is that cardiologists like to
[12:57] put down to basically bring down your
[13:00] low density lipoproteins, but your
[13:02] low density lipoproteins are actually
[13:04] responsible for mopping up the the LPS.
[13:08] In your system.
[13:09] So there is a certain amount.
[13:11] If you push it way too low, your patient
[13:14] will actually be in a chronic state
[13:15] of inflammation because what the LPS
[13:18] could not be cleared out properly.
[13:21] Now.
[13:22] Metabolite signaling, you know that
[13:24] the colonic bacteria, for example,
[13:25] produces short chain fatty acids, right?
[13:27] And and short chain fatty acids,
[13:30] as you will see in later slides,
[13:31] actually is responsible for the
[13:33] behavior of your blood brain barrier.
[13:36] And among your short chain fatty
[13:38] acids the most prominent one that
[13:40] you know about is butyrate, right?
[13:43] And there, you have seen studies
[13:45] where low butyrate actually is very
[13:47] much associated with colon cancer.
[13:49] When I lecture to my students, I tell
[13:51] them that if you're looking for a colonic
[13:53] surgeon, you should ask your colon surgeon
[13:55] what the primary fuel is of colonocytes.
[13:58] If he says glucose, you should
[13:59] ditch him and find another one.
[14:01] A, these are very simple tests.
[14:02] Ask what's the primary fuel your GI,
[14:04] what the primary fuel of your enterocytes
[14:06] are, if he says glucose, ditch him,
[14:08] or ask your cardiologist what the
[14:09] primary fuel of the heart cells are,
[14:11] and if he says glucose, ditch him.
[14:13] If you ask your neurologist,
[14:15] what's the primary fuel of the
[14:16] brain at rest, if he says glucose.
[14:18] Fire him.
[14:19] These are basic or fundamental things
[14:21] that we all should know, right?
[14:23] Both doctors and practitioners
[14:24] should be very aware of what
[14:26] fuels your fundamental cells.
[14:29] So it's the neural, it's the vagus
[14:31] nervous system, endocrine is the
[14:33] hypothalamic pituitary axis and the entero
[14:36] endocrine system then there's immune
[14:38] signaling, metabolite signaling, right?
[14:40] And then, the last one,
[14:42] actually Um, is by what's called
[14:47] bacterial membrane vesicles are
[14:48] often outer membrane vesicles.
[14:50] So that the, again, the communication
[14:53] is bidirectional that the bacteria
[14:56] actually produce membrane vesicles that
[14:58] can then fuse with your enterocytes.
[15:02] And it may contain
[15:03] anything it can contain.
[15:04] It may contain RNA.
[15:06] In fact the Nobel award for this
[15:08] was showing it containing RNA.
[15:10] So for those of you who get
[15:12] questions about COVID vaccine, right?
[15:15] That it actually has RNA and it's
[15:17] being incorporated in the system.
[15:19] Evolution has been doing this for
[15:21] us thousands of years in our gut.
[15:23] So that's just something
[15:25] for you guys to think about.
[15:28] Now, here's what I was telling
[15:30] you about, the bidirectional
[15:32] communication in the EMGB axis, right?
[15:35] This was in 2013, and he says,
[15:38] Recently interkingdom crosstalk
[15:40] was demonstrated between humans and
[15:42] bacteria through fecal microRNAs.
[15:44] What, why is that significant?
[15:46] Because interspecies talk
[15:48] is not allowed, right?
[15:50] It's just like reproducing between a
[15:52] hippopotamus and a swallow, for example.
[15:55] But now we find that they
[15:56] actually communicate, right?
[15:58] And we talk back and forth
[15:59] with them through RNA.
[16:01] They alter our epigenome, and
[16:04] guess what, and therefore they
[16:05] will alter our behavior as well.
[16:08] So the way to look at it is
[16:09] what I term as a holobion.
[16:11] We are basically an
[16:12] assemblage of organisms.
[16:14] We are a network of organisms that
[16:17] are all communicating with each other.
[16:19] We cross a species in order
[16:21] to talk to each other, right?
[16:23] So human cells, human microbiota
[16:25] food, fungi, and other viruses, they
[16:27] are all in a network within our body
[16:30] as an ecosystem, and they all talk
[16:32] to each other by different means.
[16:34] And the last means that was just
[16:36] shown was actually by membrane
[16:37] vesicles, which was forbidden.
[16:39] This form of communication
[16:41] between species was forbidden by
[16:43] biology, by dogma a long time ago.
[16:46] Finally this is 20 19 article.
[16:49] They're finally using the term holobiont
[16:52] in the microbiota gut brain axis
[16:53] articles that you will find out there.
[16:57] Now, the third part would be an
[16:59] introduction to home hope for those of
[17:01] you who weren't here yesterday and then
[17:03] how to detect and correcting balances in
[17:06] the enteric microbiota got brain access.
[17:08] And then the.
[17:09] Uh, Entire microbiota brain interaction.
[17:12] The interaction between
[17:14] the two organs, right?
[17:15] And then a neural inflammation
[17:17] and illness medicine versus health
[17:19] organization, medicine and practice.
[17:21] This is a very simple way to display what
[17:24] we do in health optimization medicine.
[17:27] In illness medicine, essentially
[17:28] you look for disease markers
[17:29] like FBS or HBA1C, right?
[17:32] And then you basically correlate
[17:34] that with some disease and
[17:36] you do disease management.
[17:37] So it's very simple.
[17:39] Here we do diagnosis and treatment
[17:40] and that's a clinical practice.
[17:42] Of illness medicine is to
[17:43] diagnose and treat diseases.
[17:45] However with the advent of technology,
[17:48] we now know how to look inside the cell.
[17:50] And by looking at it, we see that
[17:53] actually there are about four drivers
[17:55] that precede the disease markers, right?
[17:57] These are genes symbiotic
[17:59] partners, environment, and time.
