The Natural Evolution Podcast

Season 2

Episode 30

S2E30 – Insight into the Clinical World of Chronic GI Problems with Dr. Datis Kharrazian

As an award-winning clinical research scientist, academic professor, and world-renowned functional medicine provider, Dr. Datis Kharrazian focuses on developing evidence-based, non-pharmaceutical approaches to neurological and autoimmune disorders. Through developing the Kharrazian Institute, Dr. Kharrazian is able to guide other healthcare professionals in learning more about how to utilize various strategies in managing chronic disease.

Today, Dr. Kharrazian will help us further understand the nuances of chronic GI problems – including gut inflammation, food sensitivities, autoimmunity, hormone dysregulations, and even how some symptoms present in neurodegenerative diseases. He brings to light that oftentimes the problem starts in the gut.

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Visit his website to browse articles, access free education, and find practitioners.

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Listen to Episode #30

Tune in to further understand the nuances of chronic GI problems. Dr. Datis Kharrazian covers topics such as gut inflammation, food sensitivities, autoimmunity, hormone dysregulations, and how some symptoms present in neurodegenerative disease actually start in the gut.
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About our Guest

Datis Kharrazian, PhD, DHSc, DC, MS, MMSc, FACN is a Harvard Medical School trained and award-winning clinical research scientist, academic professor, and world-renowned functional medicine health care provider. He develops evidence-based models to treat autoimmune, neurological, and unidentified chronic diseases with non-pharmaceutical applications.

His clinical models of evidence-based medicine are used by several academic institutions and thousands of health care providers throughout the world. Dr Kharrazian is an Associate Clinical Professor at Loma Linda University School of Medicine.

As a researcher, Dr Kharrazian earned a PhD degree in Health Science with concentrations in immunology and toxicology and a Doctor of Health Science (DHSc) degree from the Department of Health Care Sciences at Nova Southeastern University. He completed his post-doctoral research training as a research fellow at Harvard Medical School and worked as a researcher at the Department of Neurology at Massachusetts General Hospital, where his research focus was on autoimmunity and neuroimmunology. Dr Kharrazian also earned a Master of Medical Science degree (MMSc) in Clinical Investigation from Harvard Medical School. Dr Kharrazian is an active member of the Harvard Medical Alumni Association and the American Association of Immunologists.

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Insight into the Clinical World of Chronic GI Problems with Dr. Datis Kharrazian

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Podcast Transcript

Michael Roesslein: And we are live with what’s going to be a very fun episode of the podcast. I was just exchanging France and Italy stories with Dr. Kharrazian. I am joined today by Dr. Datis Kharrazian. Thank you for being here.

Dr. Datis Kharrazian:

Pleasure, Mike.

Michael Roesslein:

Yeah, so it’s going to be fun. I’m pretty sure everybody in our audience is pretty well-versed on your work and what you do and your books. But for those who don’t know, Dr. Datis Kharrazian is a Harvard Medical School trained, award-winning clinical research scientist, academic professor, and world-renowned functional medicine healthcare provider. He’s an associate clinical professor at Loma Lina University School of Medicine and a researcher at Harvard Medical School and Massachusetts General Hospital, in addition to writing several books and having, I’ve lost track of how many different practitioner trainings now at the Kharrazian Institute website. So a very busy man doing a lot of really important work and we always appreciate your time, being here, having these conversations.

Michael Roesslein:

There’s a lot of different angles we could go with this and a lot of different conversations we could have, and I think today we’re going to focus on some outside the box thinking when it comes to stubborn or chronic GI symptoms and gut problems. And I think a lot of people might know your work on thyroid and your work on the brain and brain health, and might not see how those two things might be linked to the function of their gut or their digestion. So maybe we can kind of start there, just a little bit on the overlap between thyroid function and thyroid health and/or just brain and neurological connections to chronic gut challenges. Wherever you’d want to kick off there would be great.

Dr. Datis Kharrazian:

Yeah. I think one of the things that is an issue is people do all the right things and then they may not be able to resolve their leaky gut or have their gut issue. And by doing the right thing would mean they clean up their diet, they take digestive enzymes, they take probiotics, they eat healthy and despite all those things they have ongoing gastrointestinal issues. So then they feel like they’re the weird patient, then they go see the practitioner and they’re all confused. And they end up going from one supplement to the next and pretty soon they have an apothecary at their house with all these different nutraceuticals and they’re trying all these different recipes [inaudible 00:02:24], but despite all that, they’re gut’s not getting better. So that’s a whole different level of a patient that has a gut issue.

Dr. Datis Kharrazian:

So as a practitioner, I can tell you, if I see a patient come in and I see they have a gastrointestinal disorder, my first question, clinically, is do they deserve it or do they not deserve it? It’s just a funny way… internally I’m thinking if they’re eating processed foods and fast foods and don’t eat well and have lots of inflammation, you’re expecting them to have bloating, distention, and all these issues. The majority of the patients I think we all see as practitioners in the health and wellness community is we see the ones that don’t deserve it. They’re the ones that are completely gluten, dairy-free and that would be a first place for most people to start, as far as most common food sensitivities. But they’re gluten, dairy-free, they may even be on an autoimmune paleo diet, they’re eating really healthy foods, they’re eating organic, they’re taking digestive enzymes every single meal, they have a cocktail of probiotics. They have a whole ritual of gut issues and, despite all that, they don’t have [inaudible 00:03:27].

Dr. Datis Kharrazian:

So that’s the different population. That’s the population we should probably talk about, because they’re being missed, also, in the functional medicine community. Now, in the functional medicine community, there’s different levels of practitioners, so the very novice, new practitioner that really doesn’t understand it well, they’ll just be like, “Well, you’re taking the wrong supplements. You need this mega spore or you need this super enzyme or this need this one other thing,” and they just really try to think, “Well, you just don’t have the right supplements.” And that’s always a red flag, too. If you’re a practitioner and if you come with a chronic gut issue and the practitioners making the assumption you just need a better probiotic or something, they really do not get it. Read flag, okay? You got to go to someone who’s looking at this at the next level.

Dr. Datis Kharrazian:

So then the question is, why would someone that eats really well, takes every single support for their gut that’s available, they’ve tried everything, they still have persistent gut issues, and then you’re left with a list of a few things that are important, right? And that’s the list we should probably go over. So let me go from the most common to least common things that impact it, and you have to understand, also, with the gut, the gut is impacted by everything, right? So the gut is impacted by our immune system or systemic immune system and the microbiome communicates with our mucosal barriers, too. So our microbiome communicates with our pulmonary mucosa, it communicates with our sinus mucosa, it even communicates with our blood-brain barrier. So it communicates with T-cells and B-cells throughout our body. It responds to the skin. There’s a skin microbiome access, lung microbiome access, brain microbiome access. Right? Nasopharyngeal microbiome access.

Dr. Datis Kharrazian:

So you can have your gut activated and inflamed unrelated to your gut having a food trigger, right? Which most people [inaudible 00:05:15] every single food and hoping that’s going to resolve it. So that’s one thing and then the gut responds. Every single mucosal cell has receptors for every major hormone, testosterone, estrogen, progesterone, so the microbiome can be completely impacted by endocrine disfunction. The microbiome, it’s initial barrier, there’s a thing call immune tolerance, where unrelated to leaky gut, things like regulatory T-cells and dendritic cells have an issue. There’s intimate relationships between the liver, there’s hepatic microbiome access. So, for some people, when they do everything for their guy and their gut’s unhealthy the question is like, “Well, what’s impacting the gut?,” versus the gut being the problem? Right? So that’s the first obvious thing. I think, for some people, when they hear it they’re like, “Yeah, that makes sense. Why didn’t I think of that before.”

Dr. Datis Kharrazian:

Well, part of the reason is the world of nutrition is focused on media protocol and they’re still not thinking outside the box on systemic, even though it’s in the literature, it’s a very clear path of physiological mechanisms just not being incorporated. So that’s the story I’d like to go into. You’re good with that?

