0:07

Hey, this is Ari. Welcome back to

0:09

the Energy Blueprint podcast. With me today

0:11

is a very special guest, Dr. Jason

0:14

Parlak. He is, without a

0:16

doubt, one of the

0:18

premier, most world-class, most expert of

0:20

the experts in

0:23

the gut microbiome. So in a

0:25

world of people,

0:27

lots and lots of people who are

0:30

claiming to be gut health

0:32

experts, this is, in my

0:34

opinion, the premier gut health

0:36

microbiome expert, one of them

0:38

certainly, in the world on

0:40

planet Earth. He

0:43

is not a public-facing

0:45

influencer where people in the

0:47

general population would know him,

0:49

but he is widely known

0:51

among actual gut health experts

0:53

and physicians and clinicians, conventional

0:56

and functional medicine,

0:58

doctors who specialize in

1:00

gastrointestinal and microbiome health.

1:03

He is extremely well known and he

1:05

offers coursework for those practitioners. He's

1:07

often an educator to those gut

1:09

health experts and training them in

1:11

their knowledge of the microbiome. He's

1:14

also a clinician. He's also a professor. He's

1:17

also a researcher. He's

1:20

written over 20 textbook chapters

1:22

in actual clinical textbooks meant

1:24

for training professionals in this

1:27

domain of gut health

1:29

and microbiome health and

1:31

is really la creme de la

1:33

creme of gut health experts. I've

1:35

personally had the pleasure of taking

1:37

graduate-level coursework under him. This

1:42

podcast episode was actually recorded, the one

1:44

that you're about to hear, was

1:47

actually recorded about a year ago

1:49

and we

1:51

haven't released it since then for a reason I'll

1:53

explain in a moment here. Right

1:57

after I took his coursework, because I

1:59

was... So impressed with his

2:01

knowledge. Ah, I essentially reached

2:03

out to him and said, hey,

2:06

I've got this new brand

2:08

that I'm about to release. It's

2:10

called Human Optimization. It's gonna be

2:13

featuring the world's top experts in

2:15

these different domains of knowledge. Whether

2:17

we're talking about brain health or

2:20

cardiovascular health or mitochondrial health, or

2:22

got health and microbiome health

2:24

or fitness. Ah, and many other

2:27

aspects of health As you

2:29

guys are going. To discover in the

2:31

coming months has a. Build. This

2:33

new brand out more and more.

2:35

The new brand Human Optimization has

2:37

officially launched and. Here's.

2:39

The reason that, ah, Or

2:42

this you're You're just now getting this

2:45

podcast that I recorded over year ago

2:47

with Dr. Harlem. It's because I reached

2:49

out him and said. Would.

2:51

You like to be. V. Guts

2:54

Health and Microbiome Expert that

2:56

is featured on the Human

2:58

Optimization brand of. fortunately he

3:00

said yes and since the

3:02

recording of the podcast you're

3:04

about to here we have

3:06

since build out a whole

3:08

course on Got Health and

3:10

Microbiome Optimization. And that

3:13

course as have a few days

3:15

ago just launched under the Human

3:17

Optimization brand. you can find a

3:19

that Human optimization.com It is an

3:21

absolutely phenomenal course. Now I want

3:23

to say that. This.

3:26

Is not a course. likes his typical

3:28

courses that are meant for practitioners, training

3:30

practitioners and clinicians. and you know the

3:32

nitty gritty of you know the very

3:34

advanced science of this species of bacteria

3:37

not species of bacteria. And here's how

3:39

you analyze your your patience microbiome test

3:41

And here's what you do in this

3:43

scenario. And here's what this test you

3:45

know, result indicates and maybe you're dealing

3:47

with this kind of dysfunction. Here's what

3:50

to do next, you know and and

3:52

here's the protocol for this condition in

3:54

that condition of this is. not a

3:56

course meant for practitioners and clinicians

3:58

this is a course So

6:00

if you're interested in those things,

6:02

in optimizing your health and longevity

6:04

and energy, I would

6:07

strongly encourage you to learn

6:09

this information. Again, we just

6:11

launched the course under humanoptimization.com

6:14

and right now it's on sale for $297. The

6:17

price is going to go up here in, I think

6:19

it's in a week or 10 days or so, the

6:21

price is going to be bumped up to $500. So

6:25

go grab yourself this course if you

6:27

are a health geek like me and

6:29

you want to learn everything you can

6:32

possibly do to optimize your health, your

6:34

energy, longevity. I

6:37

would strongly recommend going to get this course

6:39

and I think what

6:41

I'll say is with no further ado, let's

6:43

get into this podcast and you will

6:46

see as you listen to Dr. Harlack,

6:49

humble as he is, soft spoken as he is, just

6:51

how knowledgeable and how brilliant he is when

6:53

it comes to this area. So I think,

6:57

I'm not trying to do any hard selling here,

6:59

I think you're going to be convinced just listening

7:01

to him what an amazing

7:03

expert he is on this topic. So

7:06

go to humanoptimization.com, get the program

7:08

if you are a health geek

7:11

looking to optimize energy, health and

7:13

longevity and with no further ado,

7:15

let's get into this podcast on

7:17

gut health and microbiome optimization with

7:20

Dr. Jason Harlack. Thank you for having

7:22

me. That's

7:24

kind of words too. Yeah,

7:27

I'm humbled. I think it's the right

7:29

word. Yeah.

7:31

So I think as a general

7:33

starting point, broad

7:37

question, maybe as an

7:39

entry point, especially given this is the

7:41

Energy Blueprint podcast, we could

7:43

talk about the relationship between gut health

7:46

and energy levels and some of the

7:48

key mechanisms there, maybe the gut

7:50

mitochondria access or any other aspects you

7:53

want to talk about the gut brain

7:55

access, any of the sort of key

7:57

mechanisms that you see linking gut health.

8:00

with energy levels. Okay.

8:05

That's a great way of introducing the

8:07

area actually. I think for me when I'm

8:09

looking at this and I'm looking at gut

8:11

health in general there's probably three components, broad

8:13

components that I look at. Number

8:16

one would be gut motility and

8:19

how long it's taking food to

8:21

go make its way through and

8:23

essentially around colonic motility or more

8:25

likely lack thereof. So when people

8:27

actually have, you know, fecal loading

8:30

or constipation, because

8:32

when we get the situation where fecal

8:34

matter is in there for a fair period of time and for some

8:36

people this can be 10, 15, 20 days actually

8:40

transit time from mouth to toilet

8:42

bowl if

8:44

it's on my patients. And I

8:46

think this is an easy thing you can test

8:49

at home. And I think everybody should be totally onto this

8:51

and be aware of this, but you

8:53

can have some corn on the cob or

8:55

some red quinoa, black quinoa, or even some

8:57

green peas. Don't chew them particularly

8:59

well, you know, don't choke, but don't chew them all that

9:01

well. You want to be able to see them come out

9:03

the other end. Just take note, write down when you actually

9:05

ate it, keep track

9:07

and look at your bowel movements in great

9:10

detail over the coming days and see when

9:12

it starts coming through. I've

9:14

had patients who were doing, you know, a

9:16

lovely type four stool, which is a Bristol

9:18

stool, which we would call the perfect poo

9:21

every single day, never missed a day. And it took 10

9:23

days for the corn at the other end. And

9:26

I've had other patients who were only pooing

9:28

every two or three days. It

9:30

was 26 days before the corn came out the

9:32

other end. And if you could

9:34

imagine how much they're reabsorbing from

9:36

that. And it's something that, you know,

9:38

Socrates said, you know, death sits in the bowels or

9:41

since all disease begins

9:44

in the gut. And I think this is

9:46

one of the concepts around that is that

9:48

when we have, and older

9:50

natural athletes call this bowel toxemia in

9:52

that we've got this sort of old

9:55

fecal matter there that's constantly leaking bacterial

9:58

toxins into the system. Yeah,

10:00

so that's one of the key things we look at, OK,

10:02

is like looking at transit time and if transit time is

10:04

slow, then we're obviously absorbing to

10:06

the colon mucosa a lot more of

10:09

those toxins. And particularly what I'm referring

10:11

to is endotoxin or also

10:13

in this lipopolysaccharide, which is

10:15

part of the gram cell

10:18

wall, gram negative bacteria, which is

10:20

a group of bacteria in the gut. That's

10:23

one one consideration is that it's

10:25

transit time to

10:27

use microbiome composition. And

10:30

this is also feeds fits in

10:32

with the endotoxin or lipopolysaccharide because

10:35

the people's ecosystems can can they're

10:38

all unique. You know, my ecosystem will not look

10:40

like yours. You can take like

10:42

a thousand people and there'll be some similarities,

10:44

obviously, but then we mark

10:46

differences. And just like your fingerprints unique,

10:48

you're like a brown signature is unique

10:50

and more similar to your siblings and

10:52

your mom and mom. But anyone

10:54

else in the world, it's still quite different. But

10:57

within that individual composition,

11:00

there'll be certain ecosystem

11:03

traits that are you'd argue that

11:05

you'd see as pro-inflammatory, depending

11:07

on the composition. And if your ecosystem

11:09

contains greater amounts of what we call

11:12

gram negative bacteria, but that's the grouping

11:14

of that called proteobacteria. This

11:18

is this they're much more problematic

11:20

from an inflammatory perspective. 80

11:23

percent of the cell wall structure of gram

11:26

negative bacteria is lipopolysaccharide random toxin.

11:28

And this isn't the toxin that

11:30

the bacteria is secreting it to

11:32

make us ill. It's like, you

11:34

know, we grow hair, we grow

11:36

fingernails. It grows lipopolysaccharide. It's just what it

11:38

does. And just when they die,

11:41

they kind of release that lipopolysaccharide into your

11:43

lumen. And now some

11:46

people only have patients yesterday

11:48

were the 0.4 percent proteobacteria. And

11:50

I've had other patients who are

11:52

50 percent proteobacteria to

11:54

probably give the two extreme ends of

11:56

that. And those people are in either

11:59

the two extremes. But

12:01

the amount of

12:03

proteobacteria that's present

12:06

has a huge,

12:08

huge contributor to potential inflammatory

12:10

lobe essentially. Because

12:13

when you've got greater amounts of

12:15

proteobacteria present and other gram-negative bacteria

12:17

and other groupings like bacteroidites or

12:19

furoochimicrobia that

12:23

also have endotoxin involved with that

12:26

they grow to, but it's far less

12:28

inflammatory. It's really proteobacteria that we really

12:30

clue in with because it's a super

12:32

inflammatory compound. Yeah. So

12:35

we look at that composition there. And

12:37

we know that little polysaccharide essentially

12:39

works as a, it's

12:41

an immensely prone sambriation. It can cause

12:43

damage to the gut itself, so cause

12:45

a leaky gut. But when it reaches

12:47

the circulation, this is where we know

12:49

can impact things like blood and sugar

12:51

regulation negatively. Decreases insulin

12:53

sensitivity. It can damage the blood-brain

12:56

barrier. It changes with neurotransmitters we

12:58

produce through its cause

13:00

and inflation of the brain. And

13:03

it interferes with mitochondrial function. Yeah.

