Defiant Health Radio with Dr. William Davis
Defiant Health Radio with Dr. William Davis
Managing Endotoxemia: Key to SO Many Aspects of Health
I’ve touched on the topic of endotoxemia in past episodes of the Defiant Health podcast. In this episode, let’s dive deeper into this topic that is absolutely crucial to understanding and managing SO many aspects of health, from subduing anxiety and panic, to depressive, to joint pain and skin rashes, to gastrointestinal conditions, even weight management.
What is endotoxemia? Fecal microbes, so-called Gram-negative species because of the way these microbes take up stain for examination under a microscope, species such as E. coli and Salmonella, have something called lipopolysaccharide endotoxin in their cells walls. Other species, so-called Gram positive species such as Enterococcus, Staphylococcus, and Streptococcus, that stain in a different manner, have something called lipoteichoic acid in their cell walls. When these microbes die, both Gram-negative and Gram-positive, these toxic factors are released into the intestines. If these fecal microbes are confined to the colon, where they belong, a section of GI tract adapted to their presence, the entry of these toxic components are limited and current evidence is unclear in how importat this process is. The real trouble occurs, however, when fecal microbes have invaded the 24-feet of small intestine, a process we label small intetinal bacterial overgrowth, or SIBO, because the small intestine—the stomach, duodenum, jejunum, and ileum are not well-adapted to the invasion of fecal species. Here, they die, release their toxic components, which then enter the bloodstream, the process labeled endotoxemia. People with SIBO therefore have high blood levels, typically 200-400% higher, levels of endotoxin. This is how microbes in the GI Tract export their effects to all other parts of the body. So let’s discuss this process and how you can take control over it to be be better able to take control over your emotions, mood, sleep, energy, weight, and numerous other aspects of health.
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Super Gut: The 4-Week Plan to Reprogram Your Microbiome, Restore Health, and Lose Weight
I've touched on the topic of endotoxemia in past episodes of the Defiant Health podcast. In this episode, let's dive deeper into this topic that is absolutely crucial to understanding and managing so many aspects of health, from subduing anxiety and panic to depression. Aspects of health from subduing anxiety and panic to depression, to joint pain and skin rashes, to gastrointestinal conditions, even weight management. What is endotoxemia? Fecal microbes, so-called gram-negative species. Because of the way these microbes take up stain for examination under a microscope, species such as E coli and Salmonella have something called lipopolysaccharide endotoxin in their cell walls. Other species, so-called gram-positive species, such as enterococcus, staphylococcus and streptococcus, that stain in a different way, have something called lipotychoic acid in their cell walls. When these microbes die, either gram-positive or gram-negative, these toxic factors are released into the intestines. If these fecal microbes are confined to the colon, where they belong, a section of the GI tract adapted to their presence, the entry of these toxic components are limited and current evidence is unclear on how important this process is. The real trouble occurs, however, when fecal microbes have invaded the 24 feet of small intestine, a process we label small intestinal bacterial overgrowth or SIBO, s-i-b-o, because the small intestine, the stomach duodenum, jejunum and ileum are not well adapted to the invasion by fecal species. Here they die, release their toxic components, which then enter the bloodstream, a process labeled endotoxemia. People with SIBO therefore have high blood levels, typically 200 to 400% higher levels of endotoxin in their bloodstream. This is how microbes in the GI tract export their effects to all other parts of the body. So let's discuss this process and how you can take control over it, to be better able to take control over your emotions, mood, sleep, energy, weight and numerous other aspects of health. And let me tell you about Define 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 make you aware also of a new source for our favorite microbe, lactobacillus roteri, and a skin formulation I designed that improves skin from the inside out. So endotoxemia is this bacterial process in which fecal microbes microbes that originated in the colon have overproliferated and when they die they release their toxic compounds, such as that lipopolysaccharide and the lipoticoic acid I mentioned. Now it's not entirely clear just how bad endotoxemia can be if those fecal microbes remain where they're supposed to be Now.
