Defiant Health Radio with Dr. William Davis
Defiant Health Radio with Dr. William Davis
The curious phenomenon of bacterial translocation that is key to so many health conditions
I’ve spent some time reflecting back on all my years practicing in hospitals, often not sleeping for extended periods, sometimes days, covering hospitals floors and ICUs, resuscitating people who experienced cardiac arrests, taking them to the cath lab to open arteries, but also witnessing people with all sorts of other health conditions: cancers, wound infections, sepsis, delirium, the various stages of dementia, and hundreds of other debilitating disease.
I now recognize that, looking back, so many health conditions can be better understood in light of the contribution of the microbiome, i.e., the trillions of microbes occupying the gastrointestinal tract from mouth to anus, the nasal sinuses, the airways, the brain, the prostate, the vagina and uterus, the skin—virtually every part of the human body. We all know about acute bacterial infections. But I’m talking about something different. While microbes exert effects via a number of different routes—think the gut-brain axis, the gut-skin axis, the gut-muscle axis, effects exerted via hormones, inflammatory mediating proteins, and bacterial breakdown products. But beyond this, there is a curious phenomenon in which bacteria and fungi themselves, by a number of means, travel through the body to take up residence and cause trouble. But the “trouble” is not an infection in the conventional sense, but something different, less acute, less urgent, less dramatic, but nonetheless playing a big role in your health. This is the fascinating and scary phenomenon called “translocation,” the topic for this episode of the Defiant Health podcast.
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I've spent some time reflecting back on all my years practicing in hospitals, often not sleeping for extended periods, sometimes days covering hospital floors and ICUs, resuscitating people who experienced cardiac arrest, taking them to the cath lab to open arteries, but also witnessing people with all sorts of other health conditions cancers, wound infections, sepsis, delirium, the various stages of dementia and hundreds of other debilitating diseases. I now recognize that, looking back, so many health conditions can be better understood in light of the contribution of the microbiome, that is, the trillions of the contribution of the microbiome, that is, the trillions of microbes occupying the gastrointestinal tract, from mouth to anus, the nasal sinuses, the airways, the brain, the prostate, the vagina and uterus, the skin, virtually every part of the human body. We all know about acute bacterial infections, but I'm talking about something different. While microbes exert effects via a number of different routes think the gut-brain axis, the gut-skin axis, the gut-muscle axis effects exerted via hormones, inflammatory mediating proteins and bacterial breakdown products. But beyond this, there is a curious phenomenon in which bacteria and fungi themselves, not their metabolites by a number of means travel through the body to take up residence and cause trouble. But the trouble is not an infection in the conventional sense, like pneumonia, but something different, less acute, less urgent, less dramatic, but nonetheless playing a big role in your health.
William Davis, MD:This is the fascinating and scary phenomenon called translocation, the topic for this episode of the Defiant Health podcast, and let me tell you about Defiant Health's sponsors Paleo Valley, our preferred provider for many excellent organic and grass-fed food products, and BiotiQuest, my number one choice for probiotics that are scientifically formulated, unlike most of the other commercial probiotic products available today. I'd like to also make you aware of a new source for our favorite microbe, lactobacillus roteri, and a skin formulation I designed that improves skin from the inside out. From the inside out. What is translocation? All that refers to is the ability of a bacteria or fungi, perhaps a virus, but we know very little about viral translocation. So mostly bacteria and fungi that can start from one place and then travel to another. This was a phenomenon that was not widely recognized until recently. In other words, it was unthinkable that a microbe, say in the airway, could find its way to another organ, another body part. Yet this phenomenon was right beneath our nose for many years. It was often dismissed. The translocation of a bacteria, for instance, was often dismissed as evidence of poor hygiene or just bad luck. For instance, staphylococcus aureus, a very common skin microbe, can cause sepsis, that is, it enters the bloodstream, or cause abscesses in other parts of the body. But there are many other examples of microbes that start in one place and end up in another and these are more likely to cause chronic conditions less commonly, acute conditions. Acute conditions are easy to recognize right If it's pneumonia or a urinary tract infection or a kidney infection, pyelonephritis or a skin infection or abscess, those are pretty easy to diagnose. I'm talking about much more difficult to pinpoint or diagnose chronic conditions that may not look like an infection, chronic conditions that may not look like an infection.
