The advice and informational content does not necessarily represent the views of mother's market and kitchen mother's recommends consulting your health professional for your personal medical condition, he... I'm Kimberly King, and welcome to the mother's market podcast, a show dedicated to the Truth, Beauty and Goodness of the human condition. On today's show, nothing controls our health and well-being as much as our gut and the microbiome and our body can make a huge difference in our health, and we feel what diseases our body can fight off, plus later, we'll tell you what's going on around town. But first up, Dr. Martha Wittenberg is a board-certified family medicine physician who received her BA in Biology from Lehigh University in Pennsylvania, and her master's and doctorate at Drexel University in Philadelphia.

After being in private practice for many years, Dr. Wittenberg pursued an additional training in holistic and integrative medicine, she was a board-certified by the American Academy of Anti-Aging and regenerative medicine, and completed a fellowship in metabolic and nutrition medicine through the metabolic medicinal medical institute.

She is passionate about helping people discover their underlying imbalances and coaching them back to wellness, her medical interests include bio-identical hormonal therapy, weight loss, Adrenal Health, mood disorders, detoxification and gut health, and we welcome her to the mother's Podcast, Dr. Wittenberg, that's impressive.

How are you?

I'm doing great, thank you, Kim.

It's nice to see you again, and before we get to today's topic, please feel is in on your mission and your work. Oh, okay, thank you. Well, I guess my mission is to try to treat my patients underlying issues instead of just their symptoms so I can truly improve their health. A lot of times people are just given medications and those are just band-aids, so I usually try to work with their lifestyle and their diet and do some additional functional testing to try to figure out what's really causing their issues. I love that.

Well, today we are talking about GI health, gut health and the microbiome of the gut.

So what is gut microbiome?

So many people probably have heard the word because it's been in the media a lot, but a lot of people don't know a lot about it, so I thought this would be a good topic. So basically, the gut microbiome is the collection of microbes that live in our GI tract, so the microbes could be bacteria, viruses, fungi or parasites, for us, they're primarily bacteria, and usually we think of bacteria is a bad thing, you get bacterial infection if you have a strep throat, or you could get a bacterial intestinal infection such as Salmonella or Shigella, and so people think bacteria is a bad thing, but the bacteria in our microbes actually are essential for our life, and they do a lot of things that actually help us survive and help us thrive, and the number of bacteria in our gut is actually staggering, so they've estimated that there are 10 trillion bacterial microbes in our gut, which is 10 times more cells than we have in our body.

Wow.

Yes. Good and bad, or no, these are the healthiest, these the ones that are supporting us.

Wow.

So yes, so the Science Arts will say, we're only 10% human, but you may be hurt that before that, all the moms, and then in addition to that, the NIH has a Human Microbiome Project and they've found at least nine million bacterial genes in our bodies, whereas our human genome only contains 20000. oh my gosh.

So you're making me think about it in a whole different light.

Right, it makes you think so just based on the numbers, this thing must be important, but what they know is, you know, the microbiome does a lot of things for our gut, so it helps us digest food, we can't... So an extract energy from our food that we can't... The microbiome can produce certain vitamins, if they converge certain hormones, they can help protect us from potentially harmful bacteria, and they even can regulate our immune system and our brain health.

So you just answered my question. Why that is important and so... Wow, so it really has many functions... Yes, yes, many, many functions. And especially with the immune system, that's something that most people don't think about, but actually are the bugs in our gut can turn on and off immune cells when necessary, so they can... Sometimes people have immune reactions that are over-exaggerated and create information, the microbes can help dampen that down if necessary, if you have a healthy population and a diverse population of microbes, What are the health consequences of imbalances in the micro-Microbial symptomatic ally? People might not have a lot of energy, they could have that, they could have skin problems like eczema psoriasis, they could have arthritis, they could just not feel well, have food cravings. Lack of energy. So when the microbiome is imbalanced, those are some symptoms that people can experience when the microbiome is not balanced, it's called dysbiosis, and basically what happens is people develop poor digestion, they can be bloated, have constipation or diarrhea, abdominal pain, cramping and reflux, bad breath, all these things but then they develop symptoms outside their gut, so the joint pain, the brain fog, muscle aches, heart palpitations, all those types of things can develop as well, and what triggers problems in the microbiome.