13:06

So we've got the situation where we've got these

13:08

bacteria that are wasting these toxins and some people

13:11

are releasing a lot more of those. And

13:13

the certain dietary choices

13:16

that we make that actually can enhance

13:18

or decrease the absorption of that endotoxin

13:20

as well. Yeah. So

13:23

you see that you're having these sort of

13:25

mitochondrial poisons that you're absorbing 24 hours a day.

13:27

And then sometimes with certain meals, you get

13:29

a spike of

13:31

little polysaccharide hitting the bloodstream. And

13:33

that's termed endotoxemia now or metabolic

13:35

endotoxemia is a bit more specific.

13:40

So that's the other aspect is looking at microbiome

13:42

composition from a

13:44

pro-inflammatory perspective. But then conversely, we

13:46

have other species in the gut

13:48

that we would see as having

13:51

the opposite effect of having anti-inflammatory

13:53

compounds. And those

13:55

have proxy to promote gut healing. So you might

13:57

put. species

14:00

that most people are familiar with, like Bifidobacteria.

14:03

It's one that we see as having anti-inflammatory and

14:05

some got healing qualities. Yeah.

14:07

There's others that are less well

14:09

known, like Acromantia, recent aphilia, is

14:11

also a species that we see

14:13

as helping promoting gut health and

14:15

gut integrity, and subsequently helps with

14:17

blood sugar regulation and even

14:20

helps determine your metabolic rate, which

14:22

I think is super cool too. But

14:24

there's another big group that we call Beterate

14:26

Producing Species. And I think you can see

14:29

Beterate is almost the counterpoint of Lipopolysaccharide,

14:31

and that Beterate has a healing

14:34

anti-inflammatory effect in the gut. It

14:38

is the main food source for your colon

14:40

cells, and many people are kind of aware

14:42

of that as it is for a long

14:45

time. But I still think it's

14:47

pretty amazing to think that we've evolved. We're

14:51

relying on bacterial production of

14:53

this compound to feed certain group of our

14:55

cells that are really key for our health.

14:59

And the issue here is if we don't

15:01

have enough Beterate Producing Species, we

15:03

don't make that much Beterate as a consequence of that. That

15:06

any Beterate we do make in the

15:08

gut is sort of avidly consumed by

15:10

our colon cells, and none of

15:13

it reaches the sort of bodywide circulation. So

15:15

when we sort of make enough Beterate

15:18

that it exceeds our colon cells

15:20

capacity, that Beterate reaches the systemic

15:22

circulation, floats through the area, and

15:25

there we get the anti-inflammatory effects,

15:27

bodywide of Beterate. And

15:29

it has a healing effect on

15:32

the blood-brain barrier, decreases neural inflammation,

15:34

and improves mitochondrial function, improves

15:36

blood sugar regulation, improves metabolism. It's a

15:39

pretty amazing substance, actually, Beterate. The more

15:41

we research it, the more stunning

15:44

we actually find that it is. And we've

15:46

got these little factories in us,

15:48

all of us do. The

15:51

population can vary dramatically too, from the

15:54

lowest I've seen is 2%

15:56

of an ecosystem being Beterate Producing Species, and the

15:58

heart rate of Beterate. So again,

16:01

a huge variation

16:03

there that can determine how much

16:06

of an anti-inflammatory effect we're

16:08

getting from that

16:10

microbiome versus the pro-inflammatory effect

16:12

that we get when it's more

16:15

prokabractory and more lipopolysaccharide. And

16:17

I think the third thing to look at is

16:19

gut integrity. So

16:22

when the gut is what we call

16:24

a leaky gut or intestinal hyperperivability, we

16:26

have more of a lipopolysaccharide that

16:28

actually leaks through into our

16:30

systemic body-wide circulation. We get

16:32

more of the negative aspects to our health and the essential

16:35

inflammation that goes everywhere.

16:38

But people will have their own sort of

16:40

weak areas where I think that inflammation will

16:42

become more manifest. And that will differ a

16:45

bit per person where some people with endotoxemia

16:47

will start developing insulin resistance. Some people will

16:49

start developing weight gain. And other people will

16:52

start, I think, it's got a role personally

16:54

with autoimmune conditions as well. Some

16:56

people get brain fogged. We know that endotoxins

16:59

play a pretty pivotal role

17:01

with septic Alzheimer's disease and

17:03

cognitive decline. There's been

17:05

some very cool research where they've

17:07

done autopsies of the brains of

17:09

Alzheimer's patients. And they're super

17:12

rich in endotoxin. And

17:14

people who do not have Alzheimer's, it's not

17:16

rich with endotoxin. It's not in

17:18

their brains. No where near is it, is it

17:20

degree? So I

17:23

think it's really those three areas

17:25

that are always looking at what's gut

17:27

integrity like, what's the microbiome composition look

17:30

like, and what's your transit time?

17:32

Because alterations in any of

17:34

those three things can certainly play

17:36

a pivotal role with essential inflammatory

17:39

status. And I think

17:41

that flows into cognitive function. I

17:45

don't think I would

17:48

suggest two for that matter. But

17:50

then if people have got two out of three, or

17:52

three out of three not working

17:55

well or are balanced, then we

17:57

get major problems. Yeah. Good

18:01

stuff. I want to mention your number

18:04

two point about short-chain fatty acids and

18:06

butyrate. I interviewed Dattice

18:09

Karazian, Dr. Karazian recently,

18:11

a few months ago, and

18:14

he actually listed butyrate as his

18:16

number one compound

18:18

for brain health as

18:20

far as supplements he was recommending. I

18:23

was a bit surprised by that. I was

18:25

expecting maybe curcumin or polyphenols or something

18:28

like that. Centropenoxine, who

18:30

knows, been post-itine. He

18:32

went with butyrate and he just raved

18:34

about the effects on brain health in

18:37

particular. This is widely regarded as one

18:39

of the world's top brain health experts

18:41

who was saying that. That's

18:44

very cool. There's a paper published, I think

18:46

it was 2016, that was one of the

18:48

earlier ones in a neurology journal talking about

18:51

how do we improve brain health? Let's give people

18:53

fiber. That was pretty

18:55

mind-blowing. I think seeing that in a

18:58

mainstream neurological journal was great. People,

19:03

particularly the top research experts, are totally

19:05

polluting to this, but their message is

19:07

seeping out. I think that's pretty amazing.

19:09

That's the number one. I

19:13

think it's so cool because we actually have

19:15

the B-ray-preaching factories already there. We just

19:18

have to make sure that we're feeding them

19:20

to actually get that benefit. Actually,

19:22

that's a point I want to circle back

19:25

to fiber and butyrate consumption later in

19:28

the podcast. Let's

19:30

talk about probiotics. This is a

19:33

huge area of passion for

19:35

you and something you know a ton about. I've

19:37

already learned a ton from you on this topic,

19:39

things that I didn't know. For

19:41

example, the

19:44

importance of strain specificity. I was blown

19:46

away by a lot of the research

19:48

you presented on that topic, which is

19:51

something I've historically brushed off as unimportant.

19:53

I thought it was mostly a marketing

19:55

gimmick that people say, oh,

19:57

this strain of lactobacillus is a pain in the ass. for

20:00

sastra, like, you know, they're the same

20:02

species, how different could they possibly be?

20:06

And, and I've

20:08

seen from a lot of research

20:10

that you've presented, they are very

20:12

different in many cases. So first

20:15

of all, can you talk about what

20:18

a probiotic actually means? And

20:20

then I want to talk a bit

20:22

about some common probiotic myths and, and,

20:24

and then the strain specific. Yeah,

20:27

so so most of us have a

20:29

vague idea what probiotics are like, you

20:31

know, beneficial microbes. But I think the

20:33

strict definition is, you know, live microbes

20:35

that when administered in adequate amounts and

20:38

confer a health benefit. Yeah. And

20:40

I think you could see that as having

20:42

a few different components of that definition is

20:44

one, they've got to be alive. So if

20:47

you're having a supplement contained dead bacteria, and

20:49

it can still be very helpful, but it

20:52

won't be a probiotic. At that point, in

20:54

fact, it should be termed a post-biotic, typically

20:56

speaking. The other aspect is that

20:58

it confers a health benefit too. And there's

21:01

certain parts of the world and certain research

21:03

scientists in this field who take that very

21:05

seriously. Whereas if you have a

21:08

strain of lactose, acidophilus or

21:10

lactose rhamnosus that has no research on it

21:12

at all, they wouldn't call

21:14

it a probiotic, they'd be likely that the bacterial

21:16

strain that may or may

21:18

not have any specific benefit. Yeah,

21:21

so I think that's the other interesting

21:23

aspect of that definition as well, as

21:25

well as adequate amounts. And this is

21:27

where this does differ a bit

21:29

per strain, that there are some pretty amazing

21:31

research on lactose rehydride

21:34

strain DSM1793H, which is

21:36

sold around the world

21:38

as bio-gaea. Okay. And

21:41

it's often the research studies often use

21:43

100 million CFUs, the colony

21:45

for me, so 100 million microbes. And

21:48

it gets these great results. It's not good

21:50

for everything, but it's good for a lot

21:52

of different things, you know, from viral gastroenteritis,

21:54

preventing endovar confuciate side effects, even

21:57

prevention of SIBO and people who take proton pump

21:59

inhibitors. Yeah, decent spread

22:02

of applications, all of that

22:04

very tiny dose, you know, where somebody would go

22:06

is nowhere near enough, we have to give you

22:08

know 100 billion on 10 different

22:11

strains to get any sort of impact, like clearly

22:13

not the case from from research and

22:15

I think that's one of the I'll

22:17

be flowing to this particular myth that that

22:19

sometimes is a methodology that we have to

22:22

give mega doses or it has to be

22:24

mega, you know, high potency multi strain to

22:26

get these sort of positive impact and that's

22:28

clearly not the case and then we've got,

22:30

you know, hundreds of research studies showing single

22:32

strains even at, you know, relatively low potencies

22:34

of 100 million or 1 billion

22:37

microbe having therapeutic effects,

22:39

clearly, in the literature.

