Episode 69: The Microbiome & Disease: Autoimmunity, Heart Health, and Hormones with Araceli Benavides, CNS
Show Summary:
How do the microbes in our gut impact autoimmunity, hormones, cardiovascular health, and inflammation? What can be done to bring our gut back into balance for long term health?
Today’s guest is one of our integrative and functional nutritionists, Araceli Benavides. Araceli is an Institute for Functional Medicine certified practitioner who works with her patients to get to the root cause of conditions including autoimmunity, small intestinal bacterial overgrowth, dysbiosis and more.
We hope you enjoy this conversation about how our gut microbiome is connected to chronic diseases and how Araceli works with her patients to identify root causes of autoimmunity, hormone imbalance, and inflammatory diseases.
Timestamps:
0:00 - Introductions
2:58 - What is the microbiome and why is it important?
3:41 - How does microbiome impact disease?
5:13 - Symptoms that can be connected to the microbiome
6:15 - What is leaky gut?
8:20 - What is functional gut testing?
10:11 - Evaluation of gut health without testing
11:11 - How common is leaky gut?
12:49 - Connections to cardiovascular disease
14:17 - Connections to cancer
15:28 - Connections to Autoimmunity
17:15 - Connections to mood disorders
20:11 - Pathogenic bacteria and disease
21:19 - Diet and supplements for gut health
24:30 - Vagus nerve and gut health
26:54 - Top foods for gut health
29:08 - Food bacteria and why they are helpful for gut health
32:55 - Retesting for gut health
37:51 - One thing under $20 that has helped Araceli’s health
Listen to the full conversation:
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Full Transcript:
Araceli Benavides:
We do see with most of our patients some sort of dysbiosis, which would be the imbalance of the gut microbiome, or intestinal permeability. And we do see these, for example, in a lot of patients with autoimmune conditions, there are certain bacteria that can be possible autoimmune triggers, like let's say Klebsiella, or Citrobacter are two of the common ones in that area. And combined with intestinal permeability, it leads to a higher risk of autoimmune conditions. So yeah, and we do see it in many, many different health conditions for sure.
Dr. Andrew Wong:
How do the microbes in our gut impact immune health, hormone health, vascular health and inflammation? Did you know that you have as many microbes in your gut as human cells about 30 trillion of each? What can be done to bring our gut back into balance for long term health, knowing that health is determined not only by your individual choices like lifestyle, nutrition, and the health of yourselves but also the health of your own microbiome? Today's guest is our director of nutrition here at Capital Integrative Health. Araceli Benavides. Araceli is an Institute for Functional Medicine certified practitioner, and functional nutritionist who works with their patients to get to the root causes of many conditions, including autoimmune disease, small intestinal bacterial overgrowth, also called SIBO dysbiosis, which in which is an imbalance in the gut bacteria and much more. I am Dr. Andrew Wong, co founder of capital Integrative Health. This podcast capital Integrative Health podcast is dedicated to transforming the consciousness around what it means to be healthy, and understanding the root causes of both disease and wellness. And one of the pillars of wellness is to support a healthy gut microbiome. We hope you enjoy this conversation today with Araceli about how our gut microbiome is connected to chronic diseases. And as a root pillar of wellness, and health care. Sally works with her patients to identify root causes of immune health issues, hormone imbalances, and inflammatory diseases. Welcome back here, Celi. We're excited to have you join the podcast again. And in case you missed it air Sally joined us for episode number three to discuss the gut brain connection. Today, we're going to be looking more directly at the microbiome and connections to disease. Welcome back here, Celi.
Araceli Benavides:
Thank you, Dr. Wong, I'm very excited to be back and to talk more about the gut microbiome.
Dr. Andrew Wong:
So this was a hot topic, because on our Facebook page, we actually had a survey of all the different topics that people want us to, you know, talk about and discuss in more detail and microbiome and connection to health and disease was actually number one. So we're really excited to take a deep dive into this today.
Araceli Benavides:
Yes, that's great, since the gut microbiome can really affect all aspects of health. So that's really exciting.
Dr. Andrew Wong:
Let's talk about the gut microbiome and sort of what it is just you know, the basics of what that really means what the gut microbiome is, and then why should we care about it? Why is it so important? Yes. So the
Araceli Benavides:
gut microbiome is made by microorganisms in our gut, and it can be bacteria, it can be fungi, or it can be parasites. And all of these micro biomes, or micro organisms can play a role in our health. And this is because it can help us to digest and absorb nutrients. But it can also affect our immune system, our detox pathways, and he can help us control inflammation. And he can, he can help our brain health as well. So there's many different aspects that we like to look into the gut microbiome, and we'll dive into a little more detail on each of those as well.
