In this Podcast Episode – we will be talking about bile, yes the stuff that makes your poo brown, but it’s more than that; because did you know that around 90% of the bile you make is absorbed in the body and it does some absolutely amazing things with your hormones, thyroid, impact on weight gain or loss and all sorts of intricate mechanisms! You won’t see Bile as Vile after this that’s for sure!
Steve: Welcome to the ATP Project, and today we’re going to be talking about bile. Yes, that brown stuff in your poo, but it’s more than that, because did you know that 90% of the bile you make is absorbed in the body, and it does some absolutely amazing things with your hormones, to do with your thyroid, helps you lose weight, all sort of things. We’re going to explore that today, and we’ve got a special guest called Elizma, and she’s going to introduce herself shortly. Sit back and enjoy today’s podcast. As always, this information is not designed to diagnose, treat, prevent, or cure any condition, and is for information purposes only.
Steve: Please discuss any information in this podcast with your health care professional before making any changes to your current lifestyle. Stay tuned. The ATP Project is about to start.
Announcer: Welcome to the ATP Project, delivering the irreverent truth about health, aging, performance, and looking good. If you’re sick and tired of being sick and tired, ready to perform at your best, or somewhere in between, then sit back, relax and open your mind, as Jeff and Matt battle the status quo, and discuss everything health related that can make you better.
Steve: Welcome to the ATP Project. You’re with your hosts Steve, Matt, and Elizma. How are you?
Elizma: [crosstalk 00:01:25], thank you.
Matt: You said it wrong. Elizma.
Elizma: Yeah, it’s Elizma.
Matt: Oh, okay, you said it right.
Steve: Elizma, absolutely. How are you, Elizma?
Elizma: Very good, thanks, Steve.
Steve: Who are you, Elizma, because we’ve got to introduce you to the rest of the crowd listening out there.
Elizma: Yeah. Well, I’m a naturopath and homeopath, qualified or I studied in South Africa and in Australia consecutively. I guess I’ve just sort of becoming very interested in a lot of different kinds of topics over all the years I’ve been practicing, which has been about maybe 20 years or so. I don’t really specialize in anything. I would consider myself a generalist, in that I love to look at the body as a three dimensional, I guess, biochemical pathway, and looking at genetic expression and all of that. That’s why I don’t necessarily specialize in separate things, but once you understand the biochemistry as you’d know, Steve and Matt, is that you can pretty much treat anything.
Elizma: Of course, autoimmune disease, hormonal issues, weight loss, if you understand biochemical pathways, it all starts to make sense. I treat a lot of chronically ill people from mold biotoxin issues, Lyme disease, all kinds of things from all over the world, so I have patients all over the world. Often travel overseas as well to lecture, and have clinics overseas as well, so it’s great. I love it. Love helping people, and love research and exploring, and growing the knowledge base, because you never stop learning when you’re in our industry, because new research comes up all the time, so you have to stay on top of it.
Steve: [crosstalk 00:02:59].
Matt: Further to that, so I met Elizma originally attending one of her seminars, and listening to her speak. I was trying to get my head around the difference between genetic expression, and the organic acid testing, and all that sort of stuff. When I started hearing Elizma speak about the generalist approach, it was the first time I think I’d ever heard anyone use that word. Everyone was talking about specializing in a thing, and Elizma was capable of getting results in all of those things by having a general approach. We talk a lot on these podcasts about, how can you have a specialist into an area when … You know, we talk about [inaudible 00:03:33], or at least everywhere at once, how could you specialize in any department when these are all level out.
Matt: I started then seeing Elizma as my naturopath because it’s really hard to treat yourself, and family, and friends I’ve found, but especially when there are so many imbalances, and there’s so many patterns within the human body. What I always struggled with is I’ll go talk to a specialist or someone that specializes in a field, and they have no idea about how to relate that to my case. Then when I go and speak to Elizma, and Elizma can go back and have a look at the documents, and the same stuff I would look at, and then go back and give a bit more priorities, and basically cut through a lot of the bias that people have. That was really impressive. I’ve never seen anyone that’s capable of understanding so much about the body in such minute detail.
Matt: I’m okay with concepts and the big picture stuff, which Elizma’s really great at as well, but then she can take that right down onto that biochemical pathway and seem to be able to understand it all, which is an amazing skill. It’s not just a matter of remembering a textbook, but actually how to apply that information in a clinical situation with real humans, as I believe one her best skill sets. With a podcast, that’s what I wanted, is someone to come and help us to be able to … Because Steve, you’re basically a walking textbook,-
Steve: That boring.
Matt: -and I’m more of a walking mine map I suppose, and Elizma’s that beautiful combination in between, where we’re capable of actually piecing it all together. I’m really hopeful that we’re going to get … Now I’ve got to do more of the Jeff role, while I’m surrounded by such academic giants, because I get to sit there and try to link it all now, which is really cool, because I’m learning so much just by having you two here talking this stuff. It’s really cool. Even this morning, I was getting so excited making all the patterns between your info, so thanks for coming.
Steve: Yeah, and you mentioned specialist, and today we’re going to be talking about bile, which is what we’re talking about today. People might think, oh, that’s a digestive thing, but we’re going to talk about bile when it’s related to type 2 diabetes. We’re going to talk about bile about how to fix the immune system. We’re going to talk bile about how the hormones affected. If you got a bile problem, you go see a gastroenterologist, a hormone person, an immunologist, that’s the problem with specialities. Jeff Bland famously said, “Specialists know more and more about less and less till they know everything about nothing.” That famous saying, which is great.
Matt: Well, a lot of people might think their only relation to bile is that, “I don’t have to worry about this anymore, because I’ve had my gall bladder removed.” If that’s you, you better listen on, because the crisis is still happening.
Steve: Mom, are you listening? You’ve had your gall bladder removed.
Matt: A gall bladder person, or a bile person, so let’s explain. I’ll just quickly summarize what we’re talking about when we mention bile.
Steve: Bile, yeah.
Matt: Okay. Bile is that yellow stuff that comes out of the liver, catches in the gall bladder, which is a little sac that sits under the liver. Then the gall bladder squeezes that bile into your digestive tract, and then it helps your bowels move, it helps to break down the fat, and that sort of stuff. What you’re basically … We’re talking about this yellow goo that’s coming out of your liver, and into your digestive tract. A lot of people think that’s it, like it’s the waste that comes out of the liver, it gets put into the digestive tract purely for the sake of turning your poo brown, and eliminating it, but we’re going to talk a lot more about how it gets reabsorbed, and its functions throughout the body.
Matt: We’re also going to talk about its actual roles with digestion, why it’s released through the digestive tract, and how it regulates microbiome and all that sort of stuff. Then how if it’s not made properly, then we can have gall stones, and maybe get your gall bladder removed.
Steve: That’s terrific, because you mentioned some bile gets reabsorbed, and you said, “Some bile,” which is correct, but we know that it’s 90 to 95% of it gets-
Steve: So why does the body-
Matt: I didn’t know that.
Steve: Yeah. Oh well, so the body sort of takes it and then most of it gets reabsorbed. Some of it ends up down the toilet, and you see that’s why your poo is brown, in case you’re wondering. That’s the color in there, the bilirubin.
Matt: Can I talk a minute, so it comes out yellow,-
Steve: Sure, talk as much … Yes.
Matt: I interrupt all the time because it’s what I do. It’s a short term memory thing. I forget what I’m going to say so I just interrupt. Now what was I going to say? No, [crosstalk 00:07:45]. It comes out yellow and as it interacts with the microbiome, they turn it brown, and acid and enzymes [crosstalk 00:07:53].
Steve: Yeah, [crosstalk 00:07:54].
Matt: Why does it go yellow to brown? Because one for example, in the naturopath clinic, some people might come in and say my poo has gone like clay colored, like it’s very pale and clay colored, like anemic looking poo. Other people will come in and say that it’s bright yellow, and then you know, we’ll talk about the poo brown. What’s the difference? When bile comes out yellow and stays yellow, and ends up in your poo, and you get a yellowy poo, that means we’ve got no conversion by the [crosstalk 00:08:21]?
Elizma: That’s right, that’s right, because one of the main species that seem to convert that conjugated bilirubin into the urobilinogen I believe,-
Steve: Yeah, that’s it.
