The Dr. Lam Show

How to Heal Leaky Gut with Dr. Vincent Pedre

January 30, 2022 Dr. Lam
The Dr. Lam Show
How to Heal Leaky Gut with Dr. Vincent Pedre
Show Notes Transcript

It's always wise to look at the gut as it's closely related to the rest of the body and can manifest symptoms in many different ways. Dr. Vincent Pedre, author of Happy Gut, provides insight on what causes insult to the microbiome and how to fix leaky gut.

03:13 Causes for leaky gut
05:45 What is the microbiome and how does it affect our lives
09:10 How the microbiome causes inflammation and affects weight
13:58 What is leaky gut and how does one get it
15:18 Bacterial endotoxins and inflammatory genes
20:45 Program for weight loss

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GUEST Information:
» Website: https://www.happygutlife.com/top10tips/
» Facebook: @drvincentpedre  
» Instagram: @drpedre  
» Email: drpedre@gmail.com 

Dr. Carrie Lam, MD:

Hi, I'm Dr. Carrie Lam and welcome to the Dr. Lam show. We're so happy to have Dr. Vincent Pedre here. He's written a really great book on called the happy gut. Dr. Pedre, is the Medical Director of Pedre Integrative Health and President of Dr. Pedre Wellness. He is a Board-Certified Internist in private practice in New York City. He practices both western and eastern medical traditions. Today we're so grateful that he can talk to us about having a happy gut life and the best way to lose weight and how it relates to fatigue and hormones and leaky gut. So welcome.

Dr Vincent Pedre:

Thank you for having me.

Dr. Carrie Lam, MD:

So I always like to ask our guests to go through their journey on how they have come to be in integrative and functional medicine.

Dr Vincent Pedre:

It's a great question, because I do think that everyone who ends up in functional medicine probably had some sort of journey, health challenge, or maybe patients that inspired them. For me, it actually goes back to my childhood, and trying to figure out what is it, that was making me sick, and I would just get sick all the time. I remember probably starting like 9-10 years old, and all the way through my teenage years going on at least two to three rounds of antibiotics every year for sinus infection, throat infection, pneumonia, bronchitis. My immune system was so weakened that sometimes I actually had to be taken to the doctor to get what was being given at the time, which I think I don't know that anybody does this anymore, a gamma globulin shot. So almost as if I was immunosuppressed. And I remember every time I would get a dose of gamma globulin, if I had an infection that wasn't getting better with antibiotics, I would feel better right away, within the next 24 hours. But no one ever thought to look at the gut. At some point it was, you know, chicken or the egg. I had been given so many rounds of antibiotics that it had decimated my gut microbiome. And in retrospect led to leaky gut and two reactions to two of the top food groups that were in my diet at the time, which were gluten and dairy. And knowing that 70% of the immune system is all along the gut lining. I was basically poisoning myself weakening my immune system. My immune system couldn't mount a defense, so I would pick up whatever was going around. I'm not a hypochondriac now but when I was a child, I was a hypochondriac. I was scared about being around people who were sick, because I felt like my immune system was so weak that I would catch anything. I hated having to go on antibiotics, but it was often the necessity at the time. As you know, it becomes a vicious cycle, the more antibiotics you take, the more likely you get more infections, and again you're on antibiotics. It really took me looking at nutrition, starting even when I was in medical school, and looking at the role that dairy played in my diet. I started not having as much dairy and noticed that my immune system started feeling a bit stronger. I was also eating a lot more avocados, olive oils, so I started incorporating more healthy fats while I was in medical school. Even though we didn't get any nutrition training, I did have enough of the science mind to ask the question like, okay, I changed this variable, which was the dairy and I added in more healthy fats. And now I see my immune system is behaving differently. I'm not getting sick as frequently as I used to. That really inspired me to keep looking for answers. It wasn't until I discovered functional medicine in the early 2000s which led to the big aha moment. What happened to me is because of what happened two decades ago, and I was dealing with it for two decades with having irritable bowel syndrome, not understanding why sometimes foods didn't agree with me and other times I was fine. Having to run to the bathroom and having all sorts of issues like mental fog, you know, that's dealing with a lot of different things. That seems to be unrelated but then finally seemed that it all tied in with my gut. And working on a gut healing program - probiotics, prebiotics, fermented foods, and really changing my diet, eating organic eating humanely raised meat. All this turned around my health, and I just started working with patients on gut health issues. And it would surprise me like they would get better.

Dr. Carrie Lam, MD:

Some things that you don't think are related to the gut somehow ends up being better, right?

Dr Vincent Pedre:

A lot of times they would tell me my gut is better. and I had this other symptom I didn't tell you about, and now it's gone. Maybe it was a skin rash or brain fog, or general fatigue. And now they feel like their energy is improving. This made me realize that while the gut is foundational to so many other conditions in the body, indeed, that it inspired me too, to write happy gut, and just try to get the word out to people about the microbiome and and how simple it is.