William Davis, MD:An overproliferation of some of these microbial species in the colon does have implications, such as increased risk for colon cancer, diverticular disease and some other conditions unique to the colon. But it appears to be the biggest problem is when those fecal microbes over, proliferate and then ascend into the 24 feet of small intestine, and this can be quite bad. For instance, people who are in their beyond age 65, it's not uncommon for them to have severe stomach dysbiosis with fecal microbes. It's not uncommon to have fecal microbes recovered from gallstones. The gallbladder and the biliary tract that empties into the duodenum is 24 feet up from the colon. 24 feet, that is three times the height of your ceiling, of the room you're probably sitting in right now. Yet those fecal microbes have managed to colonize the gallstones 24 feet higher, where they don't belong. Another example of how bad this process of small intestinal bacterial overgrowth can be. It's not uncommon for someone to have pancreatic cancer For that cancer to be examined. It's once again like those gallstones filled with fecal microbes. Well, how'd they get there? The pancreas, likewise, is 24 feet up from the colon. Well, once again, the footprints of small intestinal bacterial overgrowth, and this is incredibly common. We're not talking about something that happens to other people only. We're talking about at least at least conservatively estimated one half the US population, something on the order of 160 million people, have it.
William Davis, MD:I was skeptical that this could be true, even though the evidence tells us it is. Until the consumer device, the AIR device remember that A-I-R-E made by the Food Marble Company that tests for hydrogen gas gas as well, as now the current device measures methane also, but it's hydrogen gas we're mostly interested in and we use it as a mapping device to tell us where these fecal microbes are living in the gi tract. Are they living in the colon, where they're supposed to be, or had they ascended into the 24 feet of stomach, duodenum, jejunum and ilium? Now, if you don't know what I'm talking about, refer to prior episodes of the Fine Health Podcast, my blog WilliamDavisMDcom, as well as my Super Gut book, and it tells you how and why to use the air device. It's a consumer device. You do not need the participation of the doctor, you don't need to get the air device to do all these things, but it's just one of the things to be aware of.
William Davis, MD:So it's this process of small intestinal bacterial overgrowth that we're mostly interested in, where trillions, trillions of bacteria, fecal species, are living in the 24 feet of small intestine and when they die they release their toxic compounds of small intestine. And when they die they release their toxic compounds, especially endotoxin, lipopolysaccharide, endotoxin and lipoticoic acid, that enter the bloodstream. And this is how a disruption of the gastrointestinal microbiome enters the bloodstream and exports the effects to all other parts of the body. So, yes, a disruption of the gastrointestinal microbiome can affect your brain or your thyroid gland or your airway or your oral cavity or your skin or your prostate or your uterus or just any other organ. A lot of this is driven not entirely other processes that microbes can participate in that cause disease, but a big part of this is driven not entirely other processes that microbes can participate in that cause disease. But a big part of this is this endotoxemia of the two kinds of toxins.
William Davis, MD:Can we measure it? How do you measure whether you have an increased level of lipopolysaccharide or lipoptychoic acid? Well, unfortunately these remain research tools not clinically available. You can't go to LabCourse, say, or Quest Diagnostics and get these things measured, perhaps in the future. But the reluctance is that they are not the best methods because the lipopolysaccharide measurement, for instance, only measures the we say LPS, the LPS of only selected species. So for instance, if we measure the LPS of E coli and Klebsiella it might miss the LPS of other species and it underestimates the severity of the endotoxemia. But existing evidence tells us that in people with endotoxemia typically have 200 to 400% increase in blood levels of LPS endotoxin. My personal view is even that flawed or underestimated measurement could still be helpful. So I'm hoping at some point we can make these measurements outside of research and do them clinically, because of this difficulty in trying to quantify the severity of endotoxemia.
William Davis, MD:A second best is to measure hydrogen gas on the breath, as I mentioned, because microbes produce hydrogen gas when fed properly, that is, fed a prebiotic fiber or sugar. You cannot on your own produce hydrogen gas. So we can use the timing of how quickly hydrogen gas is released when you ingest something. We use inulin, the fiber inulin, and depending on how fast hydrogen gas is produced from the conversion of inulin to hydrogen gas, we can use that to map where microbes are living. So that whole protocol is in my blog, is in my Super Gut book, if you're interested.
William Davis, MD:Now endoscopy can be used but it's not very public because it requires an invasive procedure and when they do an endoscopy upper endoscopy they can retrieve some of the liquid in your duodenum or your jejunum and they can look at it. Unfortunately, most clinics and hospitals don't have DNA testing for this specific purpose available and they culture that liquid. Well, that's a flawed method because the vast majority of species that invade the small intestine that is SIBO cannot be cultured, and so if they culture it, it's only of limited usefulness. But if it's positive for a lot of fecal microbes, you know you've got SIBO. But don't rely on this method because it underestimates the severity of SIBO. It's only helpful when it's positive when a culture is done.
