Episode 29 of the Living Lfe Well Show: Gut Testing and Evaluation
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[00:00:00] Welcome to the Living Life Well Show, the intersection of God's Word, today's science, and healthy living with common sense application, all based on the truth of the Word of God. I'm your host, Dr. Jon Skelton. Now let's get straight to the truth.
Welcome back to the Living Life Well Show. Today I want to talk about gut testing and evaluation. Gut health is very important and we hear quite a lot about gut health in the general news and in the media. alerts many times to new scientific discoveries. We're seeing a lot of this surrounding the new weight loss drugs
today though, I want to talk about specifically how you can evaluate your gut. Now, backing up before we get into the [00:01:00] objective. if you will, we want to talk about some subjective measures that you can look at to really evaluate your gut and your response and what could be the underlying issues with you.
So gut testing can be costly and can be difficult to access, especially some of the tests that I'm suggesting, they're not widely used. used in. So really being able to do an evaluation of your gut by yourself can create tremendous benefits. One of the big principles that I have within our program at 90 days to living life well, is learning to recognize what those things are that are beneficial and all also those things that are detrimental.
Many of you are very familiar with doing a food log. Food logs are very important and they can be beneficial now [00:02:00] in Living Life Well, what I really recommend that you do is not only do a food log but do a mindset and or interaction log and even a purpose log. So basically you just combine all three of these together.
There's a little bit more to it than that and I am not suggesting that you spend 30, 40, you know, minutes a day doing this when I'm suggesting at the end of the day or the start of your day, whatever time is beneficial to look over that previous 24 hours and really just kind of write down the highlights of what you did, who you interacted with what, things you know, you came in contact with that day.
Were you traveling? Was it a routine day? Was there something out of the ordinary that happened? Those things. And as far as the food goes, what I'm talking about is not by any means quantities but really I'm talking about the [00:03:00] types of foods. I grilled chicken and I had broccoli for lunch.
I had a steak at dinner. I had this mixed vegetables or I had rice or whatever the case may be. Just kind of going through that. And then looking at that. Now, most people, when they're familiar with doing food logs, they're really kind of looking at, you know, what was done either that day or potentially the previous day as to how it's affecting their gut.
Well, we know that food sticks with us. So I like to give the example of a food allergy. So working in the emergency department. For the past 20 years, I see this quite often, is somebody will start on an antibiotic, start a food, they've ingested it. Initially, many times they have reactions right away.
Many times though, those reactions [00:04:00] are delayed in onset. You see, any time we take something into our body physically, It sits around there for two to three days and so really when you're looking at a food log and looking at potential allergens or things that could be causing in this case GI distress you really want to look back two to three days to really be sure that you're making a correct correlation.
This is going to take time to develop. This isn't something that you can do for a week and then say, Oh, I'm good. Because what you're wanting to do is you're wanting to look back at those good days as well as those bad days. bad days, looking back two to three days prior, and then draw your correlation.
Once you have multiple good days, multiple bad days, these correlations become much more easy to make. So food is pretty easy and self explanatory to [00:05:00] see that, you know, those things that we ingest can directly correlate with our gastrointestinal tract because they're solely involved in our gastrointestinal tract.
We take it in, it comes out and it is utilized in between. You know, Now, when we're talking about stresses and anxiety and stress response many times it's not necessarily the food in and of itself that could be causing the issue. Sometimes it's the underlying stress that has all altered the architecture of our gastrointestinal tract and our neurochemical cascade that is causing a GI stress response.
So that's where really looking at the interactions that you're having, your daily stresses what's going on with your routine are important as well. And so this is why I recommend you know, logging all of those [00:06:00] together so that you can get a really good picture as to what's going on. And this isn't true just for gastrointestinal distress.
This would be through true for, say, joint pains. This would be true for headaches or migraines. any type of chronic issue with fatigue energy levels doing this correlation and looking back is going to give you some good information and insight, but it has to be done consistently and over time.