Elizma: -is the Bacteroides species, so the Bacteroides species makes up a large proportion of our natural gut microbiomes.
Steve: The largest actually. [crosstalk 00:08:38].
Elizma: Yeah, the largest.
Steve: [crosstalk 00:08:40].
Matt: We talk about in other gut related podcast, and we talk about metabolism and a lot of those sort of things, we talk about the ratios between Firmicutes and the Bacteroidetes. [inaudible 00:08:52]. We talk about those ratios between those suckers there, so straight away we’re seeing some links into our other things. Some of the Firmicutes that we talk about, such things as Candida, E colis, Clostridiums, as well as the Lactobacillus species, but we’re saying that if you’re getting yellow poo, you may not have enough of the Bacteroidetes that keep the Firmicutes in control, keep your metabolism and everything cranking.
Elizma: Yep, yep.
Steve: It’s very, very interesting, because one of the side effects to antibiotics, especially the ones that aren’t absorbed properly, like Vancomycin, is yellow poo. If you’re wondering why you get yellow poo with [crosstalk 00:09:26]-
Matt: Right, it’s because you kill off the bacteria, and then you don’t have the bacteria converting your yellow bile to brown pool.
Steve: That’s it.
Matt: If you’ve got pale poo, if you’ve got no yellow or brown, then there’s a fair chance that your gall bladder is clogged. There’s no bile coming through. Your liver’s going to be making the bile. It constantly does. If it’s just not getting out of that gall bladder, it might be stuck behind a stone, or a rock, or something like that, and we can get these gall stones. Then you get the pale poo. Another thing that you notice while we’re talking poo, is one of the roles of bile is to break down fat for absorption. If you can’t break down the fat, and that fat stays in the poo, you’ll get floaters, so pale floaters, and that sort of stuff. It’s a common sign of gall bladder congestion.
Steve: [crosstalk 00:10:10].
Matt: If you’ve got yellow poo, then you’ve got gall bladder flowing. If you’ve got brown poo, we got the gall bladder flowing, you got bile in there.
Steve: All right. That’s good. We talked about the bowels enough, but 90 to 95% of this bile gets reabsorbed. They mentioned a few things that it does, and a few receptors to activate, so why does the body absorb? What does it needed for?
Elizma: Well, it’s just to keep that bile acid pool going, because as long as no more than 20% of bile is lost to the feces, the body doesn’t really have to make more. It just uses the reabsorbed bile that gets reabsorbed through the enterohepatic circulation. Those bile salts is actually really important because as we’ve sort of already eluded to it, it has multiple functions in the body. It binds to your receptors, like your [pregnane 00:11:03] receptors, your vitamin D receptors, your …
Steve: Heaps of receptors.
Elizma: I’m sorry, there’s a few of them.
Steve: Yeah, heaps of them.
Elizma: Then acts as signaling molecules. Signaling molecules for all your detoxification enzymes, for estrogen detoxification, for getting oxidized cholesterol out of the body, drug metabolism,-
Matt: Do the toxins come back in? Like if our bile is for all of our detoxification from our liver, so if our liver is converting all the fat so whatever, making bile as toxins are all in that bile, 95% of it’s getting reabsorbed, do we reabsorb the toxins?
Elizma: Not the conjugated bile acids. They will not be reabsorbed.
Elizma: That’s conjugated to glycine usually, or taurine. This is where the amino acids become really important. That’s why they are involved in detoxification, so like salicylate detoxification, things like that.
Matt: I’m so glad you … Basically, so chemical sensitivities, and food intolerances, okay, so if we have a look at, this is different to allergies. Okay? If we have a look at salicylates for example, they’re like aspirin like compounds that are found in onions, and spices, and all those sort of different [inaudible 00:12:18], honeys, and cherries, and lots of things, in aspirins, and cosmetics, and everything. After they all come through into our body, our liver is supposed to get them, attach glycine to it, this is a very simplified version, so they get the salicylates, they attach the glycine to it, which is a process known as glycination, that was an easy one, and then that salicylate bound to glycine gets put into the poo, so you can eliminate it.
Matt: If we’re not doing that process properly, the salicylates go into the bowels, and can be reabsorbed, because they’re not conjugated properly. Then if you imagine that you have a threshold of symptoms at which your salicylates build up … Okay, so it’s easy on YouTube because I can use my hands, but for those that are not on YouTube, you have to listen and imagine my hands, and like a hand model just kind of doing this wave. Anyway, you have a threshold of symptoms that might sit around here. As your salicylate levels build up, as you get to that threshold of symptoms, you react. You react with flushing, you know that funny feeling around the mouth, maybe indigestion, other problems, skin reactions, itching, scratching, confusion, behavior, that sort of foggy head and everything. There’s a lot of symptoms like that.
Matt: What happens is, every time you eat those foods, or eat the herbs, or have the salad, you increase your load of salicylates, and you get a reaction. You’re not allergic to it, but you’ve just accumulated too much salicylates into your body. What we’d usually do is tell people to avoid the salicylates for a period of time, maybe supplement some more glycine to help clear away that stuff I got. Then all of a sudden they stop reacting to it, they can tolerate these things, and then it takes ages for it to build back up again. That’s what we call a salicylate intolerance. We get a similar thing with glutamates, and there’s a lot of other compounds. They’re not allergies, they just build up into our body, and all of a sudden every time we touch them, we manifest with some sort of an immune like reaction.
Matt: We’re saying that if we support the liver conjugation, and get that bile made properly, then this stuff should be bound, and held inside the guts and eliminated. If it’s not, you reabsorb it and this can create multiple chemical sensitivities and intolerances.
Elizma: Absolutely. Also with the salicylates, Matt, is if their conjugation system, whatever the conjugation system doesn’t pick up has to go through the PST, or the phenol sulfur transferase pathway, and these are enzymes that sits in the small intestine. Bile also has a role of preventing SIBO, and that bacterial overgrowth. You can see that it can actually cause salicylate problems from both angles, from both not conjugating … the conjugation process, but also through now bacteria can just sort of like go a little bit wild in the [crosstalk 00:15:01], other enzymes involved with salicylates.
Matt: Well, okay, while we’re talking about that, just for the listeners out there, they might relate that to estrogen. We’re supposed to conjugate estrogen. We conjugate it through glucuronidation, so it gets conjugated. Then certain bugs, they love estrogen. It’s very good at growing things. Estrogen makes things swell, and grow, and thrive, so they love it. They release an enzyme, beta-glucuronidase, that liberates that estrogen. Okay? What we’re looking at here, is if you’ve got dodgy bile … I got to bring it back to the simplified things every time. If you’ve got dodgy bile, and it’s coming out, it can’t regulate your microbiome. It can’t kill off the baddies, and regulate them, and regulate their enzymes, so then they can liberate the toxins, or the things that they like. Some of them might like salicylates, some of them might like estrogen, so they can liberate these things again for their own purpose, and then they can put it back into our body.
Matt: For the people out there, a common supplement is I think Calcium D-Glucarate, which they use to … Some people think it aids estrogen detoxification. The way it works is it works for the people that have got the overgrowth of the bugs, and it stops that enzyme from liberating the estrogen. Again, dodgy bile results in an overgrowth of microbiome. Like you’re saying, SIBO, not many people, I don’t think many people go and sound that out. It’s small intestinal bacterial overgrowth, too many bugs. Most people treat SIBO with probiotics and prebiotics. They go through and feed the bugs, and throw more bugs in, because they’ve got an overgrowth.
Elizma: That’s right.
Matt: Now, I’ve tried to do that, and I was wasting my grass seeds, throwing them at weeds around my yard.
Steve: It’s crazy.
Matt: Why the hell is a … throw on a probiotic in an established colony of bugs is going to make them just pack up and leave? I don’t think so.
Steve: Now you mentioned estrogen, and we are talking about bile. Now there is a hormonal effect on bile production via estrogen. In 1973, they discovered that estriol, which is E3, inhibits the production of bile acids. What were you say …
Matt: I just got excited because another little link happened.
Steve: Yeah, yeah, I’m making the link. I’m the king of links.
Matt: Nice segue.
Steve: Yeah, exactly. That’s it. This estrogen, if women are estrogen dominant, which could be being, and the classic is the fair, fat, and 40 female, so if you’re overweight, you’re a female, you’re over 40, and you could be on … say you’re taking [crosstalk 00:17:32]-
Matt: Now that’s not … Just reference that statement, Steve. That’s not Steve’s opinion, everyone. The fair, fat females over 40, that’s actually they put through the textbooks,-
Steve: That’s the facts.