Michael Roesslein:

Yeah, yeah, yeah. I followed. I’d never heard of liver microbiome. That was a new one for me. I’ve heard of the skin and a lot of the other ones you mentioned, but I’d never heard of the liver microbiome. And, from what I gathered there, when you were saying the mucosal layers are all related, there’s the gut, there’s the pulmonary, there’s the nasal. And so, if somebody has a chronic cough or chronic nasal congestion, their heads always congested or nose is always congested, and they might not link that to, “Oh, I have a GI symptom.” Is that usually a red flag? Is that a sign that if this is inflamed of causing excess mucus production or anything like that, is that possible that that’s also going on in the gut, without actually looking at the gut, or are they not that-

Dr. Datis Kharrazian:

Yeah, and the main-

Michael Roesslein:

… this and?

Dr. Datis Kharrazian:

Yeah. There are those relationships. And the main mechanism is to impact what’s called oral tolerance. Oral tolerance and how your gut reacts to different things. So in the gut we have dendritic cells that sample food products. So, for example, the liver, the liver has Kupffer cells, which are like the macrophage or antigen presenting cell where they just kind of sample everything that comes into the liver. They directly communicate with the gut dendritic cells. And then, you have dendritic cells in the lung barrier and gut barrier. So if you get reactive dendritic cells in your pulmonary area, they send messengers that also impact your gut barrier. So you could have some, for example, that has persistent reactions to food proteins because they’re constantly getting exposed to respiratory inhalants that are triggering their immune system and making them revved up. So once those dendritic cells-

Michael Roesslein:

Those messenger molecules that get sent out in the lungs from the inhalant toxin, they go systemic?

Dr. Datis Kharrazian:

Yeah?

Michael Roesslein:

And so, the same cells located elsewhere would pick up those signals and trigger and inflammatory response. Is that-

Dr. Datis Kharrazian:

Yeah, exactly.

Michael Roesslein:

… accurate?

Dr. Datis Kharrazian:

That’s right. And when you look at the gut there’s different aspects of gut function. One is the inflammatory immune response, how sensitive it is to things, that’s its own issue. That’s where all the different microbiome connections and liver cells and Kupffer cells and respiratory issues can all activate the sensitivity and reactivity of the gut and tolerance. There’s also other things that are more related to intestinal motility, where a person can move their food properly, right? And then, there’s another mechanism of autonomic function, which is can they make digestive enzymes? Can they have smooth muscle contractions. So then, I guess to go into deeper, how we think about this clinically is, okay, if the gut’s dysfunctional, what part of the gut is dysfunctional? Is it they’re just inflamed all the time? And that would be, for example, other mucosal things will come in. If they’re inflamed all the time, meaning everything they eat causes an inflammatory reaction and they can never fix their leaky gut or intestinal barriers, then the question is what other things are upregulating the dendritic cells? What other physiological mechanisms are? So that might be where you go.

Dr. Datis Kharrazian:

But then, dendritic cells can also be dramatically impacted by stress levels, circadian rhythms and sleep have a huge impact on the gut immune response with dendritic cells. So you can find someone, for example, who’s got multiple inhalant allergies that they’re not doing anything about and maybe they’re working in their office that’s filled with dust and then they-

Michael Roesslein:

Or those little plug-in machines that spew the poison into the air that smells nice.

Dr. Datis Kharrazian:

Maybe you check their blood work and they’re off the chart with dust mites and other inhalants. And then, they constantly breathe those and they can’t really get their gut inflammatory immune response down, because they just think it’s food related and then they start cutting off every single food and as they limit their foods, they lose their microbiome diversity, which you need to help keep those [inaudible 00:10:18]. So now-

Michael Roesslein:

Which causes a self-perpetuating cycle and the toxin they’ve been breathing in has stayed the whole time.

Dr. Datis Kharrazian:

Yeah, it’s like you’ll see a person they have chronic gut inflammation and you go, “Hey, what other complaints do you have?” I have chronic sinusitis. “Well, what are you doing for that?” “Oh, nothing really. I just do my…” You’re like, “Okay, well that may be a role in why your gut may not be calming down.” So the way that dendritic cells and the inflammatory response works is it’s systemic. So if people have gut inflammatory issues, you want to look at these other variables as well, right? They can be a factor, so this may not just be gut based. And those are really important for the people constantly dealing with food sensitivities and reactions and have constant leaky guts.

Dr. Datis Kharrazian:

Now, it could also be though, and this is an overlooked area, that there’s intestinal autoimmunity and this totally gets overlooked in the healthcare system and even in the functional medicine, preventative medicine there are a lot of people that have chronic gastrointestinal issues that actually have auto antibodies to their gut proteins. So-

Michael Roesslein:

Is that like Crohn’s or IBD or are you talking more specific types of cells? Or…

Dr. Datis Kharrazian:

Yeah, so it could be Crohn’s it could be ulcerative colitis, right? It could be unnamed. You can antibodies through the smooth muscles of the gut, like actomyosin-

Michael Roesslein:

Really?

Dr. Datis Kharrazian:

… [inaudible 00:11:35] through the smooth muscles of the gut. Yep. You can have those reactions.

Michael Roesslein:

So that could contribute to SIBO situations?

Dr. Datis Kharrazian:

Oh yeah, for sure. There’s lot of [inaudible 00:11:43] that show lots of people who have SIBO really have autoimmune reactivity to smooth muscles, through their nerves in their gut. They’ll have neurofilament, [inaudible 00:11:54] resistant protein antibodies. People can have antibodies through gut mucosa like [inaudible 00:12:01].

Michael Roesslein:

Are those all on the cyrex array?

Dr. Datis Kharrazian:

Nope, they’re not all on there.

Michael Roesslein:

No?

Dr. Datis Kharrazian:

Some of those are on there like [inaudible 00:12:07], but they’re not all on there. And some of these aren’t even celiac. And some of these auto antibodies aren’t even commercially available. They’re just available in research studies. And this is one of the things that’s very frustrating. But typically your biggest clue that that’s happening is there’s also other autoimmunity. It’s pretty to have someone just have intestinal autoimmunity and autoimmunity nowhere else. So we can measure things like actomyosin antibodies and myelin basic protein and myelin [inaudible 00:12:38] protein and things like alpha-beta tubulin, and ASCA, ANCA, which are the most common ones [inaudible 00:12:44] Crohn’s. We can measure things like transglutaminase and they may show up and if they do it’s like, “Okay, well you have an intestinal autoimmunity, that’s why you really have an issue with ongoing gut issues.” But there’s a whole list of other gut proteins that have been published in research studies that you can’t get a commercial lab test for.

Dr. Datis Kharrazian:

So then, your biggest clue that that may be going on is you don’t test for those antibodies, but you have an autoimmunity. You have full-blown arthritis, if that’s been identified or you have Hashimoto’s or you have Type 1 diabetes. And, in those cases, sometimes you have to just go, “Okay, well it’s possible and highly probable, since you’re doing everything right and you can’t calm down your gut issue, that you may have some of these non-identified target proteins in your gut that may have autoimmunity that there isn’t commercial testing for yet.” You’ll see, typically, if their autoimmunity is good, their gut is good, and then when their autoimmunity bad, the gut’s bad. And then, they may make the assumption, “Well, my autoimmunity, my rheumatoid arthritis flared up, because my gut was bad.” Right? But maybe not. Maybe something else-

Michael Roesslein:

It’s more likely that the same trigger caused both of them.

Dr. Datis Kharrazian:

Exactly. So maybe they had some issues, some stress issues, and I don’t know, something else that triggered their autoimmunity.

Michael Roesslein:

Instead of viewing a symptom as a trigger.

Dr. Datis Kharrazian:

Right. See-

Michael Roesslein:

Like the gut flare-up is a symptom of the same thing as the… Yeah.