[18:01] For genes, you have the various types
[18:02] of the nuclear DNA, mitochondrial
[18:05] DNA, nucleic acids, your symbiotic
[18:07] partners, your mitochondria, which are
[18:09] endosymbionts, bacteria that live inside
[18:11] your cells, your gut microbiota, which
[18:13] are your exosymbionts, bacteria that live
[18:16] outside of your cells, your environment,
[18:18] like the direct and indirect signals from
[18:20] environment for example light, can be
[18:22] photo toxic to you and then evolutionary
[18:25] and circadian time and all of these gears
[18:29] actually produce metabolites that can
[18:31] be then detected and corrected, right?
[18:35] And you can detect and correct
[18:36] metabolite imbalances, and that's
[18:38] what we do at Health Optimization
[18:40] Medicine as a clinical practice is
[18:42] to detect and correct imbalances.
[18:45] We really don't do disease, we set
[18:47] the diseases aside and make sure
[18:48] we take care of your fundamental
[18:50] self first in terms of its balance.
[18:52] If you want to check for the
[18:53] health markers and adjust the
[18:55] metabolome itself, then use the
[18:57] science of clinical metabolomics.
[18:59] If you want to affect the DNA, we're
[19:02] too old for CRISPR Cas9 technology.
[19:05] Trust me.
[19:06] I tried.
[19:06] I bought a CRISPR Cas9 lab for
[19:09] myself and was unsuccessful.
[19:11] All I was able to do was develop a
[19:13] glowing Saccharomyces bouillardii.
[19:15] But anyway if you want to affect the DNA,
[19:18] then there's the science of epigenetics.
[19:20] Then if you want to affect the
[19:22] mitochondria and gut microbiota, you
[19:24] use the sciences of bioenergetics
[19:27] and the gut immune system.
[19:28] And if you want to affect the direct
[19:31] and indirect signals from environment,
[19:32] use a science called the exposome.
[19:35] Exposome, which is the sum total of
[19:36] your exposure to everything, right?
[19:39] And my favorite example here is that
[19:41] if a mother drinks during a pregnancy,
[19:44] then there's exposure to alcohol, right?
[19:46] And now you know why we look at this
[19:48] history when we're trying to figure out
[19:50] whether or not we have a fetal alcohol
[19:52] syndrome or an adult that was Exhibited
[19:54] fetal alcohol syndrome as a child.
[19:56] If you are looking to change the
[19:58] evolutionary and circadian time,
[20:01] you use the sciences of evolutionary
[20:03] medicine and chronobiology.
[20:05] Take a look at the Ohms here, right?
[20:07] Metabolome mitochondrial metabolome,
[20:09] got microbiome, epigenome so the
[20:12] cell danger response, a metabolome
[20:15] for evolutionary medicine and in
[20:16] chronobiology, we have the chronobiome
[20:19] and then you have the exposome.
[20:20] So these are the seven pillars of health
[20:22] optimization medicine and practice.
[20:24] Unfortunately, this is not taught to
[20:26] us in medical schools yet but we hope
[20:28] that by doing this and educating a
[20:31] lot more people, we can get to where
[20:35] we want to be in terms of health
[20:36] in this country and in the world.
[20:38] Let's define health.
[20:39] If you ask any person, especially
[20:41] a doctor, to define health, they
[20:43] wouldn't have any definition of health.
[20:45] I like a more clinically actionable
[20:47] definition of health, and this is, you
[20:50] can take this with you, A plus B plus
[20:53] C is the absence of disease, which is
[20:54] illness medicine, and the balance between
[20:56] anabolism and catabolism according
[20:59] to the cycle of life of the organism.
[21:01] And we don't do root causes of disease.
[21:04] There's only one root cause of health,
[21:05] and it's the maintenance of balance
[21:07] between anabolism and catabolism, right?
[21:10] And I hope someone now here knows
[21:12] the answer to my question yesterday.
[21:14] Is inflammation anabolic or catabolic?
[21:17] I'm not going to answer that for you.
[21:19] So it means that just because you're
[21:21] not sick doesn't mean you're healthy.
[21:22] It only means that you're not sick, right?
[21:25] And optimization Now it's defined as
[21:28] neotenizing your metabolic subnetworks
[21:31] to values that it had when you
[21:33] were between 21 to 30 years old, or
[21:36] use evolutionarily derived values.
[21:39] And neotenizing means making young.
[21:41] When your patient or client comes
[21:43] to you and says, Oh, but this value
[21:44] is normal that's normal for the age.
[21:47] But what we try to do, or what we do, is
[21:50] actually to move your values to the values
[21:53] you had between 21 and 30 the golden
[21:55] age for having children then her dog
[22:00] actually did this in hormone balancing.
[22:03] He uses a mean value of 25 plus
[22:05] minus two standard visions.
[22:06] United States, by the way,
[22:07] uses 30 for hormone, right?
[22:10] Gordon his median value is he takes a
[22:12] median value between age 20 to 30, and I
[22:15] use the 50th to 75th percentile at age 21
[22:18] to 30, or and I use evolutionarily derived
[22:22] values, for example, for vitamin D.
[22:24] Vitamin D values, as I see in this country
[22:26] the range, reference range is way too low.
[22:29] We do not use illness medicine range of
[22:31] values, lab values are cut of values
[22:33] they are survival values and are not
[22:36] optimal values and normal is not optimal.
[22:41] Now the practice is very simple.
[22:43] You measure the levels of metabolites, you
[22:45] compare them to the optimal ranges, not
[22:47] the normal ranges, and you balance using
[22:50] two major techniques, which is network
[22:51] wide range shifting and ratio correction.
[22:55] Network wide range shifting
[22:56] brings the concept of network.
[22:58] Everything is networked in the body.
[23:00] If you touch one node,
[23:01] everything else is moves.
[23:02] The other one is ratio correction.
[23:04] For example, if you are looking at
[23:06] omega 3, omega 6 balance, then you
[23:09] should correct this by correcting
[23:10] the ratio and not correcting a
[23:12] single value in those metabolites.