22:44

Very, very interesting. Okay, so as

22:48

far as strains specificity, can you

22:50

give a few examples of how

22:53

that plays out in

22:55

some specific studies about specific species

22:57

of bacteria for specific outcomes. Yeah,

23:01

this is an area like when I did my

23:03

training, I trained as my next project training within

23:05

the late 1990s and they we didn't cover strains

23:07

really at all it was kind of very superficially

23:10

and Moses was talking about species, and it's

23:12

only when I started delving into it

23:14

part of my PhD was like, he's

23:17

become familiar with these new concepts of,

23:20

you know, delved into prebiotics which I

23:22

really superficially delve into probiotics and it's

23:24

like, oh my god there's actually dramatic

23:26

differences in terms of

23:28

characteristics of quality, nevermind,

23:31

different actions, strains

23:33

within the same species and for those people

23:35

who are less familiar with the concept of

23:37

strain, I think a good analogy here is

23:39

like breeds of dog, you know, all dogs

23:41

are canisterially are they

23:43

all have certain traits in common but there are differences,

23:45

but they're all the same species. Yeah, and

23:48

with bacteria strains within the same species, we don't

23:50

have the same physical characteristic

23:52

that look different, but

23:54

we know that we can subject them to

23:56

different exposures and they will react differently, you

23:58

know, like they can somewhat some strains within

24:00

the salmon species will tolerate stomach acid

24:03

and some won't. Some will tolerate bile,

24:05

some won't. Some will attach to your

24:07

gut, some won't. Some will stay in

24:09

your gut for a few days, some will pass straight through. This

24:12

is a few of those sort of basic characters that

24:14

we're often looking for with probiotics and that we've known

24:17

for a long time. You can go back to research

24:19

in the 1970s that

24:21

we're looking at. This isolate in the 15

24:23

strains of lactose-lastoffelism is exposed to the stomach

24:25

acid. And you can see even then that

24:28

some strains could tolerate those things, some things

24:30

did not. I

24:32

think it was studying in 2010 where they

24:34

took, I think it was 90 strains of

24:36

lactose, I think from memory of fermentum. And

24:39

they said, okay, let's expose these 90 strains to

24:41

stomach acid that's exposed to bile. And let's see

24:43

how many could tolerate both of those things well,

24:46

and I think it was from memory of 4%

24:49

of those starting materials could actually

24:51

tolerate stomach acid and bile to

24:54

the point that they could theoretically

24:56

survive transit to the upper gut. The

24:59

rest of them all died. Yeah, I think that's one of

25:01

those clear examples. And there's looking

25:04

at another species, lactose-lastoffelism, eutri.

25:07

And there's certain strains of

25:09

lactose-lastoffelism that can produce an

25:11

edge microbial compound called reutrin.

25:14

And reutrin is

25:17

effective against fungal pathogens and is effective

25:19

in bacterial pathogens. But

25:21

we can't assume that all strains produce it because they

25:23

don't. Only some strains do,

25:25

even if it has the name Biosciutri, it

25:27

does not mean it produces reutrin. And

25:30

those strains that do not produce reutrin

25:32

are very unlikely to have the same

25:34

kind of benefit through a microbiome alteration

25:36

perspective, either against

25:38

fungal dysbiosis or bacterial dysbiosis as

25:41

those that produce reutrin. And

25:43

the strain that we know, that's probably the biggest,

25:48

from the research base is the one I

25:50

mentioned before, the DSN1798, which is in bio-GAIA,

25:52

which has got this cool study where they

25:54

gave it to, essentially

25:58

kids who were taking a proton population. which

26:00

are the class medications that many of you

26:02

have listened to are familiar with. And gosh,

26:05

a lot of people take in

26:07

Western nations, it's huge, but it

26:09

could suppress the stomach acid output. So it's

26:11

used to treat reflux disease, essentially, and also

26:13

pentagull disease, but it's usually a shorter period

26:15

of time. But for

26:17

a high proportion of people

26:20

who take this medication, they develop SIBO, small

26:22

intestinal bacterial overgrowth. So there's some debate about

26:24

how much that is, whether it's 50, 60,

26:26

70% of these people will develop it, but

26:28

it's pretty market anyway. So this

26:30

study was, okay, well, what happens if we give

26:32

a pro-biotic alongside the

26:34

proton pump inhibitor? Will it prevent

26:36

SIBO from developing? And

26:39

this is what the study did. They gave a placebo,

26:41

they gave this particular strain of

26:43

life is re-atry, and I think

26:45

SIBO developed in 56% of those

26:47

in the SIBO group versus 6%

26:50

of those in that pro-biotic group.

26:53

And I think what's interesting here is that

26:55

there is another study using a combination of

26:57

two different pro-biotic strains at

27:00

maybe 10 or 20 times the dose.

27:04

Same similar model, let's give it to people taking

27:06

proton pump inhibitors, it did not work. It

27:08

didn't actually stop people from developing. So it's not

27:11

something that all pro-biotics do, but

27:13

this particular strain, we know, produces reutrine,

27:15

and reutrine works against fungal and bacterial

27:17

pathogens and prevented the overgrowth from occurring,

27:19

which I think is, you know,

27:22

one of the things that's pretty amazing, it means

27:24

we just have to make sure that the strains

27:26

that we're choosing for tax has got the qualities

27:28

and actions that we're after. One

27:32

of the few studies that actually directly compared two

27:34

different strains in the same

27:36

study was for viral

27:38

gastricitis, which is something that all

27:41

kids end up getting a lot

27:43

of muscle often doing it from our kids is when

27:46

they break it home from daycare. And

27:48

that's why we call it this condition.

27:50

Generally short-lived, but it can result in

27:52

hospitalizations and dehydration and death in

27:54

kids, and also does still lead in the Western

27:56

nations because of the dehydration after these very strong,

27:59

you know, directly. causes death

28:01

is more indirectly via dehydration. So

28:03

having treatments that shorten the duration

28:06

and decrease the severity are extremely

28:08

welcome. So in this

28:10

particular study, they compared these two probiotic

28:12

strains, same species, lactose rhamnosus, one

28:15

with L-Rhamnosus GG, one with lactose

28:17

rhamnosus lactophilus, GADG,

28:20

one of the two, and the

28:22

kids that took the LGG, they got better 24 hours.

28:26

Yeah, and 24 hours a week, if you've had a kid

28:28

that's gone vomiting and diarrhea, you will notice

28:30

24 hours less of vomiting and diarrhea.

28:33

Yeah, and it also

28:35

enhanced secretory IgA production. You

28:37

know, one of the main sort of immune markers, whether

28:40

you mean this was dealing with, you know, pathogens

28:42

like viruses in the gut, whereas

28:45

the other lactose rhamnosus did

28:48

not, you know. So, and

28:50

this is, again, same species, just different

28:52

strains. And there's a lot more examples

28:55

in terms of other characteristics that we

28:57

can go into as well, but I

28:59

think it's very clear. If

29:01

you look at the literature, it's

29:04

definitely not a marketing thing. And I hear you, because I

29:06

think there's a lot of insurance, and I think this is

29:08

probably because industry promotes that idea. So

29:10

many industry do. Generally, the companies

29:12

that are... Using

29:15

non-unable strains. Noting someone who don't have research. Yeah,

29:17

that's right. They don't list the

29:19

strains, or they use strains with no research base.

29:22

So they don't want people to know about the

29:24

strain specificity. They want to cloud the... The

29:27

waters. They do that effectively. Yeah,

29:29

and this is something that I've been trying to bust for

29:32

seriously 20 years. I've been trying

29:34

to, you know, let

29:36

practitioners, clinicians, and the general public,

29:38

but mostly I work with training

29:40

clinicians. This information, so

29:42

that they can really see, through that, the cloudiness

29:44

of the thing you put out there. Because the

29:46

research is clear if you look at it. That

29:49

there are generally big differences. Now, for certain

29:51

conditions, it may not matter so much, where,

29:55

you know, maybe the similarities of like

29:57

their capacity of... different

30:00

bacteria strains to produce acetate, you

30:03

know, and that all of them probably

30:05

will share within a given

30:08

species, although there is to be differences in

30:10

terms of how it's produced in certain food

30:12

substrates, but they all produce acetate, for example,

30:14

that might mean it for certain conditions that

30:17

won't matter as much and you might

30:19

put, you know, maybe post-antibiotics

30:21

trying to restore a bit

30:24

of gut health, something

30:26

maybe won't matter quite as much, you know, in

30:28

that case, because maybe just a change in pH

30:30

is always required to help in that case. Now,

30:33

that said, it matters

30:35

heaps when we're actually giving it alongside the

30:37

antibiotics, you know, where we know that certain

30:39

probiotics make no difference. Like there was this cool

30:41

study that was published in the Lancet, you know,

30:43

it's a huge medical journal in

30:46

terms of reach and how

30:50

high it is from an impact factor perspective. That

30:53

used, I think, 60 billion CFU,

30:55

four different probiotic strains to try

30:58

to prevent antibiotic-associated diarrhea. And

31:00

I think it had like over a thousand patients, it's like

31:02

a big study, did not work.

31:04

You know, we've got other strains where you can

31:07

give, I'll go back to that, life-less

31:09

reuteroid, DSM17938, 200

31:13

million CFU, it

31:15

works, to prevent antibiotic-associated diarrhea. So we

31:17

know, alongside antibiotic strains definitely do matter,

31:19

but there will be some applications where

31:21

I think, you know, probably after antibiotics,

31:24

where we're just trying to get more

31:26

change to pH of the environment to

31:29

help indigenous populations that

31:31

we want to support to grow back quickly,

31:34

may not matter quite as much. Got

31:37

it. Okay, so the big picture summary of this

31:39

is strains

31:41

specificity, not just marketing gimmicks, often

31:43

matters in a massive way and

31:45

can be the difference between something

31:48

working exceptionally well versus not working

31:50

at all. Yes.