Dr. Andrew Wong:
Great. So I know that from a broad perspective, how does our microbiome impact disease?
Araceli Benavides:
Yes, so it can be a direct effect in the case that we have certain overgrowth of certain bacteria, and that can cause certain symptoms in our gut. A lot of the times he could be bloating, gas, or irregular bowel movements, like diarrhea or constipation. And this is typically called this IBS, or irritable bowel syndrome. And that's a lot of the times while we, a lot of our patients come with those complaints, and then we take a deeper look at the gut microbiome to try to find the root cause of what's causing this. So that's a way that we can see those symptoms manifest directly depending on certain imbalances on the gut microbiome. But a lot of the times, he could also be indirect, and it could be the imbalances in the gut microbiome affecting the absorption of nutrients and then we can have deficiencies of certain nutrients that can be presenting as fatigue, or malaise or not imbalances in the mood, or it could also be presenting a skin conditions or immune that is balanced these balances conditions or certain mood disorders. So it can be presenting in certain direct ways or indirect ways as well.
Dr. Andrew Wong:
And that's sort of what we talked about in functional medicine in nutrition. It's kind of like the symptoms that we kind of attribute historically to the gut like bloating and constipation and sort of the terrible bowel symptoms. Those are one bug If that are easy for people to understand, but the other things you just mentioned, these kind of non gut symptoms, could be gut symptoms, but they're, they're not necessarily just isolated to the GI tract. Yes. And why is that?
Araceli Benavides:
So it could be because the microbes in our gut can they secrete certain metabolites. And it could be things that are inflammatory and that can generate an immune response. Or it can also be that the imbalances in our gut microbiome don't protect the lining of our gut, when we don't have enough of the good bacteria, like akkermansia is really important to keep the mucosa of our gut lining healthy. And when that's not present, then we start to develop something called leaky gut or intestinal permeability. And when our gut is permeable, we can get exposed to certain toxins and things that come into our system, that we don't want it to be absorbed into our bloodstream. And that can generate an immune response and more inflammation that can affect other organs.
Dr. Andrew Wong:
So let's talk about leaky gut for a second, because I know that that's something that in the past, at least, it's sort of been historically sort of called the you know, not a real thing, you know, or you know, it's just people making it up. So tell us more about leaky gut and sort of the research behind that.
Araceli Benavides:
Yes. So leaky gut or intestinal permeability can be affected and can be caused by many different factors, one of them and very one very common causes stress. So when we have permanent high levels of cortisol, cortisol can affect those tight junctions in our gut. And that can affect more of the intestinal permeability. But there's many, many other factors, including food additives, herbicides, pesticides that can be present in our foods. It can be other toxins like mold, or heavy metals, it could be also medications, like antibiotics are NSAIDs that we might have taken, that can affect the lining of our gut. So it is basically that tight junction that creates this connection in between our gut cells that starts to break apart. And it is like having small like holes in our intestinal lining that allow things to leak into our system that we typically want this to protect, to keep our body healthy.
Dr. Andrew Wong:
So we can say that potentially that you know, within the gut, lumen itself or the gut digestive tract, if there's an imbalance there, people might get local GI symptoms. But if there starts to get a leaky gut sort of intestinal permeability issue, it might start to quote or leak out into the systemic, you know, more the other organs and other parts of the body.
Araceli Benavides:
Yes, for sure. And the bacteria itself, the opportunistic bacteria that are overgrowing, let's say, for example, Morganella, or pseudomonas, those can be bacteria that are highly inflammatory. And the type of inflammatory molecules that they can produce can also leak into our system and cause more systemic inflammation, more than only localized to the gut.
Dr. Andrew Wong:
So that's why we see like you just said, rashes, headache, fatigue, joint pain, etc, that are quote unquote, not GI symptoms, but they're really originating from these gut inflammation, leaky gut, intestinal microbiome imbalances, from bacteria under organism on their metabolites, I should say, great. So when you work on the gut, what kind of testing to use for you know, looking at how someone's gut health is?