Matt: -as the risk factors.
Steve: Yeah, the risk factors. Of course people in Africa and people in Asia have very low gallstones, and they have good bile flow. With this estrogen effect, think about today’s level of obesity where our fat cells are making all this estrogen. Just think about that if you’re a woman, you’ve got too much estrogen, you’re overweight let’s say, and you’re on the pill for example, it’s not unusual. In fact, pills are often [described 00:18:07] for women that are overweight, if you’ve got PCOS for example. Think about this for a second, we’ve got this major problem with estrogen recirculation that Matt was talking about, enterohepatic recirculation, and they’re taking estrogen. If a patient walked into you with all this estrogen, walks in in front of you, how would you address that excessive estrogen in that particular female.
Elizma: Well, you’d definitely want to make sure that the gall bladder is functioning properly, because like we said, they act as signaling molecules, the bile salts, so the bile salts will bind to receptors like PXR and VDR, so the vitamin D receptors, and these stimulate liver detoxification enzymes that’s involved with estrogen. If you don’t have adequate amounts of bile, if your bile is sluggish because of poor methylation or what have you, then all those enzymes, those liver enzymes that are involved with estrogen metabolism will be slowed. They won’t work as well.
Elizma: Then if you also have then the SIBO thing that de-conjugates or unbinds those estrogens that have been bound to the bile, it just reabsorbs even more, so it just becomes a never ending problem.
Matt: Then if you can [inaudible 00:19:20] around that 40 age group, most women, the progesterone drops first, so if you see that the relative excess of estrogen occurs as the progesterone drops, then at the same time as if there’s extra fat tissue that’s capable of making that estrogen, and being the source of the estrogen, the progesterone drops, we’ve got a little bit of extra fat, we got the SIBOs, or the microbiome, or maybe a chronic Candidiasis that might be happening. You end up with estrogen dominance. I don’t know about you, Elizma, I saw this all the time in my naturopath clinic, but I had a lot of Maltese clients as well. I had a very strange clinic. We had lots of different … A lot of them were related, it was a small town. I saw a massive pattern where people would come to me and tell me they’ve just had a hysterectomy because of some sort of estrogen dominant bleeding, or estrogen dominant abnormal growth, or abnormal cells, or they’ve had a hysterectomy for something usually estrogen dominant, and right around the same time, they all had gall bladder issues.
Elizma: Yeah, yeah.
Matt: Are we looking at, over time with the estrogen dominance, that it causes the gall bladder issues or do you reckon it’s the gall bladder issues that cause the estrogen dominance? It’s such a tricky [crosstalk 00:20:34].
Elizma: I believe it’s the gall bladder. It’s the starting point of a lot of [crosstalk 00:20:36].
Matt: Yeah, well if it regulates microbiome, if it’s regulating the hormones, and detoxifying the extra hormones, so just what we’re saying alone, if bile’s job is to conjugate and eliminate that extra estrogen, and then it’s being reliberated …. At the same time it’s supposed to be regulated in the microbiome. Then all of a sudden were not detoxifying the thing properly, we’re making more because of the microbiome, and then if our progesterone levels drop off for something, all of a sudden it’s the tipping point. Then you get gall stones.
Elizma: That’s right.
Steve: Then your bile stops flowing, so you definitely got bile acid. Bile acids are reabsorbed, most of them, and you mentioned a few … Another one is the [Farsenoid 00:21:16] X receptor which it binds to. Now, [Farsenoid 00:21:19], when you breed mice that are [Farsenoid 00:21:21] X deficient, they immediately get diabetes.
Matt: Yeah, wow.
Steve: So if you don’t have enough bile flow, you don’t activate those receptors, the glucose is made in the liver at a higher rate, you get insulin resistance, you get insulin production problems. All of a sudden you become pre-diabetic, or diabetic, or PCOSe, as a woman [crosstalk 00:21:39]-
Matt: [crosstalk 00:21:40] cholesterol medication causes diabetes?
Matt: [crosstalk 00:21:43], does that put in a disclaimer, but [crosstalk 00:21:46] science that says it does.
Steve: There is science, and of course like if you take a sequestrant, which of course is a drug that inhibits the reabsorption of bile, like [Questrol 00:21:55], that actually causes diabetes, and increases the risk of diabetes, so just that medications, and that’s one of their known [crosstalk 00:22:09]-
Matt: Just explain that again, so you said that 90 something percent of our bile [crosstalk 00:22:09]-
Steve: Reabsorbs, yeah.
Matt: Bile salts in acids?
Matt: Bile, all of it?
Matt: It reabsorbs?
Steve: Ninety-five percent. The rest of it’s conjugating those toxins you were talking about. That’s only 5% of the job is the detoxing.
Matt: Yeah, wow.
Steve: Nice if it’s reabsorbed [crosstalk 00:22:23]-
Matt: Nice if it’s reabsorbed including the cholesterol, which makes up 10% or something.
Steve: About 9% of the volume.
Matt: [crosstalk 00:22:29]. Then so your cholesterol then gets reabsorbed with all your bile acids, and all your bile pigments.
Matt: The drugs are designed to stop the cholesterol from being reabsorbed, but they stop everything from being reabsorbed?
Steve: [crosstalk 00:22:41] bile [crosstalk 00:22:42].
Matt: Those other bile salts and bile acids, and everything else associated with it, they’re the things that go through and regulate your receptors to prevent diabetes.
Steve: Yes. That’s why [Questrol 00:22:52] is a classic drug that they say, “No, it’s not absorbed in the body, so it doesn’t have side effects,” except it causes massive GI problems,-
Matt: I can imagine.
Steve: -and of course diabetes, because it stops the bile acid being reabsorbed, stop activating the [Farsenoid 00:23:05] X receptors, which means you get diabetes, like the rats that are bred without those receptors, so it’s a really significant side effect.
Elizma: That’s right, because the [Farsenoid 00:23:14] X receptors job is also to inhibit NF kappa beta, which is-
Matt: Nuclear factor kappa beta, yeah.
Steve: [crosstalk 00:23:20].
Elizma: Exactly, so it actually has an antiinflammatory action in bile, acids bind to that [Farsenoid 00:23:24] X receptor. I mean, we can talk about inflammation, we can talk about gut inflammation, IBS, IBD, all of that, but also we also know there’s a lot of inflammation that can stimulate the insulin resistance that Steve was talking about, and that insulin resistance can again, inhibit an enzyme, CYP701, which is the rate limiting enzyme for bile acid synthesis, so it just goes back and it becomes this vicious circle where we’re inhibiting the gall bladder even further. It just becomes a vicious circle.
Matt: Hang on, when do we have jaundice then? I mean, if we’re talking about our bile, our yellowy parts being reabsorbed, when does someone get jaundice from that?
Steve: We get jaundice from liver cancers and liver diseases, but [crosstalk 00:24:13]-
Matt: [crosstalk 00:24:12] can’t flow through. It’s supposed to be this cycle where you reabsorb it, and turn it back into the … recycle it to flush it out. A lot of those bile salts and bile acids, everything’s recycled for the purpose of clearing out the cholesterol and the other conjugated toxins.
Steve: Jaundice is often found in infants when they’re first born. It’s a quite common side effect. Jaundice causes high levels of bilirubin in the body, which can be seen in the whites of the eyes and they turn yellow,-
Steve: -and they get very, very bad itch, you know, [Becs 00:24:41] putting camomile lotion, my wife, you know, for these liver [crosstalk 00:24:45] patients. She was in the kidney ward yesterday,-
Matt: [crosstalk 00:24:47].
Steve: Incredibly [crosstalk 00:24:48]-
Matt: [crosstalk 00:24:48] a hot shower or exercising. Another one in clinic, people that would go for a walk ad their legs just go crazy itchy, that was a classic … I tell you, some of the other signs for the gall bladder congestion, in TCM they always talk about the liver heat rising, so they get red … You get yellow eyes if it’s congested, but if you get a lot of liver heat and inflammation, you’ll get the redness as well. Sometimes just be aware of that, because some people go, they can’t see the yellow because they’re all red, they [crosstalk 00:25:18] yellow, and you get the blood vessels over the top of the yellow.