[23:16] So this is a visual summary
[23:18] of home hope balancing.
[23:19] We all know that oxidative stress
[23:22] leads to all of these diseases.
[23:25] It's not only oxidative stress, right?
[23:27] There's also the nitrogen
[23:28] stress, the RNS, right?
[23:30] Which is used by the body really
[23:32] to kill viruses instantly.
[23:34] And so here it is, there's a
[23:36] redox balance and redox signaling.
[23:38] So we're after balancing, there's can
[23:40] see here the mitochondrial homeostasis
[23:42] metabolism inflammation on the other side.
[23:45] And then if you take a look, this is
[23:47] the yin yang of inflammation, right?
[23:49] For if you have , imbalanced redox.
[23:52] Then your NF kappa B transcription
[23:54] factor gets activated.
[23:57] And immediately produces your pro
[24:00] inflammatory cytokines, right?
[24:02] There's NF kappa B activation,
[24:03] your body knows what to do.
[24:06] Yeah, we're not dumb organisms.
[24:07] We evolved over time.
[24:09] We have our own mechanisms of
[24:11] healing and protecting ourselves.
[24:13] We should take a look at what we're doing
[24:15] first before we actually go gung ho and
[24:18] do different things to the body by shoving
[24:21] all sorts of things to it, we should know
[24:23] what the body is doing evolutionarily
[24:25] before you start changing things.
[24:28] The NRF2 system produces anti
[24:30] inflammatory cytokines, and
[24:32] this is the yin yang balance of
[24:34] inflammation and anti inflammation.
[24:37] Many of you like turmeric, is
[24:38] a very common way to decrease
[24:41] total body inflammation.
[24:42] Because it is a direct
[24:43] activator of the NRF2 system.
[24:45] Now, here's your pro inflammatory,
[24:47] anti inflammatory balance.
[24:49] You you can do a cytokine testing
[24:52] if you like to, or if your patient
[24:53] is rich enough to have this done.
[24:56] Again, you take a look at the
[24:58] balance of your inflammatory
[25:00] and anti inflammatory cytokines.
[25:02] In homo balancing, this is
[25:03] like the center of what we do.
[25:05] We optimize the resolution of
[25:07] the cell danger response, right?
[25:09] There is cell danger response
[25:11] consists of four major parts.
[25:13] Oxidative stress, which you could
[25:15] see can be the trigger is like
[25:17] your reactive oxygen species or
[25:19] reactive nitrogen species, right?
[25:21] And then your amplifier would be
[25:23] the inflammation by your cytokines.
[25:26] And then there's innate
[25:26] immunity, the activation of,
[25:28] say, your macrophages, right?
[25:30] And then there's the endoplasmic
[25:32] reticular stress response.
[25:33] As I said yesterday, you guys
[25:35] must be very familiar with this.
[25:36] This is unfolded protein response.
[25:38] This is elucidated over two decades ago.
[25:41] And you guys should be
[25:42] experts on this by now.
[25:44] This acute physical, biological,
[25:46] and psychological threat induces
[25:49] the cell danger response, right?
[25:51] And so does chronic physical
[25:53] chemical, and biological threat.
[25:54] Acute threats usually you can resolve
[25:56] it by ourselves, but the chronic
[25:58] threats are the ones that produce
[26:00] chronic diseases like diabetes
[26:02] or clinical cognitive decline.
[26:04] So I asked ChatGPT-4, I said, are
[26:07] there any vitamins, mineral, cofactors
[26:09] and hormones that dampen and or
[26:10] quell the cell danger response?
[26:13] And he says, vitamin DCE, A, mineral,
[26:16] zinc, magnesium, selenium, cofactor, coq,
[26:19] 10 a LA, and a D plus hormones, melatonin,
[26:22] cortisol, testosterone, and others.
[26:24] Omega-3 fats and polyphenols, right?
[26:27] But should you give everything if
[26:29] your patient is, or client is in
[26:31] a cell dangerous response mode?
[26:33] Of course not.
[26:34] What we do in health optimization
[26:35] medicine is actually we measure, right?
[26:38] So we measure the levels of antioxidants,
[26:41] vitamins, C, A, alpha lipoic acid.
[26:44] Those are measurable right now by
[26:47] clinical metabolomic testing, right?
[26:49] So before giving any of that stuff.
[26:51] Just because you have chat GPT 4
[26:52] doesn't mean you should just inundate
[26:54] your patient with all the supplements.
[26:55] Measure and see whether or
[26:57] not they need them, right?
[26:59] If your patient is in actual anti
[27:02] oxidative stress, then they are warranted
[27:04] to the levels your tests are showing.
[27:06] Remember that is there is a syndrome
[27:09] called AIS, anti oxidant induced.
[27:11] stress.
[27:12] If you give way too many antioxidants,
[27:15] your system will go haywire.
[27:18] It will go the other way, right?
[27:20] And why is this?
[27:21] For example, if you enlarge the
[27:22] pool of your antioxidant vitamin
[27:24] E, that's a very large pool.
[27:26] And remember, they're in a cycle.
[27:28] Whatever is next in the
[27:29] cycle is still a small pool.
[27:31] So when you're looking at increasing
[27:33] your antioxidant pool, for example,
[27:36] take a look at your antioxidant
[27:37] regeneration pathway, right?
[27:39] Because all of those are involved.
[27:41] What you're going to do is
[27:42] simply pool the vitamin E and
[27:45] what it has reduced in its pool.
[27:47] And then a smaller pool is waiting
[27:50] to actually do the recycling for it.
[27:53] And that's the reason why many
[27:54] studies on, for example, Oh,
[27:56] selenium and vitamin E failed in
[27:59] 80, 000 cohort for prostate cancer.
[28:02] If you don't measure this stuff
[28:03] before giving them it you are
[28:06] doing a wrong protocol, right?
[28:08] And then the imbalance of enteric
[28:11] microbiota It's called dysbiosis,
[28:12] of course, you know this, and you
[28:14] can detect and correct, for example,
[28:15] malabsorption and bacterial dysbiosis
[28:18] types of metabolites, right?