If you're only looking at the good days and or the bad days and logging those, so today was a bad day and you do that you're going to get Probably maybe a little bit of benefit, but when you do it over time, say a 90 day plus period. You are going to get tremendous benefit for doing that.
So I really recommend that you continue to do those food logs, the interaction logs the mindset, purpose logs, and even movement, because, you know, there [00:07:00] are some things. things that we're going to do when we exercise that, you know, immediately feel good. And then we're going to notice that those endorphins are continuing to be released.
And so over time, we're going to continue to get benefit from that. That can then allow us to lean into exercise and or movement that is beneficial for us. As I said, the mind plays a huge part in this, and so if you have a really negative day, typically that's going to give you some symptoms. That's going to depress those good, beneficial neurochemical release, such as dopamine and serotonin and oxytocin.
It's going to aid you. increase cortisol and stress hormone response. It's going to increase your catecholamine response, which is going to in turn cause you to feel fatigued and tired. And so that is why I say really [00:08:00] looking at a mindset and or interaction log is going to be beneficial to you. Now getting into the specifics of the gut and really looking at testing for the gut. That is my first line test, is doing that recognition log and getting a correlation. Now, that obviously is going to yield some good results, however, that is not going to tell you exactly what your gut biome makeup is. That's not going to tell you if you have specific infections.
That's not going to tell you how well the immune system of the gut is reacting. It's not going to tell you how well the liver and pancreas and gallbladder are working together in the gut to really secrete those hormones that are necessary for you to get full.
benefit of the foods that you're eating. So we want to [00:09:00] make sure that we're doing a good objective evaluation of the gut. And for those things, I recommend the GI map. The reason I recommend the GI map is as you've heard me speak about H. pylori, it covers H. pylori tells you the quantity of H.
pylori that you have. In addition, it tells you any virulence factors, possibilities. for cancer causing types of H. pylori. And then it also, if you are choosing to treat H. pylori that you have. It also updates you as to what antibiotic regimen may be best as well because it's going to show you any potential for resistance to those antibiotics that are typically chosen and recommended for treatment for H.
pylori. In addition, It tests for a whole host of other bacteria parasites worms, viruses, protozoa, all these different things that we [00:10:00] take in and are exposed to on a daily basis. So no matter how well you clean your hands, no matter how well you clean your food, These things are still going to be on there.
If you are in any type of relationship with a committed other you are also exposing yourself to what they are exposed to but for those reasons, I think objective testing is very good, especially if you're unable to get any kind of a correlation with doing these other more subjective tests that have suggest by making the recognition log.
With that being said, let's kind of get into what a GI map kind of looks like and does. So the GI map is a particular test that's made by a company called Diagnostic Solutions. And basically what this is doing, it's looking for any type of pathogenic bacteria. I will [00:11:00] include the sample report that Diagnostic Solutions provides in the show notes so you can go back and look at this yourself if you like to.
So basically the way the report starts out is it starts out with the pathogens the bacteria that are most likely to cause issues in our gut. And the way this works is it gives you a reference range on the right side of the page. If something is above that reference range, it is considered definitively infectious and abnormal levels and not just passing through.
So that is. One of the key factors that you want to look at is you want to look at, do you have any of these pathogenic bacteria? Once you see those pathogenic bacteria, they could be causing these opportunistic or overgrowth infections. What typically is kind of referred to as [00:12:00] dysbiosis. Now dysbiosis can be tested for in a different way with breath tests and things like this.
looking at different levels of gases which can in turn indicate that you have overgrowth or dysbiosis, typically bacteria in the small bowel that could be leading to a lot of your symptoms. So we think of this when we think of IBS chronic abdominal pain, bloating constipation, diarrhea these things.
And when you have these pathogenic bacteria you really want to undertake a course of treatment to eradicate them as much as possible. And so when we are looking at pathogens, what we're really looking at that they have here are things that are campylobacter, C.
diff E. coli, O157. We've seen that a lot in the media in the past. And Shigella, Salmonella and some other [00:13:00] ones. And then there's some more parasitic species. type pathogens things like cryptosporidium and then viruses as well.