Matt: For people too, with vitamin A toxicity or keratinolysis, their whole body goes orangy yellow but not the whites of the eyes, so for the people that have got jaundice, you look for the eyes and you’ll see the yellow, but just be aware that if it’s inflamed, it’ll be red as well. Okay? The gall bladder signs, we talked about the power floaters in the poo, and that sort of stuff, or just constipation, that sort of stuff, because the bile does help it flow. As it backlogs, you get the itchiness, worst after exercise or hot showers, anything that increases the flush to the skin.
Matt: A lot of people will palpate in the right upper quadrant and feel for pain there, or talk about a pain there with fatty foods, or that sort of stuff, and then trans fatty foods, but just as common as I see it at the front right upper quadrant, I see it in the back. A lot of people complain about this constant pain in their shoulder blades,-
Elizma: That’s right, yeah, sure.
Matt: -or they go, “Oh, I’ve got this knot in my …” They just won’t let go, and that sort of stuff, it just feels like something’s up under my shoulder blade, and usually on the right side, but it doesn’t have to be. Yeah, just keep aware of that, because a lot of people are just looking for this pain, and then wait until they get this pain, and by then that’s when you’ve got the gall stones that might be stuck. You know?
Steve: It’s very interesting, because another thing with the-
Matt: Frustration, sorry, the one last thing is frustration. In the Chinese medicine, they call it that Liver Qi Stagnation causes frustration, tension, irritability, and especially if that manifests with premenstrual dramas, and that sort of stuff as well, because that again, it’s [crosstalk 00:26:50] to have the traditional Chinese medicine. We’ll talk about the liver congestion, and link it directly to premenstrual estrogen dominance symptoms. It’s so cool, man, when you see these patterns. If that sounds a bit like you, if you’ve got those problems, but obviously if we got problems with cholesterol as well, then we’re going to … Gall bladder people, people that are intolerant to fatty food, some people that are just got red, angry, hot and bothered, I think in Chinese medicine, they call it Liver Qi Stagnation, Western herbalism, they call it the old SOL, shit on the liver they used to call it when I was [crosstalk 00:27:25].
Steve: [crosstalk 00:27:25].
Matt: No, man … I started my naturopath clinic in North Queensland remember, and so I used to do a lot of my work to get a bit business. I used to do free work for the Queensland Country Women’s Association. I used to go around to these sweet old ladies that would run these little associations. It was so cool. They never paid me, but I had had cake and stuff, so I’d sit there with them and eat cake.
Steve: [crosstalk 00:27:47].
Elizma: Very cool.
Matt: Then I would chat, no talk, about the old SOL. That makes them feel bilious.
Matt: You talk about [crosstalk 00:27:54], it was anger, and frustration, and heat, and irritability. They’re all signs of gall bladder congestion. Now let’s have a look at that. If we’ve got poor methylation, we recycle our catecholamines, we feel stressed, we’ve got the estrogen dominance, we can’t switch off, we get intolerance of fatty foods, we start feeling crook, we start feeling yucky, it all starts to make sense. What next?
Steve: Bile has another role when it activates these [Farsenoid 00:28:15] X receptors to stand in for a while, is it also up regulates deiodinase 2, which is an enzyme that converts the inactive T4 into the active T3. People could have a low thyroid, and it could be a gall bladder problem.
Matt: That’s fascinating too, because the [myo 00:28:33] liver deiodinase activity is seven to eight times more powerful than the females, so the male that-
Steve: Yeah, [crosstalk 00:28:41] males, we’re weird. Just get me in trouble with everyone [crosstalk 00:28:43].
Matt: No, so we were talking about estrogen before in relation to the bile. We’re looking at estrogen to testosterone ratios can significantly affect the liver enzymes and affect the bile, but this whole thing is full on, so we’re looking for … What else does thyroid have in relation to the bile? Is there a link there as well? [crosstalk 00:29:01]-
Matt: [crosstalk 00:29:02]?
Steve: Of course, so if you don’t make as much bile because you’re full of estrogen, that’s why your thyroid has slowed down often in women. That’s one of the reasons why we have slower thyroids and have more thyroid problems. Again, it’s a very interesting [crosstalk 00:29:13]-
Matt: What does thyroid do for the bile? Is that directly linked to bile production?
Elizma: Yep, it is. Like thyroxin or T4, it needs to bind to the receptors on the Sphincter of Oddi, the ones advance to those receptors the sort of like the Sphincter of Oddi relaxes, and then that allows for the bile [crosstalk 00:29:31] to flow through into the small intestine. If there is a functional hypothyroidism, it doesn’t even have to be diagnosed, because there’s a lot of undiagnosed hypothyroidism going around, [crosstalk 00:29:41], then that will affect gall bladder function. That could be one of the reasons why a lot of people with low thyroid function can get constipated.
Matt: Yeah, right. Just so I can understand, because when you said the Sphincter of Oddi, I just for some reason in my brain imagined the superheroes. If I was going to be a superhero, well, I’m from the Sphincter of Oddi. I’m Thor, son of Odin, in the Sphincter of Oddi. Now, you think you’re Thor? Thor, I can’t even poo.
Steve: Wrong sphincter, Matt.
Matt: [crosstalk 00:30:11]. What we’re saying is the … We know when someone’s thyroid gland regulates digestion, because they get lots of stomach acid, then the acid comes in, they get lots of flow of pancreatic enzymes, but you’re also saying the thyroid hormones also help the flow of bile.
Matt: By relaxing the sphincter that allows the bile to flow.
Elizma: That becomes very important. People have had their gall bladders removed because when you’ve had the gall bladder removed, generally usually they still leave the ducts, which is where that Sphincter of Oddi sits on. A lot of people were like, okay, well my gall bladder’s gone, so that’s it, but you can still control that flow. Even though you don’t have the pouch that I guess stores the bile, you can still [crosstalk 00:30:54] control the flow of it.
Matt: Is this the sphincter between the liver and the common bile duct, or are we talking the gall bladder-
Steve: Gall bladder.
Matt: -to the common bile duct?
Elizma: The gall bladder to the common bile duct, yes. If you have someone who’s had their gall bladder removed, and their thyroid sucks, then they’re going to really have major issues.
Steve: Major, major issues.
Matt: The funny thing is, this is what I see all the time. They’ve had the hysterectomy, and then they just get their gall bladder removed. They’ve had a thyroid problem, and then they get their gall … The big point is, is if someone’s out there and you’re being told you’ve got gall stones or you’ve already had your gall bladder removed, whatever the bloody problem … hormonal, or whatever your problem was is still there, okay?
Elizma: It is.
Matt: Just remove the little sac that was catching your bile, now if you had that removed, so what that means is that in that instance the gall bladder would concentrate the bile by about 10 fold, and before it splits it out so that way you can tolerate more fat in one hit. Most people who had their gall bladder removed would basically say, “Everything’s perfect now. It’s totally fine. It was just a deformed sac, a defective sac for some reason, and now that it’s gone I’ve got no problems.” Then you realize that all the things that caused that problem are still there,-
Matt: -and then they’re still going to go through and manifest the predisposition to all those other estrogens, and thyroids, and cholesterol issues.
Elizma: Because I get a lot of people who ask me, “Well, I’ve had my gall bladder removed, so what do I do?” I usually say to them, “You do exactly what you would do as if you still had your gall bladder, but it wasn’t working so well.”
Matt: Yeah. [crosstalk 00:32:20] after a fatty meal.
Elizma: That’s right, because the disfunction of the biochemicals, this regulation is still there. You haven’t fixed that.
Matt: You can only tolerate … Because instead of the gall bladder catching this bile and squirting it out when you need it, it just leaves this constant pipsqueak trickle coming from your liver into your bile, so you can only tolerate about one tenth of the amount of fat per meal. You can have the same amount of fat over the time, you just got to split it all up. You just can’t tolerate one big fatty meal.
Steve: The tricky thing is with also bile secretion, you increase GLP1, which increases systality in the brain, so you feel full longer. Unfortunately if you think about the low fat diets that are being proposed to lose weight, we’ve all been suckered to those, or we’re all familiar with them, then of course you get less bile secretion, less [inaudible 00:33:08]. Therefore you tend to overeat. That’s why fat is important to have at each meal, and good healthy fat.
