We’ve all heard “you are what you eat” and most people agree that healthy eating is important… but why? What if you knew that the bacteria in your gut are making important compounds such as post-biotics and short chain fatty acids that your body needs? Don’t let the science keep you away … It’s actually a simple solution to a complex mechanism that lives in all of us. Join the GCP and hear Dr. Ken Brown and Eric Rieger discuss how you can actually condition your body to be either more resilient or more susceptible to diseases, and just by eating the foods that your BACTERIA NEED. The list of possible diseases includes high blood pressure, diabetes, obesity, Crohn’s, colitis, Alzheimer’s, dementia, anxiety, insomnia…. So basically, fire up the show and learn how to protect your health!
Unrefined Bakery https://unrefinedbakery.com Use discount code “Gutcheck” for 20% percent off of your first online order!!!
In The End by Michael Weinberg, MD https://www.amazon.com/End-Michael-Weisberg-M-D/dp/1642374539
Chron’s & Colitis Foundation https://www.crohnscolitisfoundation.org/
All right. Welcome back. It’s gut check project, Episode Number 33. I’m here with your host, Dr. Kenneth Brown. I’m Eric Rieger. Dr. Brown. What’s happening In a day?
Not much I tell you what, this is really cool Episode 33. It’s you and I know guest because we got to cover some serious science.
Yeah, we do. A lot of people want to know what happens whenever you take certain things that works as post biotics, not just probiotics, but what do I do to feed my bacteria? And is that even number one? Is that even a real thing? What’s a post biotic? Do I care what happens with the foods that I eat and what my bacteria does with it? And if I do, what’s happening? so I’m going to, we’re going to deep into deep into, we’re going to dive in deep into some awesome science about what happens when we take care of our bodies, bacteria.
Well, the reason why I wanted to get into this is that we got tons of feedback on the fecal microbial transplant episode. And then of course, when we had Panez on here talking about Crohn’s disease. Yeah. So one of our viewers, Don sent me a message that basically said, so I’m more confused than ever. What do we do now? I started looking into it, and I’m like, Oh my gosh, now I know why so many things happen to poor Heli I, we’re going to talk about that we’re going to look into this, and hopefully clear up a few things. But I love the fact that we have viewers that are calling in be like, great episode, but now I’m more confused now and you know, follow it up. So that’s what we’re going to do today we’re going to follow it up and talk about how Heli and Panez that has groans and Ellie, with her horrible autoimmune disease and everything like that with her fecal microbial transplant. I’m now starting to put the pieces together. I’m moving this big bubble of Venn diagrams, and I’m like, Oh, my gosh, this is here. So that’s what we’re going to do today. Your job because I mean, when I mean, I got excited, like, I my hair started going up in my arms. I was like, it’s there. We’re missing this. What I’m going to do right now is talking about some stuff that probably should have been put together before or maybe it has been maybe, but I looked at a lot of research I spent I just went down rabbit holes, and I’m kind of excited to talk about it.
Well, it’s awesome. It’s easy to do. I can tell you that I would imagine that we’re probably going to talk about not only post biotics, but some really cool names like short chain fatty acids, right? We’re going to head that direction?
We’re going to talk about that ..Polyphenols
We’re going to talk about SIBO, its IBS, all that stuff.
This is gonna be a great episode. If you if you if you’re truly interested in gut health, you cannot ever stop expanding your knowledge and understanding why people say, health begins and ends in the gut. If there’s a reason why that people who change your diet feel better, and this is what we’re going to talk about today, so..
Yeah, totally. But you know, but before we get into that, we’re not just, we’re not just podcast nerds. I have a life.
I’m pretty excited. I went and I did Rachel Sheers podcast, Sheer Madness. With her little Frenchie thingy Bulldog, yeah, called Lily. And so we went and did that. That’s gonna launch here pretty soon, but you can see pictures of that. So that’s cool. Um, and I also feel like I’ve been working too hard and people ask me, they’re like, you know, do you have a hobby I’m like, wow, I’m..No so I was watching 60 minutes and I don’t know why I’m turning into my dad. We’re now I watch 60 minutes on Sundays and rather enjoy it. But I’m gonna pick up falconry. In fact, I’ve picked up falconry.
That’s amazing. You’ve already done it in such a short amount of time…
Yeah, specifically Golden Eagle falconry.
Yeah. So basically I watched a 60 minute episode and Mongolia Nomads depend on animals to get other animals because they have no agriculture. So what they do is they make this bond with golden eagles and they use them to hunt other animals for them. And they’ve been doing this for thousands of years. Well, there’s a woman named Lauren McGough. She’s a PhD, she traveled to Mongolia. She’s from Oklahoma.
Yeah, like, imagine having that conversation with your dad. You’re like, I’m gonna go to Mongolia. But she’s from Oklahoma. She found this old book on Eagle hunters. And she’s like I’m gonna go do this. So she figured out that this is such a unique way of living where you live in unison with the animals. So she went there, she captured her own Golden Eagle bonded with it, and then became part of their tribe and hunted with this thing.
And then has come back and it’s been like, you know, a conservationist and she’s a PhD and she lectures and all this other stuff. So these things, she owns her own eagle and what they do is they there’s, they describe how you actually get it, but it’s safe and everything in the ego bonds and then they let the ego go, like you’re back out in the wild. I’m done with young either, you know, do you want to leave like when the ego wants to leave, it just leaves, but it hangs out so they can fly 50 miles an hour, and they can see seven times better than a human. And then they let it go. So anyways, I got into it. So I got my first Golden Eagle. And I’ve been trying to do this, but it just keeps bringing the neighbor’s cat to me.
It’s not working the way it did on 60 minutes.
While like he keeps bringing the neighbor’s cat so it’s unharmed, which is really really sweet.
Totally unharmed. It’s it’s a completely loving eagle, the cat loves it. I just pet it for a little while. Yeah. Then it delivers it back to the neighbor. I don’t know where the neighbor is.. Could be different city who knows? Travels 50 miles an hour.
It’s common knowledge of birds of prey just don’t ever hurt anything. They just want to show it to somebody.
So that’s my hobby.
Yeah, interesting. I can’t even match that. So probably not going to, the boys are about start basketball playoffs. So that’s what we’re getting fired up to do. Weekend was nice. Did some camping Saturday, Saturday evening. Woke up to beautiful sunrise Sunday. It was it was awesome. And that really kind of what we did this weekend is can take it easy. So..