Adenovirus, norovirus these are all very common viruses that we see quite often. So we look for those and those are present when active infection going on.
So if you have any of these in general, I recommend really looking at the downstream effects, meaning looking at what's going on in the small bowel, looking at your intestinal health. These could be things that are quote passing through, but they are generally very infectious and more likely to cause a lot of symptoms.
So if you have. any of these in any kind of quantity that registers, I typically recommend going ahead and pursuing a course of treatment. And that's going to be [00:14:00] important for you to ensure that you're maintaining your gut biome because as you have these infections, they can alter the architecture of the good bacteria that are in your gut.
So you want to make sure that you really look at those pathogenic bacteria first. Well, right after those, then the next thing in this report is H. pylori. The nice thing about this is, again, it tells you about the virulence factors. If you have those or not, that are going to be associated with more severe infection or more possible complications from the H.
pylori.
The next thing that is in line is the commensal bacteria. This would be your makeup of your gut biome. So it has a reference range on the right and the type of bacteria on the left. In the middle, it tells your level of bacteria with a red, yellow, and green section. [00:15:00] Green being in the middle for the appropriate amount.
And the red and yellow being on either end for either too high or too low. What this tells us is the makeup of different families and or species of bacteria that you have. So the good bacteria being the bacteriodies fragilis, the bifidobacterium, even enterococcus, eschericia, lactobacillus, enterobacter, Akkermansia, feacalium bacterium, and Roseburia.
In addition, it also tells us about two large families and their relationship to each other, including bacteriodtes and firmicutes. And looking at that ratio there, now two of the real keystone bacteria to this. Group that are important and found in many probiotics are going to be bifidobacterium and lactobacillus.
So, when you're looking for a probiotic, you want to make sure that it has 15 [00:16:00] billion colony forming units number one, to be at an appropriate level of bacteria to be beneficial, and then two, you want to make sure that it has the makeup that it has multiple strains of bifidobacterium and lactobacillus.
These two are shown to quote raise the boats of all the other good bacteria that are in your gut and in general. Now, a couple things that they don't really seem to help with and a couple of these keystone bacteria that I find that are lacking quite often. One is Akkermansia. We talked about Akkermansia previously.
Akkermansia being a bacteria that helps with natural GLP1 production and activity, insulin sensitivity. Many people are lacking this when I check. In addition, Fecalum bacterium. Fecalum bacterium is typically found in the dirt and those things. And I joke that nobody drinks out of a water hose.
We're all drinking bottled water. [00:17:00] And so we're not getting any of the Fecalum. The good news about Akkermansia is there are supplements to help with this so that you can get a little bit of that benefit from taking in a probiotic containing Akkermansia. Currently, at least at the time of my research, time of this recording and to my knowledge, there is no available probiotic with feacalibacterium.
So those are the good bacteria that we see. And so moving on after this, it has all of the overgrowth or opportunistic bacteria. It has it listed into several disciplines. different sections. The first section being dysbiotic and overgrowth bacteria. These are going to be bacteria that are very common.
We see quite often and they can then overgrow. Same thing as discussed previously with regards to the pathogenic bacteria, we have a reference range then we have [00:18:00] a recorded range. And so when there's a number there, it means that it was detected. If it is not red, then that means that it was low, lower than the reference range and may not be causing an issue.
Now you also have commensal overgrowth bacteria. So methanobacteria and dysfolio and then you have auto inflammatory or autoimmune related bacteria, and these would be things like citrobacter, klebsiella, proteus many of these. Now, there are some good bacteria that we have that can be inflammatory and autoimmune.
Mediated, those being in the Escherichia or E. coli family, Enterobacter those can also cause overgrowth and cause issues. After that, we have a testing for fungus or yeast, Candida, Microsporidium, in addition a few different viruses, cytomegalovirus and Epstein Barr virus. [00:19:00] Now back to the overgrowth or opportunistic infections.