31:52

Even within the same species, sort of like a

31:55

Doberman and a Chihuahua are the same species,

31:57

one is a really good guard dog, one

31:59

is not. That's

32:01

exactly right. And some of this, you

32:04

might have a catalog or something that's good

32:06

for certain tasks, but not good for other tasks.

32:08

And that's what we tease out with research on

32:10

these strains, that one is good for anaerobic Absolutely.

32:28

It was helpful for me when you presented

32:31

that. I was like, wow, yeah, I never

32:33

really have considered that they're all the same

32:35

species and they are radically different as far

32:37

as their function. I have a couple of

32:40

Australian Cattle Dogs and they're

32:43

built for a certain function and

32:45

they're not good for a certain function.

32:48

If I want a dog to, if I'm

32:50

laid out in bed or I have an

32:52

elderly person in my house who

32:55

just needs a companion to lay by

32:57

their side in an apartment all day,

32:59

it's just a really bad choice of dog

33:01

for that purpose. I

33:04

used to have a

33:06

red kelpie and they're bred

33:08

to run like 60 kilometers a day

33:11

or something like that into just little

33:13

battery cells. There's never run of energy.

33:16

So not good for keeping your elderly

33:18

relative company. No,

33:21

but very good for other tasks,

33:23

definitely. Yeah. And

33:25

it might be worth mentioning. So you're

33:27

the head of research of probiotic advisor.

33:29

This is a company that I

33:32

learned about through you and I signed up

33:34

for and I have been absolutely amazed by

33:36

that. I didn't know a tool

33:38

like this even existed where I can go in

33:41

and type in a particular condition,

33:44

like, for example, my

33:46

two and a half year old, since

33:48

we potty trained her started

33:51

suffering from some constipation and

33:53

started going instead of going to the back, going,

33:58

having a bowel movement. And every

34:00

day, it became every two or

34:02

three days. And so

34:06

I can look up, oh, probiotics

34:08

specific to that function, or probiotics

34:10

specific to hand eczema, or antibiotic

34:14

use, how do you minimize

34:16

complications, certain complications when you're

34:18

on antibiotics? It

34:22

brings up the search results of

34:24

all the specific research on specific

34:26

strains of probiotics that have actually

34:28

been shown to be affected in

34:30

that specific context. So it's

34:32

an amazing tool that I didn't even know existed

34:34

until I started taking your course. Thank

34:37

you. It started off with just some

34:40

paper documents. So that started seriously probably

34:42

in 2001. I

34:46

first started teaching, you know,

34:48

when I started my research process

34:50

and I first started teaching, it's like, okay, I'm going

34:53

to pull together these resources. And

34:55

you know, the India was three different documents, and

34:57

it means 30 pages long or 40 pages long.

34:59

And it's like, okay, I need to put this into a

35:01

searchable database, it's a paper in the old

35:04

way. But yeah,

35:07

I think it's, we now

35:09

have that capacity to really look at the research,

35:11

because research has built up so much for the

35:13

last 20 years that we can, we don't have

35:15

to guess, we don't have to take the

35:18

supplier's word for it. Because

35:20

what many of the people were doing before is like, this company

35:22

says it's good for this. No, no. Look

35:26

at the research. And this just makes it easier because

35:28

yeah, you can do search of Medline. Think

35:31

we should still all be doing that frequently. Why this

35:33

is a tool that this makes things easier. You can

35:35

just type in that condition and brings up the strains

35:38

and it tells you what products in Canada

35:40

or the US or Australia contain those strains

35:42

to again make things easier. Because that's the

35:44

added bit on top is like, yeah, this

35:46

is a great stream, this great research study.

35:49

But where? Where do you

35:51

get it? And sometimes those bits and faces

35:53

are not easy to come by. Yeah, absolutely.

35:56

OK, so one other thing

35:58

related to probiotics that I want to talk about. want

36:00

you to speak to is

36:02

colonization. I

36:05

think this is also a widespread myth. People

36:07

have the assumption they take a certain probiotic,

36:09

and they think it goes in there, and

36:11

it just starts colonizing the

36:15

intestinal tract, and then starts reproducing.

36:17

And so now you've got huge

36:19

quantities of this particular species of

36:21

bacteria. What

36:23

is the deal with that? Is there any

36:25

species that colonizes? I know this is probably

36:27

something that you could talk about for

36:29

five hours, but how could you simplify

36:32

into a few-minute long answer? Simplify?

36:35

Generally, no. We

36:38

don't get colonization from current

36:40

generation probiotics. So we're

36:42

talking about lactobacillus strains,

36:44

bifidobacterius strains, even

36:48

E. coli strains we currently have.

36:50

Saccharomyces probiotics, and I'd say the

36:52

bicillus-type strains, too, they don't permanently

36:55

colonize. They're all temporary visitors. And

36:57

this has been clear for also 40, 50 years. I

37:00

think this is, for me, the interesting thing is that

37:03

there's this conception that one of the

37:05

five R points is re-inoculate, and people

37:08

think that they can just take antibiotics,

37:10

and then just pop a pill, and everything

37:13

will be replenished from that forever onwards. And

37:15

it's good to know that that's not true. Scrubbing

37:17

shit does not happen, because I think it makes

37:20

you appreciate and care for

37:22

that ecosystem differently when you know that it's

37:24

actually one that is unique. It's yours that's

37:26

been passed down your family line, and we

37:28

should respect it as such. And

37:30

two, that it's not as simple as that, and

37:33

it's not reality. If we wipe

37:35

out our bifidobacterius, we can't

37:37

replace it with one in the top one. Yeah,

37:39

it doesn't stay. And again, if

37:41

you go back 40, 50 years, it's like

37:43

a good strain, a good probiotic strain will last

37:46

a week or 10 days

37:48

in there, versus ones that just pass straight

37:50

through, ones that die in the summer first

37:52

fall intestine. And we've

37:54

had studies showing this time and time again, as

37:56

we just don't get along with the term colonization

37:58

as a general rule. There is the

38:00

odd exception, you know, like there's the odd study. I

38:03

think there's one using a strain of bifida trinium, like

38:05

it was AH12O6, which isn't commercially

38:08

available now, but that was able to colonize,

38:10

I think, in 30% of people for six

38:12

months afterwards. But that is immense rarity, because

38:14

you can just, if you delve into the

38:16

literature, you'll find that they last for five

38:19

days, two days, 10 days, 14 days, but

38:22

you can see their populations just diminish.

38:24

If you take daily stool samples, it

38:26

goes down all that time. And

38:28

you can investigate this yourself, too. I mean, you can do

38:31

a stool test whilst you're taking that probiotic.

38:34

And then two weeks later, do that same stool

38:36

test and keep everybody else variable the same, and

38:38

you'll see that maybe your bifida trinium was here

38:40

and then not there anymore. It's

38:43

pretty clear. And some of

38:45

the students have done a lot of stool

38:47

testing over the, you know, a couple of

38:49

decades in my practice using, you know, accurate

38:53

assessment techniques, you clearly see that they

38:55

do not colonize in these

38:57

patients. And I think it

38:59

really cheapens the thought of the ecosystem

39:01

and care of the ecosystem if we

39:03

think it's easily replaced just by popping

39:05

a probiotic pills. It's not. What

39:08

do you think of, and this is

39:10

something I don't believe that I've heard

39:13

you mention in the course. I

39:17

believe it's the stilis subtilis, four-based

39:20

probiotic that is in products

39:22

from MicroBion Labs. And they

39:25

talk about it like it does colonize

39:28

and that it sort of takes up

39:30

residence there and also that it has

39:32

an impact on modifying other

39:34

species of bacteria that are present in

39:36

the intestines. What do you think of

39:38

those claims about that? I mean, I

39:41

think the latter one, I

39:43

wouldn't I mean, we know that probiotics

39:45

do have some impact on the guy

39:48

ecosystem. Now, I would put that

39:50

in general as well as to be

39:52

minor. You compare that to changes in diet,

39:54

you compare that to prebiotic usage, the

39:57

alterations we get from a product are relatively

39:59

small. You know, not none often

40:02

and that can be bigger. Like if it's

40:04

right after chemotherapy, right after antibiotics, you're going

40:06

to get bigger changes from a probiotic usage

40:08

in that case, because you can see this

40:11

immensely disrupted and you know, it's more flexible

40:13

to the helping shift at that point. But

40:15

if you take someone who's more stable, this

40:17

is some you give them a probiotic, whether

40:19

it's for based or otherwise, the impact will

40:22

be relatively small, not nothing but relatively small.

40:24

But if you change their diet markedly, you

40:26

give them a couple prebiotics, you'll

40:28

see dramatic changes in that ecosystem.

40:31

But in terms of the long term colonization,

40:34

I haven't seen research to suggest that that's

40:37

the case. Now, you know, it's possible that

40:39

I've missed that study so well, you

40:41

know, showing that this long term colonization. Again,

40:45

doing lots of stool testing of

40:47

the years. I can't even recall seeing this was

40:49

showing up on stool test very commonly at all

40:51

with people are taking that when people are taking

40:53

that supplement, which makes me, whereas I do see different

40:56

actually I do see that. That

40:58

populations do go up and down and people are

41:00

taking the supplement versus not that

41:03

makes you think those show up on stool tests where

41:05

I haven't really seen that. So

41:07

which makes me less at

41:10

least at the technical levels, it seems

41:12

less likely to me that would be occurring.

41:15

Okay, so you said a couple

41:17

things in the last couple answers that

41:19

I want to maybe clarify. So you

41:21

said something really interesting, which is

41:24

that kind of alluding to our

41:26

microbiome is subject to us as an

41:28

individual, something passed down through

41:30

the generations from our family. And

41:33

along with this idea that

41:36

we could take probiotics but it doesn't really

41:38

have much of an impact they don't really

41:40

colonize. It almost paints a

41:42

picture of the microbiome as this

41:45

sort of static unchanging thing. But

41:47

then on the other hand, you've also

41:49

you also alluded to like other factors

41:51

lifestyle factors nutrition prebiotics things like that,

41:54

that do have a big impact on

41:56

it. So how do we sort of

41:58

reconcile, you know, the degree

42:00

of plasticity of our microbiome. Is it highly

42:02

changeable or is it sort of more, it

42:04

stays like unique to us and it's this

42:07

thing we get from our parents that we

42:09

can't do much to change it? There's

42:13

a limitation with how much we can change it,

42:15

I would say, because we will, we get gifted

42:17

it from previous generations for sure.