Dr. Datis Kharrazian:

Exactly. And when you have people linked cognitively like, “Oh, the gut is always going to trigger the autoimmune response,” then you start to believe that and that’s the only lens you’re looking for, because you’re going, “Well, yeah. My rheumatoid arthritis, my Hashimoto’s, my type 1 diabetes, my MS flares up when my gut’s bad.” But, like we said, that could be a [inaudible 00:14:28] that the autoimmunity’s actually getting triggered and wherever you have target antibody responses, maybe it’s your joint, maybe it’s your thyroid, maybe it’s your pancreas, but also maybe it’s your microbiome proteins, maybe it’s your nervous system proteins and that’s what’s flaring it up. So that’s one really, really common thing.

Dr. Datis Kharrazian:

And then, in those scenarios it’s like, okay, first of all stop thinking the way you’re thinking. You’re seeing this association with your gut issues then your autoimmunity, other autoimmunity issue flaring up, and you’re making this assumption that it’s your gut that went bad and then you’re constantly thinking, “What did I eat? What did I eat? What did I eat?” Maybe it has nothing to do with what you ate, because [inaudible 00:15:09]. So-

Michael Roesslein:

It could be the really stressful two weeks you just had or the three days of really bad sleep or the exposure at work or the-

Dr. Datis Kharrazian:

Chemical exposure. So that’s more common than I think you would think in real practice and once people understand that connection, then they can start to get to more answers, because now they’re not thinking all their autoimmune issues are gut issues and they start to think of it really as an autoimmune response. And then, what triggered their autoimmunity versus what triggered their gut. And the most common thing that people do when their gut gets triggered is what I ate, right? So they’re constantly looking for, “What did I eat? What did I eat? What did I eat?,” and that may not even be the problem at all. Maybe it’s your lifestyle. Maybe you overtrained at the same time you didn’t get sleep. Maybe you’re really sensitive to benzine and you were in a building with lots of cigarette smoke for too long for your immune system to handle and that triggered your response. It maybe didn’t trigger it that second, maybe it triggered it the next day, because that’s how the immune system works, right?

Dr. Datis Kharrazian:

So that’s a common thing I think everyone should know about with chronic gut issues. So if you have chronic gut issues and you have chronic inflammation and nothing really helps and maybe you have chronic SIBO, no one can figure out why you actually have SIBO, it’s possible you have auto antibodies and you may have never had any of the intestinal auto antibodies screened or you just could have one of these that have not been commercially available. And not every target protein in the gut has been identified for autoimmunity.

Michael Roesslein:

Yeah. Not only are they not all testable, we don’t even know what they all are to be able to test them. Yeah.

Dr. Datis Kharrazian:

I mean, the world of autoimmunity clinical practice and the world of autoimmune research are two different things. And what we like to do is make is seem like it all makes sense and we have all the tests for it, and we have the answers, and then we have the protocol, and then when you actually dive into the autoimmune research, even let’s just say gut autoimmunity, you’re like, “I’ve never even heard of these proteins. I’ve never even heard of these auto antibodies. What is this stuff?”

Michael Roesslein:

I think a lot of practitioners steer clear of that world, just due to the overwhelm and the lack of like, “What do I do with this? How do I act on this?,” and it seems overwhelming. I mean, there’s a few, you’re one of a few that I know that do both sides of the coin, like they’re buried in the research and they have a clinical practice. There’s not many, and I think it gets really overwhelming really quickly. And-

Dr. Datis Kharrazian:

It does.

Michael Roesslein:

… it’s like, “What do I do? What do I do with this information?,” a lot of times, because the studies aren’t designed, necessarily, the researcher not a clinician, so it’s not like, “Here’s what’s happening and here’s how you fix it.” It’s “Here’s what’s happening.” They’re just trying to figure out what’s happening.

Dr. Datis Kharrazian:

Exactly. And I have to tell you, there’s times when I’m really focused into the research community and going to conferences and hanging around researchers and thinking about my next project and doing all that. And if you’re in the world for a while you think, “Oh my god, people have no chance, no hope.” Then you realize, actually people do and people do respond and get better. And then, when you’re in the clinical world, sometimes I’ll just focus on the clinical world for a couple weeks, a few weeks, living in that world in a different identity, and it’s like, “Oh, that research stuff, once they clean up their diet and do some lifestyle things, it makes a huge difference. They don’t even understand what the possibilities are.” And then it’s like-

Michael Roesslein:

It’s sounds like two alternate realities completely.

Dr. Datis Kharrazian:

Two alternate realities and you can get depressed in either one if you go in the deep dive. But, in reality-

Michael Roesslein:

Well, I think the physiology of it is so complex. It can get incredibly complex and overwhelming and seem hopeless and then what’s really cool is, one, the human body’s extremely resilient and, two, the things that… I mean, I went through and arc when I was working with clients myself when I first started I only knew the fundamentals, the foundational things, so that’s the only things my clients would get to do. Then I started learning lab testing and more complex things and supplement protocols and functional medicine things, and then my clients got really complex, and then my approach was really complex. And then it was like, “Let’s see how complex we can make this thing.”

Michael Roesslein:

And then, what I learned, is that it’s still the foundational things that move the needle for most people, which gives hope. That gives hope back, when you lose it when you’re in the research world, knowing that they’re test subjects. If those people probably have a really disrupted circadian rhythm, they probably have high stress, unresolved trauma, they probably have toxic exposures, they’re probably not eating an ideal diet, and then you look at their physiology and the studies that they’re in and you’re like, “Oh, man. This is doomed.” But if you flipped all those switches on those people, that would look differently. And we may not understand every single mechanism by which that takes place, but you know-

Dr. Datis Kharrazian:

But here’s the thing-

Michael Roesslein:

… do X, Y, Z things and most of the time this is going to calm down a little or am I oversimplifying that? Or is that-

Dr. Datis Kharrazian:

No, you’re making a very good point. And that’s the thing, too, we’re never going to understand all of it and there’s never going to be all the commercial testing for all of it, but we do have really fundamental principles of how things work. So, for example, someone who’s got chronic gastrointestinal issues and chronic inflammation in their gut and multiple food sensitivities, they can never fix it, taking as much glutamine and probiotics and kombucha and bone broth and [inaudible 00:20:18] restriction, maybe it’s an autoimmune response, so every time your immune system flares up, you get destruction of your gut and it’s unrelated to that, and once they may understand that connection, now they start to look at other things besides their gut and they start to really think about their lifestyle and their sleep and other triggers that may be there. Then that may finally make that connection for them where they understand their gut. It’s not this mysterious thing, it’s not so debilitating and they start to see that, “Yeah, actually it’s when my autoimmune system just gets improved overall, that’s when I necessarily feel better. That doesn’t have to be just this gut relationship.”

Dr. Datis Kharrazian:

So that’s one key thing I hope we get across. Now, that’s not the only thing that is involved with chronic gut issues, but that is definitely one of the most common one with chronic intestinal inflammation. So that people that have chronic intestinal information and chronic leaky gut and food sensitivities, for some of them, less than other ones, they may have other mucosal triggers and other patterns that are impacting their gut mucosa. Maybe it’s a combination of hormones and blood sugar regulation and stress, all those things that impact the microbiome and that makes their immune system not really develop the best tolerance. And if they really think of themselves as more than just the gut, and then look at the whole physiology and go after that, that may finally fix the gut.

Dr. Datis Kharrazian:

And, for other people, it’s much more aggressive, which is really more of the intestinal autoimmune response. But the problem we have is we have people that teach functional medicine and people that write books and do stuff and say, “The gut is everything. Start with the gut.” And it’s like, well, in those cases where the gut is reactive to everything else, it’s going to completely fail. But that’s such a common health philosophy that it does lead to these patients that the gut is actually secondary to these other mechanisms and then they become the weird or difficult, and they’re not difficult and they’re not weird, they just don’t fit that paradigm of always start with the gut and if you fix the gut you fix everything. Right.