William Davis, MD:How about stool testing? Well, stool testing is useful, but think of stool testing as a rectal test, that is, a testing of a sample of rectal stool. It does not necessarily reflect the microbiome composition, say, of the ileum about five feet up from the rectum or the jejunum or the duodenum. So it can be helpful, but it really can't be used to diagnose SIBO specifically, because you really need to know where those fecal microbes are living. So stool testing can't tell you that. The best stool testing can do is if you submit a sample and you see lots of those gram-negative species like E coli, klebsiella, salmonella or a lot of those gram-positive species, especially Streptococcus, staphylococcus and Enterococcus. It hints at the presence of SIBO, even though it's taken from a rectal test or at the very least you have colonic dysbiosis. So it still can be very useful. And you know what? The methods, the strategies to correct rectal or colonic dysbiosis are not that different from the strategies to correct SIBO. So even though you really can't diagnose SIBO from stool testing, you can at least safely presume that SIBO is present if you see these kinds of patterns of excessive quantities of gram-negative or gram-positive microbes in the fecal sample obtained from the rectum.
William Davis, MD:Now there are numerous other laboratory measures that can hint at the presence of endotoxemia, but they're not specific for endotoxemia. But they're not specific for endotoxemia. They can suggest to you that something is continuing to drive metabolic distortions from endotoxemia. These mostly drive factors such as insulin resistance and inflammation. Recall that insulin resistance is the process in which your body's organs liver, muscle, brain do not respond normally to insulin. So your pancreas compensates by overproducing huge quantities of insulin and that leads to its own collection of problems, including an expansion of abdominal fat, increased likelihood of high blood pressure, high blood sugar, fatty liver, coronary disease, atrial fibrillation, cognitive impairment, breast cancer risk, etc. So these two processes insulin resistance and inflammation are very important in driving risk for many diseases.
William Davis, MD:So these measures that can suggest that endotoxemia is at work, making these measures worse, includes triglycerides. A higher triglyceride suggests endotoxemia. Low HDL, higher blood glucose, higher fasting insulin, especially above four microunits, and increased measures of inflammation, such as C-reactive protein or interleukin-6. Now here's another twist to all this. If you're on my programs in which we address diet no wheat, no grains, no sugars we address common nutrient deficiencies that drive insulin resistance and inflammation, like omega-3 fatty acids, magnesium, iodine, vitamin D, and then we take basic steps to address the disrupted gastrointestinal microbiome. And then we take basic steps to address the disrupted gastrointestinal microbiome. Well, if you've done all these things, you've lost weight and now your weight has plateaued. Maybe you lost 40 pounds doing these kinds of things, but your weight has plateaued for the last four weeks or more If you're left with any of those measures I mentioned high-ish triglycerides anything above 60 milligrams per deciliter.
William Davis, MD:Low HDL anything below 60 milligrams per deciliter. Blood glucose higher than 100 milligrams per deciliter. Low HDL anything below 60 milligrams per deciliter. Blood glucose higher than 100 milligrams per deciliter, higher blood insulin above 4 micro units or any C-reactive protein above 1.0 milligrams per deciliter. Those are all suggestions that endotoxemia is still ongoing and that specific efforts need to be made. In other words, those measures are not perfect. Those measures should be perfect on my programs Triglycerides less than 60. Hdl greater than 60. Blood glucose 60 to 90. Insulin almost zero, c-reactive protein almost zero. They should all be near perfect on the program, but if they're not, they can serve as a therapeutic test, a red flag that there's some level of endotoxemia, sibo and therefore endotoxemia driving these abnormal factors.
William Davis, MD:How common is this? How common is it to have SIBO and thereby endotoxemia in some form? Extremely common. All we have to do is look at the several dozen studies done in humans that ask this question. Now, if you've read my super guide, you already know these arguments. But nonetheless, for review, if we ask, for instance, in condition blank, what proportion of people test positive for SIBO, usually using hydrogen gas or some variation. So how about irritable bowel syndrome, IBS? Well, there's 60 to 70 million Americans with IBS and while the results vary from study to study, about 31% will test positive for SIBO. So that's 31% of 60 to 70 million? Well, that's 18 to 20 million or so people right there.
William Davis, MD:How about the 110 or so million people in the US who are obese? How many test positive? What percentage test positive for SIBO? 50%, well, that's another 50, some million people to add to the list. How about type 2 diabetes? 37 million people. 50% would test positive. Add another 18 million.