[28:20] You know how to do that, and you could
[28:22] do your recommended supplementation
[28:25] and dosing with prebiotics,
[28:27] probiotics, parabiotics, post-biotic,
[28:28] symbiotics high fiber diets.
[28:30] As I say in my lectures, the
[28:32] fastest diminishing macronutrient
[28:34] in the human diet is fiber, right?
[28:37] Lifestyle adjustments like meal timing
[28:40] all of us usually sacrifice our meal
[28:42] timing in order to do our work or to
[28:47] have our extracurricular activities.
[28:49] So let's take a look at the entire
[28:51] microbiota and the blood-brain
[28:52] barrier that you can see here.
[28:54] The role of short chain fatty acids.
[28:56] As you can see, short chain fatty
[28:58] acids you have to have the levels
[29:00] such that they actually promote the
[29:03] strengthen the blood brain barrier.
[29:05] It has an anti-inflammatory effect.
[29:07] It's neuroprotective, it
[29:08] regulates the microglia.
[29:10] Some of the SFCAs can actually cross
[29:12] the blood brain barrier, right?
[29:14] And it's an area of ongoing research,
[29:17] and it can serve as an energy source of
[29:20] in the brain, such as it's the primary
[29:22] energy source for your colonocytes.
[29:25] When you're supplementing, for example,
[29:27] the short chain fatty acids directly and
[29:29] not via a high fiber diet modification or
[29:32] prebiotic probiotic modification, then you
[29:35] make, you should make sure that the short
[29:36] chain fatty acid actually is s enteric
[29:38] coated enough to actually get uncoated
[29:41] or dissolved in your colon, right?
[29:43] Otherwise it's basically useless.
[29:48] Now the enteric microbiota and
[29:50] brain neurotransmitters, as you
[29:52] can see here essentially the
[29:55] neurotransmitters SCF FAs and BDNF.
[29:58] So the neurotransmitters, serotonin,
[30:00] 90 percent of serotonin is produced
[30:02] in the gut, but remember serotonin
[30:04] is not produced it's not, doesn't
[30:07] cross the blood brain barrier.
[30:08] So the serotonin in the brain
[30:10] is produced by the brain itself.
[30:11] You have your tryptophan.
[30:13] There's a large neutral amino acid
[30:15] transporter that actually transports
[30:17] tryptophan and creates its own serotonin.
[30:18] So this serotonin is actually produced
[30:21] for the use of the gut itself, right?
[30:24] And then dopamine Some bacteria
[30:25] can produce dopamine and they
[30:27] can have the systemic effects.
[30:29] We don't know whether or not the
[30:30] cross is a blood brain barrier.
[30:32] I suspect it doesn't.
[30:33] GABA, of course, is a notoriously huge
[30:35] molecule it does not cross a blood
[30:37] brain barrier in a classic sense.
[30:40] And therefore it has to be synthesized
[30:42] from scratch via the glutamine from your
[30:46] diet, which becomes glutamate in the
[30:48] brain and then gets converted into gaba.
[30:51] Now, certain strains of lactobacilli and
[30:54] bifidobacteria can actually produce gaba.
[30:57] And then norepinephrine is
[30:58] also produced by gut bacteria.
[31:00] So again, the main perspective here, even
[31:02] if you don't remember any of this, is
[31:04] that the gut is itself a second brain.
[31:07] It has its own neurotransmitters,
[31:10] it has its own hormones, and
[31:12] you should respect it as that.
[31:15] So the enteric microbiota effects on BDNF.
[31:19] You have BDNF upregulation, stress
[31:22] response, if you have stress induced
[31:24] changes in your gut, it will actually
[31:25] decrease your BDNF and for inflammation,
[31:28] of course, gut microbiota can
[31:30] modulate systemic inflammation, which
[31:32] can in turn influence BDNF levels.
[31:35] What if you're.
[31:35] Patient or client complains
[31:37] that he or she is so poor could
[31:39] not buy all the prebiotics and
[31:41] probiotics that you recommend.
[31:43] One of the biggest things that
[31:44] you could do is actually exercise.
[31:46] It can raise your BDNF by about 60 percent
[31:50] and beats any the results of any SSRI that
[31:53] you could give out there for depression.
[31:56] That is if you could
[31:57] push them to exercise.
[31:59] Your microbe associated
[32:00] molecular patterns, right?
[32:02] And then you have damps damage
[32:04] associated molecular patterns.
[32:05] You guys are familiar with those, right?
[32:07] Those are all terminology pumps and damps.
[32:09] And you could see here that
[32:11] microbiota actually modulate
[32:13] your neuro immune function and.
[32:15] Implications of the modulation of
[32:17] neuroimmune function, actually altered gut
[32:20] microbiota can lead to increased levels
[32:22] of pro inflammatory cytokines, right?
[32:25] When you look at immunity, when a
[32:26] patient presents to you or a client
[32:28] presents to you, for example, with
[32:29] lupus or some autoimmune system, don't
[32:32] look immediately for autoimmune causes.
[32:35] Look right away at the gut health.
[32:37] What can you do immediately for
[32:38] your patient or client is actually
[32:40] to clean up the gut, seal it up,
[32:42] and make sure that, the microbiota
[32:45] are appropriately replenished.
[32:47] Autoimmunity neuro degeneration.
[32:50] They're implicated in neuroinflammatory
[32:52] aspects of Alzheimer's and Parkinson's.
[32:55] I have a few of these patients and one
[32:57] of the first things that I do really is
[32:58] to clean up the gut and decrease total
[33:00] body inflammation because an inflammation
[33:02] in the gut will already give you a
[33:05] clue that the brain is also inflamed.
[33:08] Question again, how does one
[33:09] take care of gut dysbiosis?
[33:11] Dietary changes like prebiotic foods,
[33:14] probiotic foods, low sugar and low fat
[33:16] supplements probiotics, digestive enzymes,
[33:19] glutamine, berberine, caprylic acid, zinc,
[33:22] carnosine, curcumin, lifestyle changes.