So diet, a plant-based diet is better for your microbiome because are the bacteria in our gut digest our fiber, that's their fuel, and then from that fiber, they make fatty acids that help fuel our counsels. So diets really important, if you have a healthy diet, you'll have a diverse microbiome, and when I say healthy, I mean you eat a lot of plant-based foods, stress can also trigger problems with the microbiome because when you're stressed, your fight or flight is turned on and your arrest or digest part of your nervous system is turned off and that can adversely affect your microbiome, alcohol is toxic to the microbiome, so they now think that even in moderate drinkers, alcohol can alter the microbiome and leads to things like leaky gut or intestinal permeability and that win cells that usually our body would try to keep out, get absorbed the retinal lining, so alcohol can decrease some of your healthy bacteria, and then medications like steroids, antibiotics and non-steroidal, anti-inflammatory drugs can also be harmful in terms of antibiotics, they have done studies and for instance, they did this one study where a person was given one week of clindamycin, which is an antibiotic, and then they looked at the family of bacteria in our gut, called back to rites, and what they found was after seven days of clindamycin, she only had one strain of clindamycin resistant factories left in her gut, and then they followed her over time and even nine months later, she only had one strain of clindamycin-resistant factories, and then even when they looked at her two years later, the original diversity of her bacteria, which are healthy bacteria was not the same as it had been before.

Really?

Yes, so taking antibiotics unnecessarily for a viral infection can really be detrimental, sometimes people need them, if they really need them, it's good to take prebiotics, which are fiber and in ulan and things like that, and probiotics which can help replenish some strains of their good bacteria.

The other issue is that 70% of the antibiotics used in the United States are given to animals that raised for food, so if we eat those animal products that have been treated with the antibiotics, they can kill some of our microbes as well.

So that's why it's important to make sure that when you do buy animal products, so you know it says not treated with antibiotics because that will adversely affect you and let me think about that though, that's true that they were eating those products there.

So can you talk about the studies that are showing about the diet and the gut micro-biomes too, is the... Sure, so in terms of that, like I mentioned, more plant-based foods are better, so think of a Mediterranean diet where you're eating a wide variety of vegetables, so you wanna get a rainbow vegetables, fruits, nuts, olives, fish, that'll help your microbiome 5 too much meat, saturated fat or processed foods can kill off some of our good bugs, but the interesting thing is, it's not as though you can change your diet and two months later your microbiome is better, the microbiome that you have really reflects your long-term dietary practices, so if you're traditionally somebody who had a really poor diet, it's gonna take years to really get better to clean that out into... Are there, I don't know, I guess diseases or something that kinda go along with the microbiome that are in our body, so I don't know if that's a fair question, Are there diseases associated with you... Yes, yes. So, let's see, imbalances in your microbiome can be associated with obesity, so when people are overweight, they sometimes have overgrowth of a certain type of bacteria, so there was this one study in the Mayo clinic where they did stool samples on these people, they put them on a diet and an exercise routine, and then they did stool samples at the end and they found that women that I think it was on could have been meant to, but the people in the study that loss less weight had more of certain types of bacteria, and those Bimini Ely is associated with obesity. They actually believe that imbalances in the microbiome are associated with 90% of diseases, so it could be arthritis, heart disease, depression, immune disorders, but now they're just trying to find diseases that aren't associated with the microbiome because there are so many because... Yeah.

Oh wow.

Yeah, and it's too, I guess, yeah, too much of a... A good or bad, like you're saying, but yeah, I didn't even think about obesity.

This is interesting, we're gonna take a quick break, but there's gonna be more with Dr. Wittenberg, when we were talking about GI health or gut health with microbiome, when we come right back, stay with this.

Welcome back to the mother's market podcast. And we wanna remind you that if you missed any portion of today's show, you can find us on iTunes by searching mother's market or download the show from our website, mother's market dot com, click the link for podcast and listen to past shows. Plus download our Healthy Recipes and money savings coupons, all available at mother's market dot com. Okay, and now back to our interview with Dr. wynberg, and we're talking about GI health and the microbiome of the gut, and it's really interesting information we want... I wanted to ask you about the gut brain connection.

