Defiant Health Radio with Dr. William Davis
Defiant Health Radio with Dr. William Davis
Here’s what happens when you reduce endotoxemia
Ready to unlock the secret to your health buried deep within your gut? In today's illuminating episode, we reveal the unsuspected ways in which small intestinal bacterial overgrowth (SIBO) and lipopolysaccharide endotoxins (LPS endotoxins) can drastically alter your health. We delve into the underworld of fecal microbes and their dangerous ability to cause inflammation and endotoxemia. Connect the dots between these hidden threats and a host of health conditions, from obesity to anxiety and even dementia. You'll be astounded to know how common SIBO is, with studies showing its presence in a whopping 50% of people with fatty liver and 40% suffering from irritable bowel syndrome.
Imagine a world where conditions like restless leg syndrome, fibromyalgia, and obesity could be managed by understanding and treating SIBO? We're here to guide you through that very journey. We examine the process of detecting and treating SIBO using the revolutionary AIRE device from Food Marble. You'll learn how a rise in values by four units or more means a positive SIBO test. Lastly, we explore the power of natural remedies, like fermenting specific microbes for four weeks and the benefits of daily consumption of fermented foods. Join us, as we navigate the complex world of the small intestine, uncovering the pivotal role it plays in our overall health.
For BiotiQuest probiotics including Sugar Shift, go here.
A 15% discount is available for Defiant Health podcast listeners by entering discount code UNDOC15 (case-sensitive) at checkout.*
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Get your 15% Paleovalley discount on fermented grass-fed beef sticks, Bone Broth Collagen, low-carb snack bars and other high-quality organic foods here.*
For 12% off every order of grass-fed and pasture-raised meats from Wild Pastures, go here.
*Dr. Davis and his staff are financially compensated for promoting BiotiQuest and Paleovalley products.
Books:
Super Gut: The 4-Week Plan to Reprogram Your Microbiome, Restore Health, and Lose Weight
If you've been following my discussions, you know that I've been arguing that small intestinal bacterial overgrowth, or SIBO, is now at epidemic levels in the US and much of the rest of the world. Recall that SIBO means that due to the loss of hundreds of important species in the modern gastrointestinal tract due to overexposure to antibiotics, food additives, synthetic sweeteners, pharmaceuticals such as stomach acid blocking and anti-inflammatory drugs, herbicide and pesticide residues and food and other factors, fecal microbes in the colon as a result have been allowed to over-proliferate. But these fecal microbes have also managed to ascend into the 24 feet of small intestine where they take up residence. The small intestine is poorly equipped to house these fecal microbes. The small intestine is by design permeable because that's where amino acids, fatty acids, vitamins and minerals are mostly absorbed. But when trillions of fecal microbes come to inhabit the small intestine, they live and die every few hours, releasing their toxins into the intestinal contents. One type of toxin in particular, lipopolysaccharide endotoxin or LPS endotoxin, is able to penetrate the small intestinal wall and gain entry into the bloodstream. The process is also worsened by inflammation that these fecal microbes provoke in the small intestinal wall. When LPS endotoxin is allowed to get into the bloodstream, the process is called endotoxemia.
William Davis, MD:It is now becoming clear that endotoxemia plays a role in virtually every human health condition, from obesity to dementia, to anxiety and depression, and if not addressed, you will never have full control over any health condition. So in this episode of Defiant Health, let's discuss why I argue that SIBO and LPS endotoxemia are conditions that affect half the US population, and let's talk about steps you can take to address this situation and gain an understanding of what wonderful effects you can expect when you reduce or minimize LPS endotoxemia. Later on in the podcast, let's talk about Defiant Health's sponsors that include Paleov alley, who provides fermented grass-fed beef sticks, bone broth, protein rich in collagen, organic super greens and low-carb superfood bars, and now 100% grass-fed and finished pastured meats. And BiotiQuest, who provides unique probiotics such as sugar shift to support healthy blood sugars and simple slumber to assist in obtaining healthy sleep, probiotics crafted with the unique property of combining synergistic microbes.