Matt: Yeah, that’s something cool, so [crosstalk 00:33:14] [Amado 00:33:14]. Amado’s a cool herb. We use it like an alternative to coffee in South America and that sort of stuff, but it actually … Most caffeine supplements do this, or caffeine coffees, they get the bile flowing. An interesting fact is you have [Amado’s 00:33:32] claim to fame when it comes to fat loss, as its ability to increase GLP1. I wonder if you have [Amado 00:33:37] is just working as a [color gog 00:33:39]? You got herbs that make bile flow through the liver, and that’s what they call [color gogs 00:33:45], and the ones that then support the bile flow through the gall bladder they label [collarating 00:33:49]. If you want to go through and Google [color gog herbs and colorated herbs 00:33:52], and find out any herbal support that might get that bile flowing, that’s all cool.
Matt: I wonder if that’s … It’s so fascinating. All this stuff’s starting to piece together. Then this is why you got to be a bloody generalist, not a specialist.
Elizma: That’s right, that’s right.
Matt: How many times would a specialist sit here by now and say, “What a load of crap.” You know?
Elizma: Yeah, except the [crosstalk 00:34:14].
Matt: Yeah, except the gastroenterologists, because he’s [crosstalk 00:34:16].
Steve: But they know a patient which has diabetes, oh, you better go and see a dietician or someone, or they’ve got hormonal problems, you better go and see the endocrinologist. Specializing is quite bad. We’re still [crosstalk 00:34:28]-
Matt: I let you talk about your receptor. I keep interrupting you.
Steve: It’s all right.
Matt: It’s so cool, man, because every one of these little points you make is starting to piece a lot of the other puzzle stuff back together.
Steve: That’s why I’ve got it written down nice [inaudible 00:34:40]. You mentioned before about inflammation and the [Farsenoid 00:34:42] receptors. If you activate those receptors, it reduces [inaudible 00:34:45] so you get reduced inflammation, and up regulates transforming growth factor beta, which is a great regulatory thing. It’s great for inflammation of the bowel. You mentioned Crohn’s disease before, ulcerative colitis. This is what this receptor does, so if you’re not reabsorbing these acids, you don’t get all tolerance, you don’t get the bowel inflammation. In your experience, and seeing patients for 20 years, when you see someone with inflammatory bowel disease, it’s so important to regulate the bowel.
Elizma: Oh, absolutely.
Steve: You want to just elaborate on that?
Elizma: Yeah. Well, what they’ve also found in a lot of people with ulcerative colitis and Crohn’s disease, is it’s usually some kind of a microbe involvement. It was interesting, Matt, you sort of touched on it about the dripping of the bile when you’ve had your gall bladder removed. One of the interesting things that I just love about bile is the way that it kills bacteria. When I saw the picture I just thought, this is so cool, because what bile actually does, if it is secreted in large amounts, I’m not talking about the little drip effect, if it’s in large enough amounts which would be the case in a healthy gall bladder, then it actually … It’s like it punctures holes in bacterial cell membranes. It causes those membranes to dissolve and it leaks like the insides of the bacteria out.
Elizma: They shrink and then they die.
Matt: Yeah, cool. Unless you’re a bug.
Elizma: Well, unless you’re a bug, it’s not so [crosstalk 00:36:07]. Now a natural or a good bacteria, they’ve developed genetic adaptations over centuries, so the bile doesn’t affect them. It only affects the pathogenic bacteria.
Matt: [crosstalk 00:36:18].
Steve: [crosstalk 00:36:18] the newly introduced ones.
Elizma: That’s right, but if you have like a drip, drip, drip of bile, such as when you’ve had your gall bladder removed or it’s just sluggish, then it actually has the same effect as an antibiotic resistance kind of thing, because it’s like giving bugs just a little bit of antibiotics, and then they become resistant. The same thing happens, like these bacteria, they become resistant to biles anti microbial activity. Now they get the overgrowth, they get the Crohn’s disease, they get the inflammation, and they don’t have the bile acids to stimulate those receptors.
Matt: Isn’t it surprising these things can get up and go all the way out into the small intestine, to the duodenum, even infections up through the common bile duct, and that sort of stuff, getting all the way up through into the … You know, that’s how we get pancreatitis, and that sort of stuff. A constant trickle would actually allow them just to [crosstalk 00:37:06].
Elizma: Yeah, it allows them to just become very, very resistant, and also you need those bile acids to bind to the … I think it’s the [Farsenoid 00:37:15] X receptors in the ilium.
Steve: It is. Yeah, in the ilium, yes.
Elizma: Which is where SIBO often takes place.
Steve: Ilium’s in the small intestine [crosstalk 00:37:22].
Elizma: The small intestines, right. You need the bile acids to bind there.
Matt: That’s the other end to the duodenum, right.
Steve: Yeah, [crosstalk 00:37:27] duodenum, the ilium, and [crosstalk 00:37:27].
Matt: [crosstalk 00:37:27] yeah.
Elizma: It’s right at the end. That’s where it stops bacteria from the colon to get into the small intestine, and you need those bile acids to bind there to release these antimicrobial compounds, and to also up regulate the iNOS system, which is where the nitric oxide gets produced, which is another way that we kill off bacteria.
Matt: Yeah, that’s really interesting too. In the sports world though we talk about nitric oxide as a vasodilator. A lot of people take vasodilating compounds for example, big doses of oral arginine, and that sort of stuff, to have a vasodilation effect in the skeletal muscle. If you’ve got a dysbiosis, if you’ve got a SIBO, if you’ve got an overgrowth, or an imbalance in your microbiome, a lot of those precursors to nitric oxide can be used by the infective organisms to actually aggravate their condition, or aggravate your symptoms and make it worse. When you take oral vasodilators, if you’ve got an inflammation in the gut, then they’re going to get significantly worse, because that’s where they’re going to hit first, and it’s going to flare it up. That’s [crosstalk 00:38:31]-
Steve: That’s nitric oxide, and that’s really good. That’s the great thing about those receptors now. We were just talking on the antibiotic resistance. Just so as that people understand this, is this is why your doctor will say, “Make sure you finish this course of antibiotics if you’re taking them,” because you get a low dose, you’ll kill half the bugs. The other half survive that low dose, so they’ll grow back, reproduce, and become resistant to a higher dose, and so on, and so on. There’s a famous Harvard study where they videoed E colis [crosstalk 00:38:57]-
Matt: [crosstalk 00:38:57] effect that they’ve put antibiotics through all the animal feed, [crosstalk 00:39:00] dose of antibiotics,-
Elizma: Yeah, that’s that small [crosstalk 00:39:02].
Matt: -through the animal food would have to be one of the worst, because they’re not doing big doses to treat infection. They’re doing low doses to regulate [crosstalk 00:39:09].
Steve: They give them low dose because it actually increases microbes, that increase calorie absorptions, like the Firmicutes, and so they get fatter and [crosstalk 00:39:17].
Matt: Yeah, exactly, yeah, and the funny thing is, Steve, so I’ve been to some closed group confidentials, so I can’t tell you details, but I’ve been to some closed group investment opportunities looking at different organizations, that all the stats were based on carcass white game, and dollar per animal, and [inaudible 00:39:39], and justifying it through per animal we’re going to get more … They justified it in a sense that they didn’t have those phases of infection that create [white 00:39:48] loss, but the reality is, by wiping out the Bacteroidetes, increasing the Firmicutes, you get 20% increase in calorie yield from the same food, and you’re going to get a bigger carcass.
Steve: Of course you are.
Matt: Man, that’s amazing.
Steve: Also of course, if you stuff up your bile, of course the animals’ thyroid levels drops, so they actually put on more weight as well.
Matt: I’m going to ask a dumb question, because I like them. I mean, you guys keep talking about bile acids. Not you guys, I mean, we in that.
Steve: We love them, we’re obsessed [crosstalk 00:40:17].
Matt: We’re talking about bile acids. When we talk about microbiome research we’re talking about short chain fatty acids. All these markers of intestinal health, we’re talking about acid, acid, acid, but isn’t the intestine supposed to be alkaline to be healthy? Are we supposed to have more of an alkaline environment in the intestine, like acid in the stomach, and then alkaline? Do we want our stomach, our bowels, to be really acidic or is there an alkaline [crosstalk 00:40:42]?