Dr. Carrie Lam, MD:

That's great, like you said, I have patients that have had antibiotics since they're young, and they don't really think about it unless a functional doctor asks that question. And everyone thinks, oh, as a child, I have ear infections, I always take antibiotics and that's normal. But that's not normal for your gut microbiome. So thanks for telling us your journey. Tell us a little more about what is microbiome and break it down and how it affects us in our lives?

Dr Vincent Pedre:

There are many microbiomes in the body, it's like the United Nations, there's different zones, regions, you know. So there's microbiome in your hands, mostly concentrated in the creases. There's microbiome inside the nose, inside the mouth, inside the lungs. And all along the intestinal tract and the stomach, the small intestine. And each region has a different predominance of different bacteria as well as concentration. But the biggest reservoir of the microbiome in the entire body is actually in the large intestine, where they calculate that there could be up to 100 trillion microorganisms, and anywhere between. There are 500 to 1000 different species of bacteria and their aggregate DNA, outnumbers, our DNA. I think, like 100, to one and the number of bacterial cells that we have in the body outnumber our own cells 10 to one. So we are these super organism that exists symbiotically with this hidden world that you cannot see with your eyes. But it is affecting a lot of other aspects of our health which is quite fascinating. Last year, on my blog, I've been writing about the interconnections with the microbiome, talking about the gut-skin connection, and how the microbiome in the gut can affect skin issues, the gut-heart connection, and how depending on the types of gut bacteria, and the type of food that you're eating, and whether you have leaky gut that can increase your risk for heart disease up to twice, and even stroke. So there is a gut brain connection and mental health connection. So there's all of these things that we're learning. Recent research shows that there are different strains of the microbiome bacteria, that can affect different things, including controlling the amount of inflammation in the body, the sensitivity to the hormone insulin, which helps control blood sugar, and even the way that we digest and absorb calories. How many of those are available in the body that then can cause weight gain, or can help with weight loss. So it's quite a fascinating thing, even just recently looking at a study on the aging microbiome, what is unique is in the microbiome of centenarians. And there was a study that looked at secondary bile acids and certain bacteria that existed in the centenarians that are producing these anti inflammatory secondary bile acids which are basically metabolites of a metabolite. That's what I think is happening in the guard is it's not just about the microbiome, it's about what they are producing that we then absorb into our bodies and they are like the puppeteers, affecting every organ system, including the hormone system, and the balance. There's a lot that we still need to learn.

Dr. Carrie Lam, MD:

I love that you bring up the centenarians, I used to live in Loma Linda, which is one of the Blue Zones, meaning the highest number of centenarians, people who live to 100. So I think definitely the diet and the microbiome has a big, part to play in what it produces. And like you said, even the microbiome can produce the neurotransmitters, substrates, so that you can make a right the right neurotransmitters that so it affects your mood, and also the brain health and the hormone health.

Dr Vincent Pedre:

Something that people don't realize is that, for example, serotonin or happiness molecule, more than 90 percent of it is produced in the guts, not in the brain. And there are serotonin receptors in the gut. And both these endocrine like cell they call them enteroendocrine cells, as well as the nerve endings of the vagus nerve, which is one of the longest nerves in the body. That sends signals to the brain that communicates to the brain, the state of the internal organs, and helps the brain decide the balance of excitation versus relaxation that needs to happen in order to allow processes like digestion and absorption to happen and peristalsis that moves the food down the intestines. So it's this beautiful bi directional communication that is happening between the brain and the gut, and vice versa.

Dr. Carrie Lam, MD:

Yeah, that gut is the second brain, right? So can you talk a little more about leaky gut and how does someone get leaky gut? Do a lot of people actually just have it because of their diet and what they eat? Or are they born with it? Are there certain markers?

Dr Vincent Pedre:

It's a little bit controversial in terms of what are the best markers as clinicians to know what to check to establish if a person has leaky gut. We know that definitely going on antibiotics may cause leaky gut because it's altering the gut microbiome and the balance of the good bacteria that help along that gut border, communicate with our immune system to maintain the integrity of that border. But we also know that stress can affect the gut microbiome. It can even cause increases in intestinal permeability, poor diet or eating too much sugar, leading to an imbalance between good and bad bugs and yeast overgrowth that can increase gut permeability. There's a lot of medications that people take that are over the counter that you would think are okay to take because the FDA has ruled that it can be taken without a prescription. This must be fine, like ibuprofen or acetaminophen, even which I was surprised because I know classically we learned that and said, can increase intestinal permeability. I found studies that showed that even acetaminophen can have an effect on the gut microbiome and increase intestinal permeability. And the shocking one is for women, as the birth control pill, also increases intestinal permeability which I'm sure a lot of women have experienced. I've seen this so many times over the years, a woman patient is put on a birth control pill, and they gain weight. But they didn't change their diet or exercise and yet gain weight. One of the ways to explain that is leaky gut. When your gut becomes leaky, you get more of an influx of inflammatory substances. And we now know, there was actually a study I looked at about two months ago, that showed that when there is leaky gut, you can find bacterial DNA in the blood circulation. So we know that bacteria can actually get through when the gut is leaky, and that causes an activation of the immune response. But we also know that Gram negative bacteria in the large intestine produce endotoxin, a lipopolysaccharide. Anything endo is inside, which is interesting because they thought that it was only released when the bacteria died. But now they realize that these bacteria actually release endotoxin into their environment. And it's one of the biggest instigators of the immune response. For anybody who understands functional medicine, it activates the NF Kappa b pathway, which is an intracellular pathway that turns on inflammatory genes. And it will do that in muscle tissue in the liver. When you're turning on inflammation in the liver, you can cause insulin resistance. And then it can do it also in the brain. And it can easily get through the blood brain barrier, because it's a lipopolysaccharide. So you turn on inflammation in the brain that can lead to depression. If you're depressed, then what are you going to want to do, you're going to want to eat comfort foods, and then you get into this vicious cycle of weight gain. There was a study that showed that you could measure rises in endotoxin in the blood postprandial and that the level of the rise was a predictor of the person developing metabolic syndrome, obesity, and eventually diabetes. So endotoxin plays a really significant role. That's how we tie in why leaky gut is so significant. And for anybody who is having trouble losing weight, and they think they're doing everything, right, you have to look at the health of the gut lining and the gut microbiome and see what's going on there.

Dr. Carrie Lam, MD:

That's so true. I remember a study about the two mice, one was skinny and one was fat. And then you transplanted the microbiome, right from the fat mouse to the skinny mouse, and then the skinny mouse became fat. And so it's like the even the microbiome have memory. And if you change that memory cells, you will also start to gain the weight by having a leaky gut or the microbiome changes.

Dr Vincent Pedre:

And we know from, I think a patient who received a stool transplant from her daughter, who had intractable fetus. And the patient did not have metabolic syndrome, the daughter had polycystic ovarian syndrome, which often is accompanied, there are just two types, but she had the type that is accompanied by insulin resistance metabolic syndrome. And after the stool transplant, the mother developed metabolic syndrome that she did not have before. And that's why I get asked if there is a need to do a fecal transplant to heal the gut? And because it's not FDA approved, some people go outside of the country and I tell them, you need to make sure that they're screening, the person who's donating the stool and make sure there is no metabolic syndrome, no diabetes, or any other potential diseases that can be communicated by the gut microbiome. As you saw in that mice study where you can make thin mice fat by giving them the microbiome of the fat mice, and then they gain weight.

Dr. Carrie Lam, MD:

Got to be careful where you get your transplant from, because you can get defects that you don't want. That's very interesting. So we talked about the microbiome and leaky gut. What else? How do you you have a also a program for weight loss, and you say, you can see differences in 28 days? How do you do that?

Dr Vincent Pedre:

I have different programs that I've put together, I have a 20 day program, which is kind of a really deep cleanse for the gut for people with severe gut imbalances or what I call gut related health issues, like skin rashes, chronic fatigue, mental fog, joint aches, just feeling old and creaky. And that program is really excellent for rebalancing the gut. It's like putting the gut in a blank slate and receding it with good bacteria. It's really good for rewiring the person's relationship with food. Then I also have another program which is a seven day detox. It is focused on opening up those liver detox pathways, the phase one phase two, liver detox, while balancing what I call the three pillars of detoxification, the liver, the gut, and the gut microbiome. So it works on all those levels to help people cleanse out substances and metabolites from their body. It includes those women who have estrogen dominance, and experiencing symptoms like water retention, tenderness in the breast around the period. And what I found with this program is that it can be really helpful in both men and women for breaking through a weight loss plateau. And a lot of times when there is a weight loss plateau, the body needs to detoxify, and it needs that support, especially with phase two liver detoxification, which tends to be slow in most people.

Dr. Carrie Lam, MD:

So sluggishness in the liver occurs when toxins accumulate and cause inflammation leading to weight gain. So look at all these triggering factors first, before you just go for a diet or for an exercise. So that's great that you have a big picture, dealing with their gut first, and then their hormones and weight. So thank you so much for being on the Dr. Lam show, Dr. Pedre. How do people get hold of you, if they wanted to find you?

Dr Vincent Pedre:

They can go to my website, happygutlife.com and they can also learn a lot about what I do and just get free information by going to my Instagram account @DrPedre and that's a great place to interact with me. I sometimes answer my own messages. I try to go in there and talk with people and just put out a lot of really great, shareable free information on gut health and gut healing that can inspire people to go on their own healing journeys.

Dr. Carrie Lam, MD:

That's so great. So we will put all those links here below and even you have a free gift called Top 10 tips from happygutlife.com. We're thankful that you came here to talk about the microbiome and the leaky gut. And if you like this episode, make sure you like and subscribe, and share with those who are struggling with this so that they can all learn. We want to really change the world and how we practice medicine. So stay tuned for the next episode.

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