Michael Roesslein:

And all of their interventions are focused directly at the gut where the gasoline is being put on that from somewhere else. So you really just are scooping water out of a boat with holes in it and not addressing the holes in the boat or the thing feeding. And you mentioned hormones. I’ve had men, mostly, kind of question the connection of their hormones linked to their GI symptoms or their gut function and I tell them just ask some ladies about that. Because some of my clients, their digestion was very different at certain times of the month and they would often get it backwards, too, because of the programming from what they’ve learned a lot of is that, “My gut’s really messed up, so my PMS was bad this month,” or “My gut’s really messed up right now, so my hormones are out of whack.” And it was usually the other way around. If it’s cyclical and the gut gets messed up on the same four days of the month every month, it’s not the gut doing the hormones, it’s the hormones doing the gut.

Dr. Datis Kharrazian:

Exactly. Yeah, and you make a good point. It’s much easier to see with women that are having menstrual cycle fluctuations and big spikes, because then you can clearly see the relationship. With men, it’s much more difficult, because they don’t have those big huge spikes of hormones-

Michael Roesslein:

Big swings. Yeah.

Dr. Datis Kharrazian:

… [inaudible 00:23:31]. Their levels fluctuate throughout the day, but nothing dramatic. And that’s another thing, when you look at the gut, hormones have a huge impact on various target proteins and target cells in the gut. So, for example, gastrointestinal motility, the ability to cause smooth muscles to contract, that ability to activate the [inaudible 00:23:52] to move food and control bowels, you don’t have things like SIBO and have normal bowel movements. They’re totally, 100% dependent upon thyroid hormones. Well, actually, one of the most common symptoms of people that have subclinical hypothyroidism is chronic constipation. So there’s a large population of people reported in the thyroid disease literature where their only symptom is chronic constipation and nothing has helped. And they don’t have weight gain issues, they don’t have hair loss, they don’t have the cold hands, cold feet, they just have chronic constipation. Not enough for someone to say, “Oh, you should get your thyroid checked.”

Dr. Datis Kharrazian:

And then, what they find is that when those people get their thyroid checked-

Michael Roesslein:

And then four practitioners later someone tests more than just their TSH.

Dr. Datis Kharrazian:

Right. Then you can deeper into [inaudible 00:24:42] and all those things. But for a lot of them in the preventional literature it’s actually just hypothyroid and as soon as they go on some replacement-

Michael Roesslein:

Interesting.

Dr. Datis Kharrazian:

… motility improves. Overnight. Like, “Boom. I have gut function again.” So that’s a very common presentation of subclinical hypothyroidism. So that’s how thyroid hormones, for example, impact the [inaudible 00:24:59] nervous system. But then, you have reproductive hormones like estrogen, progesterone, testosterone. They help regenerate the mucosal lining. They help the anabolic effect in the mucosis so it can repair and regenerate. Because we’re having some degree of destruction of our mucosal cells every day from just the inflammatory response of exposing dietary proteins to the gut. That all triggers the immune response, to some degree and cells die off. But in a normal response, too, but cells have to regenerate. So if you have a male that has really low testosterone or low growth hormone, if you have a female that has abnormal progesterone levels or estrogen levels, that has an impact on how the gut mucosa regenerates.

Dr. Datis Kharrazian:

And every single of one of these hormones estrogen, testosterone, progesterone, DHEA, T3, T4, these hormones all impact the dendritic cells and the regulatory T-cells of the gut. So hormones have a role, too.

Michael Roesslein:

The regulatory T-cells, for people who might not be up on their immunology terms, those are the cells that kind of quell autoimmune responses or do the self, non-self overseeing a bit? Right? When those are low or not functioning properly, there’s much more likelihood of autoimmune attacks. Right?

Dr. Datis Kharrazian:

Exactly. And these regulatory T-cells [inaudible 00:26:31] and there’s regulatory B-cells, too, but regulatory T-cells determine how aggressive the immune response will be and if it will even respond and if it’s going to calm down. So regulatory T-cells basically control, suppressor T-cells and helper T-cells. Suppressor T-cells calm down your autoimmune response, helper T-cells activate the autoimmune response, so they regulate that.

Michael Roesslein:

So it’s like the gas pedal, brakes.

Dr. Datis Kharrazian:

And it’s very clear with the research in autoimmunity, they dysfunction in autoimmune disease and the less dysfunctional they are, they less your autoimmune disease expresses itself. And the more dysfunctional they are, the more autoimmune disease you have. And in animal studies, if they cause T-cells to dysregulate the person will develop autoimmunity and it’s that clear, how much of a central role they have, how much affect they have on the system. So hormones really have an impact on these T-reg cells and as they continue to work on drugs and things that impact these regulatory T-cells, that might be how they may make a drug that can dampen autoimmunity in the gut at some level from the pharmaceutical world. From the natural medicine world, it’s basically things that optimize regulatory T-cells would be hormones and vitamin D and lifestyle factors that increase things like growth factors, like exercise, healthy emotions, those things all have an impact on these regulatory T-cells.

Dr. Datis Kharrazian:

But it’s a combination of getting those regulatory T-cells under control and those dendritic cells that react to all the other mucosal barriers under control in autoimmunity. So hormones have that role and when men have low testosterone their regulatory T-cells are not as responsive and functional. So lots of men have low testosterone, lots of men have hormonal imbalances. When they finally get checked and the interesting thing about that is the most common cause of it is these testicular cells called Leydig cells have no antioxidants, so the Sertoli cells, the Leydig cells that involve with helping produce testosterone and sperm, they have no actually antioxidant protection, so they’re very, very, very susceptible to inflammation.

Michael Roesslein:

Wow, okay.

Dr. Datis Kharrazian:

So when men get inflamed, these cells literally degenerate very, very quickly.

Michael Roesslein:

They’re defenseless.

Dr. Datis Kharrazian:

Yeah, defenseless. So a lot of men that have [inaudible 00:29:00] gonad are actually having it from too much [inaudible 00:29:03] stress, too much inflammation and a lot of this came out of the infertility research world, because they’re like, “Why do these men have abnormal sperm?” Then they find out, well they also have [inaudible 00:29:11]-

Michael Roesslein:

We’ve got some scary stats around trends in men, testosterone levels, fertility, infertility rates all of that type of stuff. I read an article a few weeks ago that on this current trajectory, we’re a few generations away from not having people, because of the steep decline in fertility rates and testosterone levels and all these kind of things. Now, obviously, no one can predict that something’s going to continue at such a sharp situation, but I see no indicators that the massive things that are contributing to it are changing on any real level, so it’s like, maybe. But there’s some pretty scary… I’ve read that one in two, almost, couples now are seeking fertility help.

Dr. Datis Kharrazian:

It’s a big issue. Yep. And then, when they look at fertility causes, there’s a male factor and female factor and they current data is showing one-third are female factors, one-third are male factors, and one-third are combined.

Michael Roesslein:

Yeah, because to be the singular factor it probably has to reach a certain tipping point, but if both of them are not all they way to that tipping point, but sort of, then the total, this is a really rough metaphor, but the total bucket is high enough that the thing’s broken.

Dr. Datis Kharrazian:

Yep.

Michael Roesslein:

So to find two people that are healthy enough, both of them, to make kids now is less than half of the time that couples get together.

Dr. Datis Kharrazian:

It’s also making healthy children, right?

Michael Roesslein:

Yeah, healthy children.

Dr. Datis Kharrazian:

For example, the rates of autism have skyrocketed

Michael Roesslein:

Yeah.

Dr. Datis Kharrazian:

All the research is showing autism is developing during fetal development, that they can actually determine markers for brain inflammation, neuro inflammation, during pregnancy.

Michael Roesslein:

Really?