42:19

And there'll be unique strains that get

42:21

passed down your family line, which

42:24

I think is amazing. And I think what's

42:26

even more amazing is, you know, women's breast

42:28

milk contains unique sugars, their yeast to her,

42:30

that feed those family line

42:32

different bacteria for example, that don't

42:35

feed other bacteria as well. It's

42:38

a pretty amazing process when we

42:40

go into the finer details and you just get

42:42

to really appreciate the

42:44

uniqueness and nuances when you delve into

42:46

it more. And it also makes you

42:48

worry about alterations on the

42:51

ecosystem to a far greater degree too, because you

42:53

know it's not easily fixable.

42:55

And you know, I

42:58

think that thing of custodianship of

43:00

your familial line of microbes, if

43:02

you take that on board, it

43:04

really changes your choices in life in

43:07

terms of what you're going to do to that ecosystem. So

43:12

we get it, we inherited this ecosystem, and

43:15

then we can change populations within

43:17

that by through dietary factors, lifestyle

43:19

factors, and medications. And

43:21

medications like antibiotics, you know, can cause

43:23

extinction events to that. So and

43:25

many people would argue that with every

43:27

course of antibiotics, our ecosystem gets less and

43:30

less diverse. So we can only pass

43:32

on what we've got, you know, so you know, I

43:34

would be able to pass on less than what my

43:36

mom passed to me, for example, sadly,

43:38

because I was those tons of antibiotics when I was

43:41

a kid, I grew up in the 70s, where every

43:43

single sniffle or cough or sneeze, they're

43:46

like take antibiotics, take antibiotics, take antibiotics,

43:48

you know, it's really only when I

43:50

was in my 18 when I

43:53

kind of discovered, moved

43:55

out of home and like discovered the world and discovered

43:58

health. That was like, oh my, I, you know, I've

44:00

had almost no antibiotics since then, but it's like, yeah.

44:04

So. I can still taste

44:07

the amoxicillin. If I just

44:09

conjure the memory of every time I had a

44:11

cold, I was given amoxicillin. Yeah.

44:13

I feel that the viscosity of

44:15

it, the flavor of it, the

44:18

pink look of it. Yeah. Yes.

44:21

Yeah. I know. I've

44:23

got that clear, very clear memory too, sadly.

44:25

Yeah. There's this cool study published in God

44:27

a couple of years ago where they were

44:30

looking at one person's ecosystem, essentially taking it

44:32

almost like daily stool samples. And the ecosystem

44:34

was immensely stable without any change of diet

44:36

or lifestyle. Gave them a single

44:39

shot of, you know,

44:41

in the blood bloodstream, intravenous antibiotics.

44:46

Nine species went extinct. Wow.

44:48

Even through the blood, through an injection.

44:50

That's crazy. Yeah. From a

44:52

single dose of the antibiotic. And to me, that was just like

44:55

mind blowing that we can lose nine

44:57

species from a single antibiotic exposure. Yeah.

45:01

And it caused massive disruptions in this ecosystem. In

45:03

fact, there was a species that went from like

45:05

0.02% up to 96% the day afterwards that they

45:12

hadn't even named before. And then they named it

45:14

up to themselves as researchers often do. Like

45:18

bork, folkyi, ceftriaxone, or something like

45:20

that, a very funky name. So

45:24

that was one of the interesting things, like how

45:26

much dynamic system there was for the first week

45:28

or two afterwards. It was crazy dynamic. I think

45:30

this has been settled into a new pattern two

45:33

weeks after that. A different pattern than

45:35

it was beforehand. But I

45:37

think the thing for me, two years afterwards, still

45:39

nine species were missing. Wow. And

45:41

you're like, and how many antibiotic courses do we get?

45:45

I had a child patient the other day that

45:47

had 14, by the time there's three. And

45:50

you're like, what's happened to their ecosystem? It's

45:52

like we've narrowed it down so

45:55

much. Yeah. So we have

45:57

things like that. We have proton pump inhibitors. want

46:00

to use clouds of indications. As

46:02

mentioned before, increased emo risk hugely.

46:05

But they're selected antibacterial,

46:07

so that they actually kill bacteria.

46:10

And they actually decrease the diversity of

46:12

eclosives dramatically. And we've got patients, people

46:14

taking it for years on a daily

46:16

basis. And again, we're

46:18

just narrowing this population. So while

46:20

we were gifted from our previous

46:23

generations, it gets narrower and narrower

46:25

in that situation. And we can

46:27

obviously make certain proportional changes with

46:30

dietary fact interventions, or our dietary

46:32

choices. Pre-biotics can make pretty

46:34

major shifts in proportions

46:37

of microbes. We

46:40

know that we can have temporary increases

46:42

in diversity by spending time in nature.

46:45

Going out for a lovely hike in the woods

46:47

or in the rainforest, organic

46:50

gardening, all these things will temporarily boost

46:52

diversity. And if we're doing it daily,

46:54

then we get these lovely continual boosts

46:58

of diversity that come with that. But

47:00

they're generally just temporary visitors again. And

47:02

I mean, it's not to say we

47:04

don't pick up microbes, because I think

47:06

we've always picked up micros from

47:08

a female oral root. If

47:10

you go back before we had such

47:12

clean water supplies, we

47:15

were always picking up microbes from people upstream

47:18

from us. We were bathing in polio.

47:21

Yeah, or bathing in other people's gut bacteria.

47:24

And if they didn't have gut diseases, it's

47:26

like, that's a good way to pass on

47:28

microbes. You know, when I was using Sri

47:30

Lanka, they have the amazing system of canals

47:32

that were set up, you know, 1,300 years

47:34

ago. They

47:37

go for like hundreds of kilometers. But

47:39

people out there, their feces and

47:41

their laundry and stuff goes into that canal.

47:43

And it's the way it's been for 1,000

47:45

years, and people downstream are

47:48

bathing in that same water. And,

47:50

you know, yes, if they've got

47:52

Giardia or Salmonella or something, that's obviously

47:54

going to be problematic. And

47:56

it is an occasion, obviously, but it's also a

47:58

way of passing on microbes. So there are ways

48:01

of getting some species back in that we've

48:03

lost, but it's when it comes to species

48:05

exposure where that's accidental or whether

48:07

that's intentional when it comes to things like fecal

48:09

transplants. But we can, we gain species in a

48:12

more permanent way that way. Yeah,

48:14

I've been to Sri Lanka and I've been to

48:16

India and I've seen some of these scenes of

48:19

people bathing and doing their laundry in

48:21

a river with, you know, literally

48:24

corpses floating through the river. And

48:27

I can picture this as something

48:30

and obviously sewage pouring into the river and

48:32

things like that. I

48:36

picture this as almost the opposite end of

48:38

the spectrum of what we do in the

48:40

West of giving, you know, the antibiotic courses

48:43

that you were just talking about, you know,

48:45

these are people being exposed to all kinds

48:47

of crazy microbes on a

48:49

daily basis, whether they call an

48:51

item or not, there's exposure happening

48:53

and immune training and all I'm

48:55

who knows what other complex physiological

48:57

responses there are to that exposure.

49:01

Yeah, totally. Thankfully, in Sri

49:03

Lanka, I wasn't seeing the dead bodies. Downstream,

49:06

that's another level of microbial exposure

49:08

for sure. So

49:13

one other thing I wanted to ask you was,

49:16

OK, so you've mentioned prebiotics a

49:18

couple of times. Yeah. How

49:22

do we know when to

49:24

use prebiotics versus probiotics? If

49:27

you're saying, you know, in

49:29

general, probiotics, it's

49:32

interesting what you're saying in the sense

49:34

that most people, I think, are under

49:36

the impression that probiotics are really what

49:38

matters. Probiotics are the things that

49:40

I need to take that are really going to

49:42

have an impact on my gut. And most people

49:44

in general, while this is trending

49:47

in a good direction, most people

49:49

in general have kind of brushed

49:52

off prebiotics as unimportant, whereas

49:54

what you're saying it sounds almost like the

49:56

opposite. So how do people know how should

49:59

they prioritize? pre versus probiotics?

50:02

Yeah, and I think you're spot on there in that. And

50:05

I think it is changing too. It's something you flagged too.

50:07

It's a growing understanding

50:09

of the importance of fiber and

50:12

prebiotics in terms of tools that we

50:14

use to make more substantive shifts

50:16

to the ecosystem. And I don't wanna come

50:18

across as anti-probiotics because I'm not trying to

50:20

use probiotics every day in my clinical practice,

50:23

but I think it's important that we frame what they do

50:25

well and what they don't do. And

50:27

if you're after optimizing your

50:30

gut ecosystem, prebiotics are

50:32

far, far more effective at doing

50:34

that. They're far better at increasing

50:36

levels of beneficial species and decreasing

50:38

levels of what we call pathobionts

50:40

or pathogens. Pathogens are, people

50:42

are more familiar with their bad bacteria.

50:45

Pathobionts are ones that in the right

50:47

amount are helpful to us, but when

50:49

they overgrow, they're problematic and cause harm.

50:51

And we've got a number of those

50:53

in our gut. And what I love

50:55

about prebiotics is their capacity

50:58

to lower levels of pathobion and pathogen

51:00

and at the same time, increase

51:02

levels of beneficial bacteria. And I think

51:04

that selectivity of

51:06

their impact on the ecosystem is just brilliant.

51:08

So I have these, since I learned about

51:10

them really, which goes back to 2001, they've

51:15

been a core part of my clinical

51:17

practice since then. And we have been

51:19

core because I think their capacity to

51:21

shift ecosystems in dramatic ways is,

51:24

you can see that. You do the right stool

51:26

test and you can see dramatic impacts

51:28

after two months of use on a prebiotic.

51:30

And if you took a probiotic for that

51:32

two months, you would not see that. There'd

51:34

be some little shift. It's not to say

51:36

that the probiotics can't help with speeding transit

51:38

time. They can help with healing up the

51:40

damaged gut. They can help

51:42

with increasing inflammation. There's lots of good

51:45

reasons to give, to use specific probiotics.