Good for you. Taking it easy is good. I want to bring up one in the news article that I saw because pretty cool.
All right. You’re gonna love this. Just published this month, actually. It was published the February 14th. So in the news, the American Heart Association published a study out of Northwestern on peace. With peripheral artery disease PAD, also known as PVD, peripheral vascular disease. Now peripheral vascular disease or arterial disease is a narrowing of the arteries that reduces the blood flow from the heart. So the further away from the heart. Imagine you have coronary artery disease. Same thing happens all over the body… But the further away it gets, it can actually affect people where you can’t walk very, very far and it affects over 8.5 million people 40 years of age or older nationwide. It’s a big deal. Sure. So this is so cool. In a small study of 44 people at Northwestern University of patients over the age of 60. They gave them a beverage drink containing flavonoid rich cocoa.
They gave them cocoa and then they added some epigalic tannins to it.
Hmm, sound familiar?
Thats polyphenol people right there polyphenols, they gave people polyphenols the American Heart Association is now starting to catch up they’re, I think watching the podcast.
I’m sure they are.
I think they are. So basically what they did is they showed that people that took this three times a day for six months, which shows that it is a supplement three times a day in a cardiac diseased laden population, … no side effects… three times a day, six months, and they improved their six minute walking test compared to those who drank the same number and type of beverages without the supplement.
It’s funny you say that because people who have serious complications with diabetes that ends up with PVD or PAD, oftentimes, they end up doing that walking test, especially if they have numbness in their feet, or they notice that they have sores on their toes that they’re unaware, but a family member sees, right?
So just a side note, if you happen to have diabetes, it may, it may behoove you to keep up with your polyphenol intake daily.
And it also may behoove you to listen to the rest of this podcast because I’m going to get some cool stuff but so look at this.. so you’re like, Okay, well what does that mean? So if I drink cocoa notes cocoa enriched with epigalic, tannins, same tannins that we have in Atrantil the right part, those are the polyphenols. So those that drank this, they improve their muscle function over the placebo. But what’s really cool is they showed that they did muscle biopsies and they showed increased mitochondrial activity. It improved the mitochondria increase the blood flow through through..
The mitochondria what are you saying?
No, no, it increase the blood flow because of the polyphenols through..?
Dilation, because of nitric oxide production.
Everything that we’ve been talking about.
I know he’s teeing me up folks, I really hate them. Because there was lots of through there and and
Yeah, I’m just just follow this basically.. We now have scientific reasons why polyphenols improved sports performance, okay. It affects mitochondria and it increases the blood flow.
Now we’re into a much better realm. And I understand the categories that we’re in because we’ve multiple times referenced the studies that Jo Bowtell from from England was talked specifically about increasing nitric oxide, specifically in athletes to increase blood flow, increased performance, etc. So sorry, I didn’t see the tee-up there.
Well, this is what’s so beautiful. We always talk about, you know, athletic performance. Now we’re talking disease. Now we’re saying that, okay, yes, if you’re a triathlete, or if you’re a marathon runner, but there’s a whole lot more people, you want to see how many people actually have peripheral vascular disease. Go to the airport. I remember and this is a man, this was a I remember when I was flying. I think the flight was going to Florida. Oh, and so there was quite a few people over the age of 60. They were all in shorts. None of them had leg hair.
Oh, well, and circumference right..
All the way … So just so you don’t get along because I’m one of these if you still have hair. On one side of your leg, but on the other, that’s not what we’re talking about. But if you have a, there’s like a line of demarcation… And then suddenly the hair stops you, you probably need to at least be checked out because there’s a lack of blood flow.
Yeah. So what ends up happening is is that the blood flows to go from the heart all the way to the toes. And so the micro vasculature starts decreasing before the macro vasculature meaning you’re going to sacrifice the skin, blood flow to protect the muscles and the joints and the cartilage and all that other stuff. So that’s how many like I looked around one day and I was like, Oh my god, I truly believe that almost everybody here has coronary artery disease slash PAD. Now we’re looking at this going they all need to be on a polyphenol..
Yeah, absolutely. Yeah, that’s really, really interesting. And that’s crazy. So yeah, so these these polyphenols definitely will help naturally benefit and produce nitric oxide so that you can increase your blood flow. And if you’re already compromised help your body out.
Dude, never even thought about the whole mitochondria thing.
Now? Obviously I didn’t either, because I just sat there and stared at you. I said
Yeah. Now the question is they didn’t get into why they’re actually asking in the article at Northwestern. They’re saying the etiology, or the the physiology of how this is accomplished has yet to be determined. But we know it increases nitric oxide.
Yeah, we do.
I’m going to get into some stuff here shortly where I’m going to tell you that it’s all about the post biotics.
It’s nuts. So for the next so I’m going to that’s, that’s it. That’s our that’s our fun part of the podcast.
Now, that is fun, though. Honestly, if you’ve got circulatory issues, at least, you know, there could be a natural solution that will at least help. Number one, give you some more time. Number two, give us an idea of what you can do to improve things for yourself.
So I mean, if there’s one reason to do this podcast, and I keep saying this every single time, but I’m getting I’m learning I’m getting better. We’ve got our little secret weapon that keeps sending me articles and I’m just like, Oh my gosh, this one ties to this this one ties to this. So this is going to be a review of short chain fatty acids and you’re like, I don’t own any of those. I’m gonna get off. No, you need to hear this. Basically if you’re a mammal on the planet Earth, this is a really important podcast for you.
If you can understand the words he’s saying that is you… yeah.
Unless you’re a flat earther
Yeah, well they probably still should take they still take polyphenols..
Should I shouldn’t take that back question discriminated against. Unfortunately, I just watched that Joe Rogan episode with the astronauts. I’m all about space right now.
Oh, yeah. Well, it’s funny just the other day I passed the flat earth mobile in Denton, Texas. Yeah, it’s pretty fun. On the back it says the earth is flat and you pan down to is buffered it says and motionless, which I think is awesome. But whatever. Well, so let’s get into short chain fatty acids post biotics. Let’s, let’s get into some some awesome science here and, and let people know why it’s so important.
Alright, so I mentioned the very beginning that this was sort of brought on because the viewer Don said, Well, what next and then I started going down this rabbit hole, then I started Heli. If you watch the episode where we do the fecal microbial transplant This is that mean that she’s not an actress, she’s desperate.