Dr. Datis Kharrazian:

Yes.

Michael Roesslein:

In the fetus?

Dr. Datis Kharrazian:

In the fetus. And then, new studies have been published where they immediately do brain scans and they see changes in white matter development during pregnancy. And they can actually predict autism with hearing tests within the first few weeks, when a child is born even before any vaccination or any of those factors.

Michael Roesslein:

Wow.

Dr. Datis Kharrazian:

And there’s a strong link to maternal health and these risks, too, so it’s not just like, hey, you’re able to get pregnant, it’s like you got to be healthy enough to have a healthy child, by healthy child I mean-

Michael Roesslein:

Yeah, that’s another level.

Dr. Datis Kharrazian:

It’s another level.

Michael Roesslein:

Have the baby, one. Have a healthy baby, two. And childhood chronic disease rates are skyrocketing, too, and some of that, I’m sure, stems from in utero, before birth. I recorded a podcast a couple weeks ago with a fertility specialist that works with couples that are having a really hard time conceiving and she was telling me some statistics on the increase of certain problems with people who use some form of medically-assisted pregnancy. There was a term for it, not just IVF, there’s other interventions, but all interventions total. Because in my simple mind of how I understand these things around fertility, being unable to reproduce is a sign.

Michael Roesslein:

That’s an action, that’s the nature, that’s the body being like, “This is not a good time. This is not a good place. You’re under too much stress. This environment is unsafe. Something is unsafe,” so then the hormones are out of whack, everything’s out of whack and it’s basically the way to not bring kid into an environment that you’re either incapable of growing them or raising them or birthing them or having them safely. And then, we override this, but oftentimes, she told me her clients she’s like, “No, no one ever told them there’s another way,” so they override it and then they give them the IVF, they give them this, they give this, they give them this, but they don’t talk to them about any of the things that contributed to them being unable to have kids in the first place, so then they’re pregnant doing the same things they were doing to not be able to be pregnant, yet we overrode the warning light and then they grow and birth a child into that same situation.

Michael Roesslein:

I’m not trying to throw dirt on anybody or criticize, people do what they know. And she said no one tells them this, the fertility doctors. So I don’t know, that was just a little sort of unrelated rant, but-

Dr. Datis Kharrazian:

Yeah, it’s a different world. I mean, the world of fertility is its own separate world of you’re dealing with timing issues, there is a point where you get follicle depletion and you lose [inaudible 00:33:51]-

Michael Roesslein:

Yeah, then it’s impossible.

Dr. Datis Kharrazian:

There is a real thing and then there’s the urgency for doing that. And then, there’s active reproductive technologies, ARTs, the different various ones. There’s all these options. But it’s always like, “We got to do this now.” And then, a lot of these things get overlooked. For example, if you’re 36 and now your ovarian follicle levels are not as healthy and they do something like an AMH [inaudible 00:34:16] hormone and that’s showing your follicles don’t have much time left. Does the person have two years to get [inaudible 00:34:24]-

Michael Roesslein:

Time to fix their health. Yeah.

Dr. Datis Kharrazian:

And so, there’s a different issue. But going back to the gut, going back to hormones, the point of all of this is that hormones have an impact on the gut and they can have an infuction. And so far we’ve talked about people have mucosal immune triggers through other mucosas like the lung mucosa and the nasopharynx mucosa triggering the gut inflammation. We talked about possible [inaudible 00:34:46] autoimmunity occurring at the same time as their other autoimmunities. We talked about how hormones, they have some role with gut function, but I want to also talk about another really common one, since we’re on this topic that people are also aware of that, which is a lot of neurodegenerative diseases start in the gut. And the most common neurogenerative disease that starts in the gut is actually Parkinson’s disease.

Dr. Datis Kharrazian:

And Parkinson’s disease, they find degenerative changes and Parkinson’s disease everyone thinks of it as, oh, you have a low dopamine and if you take dopamine it’s better. It’s actually not that. Parkinson’s disease it’s what’s called an alpha synucleinopathy. And what that means is there’s normal protein in the nervous system called alpha-synuclein, and in Parkinson’s disease it basically clusters together and gets in the way of normal neurotransmission. Like in Alzheimer’s disease there’s a different protein it’s called beta-amyloid that starts to cluster together and it prevents neurons from synapsing. Well, in Parkinson’s these alpha-synuclein starts to build up together and it prevents neurons from firing and then eventually those neurons start to degenerate.

Dr. Datis Kharrazian:

Well, they’re finding that in Parkinson’s disease this alpha-synuclein actually starts in two places before it even hits the brain dopamine centers where people start to have tremors. And it starts in the olfactory bulb, where you perceive scent and smell and it starts in the gut. And one of the initial presentations for people that have early Parkinson’s disease is chronic constipation. And when you have, let’s say, this Parkinson’s disease presentation in the gut, 10, 20 years before you have tremor, any identifiable [inaudible 00:36:25]-

Michael Roesslein:

Oh, wow.

Dr. Datis Kharrazian:

… symptoms. You have a chronic gut issue that no one can figure out. And you have a chronic gut issue and the gut issues, you have to take magnesium every day to have a bowel movement or you have to do an enema or you have to eat really small meals to be able to digest, because a large meal you can’t handle. Those are all signs that it’s not a leaky gut, it’s not a barrier issue, but it’s that motility. Right? So that’s a different mechanism that’s [inaudible 00:36:52]. So people that have chronic motility issues, we talked about hypothyroidism, maybe something that has to be investigate, but also it could just be a neurodegenerative disease that starts in the gut nervous system and starts to degenerate that away. Now, when a person loses their intestinal motility efficiency, meaning how their small intestine and large intestine contracts, so they can move food, then they also will end up with leaky gut, [inaudible 00:37:15], food sensitivities, those other things, because it changes the environment of the gut and it changes the pH. It creates this fermentation and lactation.

Dr. Datis Kharrazian:

So they can go and get a comprehensive digestive stool analysis and they have dysbiosis and they have, I don’t know, high methane, high-

Michael Roesslein:

They have dysbiosis because their gut isn’t moving.

Dr. Datis Kharrazian:

Right.

Michael Roesslein:

Yeah.

Dr. Datis Kharrazian:

And then, the gut is not moving and then they get bacterial overgrowths, and then they get inflammation from bacterial overgrowths, now their tight junctions break and now they have multiple food sensitivities and they go there and they’ll see someone and they go, “Oh, well I know why you’re sick. You have leaky gut.” No, that’s not why. I know why you’re sick-

Michael Roesslein:

It is possible, clinically to find those clusters of proteins in the gut that are related to Parkinson’s? Is that-

Dr. Datis Kharrazian:

Well, there’s scanning-

Michael Roesslein:

Can you test for that?

Dr. Datis Kharrazian:

Yeah, they’re scanning guts now and finding alpha-synuclein. You can do an alpha-synuclein tracer marker to see that. Once again-

Michael Roesslein:

What kind of scan is that?

Dr. Datis Kharrazian:

It’s basically an MRI or CT and depending on [inaudible 00:38:22] to trace it. And they can do it, but it’s, again, not commercially available.

Michael Roesslein:

Yeah, yeah, yeah. But it is possible?

Dr. Datis Kharrazian:

It’s possible. You could do that tomorrow, if you’re at an university that has that research on Parkinson’s. Yeah, you could do it tomorrow. And there’s already-

Michael Roesslein:

But not commercially available, so not available to clinicians.

Dr. Datis Kharrazian:

No.

Michael Roesslein:

So you’d have to go on the symptoms and the-

Dr. Datis Kharrazian:

Right. Yeah, you have to go on the symptoms.

Michael Roesslein:

… history of the patient?

