Infertility, Miscarriage, Premature delivery: The Crucial Role of Endotoxemia

The evolving science has become overwhelming: Lipopolysaccharide endotoxemia, i.e., the entry of bacterial breakdown products into the bloodstream, is a major driver of multiple problems in female reproductive health. Unfortunately, this crucial factor is almost never addressed in conventional healthcare settings. 

Thankfully, there are steps YOU can take personally to address this important health issue. 

Transcript

Endotoxemia And SIBO Basics

William Davis, MD 0:00

I'd like to talk about what the science is showing us, this evolving science is showing us, on the effects of endotoxemia on female reproductive health. Now recall that endotoxemia means or refers to the entry of bacterial breakdown products, but specifically the lipopolysaccharite, or we say LPS, endotoxin that's released by fecal microbes. So recall that modern people have allowed, because of our exposure to antibiotics and many other factors, we've allowed fecal microbes in the colon, species like E. coli and Salmonella and Crasea. Those names may be familiar because they're also causes of urinary tract infections and other infections. So they're not good microbes. Well, they've overpopulated because of our exposure to antibiotics and other factors. And in many people, I would say in roughly half the U.S. population, those fecal microbes have been allowed to ascend into the 24 feet of small intestine. Recall, the small intestine is by design very permeable. It's supposed to be permeable because that's where we absorb nutrients, like amino acids and vitamins and minerals. But when you have the entry, the colonization of the small intestine not well equipped to deal with hordes, billions, trillions, of fecal microbes in the 24 feet of small intestine, it further inflames the small intestine, increases permeability even more, and when those trillions of microbes live and die, they release some of their toxic products, specifically that endotoxin that gets into the bloodstream. Now, once you hear all the effects of this phenomenon of the entry of endotoxin from the overgrowth of fecal microbes in the small intestine, a process, by the way, we call SIBO, small intestinal bacterial overgrowth, or SIBO, you'll see that without appreciating the impact of endotoxemia on female reproductive health, you're lost.

Why The Small Intestine Leaks

William Davis, MD 2:06

And it's no surprise. If you actually look closely and critically at the way things are done in conventional reproductive health for females, you'll see it's mostly just patches or band-aids or completely unsatisfactory. Now, what is a cardiologist, me, doing talking about female reproductive health? I'm not a gynecologist, I'm not an obstetrician. I did training in those things many years ago. But what brought this to my attention and brought to the forefront of my attention lately is that I have three new grand, relatively new grandchildren, most recent within the past year, and I saw their mom receive almost no, no, received no, zero counseling on all the things she could do to improve her microbiome, her gastrointestinal microbiome, as well as other eras of her microbiome, especially the vaginal microbiome. None of this was mentioned. In other words, clinical practice is behind. 10 years, 20 years, 30 years. She got the usual, she got antibiotics, she got spinal anesthesia, all those kind of routine things they get. But she did not get

Microbiome Blind Spots In Care

William Davis, MD 3:16

a single word mentioned about the role of the microbiome. And you're going to appreciate that the role of the microbiome is not just important but critical. I liken it kind of to the James Webb telescope. Have you followed that conversation? Where there's now a very powerful telescope a million miles from Earth sending back images of deep space. And what blew my mind was one of the things, one of the great findings of this incredible project, is that what we thought were stars, many of the things we thought were stars that you see in the night sky standing on Earth are really galaxies, each with hundreds of billions of stars in each. In other words, you see a star in the night sky, it may actually be an entire galaxy comprised of hundreds of well, think about that. It is mind-blowing to think how large the universe is. But the James Webb telescope opened up an entire universe of new thoughts, new ideas, new concepts, new findings. I think the appreciating the role of the intestinal microbiome and the vaginal microbiome is the same kind of thing. It is so huge, it's going to change. It fills in so many of the blanks, the empty spaces we didn't appreciate, and tells us why conventional treatments for things like fertility or miscarriages or premature delivery of a child are so inadequate.