William Davis, MD:One great example is the mouth microbe Fusobacterium nucleatum. This is a microbe that's present in most people's mouths, the mouth microbiome but it proliferates out of control. When you have phenomena like bleeding gums or gingivitis or periodontitis, and Fusobacterium proliferates to abnormally high levels, you might not even be aware of it beyond the phenomena associated with the bleeding gums, gingivitis and periodontitis. But Fusobacterium, while you swallow it in your saliva, it doesn't seem to be very good at colonizing other parts of the GI tract until it colonizes the bloodstream. So whenever there's any kind of microtrauma to your mouth maybe it's toothbrushing or maybe it's flossing a Fusobacterium enters the bloodstream and then takes up residence in the colon, where the evidence is quite good that it is a major cause for colon cancer. If you take that Fusobacterium and put it in the colon of a normal mouse without cancer, it gets colon cancer. And the colon cancer in a human, as well as the metastatic lesions like in the liver, are filled with this microbe. So the evidence is pretty good that Fusobacterium in the mouth is an initiating factor in many cases of colon cancer. So that's a kind of a prototypical example of translocation, in this case from mouth to colon.
William Davis, MD:Now, as an aside, the gastroenterologists are tied up doing lots and lots of endoscopies and colonoscopies, mostly in the hope of identifying early colon cancer. Why haven't they yet embraced this idea that colon health and the avoidance of colon cancer shouldn't stop at just removing polyps, looking for polyps and removing them, but should involve a look at the oral microbiome and the colonic microbiome to set things right so that this does not allow the appearance of colon cancer? But that's not going to happen for another few generations probably. As current physicians become educated. The process takes a long time, many generations typically.
William Davis, MD:Another good example is candida, albicans and other fungal species. There's a Spanish group that's done a lot of research in this. They did something extraordinary they took the brains of young people who died, say, in car accidents, and then looked at the brain for the presence of fungi very rare fungi. They looked at the brains of elderly people who did not die of dementia but other causes, maybe cancer or car accident or a fall, and they had a moderate quantity of fungi riddling their brain. Then they looked at the brains of people who had dementia Alzheimer's dementia and their brains were filled with fungal species. They also looked at the presence of fungi in the cerebral spinal fluid that bathes the brain and spinal cord and the blood, and they found plenty of fungal proteins in DNA.
William Davis, MD:Now it's not clear what role these fungal species in the brain play in causing dementia. It could simply be an accompaniment, perhaps it is making it worse, but no one really knows for a fact. It's very difficult to figure that out because no living person wants a brain biopsy to find out right. But it is a good example of translocation of fungal species, that is, the fungi had to come from someplace else and then translocated, got access to the brain. Now, by the way.
William Davis, MD:That opens some very important questions. Where did they originate? My bet is that it came from fungal proliferation in the colon and possibly in the small bowel, sifo small intestinal fungal overgrowth. Another potential route of entry are the sinuses. Many people do have fungi in their sinuses and perhaps even the oropharynx, that is, the mouth. So no one really knows where these fungi originate. But the fact remains somehow, from some source, fungi can translocate to the brain. Another example of bacterial translocation is Porphyromonas gingivalis. This is an oral microbe. It's in your saliva and in your mouth and, like fungal species, can translocate to the brain. Now, like fungal species, it's not quite clear whether it's a causal factor in dementia or whether it's just an accompaniment Once again difficult to establish but it's yet another example of how a bacteria can gain access to another organ, in this case the brain.