William Davis, MD:Now add on fibromyalgia, restless leg syndrome, sleep apnea, various forms of inflammatory bowel disease like ulcer of colitis and crohn's disease, neurodegenerative disorders like Alzheimer's or Parkinson's disease. How about autoimmune diseases? Add those all. There's going to be some overlap. Right, an obese type 2 diabetic with fatty liver, but you can see that we rapidly exceed 150 million people. We don't have a precise number, but we don't need to. You know that this is exceptionally common. Look to your left, look to your right. You're going to see at least one, if not two, people with SIBO, who often are not aware of it, that this is driving their diseases. And without specifically addressing the SIBO and endotoxemia you can never hope to have Now let's pause for a moment for a word from the sponsors of the Defiant Health Podcast. When we come back, let's consider many of the most common conditions in which SIBO and endotoxemia are major driving forces, and then we'll conclude with what you can do about it to stop this.
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William Davis, MD:Now let's get back to our discussion. Let's first consider overweight, obesity and the expansion of abdominal fat. For the sake of illustration, let's assume you start this process without SIBO and you're slender and don't have a lot of abdominal fat. Of course that's not. You start this process without SIBO and you're slender and don't have a lot of abdominal fat. Of course that's not the case for many people. They've got abdominal fat and are overweight because of overconsumption of sugars, grains and other junk foods, ultra-processed foods. But for the sake of illustration, for the sake of argument, let's assume you start in good health with only minimal abdominal fat and you're not overweight. Start in good health with only minimal abdominal fat and you're not overweight. Well, you develop SIBO for whatever reason. Maybe you took a course of antibiotics, maybe you've been overexposed to the glyphosate in grain products, maybe you eat too many processed foods with additives like emulsifying agents or preservatives that are antimicrobial. For whatever reason, you develop SIBO and thereby endotoxemia.
William Davis, MD:Recall that endotoxemia drives insulin resistance and inflammation that causes the expansion of abdominal fat. Abdominal fat, of course, is the form of fat that is inflammatory and makes insulin resistance worse. So you can appreciate what is getting started. Here is a vicious cycle, right SIBO, endotoxemia, resulting in insulin resistance and inflammation, which causes expansion of abdominal fat, and weight gain, which in turn, worsens insulin resistance and inflammation, which causes further expansion of abdominal fat. That, in turn, amplifies the insulin resistance and inflammation around and around and around in this awful vicious cycle that is very difficult to break if all you do is change your diet. So, while changing diet is very important, addressing those common nutrient deficiencies like vitamin D and magnesium that help regulate insulin responses you also have to address the SIBO and endotoxemia that is driving these processes. In a similar way, type 2 diabetes high blood glucose from excessive levels of insulin resistance and inflammation is driven by SIBO and endotoxemia. Inflammation is driven by SIBO and endotoxemia. So while, yes, you can do things like cut your carb content, get vitamin D those are all very important you can also go farther by addressing the SIBO and endotoxemia.
William Davis, MD:I would like you to ignore the people, many of them the American Diabetes Association. Most doctors, including endocrinologists, say that once you have type 2 diabetes, you can never not have type 2. This is patent nonsense. There's more than ample evidence to tell us that type 2 diabetes in most not all, but in most cases. There are some exceptions in most cases is completely reversible or at the very least, you can further. You can reduce measures like hemoglobin a1c to the very lowest possible range.
William Davis, MD:I, for instance, was a type 2 diabetic about 40 years ago. It lasted maybe six months until I understood what was going on and, by the way, that developed in me when I follow a strict low-fat vegetarian diet, even though I was jogging several miles a week. I was riding my bicycle playing tennis. I was in my 30s, so a long, long time ago. Yet I developed type 2 diabetes. I stopped eating badly that is, eating a low-fat vegetarian diet added back oils, fats and started limiting carbohydrates instead and became confidently non-diabetic, and have remained so for the last 40 years. So don't listen to the people who say you cannot undo it. The rare exceptions are people who've done irreversible damage to their pancreases, and you'll know that if you do everything right, you've lost the weight, you've addressed endotoxemia, you've restored vitamin D, magnesium, omega-3 fatty acids and iodine, your thyroid's in good shape, yet you still have some measure of insulin resistance or type 2 diabetes that tells you you've damaged your pancreas. Thankfully, that's less than 5% of people who are currently type 2 diabetic, meaning the great majority over 90% have the capacity, if given the right tools, to undo completely, reverse type 2 diabetes.