51:47

But if you're after like shifting that

51:49

ecosystem dramatically, prebiotics or a change in

51:51

dietary approach will produce far

51:53

greater shifts. Very,

51:56

very interesting. That was a very strong statement that

51:59

you made. I think if

52:01

people really hear that, it will

52:03

blow a lot of minds and

52:05

change a lot of perceptions and

52:08

make people realize that prebiotics, that

52:10

they've really been neglecting and underappreciating

52:12

the value of prebiotics. I know

52:14

that that was even true of

52:16

me prior to going through your

52:18

course. I had already read

52:20

a lot about prebiotics. I can supplement prebiotics,

52:22

but I still was kind of blown away

52:25

with how you sort

52:27

of rate the magnitude

52:29

of effect size in changing

52:31

gut microbiota. Yeah, and

52:33

I think if you

52:35

do lots of microbiome assessment with patients

52:38

preimposed, you see it for

52:40

a second and you see how that correlates

52:42

with the shifts in their energy, their cognitive

52:44

capacity and their gut symptoms. And

52:48

it can be dramatic. I remember having a

52:50

gut one patient who when I started working

52:52

with her, she was like essentially

52:55

bent down. She could barely sit

52:57

up. She couldn't feed herself. She had

52:59

to have people feed her and then to working

53:01

on a microbiome only level. Now,

53:04

I wasn't giving mitochondria support or other things

53:06

just microbiome stuff and we couldn't do much

53:08

with diet because it was kind of restricted

53:10

with because she wasn't control of her food.

53:12

She was an institution and she

53:14

just got an institutional food, which I think we'd know.

53:18

So we just worked with prebiotics and probably

53:20

some curcuminous because now she's inflammatory as well.

53:23

She's with prebiotic work and geez, I spoke

53:25

to her just the other week and she

53:27

is now in a wheelchair.

53:30

She's going outside daily and she's able to feed

53:32

herself and we'll sit up and it's just like

53:35

the difference for her. Now I feel like a

53:37

relatively small thing. It was huge, huge

53:40

in so many ways and she's

53:42

getting better as each progressing week

53:44

or month, things are more functionalities

53:46

returning. And

53:48

that's one of those cases that demonstrates the

53:50

huge potential impact that we can get if

53:53

we change the ecosystem. And her ecosystem

53:56

was very dysbiotic, had very high levels

53:58

of proteobacteria and very up which

54:00

were the endotoxin that we start off talking

54:02

about, and very low levels of beneficial anti-inflammatory

54:05

bead weight produces. So it was rife for

54:07

the changing. And we did a full up

54:10

stool analysis and we

54:12

reduced the proteobacteria by half and we increased

54:15

beneficials pretty dramatically, even

54:17

though we weren't able to implement all the things because we

54:19

had to do very tiny, tiny

54:21

doses, stepwise increase because her system

54:23

was so sensitive. And

54:26

even within that context there was dramatic change, but you

54:28

can see it. And I think that's the thing too,

54:30

is you can clearly see the impacts of how dramatic

54:33

they could be by using a

54:35

good stool analysis pretty much. I

54:38

want to talk kind of, I think,

54:40

a natural segue from what you were just

54:42

talking about. And you've made a couple of

54:44

allusions to the importance of

54:46

fiber in the diet for maintaining

54:49

the gut microbiome and

54:52

prebiotics. So I'm curious,

54:56

are you aware of the carnivore

54:58

diet that

55:01

is kind of trending in some circles right now? And

55:03

I'm curious what your thoughts are on it. Yeah,

55:07

I think

55:09

it's probably effective at reducing

55:11

certain gut symptoms short-term,

55:13

like gas related symptoms,

55:15

because you essentially produce a lot less hydrogen gas

55:18

when you eat only meat. Yeah,

55:21

because it does get fermented. In fact,

55:23

it's called petrifaction when

55:26

meat gets fermented in the gut and it

55:28

just produces maybe one-third specific gas level is

55:30

what you get when you produce new fermenting

55:33

fiber from carbohydrate

55:35

compounds. So I think you

55:37

can definitely help with these symptoms, but I

55:39

think there's a major trade-off with

55:41

that, because you've got to be aware that

55:44

most, if not all, the beneficial species

55:46

in our gut are fiber or

55:49

oligosaccharide or carbohydrate consumers. And if you

55:51

start feeding them, their

55:53

population dips. Not surprisingly, if

55:55

you start feeding something, it goes down. And

55:58

at a certain point, your He's

56:00

going to reach the point of extinction. If he's

56:02

to stop feeding things long enough and there's not

56:04

enough food for them, their populations will eventually

56:07

just go out. And then

56:09

it's impossible, really hard, but it's not a

56:11

difficult transplant to bring them back. And

56:13

as some of these have worked with people

56:16

that have been on the carnivore and

56:18

are really unwell and trying

56:21

to get them back, it's really hard work. Because

56:23

part of the other issue here is what they

56:25

are feeding. It's like we know they're not feeding

56:27

B-rate producers. They're not feeding Bifidobacteria. And

56:30

that's really problematic. What

56:32

they are feeding is hydrogen sulfide gas producers.

56:35

Because they quite like eating protein. And they're quite like

56:37

eating bile. And there's a lot of that in the

56:40

reach of the gut in that kind of dietary approach.

56:42

And hydrogen sulfide gas causes kind

56:45

of gut leakiness, but it causes

56:47

also visceral hypersensitivity, which is when

56:49

the nerves in the gut are

56:51

hypersensitive. So you can start feeling

56:53

even little bits of gas moving

56:55

their way through. Little bits of

56:57

fiber compounds moving through. You start

56:59

feeling it. And logically,

57:02

it would make sense then that

57:04

there's a possibility that someone who adopts

57:06

that kind of diet and then tries

57:08

to reintroduce plant foods might be way

57:10

more sensitive to them and

57:12

therefore kind of almost insidiously then

57:15

even more convinced that those foods

57:17

are harming them. Yes,

57:19

exactly. Yeah, and this

57:21

is where it's really hard to get people off

57:23

of that because their gut has now become so

57:26

inflamed and so not severe visceral hypersensitivity. That

57:30

even like a small, tiniest amount

57:32

of substrate fiber plant-based

57:34

food or that they used to tolerate

57:36

fine or prebiotic actually

57:39

causes them excruciating pain. And

57:42

discomfort. And it's like, OK, how do

57:44

we work forward? It's really slow going

57:47

because you have to try to do... This

57:49

is where you might use subplantal butyrate. Yeah,

57:51

because we can't feed the butyrate producers. Yes.

57:54

Because of the greed and inflation. So severe, we have

57:56

to use lots of gut anti-inflammatories to get to the

57:58

point where... And we have... these things

58:00

that help with detoxification, hydrogen sulfide gas.

58:04

Initially, before we can start increasing

58:07

pre-biotics to shift things more, more

58:09

probably because it's more positive, but it gets really tricky.

58:11

And this is where we worry about is

58:14

that, you know, for a week, yeah, not

58:16

a big deal. But you start doing this for

58:18

months is you start making more longer

58:21

term impacts to the

58:23

ecosystem, but also just the

58:25

environment and the information

58:28

level that are hard to come back from.

58:31

Do you think that there's a possibility

58:33

as kind of along the lines of

58:35

what you were talking about with antibiotics,

58:37

there's a possibility of extinction

58:39

events for certain species of bacteria

58:41

that maybe you can never get

58:44

back? I would think

58:46

yes, but it would probably be

58:48

time duration dependent. So

58:50

again, for a short period of time, probably

58:52

not extinction, the populations will just go down,

58:54

but there'll be a point at which you

58:56

expect them to be extinction events. If

58:58

you just make sense, you can. There'll

59:02

be a consequence. And when I remember working

59:04

with one person who

59:06

is just eating two chickens a day, that's

59:08

all this person ate. And

59:12

looking at that guy, the system is

59:14

like so high in hydrogen

59:16

sulfide gas producers, so high

59:18

in bile years who create

59:20

secondary bile acids, which are

59:22

also pro-inflammatory in the colon

59:25

and no bistevactria, no

59:27

fecalibactrium. I'm

59:29

surprised there were 2% of

59:31

bean array producers in that ecosystem, which is I think

59:33

from the lowest I've ever seen. And

59:39

through a lot of work, we're able to expand

59:42

things and eventually diet too,

59:44

for that matter. But

59:47

I still think that there are some species that

59:49

will never recover tissues on that diet for long

59:51

enough that I think there will be extinctions. And

59:53

the diversity was never going to be as

59:55

good as it would have been otherwise. Yeah.

59:59

Based on what you're saying, it seems... like it

1:00:01

has the potential to be a pretty insidious

1:00:03

thing in the sense that a person might

1:00:05

adopt this kind of diet and

1:00:07

experience only benefits initially. Initially.

1:00:09

And therefore be convinced that

1:00:12

this is, they've discovered the

1:00:14

best way to eat and

1:00:17

making them lose weight. They're feeling good.

1:00:19

They have way less abdominal symptoms, GI

1:00:21

symptoms. Uh, and, and

1:00:23

they, the, the subjective conclusion

1:00:26

from, from that feedback is.

1:00:29

I've found the magic best human diet

1:00:31

that is, that makes me kick butt.

1:00:34

And, uh, and

1:00:36

then only later will

1:00:38

they start to develop all kinds of

1:00:40

other problems, which they probably will not

1:00:42

then attribute to the diet that they

1:00:45

are convinced is the best diet. Yeah.

1:00:47

No, I think you're totally spot on. Yeah.

1:00:49

We spot on there. Yeah. Okay. So,

1:00:52

um, the, maybe the last 20 things

1:00:55

I wanted to ask you about, um, uh,

1:01:00

if the last thing that I want to

1:01:02

cover is probably SIBO. Um,

1:01:05

SIBO has become somewhat of

1:01:07

a controversial thing. Uh,

1:01:09

and I have, I have personal friends

1:01:12

on both sides of this who,

1:01:14

uh, some people are, you

1:01:16

know, sort of in the

1:01:18

mainstream functional medicine camp. They're sort of

1:01:21

diagnosing everybody and everybody with, with SIBO

1:01:23

based on hydrogen breath tests. And

1:01:25

then I have other friends, for example, uh, Dr.

1:01:28

Alan Christiansen, who has written an article

1:01:31

that caused quite a stir in the

1:01:33

functional medicine community, basically

1:01:35

attempting to debunk SIBO as a thing.