And things are happening to her and they’re happening fast and she is panicking. We had Pannez that is at risk for all these things that we’re talking about, but it’s super complex. Ultimately, it all comes down to the microbiome. Unfortunately, As Americans, we disrupt our own microbiome by our lifestyles, like eating crappy diets, taking antibiotics, lack of exercise, and probably poor sleep are the biggest deals. And this is going to result in a decrease in diversity. You’re going to hear this term over and over and over again. People always talk about I’ll just take probiotics and improve this. No, it’s way more complex than this. We’re going to get into it. But basically, you need a true diverse microbiome, to aid in your health. Researchers are now showing that neuro degenerative issues like dementia, Parkinson’s, anything that affects your brain. And you know, Eric, we’ve talked about this a bunch that my goal as a physician right now is to figure out a way to stop dementia.
Because we come on the show and we talk we talk about our kids or about our wives. We talked about stuff. Imagine if all of a sudden it’s gone. What was your life, ultimately, your life becomes memories and those memories are what forms your personality and all these other things, and then they affect stuff. The thought of taking away my memory is, I mean, people people don’t really think about how, how difficult dementia really is.
I mean, it’s it’s a it’s a hard one. I’ve had friends whose parents have faded away.. My wife’s grandmother, I mean, she was a wonderful woman and went through just honestly her own living hell not being able to relate to the people that she felt like she knew around her. And just it’s no good.
No. And so if we can sit down, start piecing things together.
And not only the neurodegenerative things, but now researchers are starting to look at this. I mean, I just gave that article about the American Heart Association looking at a polyphenolic complex. That means that the traditional medical complex is starting to look at this stuff starting awesome
Now there’s evidence to show that heart disease, heart attacks, strokes, diabetes, obesity, so if you’re like, Oh, I don’t know anybody with dementia. But do you know anybody with obesity, ever had a heart attack? You have a family history of anybody with diabetes? Any all that stuff is the real question is how and why?
Why didn’t Heli develop all these autoimmune issues after fecal microbial transplant? My theory I’m not I’m not a smart enough to be a flat earther that has cool bumper stickers like that. But so my theory is just looking at all this and looking at my patients. I’m not a I’m not a PhD bench researcher, but this is what the world needs is bench researchers coming up with stuff having animal models, clinicians out here, slugging it away, and weirdos getting on the air and talking about it yet try and figure it out. Yeah, bridge bridge the gap between traditional medicine and natural solutions. Alright, so my theory is that our microbes, our microbiome, the most important thing in your body that really helps regulate everything. Do we live for them? Do they live for us? We don’t know. But it can be symbiotic. Meaning you can work together. They’re fed by the food we eat specifically fibers and complex polysaccharides. polysaccharides are hard to digest starches, right? So through various mechanisms their, these bacteria break them down, they eat it. And then their waste products or basically what they leave over. We use .. So their compost is our fuel, right? It’s a fantastic thing that we’ve never really thought of before..
Their compost is our fuel. That’s that’s, yeah, it’s nice.
Yeah, so that’s what we’re now calling post biotics
And it’s not a bad thing at all because what they produce in general post biotics, you can describe post biotics by their composition, like is it a fat, short chain fatty acid? Is it a complex molecule that we don’t really know very much about it? Or does it do like your religion is one of them, your religion that creates the Mito con the mytophogy, right affects old and sick mitochondria.
And if you’re keeping up that’s also known as the anti aging post biotic
Produced by bacteria that breaks down these things a post biotic or the physiologic function that it causes. So we know that there’s certain things about to reproduce that we haven’t been able to label yet. There’s been 800 post biotics, and they create all kinds of different diseases
Again, 800 post biotics
That scientists have at least discovered
Right. And it’s just to be fair, it’s much like the ocean, there’s just because we have 800.. I don’t even think we’re near the end. I mean, there’s lots to figure out and the combinations thereof anyway, I don’t want to sidetrack
No, totally sidetracked the whole time. In fact, your sole job, because I’m like, when I mean that we discovered a topic here that I was like going, Oh, my gosh, we’re, we’re piecing things together. So when I start going down a rabbit hole too much, interrupt immediately and go, you don’t you’re not making any sense
Just stop and start me over here. So this all started because of the fecal microbial transplant thing with Heli. And then Don says I’m more confused so that I started looking into it. And now I started realizing that these post biotics there’s 800 of them, but let’s Focus on one that we’ve done some serious research on, which is short chain fatty acids..
Now short chain fatty acids are fatty acids that are really small. They’re like fewer than six carbon atoms, meaning that it’s very tiny. And they’re made by our bacteria in our colon from undigestible, or from indigestible foods like fibers. And I always thought of them as fuel for the colon. That’s how I was taught during my fellowship and residency in medical school, that they’re, they’re local. But the reality is it goes way beyond that, way, way, way beyond that. So these short chain fatty acids do include in to the geeky part, names like butyrate, acetate, propionate, and lactate, don’t get hung up on the names, but in particular, butyrate is one that everybody talks about..
It’s super important for gut health, and it’s also known to help with gut motility corrects leaky gut, it works locally to heal the lining of the colon. But we now know that the other short chain fatty acids can actually be absorbed systemically as well. And we have not been paying attention to them. And they can influence the body in all different kinds of ways, depending on the host genes..
So you and I may react differently to these short chain fatty acids, depending on your genes. That’s the epi genetic phenomena, right? That’s how come Heli he developed all these issues when her donor did not have the issues. So that’s a separate rabbit hole. But what I want to talk about is butyrate is so important that most nutritionists and scientists study this molecule that is its own episode.
I’m going to talk about the black sheep of short chain fatty acids..
Which ones at that?
Oh, everything else but butyrate it okay. So if butyrate just know it’s good, and you want butyrate? Yep. Now we’re going to go into everything else and I want to explain how my patients like Pannez may have developed her problem, and we’re going to bring it all the way back to short chain fatty acids like acetate and lactate and talk about that. So, the rest of this is I’m going to show you the model that I’ve never been able to explain up until right now. Okay. For instance, every time somebody sees me with SIBO small intestinal bacterial overgrowth, or irritable bowel syndrome, IBS, or inflammatory bowel disease, IBD, Crohn’s colitis, I like to ask them a question. I’m like, Do you ever feel like you’re in a brain fog? Do you ever have anxiety? Has your mood changed? You have sleep disturbance? The first thing I do is go right from the gut to the brain
And I asked because I’ve seen this correlation. And I’ve always said, Well, it’s because of the inflammatory process. haven’t really gone that deep into it because all the articles I was reading about that all showed that a inflamed gut can lead to an inflamed brain. Now let’s dive a little bit deeper and find different reasons how these post biotics actually lead to that.