William Davis, MD:Coronary disease Coronary disease or coronary atherosclerosis is the process, of course, that leads to heart attack. Sudden cardiac death leads to procedures like stent implantation and bypass surgery which, becoming clear, if you have coronary disease meaning you had a heart attack or you had a procedure like a stent implantation or you had a positive coronary calcium score, say, of 200 or 700 or whatever you have endotoxemia, sibo and endotoxemia driving the expansion of coronary atherosclerotic plaque. Even worse, endotoxemia seems to drive events that is, the rupture of so-called soft plaque, the fatty elements in atherosclerotic plaque. That rupture and that's what causes the internal contents of that plaque to be exposed to circulating blood rushing past and that provokes blood clot. And so, while blood clot is not the primary process, it's a consequence. It's the coronary disease that's being driven by endotoxemia. Inflammation in the atherosclerotic plaque leads to plaque rupture. So seabone endotoxemia, major players in all the various ways that coronary disease can show itself.
William Davis, MD:Atrial fibrillation is very common. Abnormal heart rhythm in which the top little sacs of the heart ordinarily low pressure and you're not even aware that these things are contracting in your heart. When you feel your heart beat by the way, that's the major pumping chamber, the left ventricles you don't really feel the atria on top, the right and left atria. You don't feel them, but they're contracting and contributing to the output of your blood flow from your heart. When the atria are exposed to endotoxemia, they gradually develop fibrosis or fibrous tissue deposition into the walls of the atrial muscle and that causes chaotic rhythms, chaotic electrical rhythms that result in this rhythm called atrial fibrillation.
William Davis, MD:Typical experience Someone's just sitting minding their own business, maybe watching TV, and they all of a sudden are breathless, lightheaded. They check their pulse Rather than a normal 70 or so beats per minute, it's 150 or 160 or something like that, and you feel breathless. You go to the ER. They thin your blood with an anticoagulant to prevent the stroke that can come from this rhythm. They slow the rhythm down so that you can catch your breath and then over time they do other things like try to convert the rhythm with medications very dangerous by the way, or what's called cardioversion, where they give you a shock to the chest to break the rhythm and some other methods. It's something you don't want.
William Davis, MD:Atrial fibrillation once you develop it tends to rule your life. You're back and forth to the emergency room having recurrences. They sometimes then tell you to have it ablated, where they take catheters and they burn out the source of the rhythm. Sometimes it's effective, sometimes it's not. Bottom line here, major driver of both the development of atrial fibrillation and the very frequent recurrences is endotoxemia. Sadly, once you've developed atrial fibrosis that is, fibrous replacement of atrial muscle tissue with fibers it becomes harder and harder to control the recurrences of this rhythm, even if you address endotoxemia. So the key is to address endotoxemia as early as possible, before irreversible changes develop, such as atrial fibrosis, skin rashes.
William Davis, MD:It's become clear that some of the more complex skin rashes, especially rosacea and psoriasis, are driven largely by seabone endotoxemia. So once again, an example of how body part skin far away from the gastrointestinal tract is influenced by what goes on in the gastrointestinal tract. Now there's more to skin rash than this. There's also disruption in the skin microbiome, such as the provocation of the pathogen Staphylococcus aureus instead of the beneficial microbes Staphylococcus epidermidis. Please see my other Define Health podcast episodes and my blog for a conversation about that. But know that a driving initiating factor is endotoxemia from your GI tract and if you want control you can take those biologics that blocks one part of a pathway that leads to skin inflammation. But why not go to the root source, endotoxemia that initiated that inflammation in the first place?
William Davis, MD:Cognitive impairment, all the phases and degrees of cognitive impairment, early cognitive impairment, early dementia, well-established alzheimer's dementia. A big player is SIBO and endotoxemia. That's why if you ask anybody who's got cognitive impairment, ask them about their gastrointestinal health, they'll say well, I'm either constipated or have intermittent diarrhea or abdominal pain. They have other problems, gastrointestinal problems, because a driving force here once again is SIBO and endotoxin or, at the very least, colonic dysbiosis. So you can imagine you can take those silly drugs for cognitive impairment, the so-called acetylcholinesterase inhibitor drugs, very expensive, that do almost nothing for improving memory and certainly do not do anything in slowing the progression of the disease. So you need to get at the root cause, in this case the thing driving endotoxemia, and that's where you start to regain control over cognitive health.