1:01:37

And, and sort of, and he had

1:01:39

multiple sort of lines of evidence and

1:01:41

logic that he presented to

1:01:44

essentially conclude that, you know,

1:01:46

it's just the evidence

1:01:49

doesn't support that SIBO exists and

1:01:51

is a cause of, um,

1:01:54

IBS like symptoms and that sort of thing. So

1:01:57

what, what do you,

1:01:59

I know this is. I

1:02:01

went through two hours of lecture of yours on

1:02:03

this topic. So I know it's something you can

1:02:05

be three hours enormous. Yeah. Yeah.

1:02:08

But how would you

1:02:10

sort of speak to the legitimacy

1:02:12

of SIBO and and maybe problems

1:02:15

with a lot of the testing that

1:02:17

goes on with it? Yeah,

1:02:20

I mean, I actually came from the very

1:02:22

skeptic camp to to be honest, because I

1:02:24

was using my PhD in the role of

1:02:26

dysbiosis in critical bowel syndrome. When

1:02:28

this first this idea and this is

1:02:31

looking at colonic dysbiosis and all the

1:02:33

research was around colonic imbalance. And

1:02:36

then this researcher came at all this

1:02:38

idea of small intestinal bacteria playing a

1:02:40

role and antibiotics may be helpful for

1:02:43

IBS. And before that,

1:02:45

all the research was showing the antibiotics were a

1:02:47

common cause of IBS occurring.

1:02:49

So I was immensely skeptical

1:02:52

when that first came up. So

1:02:55

I will flag that because I'm

1:02:57

like, hmm, that really fit the

1:02:59

broader literature around that. And

1:03:01

the only discussion of SIBO was really in before

1:03:05

Pimbile stuff with essentially in people

1:03:07

had short bowel. People had gut

1:03:10

surgery, part of the small bowel removed,

1:03:12

and they would have a raging SIBO and

1:03:14

they'd end up in hospital. So there were cases

1:03:16

of SIBO discussed in literature, but it

1:03:19

was very much the search

1:03:21

with abdominal surgery. That was kind

1:03:23

of the thing that we saw with

1:03:25

SIBO up until Pimbile's ideas started coming

1:03:27

forth. So I was cautious about it

1:03:29

too because my area was IBS and it was

1:03:31

dysbiosis. Those are my areas. So it was like,

1:03:34

this was just, and also latulas

1:03:36

as a tool to diagnose it with peculiar

1:03:38

to me too, because it was like, I'm

1:03:41

using latulas as a prebiotic.

1:03:43

And it's a, we know it's a selectively

1:03:45

fermented substrate that only some bacteria eat and

1:03:47

a whole bunch can't. So you're not going to see if

1:03:49

those bacteria are present in the small bowel because they can't

1:03:51

eat it. That's going to pass

1:03:54

through. So I

1:03:56

was on skeptic system towards that as a

1:03:58

diagnostic tool as well. But

1:04:01

you fast forward to 2022, here I am. I

1:04:05

actually do believe in SIBO and I do

1:04:07

use breath testing and I treat patients with

1:04:09

SIBO and their IBS symptoms get better long-term

1:04:12

and you can cure people with their IBS

1:04:15

symptoms. So I think

1:04:17

it's one of those, for me, an interesting journey

1:04:19

that's gone along the way as

1:04:21

research has changed. As

1:04:23

you start in trying different things clinically

1:04:25

and seeing things. Now I don't use

1:04:27

antibiotics to treat SIBO. I use herbal

1:04:30

selected reacting anti-microbials. I use probiotics. I

1:04:32

use prebiotics. So a way of altering

1:04:34

that ecosystem. But I think

1:04:37

there is, for me,

1:04:39

it's clear that there are people who

1:04:41

do get over-roastobacteria in their small intestine.

1:04:43

And we treat that and their symptoms

1:04:45

go away. Not only gut symptoms, but

1:04:47

some people who have brain fog, they

1:04:49

get fatigue, aches and pains. Those things

1:04:51

go too. And I

1:04:54

see this every single week in practice. So

1:04:56

no matter how much somebody says, I

1:04:59

don't think this conditioning exists, I

1:05:01

would say, I see it. I

1:05:03

can do pre and post breath testing. And breath

1:05:06

testing isn't perfect. And I think

1:05:08

if we rely solely on lactulose, we're actually getting

1:05:10

false positives and we're getting a lot of false

1:05:12

negatives. So it's pretty problematic if we only use

1:05:14

lactulose, which is for me, one of

1:05:17

the reasons I was so distrustful of

1:05:19

lactulose as a diagnostic tool that I

1:05:21

started using, I was always using glucose

1:05:23

breath testing and I started using fructose breath

1:05:25

testing and then I started doing triple breath

1:05:27

testing at every single patient, I suspected a

1:05:29

SIBO over the last 10 years. So

1:05:32

you can actually kind of start seeing patterns. And

1:05:35

start seeing which sugar substrates I think are more

1:05:37

effective for diagnosing SIBO. And I would actually argue

1:05:40

from a clinical perspective that

1:05:42

fructose is actually a more accurate sugar

1:05:45

than other lactulose or glucose, but I

1:05:47

generally will do at least fructose and

1:05:49

lactulose or all three, if I really

1:05:51

want to get the best chance of

1:05:53

seeing if they're not. But what we can see

1:05:55

is let's say we have this early rise on

1:05:57

fructose. So, you know, there's a breath gas spike.

1:06:00

at the 20 minute mark. Yeah, and

1:06:02

it's extremely unlikely that fructose has reached

1:06:04

the colon in 20 minutes. Is it

1:06:06

possible in some people? Yes, but in

1:06:08

those people, in that situation, it's not

1:06:11

the case. And then we can treat that

1:06:13

person for that, you know, apparent bacterial liver

1:06:15

growth with those selective reacting

1:06:17

herbal anti-microbials, pre and probiotic combinations. We

1:06:19

can do, their symptoms go. We can

1:06:21

do a retest and they no longer

1:06:23

have that spike

1:06:25

in gas at any time point,

1:06:28

you know. So we get this objective data showing that that

1:06:31

is no longer the case. And we get the

1:06:33

subjective improvement of symptoms that go with that. And

1:06:36

as I said, that's something that I see on a weekly

1:06:38

basis. So I have a hard

1:06:40

time thinking it doesn't exist. I think

1:06:43

it's just an artist like that. But

1:06:45

I also share some of the concerns

1:06:48

that people have about

1:06:50

the broader SIBO field.

1:06:53

And that's, you know, not everybody's got SIBO. And I

1:06:55

think I have issues too, I always think everybody with

1:06:57

IBS has got SIBO and that's clearly not the case.

1:07:00

And we're gonna put data on that. And I still

1:07:03

don't think we've got the idea ways of diagnosing SIBO

1:07:05

or defining SIBO. I think there's still areas

1:07:07

that are open for improvement. Yeah, but I

1:07:09

do think there are people who have this

1:07:11

early rise in breath gases, sugar

1:07:14

substrate, breath testing, and

1:07:17

apparent gut seems to go with that, that

1:07:19

when we treat that and the breath normalizes,

1:07:21

it's got such a good way. Okay, so

1:07:23

you said something else in there that I wanna

1:07:26

flag, it's interesting. I think

1:07:28

it was the case for me and

1:07:30

it's the case for many, many functional

1:07:32

medicine practitioners that I know that there

1:07:35

is a general sort of

1:07:37

fear over prebiotics when dealing

1:07:39

with SIBO. Because

1:07:41

these people have this dysbiosis and

1:07:44

bacterial overgrowth in the wrong place,

1:07:47

that's leading often to this

1:07:49

reaction to certain kinds of

1:07:52

prebiotic fibers. And

1:07:54

the tendency in thinking, if I

1:07:57

can generalize, is towards

1:07:59

maybe like that. elemental diet

1:08:01

is towards reducing fiber and

1:08:04

avoiding any fibers that could feed

1:08:06

the bad bacteria and bacterial overgrowth.

1:08:11

And your course

1:08:13

really presented a big shift in thinking

1:08:16

because you pointed to all this research

1:08:19

basically showing that

1:08:21

certain prebiotics are actually highly

1:08:23

beneficial and can help resolve

1:08:26

SIBO. So can you just

1:08:28

speak to that maybe trend of thinking

1:08:30

and why prebiotics

1:08:32

are not something to fear? Yeah,

1:08:35

and I think we can even put probiotics

1:08:37

in that too. In that the general consensus

1:08:39

is in don't give probiotics SIBO because you're

1:08:41

already deciding more bacteria to an already overgrown

1:08:43

system. But then you look at the research

1:08:45

data and it's very clear that

1:08:48

probiotics are helpful. There's

1:08:50

individual studies, but then there was a

1:08:52

meta-analysis published a few years back

1:08:54

that looked at grouping all probiotics together, which

1:08:56

I think is problematic, but it can still

1:08:59

give a general

1:09:01

idea about perhaps

1:09:04

broad effectiveness. And there's a

1:09:06

50% clearance rate of curing

1:09:08

of SIBO with probiotic. And

1:09:10

given that, you know, refactoring the main

1:09:12

antibiotic used is like somewhere between 50

1:09:16

to 70% effective, depending on which

1:09:18

systematic read you read. You

1:09:21

know, not markedly different than that. We

1:09:23

still have people saying don't give probiotics because

1:09:25

of the theoretical consideration, but they

1:09:27

don't look at the research that says, look at the

1:09:29

research. It's very clear, you know, and there's some strains

1:09:31

that have better efficacy than 50%, but that's just what

1:09:34

you get in them all combined. And

1:09:37

I think too, you look at the

1:09:39

research around prebiotics, it's like we know

1:09:41

that let's look at partially hydrolyzed guarigam,

1:09:43

which is a fairly unique prebiotic substance

1:09:45

because it technically targets bead rate producing

1:09:47

species, I would say. A little bit

1:09:49

of bifidobacterium, but mostly bead rate producing

1:09:51

species. We know if we

1:09:53

give that alongside, let's say, refactment for

1:09:55

the treatment of hydrogen-dominant SIBO, that we

1:09:58

improved essentially the cure rate from... 67%

1:10:00

to 82% by

1:10:03

using a pre-biotic alongside the antimicrobial.

1:10:06

And then we have like methane overproduction,

1:10:09

which can happen in the small bowel

1:10:11

or colon or both. And

1:10:14

we know that giving part to the hydrolyzed

1:10:16

garden decreases methane output with

1:10:18

continued use. And following on from that,

1:10:20

we know that other pre-biotics can decrease

1:10:22

methane as well, like galactyl and nusaccharide

1:10:24

can as well. Now, we're kind of

1:10:26

limited with there's not that much human

1:10:28

research around tools to help decrease methane.