So if you’re somebody that suffers from anxiety, it may have nothing to do with your brain. It may all start in your gut. And this is really wild. So step one, something happens.
You get back bacterial overgrowth, SIBO you have an infection, eat a crappy diet. This leads to leaky gut, or intestinal permeability. Now, new research is showing that this will actually once you develop intestinal permeability, it actually allows acetate and lactate to get absorbed more into the bloodstream.
That’s not really what we want is it.
It’s not what we want. So once it gets absorbed into the bloodstream, these short chain fatty acids have this incredible mechanism to cross the blood brain barrier through its own transport molecule. So in the past, we’ve always talked about leaky gut leaky brain. This actually has its own transport, it doesn’t even have to be a leaky brain, it’s got a little bridge that these guys ride.
So, in short, if I think this can be beneficial if you have a transport mechanism at the cellular level, basically, that just means that there’s a little protein that’s allowing passage or exchange of something to be taken from one side to the other. And I think that what you’re explaining here is, we don’t really want these molecules crossing over to the brain, but now that they are rapidly being absorbed through the gut, that they’re more abundant in the brain, and that’s not really what we’re after.
So these guys finally get out of the gut. They got a VIP card. Yeah, they’re like, whoo, VIP card front of the line, let me know the brain. So that’s what’s really fascinating. So acetate and lactate, once it gets in the brain. They can actually directly influence neurons. causing a series of effects. said again, it’s a direct neuro transmitter. Nobody’s ever said this that I’ve learned this in neurology..
Yea me either.
So lactate and acetate can cause a direct influence on the neurons by stimulating sympathetic nervous activity. What that means is..
They turn on the fight or flight.
Yeah, interesting. Well, guess what? Yes.
So this can cause a rise in blood pressure, heart rate and the opposite effect in the gut. When you have a sympathetic effect in the brain. You have a parasympathetic effect in the gut. What I mean by that is, I always tell my patients, the more because they’re like, oh, man, I’ve been so stressed. I built constipation. Like it’s a physiologic phenomenon when we were evolving. If you’re being chased by a saber toothed tiger, you don’t want to have sex or take a poop. Right as you’re getting giddy.
Yeah. So you have to think fast and run.
Yeah, it’s really funny. So like, I’m always thinking about that, like from sex. To actually have an erection. You have to have a para sympathetic response. wants to have an orgasm you need a sympathetic response and to actually have a bowel movement you need a parasympathetic. So parasympathetic is the opposite side of the fight or flight..
So now we’ve got this thing. I’m like, Oh my gosh, wait a minute. So, when you have SIBO, I’m just going to keep using the SIBO patient because, for the first time, I could say, oh, Heli on the interview, kept saying, I just am so anxious and just in and remember, I took a two hour interview to 15 minutes. I really kind of had to get her back focused the whole time. She was just like, I’m just wired and not wired like Robb Wolf. Alright, so then this becomes this really wild, this sympathetic effect causes a rise in the blood pressure, heart rate, and then the opposite effect, where then the motility gets messed up leading to more leaky gut. It becomes a vicious cycle.
So then while all this is going on, more inflammation happens. In the gut, the leaky gut then turns on the inflammatory cascade. So then that becomes our normal talk. That’s I’ve given lectures on this part where I can show interleukin 12 and other 23. You know, cytokines blah, blah, blah, histamine..
These are all inflammatory markers.
Yeah, yeah. Oh my gosh, what if the very, very, very, very beginning of it is too much lactate acetate getting into the brain that then tells the brain to turn on the gut, or to turn down the gut to create more inflammation. And now you’ve got this process going on. So we’ve talked about this for SIBO in years, but now I’m saying oh, my gosh, we gotta fix the post biotic situation before we can fix everything else. Yeah. So now you may be thinking, Okay, this is crazy. I don’t have you know, it’s, it’s interesting. I don’t have anxiety, I dont have depression, I don’t have bloating, I don’t have gut issues. I’m going to turn this off dope because Oh my goodness. Now we’re going to look at some different things that these post biotics are actually linked to certain diseases..
And now we’re going to get outside of the gut. And I’m going to give you mechanisms about how these things affect or can create diabetes, blood pressure, dementia, all kinds of stuff.
Before we jump too far ahead. Can you give us an idea on what type of foods are used by these bacteria to create the post biotics that we don’t want?..
To create the post box that we don’t want? That’s that is a great question. What we do know more is that the foods that produced the post biotics that we like are fibers, and digestible starches are resistant starches, things like that, right? overnight oats, you know, whatever type of fibers, polyphenols, the skins of vegetables and fruits. What we do know is that when you eat a diet high in processed foods.. you end up creating more bacteria that produce more lactate and acetate.
They’re the things that I was kind of hinting at. And I kind of cheated a little bit but the things I was kind of hinting at were unrefined, our refined sugars. Yeah. And things like oils that we’re not really supposed to consume like high, high pressed vegetable oils and different things like that they, they believe that those may be the the foods that allow the bacteria to produce the postbox that we don’t want preservatives, foods that shouldn’t be sitting on a shelf for months at a time and suddenly they’re just fresh because they’re in a package. Those may they don’t know this for certain, but they think that those may be the kinds of foods that would lead to a lot of this lactate and acetate.
And nobody’s talking about the post biotics doing this. And spoiler alert, I’m going to get into it a little bit. But basically, once you start producing more of it, you’re it sends signals to those bacteria that are like we’re winning..let’s keep doing more. Yeah. So they end up propagating more or they end up colonizing more. whatever word you Want to use? Then you end up with more of that. And then they’re sending brain signals to eat more of that. And that’s that whole thing where now you’re out there wondering why you’re cracking open a bag of Oreos?
Well think about it if if I post bodek is influencing the way that my brain thinks she would have to draw the assumption that if I’m suddenly addicted to sugar, and I’m always craving sugar, whereas maybe I didn’t before but now everyone my friends would know me as someone who just really likes sugar all the time. That could just be the the lack of that post biotic influencing the brain who’s now told me Oh, you need to quickly go get this fix to make you feel this way.
Oh, I’m so glad you went with sugar on this one.
Let’s talk about diabetes.