Fertility And Pregnancy Risks

William Davis, MD 4:40

So let me list some of the conditions that are affected by this process of endotoxemia that is caused by having SIBO. Well, because endotoxemia affects the brain, specifically the hypothalamus and pituitary, it reduces the release of hormones, results in a drop, a reduction in progesterone and estrogens. And that has a whole long collection of consequences, but it distorts your female hormones. Having endotoxemia disrupts the capacity of a fertilized ovum, an oocyte, to implant itself into the uterus. It impairs or disrupts the maturation of the embryo once it is implanted into the wall of the uterus. It disrupts your capacity for ovulation. So it can be one of the factors that plays a role in infertility. That, of course, ladies pay tens of thousands of dollars for in vitro fertilization. And here we find out that endotoxemia is at the root cause of many, maybe not all, but many instances of infertility due to the disruption of ovulation and implantation of the embryo. Endotoxemia inflames the endometrium, the lining of the uterus. Well, that's important because when the endometrium and then the cervix becomes inflamed, it causes premature relaxation of the cervix. And that's what can one of the factors can lead to premature labor, premature delivery of a child. And you may know that if a child says deliver at 28 weeks or something like that, it's catastrophic. That child has to put on a ventilator, is going to live in the neonatal ICU for weeks, if not months. How about the financial burden? A million dollars? A million dollars of hospital costs is not uncommon. That poor child will not develop normally. It'll have impaired neurological, immunological, and psychological development, be much more prone to all kinds of health conditions, all because of premature labor, premature delivery, and one of the major causes is inflammation of the endometrium and the cervix from this process of endotoxemia. You can actually, a very important study was released by an Italian group where they actually looked at the contents of endometrial fluid, and they found much higher levels of endotoxemia and much higher levels of numerous inflammatory factors. So explaining why there's premature labor in a woman who's got endotoxemia. Endotoxemia can reduce the likelihood that you deliver a viable child. It can cause miscarriage, it can cause stillbirths, it is responsible for multiple pregnancy failures. So a woman who says things like, I've been pregnant four times, I lost all four of them. You know, that's emotionally catastrophic. It's an awful experience for anybody, uh, but especially for the mother. Well, one of the driving causes, and this is well worked out now in science, is endotoxemia. It inflames the uterus cervix, as I mentioned, and it caused you to lose that child. Think how profound that is. That endotoxemia that originates in the gastrointestinal tract can cause you to lose a child. Isn't that awful? So you can see this is a whole new world of understanding of what goes on in pregnancy and what can be done to reduce the like of all these adverse outcomes. So, another aspect of endotoxemia, it increases a woman's risk of having preeclampsia or clampsia. You may know that those things are fairly common, and so there's a lot of effort devoted to identifying and then trying to stop it, typically with such things as intravenous magnesium, which is a whole other conversation, right? Why is magnesia only given acutely in hospitals and often not given chronically? The issue is chronic depletion or lack of magnesium. But endotoxemia is a major driving factor in preeclampsia and eclampsia, because you don't want the child nor the mother to have seizures, because either one can have a fatal outcome when a child or the mom has seizures from eclampsia or preeclampsia, and a driver here, once again, endotoxemia. So, in other words, this is not a small matter. This is not a curiosity, this is not a matter of bloating and diarrhea or abdominal discomfort. This is a matter of profound importance for a child's long-term welfare, for a mother's welfare, for having safe pregnancy, for being able to deliver. And there's now even emerging evidence that if a woman is pregnant and has endotoxemia, and that thereby the fetus, the child is exposed to endotoxemia, that child is more likely to have impairment of his or her neurological maturation, have lower intelligence, impaired memory, impaired learning, and more likely to have issues later in life like adolescent obesity or type 2 diabetes. So even the child in utero, in utero exposed to endotoxemia, can expose can be exposed to adverse effects that has lifetime implications. This is, you can see, not a small matter. This is a big matter.