1:10:30

But we do have that one study

1:10:32

with archaeohydrolyzed garden. And we have research

1:10:35

on the, we'll go back to the

1:10:37

bio-gaya, DSM1739, 3H3N3,

1:10:39

and the lactose-reuteri, which has been found

1:10:41

to decrease methane output as well. So

1:10:44

here we have these tools that somebody would

1:10:46

just say, we can't use pre-improvotics despite

1:10:48

the fact we have clinical trials showing

1:10:50

that they're actually helpful. And I

1:10:52

think that's what I find frustrating is

1:10:55

that when people get stuck in very

1:10:57

rigid thoughts around conceptions and theories that

1:10:59

they can't accept the evidence that is

1:11:01

being published and right there. And it

1:11:03

just means the patient gets care because

1:11:05

of people being closed and

1:11:07

too rigid and not open to new evidence

1:11:09

when it comes up. Yeah. Fascinating

1:11:13

stuff, Dr. Harlach. I really want to

1:11:15

thank you for your time. This has

1:11:17

been absolutely wonderful. Thank you for going

1:11:19

over our hour of allotted time. And

1:11:21

the last thing I want to ask

1:11:23

you to wrap up with is if,

1:11:27

and this is maybe a hard question, if

1:11:30

you were going to generalize how

1:11:32

to best take care of one's

1:11:34

gut health, what would be your

1:11:36

top three recommendations that you want

1:11:38

to leave people with? Avoid

1:11:42

antibiotics as much as you can. Make

1:11:45

sure you check if they're actually needed. They're

1:11:47

still used far too often for viral infections.

1:11:49

I wish they

1:11:51

weren't, but they still are. Number one,

1:11:54

two, eat prominently plant-based. It

1:11:57

does not be completely plant-based, it's mostly

1:11:59

plant-based. So you're getting and choose,

1:12:01

eat a variety of different plant

1:12:03

foods. Yeah, so you're having like

1:12:05

goons, whole grains, nuts, seeds, fruits,

1:12:08

vegetables, multiple colors, because that's what's

1:12:10

feeding a diversity of microbes. Yeah,

1:12:12

because most of the species in there are

1:12:14

fiber and polyphenol consumers. So if we're eating

1:12:16

some purple carrots, you're eating some black rice,

1:12:19

some black beans, we make sure we're feeding

1:12:21

a wider diversity than if we're eating, you

1:12:23

know, orange carrots only, brown rice only or

1:12:25

white rice only. You know, since it's, I

1:12:27

think those things are probably

1:12:29

the most important, but I would actually tag

1:12:31

on like exercise in nature as a way

1:12:33

of making two things we

1:12:36

know are important. One is getting water amounts

1:12:38

to exercise is important for diversity. And two,

1:12:40

being in nature is another great way of

1:12:42

increasing your eucus and diversity. So if you

1:12:44

can join those two together of, you know,

1:12:46

hiking in the woods or running

1:12:49

through the woods, that I think

1:12:51

would be my third on

1:12:53

that list. Beautiful, thank you so

1:12:55

much. And the last thing is

1:12:58

just where can people get ahold of you, follow

1:13:00

your work, get in touch with you if they

1:13:02

want to work with you or where do you

1:13:04

want to send people? I

1:13:06

mean, probiotic advisors is a good port

1:13:09

of call in that I've got a number

1:13:11

of courses online, mostly geared for practitioners, but

1:13:13

I'll ask for, you know, the health conscious

1:13:15

general public as well. And

1:13:18

then I've also practiced in

1:13:20

the world of natural medicine, which is a

1:13:22

clinic in over in Tasmania in Australia, even

1:13:25

though I don't actually really know right now,

1:13:27

it's all virtual these days, but I practice

1:13:29

still because I think, and

1:13:31

I'm still researching too. And I think that I

1:13:33

love all those aspects of things. I think they all feed

1:13:36

into each other really well. Is I think

1:13:38

working with those patients and seeing the impact

1:13:40

is immensely important. Trialings you see in research and

1:13:42

going, does it work in the real world? How

1:13:44

do we implement it in the real world to

1:13:46

get the benefits? Because yeah, I

1:13:48

think it's really important. But yeah,

1:13:51

but I think that- You work with patients all

1:13:53

over the world or just- I do. Okay.

1:13:56

No, no, these for the last, you know, five or 10

1:13:58

years has been mostly all over the world. the world. Okay,

1:14:01

so somebody wanted to work with you one

1:14:03

on one, they can contact you, let's say

1:14:05

they're in Canada or in states or in

1:14:07

Europe or something like that. And you could

1:14:10

potentially have them get certain testing

1:14:12

done. And then

1:14:15

you can evaluate them and evaluate the testing

1:14:17

and then work with them. Yeah,

1:14:19

pretty much so. And I'd say at least

1:14:21

half my patient load is in North America

1:14:23

or Europe now. Excellent. Excellent.

1:14:26

Well, thank you again so much. On

1:14:28

a personal note, I've really, really enjoyed your

1:14:30

course and benefited hugely from it already. And

1:14:33

thank you so much for coming on

1:14:35

my podcast and sharing your wisdom with

1:14:37

my audience. I'm really appreciative of everything.

1:14:41

You're very welcome. And it's a lovely

1:14:43

chat, actually, I do it thoroughly. Hey,

1:14:45

this is Ari again, I hope you

1:14:47

enjoyed this episode. And I think you

1:14:49

probably can now see why I sought

1:14:52

out Dr. Harlack to partner with

1:14:54

him to create this program under

1:14:56

my new brand humanoptimization.com, why I

1:14:58

made him the expert on gut

1:15:01

health and microbiome optimization. Again, if

1:15:03

this is an area you are

1:15:05

interested in optimizing, which it should

1:15:07

be because again, we know that

1:15:09

gut health and microbiome health connects

1:15:12

with every aspect of our broader

1:15:14

health, our metabolic health, our brain

1:15:16

function, our energy levels, our mitochondrial

1:15:18

function, our body composition, our insulin

1:15:20

sensitivity, our performance,

1:15:23

our immune health, and so much more. If

1:15:26

you are serious about optimizing

1:15:28

your gut health and

1:15:31

your microbiome health, and you really want to

1:15:33

learn the real science, no hype, no BS,

1:15:35

no one size fits all

1:15:37

sort of kill protocols and reseeding

1:15:40

protocols, but just here's the actual

1:15:42

real science of how to optimize

1:15:44

your microbiome health. I really encourage

1:15:46

you to go to humanoptimization.com and

1:15:49

get the new course that we

1:15:51

just launched with Dr. Harlack. I

1:15:53

think you're going to be blown

1:15:55

away by it. As always, you've

1:15:58

got a 30-day refund policy. so

1:16:00

you can get access to the course, try it

1:16:02

out, see it for yourself, check out the

1:16:04

whole thing, go through the whole course if you

1:16:06

want. If you're not blown away by the

1:16:08

material, feel free to ask for a refund. Of

1:16:12

course, I want everybody who gets this

1:16:14

course and all my products and programs

1:16:16

to be blown away, to be more

1:16:18

than satisfied, to feel like they

1:16:21

got much more in terms of

1:16:23

the value and the results that they got than what

1:16:25

they paid for it. And that's

1:16:27

why I give that 30-day refund window to

1:16:29

make sure that that's the case for you. And

1:16:32

I think that even if you

1:16:34

are a seasoned health geek like

1:16:37

me who has spent many years studying

1:16:39

gut health and microbiome health and you

1:16:41

think you know it all already, I

1:16:43

think you're still going to learn a

1:16:45

lot from this program. I can say

1:16:47

that even for me as somebody who's

1:16:49

been studying health science for three decades

1:16:51

and learning a lot from lots of

1:16:53

gut experts interviewing a dozen

1:16:55

or so top gut experts

1:16:57

on this podcast, even I learned

1:17:00

a ton from Dr. Harlach in

1:17:03

the coursework I did with him and

1:17:05

in the course that he's produced for

1:17:07

the human optimization brand. So I'm very

1:17:09

confident you're going to be blown away

1:17:11

by this and the value you get

1:17:13

from it and how that's going to

1:17:16

translate into practical benefits in your life.

1:17:18

So go to humanoptimization.com, grab yourself the

1:17:20

course and enjoy it, enjoy all

1:17:22

the value that you get from it. You

1:17:25

know I think at the end of the day what

1:17:28

we're really talking about when we're talking about

1:17:30

optimizing our gut health and our microbiome health

1:17:33

is we're talking about you

1:17:35

know how this is going to impact

1:17:37

your metabolic health, how it's going to

1:17:39

create subtle impacts or maybe not

1:17:41

so subtle maybe very noticeable impacts

1:17:44

and immediate impacts on your brain

1:17:46

health and your mood and your

1:17:48

brain function and performance on your

1:17:51

mitochondrial health and your energetic

1:17:53

performance, how much energy you

1:17:56

have and the

1:17:58

broader landscape of things like immune. immune health

1:18:00

and metabolic health and risk of various

1:18:02

diseases over time. You

1:18:04

know, when, when you look at things on

1:18:07

that sort of timeline, how many years of

1:18:09

life. Can this potentially this

1:18:11

knowledge potentially add to my life.

1:18:16

And how much quality of life how

1:18:18

much life is in those years that

1:18:21

I've added you know how much better

1:18:23

mood and brain function and energy and

1:18:25

metabolic health and vitality and

1:18:28

better functionality and

1:18:30

performance in all the systems of

1:18:32

my of my body, have I

1:18:34

added to my life span. Because

1:18:38

of this information. And when

1:18:40

you look at things that way when you

1:18:42

realize this is an opportunity to get

1:18:45

essentially the distilled practical

1:18:47

need to know information about how do

1:18:49

you optimize your gut health and microbiome

1:18:51

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1:18:54

top experts. I think it's really a

1:18:56

no brainer. So, go to

1:18:58

human optimization calm grab yourself the course, and I

1:19:00

think you're going to be very happy you did.

1:19:03

Thanks so much for listening to this podcast I

1:19:05

hope you enjoyed it and I hope you will

1:19:07

take the next step to check out the program

1:19:10

with Dr. Harlak on gut

1:19:12

health and microbiome optimization.