All right. So I found an article that basically looked at diabetes in a rat model. This research showed that diabetic mice fed a sad diet, a standard American diet, and this diet which is high sugar, high fat, high fats not bad, right? High. I think high sugar is always bad, right? You combine the two and it’s a, it’s horrible. Basically, they fed us they fed these diabetic mice a sad diet, and they showed immediately that the acetate level jumped right up. This rising acetate caused an acute rising glucose leading to the pancreas to secrete excess of insulin Yeah, then it should have and then this rise in insulin led to a huge rise in a hormone called ghrelin. Ghrelin..
Yeah. Can you go ahead and explain to everybody what ghrelin is. So,
Ghrelin is the the mechanism by which your your gut, your GI tract tells you that you’re hungry, and you’re going to want to go out and eat. And you really want leptin to kick in and whenever you’ve not, or when you whenever you don’t need to go out and get hungry, basically. I mean, so whenever you see the commercials for what was The name of that lipitor or whatever it was, it was making people feel like they were. They were full. They were they were basically trying to mimic leptin.
Yeah, to make you feel full. Never saw. Not only works, but
But regardless, grillin is the opposite. Ghrelin is the one that drives you to go and seek food to go get nourishment. But it’s funny because they started to think and you could be, you could correct me on this, but ghrelin it certain instances, like for the sugar lack, that if you get low on sugar, then suddenly your brain is now programmed. Well, we’ll raise ghrelin whenever our sugar load gets low, right?
Yeah. So what was so cool is that these guys looked at, usually somebody will look at one thing, but they’re like, okay, our theory is this, we’re going to look at the post biotic acetate and see what its effect does. And those that have higher acetate levels are showing higher insulin, higher ghrelin levels. And so then those mice became voracious. They want to eat more than what did they do? They produced more and their desire to eat the crappy sugary type stuff because the ghrelin is saying get the cheapest, easiest calories.
Yeah led to higher acid..acetate.
Yeah, wait. Just Just a side note. This is also the argument that a lot of dietitians have on why it’s important to have what they call high density foods. So a refined sugar is not a high density food at all. It’s short lived in terms of the satisfaction, and you’re going to always want to keep consuming whereas if you eat the foods that you should eat, you the fibers and the polyphenols, etc, you you fill up and it leaves lots of work for the bacteria to produce the types of post biotics that you want.
100% so I have all these diabetic patients that struggle to lose weight, but really, it could come down to the bacteria and the bacteria that are producing acetate. I mean, maybe the future treatment. I mean, American Heart Association just got done doing this studying peripheral vascular disease. Maybe the encrinologist will start looking at changing the bacteria to help with diabetes instead of just throwing drugs at people. because quite honestly, once you get put on insulin that it’s it’s erases your ghrelin everybody I talked to they’re just like, man, I take an insulin shot. Bodybuilders take insulin so they can eat more and their growth hormone goes up.
Yeah, kids don’t do that. That’s not the reason.
So diabetes, I don’t care about diabetes. Nobody. My family has diabetes. It is what it is. That’s what somebody out there saying, Man, this guy keeps talking about anxiety. SIBO IBS had an effect me or anybody in my family. All right, I’m telling you that. Now let’s talk about blood pressure. The silent killer.
Definitely How many? Honestly, side note how many times do we have patients come through every day? We have a full load. I would say probably 20% of those on a full load day. We probably have to inform them about a blood pressure issue right or wrong?
Oh, we’ve seen more than 100 million people in our clinic. Yeah. Wrong. That’s that’s wrong. That’s 100 million people have high blood pressure in the United States. Okay. Yeah, we seen 100 million feels like 100 million.
Yeah, I didn’t know what that number was going. That sounded like an awful lot. But, but we do, but we do have people who for the first time ever, it they say feel fine, no meds. And then suddenly we look at their blood pressure, and it’s 170 over 98. So not normal.
And I’ve been pre hypertensive for a long time. I’ve changed my diet. And you know, I’m knocking right on 49 right now. So I’m pushing 50 here, and my blood pressure is better. It continues to get better as I focus on my diet
And I’ve always like, Man, that just doesn’t make any sense. Why would because, you know, I, you know, I’ll sit there and I’ll fly off the rails and cheat and pizza and stuff. Now we’re going to get into some of this stuff. So the American Heart Association says it over 103 million US adults have high blood pressure.
That’s a lot.
I still think that there’s more people that they don’t even realize.
100% because there’s only what 300 I’m guessing here. 340 million people in the US something like that.
Yeah. And so high blood pressure leads to stroke, blah, blah, blah, blah, everything else, you know, it’s that whole syndrome x thing. Yeah. So Oh, by the way, you know who does a really good job of explaining the whole syndrome x, the ne ne coined the phrase, it is Rob Wolf. Diabesity.
Diabesity. In his book, The Paleo solution, yeah, he actually describes this whole process of what I learned a syndrome x he’s calling diabesity. And how once you get into this pathway, what I’m going to say is maybe this pathway, this shift is now we have a mechanism that these post biotics are actually creating this whole diabesity issue..
Wow.. they could be and this would be obviously a step in the right direction.
So do remember the whole thing that I told you about the sympathetic neuron activity so acetate and lactate get in there, their little free pass VIP card. Yeah, and then actually poke on the nerves chair and they turn on the sympathetic system. Well, researchers showed that young pre hypertensive rats exhibited leaky gut protein expression. They were pre hypertensive, and they were looking specifically at leaky gut. I don’t know if it was zonulin or whatever they were looking for. But they found it before they were hypertensive. Starts in the gut..
Crazy. Now, the more signs of leaky gut, the more sympathetic output these rats showed, increasing the permeability led to increased brain permeability. And they showed that acetate and lactate stimulated an area of the brain called the hypothalamus,
Very important master gland
Master gland super, super crucial thing. Now, this actually increased the sympathetic signals leading from the hypothalamus down and blood pressure started to rise accordingly, as asked lactate levels went up
That’s a no one’s really built that, that that pathway. I’ve never seen anybody do that.
It’s, I mean, I read this and I was like, What? How are we not describing a treatment for high blood pressure, diabetes, obesity and thinking more about the our microbiome than just throwing? I mean, how many of my patients have six, seven? I mean, you take a beta blocker, what are the side effects of that fatigue, depression, erectile dysfunction, then you take calcium channel blocker, and you’ve got cough, and you’ve got ankle edema, and we’re throwing this stuff, and all of a sudden, we’ve got rats where we can show if we decrease this. More importantly, they show that the sympathetic shift, altered the microbiome, which led to a less diverse microbiome and increase in lactate and acetate producing bacteria. One more time it got into the brain, the brain sends signals to the body. That is you’re in fight or flight.