Oh, okay, yeah, so the GU-ring connection just speaks to the interaction between the microbes in the gut and the brain, they typically communicate through the vagus nerve, but the gut brain connection has been shown to have things to do with depression or neuro-degenerative diseases, so if somebody has low microbial diversity, perhaps they don't make as much trip to fan, and that's used for serotonin that helps with mood, sleep and appetite, or if somebody has intestinal permeability and pathogens and inflammatory cells are getting into their body, then they can also be getting into their brain, and that has been associated with problems with Dementia also.

So yeah, so again, it all goes back to the microbiome, right.

So when they talk about the gut brain connection, they talk about treating it from the bottom up, so maybe giving somebody probiotics or eating more probiotic-containing foods and a better diet to help stimulate growth of those micro... Microbes and the microbial diversity, and then from the top down, which means doing things that help with relaxation, help with stress management, because the signals that the gut receives from the brain can affect the function of the god as well, so you know when you're nervous and you have butterflies in your stomach, those are signals from your brain talking to your video... Yeah, that makes sense. What is the best diet for gastro intestinal health?

So the best tip for gastrointestinal health is a heavy plant-based diet, so something pretty anti-inflammatory, like a Mediterranean diet that features a wide array of veggies, fruits, nuts, olives, fish, limited meet, you wanna be careful with too much animal protein and definitely be careful with processed foods.

Okay, so the best way to change your microbiome over time is to stick to a diet like that, although some people who have a lot of gut issues have a hard time digesting a lot of fiber up right off the bat, so they have to be introduced gradually. So first, maybe they can eat some STIS so that the veggies are cooked or pride, there are certain digestive enzymes like cellulitis that help your body break down some of that plant products and plant fiber, if you don't have the healthy microbes to do it in your gut. And then they can go to steamed veggies, and then if they can tolerate it, increase the amount that they're eating and hopefully, eventually one day I will be okay with raw veggies to...

Okay, oh, that's... Again, to know if someone is having GI issues, what should they do besides to change their diet, so other lifestyle factors help, so exercise is great because it's good for gut motility when somebody's constipated, undigested food can be kind of festering and fermented by a potentially harmful bacteria so it can create more inflammation if somebody has constipation, so exercise is important, drinking lots of water is also important for preventing constipation, stress management, which speaks to the gut brain connection, and then adequate sleep is really important to... Our microbes actually also have a circadian rhythm, so they want their sleep as well, it's funny because you mentioned that exercise and getting things moving, basically, it works in animals too, I always notice that with my dog, if he's constipated and that's just dossier run is all of a sudden I'm like, wow, you've been waiting. But anyway, it gets it moving and grooving, so are there specific tests to look at the gut microbiome... Yes, there are, there are definitely tests that we order in the office that can give you a microbial analysis of a patient's healthy bacteria, so one of the kids that we use look at not every single microbiota, 24 of the most studied ones, so you can look at the balance, and sometimes you'll see certain ones that are really important are undetectable or other ones are too high, so they're just not balanced and people can develop symptoms from that, and then in addition to the microbial analysis, it can tell you if there's overgrowth of potentially harmful bacteria overgrowth of the overgrowth of parasites, so they also do a culture on this tool as well, and then it looks at markers of pancreatic function, so you need good pancreatic function to digest and absorb your nutrients as well, and then it looks at markers for inflammation and... Levels of short-chain fatty acids, so these are the fatty acids that bacteria make when they digester fiber. And so if you have low short chain fatty acids, either you're not getting enough fiber or you don't have enough healthy bacteria, and about in addition to the diet, are there certain supplements that we can also take to help... Yeah, so my first two that I would recommend would be prebiotics, so prebiotics are plant-based, so for instance, in ulan is a type of fiber found in onions, leak, Carl, artichokes, but it can also be taken as a supplement, so if they need it, they could take a prebiotic supplement, and then probiotics are really important, so again, people can get probiotics and food, so probiotics are live organisms, you can get those in fermented foods like yogurt, kombucha, kimchi, sour crowd, and eating a variety of those are good if you don't like those or you are doing that and you're still having an issue then, you know, you can add in a probiotic and when you're looking at a probiotic, you don't wanna just look at the one that has the highest number of bacterial colonies, you also wanna look at what type of bacteria is in that probiotic. And if you look at the fine print on the label, you wanna make sure that it says the potency is guaranteed through the expiration date, because sometimes there'll be a hashtag that says guaranteed at the time of manufacturing, so you don't really know if the organisms will still be alive by the time you take them...