Araceli Benavides:
Yes, so we'd like to use a functional stool test to take a closer look through PCR checking the DNA on the stool to try to detect for bacteria, parasites, yeast, and also some digestive markers, like taking a look at how digestive enzymes are being produced, or if there's a fat malabsorption, or how the immune production or response in the body's working. So we'd like to use a functional stool test. But we also use a breath test to see if there's any small intestinal bacterial overgrowth, or SIBO, which can also be responsible for a lot of the GI symptoms, but also not GI symptoms that can be attributed to SIBO as well.
Dr. Andrew Wong:
So let's talk about the stool test for a minute, because we know that there's a lot of doctors, other practitioners that will use different stool tests conventionally, how does a conventional stool test differ from say, like a functional stool test,
Araceli Benavides:
go measure those stool tests that tend to look at more of the acute type of infections, and we take a deeper look at the whole gut microbiome with the functional stool tests to see more of the imbalances that are not necessarily causing an acute infection but might be affecting health more in a chronic way and that might be present for longer
Dr. Andrew Wong:
Yeah, yeah, that's a great that's a great answer because I think a lot of times when people look at the stool test, you know, functional stool test recommendation, they might just be like, Well, I've already had you know, three stool tests from my GI doctor, but Maybe those were the acute you know, the they're better at picking up acute things like food poisoning and other you know, acute bacterial infections and stuff but not something chronic, like you said, and then for the people that For whatever reason, they're not in a functional practice, or they're not they can't afford the soil testing. How do we, how can we evaluate the health of someone's guts? Without using testing?
Araceli Benavides:
Yes, for sure. We definitely also use clinical presentations and clinical symptoms, like making questions about how the frequency of the stools as well as how they're confirmed if they're floating, if they're sinking, if they see undigested food in their stool, if they're having gas or bloating, when is that presenting is it as soon as they eat or if it's like hours after, and we can determine if maybe there's low stomach acid or insufficiency of digestive enzymes, and what's happening depending on that as well.
Dr. Andrew Wong:
So there's different other things that that we can do clinically or some other kind of at home tests that people can do to figure out if someone has low stomach acid, or if someone's going to just need food as well, things like that.
Araceli Benavides:
Yes, just by using sodium bicarb, we can do an at home test as well to detect for low stomach acid has
Dr. Andrew Wong:
got it, how common is leaky gut, how common is is gut leaky gut, and then also gut microbiome issues is something that's you know, 10% 20%, or how common are these issues.
Araceli Benavides:
They're very common, I'm not sure if I can say an exact percentage, but I would say that we do see with most of our patients, some sort of dysbiosis, which would be the imbalance of the gut microbiome, or intestinal permeability. And we do see these, for example, in a lot of patients with autoimmune conditions, there are certain bacteria that can be possible autoimmune triggers, like let's say Klebsiella, or Citrobacter, are two of the common ones in that area. And combined with intestinal permeability, it leads to a higher risk of autoimmune conditions. So yeah, and we do see it in many, many different health conditions for sure.
Dr. Andrew Wong:
So let's talk about the top three, some of the top three health conditions that that kind of we see statistically across across the world, at least from a chronic disease perspective, what's called NCD or non communicable diseases. So obviously, there's things like sexually transmitted diseases and acute infections. And a lot of the studies that are done on say, health conditions, both acute and chronic, are kind of mapped out by the World Health Organization. So in the top 10, you know, you have different conditions like acute pneumonia, or something like that, or or you know, STDs like HIV and things like that. But then there's also these what are called NCDs, which are chronic diseases. And some of the top three include cardiovascular disease, cancer, and autoimmune conditions. And let's kind of just walk through for listeners here on what the connection is between the gut microbiome and those some of those top three non communicable disease, chronic disease killers, or you know, things that really affect someone's health. What's the connection between gut microbiome and cardiovascular disease?
Araceli Benavides:
Yes, so the definitely it, all of those three conditions can they all have in common inflammation, so we need to control inflammation, and definitely the Godwin need is not in good shape, and there's imbalances of the gut microbiome can be a big source of inflammation. So it helps both lower inflammation when we treat the gut. And it also helps to strengthen our immune system, because we need our immune system to be strong to be able to fight off, let's say any possible, like cancer cells, or just sort of keep the inflammation like regulated, and then also for cardiovascular health, because of the the blood vessels like when those like we want the endothelial to lower the like, we want to lower the inflammation on the endothelium to keep the blood pressure healthy, and the heart health and also like circulation issues and all of that. So yeah, but I think it definitely comes down to inflammation and helping the gut microbiome and the gut health to lower the inflammation overall systemically.