Now, My practice is that when I see multiple of these bacteria and I see pathogenic bacteria present via E H. pylori or one of the, one of the others, like Campylobacter I always treat that first. We see kind of what happens with symptoms and maintaining a better diet, and then potentially we'll treat with a regimen of either antibiotics and or herbal supplements depending upon what the client desires.
Now the interesting thing about the antibiotics that are associated with treating dysbiosis the not systemically absorbed. Primarily what we're talking about is Xifaxan and Neomycin and the good news is they're not systemically absorbed so you don't really have to worry about getting into the body and causing more [00:20:00] issues there they do tend to just work locally, which is nice.
The bad news is that depending on insurance Xifaxan can be extremely expensive up to about 1, 800 for a 10 day course, which would be required. In addition, treating The dysbiosis with an herbal remedy shows just as good success rates when compared head to head with these other antibiotics, Xifaxan and Neomycin.
So for many of my clients, they choose to go the herbal route. Now, moving on with regards to the GI map, the next thing that we see on here are parasites and then worms protozoa and worms and so if any of those are present it will have a notation there as well. Finally, for the GI map, we have the intestinal health markers.
So the first section is the steatocrit and elastase, and this is really dealing with the liver function, gallbladder [00:21:00] function, pancreatic function their enzymatic secretions and how well those seem to be occurring and helping in digestion. In addition, you have some GI markers with
beta glucuronidase and occult blood. And so beta glucuronidase can come back at high levels causing some disruption in the gut and allowing for further overgrowth. In addition, blood can be present if blood is present typically want to do follow up with regards to this especially if it's in a large quantity.
And then the next section is the immune response. This consists of secretory IgA, antigliadin, and eosinophil activation. The secretory IgA is associated with the immune system response in the gut. And so when you have multiple infections, you would anticipate a higher response. Many times what we see is that these infections have been chronic and there's been somewhat [00:22:00] of a depressed response in the gut with low levels of a secretory IgA.
We also see the antigliadin. Antigliadin can be associated with gluten intolerance or reaction. And so, many times, when somebody comes in and has high antigliadin, doesn't necessarily mean that they have celiac, it does mean that they are sensitive to gluten. Once they take a period of time where they are eliminating gluten, eliminating grains, eliminating sugars this antagliadin will come back into normal range.
I've seen it to where it's been over 500 and then subsequently comes back in is now in the normal range and the client can then tolerate some gluten be it better to be sprouted grains and ancient grains than what is typically on the store shelf, but they can participate in things like bread or tortillas or [00:23:00] pastries.
And so, that is something that, that we want to look at and know, and that really helps guide dietary instructions for people as well. In addition, we see in eosinophillic activation. eosinophil activation protein which could be associated with parasitic infection, autoimmune disease, or chronic infection as well.
And so, that's noted. Now, calprotectin is associated with inflammation of the colon. colon and when it's elevated and we're seeing occult blood then we definitely want to look at getting evaluation directly of the patient's colon typically with getting a colonoscopy at that point.
because calprotectin can be associated with inflammatory bowel disease things like Crohn's or ulcerative colitis. So it'd be really important to follow up on that anytime that comes back elevated or we're seeing a lot of blood in the stool and or both. [00:24:00] And then finally the last thing is the zonulin.
Zonulin is associated with leaky gut. When this comes back high, what this is telling us is that your food that you're ingesting is not being broken down to the very small particles God intended, and so, that barrier that is tending to keep the food out until it's at such a small particle size has been disrupted.
And so now proteins and the different nutrients are coming in, in a larger than expected size. That then can trigger an auto replication. autoimmune response and cause your body to essentially attack . Over time this can get worse and worse, especially with eating a high sugar or potentially a high grain diet in general can cause [00:25:00] Increase in the zonulin or basically increasing leaky gut and therefore furthering the autoimmune response.
So, that's something that we want to take a look at as well. And then finally if you do have any of the antibiotic resistance genes to H. pylori those are going to be listed on the final page as well. So when we are looking at really wanting to try and heal the gut we've got to really make sure that we are being patient.
So when we're making changes with regards to the gut, we want to give that a period of time. In addition, we really need to be. As much as we can consistence. Consistency is really going to allow us to really get that change that we're looking for.