Targeting SIBO With Fermented Probiotics

William Davis, MD 10:10

So this is why we address the microbiome. So know that if you've been following my conversations, one of the solutions I advocate is my formulation for SIBO yogurt. Recall that. So there are other things you can do. You can take antibiotics like rifaximin, which I find objectionable. You know, antibiotics are part of the reason that many people got here and developed SIBO or at least colonic dysbiosis in the first place. So if antibiotics were a big part of the reason it got you into this trouble, is an antibiotic part of the solution? I have a hard time with that. So the solution I've been working with, and it seems to work quite well. We still have to go through the formal clinical trial, but the the effort is so benign and so beneficial in other ways that the bar to doing it is so low. It's SIBO yogurt. And the current way we're doing it is to get three microbes, ferment them individually, or ferment two of them together. Lactobacillus roterite, lactobacillus gastri. You can ferment those two together because they require similar uh uh environments to ferment. And the separately Bacillus subtlis. So if you want to know how to source those, see my super gut books, see my thousands of blog posts, join me conversations in my inner circle dot drdavisinfinite health.com. I try to make this as available as possible. Where to source them? Now we ferment them by using my methods of prolonged fermentation. We don't do what they do in yogurt making factories, which that's something different, right? The stuff they sell in supermarkets, completely different. I call it yogurt because it looks and smells like yogurt, but it's not yogurt, right? It's so we're gonna ferment lactobusis rotari, lactobacillus gastri, and bacillus subtilis. The rotori gastraite, you can ferment 36 hours at human body temperature, so around 97 to 100 degrees Fahrenheit, 37 degrees Celsius. The uh bacillus subtilis you can ferment at a lower temperature, 90 degrees Fahrenheit. We ferment for only 24 hours, it it reproduces faster. We used to do all three together. I think it's better though to ferment each one individually. You get higher counts that way. One of the things we don't know when you ferment things together, like if you ferment a commercial probiotic with seven species, say, you don't know what happens in in batches down the line. That is, you make the first batch from your probiotics, second batch from a little of the prior batch, third batch, a little of the prior batch. Well, over time there's a shift in the relative proportions of each microbial species. And you'd have to perform DNA sequencing, some other methods to identify exactly how much you have at, let's say the seventh, eighth, or tenth batch. So to circumvent that uncertainty, I've encouraged people to individually ferment each. It's more work, but at least you know you've got hundreds of billions of each one. And the best way, of course, is ferment the roterite gastray separately. But if you really don't want to go through the hassle, you can ferment those two rotorite gastray together. Another microbe to be aware of that plays an outsized role in female reproductive health is bifidobacterium longum. Now, one of the problems with bifidobacterium longum is that there are literally dozens, if not hundreds, of strains. We don't know how much they overlap and their benefits, but one strain that is not commercially available, called the ES1, has been shown to have dramatic effects on reducing uh both endotoxemia in the bloodstream as well as in the uterus. So the bifetobacterial longum is an important microbe, not quite as important perhaps as, say, lactobacillus rotori, but still very important, has many, many effects on multiple aspects of health, but including female reproductive health. So if you're thinking of doing all these kinds of things, also think about getting some bifetobacterium longum, such as the 1714 strain. That's one of the best strains you can get. You can get that commercially. And fermented, you for use the same methods, 36 hours, human body temperature. And by the way, it makes the very delicious yogurt. There's a real taste difference when you make these yogurts, not yogurt, of course, depending on the species you use. For instance, lactobacillus crispatis. If you missed that conversation, another extremely important microbe for vaginal health, that makes a very delicious yogurt, one of the most tasty, tastiest, smoothest, and richest yogurts you've ever had, Lactobacillus crispatus. But the bifidobacteria longum is a pretty close second. Very smooth, very tasty. I even ate it without use of a sweetener. You know, the rotarice is kind of sour, gas, right a little bit sour. You really have to use some kind of a non-nutritive sweetener like stevia or allulose or monk fruit. Uh I found with the bifidobacteria longum or with the lactobacillus crispatis, they're so delicious on their own. You don't need a sweetener. You don't need blueberry. You could, of course, but you don't need to because they're actually delicious all on their own. Now, if you want some guidance, of course, I remind you you can always join my conversations, two-way zoom conversations, and other resources in my inner circle.dr Davisinfant Health.com.