Dr. Andrew Wong:
So the endothelial is the inner lining of the arterial wall. And if we have that inflamed, and sometimes the reason that it is inflamed is from gut inflammation. Is that right? Yes. Got it. So, so gut can affect the heart and blood vessels. How does how does the gut microbiome impact the risk of cancer? Especially thinking about things like beta glucuronic days and things like that?
Araceli Benavides:
Yes. So when we have the marker, better glucarpidase elevated in the gut, that means that our detox pathways in the gut are not working well. But instead of eliminating hormones that we don't need any more, or eliminating toxins that we need to get rid of. We recycle these things into our system. So we would definitely be at a higher chance or risk of high and having higher estrogen. And if we have too much estrogen when we don't need it, and there's some like hormone dependent tumors or cancer cells, that could definitely increase the risk for cancer.
Dr. Andrew Wong:
So it's kind of like taking out the trash but then realizing the trash truck didn't come. You have to bring it out back to your house or something. Wait to the next week. Exactly. Got it. And then autoimmune. So you know, autoimmunity is actually thought to be behind some cardiovascular disease and cancer and some autoimmune experts feel that autoimmune disease is actually the number one number one chronic disease. And that, you know, the, you know, cardiovascular and cancer are kind of like some some of some subtypes of that are caused by autoimmunity. So let's kind of dive in a little deeper to gut health and gut microbiome and how that affects autoimmune conditions.
Araceli Benavides:
Yes, for sure. So when we think of intestinal permeability, and having those small holes, if we can call it that way, in our gut lining, that allows for us to absorb undigested food particles and certain toxins that are coming in with our with our food, and when we're eating, and when that gets and leaks into our system and gets into our bloodstream, our immune cells don't recognize us as normal. So then they feel like it needs to be fire, like they need to fight that off. And then we create an immune response. And a lot of the times that immune response is over activated, and it can be similar to some of our own cells in the a very specific example can be gluten with our thyroid cells, and they have something called molecular mimicry. So our body starts to fight off like certain gluten molecules that have been absorbed, but they're very similar to our thyroid. So it can also start to attack our thyroid. And that's something very common present when TPO antibodies are elevated in hashy models. That's something that we see for a lot of patients that they eliminate gluten and dairy. And then we see those antibodies come down as well, when they're sent. Sometimes
Dr. Andrew Wong:
even the TPO antibodies normalize. Yes, gluten free diet, which is pretty amazing. Yes,
Araceli Benavides:
that's yes, that's definitely true, and addressing the gut lining at the same time,
Dr. Andrew Wong:
right? Because if we just don't address the gut lining and just eliminate the gluten only then that probably won't result in long term benefit. It sounds like Yes, got it. So there's other other conditions that are associated gut microbiome, I think, since we both like brain health, you know, we have to talk about brain health and mental health. So what's the connection between, say gut microbiome and risk of Alzheimer's, gut microbiome and risk of things like mood disorders, like anxiety and depression?
Araceli Benavides:
Yes. So one important data I would say is that about 90% of the serotonin can be made or transforming the gut. And that's very important to regulate mood, and that's a neurotransmitter that can help us feel happy, and sort of fight off depression in a way. So definitely the gut microbiome is really important for mood disorders. And really key it's very important to have a good level of beneficial bacteria in our gut for these to be working properly. So yeah, and that can also affect also related to anxiety, because there are certain bacteria that can help us degrade histamine, and we need for that process to be working well for anxiety to be regulated, too.
Dr. Andrew Wong:
So if if the bacteria are not degrading the histamine then that could have an excitatory, like over excitatory component and cause someone potentially to feel more anxious. Yes. Okay. So interestingly, it's, it's, you know, because we think of these things, like histamine, and we think of these things like dopamine and serotonin as, as really things that affect the brain. But in fact, like you said, a lot of these neurotransmitters are made in the gut. So it's almost like a misnomer. Like it could be called gut transmitters. neurotransmitter is a term, new term. Yeah, we can we can make that up today.