Dr. Datis Kharrazian:

Yep, exactly. And also, there’s a lot of post biopsy studies they do and they can see these changes, but in the world of Parkinson’s disease research, it’s really not even a question. That is where Parkinson’s disease is starting. It’s starting in the olfactory bulb and it’s starting in the gut. And when it starts in the olfactory bulb, they have some found some very interesting connections with that, because the people will start to lose their sense of smell and they’ve even gone further into the world of research and they’ve found there’s actually three really predictive smells you lose in early Parkinson’s disease that can be predicted and it’s the ability to smell coffee, peppermint, and anise.

Michael Roesslein:

Oh, that’s terrible. Well, I guess that’s a matter of preference, but I just got sad.

Dr. Datis Kharrazian:

So those are really-

Michael Roesslein:

But that comes on well before the tremors though, right?

Dr. Datis Kharrazian:

10, 20 years before.

Michael Roesslein:

Wow. Okay. Interesting.

Dr. Datis Kharrazian:

So, for example, if I’m working with a person who has a chronic gastrointestinal issue, and then I’m going, “Why do they have a chronic gastrointestinal issue?” And first of all I see, you know what? Their main complaint is the motility issue, meaning they’re not moving their food. So if they have chronic SIBO, no one’s been able to figure out why they have chronic SIBO and their methane and [inaudible 00:39:59] are always high, right? They have chronic dysbiosis or leaky gut no one can fix and all that and you go, “Okay, well, really when we think about your history and your timeline, you’re not having bowel movements,” and the biggest clue of that is they have to take something to have a bowel movement, right? They have to take softener and take magnesium, they have to do coffee enema, that is like, ding, ding, ding, ding, ding, red flag, red flag, red flag as a clinician. You’re going, “Okay, well, that’s a motility issue.”

Dr. Datis Kharrazian:

So then we’re going, “Okay, well, what’s going on with their motility?” And you can have injury to the neuroplexus from an intestinal inflammatory response that’s severe or infection in the gut or those things, but most of the time it’s not that, it’s early Parkinson’s and early Parkinson’s, you can start having presentations in your 30s, age 30 to 35. So they’ll be like, “My gut was fine until I finished graduate school or until I got older or until I had kids,” when they have nothing to do with that, it’s just the fact that that’s the time in their life when those other things happened, right?

Dr. Datis Kharrazian:

Again, the associations [inaudible 00:40:55]. So you’ll check them and then you’ll see, okay, they’re having some smell, taste issues, but some of the earlier signs of Parkinson’s will also be slowness of movement, they’ll just get slower. You get to that as an initial presentation way before tremors, so they just know their not moving as fast as they used to. They can see that as being old age. And then, they also start to get rigidity in the early stages, too, rigidity just being stiffness and what’s interesting about the rigidity is it starts in one limb first, so it’ll start as a frozen shoulder or a frozen hip first, like a tight psoas they can never release.

Michael Roesslein:

Interesting.

Dr. Datis Kharrazian:

“Hey, I’ve got this tight psoas,” I release it, in only lasts for like a minute.

Michael Roesslein:

So they’ll go to a massage therapist twice a week.

Dr. Datis Kharrazian:

Yeah, so someone who can’t smell coffee and anise and has chronic gut issues and has a chronically tight psoas they can’t release all the time.

Michael Roesslein:

Yeah, start a Parkinson’s protocol right away.

Dr. Datis Kharrazian:

Then you might think, “Oh, that might be Parkinson’s.” Right? So it’s another really common mechanism. And Parkinson’s disease is only second to Alzheimer’s disease and Parkinson’s disease happens much, much earlier than Alzheimer’s. So there are a lot people that have young onset Parkinson’s disease and-

Michael Roesslein:

I know two people in their 40s with pretty severe Parkinson’s.

Dr. Datis Kharrazian:

Yeah.

Michael Roesslein:

Friends of mine. One came on like early 30s. I mean, he even made it to tremors in his 30s, so it’s earlier.

Dr. Datis Kharrazian:

Right. And one of the interesting things with those individuals, too, is they try to prevent using L-DOPA, which is something that helps. Then they did it as late as possible, because L-DOPA leads to a side effect called tardive dyskinesia where have you ever seen Michael J. Fox, he’s moving all the time and doing all that. That movement all of the time, that’s not Parkinson’s that’s the effect of the drug. That’s called tardive dyskinesia it’s from the dopamine receptor’s being oversaturated. But when they initially take L-DOPA their gut function normalizes. It comes back.

Michael Roesslein:

Yeah. We had a master class presentation on Parkinson’s where they talked about that and said there’s usually initial benefit to taking that pretty significantly, they feel a lot better, symptoms reduce, everything gets a lot better, and then they get oversaturated and then the side effects end up driving faster than the disease.

Dr. Datis Kharrazian:

Right.

Michael Roesslein:

And then, you’re dealing with a whole nother set of problems that come on from doing that.

Dr. Datis Kharrazian:

Right. But the key thing is someone who’s had chronic gut issues for 20 years of their life and then starts to finally get diagnosed with Parkinson’s the first day they get on L-DOPA they’re like, “My gut is normal. It’s functioning.” And it’s like, “Okay, well there you go.”

Michael Roesslein:

There we go.

Dr. Datis Kharrazian:

It doesn’t last, it has a honeymoon period, but that’s the main mechanism. So that’s another reason why people have chronic gut issues is that they have some neurological degenerative changes that are happening there. And then, to go further into that, it doesn’t always have to be neurodegenerative disease of the gut. There are people that get traumatic brain injuries that catch up with them over time and then that throws off their brain to gut access and this has been studied and published in the literature in animal models, in human models, where the field of the brain-gut axis and the gut-brain axis are areas of very exciting topics in research. Now, they have all these people excited about publishing these, there’s even journals on brain-gut axis, and so forth. And there’s experts both ways, the ones that are focusing on how the microbiome impacts the brain, how the microbiome impacts moods, neurodegenerative and neuroprotection. And then, there’s the other that are studying traumatic brain injury and how it impacts the gut.

Dr. Datis Kharrazian:

One of the interesting things about traumatic brain injuries are that traumatic brain injuries change the brain forever, if the injury’s sever enough and if you lose consciousness and have a severe blow to your head, you may have had these changes happen and not even know it. Right? And this is where these immune cells in the brain called glial cells get activated and they get primed. And then, over time, it’s like a little fire that just spreads. So there’s been a lot of understandings of traumatic brain injuries over the years, the chronic traumatic encephalopathy and there’s been a lot of research and attention focused on NFL players and hockey players they get brain injuries, have problems, boxers, right?

Michael Roesslein:

CTE. Yeah.

Dr. Datis Kharrazian:

CTE. And soldiers getting blast explosive surgery and then having chronic issues and PTSD after head trauma. And this is all linking back to these glial cells that get overactive. So there’s a term in the world of neurophysiology called prime glial cells, so these glial cells and immune cells are normally there to clean up the brain. Neurons eventually have proteins and branches that need to be digested and eliminated out of our brains to keep out brains healthy with clear synaptic pathways. You have debris, just dead cells that need to be cleared out of the way. And these microglial cells normally do that. So they’re really protective and healthy for us. But if there’s a trauma to the brain, that injury to the brain turns these glial cells on so aggressively that they don’t turn off. Now, they don’t have to have unhealthy neurons to digest, they’ll just digest normal neurons and then they’ll just create inflammation and then they’ll just have this force fire just start to injure and destroy the rest of the brain and it kind of spreads from where the injury was to these different regions. And, for some people-

Michael Roesslein:

I learned about this from you. You did a presentation on glial cells for our brain and nervous system master class a couple years ago. And I made changes to my own life after that. You talked about fasting and certain anti-inflammatories that make it through the blood brain barrier, so I got some of the Apex resvero, tumero and I started implementing more fasting. I do a three day fast once a month and I usually do a one-day fast every week or pretty frequently and I’ve noticed less severe… I have really severe ADD/ADHD and it’s less and less brain fog. And by the third day of my fast, I feel like a different person. I get physically tired. Some people are like, “Oh, I feel so amazing on the third day of a fast, I could run a marathon.” Me, no. I don’t physically super awesome. I’m tired. I’m hungry and I don’t want to go run a marathon. But mentally it’s like someone turned the lights on or someone turned off the disco ball or whatever the thing is. And yeah, I’ve made more changes to my own habits in life based off that presentation than probably any of the other ones I’ve recorded.