William Davis, MD:Another issue to consider with regard to fungal species like Candida albicans, candida tropicalis and others is that you'll see this happen most commonly and flagrantly in people with diabetes type 1 or type 2, who, of course, have high blood glucose levels, and fungal species thrive on sugars. So you'll see people with diabetes type 1 or type 2, who have, especially if they have poorly controlled blood glucose levels, that is, they're having they're experiencing blood glucose levels, that is, they're experiencing blood glucose levels at 200 or 300 or higher. You'll see fungal overgrowth in the skin, such as under the arms, under the breasts, behind the ears, in the groin on the feet. So fungi thrive on those sugars. And it's also become clear that people with diabetes also have fungal infestation of their colon and small intestine as well, and it's likely that this may also serve as a repository or a source for translocation of fungi to the brain as well. So we see this phenomenon of fungal translocation most flagrantly in anybody with diabetes.
William Davis, MD:Another really interesting example of bacterial translocation is with the microbe Lactobacillus crispatus. This is a microbe that's meant to dominate the normal vaginal microbiome. So people with healthy vaginal lining and moisture and freedom from infections like candida or bacterial infections like E coli, people who have more Lactobacillus crispatus, are protected from those kinds of infections or infestations. Well, let's say, a woman loses her Lactobacillus crispatus are protected from those kinds of infections or infestations. Well, let's say, a woman loses her lactobacillus crispatus because, like other lactobacillus species, it's very susceptible to common antibiotics like amoxicillin or penicillin or many others. So if a woman loses crispatus she's more prone to vaginal infections, fungal infections, sexually transmitted diseases and even premature labor, premature delivery and miscarriage. So restoring lactobacillus crispatus can be very important for a woman's vaginal health.
William Davis, MD:Well, let's say a woman takes lactobacillus crispatus orally. It will come to translocate to the vagina. Now how does that happen? There is no connection between the gastrointestinal tract and the vagina. Now how does that happen? There is no connection between the gastrointestinal tract and the vagina. There is contiguity or nearness in the perineum, in the groin area. So we don't really know. No one knows how chrysoprase gains access to the vagina, but presumptively via translocation over the perineum. And then, even more remarkably, lactobacillus chrysoprase in the vagina, where it's doing good things, then comes to colonize the bladder, the urinary bladder, an area we thought was supposed to be sterile. It's not sterile. It has its own unique microbiome. It's not thickly colonized like the colon, but it still has nonetheless its own urinary bladder microbiome.
William Davis, MD:Well, restoring lactobacillus crispatus to the urinary bladder reduces the likelihood of repeated urinary tract infections dramatically, about 50%. It also reduces incontinence. So there's urge and stress incontinence, that is, a woman urinates involuntarily upon sneezing or upon laughing, or just has urgency and can't control when she empties her bladder, while restoration of lactobacillus crispatus reduces incontinence. Also, yet another example of a microbe crispatus that translocates from the gastrointestinal tract to the vagina, then to the bladder. Now, once again, there's no connection. There's no direct connection between the vagina and the bladder, so it's not quite clear how lactobacillus crispatus translocates from vagina to bladder. It is, once again near. Those two organs are very close to each other, they're contiguous, but there's no direct connection. So maybe it translocates via contiguity in the perineum, maybe some other method, but so far nobody knows. But it's a great example of bacterial translocation.
William Davis, MD:Now, before we go any further, let me tell you something about Defiant Health's sponsors. When we come back, let's talk about some more examples of translocation that are important to your health. The Defiant Health podcast is sponsored by Paleo Valley makers of delicious grass-fed beef sticks, healthy snack bars and other products. We're very picky around here and insist that any product we consider contains no junk ingredients like carrageenan, carboxymethyl cellulose, sucralose or added sugars, and, of course, no gluten nor grains. One of the habits I urge everyone to get into is to include several servings of fermented foods every day in your diet, part of an effort to cultivate a healthy gastrointestinal microbiome. Unlike nearly all other meat sticks available. Paleo Valley grass-fed beef, pork and chicken sticks are naturally fermented, meaning they contain probiotic bacterial species. Paleo Valley has also launched a number of interesting new products, including extra virgin olive oil, spice mixes, organic coffee, strawberry lemonade, super greens and essential electrolytes in a variety of flavors. And if you haven't already tried it, you've got to try their chocolate-flavored bone broth. Protein that makes delicious hot chocolate and brownies. See the recipes for the brownies in my drdavisinfinitehealthcom blog. Listeners to the Defiant Health podcast receive a 15% discount by going to paleovalleycom.