[33:25] Stress management, physical exercise,
[33:27] adequate sleep medical treatments, right?
[33:29] If antibiotics are warranted, I
[33:31] prefer to use natural antibiotics
[33:33] and antifungals, right?
[33:34] And fecal microbiota transplants those
[33:37] have been in the news over five years ago.
[33:39] These are the classes of what
[33:40] actions you can think about for your
[33:42] patient or client, dietary changes,
[33:44] supplements, lifestyle changes, and if
[33:47] if warranted, any medical treatments.
[33:50] So you know, this is
[33:51] just a simple diagram.
[33:51] You already know what this means.
[33:53] Probiotics are healthful
[33:55] microbial living cells.
[33:56] Parabiotics are dead or
[33:57] inactivated probiotics.
[33:59] And then prebiotics are chemical
[34:01] agents that have the ability
[34:02] to stimulate probiotics.
[34:04] Postbiotics are beneficial
[34:05] metabolites of probiotics.
[34:06] Prebiotics and modulation of
[34:09] the microbiota gout brain axis.
[34:11] So that's how this is from this
[34:12] paper and that's how I'd like you to
[34:15] remember the gut is, it's not as a gut,
[34:18] but microbiota gout brain axis, gut
[34:21] associated lymphoid tissue, because
[34:23] that's where most of the problems of your
[34:25] patients or clients will be coming from.
[34:27] Think of it as really an immune system.
[34:30] And as I say to my guys in health
[34:32] optimization medicine, your immune
[34:34] system is responsible for your defense.
[34:35] And if you look at the United
[34:37] States, the Department of
[34:38] Defense has the biggest budget.
[34:40] Energy budget of the body is also
[34:42] the biggest for its immune system.
[34:45] Alright, so again there's the imbalance
[34:48] of the gut immune system, you have a leaky
[34:51] gut you guys are very familiar with this.
[34:53] As you can see here there are
[34:54] factors that can cause decreased
[34:56] permeability, like propionate,
[34:58] butyrate, oligosaccharides, fiber.
[35:01] Increased with propionate,
[35:03] glucose, fructose.
[35:04] So always have that balancing principle
[35:07] in mind when you're looking at the gut or
[35:09] the brain or any other part of the body,
[35:11] and if there is too little permeability,
[35:14] then you cannot absorb anything, right?
[35:16] It's too much, then you have
[35:17] what's called a leaky gut.
[35:18] So what you have in here is you
[35:21] achieve a balance between an optimal
[35:23] type of permeability for your client.
[35:26] And this is very individual.
[35:27] Because the lifestyle, the diet of your
[35:30] clients usually stay in one place and
[35:32] then it's usually very steady, it's
[35:34] continuously very fatty, and you guys know
[35:37] that the most difficult thing to change in
[35:39] any client or patient is behavior, right?
[35:42] So you have to follow their behavior
[35:44] for a while, while adjusting
[35:46] the permeability of their gut.
[35:48] It's not a one size fits all thing when
[35:50] you're looking at the client, right?
[35:52] So the, and then you could measure,
[35:54] calprotectin, EPX, fecal secretory
[35:56] IgA, the butyrate, pionate, acetate
[36:00] take a look at those levels and
[36:01] determine appropriate supplementation.
[36:03] Now you could do your elimination
[36:05] diets, your glutamine, probiotics,
[36:08] digestive enzymes, et cetera.
[36:09] One of the things that induces
[36:11] leaky gut actually from stress
[36:13] is post operative patients.
[36:14] when you're dealing with a post operative
[36:16] case, and they usually just dump the
[36:19] patients in the recovery room and give
[36:21] them nothing by way of any support.
[36:23] And when you receive the patient
[36:25] is in severe leaky gut and
[36:27] complaining of other problems.
[36:29] So what you can do there is to
[36:30] recommend six grams off of glutamine
[36:33] in a liter of water to be sipped by
[36:35] the patient in a while in the OR,
[36:37] especially if intestinal surgery, right?
[36:40] And that actually keeps the patient
[36:42] in positive nitrogen balance, right?
[36:44] And that will make sure that
[36:46] your intestinal permeability
[36:48] is not harmed that much.
[36:50] It will say any surgery to the
[36:52] body is still stressful, right?
[36:55] How does one take care of
[36:56] the leaky gut syndrome?
[36:57] So you don't need me for this
[36:58] anymore, you just need to chat GPT 4.
[37:00] Dietary changes like the elimination
[37:02] diet, high fiber foods, probiotic
[37:04] rich foods, supplements, probiotics
[37:07] glutamine, digestive enzymes, omega 3s,
[37:09] zinc, collagen or bone broth, right?
[37:11] Vitamin D, turmeric, lifestyle changes,
[37:14] stress management, if they need to
[37:15] divorce their husbands or wives, right?
[37:18] Adequate sleep, right?
[37:20] If the partner is snoring, it's
[37:22] been shown that for each snore the
[37:24] cortisol level rises in your partner.
[37:26] each snore that your partner makes,
[37:28] your cortisol actually rises.
[37:29] You may be in love, but
[37:30] you are sleep divorced.
[37:32] And then regular exercise, which is
[37:33] one of the most difficult things to
[37:35] get your clients to do, unless they're
[37:36] actually younger and seeking a mate.
[37:39] Now medical treatments,
[37:40] as I said, only if needed.
[37:42] Antibiotics, antifungals,
[37:43] anti inflammatories, right?
[37:45] And what I want you to note
[37:46] here is simply the classes.
[37:48] Dietary changes, supplements,
[37:49] lifestyle changes, medical treatments.
[37:52] , we're looking at brain balance when you go
[37:54] take a look at neuroinflammation, right?
[37:56] It's a balance of micro, microglia.
[37:58] They're either activated or inactivated.
[38:01] Arresting microglia will have
[38:03] a regular phagocytic function.