Araceli Benavides:
Yes, and we didn't touch on the site of the cognitive cognition or cognitive impairment, definitely, for all of our patients with mild cognitive impairment or Alzheimer's disease, we do take a deeper look at the gut microbiome to make sure that, again, inflammation is is taken care of and detox pathways are open up through the gut. And because these bacteria, as we mentioned before, they can be through the LPs, they can also cause more brain inflammation. So we want to try to reduce that. And we know other things like sleep, and nutrition and other lifestyle factors can be also very important for brain health.
Dr. Andrew Wong:
Absolutely. And just for listeners, LPs, is lipo polysaccharides. So that's a substance it's secreted by some of the bacteria. Yeah, negatives. Yeah. And why is lipid polysaccharides so important? I think that's something that is a not a bacteria, but it's a bacterial byproduct, right?
Araceli Benavides:
Yes, that's great. Yes, because it basically can be absorbed through the bloodstream, like to the bloodstream, and that can cause more inflammation. And that's something that can trigger inflammation in the brain as well.
Dr. Andrew Wong:
So it's like a Hylian. It's almost like a hot potato. Yes. It gets through that lining and it can cause damage sort of in other parts of the body. So you mentioned some before opportunistic or pathogen effect, Syria, I think you mentioned Pseudomonas Klebsiella. How are they connected to disease, you know, some of these some of these bacteria that we might see on a stool test, let's say.
Araceli Benavides:
So when we, when we see elevated levels of Citrobacter, on the stool tests, these being a potential autoimmune trigger bacteria. In research, it has also been linked to RA or rheumatoid arthritis. So I will always ask my patients if they experience any joint pain or anything else related to that, but it's definitely a bacteria that we would try to address and decrease. And on the other side, other bacterias, like, let's say produce, I would see a lot of my patients experiencing diarrhea, it can also be as it has been associated in research with inflammatory bowel disease. So yeah, that's something else we would look into treating.
Dr. Andrew Wong:
I feel like the more research is done, the more we find, because I believe that produce is also socially with RA as well as Citrobacter. So it's like, everything is kind of synergistic in a way. What can we do about the presence of these bacteria? Should we just mow them down and kill them off? Or how do we, what steps do we take with patients when they show up when these different opportunistic or pathogenic bacteria show up on a test or there's a certain diet changes or supplements or lifestyle changes that could be helpful?
Araceli Benavides:
Yes, so we always individualize and personalize the treatment to each patient. But in a general way of looking at it, we do want to remove any pathogenic bacteria that are present in the gut that are causing any like inflammation or GI symptoms. So we tend to start there. And then we do want to make sure we're balancing the amount of stomach acid or trying to stimulate more stomach acid, if that's present, if there's no stomach acid detected, or we want to replace some digestive enzymes, if that's the case. And just for our listeners, when we're talking about removing pathogens, we don't necessarily think about antibiotics all the time, we use and in certain cases, we might need to use some antibiotics. But we also use a lot of antimicrobial herbs that tend to be a little more gentle to the guide, and it have less of an impact on clearing the good bacteria. So we use herbs or antibiotics depending on the case. And then we can use certain gentle things like apple cider vinegar to stimulate the stomach acid and digestive enzymes. Or we might use some digestive bitters, as well to stimulate digestion. And there's other supplements as well that can help with these like betaine, HCl or digestive enzymes. So that's sort of the beginning of the treatment. But we always want to make sure we're also addressing the gut lining and trading, if there's any intestinal permeability, or leaky gut with certain nutrients that can help us rebuild that tight junction of the cells. Things like L glutamine, or slippery elm, St. carnosine, or marshmallow root, there's many different herbs or nutrients that can be helpful for this. And we always want to make sure we rebalance and make sure we have a balanced nervous system. Because if we do all of these treatment, but we're still very stressed and anxious, and that sort of still disrupts our gut lining and affects the balance of our guard, we see more and more patients that have followed a very rigorous protocol on removing the bad bacteria and replenishing the stomach acid, digestive enzymes, good bacteria. But then if the nervous system is not well balanced, that affects our motility and sort of things can reoccur and then we have to go through the whole process. So making sure we rebalance the nervous system and we stay as calm as possible to stimulate digestion. That's also very important.
Dr. Andrew Wong:
Yes. And I feel like we always talk about this on this podcast and in the clinic. But a lot of the root causes do end up going back upstream distress, which will imbalance the nervous system and the nervous system is tied to the gut because the gut has a nervous system. As we talked about in Podcast, episode three, which we should listen to, again, is a great episode Aircel here on on how the gut affects brain health and brain effects gut health, and there's that bidirectional interplay with the vagus nerve and everything. And just the idea that, really, when we look at the lifestyle factors, lifestyle changes that that people can do that are free, that are accessible and very practical to them that will improve their gut microbiome. Things like sleep and stress management. Can you talk a little bit about that?