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William Davis, MD:Another very common example of bacterial translocation is when E coli gains access to the urinary bladder, but this time it comes from the colon. E coli, of course, is a colonic microbe. It's also a microbe of SIBO, small intestinal bacterial overgrowth. So it can also survive in the small intestine where it causes a lot of trouble body-wide, not just in the intestines via endotoxemia, as you'll recall, but E coli in the GI tract gains access to the bladder readily. It also gains access to the vagina so it can cause urinary tract infection. It's the most common cause of urinary tract infections. It's also a common cause of a bacterial vaginitis, which is very annoying, very irritating, painful for ladies. Now we know with good confidence that E coli gains access to those two other organs via surface translocation, that is, via contiguity in the perineum. There may be another way, but that's the only way I'm aware of. That is by contamination of the perineal area from stool. I know it's not the most pleasant idea, but it's likely the explanation for the way E coli gains ready access to the vagina and to the urinary bladder.
William Davis, MD:Bacteria can also translocate or leap from one person to another. There are numerous examples of this, even beyond infectious diseases, like the flu, say, or COVID-19. Most of this happens via intimate contact, for instance Helicobacter pylori. You may know that this H pylori microbe is a common inhabitant of the stomach. It used to be half of the US population. Now it's down to 15% because of efforts to eradicate the microbe with antibiotics.
William Davis, MD:Eradicating H pylori can be important because it can lead to ulcers as well as stomach cancer. So H pylori in the stomach also in the mouth can be transmitted from one person to another. So let's say you had it identified in your stomach and you took the cocktail of antibiotics and eradicated it in the stomach, but a few months later it comes back. One of the reasons it can come back is because it also colonized the mouth in many people. That's also how you pass it on to somebody else. Via intimate contact, via kissing, you can give somebody H pylori in the mouth and thereby in the stomach. So this takes specific efforts to eradicate both stomach populations as well as oral populations so that you don't pass it on and translocate your H pylori to somebody else.
William Davis, MD:The lactobacillus crispatus microbe that I discussed earlier, that a woman has and can be recolonized with in her GI tract and then the vagina and then the bladder, can be passed on via sexual intercourse to her male partner, where there's preliminary evidence that Crespatus, while we think of it as a female microbe, can also be a male microbe that appears to reduce prostate inflammation, which may be a driving factor in such things as benign prostatic hypertrophy, bph, and perhaps even prostate cancer. Now, that evidence is preliminary, but it could be very exciting this idea that a woman passes on to her male mate lactobacillus crispatus that may translate into improved prostate health. Another example of translocation from one person to another are the two Staphylococcus species Staphylococcus aureus, a pathogen, a very dangerous pathogen, and Staphylococcus species Staphylococcus aureus, a pathogen, a very dangerous pathogen, and Staphylococcus epidermidis, more likely to be just a benign or beneficial species. Now, those two microbes live on the surface of your skin and people who have diseased skin, like acne, psoriasis, rosacea, seborrhea, eczema they tend to have a lot more staphylococcus aureus, both in the areas of the rash or the lesions, as well as in other areas. So even if you have eczema, say in your hands or your arms filled with staphylococcus, you can still have lots of staphylococcus on your legs or your back or your chest. So people with these skin problems tend to have body-wide Staphylococcus aureus colonization, which is not healthy. People with healthier skin, without those skin conditions, tend to have more Staphylococcus epidermidis, a more benign and often beneficial microbe. But you can pass both of these, as well as other skin microbes, on to people you have intimate contact with, such as in sports or, of course, a relationship, and so another example of bacterial translocation, in this case from one person to another.