And because and have, you can logically try and work your way around this. But basically those same signals, tell more of those bacteria just like you talked about with the sugar..
Now more of the bacteria are being signaled to grow. And now you’ve got a cascade of high blood pressure type stuff.
Unfortunately, it sounds like what what we’re doing is building a friendly utopia for the bacteria that we don’t want, right? And then they’re basically telling your brain to go and get some more the food that will allow them to build more of the byproducts or the post biotics that you don’t need that are going to make your problem worse. And just a side note, so overstimulation of the sympathetic nervous system. It’s really funny how we’re talking about diabetes, we’re talking about high blood pressure, we’re talking about insomnia, we’re talking about anxiety, all of those things are just simply going to compound and make the same situation worse, the diabetes gets a little bit more out of control and the insulin goes up and the ghrelin goes up. I’m gonna keep eating. And by the time I keep eating and I post biotics make my anxiety level go up and I can’t sleep, that’s only going to perpetuate more of the same and you can only I would assume, correct that by getting the right bacteria to eat the right. the right food, so that you have the right post biotics, right?
That’s exactly it. Just that easy Eric.
That’s all you got to do. All right, well I guess thats it..
Mic drop spoiler.
But it just it’s it’s scary, though, that that quickly, you can escalate while you actually have no idea that it’s happening to you. You just don’t know.
You’re not in control.
No you’re not.
So I mean, here we have this deal with a rise in lactic acid acts like a positive feedback loop to create its own little lactic acid factory.
It’s self serving. It’s not in here for you
No, those bacteria, everybody We talk about an ego centric society and everything. Well, as it turns out, I’m learning more and more that bacteria are truly egocentric. Also
You gotta keep them in check.
You know, C. diff would love to just run rampant and do this. See that being a bacteria that when you wipe out other bacteria due to antibiotics, you end up with horrible diarrhea. That’s something we deal with all the time. They just be they have this they throw this big party and make you really sick.. so the bacteria themselves, they have a self serving need to keep growing. They’re not looking around going. I need more diversity here. Everybody wants to win. And when you have lactate producing bacteria they want to win. That goes back to the whole Satish Rao article where he gave SIBO patients probiotics, and they produce more lactate. He checked the lactic acid levels and those people that had higher lactic acid levels had higher depression and anxiety.
Damn, that’s not good. That’s not what you’re after.
So what we’re looking at here is microbial dysbiosis micro dysbiosis is the term that the natural path to use everywhere. And really what that means is a lack of diversity is not dysbiosis. It just means that there’s an imbalance in your microbiome, you have too much of something and not enough of another. They showed with rats that those rats with a lack of diversity tended to have higher levels of the lactate and acetate.
And, again, not the post biotics the short chain fatty acids that we want.
So understanding that knowledge, these researchers started to look at stroke and dementia. And getting back to the brain. Yeah, so using that model, they were able to show that acid and lactate can cross the blood brain barrier, which we’ve already discussed. Then these guys focused on one unique thing I already discussed how they tap on the neurons and do this. Well. Something else that that these post biotics short chain fatty acids do is that they actually lope they actually dropped the local Ph. So this local drop in pH caused inflammation At the neuron level, this inflammation led to increase in certain markers of inflammation like human necrosis factor, and it causes cell death.
So just in layman’s terms, why that matters is if you drop the pH and basically you are creating a more acidic environment. And just a side play, which we haven’t even mentioned yet that actually creates more work for your respiratory system to basically correct that. And by you know, I’m saying because you have to blow off the acid your blood, but your blood buffering system is going to have to produce more bicarbonate just to basically take care of the neurons that are now in a more acidic environment. This is exactly why whenever you’re an athlete running around, you breathe heavier, right? Because the acid formed by the activity throughout all your muscles is dumping into the bloodstream so that you can breathe out co2, well, if you’re not running around, you don’t really want to be dropping your pH systemically. So that’s That’s a big No, no, that’s not what we’re after.
So once you have a cell die, that leads to oxidative stress… which ultimately leads to inflammation. Those rats develop dementia.
So chronic inflammation..
Chronic inflammation. So we’ve always talked about chronic inflammation. This is first domino effect.
The first domino effect is this we’re getting into a cellular level. They even took normal tensive rats, so rats with normal blood pressure, and they gave a microbial transplant fecal microbial transplants on mice that were genetically prone to have high blood pressure and strokes, okay. And the rats who received the transplant developed high blood pressure and had strokes. So watch the episode where we talk about Heli. Like once I’m getting into this, I’m like, why would we do fecal transplants without knowing all of this?
So let’s break that down real quick. Basically, what you’re saying if I understand correctly They took the bacteria that was somewhere else and put it in another rats colon. And they were able to replicate that these bacteria when fed with the wrong stuff being the wrong count of bacteria wrong diversity count, right? They gave off post biotics that lead to more damage to the rat itself.
So the so the rats that they euthanize when they saw that they had strokes or that they had dementia, they show that they had much higher levels of acetate and lactate, the rats that lived surprising, not surprisingly, at all, actually, now after looking at this, right, the ones that did not develop high blood pressure or have a stroke had higher levels of all short chain fatty acids, but they had higher levels of butyrate overlapped.
So they had but they had they had the right concentration. Right?
They had the right concentration.
It’s not that lactate and acetate should never be produced. It’s that they’re they’re being overproduced at the expense of what’s healthy for your body.
And so one other thing one other brain disease that I want to get at and then we’re actually done with these diseases. But I hope you’re seeing that we have diseases that are specifically related to this.
So can you smell me and tell me if I Parkinson’s? Hang on a second?
That is not something I can detect.
But somebody can because you sent me that article.
I did. Yeah.
Tell me about that.
Well, there is apparently a woman who has a, I can’t remember what the study is you kind of put me on spot here. But basically, she was able to show all but less than 3% of the people she was able to identify disease states in them and one of them was parkins by a smell or an odor they put off which I found fascinating. She was able to accurately diagnose people by the the odor or the the pheromones or whatever it was that she detected. And then of course, you did a little bit deeper. They talk a little bit about why so..