William Davis, MD:So the entire situation begins with small intestinal bacterial overroute, sibo, that is, the overproliferation of fecal microbes. These are species of microbes that ordinarily live in the colon and comprise your fecal material. These are species like E coli and Salmonella and Campylobacter. Because we've lost so many beneficial species in the colon, it's allowed these fecal microbes to over-poliferate and, even more remarkably, then ascend into the 24 feet of small intestine. As you can imagine, that's a very inflammatory situation. That is, you have these fecal microbes living where they're not supposed to be in the small intestine. The small intestine is protected by a thin single layer mucus barrier, unlike the colon that is adapted to having lots of fecal microbes. That has a much thicker two-layer mucus barrier, and the small intestine beyond that also is very permeable. And that's why, when fecal microbes have over-pliferated and ascended into the small intestine where they live and die in short order, microbes only live for a few hours at a time. So you have trillions of microbes living and dying in rapid succession in the small intestine. This is when they die.
William Davis, MD:They release something called endotoxin, as I mentioned in the opening comments. When endotoxin enters the bloodstream, that's endotoxemia, and this explains how microbes in the GI tract can be experienced as skin conditions like rosacea or seborrhea or psoriasis, or as conditions in the brain, such as dementia, anxiety, depression, parkinson's disease, or conditions in the joints and muscles, such as fibromyalgia, rheumatoid arthritis, or as metabolic diseases like type 2 diabetes, obesity, heart disease. In other words, you really have to reconsider, redefine virtually all human disease in light of this, the contribution of endotoxemia. Now, when this lipopolysaccharide endotoxin enters the bloodstream, it's not as bad as in sepsis. This is the situation where you have an infection, let's say urinary tract infection that in some people, enters the bloodstream, so microbes enter the bloodstream. That's called sepsis and that can make you extremely sick. Those are people who go into respiratory failure, get put on a ventilator, they have low blood pressure, they can die of shock. So in that situation the level of endotoxin is a hundred times or more higher. In endotoxemia it's not that bad like in sepsis, but there's a 200 to 400% increase in the level of endotoxin in the bloodstream. Enough to have these metabolic consequences and effects on other, causing other health conditions. Now to get our arms around, just how many people are affected by this process, let's consider studies like this In condition blank what proportion of people test positive for SIBO?
William Davis, MD:So let's consider fatty liver. There's about 100 million Americans with fatty liver. That is, infiltration of the liver by fat that can lead to cirrhosis over time. Well, of the 100 million people with fatty liver, what proportion test positive for SIBO? There's a variety of ways this is done, such as testing for hydrogen gas and breath that are produced by microbes. Sometimes it's done by an endoscopy and an aspirate is obtained from the stomach, duodenum or dejunum and that can show the presence of microbes. Regardless, what proportion of people with fatty liver test positive for SIBO? Well, 50%. Well, 50% of 100 million is 50 million people right there.
William Davis, MD:How about people with irritable bowel syndrome, ibs? Well, there's about 60 to 70 million people in the US with IBS, and approximately it varies from study to study, but approximately 40% of those people test positive for SIBO. That adds another 24 million or so people to the list. Well, let's throw in people with obesity there's about 115 million people in the US with obesity and 50% test positive. So that's another 60 million or so. And now there's some overlap, of course, an obese type 2 diabetic with fatty liver. But let's throw in all the people who have fibromyalgia, autoimmune conditions, neurodegenerative conditions, restless leg syndrome, food intolerances, on and on. You can see, we easily can exceed 150 million Americans who have SIBO and thereby endotoxemia. So, given these numbers, we're talking about one of the worst epidemics ever in the history of our species on this planet. It affects approximately one in every two people, and that includes teenagers and children, by the way.
William Davis, MD:Now, when there's endotoxemia, it drives a number of processes that lead to various health conditions. It leads to, for instance, insulin resistance. That is, the situation in which your body's organs, like muscle and liver and brain, no longer respond properly to insulin, and so the pancreas compensates by producing huge amounts of insulin 10 times more, 30 times more, 100 times more in order to overcome that resistance to insulin. So that situation of insulin resistance is the underlying process that drives risk for other conditions such as heart disease, coronary disease, dementia, breast cancer, obesity and many other conditions. Couple that also with the inflammation that endotoxemia causes. One of the other effects of endotoxemia is it causes expansion of abdominal visceral fat, that is, fat in the abdominal cavity that is very inflammatory, so that fat in the abdominal cavity is itself inflamed and it also releases inflammatory so-called cytokines, or factors that export inflammation to other parts of the body, such as the brain or the heart's arteries, the coronary arteries, or skin or thyroid or liver. Just about all organs are exposed to this process, and it can drive diseases or other health conditions in those organs. There probably is no organ that escapes the effects of endotoxemia and thereby insulin resistance, inflammation and other conditions. Endotoxemia also amplifies pain, so if you have some other reason for having, say, a bad knee or bad hip, it will amplify that pain, making it more difficult to control symptoms. I think you can appreciate what a powerful driving force endotoxemic can therefore be in increasing your potential for type 2 diabetes, hypertension, high blood pressure, coronary disease, cognitive impairment and dementia, fibromyalgia and on and on to include virtually all human disease. That's the bad news. The good news is, once you recognize this and learn how to deal with it, you have been given enormous control over your health. Now let's pause for a moment so I can tell you about Defiant Health's sponsors. When we come back, let's talk about all the wonderful benefits you can experience when you learn how to manage and eradicate SIBO and thereby endotoxemia.