William Davis, MD:And another excellent example of bacterial translocation occurs with both birth and breastfeeding. So at birth the mother is meant to pass on numerous microbes to the baby, but a very important microbe is Bifidobactera infantis. Because if the mother passes that on to the child by its passage through the birth canal or breastfeeding or just contact, that child is better able to metabolize the human milk oligosaccharides that mom provides in breast milk. These are essential for neurological and immunological maturation. In other words, if the baby does not have this microbe, it cannot metabolize those human milk algosaccharides and will have impaired neurological maturation. It'll have more susceptibility to asthma, type 1 diabetes and other autoimmune conditions. It will be more likely to be obese and have type 2 diabetes as a teenager and will have a lower IQ. So it's essential that the mother translocates Bifidobacteria infantis from vagina or breast milk or skin contact to the child and this becomes the dominant microbe in the child's microbiome for the first year of life. Another example is the translocation of my favorite microbe, lactobacillus roteri, that we make yogurt out of for high bacterial counts, either with passage through the birth canal or with breastfeeding giving it to the child. Lactobacillus roteri will not become a dominant microbe in the gastrointestinal microbiome of the infant but will become a dominant microbiome later on in life. But will become a dominant microbiome later on in life. Unfortunately, as you recall, lactobacillus reuteri is also very susceptible to common antibiotics, so the mother may not even have had it in the first place to pass on to the child, or the child received antibiotics at birth or later on in life and it wiped out the entire population of lactobacillus reuteri. Nonetheless, lactobacillus reuteri passed from the mother through breast milk and the vaginal canal to the child.
William Davis, MD:Another example of bacterial translocation. Another example of bacterial translocation is that if you have gallstones or pancreatic cancer and you examine it using DNA methods, you will find fecal microbial species in the gallstones and in the pancreatic tumor. Now how did they get there? Because the source of fecal microbes like E coli and Klebsiella are 24 feet, 24 feet down from the gallbladder or the pancreas. So how do fecal microbes that originate in the colon gain access to those organs? 24 feet up the gastrointestinal tract. Once again, translocation. So you can see this becoming an extremely common and frequent phenomenon in many people. So you can appreciate that we live in a world, a microbiome world, where our bodies are having all sorts of translocations of many species. The full extent of this has not been fully mapped out, but it is opening doors and shedding light on new ways to understand disease and disruption of the microbiome.
William Davis, MD:Now you can readily see there are several strategies that can reduce the likelihood of these various translocating phenomena. For one, pay attention to oral hygiene. Make sure, for instance, that dental flossing or other methods of breaking up the bacterial biofilm on teeth is broken up every day. Of course, have your dentist address the gingivitis or periodontitis and you can even do an oral microbiome test to see if you have such microbes overgrown like Fusobacterium nucleatum that can prevent colon cancer, or Porphyromonas gingivalis that may have a role to play in dementia. You can see that, making sure you have a normal or healthy vaginal microbiome, you can also do a vaginal microbiome test and if you lack lactobacillus crispatus, you can restore it and thereby gain also protection against urinary tract infections and incontinence.
William Davis, MD:Addressing SIBO and SIFO small intestinal bacterial overgrowth and small intestinal fungal overgrowth, as well as colonic dysbiosis and fungal overgrowth, also likely limit the ability of bacterial and fungal species to transmigrate to other parts of the body. This may be especially important in SIBO, that is, small intestinal bacterial overgrowth, because when you have fecal microbes infesting the small intestine it increases the already permeable, very permeable small intestine and allows translocation into the bloodstream, into the lymph and thereby to other parts of the body. Now, if you've learned something by listening to this episode of the Defiant Health Podcast, I invite you to subscribe through your favorite podcast directory. Post a review, post a comment. Help me build this movement of self-empowerment in health. Thanks for listening.