Steve: It’s a good question. Do you want to answer that? [crosstalk 00:40:43]. I can answer it. Do you want?
Matt: What do we want to [crosstalk 00:40:46]?
Elizma: You can. Well, my understanding is that it has to be slightly acidic.
Steve: Of course it does, below Ph of 6. Now, 7 is neutral for those who don’t know, anything above 7 is alkaline, below 7 is acid. We want it 6, and in the large colon we want to drop it to about 4, because that’s where you make those short change [crosstalk 00:41:00] butyric acid, [crosstalk 00:41:02] acid, balearic acid, also balearic [inaudible 00:41:04] acid, so those acids are good for the colon. I hope the myth is gone now. When we talk about bile acids, that acid causes cancer, [crosstalk 00:41:13]-
Matt: [crosstalk 00:41:13] short chain fatty acids-
Steve: Are good for you.
Elizma: Yeah, good, and inflammatory-
Steve: They protect against cancer.
Matt: Because I mean, we’re always getting told to have these alkalizing foods, or sorry, no, don’t say the right word, alkalizing, we’re told we’ve got to have alkaline foods. That’s what’s tough. Those foods that are on those alkaline food lists seem to be some of the best ways of generating fatty acids. This whole acid alkaline thing, it’s not like alkaline is good and acid is bad. We’re finding a lot of these amazing things are acids, and we need a lot of acid to maintain our digestive tract [crosstalk 00:41:47].
Steve: In fact, if you’ve taken antacid … Now I want to talk about a proton pump in here, but [crosstalk 00:41:51]. They as we know before, we saw that big Chinese study where they increase stomach cancer, so they’re not good for your stomach, even though they stop acid production if it’s a nestled thing, because a proton is a H plus ion, which is an acid by definition. Proton pump inhibitors inhibit that. If you take that with regards to bile, it slows down bile production, because the acid stimulates bile release, and you have all these major problems of bile deficiency if you’re on an antacid. I’m talking about the one you get, the Mylantas, or your one from your doctor, whichever ones reduce acid in the stomach has terrible problems [crosstalk 00:42:26].
Matt: Yeah. A lot of those are marketed to stop throat cancer, or esophageal cancer from the reflux. They’re designed to stop the acid from getting out of the stomach into the throat, but in doing so, they stop the acid in the stomach which predisposes to stomach cancer.
Steve: Of course it does.
Matt: Yeah, right.
Steve: It is well known. Of course it has these bile problems, that’s one of the major problems. Of course the other problem with our diet, with regards to the bile acids, is we’re told to have a low saturated fat diet. In animal studies of course, because they give them a carcinogen from the go, and they give them either a polyunsaturated fat or a saturated fat. The polyunsaturated fats increase colon cancer worse, so that’s why these saturated fats, not stearic acid, and these medium change triglycerides are very, very good for the colon as well.
Matt: If I had low stomach acid, so if I was eating on the run, stressed type of person, not getting in the stomach mode, for whatever reason I had just typically low stomach acid, now immediately when I eat, I’m just going to eat that food, and then after a little while it’s going to move on. If I get indigestion, or heartburn, if that’s an hour after or half an hour after I’ve eaten, is it plausible to think that my low stomach acid meant poor acid coming at my low acidic [inaudible 00:43:47], mush coming out of my stomach into the duodenum, less signals then for the bile flow, resulting in undigested food through a mechanism then sending a message back to my stomach saying, “You idiot, you needed more acid.” Then an hour later I then get this surge of acid through my stomach, which I then take to mean that I have too much stomach acid, and then I take an antacid.
Matt: This is another common link I see. When people come to me in the clinic or … A lot of people, they get heartburn or get told they’ve got high levels of acid. It’s in the wrong place at the wrong time. For people out there that are getting heartburn and gastric reflux an hour or so after, if you’re medicating your reflux because you’re getting acid in your throat when you’re going to go to bed hours after eating, or you’re getting acid in your throat an hour or so after meals, and that sort of stuff, would you think that some of those people might have started with low stomach acid, and this acid production is maybe a reaction to poor digestion, or poor bile flow? Is there a big link with gall bladder problems and other acid refluxes and things do we think?
Elizma: Yeah, absolutely.
Steve: You can talk about that. Digestive, I mean, a lot of prescriptions are for stomach acid [crosstalk 00:45:03] digestion. You give them like betaine hydrochloride, which is hydrochloric acid. That’s a great treatment for stomach reflux. With indigestion, like again in practice, how would you commonly treat someone who’s got indigestion. There’s two schools of thought. You’d help the digestion or you’d suppress the digestion.
Matt: Yeah, well that’s the point. Do I-
Elizma: Exactly, yeah.
Matt: -then acknowledge that potentially your reflux is because you’ve got low stomach acid when you’re trying to eat. Say you’re getting a high stomach acid in other times, or what do you do? What do you [crosstalk 00:45:32]?
Elizma: Yeah, the way that I look at it is, exactly that it is a lack of adequate stomach acid production when it is needed, because you do need that stomach acid. You do need that acidic [inaudible 00:45:43] to send a feedback mechanism for the pyloric sphincter to close,-
Matt: [crosstalk 00:45:49].
Elizma: -which is between the esophagus and the stomach. If that doesn’t close and it’s open, and even if you have limited amount of stomach acid, it will just-
Matt: Be in the wrong spot.
Steve: [crosstalk 00:45:59] ferments, and gas produced, and-
Steve: -you get GORD.
Elizma: You get a GORD, so you want to-
Matt: GORD, oh my GORD!
Elizma: That sounds a little bit evil or something.
Steve: Gastro something, yeah, yeah, it’s reflux. Let’s just call it reflux.
Elizma: That’s pretty much [crosstalk 00:46:12].
Matt: Oh look, [crosstalk 00:46:13], oh my GORD, let’s call it oh my GORD. Oh my GORD.
Steve: All right.
Elizma: You want to do two things. You want to soothe the mucous membranes because they are obviously inflamed and irritated, but you want it to estimate as stomach acid, at the same time as well. Getting off of [crosstalk 00:46:25].
Matt: I mean, you got to treat the symptoms, because otherwise acid’s going to rip a throat apart, but the way to treat the cause would to be actually increase stomach acid before the meals. I don’t want to get too distracted or down that tangent, because we’ll do another podcast just purely talking about stomach acid and that sort of stuff, but I always … curious about it, because one of the questions that I always get asked, and that sort of stuff, and I have an answer, but I’d like to know your thoughts of it as well. With meals, okay, so one way to aid digestion or something that we’re taught in naturopath college, is like a bit of warm water or something, with some lemon or lime, or something in it, but I’m aware that the water would be relatively Ph neutral, and I’m also aware that the lemon juice or something like that is nowhere near as acidic as the stomach environment.
Matt: Now, I considered stop drinking water when I research and study, because I read a line in a textbook saying that water reduces concentration. That was a little joke actually. It increases dilation, so you dilute things with water. That’s how it reduces concentration, through dilution. That’s my funny joke that no one got. We’re [crosstalk 00:47:44] the scientists and no one got the fucking science joke. Anyway, so water reduces concentration through dilution. That’s my funny joke. You got that?
Steve: Yes, I got that.
Matt: In your stomach, if I fill up my stomach with warm water with lemon juice, am I increasing stomach acid and supporting digestion, or am I diluting my stomach acid and reducing digestion?
Elizma: Well, I guess I’d like to rather add bitter foods in than rather and they say dream something. I’d rather say,-
Matt: Did you say, “Bitter?”
Elizma: Yeah, bitter in foods. Bitter foods could be lemon squeezed over something, it could be using vinegar in a salad dressing, it could be adding something like sauerkraut as a condiment, not as a food. People overdo these things. It’s a condiment. Anything bitter as a food would stimulate, so [crosstalk 00:48:32]-
Matt: There’s a nerve that goes from the bitter taste buds of our tongue through to the transverse column, the vagus nerve, and so when we activate that, that’s a way our stomach knows we’re about to eat. It’s part of the parasympathetic nervous … Our body is split between two, survival mode and rest and digest. If we can activate that nerve, and increase the blood flow, and increase the energy, and the nerve activity into the stomach, and reduce our signals to our sympathetic nervous system, so sit down, don’t eat on the run, don’t be thinking, working, and doing stressy things when it’s meal time. I believe that’s the Mediterranean paradox. It’s the four hour lunch breaks, not the olive oil and tomatoes, and whatever. You know what I mean?