Dr. Datis Kharrazian:

Wow, that’s awesome to hear. Your experience [inaudible 00:48:03] other people. That’s awesome.

Michael Roesslein:

Yeah, yeah, because I recognized so much in myself in what you were talking about in the presentation. I do have multiple head injuries where I lost consciousness. I played soccer, I played football, I played basketball. I did really dumb things that led to some of those, as well, that nothing to do with sports and I’ve been in car accidents, whiplash. I check a lot of boxes on brain injuries. And it really makes a different, the fasting makes a huge, huge difference on my concentration.

Dr. Datis Kharrazian:

Yeah, and actually you’re promoting autophagy and most likely getting rid of [inaudible 00:48:38] glial cells.

Michael Roesslein:

Because that’s the only way you can get rid of them, right? The activated ones. The glial cells.

Dr. Datis Kharrazian:

Based on animal research. We have to just assume on humans. We’re never going to be able to do the human trials of [inaudible 00:48:49]-

Michael Roesslein:

Yeah, yeah, because you’re not going to bash somebody in the head with a hammer and then try to fix them. Luckily, those types of things are banned now.

Dr. Datis Kharrazian:

But that brings us to the point of-

Michael Roesslein:

But that’s the only way we know of, physiologically, that you can get rid of the prime glial cells is through autophagy?

Dr. Datis Kharrazian:

Yeah, well there’s things you can do for every single one of these things. You can do things for Parkinson’s, you can do things for autoimmunity, but you can’t do anything unless you know the mechanism. So for some people that do get traumatic brain injuries in their prime glial cells they will, over time, lose their integration of their brain gut axis. And as they lose their integration of the brain-gut they get chronic motility issues, also, just like Parkinson’s disease patients. In animal studies, I may have showed them in that talk, but they injure the brain and within two to three hours there’s intestinal permeability that takes place and there’s severe inflammation in the gut that gets triggered once those microglial cells get activated, they actually send messengers down via the vagus nerve to the mucosa and then those gut cells can become inflamed and overreactive. And-

Michael Roesslein:

With no offense happening to the gut, this is purely just from the brain injury?

Dr. Datis Kharrazian:

Yeah. And even research has now shown brain injuries release zonulin and zonulin is opening up-

Michael Roesslein:

Which leaky gut.

Dr. Datis Kharrazian:

Yeah, but the zonulin is opening up the tight junctions of the brain, because once there’s an injury to the brain, the barriers have to open up to bring in T-cells and B-cells to help clean the debris and deal with the injury, because the injuries just responds as if it’s an infection.

Michael Roesslein:

But that doesn’t happen locally-

Dr. Datis Kharrazian:

No-

Michael Roesslein:

… that happens systemically.

Dr. Datis Kharrazian:

… it happens systemically. So now you get a brain injury that also opens up the gut barriers so they have zonulin. So now you have a leaky gut, leaky brain, gut on fire, brain on fire, and chronic gut issues. And you could be doing everything wrong for the gut, but unless you address the brain inflammation and the neuroglia, you’ve been doing another thing. You may not be able to really fix the gut. So there’s a whole nother population of people that have chronic gut issues that have there brain injuries, microglial priming that have caught up with them over the years, now their brain-gut axis is dysfunctional. And then-

Michael Roesslein:

So for practitioners, where this would come in would be extensive case history, like looking at does this person have brain injuries, do they have, like you said, the shoulder or the hip issues? Do they smell issues? Do they have motility issues? Looking at the extensive history, because some of these, I mean you’re talking about animal studies and some human studies that clinicians today can’t run those types of tests, so there’s no way to… you’re not going to scan somebody’s head for glial cell activation.

Dr. Datis Kharrazian:

No. It’s not that hard to diagnose and to figure out, because first of all, number one, well, some red flags, let me show you the red flags. One of the red flags would be a patient that says, “Don’t give me a lot of supplements, I can’t swallow. I got to take them a small amount at a time.” So swallowing is an aspect of cranial nerve nine and 10 vagus. So ultimately, the intermediate between the brain and the gut is the vagus nerve and the vagus nerve has windows of examination potential that we can look at as clinicians. So the vagus, first of all, is involved with swallowing and it’s also involved with raising the palate. So as a clinician we can look at someone and have them say, “Ah,” and we can see if their palate moves. But sometimes it’s not just not [inaudible 00:52:11] palate moving, it’s that if you repeat that test like 10 times in a row, and have them go, “Ah, ah, ah,”-

Michael Roesslein:

Is it the same?

Dr. Datis Kharrazian:

… [inaudible 00:52:17] fine, it just stops moving, and that’s not normal.

Michael Roesslein:

[inaudible 00:52:19]

Dr. Datis Kharrazian:

[inaudible 00:52:19] that whole area of fatigue. So when they go and get an exam they go, “Hey, the gag reflex was intact,” yeah, because they did it for one second. But when there’s injury there’s less mitochondria in those neurons and when you repeat that movement over and over again and than you see it not work anymore, that’s a problem. If you have an injury to your brain, you may be able to move your arm once, if [inaudible 00:52:41] the specific region. But if you keep doing it, then your arm just may freeze, because it doesn’t have the fuel there. So we say gag reflexes that are unresponsive, we’ll see the palate muscles not move, we listen to their gut, we don’t hear any gut activity, that’s like the clinical ding, ding, ding, red flag. And then you’re like, “Hey, tell me about your brain injuries, tell me about what’s happened in the past,” and that’s when you start to find these traumatic brain injuries that have caught up with them, and that’s when you begin to suspect a brain-gut axis issue.

Dr. Datis Kharrazian:

So you will see examination findings of the palate not moving and the gag reflex being abnormal, and you can listen to the bowels and hear lack of activity there, so those are what triggers you as a clinician and I teach all this to practitioners as you know, you talked about earlier, at the Kharrazian Institute, where I teach practitioners how to do functional medicine. And we have 3,000 practitioners from all over the world taking courses there. But it’s a thought process. It’s not a curse. This is the frustration for me as an educator to functional medicine practitioners.

Dr. Datis Kharrazian:

It’s like, “No, their chronic gut issue isn’t because they don’t have this new strain of probiotic or this new enzyme of special thing, and there’s more foods to limit.” And then, it goes down the step process. Is it an intestinal motility issue, which would be more things like neurodegeneration or traumatic brain injuries or dysfunction in that brain axis or actually brain-gut axis? Is it a chronic inflammatory state, because other mucosal things are being a trigger? Do they have a history of autoimmunity? It is intestinal autoimmunity that has been identified? So those are-

Michael Roesslein:

Thyroid.

Dr. Datis Kharrazian:

Is it hormonal? It is metabolic? Is it a combination of little things that are impacting immuno tolerance? And then, you just go through the steps and it’s like there is no mysterious gut issue. They’re there, there’s reasons why they’re there. Some are easier to manage, some are harder. If you get diagnosed with early Parkinson’s in the early stages, you can make a big difference. If you get diagnosed at the point you’re 10 years, 20 years into it with tremor, your prognosis is going to be much much worse. Right? You have just immune tolerance and inflammatory issues happening throughout pulmonary mucosa and gut mucosa and just a couple hormone imbalances and, I don’t know, a little bit of stress and an unhealthy lifestyle. You can have your total-

Michael Roesslein:

[inaudible 00:54:52]

Dr. Datis Kharrazian:

You can have chronic gut issues despite all the supplements and diet restrictions you’re doing and those need to be addressed or you could have severe autoimmunity that is really active and you may have a very, very hard time getting your gut under control, because your autoimmunity is so revved up that it may not be as responsive to diet, nutrition, and lifestyle. But those are all the [inaudible 00:55:13].