William Davis, MD:The Defiant Health podcast is sponsored by Paleov alley makers of delicious grass-fed beefsteaks, healthy snack bars and other products. We are very picky around here and insist that any product we consider has no junk ingredients like carrageenan, carboxymethylsalos, sucralose and, of course, no added sugars. And all Paleo Valley products contain no gluten nor grains. In fact, I find Paleov alley products among cleanest in their category. One of the habits I urge everyone to get into is to include at least one, if not several, servings of fermented foods per day in their lifestyles. Unlike nearly all other beefsteaks available, paleo Valley grass-fed beefsteaks are all naturally fermented, meaning they contain probiotic bacterial species. And now Paleov alley is expanding their Wild Pastures program that provides 100% grass-fed, grass-finished pastured beef and pastured chicken and pork raised without herbicides or pesticides. And they just added wild-caught seafood caught from the waters of Bristol Bay, alaska. Among their other new products are pasture-raised fermented pork sticks, chocolate-flavored grass-fed bone broth protein and grass-fed organ complex in capsule form, and new essentially electrolytes in powder form to add to potassium and magnesium intake, available in orange, lemon and melon flavors. Listeners to the Defiant Health podcast receive a 15% discount by going to paleo valley. com/defiant health.
William Davis, MD:I'd like to welcome Defiant Health's newest sponsor, BiotiQuest. I've had numerous conversations with BiotiQuest founders Martha Carlin, and academic microbiologist, dr Raul Cano. They have formulated unique synergistic probiotic products that incorporate what are called collaborative or guild effects, that is, groups of microbes that collaborate with each other via specific metabolites, potentially providing synergistic benefits. They have designed their Sugar Shift probiotic to support healthy blood sugars. Simple Slumber to support sleep. Ideal Immunity to support a healthy immune response, Heart-Centered that supports several aspects of heart health, and Antibiotic Antidote designed to support recovery of the gastrointestinal microbiome after a course of antibiotics. BiotiQuest probiotics are, I believe, among the most effective of all probiotic choices for specific health effects. Enter the discount code UNDOC15 for a 15% discount for Defiant Health listeners.
William Davis, MD:So what sorts of benefits can you expect by reversing or suppressing SIBO and the accompanying endotoxemia? Well, the list is long and it includes virtually all common chronic diseases that you're likely familiar with. So you can expect that you can reduce blood pressure, often dramatically. You can reduce insulin resistance and thereby reduce your risk for numerous other diseases that result from insulin resistance, including coronary disease, that's, heart attacks, need for procedures, etc. Fatty liver, high triglyceride levels, low HDL, small LDL particles, cognitive impairment and dementia, breast cancer and other cancers that are triggered by insulin resistance. You can expect weight loss, especially from abdominal visceral fat. You can see this in a reduction, for instance, in your waist circumference.
William Davis, MD:Reduced depression and suicidal thoughts. Reduced anxiety. Reduced potential for heart rhythm disorders like atrial fibrillation. Reduce severity or development of congestive heart failure. Reduced Arthritis Pain. Reduced risk for diverticular disease such as diverticulitis and colon cancer. Reduced risk for Crohn's disease and ulcerative colitis. Reduced risk for Irle bowel syndrome. Reduced risk for Restless leg syndrome, since restless leg syndrome is virtually synonymous with SIBO. Reduced potential for food intolerances to FODMAPS, nightshades, fructose, histamine-containing foods, legumes and nuts this all represents forms of SIBO. Reduced risk for Neurodegenerate conditions and slowing of many of the phenomena of aging. Now, that's only a partial list.
William Davis, MD:If you have any health condition, you should at least consider Whether SIBO, and thereby endotoxemia, is either an initiating factor that is, the cause or an exacerbating factor that is, makes the disease worse. So, in other words, in type 2 diabetes, you can make yourself diabetic just by eating bad foods, but you can also contribute to high blood sugars and insulin resistance via SIBO and metabolic endotoxemia. So maybe SIBO and endotoxemia was not the initiating factor, but it is an amplifying factor. It makes it much worse and harder to control. So how do you attack this problem?