We're talking about affecting the gut biome, those opportunistic and pathogenic infections, [00:26:00] as well as our own bodies.
Immune response and digestive properties through the gallbladder, the liver, the pancreas, the inflammatory response to the foods that we're eating to calm down. So the more often that we kind of. Indulge and give ourselves a little bit of those things we're talking about sugars and grains. The more likely we are to cause confusion in our body's response. Meaning our immune system response.
In addition to our gallbladder pancreas. And liver response. We're kind of on this yo-yo. Going back and forth with, okay, today we're eating good tomorrow or not today. We're eating good. Tomorrow not breakfast is good lunches, horrible dinners kind of in between.
So when we're on this kind of yo-yo train, our body never [00:27:00] really has the opportunity to help really resolve any issues that may be ongoing. So the other reason that we want to provide consistency for a significant period of time is the fact that. These changes can occur slowly, and when we are doing an intervention like antibiotics or a particular herbal regimen we need to make sure that it is effective.
The issue being, specifically with bacteria, when we take, say, antibiotics, we can kill it down to a significant level to where There's only a few cells potentially left or we may have eradicated all of them. The problem is that if we leave a few cells and we test immediately after finishing treatment, we may miss the fact that those cells are [00:28:00] still there.
Over time, those cells will begin to replicate and then start to affect our gut because they will now be in larger numbers again. Just like a baby grows and gets bigger same thing is going on here. There are more and more cells developing and so, the orders of magnitude of the number of cells are going to then start creating other issues.
So we might fool ourselves if we test right after taking a treatment for, say, H. pylori, and we show that There's no H. pylori present because we've killed it down to such a small level that it's not going to register on the test because there's so few cells. However, if we had waited a few weeks and then retested, we would be able to see that Oh, okay, I'm not imagining things, I'm [00:29:00] still having these symptoms, and H.
pylori is still present. So specifically with H. pylori, what we do is and this would be the same would be true for any of the real pathogenic type bacteria we are going to make sure that we've eradicated those, but we're going to Institute of treatment, whether that's going to be traditional antibiotic therapy, herbal therapy just diet and or quote supplement therapy.
We're going to treat that for a time that's been shown to be beneficial. Then we're going to wait at least 30 days and we're going to retest. Now, when we retest, again, we want to make sure that we're doing a good test. You would need to speak with your physician about what that actually constitutes, but the important thing is that you want to retest and confirm that you have eradicated the issue.
If. You retest [00:30:00] and it is still present and you have a significant other or somebody that you're doing life with and in very close quarters, you may want to have them tested as well to see if it could be an ongoing exposure that you're having. Those are kind of key principles when you're talking about the pathogenic aspect.
Now, when you're talking about healing the gut with regards to the immune system and the organ function, again, that's a longer process,. Because What you have to have is you have to have a good starting point of digestion and being consistent with that supplement taking, that diet regimen, that lifestyle regimen to decrease those inflammatory responses like cortisol and allow for healing to occur.
You want to institute that be consistent with it, in my opinion, for at least six months before you would repeat. [00:31:00] an entire GI map to really assess where your gut biome is now, what is the presence or absence of these overgrowth infections and or pathogenic infections and then really just to see how your immune system and organs are responding.
Have you been able to heal your leaky gut during the course of this time? So I hope this has been It's been official. I hope it's been informative. And thanks and God bless. That's it for this episode of the Living Life Well Show. If you like what you've heard and want to learn more, or want to know how to put this into practice for yourself, go to livelifewellclinic.com. Until next time, this is Dr. Jon Skelton saying, go out and live the truth so you can live life well. The preceding is for entertainment and educational purposes only. It is not meant to be used to [00:32:00] prevent, diagnose, treat, or cure any condition. The information contained in this show does not substitute the need for a qualified medical professional, nor is it meant to provide medical advice or services.
If you feel information presented in this show may apply to you, we recommend you seek out the help of a qualified medical professional who can evaluate and treat your specific concerns.