Michael Roesslein:

Yeah, yeah, yeah. Yeah, the gut’s almost… it is possible that something going on in the gut starts or happens in the gut, we’re not totally discrediting that that’s even a thing. It’s just these are a ton of different ways that the gut almost is the canary. It’s the first symptom that people will notice, for a lot of different conditions that they may think are not them or not even looking at it or it’s unrelated or they’re looking at the cart before the horse-

Dr. Datis Kharrazian:

It’s not a philosophical thing.

Michael Roesslein:

… type of thing.

Dr. Datis Kharrazian:

It’s basically diagnostic. If you eat terrible and you have processed foods you probably will have bloating, distention, and gut issue, [inaudible 00:55:56].

Michael Roesslein:

Like you should.

Dr. Datis Kharrazian:

Like you should. That’s what’s going to happen and if you eat really healthy and you ear antiinflammatory foods and you have lots of fiber and you don’t eat processed foods and you don’t eat fast foods, and even more if you take digestive supplements and nutraceuticals and other things, you should have a healthy gut. And if you don’t, everything we talked about is where this comes in. So there’s a reason why you would have to go deeper, it’s not based on philosophy, it’s just based on what the clinical outcome is, right? So everything a person puts in has an outcome and then all we need to do is go, “It is an issue with what they’re doing or is there something else that’s there?” And that’s the topic I think we focused on was really these patterns. And there are some variables, some people can have chronic gut infections, those do occur, as well. But, for the most part-

Michael Roesslein:

But some of these other things probably make you even more susceptible to that, because if your motility is shut down, things aren’t moving, if the hormones are out of wack, the immune systems not going to be working properly. That also is generally, probably, a symptom, a lot of the time, not the original driver.

Dr. Datis Kharrazian:

That’s a good point. That’s a really good point, and I’ve seen that. I’ve seen the patient come in and say, “I keep getting parasitic infections,” and they’re spending the past five years on different antiparasitic-

Michael Roesslein:

Doing cleanses and…

Dr. Datis Kharrazian:

… and doing cleanses and they think their issue is getting these bugs and bugs just-

Michael Roesslein:

These parasites just love me.

Dr. Datis Kharrazian:

Yeah, right.

Michael Roesslein:

Yeah, but parasites and bugs, they like the place where they can live. It’s not personal, it’s comfortable there for them, and why? Infections, too. I used to think that the infection caused all the problems and it’s more the problems open the door to the infection. It’s like look at what we’ve dealt with with the current pandemic situation, it’s the people with a whole bunch of problems, the infection takes hold and is a lot worse and puts them over the edge of what their body can handle. I would guess the gut, you have slow motility, you have hormones out of whack, you have all these other things going on, bugs are going to be like, “Hey, this place is sweet. Let’s go here. We can set up shop here and this is going to be okay.”

Dr. Datis Kharrazian:

Yeah, and all these things, add layers and layers and it becomes frustrating, obviously, to the person dealing with it, because it’s very frustrating for the practitioner. But I think the most important thing is to understand that these concepts are there are to dig and to kind of make sure… I would say, the main takeaway message of this whole talk is if you’re doing everything right, meaning you’re eating well, [inaudible 00:58:40] nutraceuticals and things, by eating well all I mean is you’re not on the standard American diet, you’re eating vegetables and [inaudible 00:58:46]. You’re eating like people used to eat.

Michael Roesslein:

Yeah, like food. You’re eating food.

Dr. Datis Kharrazian:

If you eat real food and especially if you’re taking supplements and you have fiber in your diet and there’s something off, and even more so if you try strong effort interventions, trying all these things to fix a leaky gut and change your diet and do all these things, and that hasn’t worked, it’s a red flag to go deeper and may not be that the gut is the cause of all these, but the gut is being impacted by other physiological factors that need to be addressed. And we talk about this and when we talk about it it sounds so obvious like, “Well, yeah, of course.” But you know what? In the real world, no one thinks about this or very few people do. And this is why you have so much confusion and so much frustration and it goes all the way from practitioners that don’t understand this all the way down to patients frustrated, searching all over the internet for clues and suggestions. Good for what you’re doing here, Mike, you’re getting the information out to people.

Michael Roesslein:

Hey, man. I don’t know how I got into this, but I sit here and I interview brilliant people talking about incredible things all the time. I’ve recorded probably 30 podcasts in the last two months and just last night I was interviewing Dr. Eric Gordon who’s up in the Bay Area. He works with Robert Navio on cell danger response studies and things of that nature and was getting into all of that. And I just feel like I have a front row seat at the most cutting edge conversations that are happening and I’m grateful for it. It all makes sense though. It’s all super complex and it’s simple at the same time. The mechanisms by which everything happens are really complex and understanding the connections between them exist that’s simple and it makes sense and of course they’re there. So I tend to lean more towards the latter. I don’t dive into the super heavy biochemistry, I’m not a biochemist.

Michael Roesslein:

But the lines connecting everything always make sense and there’s no mistakes, the body, nature doesn’t screw up, there’s not accidents. So if something’s going on, there’s a reason for it. And the, “It’s just me,” or “It’s just because it’s me,” answer, it’s not just you. Yeah. And so, if people do want to dive deeper I think you’ve got a practitioner program, but really good information. Gut Health: Solving the Puzzle online program, is that your gut training or is that something else?

Dr. Datis Kharrazian:

I have two educational arms, one is for health care professionals, which is the Kharrazian Institute and that’s really for people that have a license in practice, right? But then I have another educational arm, which is where I write books for the public and I have some online programs.

Michael Roesslein:

Yeah. That’s the online one, the Gut Health: Solving the Puzzle.

Dr. Datis Kharrazian:

Yeah, so in way, for me-

Michael Roesslein:

Okay, we’ll-

Dr. Datis Kharrazian:

… what I’ve realized is-

Michael Roesslein:

… link to that below the video.

Dr. Datis Kharrazian:

Yeah, Gut Health: Solving the Puzzle. That’s for me walking a patient through all the steps they may need to go through and then partly because there’s not enough practitioners out there to go deep enough for what the mechanisms are, so in that course we teach them how to go through the steps and understand things. And I think with modern technology, writing a book is not as efficient as putting together an online video course and program that walks you through everything step-by-step [inaudible 01:02:04] videos.

Michael Roesslein:

Yeah, not anymore. I don’t think so.

Dr. Datis Kharrazian:

So the Gut Health: Solving the Puzzle is my attempt to share with non-practitioners, people looking for their own solutions. That’s at Dr. K News. drknews.com.

Michael Roesslein:

We’ll put all the relevant links. We’ll put the link to your site, we’ll put the link to that underneath here for the people who want to investigate their own situation and we’ll put a link to the practitioner trainings, too, because we do have practitioners that watch and listen to our interviews and podcasts, especially when certain people, like yourself, are on. I know that draws more practitioners. So we’ll throw that down there to make it easier to find, as well. So if you’re looking to solve your own puzzle or a practitioner looking to increase your skills and awareness and ability in your practice, we’ll have something down below. As always, I learn so much whenever we talk and I appreciate the time. I know how busy you are and it’s always a pleasure. And we’re really grateful that you take the time to do these.

Dr. Datis Kharrazian:

Pleasure. My pleasure to always talk with you.

Michael Roesslein:

Maybe we’ll record a short thing sometime in Europe this summer.

Dr. Datis Kharrazian:

That’d be fantastic.

Michael Roesslein:

We’ll do a food tour of what real food looks like at a market in France or Italy.

Dr. Datis Kharrazian:

Oh, well that’d be awesome.

Michael Roesslein:

All right. Thank you so much, Dr. K.

Dr. Datis Kharrazian:

Pleasure.