William Davis, MD:Cancers it's becoming clear that numerous forms of cancer are driven by SIBO and endotoxin Gastrointestinal cancers like pancreatic cancer or colon cancer or small intestinal cancers or gallbladder cancer or liver cancer, but also cancers outside the gastrointestinal tract Breast cancer, prostate cancer, other cancers. In fact, I call endotoxemia the uber risk factor for cancer, that is, it's responsible for so many forms of cancer. Maybe there's more to do to prevent cancer beyond addressing endotoxemia, but knowing that endotoxemia is a major driver gives you the key to reduce cancer risk dramatically across numerous organs. Female health, the two ends of female health, reproductive age when you're having children and menopausal and postmenopausal the microbiome plays a huge role. A disrupted vaginal so we're talking about vaginal and gastrointestinal microbiome leads to unhealthy things like eclampsia and preeclampsia in pregnancy that can lead to seizures in the mother and the child and threaten the survival of either or both Endometriosis very painful condition driven by endotoxemia. Premature labor and miscarriage driven by both a disrupted vaginal microbiome and a gastrointestinal microbiome. Even difficult or turbulent menstrual cycles with a lot of pain and cramping or excess bleeding, also driven by the vaginal and the gastrointestinal microbiome. Now, this is one area I won't fully cover in this episode of the podcast. I'll cover this separately, or see my Super Gut book or my blog, williamdavismdcom. You'll see several conversations about the unique features of a disrupted female microbiome and what steps you can take both for the gastrointestinal and the very important vaginal strategies you can adopt to reduce the risk for all those health conditions.
William Davis, MD:How about mental or emotional effects? What's become clear? That the gastrointestinal microbiome, via endotoxemia, is a major driving force. A major driving force in numerous aspects of mental health depression, anxiety, panic attacks, uncertainty, that feeling of you don't really know what you're doing, hatred, violence, social anxiety, anxiety in social settings and numerous others. These are, to an astounding degree, phenomena driven by a disrupted gastrointestinal microbiome via blood-borne endotoxemia. For similar reasons, disruption of sleep and nightmare dream content, largely influenced by what's going on in your gastrointestinal system and your bloodstream. So if you're struggling with sleep frequent interruptions, early morning awakenings, nightmares, unhealthy dream content think about endotoxin as a driver of those phenomena.
William Davis, MD:Now here's a twist it's shocking how many people have no symptoms. So people often say I have no symptoms of diarrhea or bloating or abdominal discomfort, I must therefore not have SIBO. Not true? Remarkably, this fact is often overlooked. If we looked at all those studies we talked about, in which we asked, in condition blank, what proportion tests positive for SIBO? Well, those people, let's say, with irritable bowel syndrome or ulcerative colitis or obesity or type 2 diabetes, are compared to so-called healthy controls. These are people chosen for comparison in these studies because they lack those conditions and lack any symptoms of gastrointestinal disease. They don't have bloating, they don't have diarrhea, they don't have constipation. They have no symptoms. What proportion of those people purported healthy control people test positive? Well, it varies widely from study to study, but typically 20 to 30% or so test positive for SIBO. In other words, you can take what appear to be healthy control people with no gastrointestinal symptoms, no coronary disease, no atrial fibrillation, no rosacea, nothing. Yet they still test positive. About a fifth to a quarter or even a third of those people test positive. And accepting that the methods of testing likely underestimate how many people do test positive, but recognize that the lack of symptoms does not necessarily mean you're not heading to a level of endotoxin that could trigger such things as atrial fibrillation or fibromyalgia or weight gain.
William Davis, MD:Now let's talk about how to correct this. Now, if the solution was something drastic, like surgical removal of your small intestine, well, we better be absolutely certain, as certain as we can be, that this situation applies to you and that a surgical solution is necessary. But what if the solution is something that looks and smells like yogurt? It's not yogurt, but it looks and smells like yogurt that you can make in your kitchen, and that's what I call SIBO yogurt. This is a recipe or formulation I created by asking this simple set of questions. If you have SIBO right 24 feet of small intestine, bacterial overgrowth, thereby endotoxin, but driving all those processes we talked about, what if you just took a commercial probiotic off the shelf from the health food store or the big box store? Will this process go away? No, those studies tell us you cannot take a probiotic and expect SIBO to recede completely. It might be reduced slightly, you might experience a little reduction bloating, for instance, or some phenomenon associated with SIBO like a skin rash but it will not get rid of the SIBO.