[38:05] They will have steady state monitoring.
[38:07] Remember, this is an immune system.
[38:08] They're soldiers.
[38:09] They're sentinels.
[38:10] They monitor their environment, even
[38:12] if you consider them as brain cells.
[38:13] They serve as the immune function.
[38:15] And then there's the activated
[38:17] microglia, which now produces
[38:19] your pro inflammatory cytokines.
[38:21] And you can see here there's an
[38:23] active function, neural injury.
[38:25] I went quickly through a slide earlier
[38:27] that showed the cell danger response.
[38:29] Now, what I wanted to emphasize
[38:31] there is the following.
[38:32] There are only eight ways by which
[38:35] a cell, a fundamental cell, can
[38:37] respond to stress evolutionarily.
[38:39] All the other ways that it responds are
[38:41] actually due to the specialized functions.
[38:43] And that's what we actually
[38:45] teach in our online module on
[38:47] evolutionary medicine, is the cell
[38:48] danger response metabolome, right?
[38:50] There are only eight of those, and if
[38:52] you could actually resolve those eight
[38:55] different steps, you actually have already
[38:57] resolved the cell danger response that
[38:59] the the stress is putting out, and you
[39:01] have quelled it, and you're Patient
[39:03] or client would start feeling better.
[39:06] All right.
[39:07] Now, here's a cell with
[39:10] no neuro inflammation.
[39:11] There is an oval for inflammasome
[39:13] unless you've been living under a rock.
[39:15] You.
[39:15] All know what an inflammasome ear
[39:17] is, the most famous one of course
[39:19] is the NLRP3 inflammasome, right?
[39:22] This is the staging area
[39:24] for your inflammation.
[39:26] As you can see, everything
[39:27] is nice and neat and clean.
[39:29] And when you look at the gut, you should
[39:32] always think about the brain, right?
[39:35] Because they have the same
[39:37] fundamental structures.
[39:38] You have your bloodstream, you have your
[39:41] endothelium and you could see that The
[39:44] lymphoid tissues are underneath the gut,
[39:46] whereas in the brain, your glial system
[39:49] actually serves as the immune system.
[39:52] So always think of these two in
[39:54] parallel, especially if you're.
[39:56] patients or clients are exhibiting
[39:58] brain fog at the same time, right?
[39:59] You might think, oh, the thyroid.
[40:01] No, it may just be a simple
[40:02] neuroinflammation from
[40:04] a gut dysbiosis, right?
[40:05] Don't jump into conclusions
[40:07] immediately that your patients need
[40:09] any of these big guns right away.
[40:12] Now, see here, take a look at
[40:14] neuro inflammation, they will occur
[40:16] almost at the same time if you don't
[40:17] address the inflammation of the gut.
[40:19] inflammation of the gut usually
[40:20] occurs first because that is
[40:22] what is exposed to food, right?
[40:23] External elements.
[40:24] So the body has to fight what it doesn't
[40:27] want inside and actually allow what
[40:28] it wants to get inside, and you could
[40:31] see here is a total inflammation.
[40:33] And when I say inflammation, not
[40:35] the traditional mosquito bite
[40:36] inflammation should come to your mind.
[40:38] It is, it should be what's
[40:40] called molecular inflammation.
[40:42] What you should think about is that there
[40:44] is heavy reactive oxygen species load.
[40:46] Your NF kappa B is activated.
[40:49] Your cytokines are being produced.
[40:51] That's the kind of inflammation
[40:52] that should be in your head.
[40:53] We're no longer in the 1940s,
[40:55] where you have to look at
[40:56] microscopes to do that, right?
[40:58] We deal with metabolites now.
[41:00] And you could see in the brain itself,
[41:02] you could see that the Euglia cells
[41:05] are the ones responding as your
[41:06] lymphoid tissue in the brain and the
[41:08] alter your neurotransmitters, right?
[41:11] Chat GPT 4, like what can be done to
[41:13] dampen or quell inflammasome activity?
[41:16] It says here.
[41:17] Natural compounds like curcumin and
[41:18] resveratrol lifestyle and diet like
[41:22] fasting and caloric restriction and
[41:23] anti inflammatory diet, microbiota
[41:26] modulation, probiotics and prebiotics
[41:28] fecal microbiota transplant, I've had
[41:30] cases where I actually had to send or
[41:32] accompany clients in Germany for adult
[41:35] fecal microbiota transplant for C.
[41:37] diff, severe C.
[41:38] diff in adulthood.
[41:40] And epigenetic modulation
[41:41] metabolomic approaches, which is
[41:43] what we actually do in HomeHope.
[41:45] So not all neuroinflammation is bad.
[41:49] Your gut, there's a certain optimal
[41:51] form of leakiness in the gut.
[41:52] There's also an optimal form of
[41:54] inflammation that's optimal to the brain.
[41:57] So on low inflammation.
[41:58] There is immune to brain communication
[42:00] with immune surveillance.
[42:02] There is the, it's involved in
[42:03] development, memory, and learning.
[42:05] Transient inflammation is involved
[42:07] with injury and induced remodeling.
[42:10] And this is called eustress.
[42:12] This is eu inflammation.
[42:14] And for those who are
[42:15] stoics here, eudaimonia.
[42:17] Anyway negative aspects of
[42:19] neuroinflammation, as you can see.
[42:20] These are high inflammatory states.
[42:22] And again, when you think of
[42:23] inflammation, think molecular, right?
[42:26] Your mitochondria are highly
[42:27] stressed out, they will put
[42:28] out a lot of reactive species.
[42:30] They will induce your cytokine production.
[42:33] Those will activate your NF KB.
[42:35] They'll induce your cytokine production,
[42:37] and then you will have all the downstream
[42:39] effects of molecular inflammation alright.
[42:43] Now, what's wrong with this picture?
[42:45] Can anyone tell me what's
[42:46] wrong with this picture?
[42:47] Microbiota and gut brain axis.
[42:49] Implications for a new
[42:50] therapeutic design in CNS.
