More than 2,000 years ago, Hippocrates suggested all disease begins in the gut. He was mostly right, and we've talked about the gut many times on this podcast – in relation to athletic performance, optimising the gut microbiome, and even how to use probiotics. But a couple of weeks ago I realized that we've never talked specifically and in depth about exactly what to do when you have a gut problem. GI issues are where I started my health journey, and probably bring more clients through our doors than any other condition, and they can affect absolutely anyone - athlete or not.

On this podcast, NBT Scientific Director Megan Hall and I are talking about the steps to take when your gut isn't working right. We talk about how things tend to go awry in the first place, signs and symptoms that you have a gut problem, and the first things to try to get quick relief. Megan also discusses the most scientifically-validated lifestyle modifications, supplements, and lab tests to try, as well as the pros and cons of using antimicrobials.

Be sure to follow along with Megan's outline for this podcast.

Here's the outline of this interview with Megan Hall:

[00:00:58] How Megan fixed her gut.

[00:05:26] Why you should care about gut health.

[00:06:26] Podcasts with Dr. Malcolm Kendrick: 1. Why Cholesterol Levels Have No Effect on Cardiovascular Disease (And Things to Think about Instead) and 2. A Statin Nation: Damaging Millions in a Brave New Post-health World.

[00:07:30] Signs and symptoms of gut problems.

[00:10:00] How things go wrong.

[00:10:02] Podcast: The Athlete's Gut: Why Things Go Wrong and What to Do About It.

[00:11:42] First line of defense interventions; Step 1 - Diet.

[00:13:57] Autoimmune Protocol (AIP).

[00:15:16] AIP recipes by Micky Trescott and Louise Hendon.

[00:16:23] Low FODMAP diet lists: comprehensive list, simpler list, app.

[00:18:08] Low histamine diet; Podcast: Understanding Histamine Intolerance: Symptoms, Causes and Treatments.

[00:20:39] Carnivore diet.

[00:21:33] Pegan diet.

[00:22:12] Endotoxemia; Podcast: Postprandial Fatigue, Part II: Endotoxemia, Inflammation, and Mitochondrial Dysfunction.

[00:24:54] Elemental diets: Physicians Elemental Diet, Dr. Ruscio's Elemental Heal.

[00:27:26] Podcast with Jason Hawrelak, PhD: How to Use Probiotics to Improve Your Health.

[00:29:03] Polyphenols and fiber.

[00:30:38] Soluble vs insoluble fiber.

[00:31:29] Other potential triggers: coffee and alcohol.

[00:34:05] Eating in a parasympathetic state.

[00:34:33] Physiological sigh.

[00:35:32] Simon Marshall's stress audit; Podcast: How to Manage Stress.

[00:36:15] Social connection and isolation.

[00:36:45] Podcast with Julian Abel, MD: Building Compassionate Communities to Improve Public Health.

[00:37:18] Proper chewing.

[00:39:56] Food timing in relation to exercise and sleep.

[00:41:16] Bidirectional relationship between gut microbiome and circadian rhythm; Study: Mashaqi, Saif, and David Gozal. ""Circadian misalignment and the gut microbiome. A bidirectional relationship triggering inflammation and metabolic disorders"-a literature review." Sleep medicine 72 (2020): 93-108.

[00:41:43] Gut microbiome diversity is associated with better sleep; Study: Smith, Robert P., et al. "Gut microbiome diversity is associated with sleep physiology in humans." PLoS One 14.10 (2019): e0222394.

[00:43:15] Probiotics.

[00:44:50] Visbiome/VSL #3; Study: Cheng, Fang-Shu, et al. "Probiotic mixture VSL# 3: An overview of basic and clinical studies in chronic diseases." World journal of clinical cases 8.8 (2020): 1361.

[00:46:08] Florastor; Study: Kaźmierczak-Siedlecka, Karolina, et al. "Saccharomyces boulardii CNCM I-745: A Non-bacterial Microorganism Used as Probiotic Agent in Supporting Treatment of Selected Diseases." Current Microbiology 77 (2020): 1987-1996.

[00:46:55] Mutaflor; Study: Sonnenborn, Ulrich. "Escherichia coli strain Nissle 1917—from bench to bedside and back: history of a special Escherichia coli strain with probiotic properties." FEMS Microbiology Letters 363.19 (2016).

[00:47:45] L. rhamnosis GG (LGG).

[00:49:06] Choosing a probiotic; Probiotic Advisor database.

[00:50:59] Digestive enzymes, digestive bitters, and tea.

[00:54:32] Other helpful supplements.

[00:54:50] General gut healing.

[00:55:25] Serum derived bovine immunoglobulins (SBIs); SBI Protect.

[00:56:14] ProButyrate.

[00:56:52] Megan's outline for this podcast.

[00:56:58] Article: Singh, Vishal, Beng San Yeoh, and Matam Vijay-Kumar. "Feed your gut with caution!." Translational cancer research 5.Suppl 3 (2016): S507.

[00:58:28] Testing: GI-MAP, Genova GI-Effects, Doctor's Data, GutBio, Organic Acids Test (for yeast).

[01:05:03] Food intolerance testing.

[01:06:21] Blood chemistry: signs of gut trouble.

[01:07:36] Podcast: How to Interpret Your White Blood Cell Count.

[01:07:46] Small Intestinal Bacterial Overgrowth (SIBO): signs and symptoms, causes.

[01:08:30] SIBO indicates dysbiosis rather than overgrowth; Study: Saffouri, George B., et al. "Small intestinal microbial dysbiosis underlies symptoms associated with functional gastrointestinal disorders." Nature communications 10.1 (2019): 1-11.

[01:09:49] Pros and cons of using antimicrobials.

[01:10:05] Pomegranate husk powder; Jason Hawrelak's course; cheat sheet.

[01:11:37] Bixa Pomegranate Peel Powder.

[01:13:45] Binders.

[01:14:52] Dr. Josh Turknett's 4-quadrant model; Videos from his site.

[01:16:51] Schedule a free 15-minute call with Megan or Clay.