Matt: If we can get that, so you’re saying with the bitter … What we want to do … This is what I was hoping you’d say, because the bitter principles, we want the … It’s actually the bitterness from the lemon, not the Ph. It’s actually the activation of that nerve, not the actual increase of the acid. What’s your thoughts of the people that would then get up in the morning and have a drink of apple cider vinegar and water, or lemon and water? What’s the benefit of that? Is that going to increase our bile flow? Is that going to do anything for us other than what [crosstalk 00:49:43]?
Elizma: I think the bitter would still that. I guess it depends on how far away. If you do it like first thing in the morning, you still wait a bit before you eat, I think it’s fine because I don’t think water stays in the stomach for that long, especially not if it’s warm or a warmer kind of temperature. I probably wouldn’t drink it at the same time as the meal, because then [crosstalk 00:50:00] stomach acid, but if you’re doing it first thing in the morning and let’s say you wait 30 minutes to an hour before you have breakfast, I think it’s fine.
Matt: Yeah, no biggie.
Steve: Absolutely. Just as a-
Matt: [crosstalk 00:50:09] we get stretch receptors too. In our stomach we’ve got stretch receptors. If you dilute the stomach, the stretch receptors say, “We’ve got more stuff here. Let’s make some more acid and enzymes.”
Steve: Also from an evolutionary point of view, bitter foods, rough and poison, so the body would react by making all this acid to kill the poison.
Elizma: Oh, how interesting.
Matt: [crosstalk 00:50:25].
Steve: [crosstalk 00:50:25] point of view. I didn’t want to interrupt you guys.
Matt: Up regulate the bile production as part of the detoxification of the poisons.
Steve: Yeah. We know that because we now know one of the other side effects of proton pump inhibitors, antacids, is gall stones. It’s a big risk factor, so that, where we draw it back to the bile there. If you don’t have the acid in your stomach, you’re going to get gall stones.
Matt: That bitter thing that you mentioned before,-
Steve: Yeah, the evolutionary thing, yeah.
Matt: -we’ve mentioned this on podcast before, it’s one of the reasons why it’s so hard to get your kids to eat your veggies, because they naturally they have this thing where the bitterness of the broccolis, they they’re actually more sensitive to the bitterness in vegetables because of that innate acquired defense mechanism. It’s very important just to keep putting it in. You just keep putting on a plate till their body realizes and desensitizes to the bitterness, and takes on the other stuff. That’s so important. Even if they just nibble it, they’re going to try a little bit, they’ll actually desensitize to that flavor. That’s why often when we’re kids, there’s foods that we just can’t tolerate, we absolutely hate. Then as we become adults all of a sudden it’s something, man, that’s actually really good.
Elizma: Or it can also depend on how you grow up. Like I have friends who started their kids off from when they were babies, on GAPS diet principles. They love sauerkraut and stuff like that, so I think it’s also because our kids are very more sweet sensitized I guess, used to sweet stuff, because a lot of parents start off with the sweet, the fruits, the pureed fruits, the pureed pumpkin, all the sweet ones when they should probably start with the blander ones and [crosstalk 00:51:54].
Steve: Absolutely, yeah. Very interesting. You mentioned stress before, and they’ve done this study on rats. What they’ve done is they’ve given them chronic intermittent stress on rats. I’ve got a great diagram here that’s got a little rat that’s very cute. They gave them stress. It caused a few things. It caused reduction in bile acid secretion, and liver injury. Chronic unpredictable stress sounds like someone in a job that they stressed about, and something comes up at work, and you get stressed out. Now this is huge. Now obviously we could tell everyone to leave work, but from a practitioner point of view how would you help people cope with stress. I mean, who are these little rats in these situations.
Matt: What happens, that stress changes your priorities. With your liver, it gets like every drop of blood in your body goes through the liver like every hour, so during the stress response, your liver’s capable of changing the way your blood … It’s capable of changing the way it works to help short term stress. It doesn’t care whether it’s long term, short term, whatever, it just does whatever it has to do. Usually what you did last time to survive, which is why we get further and further out of whack. Part of our survival response to stress is increasing the phase one side of chrome P450s, which make it more likely to make water soluble toxins, so you can froth at the mouth, vomit, diarrhea, sweat, whatever, purge the toxin, but if you imagine, that’s how we get a lot of chemical sensitivities as well.
Matt: Phase one runs fast as part of the stress response. Phase two which is associate with those, we mentioned the conjugation, so the attaching of the amino acid to that poison or the venom to complete the detoxification, to actually allow it to sit in the bowels and fully be eliminated, it doesn’t wait for that. Phase one just runs faster, and faster, and faster. Again, because the blood goes through the liver then you get I think called acute phase response, or a survival response. It makes your blood go sticky, makes it easier for you to clot if you’re going to bleed to death, by releasing fibrin, and taking away the positive charges off your red blood cells, which they call the zeta potential, and allows them to clump around so you bruise, and all that sort of stuff, and flushed.
Steve: So you don’t bleed to death too.
Matt: Lots of stuff. Your body does not care and cannot afford to wait to see if you are training with angst, if you’ve got road rage, if you’re an endurance athlete having a ball, whether you’re paying your bills, working, answering the phone, dealing with immune stuff, dealing with inflammation, dealing with excessive microbiome, whether it’s in [inaudible 00:54:16] or an infected organism. It does not care. If it gets a stress signal, it will quickly change. If those things keep stacking on top of each other, then eventually your liver’s going to go way out of whack. You’re going to manifest with gall stones, you’re going to manifest with chemical sensitivities, intolerances, recycling your stress chemicals, recycling your hormones, all that sort of stuff.
Matt: It’s so important during a stress response to try to work with the person, and remove the burden from as many of those things as possible. You can’t cure the world, which is why you can’t cure anything, really. Most of these things are management. Now you got to realize as part of the stress response, what you did last time to survive the stress, is what gets programmed as a memory to do again. Most people that I see, their phase one detox pathways go faster, faster, faster, faster. We can try to give them all the amino acids and supporting new trends to make phase two keep up, but if we’re not slowing down that phase one, and slowing down this stress response, then they’re going to be constantly out of whack.
Matt: That’s why we talk about antioxidants, and that’s why things like [inaudible 00:55:26], Schisandra, these things have become so valuable in the clinic, and so popular worldwide because they can work on so many systems systemically by reducing inflammation, and immune, and acids, and all these other triggers that might be driving the stress nervous system at the same time, as they can just dampen down the innate defense mechanisms. That includes slowing down the liver, slowing down the immune, slowing down all those sort of things. When you talk about these stressed rats, they’ve got no idea what it’s like to pay a bill. They’ve got no idea. The phone doesn’t ring. You tell them, hey just whisper in the ear, hey, they’re going to kill you after the study.
Steve: Do you want me to tell you how they stress them?
Steve: They put them in their cage-
Elizma: Shock them?
Steve: Yeah, and they just randomly put a shock on them, so they’ll be sitting there really and all of a sudden, bzz. The [crosstalk 00:56:12] would be worse.
Elizma: That’s right.
Steve: These poor rats, what happened to them of course, they also measured their hormones and of course their progesterone levels dropped, because cortisol is made from progesterone for those who don’t know. Therefore, relatively their estrogen levels were higher to progesterone. That was another mechanism why their bile acids stuffed up, because of the high estrogen [crosstalk 00:56:30]. Elizma, I’ll ask you, say we’re training a rat like …
Elizma: Stressed rat.
Steve: Say this stressed rat came to see you. What would you-
Matt: What would you ask?
Matt: What was the first question you would ask that rat?
Steve: Yes. [crosstalk 00:56:48].
Matt: [crosstalk 00:56:48] the horse.
Elizma: Well, there are probably a few questions I would ask. I mean obviously I would look at their blood sugar, like if they skip a meal, do they get really jittery, because those blood sugar dysregulation or blood sugar symptoms are what you usually look at using adaptogens, and things like that, when you have that stress in the blood sugar, and all of that kind of stuff. I’d definitely also consider, this is just to sort of like tie it in a little bit with the bile, is obviously when you’re under a lot of stress you burn through a lot of methylating nutrients, your SAM, your folic, your B vitamins, and all of that. Methylation wants things to slow down a little bit if this chronic stress, which means they don’t make the phospholipids, and the phospholipids makes up a large portion of bile. Our cholesterol and phospholipids needs to be in a ten to one ratio for bile to be fluid, and flowing.