Araceli Benavides:
Yes, for sure. So there's different as Dr. One mentioned, the vagus nerve. That's what, that's a very important nerve that connects the brain and the gut and needs a bi directional communication. And definitely we talk more about that on episode three. But there's different Vagus Nerve Stimulation exercises that we can do at home, like gargling until our eyes feel watery. That's when we know that the vagus nerve has been activated. And we can practice that a couple times per day to make sure we strengthen the vagus nerve. But we can also do other things like belly breathing, or alternated nostril breathing for rounds of five or six times, especially if we do it around meals, that's great, because we're going to be in a rest and they just stayed a parasympathetic state to make sure we have an optimal like balance, balance of our nervous system for digestion. Those are some some exercises, but there's definitely more like chanting humming and gag reflex different things
Dr. Andrew Wong:
and laughing telling jokes, maybe telling some jokes before you eat. Something like that sit down smell, that's definitely think about someone sitting, you know, with a bunch of friends or family and you know, laughing and talking and telling jokes. And that's kind of a nice way to look at things. A lot of times, you know, a lot of us, including, I know myself, I'm not sure about you, but I always kind of like maybe I'm eating on the run too much. You know, I'm like, fast. And that's sort of making that nervous system imbalanced, which is affecting the gut microbiome. Yes, for sure. So we definitely want to emphasize here that things like stress management and being relaxed and getting enough sleep, and all these things will affect the gut microbiome. Yes, in addition to the nutritional changes in nutraceuticals, and different things that can be helpful. Antibiotics when needed?
Araceli Benavides:
Yes, definitely. With nutrition most, most of our patients or in general, people here, tend to lack fiber. And we do want to emphasize that because fiber is one of the main foods that feed the good bacteria, and we are lacking that a lot of the time. So emphasizing a lot of increasing vegetables and increasing seeds like flax seed or chia seeds that can have great sources of fiber. So yeah,
Dr. Andrew Wong:
so let's talk about some top foods now. You know, some foods that would nourish our, our microbiomes, and therefore, you know, help to improve our health overall, you know, as a result of improving that microbiome, what are your top foods that you recommend with people?
Araceli Benavides:
Yeah, so once we get to the point that the pathogenic bacteria that might be causing like digestive discomfort are better, we definitely focus on increasing foods that would have fiber like cruciferous vegetables, and things like artichoke or asparagus that those would be prebiotic foods, chicory root ocra. All of those are great sources of prebiotics, that those are fibers that would feed the good bacteria. And at the same time, we want to do foods that have the good bacteria themselves that are probiotic foods, that would be fermented foods. So sauerkraut or kimchi or kefir, if they do okay with dairy would be great options on the side of probiotic foods or pickles as well. So we want to have a mix of the prebiotics and the probiotic foods. And just to mention as well, cabbage can be a really important and really good for healing the lining of the stomach and the lining of the gut. So sometimes, like including cabbage or cabbage juicing, it could be helpful to
Dr. Andrew Wong:
okay for gut lining. What is the relative importance? What's your opinion on that in terms of between prebiotics and probiotic foods? Should we have more of one or another? Or how important are they relative speaking,
Araceli Benavides:
it's good to combine them, I would say like, definitely probiotic foods is not something that we would have in the same amount of than the prebiotic foods because we definitely want the vegetables and the seeds to be present on every single meal. But maybe we might not have like something fermented with every meal. But we probably want to do it at least once a day, once the gut is healthy enough. And we always recommend these based on tolerance. A lot of the patients take some time after healing some of these pathogenic bacteria as are their gut are still a little sensitive. So they don't might not tolerate all of these foods at the beginning. But we would start to reintroduce slowly.
Dr. Andrew Wong:
Okay, so So kind of go slow and listen to your body and things like that. Yes, yes. Okay. I think, you know, this is a good overview of gut microbiome. Let's talk about, but we talked about the pathogenic bacteria. Let's talk about some of the good bacteria some of the big gut superheroes here. Yes, yes.