[42:52] This was just published in 2022.
[42:55] So this is beautiful, right?
[42:57] microbial metabolite entry,
[42:59] altered receptor activity, altered
[43:00] neurotransmission, the pathways that we
[43:02] discussed, immune, neuroendocrine, enteric
[43:04] nervous system, circulatory system,
[43:06] vagus, secretions, peptides, gut hormones.
[43:09] Very nicely done, right?
[43:11] And then up there you have your
[43:12] neurodegenerative diseases like
[43:15] MS Parkinson's, Alzheimer's, brain
[43:17] tumors, and then neurodevelopmental
[43:19] and neuropsychiatric disorders like
[43:21] autism and depression and anxiety
[43:24] and stress and schizophrenia.
[43:25] They immediately proceed
[43:26] to disease, right?
[43:28] Many of your clients or patients will not
[43:31] be having these things beforehand, right?
[43:33] These things come as a consequence
[43:36] of what happens beforehand.
[43:38] So if you could catch that for
[43:40] them beforehand or prevent that
[43:42] beforehand, why would you not do
[43:43] it if you already have the tools
[43:45] and the products to do it, right?
[43:47] So it's not always about disease.
[43:50] It's time to think of health first.
[43:52] So when you see a client, you
[43:53] set aside what their diagnoses
[43:55] are, and take a look at what the
[43:56] fundamental or basic cell is doing.
[43:58] Is the mitochondria all right?
[44:00] Is the cytoplasm okay?
[44:02] Are the cell membranes okay?
[44:03] Is there very fast oxidation
[44:05] of the cell membranes?
[44:06] Is there any indication that the
[44:08] DNA, nuclear DNA is oxidizing?
[44:11] Very rapidly.
[44:11] You could see all of those in a
[44:13] fundamental cell and all cells
[44:15] of body have that, except, of
[44:16] course, for mature red blood cells,
[44:18] which don't have mitochondria.
[44:20] So you could see here that diet, genetics,
[44:22] and epigenetics, mode of delivery,
[44:24] environment, drugs, and exercise affect
[44:27] the enteric microbiota gut brain axis,
[44:30] and it will affect the behavior, food
[44:33] intake, cognitive behavior, stress,
[44:35] social interaction, fear, and as I said
[44:38] earlier, it can affect your enlightenment.
[44:40] Because it affects your
[44:42] default mode network.
[44:43] It can affect your spirituality, because
[44:45] it affects your periaqueductal gray.
[44:47] Take care of this organ that grows
[44:49] after you're born, or after your
[44:53] patients or clients are born.
[44:55] Let me just show you the difference
[44:56] in care between illness medicine and
[44:58] health optimization medicine on the
[45:00] enteric microbiota gut brain axis, right?
[45:02] The first one is a diagnosed disease.
[45:04] In illness medicine, you have
[45:06] anxiety, depression, multiple
[45:08] sclerosis, Parkinson's, Alzheimer's.
[45:10] Whereas what we do is we
[45:12] just detect imbalances.
[45:14] We use metabolomic tests to detect
[45:16] imbalances in vitamin, mineral cofactors,
[45:18] carbohydrate, protein, fat, hormone,
[45:20] metabolism, exposure to toxins, etc.
[45:23] And then use the enteric microbiota.
[45:26] Your goal there is to achieve eubiosis.
[45:28] For us, we want to correct imbalances
[45:31] with supplementation, diet, exercise,
[45:33] sleep, and other lifestyle advice, right?
[45:36] For illness medicine, you
[45:37] want to seal the leaky gut.
[45:39] And for us, we want to resolve
[45:41] the enteric neuroinflammation.
[45:43] Neuroinflammation is not
[45:44] only in the brain, guys.
[45:46] Remember that you have a second
[45:47] brain, and therefore, you have
[45:49] an enteric neuroinflammation.
[45:51] All right?
[45:51] Don't forget these things.
[45:53] When you remember this become very
[45:55] fundamental to your care because you
[45:57] will remember immediately what to do
[45:59] with your patients or clients, right?
[46:01] Oh, I'm not only dealing
[46:02] with neuroinflammation here.
[46:04] I'm also dealing with
[46:05] brain inflammation, right?
[46:07] Because they will tend to
[46:08] co occur after a while.
[46:10] In the brain, you treat the
[46:11] disease like with drugs, right?
[46:12] So for Parkinson's, for example, and
[46:15] in the brain, you resolve the CNS
[46:16] neuroinflammation, which includes
[46:19] achieving eubiosis and sealing the gut.
[46:22] Now for those of you who have
[46:24] Parkinson's patients or are Parkinson's
[46:27] clients, you already know that the
[46:29] Parkinson's is now considered to
[46:30] have, a dual etiologic pathways.
[46:33] One is actually via the gut.
[46:36] And the other one is central.
[46:38] you could see now that we are
[46:40] seeing the gut brain connection
[46:41] even in the diseases themselves.
[46:43] HomeHope, take care of the needs of the
[46:45] fundamental cell in its network first,
[46:47] and the rest will follow, because disease
[46:49] is managed, but health is optimized.
[46:51] Managing means that, you're only
[46:53] there until the disease resolves,
[46:55] but health, you're there every day.
[46:58] And my favorite question here from
[47:00] an audience one time is asking
[47:01] me whether or not we could bank.
[47:03] We could bank exercise.
[47:04] Actually, you can't.
[47:06] And just that's just like
[47:07] health optimization, right?
[47:09] So the order of use of balancing agents,
[47:11] the first line will be your bioidenticals
[47:13] and bioactives, like bioidentical
[47:15] hormones, bioactive nutrients.
[47:16] An example here would be using
[47:18] methylcobalamin instead of cyanocobalamin.
[47:21] Cobalamin is an artifact of manufacture
[47:23] cyanide is an artifact of manufacture
[47:26] in cyanocobalamin, Second line would
[47:28] be phytocyticals, fungicyticals,
[47:30] bacteria, like your probiotics phages.