Oh, that's also a really good point. That's true.

So those are the top two that I recommend, and then based on what we find on the stool study, like if they have a lot of inflammation, I may recommend Berbera or glutamine, which help decrease inflammation in the gut lining and glutamine is a source of fuel for your call themselves, if they are low in pancreatic lactase, I may ask them to take extra digest I enzymes, things like that, so there's a variety of different supplements that you can recommend based on what you find if they have overgrowth of pathogenic bacteria, you can sometimes do natural antimicrobials, Berber is actually one of those, but there are other ones that can use as well, and the nice thing about the testing is they'll do sensitivity on medications you could take or natural supplements you could take to try to kill the overgrowth of these organisms. And I think we may have about this a little bit, but how long should someone follow that gut protocol before here you notice that change in their health, so after they do a stool test, whatever issues we find, we'll usually put them on a protocol, which you've probably heard of the 5R protocol, forgot health.

So it's a framework that functional medicine uses for the five Rs, the first one is removed, so if you do have some overgrowth of harmful bacteria or parasites or as you remove it to would be replaced. So that would talk to taking digestive enzymes, if those are low, three is Renault for improving prebiotics and probiotics for is repair, which speaks to inflammation, and then five is rebalance, which talks about the lifestyle with the stress reduction and the exercise and the sleep. So I'll typically tell people, at least with the supplements, to do this for three months, people start to feel better within a month, but I'll say, Do this for at least three months.

However, the diet is... Dietary changes should be something long-lasting if they're gonna have a real benefit from it.

Okay, that's great. Yeah, interesting information. Is there anything else you need... You want link to discuss... To that, I just think it's a fascinating field, I used to think the gut was important and I incorporated that into my practice, but now that I've learned more about the microbiome and how it really controls so much of our health and our well-being, I'm focusing on it even more, which is so smart, and I think especially that connection with the gut brain as well and how it is connected, I think, does that gut health change over time with our bodies or with the information... Oh, it definitely can. So basically, when you're born, your gut is sterile, and so the first introduction you get to microbes, if you're born vaginally through your mother's vaginal canal, that's what starts your gut microbiome, so actually kids that are born VC section are a little bit of a disadvantage, and they see, there's more allergies or more asthma, there's more emanates that were born VC section, and that could be why.

Now, some places are even doing vaginal swabs in C-section born babies, so taking vaginal swabs from the mom, putting it around the mouth and the face of the baby to see if that can help stimulate the beginning of their microbiome, and then the microbiome continues to develop your broad iPad. So a baby that's C-section born and bottle-fed again, is that like a serious disadvantage because you get a lot of those healthy bacteria through your mother's breast milk, so that it basically develops throughout your childhood, but if kids are on antibiotics really early in their childhood, it's gonna cause problems or otitis media, a lot of kids that's a middle ear infection, a lot of kids will get antibiotics, but a lot of times, it's viral. So different stages of life, it's supposed to grow and diversify when you're younger, but if you have any medical issues or you have to be on any medication that could affect it... That could change.

Wow, that's interesting though, about the C-section and then kids that are more naturally and then I think more than age, it has to do with what your exposures are over time, so you have a lot of exposures that adversely affect your microbiome... Yes, it will change over time. But if you're doing all the right things, I can stay consistent. No, that's fascinating. Well, thank you very much for your time. This has been a great topic, Dr. Wittenberg and we look forward to having you on again but in the meantime you can also catch more of Dr Wittenberg on her website I progressive Med dot com and learn more about her passion for alternative medicine and the other great thing she's involved with we look forward to your next visit thank you Cam thank the advice and informational content does not necessarily represent the views of mother's market and kitchen mother's recommends consulting your health professional for your personal medical condition AA