Araceli Benavides:
Yes. So we briefly mentioned at the beginning, ocher Mansi, I believe, and that's really important to keep the mucous lining of our guide healthy and to prevent leaky gut. So there's only one probiotic on the market nowadays that has akkermansia that I know my patients sometimes really like it because it can be really, really healing and really soothing for the gut. But if not, there's the prebiotic foods will help us to increase the dollar amount of akkermansia. So that's a really important bacteria to keep our gut healthy. But there's other bacteria that will produce butyrate, which we haven't mentioned yet, but it's an anti inflammatory, short chain fatty acid that our bacteria can produce. And there are certain bacterias like ficolo bacterium and bacteroides that can make butyrate and and help to decrease inflammation in our gut and systemically so those are all So very important bacteria. And there's others like Escherichia or bacillus or lactobacillus that can be present as well in their gut that can be helpful for different things like the absorption or digestion of, of nutrients or breaking down histamine and other beneficial components of our gut.
Dr. Andrew Wong:
So where's the researcher solely on sort of specific foods or specific ways to modulate that gut microbiome with individual strains of bacteria? Is it is it is it getting to that point where now we can say, Okay, eat this food, try to increase akkermansia? Or, you know, butyrate producing bacteria, let's say? Or how specific is the research on that? No,
Araceli Benavides:
I wouldn't say that too specific from like, one food to one bacteria. I have seen a couple and I won't like I won't specify too much on the, on the, like, couple foods, I have seen certain research that are they're trying to demonstrate that could potentially help akkermansia. But I tend to go more on the combination, just because like all the synergistic effects of like the foods and combination of them that can be like really beneficial. But yeah, that would be interesting. I'll look more into that.
Dr. Andrew Wong:
Yes. And I guess also cyber fiber. A lot of these, you know, fruits and vegetables are high in fiber. Are there any other foods that are good for kind of soluble fiber?
Araceli Benavides:
Yeah, definitely could be like avocados could be a good option for that if they do well, with with fats. And yeah, like oats and other other types of like, fibers are also good. And even foods as well, if their blood sugar regulation is good, okay, some pomegranate seeds and other things,
Dr. Andrew Wong:
other things like that. And what about berries? Where does that fit into the whole? Like, how does that help the microbiome or not?
Araceli Benavides:
Yeah, well, berries have a lot of phytonutrients. And they also have fiber and phytonutrients can also be helpful for modulating the the gut microbiome in a positive way. And they have a lot of antioxidants, which of course, are great for health, both gut microbiome and health in general. So yeah, I definitely recommend adding berries as well.
Dr. Andrew Wong:
How about another thing I always wonder about is bone broth? Where are you on bone broth? And you know, is that something helpful for people assuming that they, they can eat bone broth?
Araceli Benavides:
Yes, that's actually a great option for healing the lining of the gut. Sometimes patients don't necessarily tolerate the supplements that combine all of these nutrients. And starting with some bone broth can be very soothing and very helpful for the tight junctions and healing leaky gut.
Dr. Andrew Wong:
Great, great. So I think we covered you know, a wide variety of things here. If someone has a gut stool test, let's say or a breath test with for, say, a small intestinal bacterial overgrowth, when when do you how do you know when to decide to retest them? In terms of to see where the microbiome is? Or do you do just kind of see if they improve? What's kind of the management of that typically, when you work with someone,
Araceli Benavides:
yes, we do try to work around their symptoms. So if they, if they're feeling better, and they can afford to retest, because that's the other piece, sometimes he says can be out of pocket, we either feeling better, we might retest and make sure that everything is looking good, and that we addressed and covered everything that we were willing to, and also some other patients that might have certain symptoms that got better and certain others that nod, we might retest at that point, as well to see if we're missing anything, or if there's something that hasn't totally resolved. But yeah, definitely depending on each like case and each patient.
Dr. Andrew Wong:
So thank you. So we also mentioned the beginning that the microbiome is actually made up of, of different colonies of organisms, not just bacteria, but also viruses, fungi, and parasites. So I'm going to make up a couple of words that maybe there maybe they are existing, but the like fungal biome or via Rome, Parasite home. In other words, there's other parts of the microbiome that we don't always they don't they don't always receive the press that like a good or bad bacteria do. But can you talk a little bit about, you know, is there any research on say, viruses in the microbiome or fungi like Candida, let's say, or parasites, like how do we how do we figure out if they're in there or not? And what do we do about that?