William Davis, MD:So I asked a different set of questions. I asked what if we specifically chose microbial species that are known to colonize the small intestine? That's where SIBO occurs, right, that's where the increased permeability that allows endotoxins to enter the bloodstream. So what if we chose species that colonize the small intestine where all this occurs, and also produce bacteriocins? These are natural antibiotics effective in killing fecal microbial species, both gram-negative and gram-positive. I chose three. I chose a strain of lactobacillus reuteri, a strain of lactobacillus gasseri and the spore-forming microbe bacillus coagulans, because all three will take up residence or will germinate in the small intestine and produce bacteriocins. So I call this SIBO yogurt.
William Davis, MD:We're going to use my method of extended or prolonged fermentation because microbes don't have sex right. There's no male and female microbes, they just double themselves. Well, lactobacillus rhodori, which is probably the most important of the three, we use doubles every three hours at human body temperature, every three hours at human body temperature. So let's ferment it for 36 hours, or 12 doublings. We count the microbes using something called flow cytometry and we get 300 billion microbes per half cup or 120 milliliter serving. We do that for four weeks and so far this has exceeded my expectations.
William Davis, MD:By the way, I initially formulated this I didn't think it would get rid of SIBO. I thought it might help people get some relief from some of the symptoms of SIBO, like bloating and diarrhea. To my great surprise, with the availability of the air device that tests and maps where microbes are living fecal microbes in the GI tract, lo and behold, we're seeing about a 90% success rate when this SIBO yogurt is consumed every day for four weeks. Now some people an occasional person has SIBO so bad that they have to do it for months. These are people who say things like I've taken an antibiotic for the last three years for this or that process, like acne or something like that. Those people have SIBO to such an extreme degree that a prolonged course of the SIBO yogurt is required. But no, it's just something that looks and smells like yogurt and so far it has exceeded expectations.
William Davis, MD:In normalizing breath hydrogen gas, the only caution is that lactobacillus reuteri itself can cause release of hydrogen gas. Hydrogen gas is not per se harmful. It's just a reflection of fecal microbes in the small intestine. But oddly, lactobacillus roterite shares that capacity to convert inulin that we use to provoke this to hydrogen gas. So if you're going to test at the end of your SIBO yogurt course, you have to stop the SIBO yogurt for two weeks, then test and you can see whether you're positive or negative.
William Davis, MD:Or you can watch some symptom Like is your food intolerance better? If that's true, you got rid of SIBO. Is the fat malabsorption? Fat drops in the toilet. Has that stopped? That means you reversed SIBO? Is your sleep disruption much improved? You've likely reversed SIBO, so you always use one of those signs to tell you whether or not your SIBO has been corrected or not. But you know what? I kind of regret calling it SIBO yogurt, because it makes it sound as if it's only useful for management of SIBO, which is not true.
William Davis, MD:Especially, rotaroy has benefits far beyond just reduction of SIBO and endotoxemia. Recall that Rotarot can do all kinds of things via its capacity to provoke release of oxytocin from your brain, as well as colonizing the GI tract, the entire length of the GI tract, and producing bactericids. So you can expect all kinds of other effects an increase in empathy and generosity, a return of youthful musculature, an increase in libido, reduction in waist circumference, abdominal fat, so many other things. So for that reason and because SIBO recurs, the rule is recurrence. You may have had a successful eradication and then it comes back in three, four, five or six months.
William Davis, MD:So while we use the SIBO yoke for four or more weeks, it's also a good idea to continue to get it two or three times per week for the rest of your life or until we figure out how to make rhodorite and those other microbes take up permanent resins. No one has figured that out yet. So until then we continually or occasionally re-implant those species to keep SIBO from recurring and to make sure you continue to enjoy all the wonderful benefits of those microbes, but know that you have extraordinary control over what goes on in your gastrointestinal tract and thereby endotoxemia, and you thereby can address risk for all those conditions we talked about obesity, type 2 diabetes, atrial fibrillation, skin rashes, cognitive impairment all starting with restoring this collection of microbes that we call SIBO yogurt. Now, if you've learned something from this episode of the Defiant Health Podcast, I invite you to post a review, post a comment, subscribe to your favorite podcast directory. Let's help build this movement of self-empowerment and health that you can accomplish on your own, without the interference of the doctor. Thanks for listening.