William Davis, MD:Well, first of all, question whether you have it. So one way to find out is to test with the AIR device AIRE from the company of Food Marble, and all that is is a breath testing device that talks to your smartphone on a scale of 0 to 10, and it arrives from baseline of more than four units, it's a positive test. So let's say you there's a preparatory diet. You go on with no fibers or sugars for 12 hours or longer prior to testing. Morning of testing get a baseline level should be low, like maybe 1.2 or something like that and then consume something with prebiotic fiber.
William Davis, MD:The easiest thing to do would be a cup of coffee with two teaspoons of inulin. Inulin is the best prebiotic fiber to test with because it's consumed by the most microbe, by many microbes that comprise SIBO. So drink that coffee. You can eat other foods also and then test again 30 to 45 minutes and every 30 to 45 minutes thereafter for up to 90 minutes. Any rise in values of four units or more. Let's say the next measurement you get is 9.8, that's a positive. That means that microbes are living high up in your gastrointestinal tract, in the stomach, duodenum and jejunum. Because it takes 90 minutes at the least, at the very least, for that annulin to reach the colon, where production of hydrogen gas is normal. So production of hydrogen gas before 90 minutes is abnormal, signifying microbial colonization of the small intestine.
William Davis, MD:Now, it's not a perfect method, but it's a method that you can use. It's also helpful for tracking long term. Now there's some more detail to this. I urge you, if you want to use the air device, see my super gut book. It has detailed instructions on how to use it for this specific purpose.
William Davis, MD:Another way is to just look for signs that you have SIBO. Food intolerance is virtually guaranteed. You have SIBO. Some conditions like restless leg syndrome, urinal bowel syndrome, fibromyalgia, are so commonly associated with SIBO and endotoxemia that you can safely assume that you have it. Any neurodegenerative condition, any autoimmune condition, obesity, type two diabetes and fatty liver are also very highly associated with SIBO. It's a safe assumption. Now, I think it's a safe assumption because my solution to SIBO is so benign, that is, if the solution was something drastic like taking out your small intestine, well, you better be damn confident, right, that you really need to go through that. But what if the solution is something that smells and looks like yogurt? It's not yogurt. It's not the stuff you buy in the store. It's very different, but it is something like yogurt.
William Davis, MD:So the way I've been getting rid of SIBO is to ferment three microbes A strain of lactobacillus reuteri, the 6475 strain. A strain of lactobacillus gasseri, the BNR17 strain. Those two microbes are unique and that they colonize the small intestine. That's where SIBO occurs. Right, that's where the battle is. So those two species colonize the small intestine and produce what are called bacteriocins. These are natural antibiotics effective against the species of SIBO.
William Davis, MD:I threw in another microbe, bacillus coagulans, the GBI-30,6086 strain. I included it for three reasons. One is it also produces bacteria that are effective against some different microbial species than the other two. The combination has a very broad spectrum of antimicrobial effects for the SIBO species. Two, it has a great track record in reducing the symptoms of irritable bowel syndrome, which is essentially the same as SIBO, and it makes the yogurt taste better. It makes very delicious yogurt, so it kind of softens the edge of the sourness that lactobacillus gasri tends to cause. So we ferment those three microbes for 36 hours, we co-framed it together and then we consume it for four weeks.
William Davis, MD:If you have a really bad case of SIBO, as sometimes happens in people who've taken prolonged courses or repeated courses of antibiotics, you can do it much longer, but a minimum of four weeks. And then, if you're gonna test again with the air device, you wanna stop the Rhodorite specifically for two weeks and then test. And the reason for that is Rhodorite also produces hydrogen gas and it's in the small intestine. So it gives the appearance of a positive test and so you have to stop the Rhodorite for two weeks after your four week course before you test again Then. I urge people to continue, not daily, with the what I call SIBO yogurt, those three microbes, but to do it occasionally, maybe two or three times a week, because it seems to be helpful in preventing recurrence. Recurrences of SIBO and thereby endotoxemia are very common and I believe continually to consume the SIBO yogurt prevents recurrence. After all, these are at least the Rhodorite and gasri are keystone species that you should have had all along, but they were eradicated by a course of antibiotics may have taken many years ago or sometime in your past.