[47:32] And the third line would be xenobiotics.
[47:35] And why do I put drugs last, even
[47:36] if I'm trained in pharmacology?
[47:38] is because Almost all the drugs that We
[47:40] have out there have never been encountered
[47:43] by the body in evolution, and the
[47:44] body doesn't know what to do with it.
[47:46] But it knows what to do with your
[47:48] hormones, nutrients, and other
[47:49] things that it actually uses to
[47:51] heal itself or to balance itself.
[47:53] So use those first, and use the big guns
[47:58] later, because you know when you start
[47:59] to use a synthetic antibiotic, you're
[48:01] going to bomb your gut microbiota organ.
[48:05] So this is the balancing very simple,
[48:07] you measure the levels of your
[48:09] vitamins, minerals, cofactors toxins
[48:12] and neurotransmitters and so on, and
[48:15] then you give them measured supplements.
[48:17] So the era of asking me whether or not
[48:20] vitamin E is good for you is over, right?
[48:23] You can measure all of
[48:24] those things and they can be
[48:25] measured at a reasonable price.
[48:28] The latest developments we
[48:29] have in this particular areas.
[48:31] The doudna herself is now in the game.
[48:33] She's she's Nobel Laureate
[48:35] in the CRISPR Cas9 team.
[48:36] Technology, right?
[48:38] And watch out guys.
[48:39] She's ready to tackle gut microbiota
[48:42] on changing the genome according to what
[48:45] you want them to produce, whether or not,
[48:47] are we going to have non GMO microbiota?
[48:50] I have no idea, but, she's already
[48:53] expressed her Interest in the game.
[48:55] They found that there's a dedicated
[48:57] cytoplasmic container that collects exo
[48:59] Somal, DNA, away from the melian nucleus.
[49:02] And it's a new organelle . It's
[49:03] called the Exclusome.
[49:05] So you now know that we have
[49:07] another organelle in the cell, and
[49:09] it's called the Exclusome, right?
[49:11] And the latest developments in the
[49:13] brain a new kind of cell shakes
[49:15] up neuroscience and we continually
[49:18] find newer and newer cells, right?
[49:19] The specialized astrocytes
[49:21] mediate glutamatergic glia
[49:24] transmission in the CNS.
[49:25] So if the new organelle is called the
[49:27] exclusome, this is called the what?
[49:29] This is called the
[49:30] glutamatergic astrocytes.
[49:32] Astrocytes are not supposed to
[49:34] produce any neurohormones, but this
[49:36] one produces actually glutamate.
[49:39] All right.
[49:40] So the latest developments in the
[49:41] enteric microbiota gut brain axis,
[49:43] Kieran yesterday was discussing, how you
[49:45] develop drugs and how you do test various
[49:48] types of microbiota in the SHIME system.
[49:50] Now they're going ahead rather
[49:52] than using the SHIME system.
[49:54] What I want you to see here is that one.
[49:57] And term that I'd like you
[49:58] to remember is organoids.
[50:00] You're now, they're now using intestinal
[50:02] organoids and brain organoids to
[50:05] test what particular microbiota
[50:08] are producing what particular
[50:10] metabolites that will affect the brain.
[50:12] And this is big news.
[50:14] This is a totally different
[50:16] way of doing things now.
[50:17] We've been doing things
[50:18] forever via the SHIME system.
[50:20] So the latest developments in AI I created
[50:23] this chatbot for us who actually do not
[50:26] like to memorize things and just like to
[50:28] seek things out this is what's coming we
[50:30] intend to give this to our practitioners
[50:32] health optimization medicine.
[50:34] And health organization practice
[50:36] practitioners initially, right?
[50:38] This is what to do if orotic acid is high.
[50:41] And I threw in a few books in there
[50:43] and KB stands for knowledge base.
[50:46] And this is what it came up with
[50:48] after looking at the books that
[50:50] I put in there, if orotic acid
[50:51] is high, it may be indicative of
[50:53] abnormalities in our gene in metabolism.
[50:55] And then I actually placed in a separate
[50:58] window, the chat GPT response itself.
[51:00] As you can see, your, if your books are
[51:03] in here, the professional books, the
[51:05] response is a lot more professional.
[51:07] To your liking, ChatGTP is a slightly,
[51:09] a little bit more general, but can
[51:11] provide you insights as to the other
[51:13] things that you may want to investigate.
[51:15] So this tool will be available hopefully
[51:18] next year to our practitioners.
[51:20] And a lot of AI are actually already
[51:22] being used now for the gut microbiota and
[51:25] development of more of newer probiotics.
[51:29] Okay.
[51:29] Here's our summary this is my ending
[51:31] slide, here is all the things that we
[51:33] talked about, the enteric microbiota
[51:35] gut brain axis the ways by which
[51:38] they communicate what can go wrong
[51:41] with the communication is usually
[51:43] mediation by inflammation, right?
[51:46] And so the ability of
[51:48] brain to influence intestinal
[51:49] microbiota, that's one way down.
[51:51] And the ability of microbiota is to go
[51:54] the other way up in a bidirectional way.
[51:57] Don't forget that the classic
[51:59] things that you learned about have
[52:00] their counterparts in the gut,
[52:01] like the vagus has the enteric gut.
[52:03] Nervous system, right?
[52:05] The HPA axis has your
[52:07] enteroendocrine system, right?
[52:09] So think of it really as another brain
[52:12] that actually has its own functions.
[52:14] It's what's gives you your butterflies in
[52:15] your stomach, right when you're nervous or
[52:18] when you're about to divorce your spouse.
[52:20] So when homeHope takes care of the
[52:22] needs of the fundamental cell and its
[52:24] networks first, and the rest will follow.
[52:27] Remember, the disease is managed,
[52:29] health is optimized, and I encourage
[52:31] you to optimize the health of
[52:33] your patients or clients rather
[52:35] than managing their disease.
[52:38] Thank you very much.
[52:39] This is my last slide.

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