Yeah, so as it turns out, so this woman, her husband, died of Parkinson’s, and when she was in support groups, she remembers her husband smell started to change like a decade before. Then he started developing symptoms.
Oh, you know what, I’m sorry, quick shout out my youngest son Mac. He’s the one who showed me an article did it
Really? …. Cool. So it’s, I looked at the they believe they’ve discovered what molecule she’s actually smelling through mass spec. But that’s kind of irrelevant, because what’s happening is is now I’m linking that to this. Because evidence is now showing that dementia and Parkinson’s begins 10 to 20 years before the brain is actually affected.
And if I remember correctly, further down the article didn’t they say they were experimenting with her to try to find alzheimers?
Correct, correct. Yeah. So everybody’s like, Oh, this woman’s got this magic skill. What is she’s smelling?
Acetone when I go into ketosis.. I have acetone coming out of my breath. Right Haven’t you you’ve actually smell different what you’re breaking down. It’s ketoacidosis
Or severe diabetics
fruity acetone, head on.
They have the fruity acetone..
So we definitely put off different smells and different, you know, chemicals builder. So this is interesting Parkinson’s, these diseases have build up. So Parkinson’s specifically has a buildup of proteins that are actually seen in the gut first. So when they look at the proteins that create the Parkinson’s disease, right now, researchers are looking in the gut, and they’re finding that protein buildup in the gut before it builds up in the brain.
And just so you all know that this is not made up pseudoscience, just a completely separate example, GI bleeds, going through a hospital, you can almost always tell a patient that’s dealing with a GI bleed simply because I mean that that smell is unmistakable right?
Oh, yeah. I mean, I think that I think other third world doctors rely on their senses visual smell.. to really try and diagnose a patient.. And they get a little bit more deep in it kind of thing.. So that you know, there’s the when I did gynecology, you did what was called With test, which is the pap smear when you try and smell a fishy odor and things like that, so we don’t do that much anymore because you said it to a lab, but..
Yeah, hard to do.
So these, these diseases Parkinson’s could actually develop early on. Now what’s really interesting is that Parkinson’s could be related to the Vegas nerve.
Causing the inflammatory buildup of these proteins.
So rats given a fecal microbial transplant from a Parkinson’s rat immediately showed an increase in acetate levels. Then when they followed these rats, they slowly developed motor function problems. In humans, we now realize that those people with Parkinson’s have a dysbiosis I’ll say it one more time. Now we’re starting to look at all these chronic diseases and researchers are going let’s look at their microbiome. Almost all Parkinson’s people have a dysbiosis
So people would say, Oh, well, if you have Parkinson’s, you’re sick. You have a dysbiosis. I’m saying no, the dysbiosis caused the Parkinson’s.. we have to prevent that. Start there. So to answer in a very long winded, complex way to answer Don’s question, shoot, it’s so complicated. But I think we are now seeing a starting point. I think that if you keep your microbiome diverse, plenty of bacteria that can produce butyrate and other short chain fatty acids, and in my opinion, now thinking about it, that fecal transplant, getting a fecal transplant may carry more risk than we ever thought looking at these animal models. So Don’s question was, Well, what do we do? Is fecal transplant good or bad and only in that we know for certain as if you have a complex microbiome, a diverse microbiome, and you feed it, what it needs, then you’re going to produce the appropriate amount of post biotics, which will keep you healthy.
Yeah, well, that makes that certainly makes the most sense. And to your point where you kept resetting for people who may not have known someone who has high blood pressure, dementia, diabetes, Parkinson’s, anxiety, insomnia, if you exist, where you don’t know anyone else like that, thank you for making this podcast, the only thing that you do to connect with other humans, because that’s impossible.
They’re living in this utopia.
It’s just impossible not to know someone who’s at least affected by something like that. And so I mean, it’s kind of crazy to think that it all comes down or it could possibly all come down to the bacteria that we have naturally inside just simply need to be fed the right things at the right times and in the right amounts. You can make The case of I don’t want to look obese I said together so not don’t eat fast food. Well, the truth is, you look, you have those kind of manifestations where people aren’t happy and stuff like that, because that’s not the food you should be eating all the time. You’ve got to take care of yourself. Polyphenols is an easy way to get started.
100% So, the now I’m gonna have to do a whole episode on butyrate because I went down
Well, we should though.
I started go down butor and then I found all these great articles. There’s articles looking at different polyphenol supplements in the butyrate elevation that they are. Watch the plant based episode with Dr. Juan. Yeah, because he gave me his Neo greens as a sample and we showed it there. I looked at it. If he thought about this, then he’s I mean, he’s a super wicked smart guy in there. It’s he’s got probiotics, fermented, fermented vegetables, probiotics, with polyphenols in there, which means that possibly, spoiler alert, again, is just it’s too much. But there’s, there’s there’s people out there that are combining polyphenols and probiotics to produce these short chain fatty acids, right and ratios that they want.
And maybe not fully understanding why.
Not understanding why not understand if it gets absorbed, not understanding if it’s a natural way to do it, I don’t know. But it’s at least a step in the right direction.
I’ll even reverse that. The answer oftentimes, when people only add, let’s just say they’re only adding butyrate that’s probably not the answer either. You still need the healthy ratios of butyrate along with acetate and propriate. And, and lactate, it would be odd to only produce butyrate because that will probably yield something else that nature has a great way of having Governor’s on certain systems, right. So I would imagine that there’s probably going to be a healthy balance a healthy ratio, which is why you want the bio diversity in your gut.
I’m sure 40 years ago, Dr. Ian Quigley, the godfather of probiotic sat there with a petri dish and went his hair stood up. And he went, Oh my gosh, this, this live bacteria is doing amazing things in the gut. And then 40 years later, we’re still trying to figure out how to get probiotics to people. Because in a petri dish, it does amazing things in the human body, giving one strain and now we’re up to whatever who knows. 50 strains of 50 billion units. Is it really doing anything? We don’t know?
Is it even getting there?
Is it getting there? We don’t know. And this could be the exact same thing. So the knee jerk reaction would be, oh, I’ll just take more beer right and then I started looking at different there’s a ton of different butyrate supplements much like sulfurophane where a lot of people are trying to you know, jump on the marketing bandwagon of broccoli sprouts… And so there’s very few of those that are actually viable. Yeah, now now we’re which broccoli is one. That’s what I like to recommend Brock elite. But I am so excited because I feel like because of this podcast, because Atrantil to because of what we’re learning and the scientists that I’m meeting, it’s all starting to come together and truly I feel like we are changing the health landscape of anybody who purchases Atrantil to and our whole separate episode of kicked him out neuroinflammation acetate touching this and that don’t even get me started on how the fatty acids in a full spectrum hemp CBD product
Cross the blood brain barrier and start mitigating some of that
I mean if I if I had Elon Musk money and I could just sit there and look at different things. I mean, like, I want to know what what this CBD product does on acetate levels in the brain.