Araceli Benavides:
Yes, the functional stool tests also looks for fungi, viruses and parasites. And we rarely find any viruses on the on this type of tests, but we do find parasites and fungi, especially candida overgrowth, so we would, we would also address these because you can cause a lot of the GI symptoms and you can also once we find Candida in the gut, it might also be present in the sinus like Carnac, like congestion might be because of Candida, or they might be like the vaginal yeast infections or something else going on. So we would also address it either with herbs or with antifungals as medications to try to lower the overgrowth of Candida, and sometimes there's mold as well like playing a role like just multaq CCD or something else that we need to detox. So yeah, and we try to do an anti Candida food plan as well and try to limit simple carbs and sugars that might be feeding yeasts. A lot of the times we have sugar cravings when we have yeast overgrowth, so we want to try to starve the yeast in that way, if we find that there's an overgrowth, and for the parasites to we would treat that we can either use herbs like warm wood, or there's different herbs that could black walnut, a warm wood that can be helpful for parasites, or they can decide to use medicine as well.
Dr. Andrew Wong:
So in general, it sounds like there's multiple organisms that in the right setting could cause leaky gut bacteria could have they overgrow, parasites could I'm assuming viruses could Yeah, and fungi as well. Yeah, it sounds like that could be a combination of those things, too. All in one packet for Yeah, for them in the person's gut. So just from a perspective of, you know, gut health, what is one thing you wish everyone knew about gut health and how it impacts both health and disease?
Araceli Benavides:
Well, I would say that just sort of for everyone to know that they might already know that it's been going around is that all disease can start in the gut. So keeping a gut healthy can help us to keep our overall health. So just paying a little more attention to that and trying to not focus too much on managing symptoms when there's happening, like any disease happening, but more like looking at the root cause and maybe trying to address certain like God conditions that might be leading to other health conditions.
Dr. Andrew Wong:
So people that have maybe cardiovascular risk factors, cancer risk factors, autoimmune conditions, if they have gut symptoms, obviously, really, would you say would be a good candidate to get more of a gut health evaluation?
Araceli Benavides:
I would say most patients would be good candidates. I know some patients don't have any gut symptoms, but they still have some like gut microbiome imbalances that are affecting other health conditions like, like blood sugar dysregulation or blood pressure or something else that might be going on that is unnecessarily linked to the gut. So I'd say most patients, but especially if they're having certain guide symptoms, like irregular bowel movements, gas, bloating, or acid reflux that we haven't touched much on today, but definitely any of those would be a good reason to look deeper
Dr. Andrew Wong:
reflexes, definitely a topic for another podcast. So that's another big topic. Thank you so much for si for coming on again. today. It's been really great conversation talking about gut microbiome connections to health and disease. Let's talk about a bit about access. So if someone is basically you know, out there listening and just wondering, what is one thing under $20 that has positively impacted your health and you feel like that could be helpful for listeners?
Araceli Benavides:
Yeah, I would say probably apple cider vinegar would be a good option diluted apple cider vinegar, we definitely don't want to drink it straight. Okay, but about like one tablespoon in a full glass of water could be around 10 minutes before food can definitely stimulate digestion and I've seen patients that that has helped a lot for like even things from like acid reflux to like constipation just because of like getting things like stimulated on the site of stomach acid and digestive enzymes. So apple cider vinegar or ginger as like ginger tea can be very anti inflammatory for the guide and it can also stimulate motility which sometimes in per motility can be the root cause for many gut conditions. So those two would be good
Dr. Andrew Wong:
I love that and of course apple cider vinegar and ginger I guess you can put into different recipes and eat yes foods.
Araceli Benavides:
Yes, for sure.
Dr. Andrew Wong:
Do you have any favorite recipes with those or anything you'd like to, um,
Araceli Benavides:
I I've done like some salad dressings with apple cider vinegar. And I like Asian foods. So that typically comes with ginger. But if not just like a ginger tea, I love to like boil fresh ginger and just make ginger tea out of that.
Dr. Andrew Wong:
Great. Well, thank you so much for coming on today and look forward to another episode soon.
Araceli Benavides:
Thank you, Dr. Huang. Appreciate it.
Dr. Andrew Wong:
Thank you for taking the time to listen to us today. If you enjoyed this conversation, please take a moment to leave us a review. It helps our podcasts to reach more listeners. Don't forget to subscribe so you don't miss our next episodes and conversations. And thank you so much again for being with us.