William Davis, MD:Another useful strategy to fight back SIBO and thereby endotoxemia is to include lots of fermented foods in your daily routine. Caffirs, kombucha, kimchi, veggies you ferment on your kitchen counter. You want to do this several times a day. It doesn't have to be a large serving, but several times a day for maximum effect. What fermented foods do is the microbes that are in the fermented foods, such as leuconostoc, mesenteroides or various pedicoccus species. These microbes don't colonize the intestines but they feed the beneficial microbes. So, for instance, leuconostoc produces metabolites like acetate and lactate that feed important species like fecalobacterium. So you don't have to remember all that detail. Just remember that lots of fermented foods in your lifestyle is very helpful and helps keep SIBO away.
William Davis, MD:Another thing you want to do is to include plenty of prebiotic fibers and other related compounds. Fibers, for instance, get fructo-oligosaccharides and inulin from foods like onions, garlic and other root vegetables. Galacto-oligosaccharides from legumes and root vegetables. Hyaluronic acid a very important one, even though it's not sourced from plants but from animals. You want to make a habit of this and if you're counting your prebiotic fibers, a minimum of 20 grams per day is a really comfortable number. That generates lots and lots of species diversity in your GI tract.
William Davis, MD:Another strategy to be aware of is clove green tea. It's my recipe for using clove as a source of the essential oil eugenol, and eugenol essentially doubles the thickness of intestinal mucus, at least temporarily. In green tea are green tea catechins like epigallocatechin that cause the mucin proteins in your intestinal mucus to cross link and thereby convert intestinal mucus from a semi-liquid to a semi-gel. And lastly, we include inulin and fructo-oligosaccharides as a powder, and this causes a bloom in butyrate, producing species like fecalobacterium and necromancia and this leads to a better mucus barrier, better intestinal barrier. So we make it as a clove green tea See my recipe in the Supergut book, page 246, but it's very easy.
William Davis, MD:It's a couple tablespoons of whole cloves. Don't use ground cloves, you want whole cloves. Put it in a saucepan with about two cups of water, bring to a boil, reduce the heat so that you can maintain a low boil for about 10 minutes and then put your green tea bag or whatever device you're using to make green tea A. Good choices include Trader Joe's Peek, piq-uet Crystals, newman's Own and Numie and UMI Organic Gunpowder Green Tea. These have been shown to have the highest catechin content. So you get that crossed linking effect and then you let it cool, add the inulin, fos, stir and then sip it.
William Davis, MD:This is really helpful, especially in the beginning when you're having a lot of die off or a lot of uncomfortable symptoms as you're killing off fecal microbes with your SIBO yogurt or whatever strategy you're using for killing off the SIBO organisms. Eating whole foods, as we do, also helps, because whole foods contain additional factors such as polyphenols, resveratrol, capsaicin that's the thing that makes peppers hot. Those things also have modest effects on improving gut health while also suppressing SIBO and endotoxemia. Probiotics can sometimes be helpful, but especially the bio-dequest sugar shift, the sponsor of this podcast. They have conducted a clinical trial to demonstrate a dramatic reduction in endotoxemia, and the omega-3 fatty acids and the vitamin D in our basic program also contribute to maintaining the mucus barrier and the intestinal barriers. They also contribute to reducing endotoxemia.
William Davis, MD:There you go, because we have such a benign potential solution to SIBO yogurt. What I'm calling SIBO yogurt, that is, the yogurt that we ferment for 36 hours with lactobacillus gastrolyte, lactobacillus rhodoride and bacillus coagulant so far has had a very high success rate. About 90% of people who've done this 50 people who've done this anecdotally have tested negative by the air device for hydrogen gas. I hope to perform a formal clinical trial to validate this, but it's so benign and so easy to do, doesn't cost very much. You make the first batch by acquiring those three commercial probiotics, but then future batches you can make from a little bit of a prior batch. And if you don't know what I'm talking about, please see my super gut book as well as my DRDAVSInfiniteHealthcom blog and you'll see that it's very easy to make these yogurts.
William Davis, MD:They're not really yogurt. Please don't get me confused. There's nothing to do with the stuff in the store. That's something completely different. That's kind of garbage the stuff they sell in the store because it's fermented too briefly and they use microbes that really don't have that much benefit. We are choosing microbes with very specific properties, such as upper GI or small intestine colonization and bactericin production. So please don't confuse what we're doing here with anything you buy in the store. Now, if you've learned something from this episode of the Defiant Health Podcast, I invite you to subscribe via your favorite podcast directory. Post a review, post a comment. Tell your friends. Let's build this movement of self-empowerment in health. Thanks for listening.