And just start asking questions like that. Each one of these studies was somebody who had a question, and it just happened to be that they were looking at short chain fatty acids, the effect and the effect it had systemically and props to these people to start doing that because that’s hard work.
So in short what should someone do? Who hears, okay, I need to have great bio diversity. I want to change the way that I’m approaching stuff. I want to be able to feed my new bio diverse microbiome correctly. Dr. Brown? Where would I start?
Well, just I’ll tell you and I don’t ever tell people to do things I don’t do
So and I don’t ever tell people to stop things that I still do. So be careful what you ask. Number one, we need to increase the diversity of the microbiome. The best way to do that is to increase your fiber. So the fiber that means soluble and insoluble fiber, two different kinds of fiber one soluble mixes in water that’s like Metamucil insoluble, it’s like the skin of vegetables. What we are now realizing is that skin of vegetables has this other beautiful molecule called polyphenols at what makes vegetables colorful. So I try to take in a certain amount of fiber I try and I’ve now because I read this. I went to Carla and I went to Whole Foods and I got some steel cut organic oats. And now I’m just soaking them in the fridge. So now I have cold oats. And the reason why is oats are a resistant starch. If you cook them and make oatmeal, the way we do it, you make it more easy to digest by making a resistant starch. I’m going to increase the type of bacteria that produce more butyrate.
Yeah. So now since I’ve done the research on this, I wake up and I just take a couple spoons of these oats that are just soaking overnight. And now when I tell people that watch Dr. oz and stuff, they’re like, yeah, overnight oats. Where were you in 88 when Oz talking about whatever he started. Like really, people were talking about that they didn’t know why they were talking about now. That’s the kicker. So one of the problems that I have is that if you tell me to do something, I need a mechanism of action.
If I can explain the mechanism Then it works for me.
Now I’d say that I would say that I’m open to ideas also, but I don’t want to change this because you say it’s great.
Just tell me why.
Yeah, tell me why. So, increase your fiber, increase your resistant starches. You can do the resistant starches a lot of different ways. green bananas or plantations. Lloyd is Puerto Rican. So we do a lot of plantation nice. So that’s a that’s a paleo friendly, definite starch.
Shout out to Bubbas sells. green bananas. That’s what makes Oh, yeah, they are well designed by a guy who had Crohn’s disease. Right. You talked to him? Yeah, it’s so Bubbas Fine Foods, you can check them out. So if you’re looking for a safe snack, there you go.
And then now I’ve got all these articles words, people are actually starting to look at that the American Heart Association at the beginning of the show, I talked about how they’re using polyphenols to help with peripheral peripheral vascular disease. I know that one of the best ways to create post biotics and I wasn’t even thinking short chain fatty acids. I was thinking more along urolithin and these complex molecules that these other scientists talk about, there was an article that actually showed a molecule similar to Atrantil had an increase in butyrate, a whole separate show, because that’s going to be a, that’ll have to be a two hour show about how to increase your butyrate levels
But the beauty is, it isn’t like you’re just increasing butyrate levels you’re going to eat, you’re going to increase the diversity of the microbiome and allow it to happen. And then ultimately, polyphenols, fibers, resistant starches, and I’m going to now go down the pathway of why so many of my patients feel better on CBD. I think there’s something to do with these short chain fatty acids. I just did. I have not gone there yet, but we’ve got our secret weapon and she’ll find something out there.
So ladies and gentlemen, if you want to start to work on making your gut a little bit more diverse and healthy, go ahead and get your soluble insoluble fibers supplement with good trustworthy polyphenols. There’s nothing wrong with controlling inflammation systemically with a good CBD a good diverse whole foods diet that’s really coming down to and I’m about to try your idea for overnight soaking oats I’ve never done that before
I just started doing it. And if you don’t have, like if you’re lacking diabetes, you don’t have enough high blood pressure. You’re not obese enough, then ignore this whole podcast.
Yeah, do whatever you want. That’s awesome. That sounds great. What lots of knowledge day on the show. Thank you all so much for watching and listening, Be certain to like and share if you want to go back and check out the episodes with Heli, with Pannez, or Dr. Doug won. Just go back to gut check project.com You can find all of our episodes cataloged on there on the page this we’re improving it all the time, be sure and sign up for the newsletter. Starting tomorrow, everybody who is in the KBMD health universe will be reminded of the latest published show. So if you ever get to catch up with the shows, just sign up, you’ll be notified each week, every new episodes, we release it
Go to KBMDhealth.com. Right. And one of the things that I get that I see the most common is rectal bleeding. And we went through the trouble putting together a little rectal bleeding free book that So download that you get a free book. And then we can keep you updated to these shows. One of the things if you can like and share this, the more this grows, the more that we get access to scientists, the more that I can take deep dives into stuff like this. If you’re still listening, thank you. This is like that person that actually reads the whole I saw some some Reddit deal with some woman got $10,000 because there was like a 10 page like one of those weird contracts for like a nothing that you’re supposed to sign like, like an iTunes agreement or something. Yeah. And there was a little tiny fine print in the bottom. If you’re the type of person that’s reading this fine print and you send us an email and you’re the first person to do it will send you $10,000 they send it $10,000 so if you’re actually still listening after all that nerdy stuff that I just talked about, we can’t send any money..
Be the first one in the subject line to write the word butyrate spelled correctly and you will get a free altran to bottle and CBD of your choice.
Butyrate so the first person to send in an email to.. no they have to download the book.
Yeah download download the book.
Yeah, they have to download the book title the book and then reply with a type butyrate
Yeah, type butyrate just spell it correctly. Look it up and send it to us. It’d be awesome. You be the first one you get a free Dr. Brown’s signature package. Let us know if you want sentiment or natural
Does that mean I sign the box of Atrantil that the signature package
So much extra stuff you want to do its not going to work out? Thank you so much like and share like and share. Remember, this show isn’t intended to treat or diagnose. If you have a health issue, be sure you go and check it out with your physician. We will see you at Episode 34 coming soon. Thank you.