Elizma: As soon as that ratio diminishes, so the cholesterol makes a bigger portion of it, that’s when you get the gall stones. I definitely want to make sure that they don’t have any nutritional deficiencies, but definitely look at blood sugar, and I would be looking at using adaptogens and things like that. Just help them cope with the stress, but of course, you’re right, you can’t remove stress. We live in a stressful environment, but you can strengthen the resilience of the person and how they cope with that stress. Obviously they still have to make some lifestyle changes, like the rats need to remove themselves from the environment where they get shocked all the time,-
Matt: Yes, such is a lab.
Elizma: -so they can eat in a relaxed environment without being shocked. Yeah, you want strength in that reason, yes.
Matt: Poor bloody rat.
Steve: Poor rat.
Matt: The last rat study we talked about it was all about [cupper fodgy 00:58:23]. They were running around-
Steve: Eating the poo.
Matt: -eating the poo of the other rats.
Steve: It’s amazing. There is another-
Matt: [crosstalk 00:58:30] stressed. Hey, can I say before … Just something you mentioned there, it’s going to bug me. You mentioned the ten to one ratio for the phospholipids. When we talk about phos … Is that the same stuff that we find in lecithin? [crosstalk 00:58:42], because yeah, lecithin in a clinic, if someone’s intolerant, going to spew after eating their roast dinner, and then I just-
Elizma: Yeah, we usually suggest to have some lecithin.
Matt: Some lecithin to help emulsify the fats.
Matt: Lecithin’s full of phospholipids?
Elizma: It’s full of phospholipids. Specific it has phosphatidyl choline, which is made by the PNMT enzyme that needs SAMe, which is a methylation byproduct to work, and then your lecithin. I can’t remember the complete composition. I think it’s got a variety of different kinds of [crosstalk 00:59:13]-
Matt: It’s got phosphatidyl serine, phosphatidyl inositol, phosphatidyl choline, make up about a 30% of that lecithin extract.
Elizma: Yeah, so definitely, as a food, that’s a great way of sort of like helping with [crosstalk 00:59:23] as well.
Steve: Yeah, I’m just saying, SAMe is S-Adenosyl Methionine, just for those people who think that’s a common supplement you can get around the place. Very interestingly, that we’re talking about stress there and the poor old rats and that sort of thing, and they can’t cope with stress. It was a new paper in the Journal of American Medical Association, it’s all about stress and depression. They mentioned three things. Firstly, that Ketamine has been approved for the treatment of depression. Ketamine is a-
Matt: Horse tranquilizer, isn’t it?
Steve: It’s a tranquilizer that puts people out. In 1962, it was the number one drug of putting people under anesthetic. It was used heavily in the Vietnam War. It was a good drug for that. Dr. [inaudible 00:59:57] knew all about that. With the other thing of course, the other two things I mentioned was resistance exercise, and diet to reduce stress burden, in the Journal of the American Medical Association.
Matt: [crosstalk 01:00:11].
Steve: It’s like going, oh, yeah, Ketamine, that’s been approved. That’s interesting and good. They have nasal spray of it now. They’ve got it so you can have a bit of anesthetic whenever you want.
Matt: Oh my gosh, [inaudible 01:00:20].
Steve: It also causes amnesia, so if you’re stressed and you’re snorting this stuff, you forget what you’re stressed about.
Matt: [crosstalk 01:00:28] clear and confused.
Steve: Oh, it causes hallucinations too, so you can imagine people spraying yourself at work, and seeing pixies in front of them. That’s why people when they wake up out of anesthesia are off with the pixies, and people are just not with it, and they say ridiculous things. They’re very interesting. Resistance exercises are very, very good. They’ve done a big study coming out now, and of course diet. If now those things are starting to be considered to remove that stress burden off the people, of course they mainly talked about the drugs, so I’m spinning the article a bit, but the fact that they’re talking about resistance exercise, getting people into the gym for their resistant depression, and stress, and anxiety, is a really good [crosstalk 01:01:09].
Elizma: [crosstalk 01:01:09].
Matt: [crosstalk 01:01:09] horse tranquilizer before or after the gym?
Steve: I’d have it beforehand. Imagine what you’d do at the gym then. You forget you’re at the gym, and you’d be saying things like-
Matt: [crosstalk 01:01:18] pain.
Steve: Oh no, you wouldn’t feel pain, because it blocks pain receptors. This is a great way, but really in a more serious note, removing the stress burden is a great way to help with digestion, which helps bile flow. You’ve got to do what you guys are saying, is try and remove as much stress as you can from your body, get yourself eating in a nice friendly environment. We’ve said it before but this is another reason why to get the bile flow-
Matt: I wonder if having a horse tranquilizer before you go to the gym might reduce the amount of angst.
Steve: You might [crosstalk 01:01:48].
Matt: If you imagine, there’s a lot of people that seem to be very angry at the gym, and could possibly be their angriest time of the day.
Elizma: Wouldn’t you want to go to sleep if you’ve had a tranquilizer? I would just want to curl up and rest.
Steve: Yeah, it knocks you out so you can be operated on. You know? This is what it’s for. It’s a [crosstalk 01:02:02]-
Elizma: You’re just passed out in the stretching section of the gym. You know?
Steve: You’d be pretty chilled out, I’ll tell you. Of course, magic mushrooms was also mentioned that they’re trying to push through the FDA to help. Remember, that’s [crosstalk 01:02:14]-
Matt: Which gym is this?
Steve: No, this is not a gym, it’s in the Journal of the American Medical Association, so this is-
Matt: [crosstalk 01:02:19] a gym membership. You’re doing the old Ketamine, [crosstalk 01:02:22] Ketamine, and what was the next thing they tried?
Steve: Magic mushrooms.
Matt: Magic mushrooms.
Steve: This is true, it is what they do. Getting rid of the stress out of your life as much as you can, or being able to cope with the stress better.
Elizma: [crosstalk 01:02:32].
Matt: Yeah, [crosstalk 01:02:32] cope with heavy drugs at the gym is impressive, Steve.
Steve: Exactly. You’ve got a shitty job at work and-
Matt: Day and night, he used to be in a band, or he’s still in a band.
Elizma: I heard. Long hair.
Steve: Oh dear.
Matt: [crosstalk 01:02:42].
Steve: Yeah, we did-
Matt: That’s amazing.
Steve: Yeah, that’s very interesting stuff. The bile is mainly reabsorbed to activate these receptors in the body, to help with diabetes, help the immune system, reduce inflammation, and have a wonderful effect on the physiology-
Matt: So if someone’s got subclinical thyroid, so they’re manifesting saying, I’ve been to the doc, my weight won’t change, I’m cold, my hair, skin, nails are crappy, and all that sort of stuff, and I’m holding fluid, and all that sort of stuff. If someone’s got estrogen dominance or something like that, saying, “My menstrual cycle, coming in towards my menstrual cycle, my boobs are sore and swollen,” which is the same thing the thyroid people are saying by the way, and then they’re getting this excessive bleeding, and clotting, and pain, my brain’s going crazy, I’m worrying too much, and all that sort of stuff, maybe headaches, and that sort of thing, if the same person they might be manifesting with sticky blood, like bruising, or varicose veins, poor circulation. Again, they can manifest as migraines and that sort of thing, that same person then might say, “My digestion, my gut’s not awesome. I just don’t seem to be able to tolerate fatty foots. My bowels alternate constipation to diarrhea. An hour or so after meals I get a congested feeling, or I feel spewy, and I need something.”
Matt: If that sounds like you, I would look into the bile, but how does someone look into … We talked about the symptoms they might get from the digestive tracts, like weird colored poo, or floaters, constipation, alternating with diarrhea, that sort of stuff. Most people that I spoke to that find out about gall stones, or … The first time they mention about bile is after they’ve had their gall bladder removed. They said, “For some reason my gall bladder is …” How the hell do we tell people now to know … How does someone out there know, if you manifest all those sort of symptoms, if you’re one of those people and you were judged by Steve as being fair, fat, and 40, and stuff like that, how would you know if this is your problem? What’s the best way to test it, because I mean, if I do a liver … A liver function test, not a liver function test, what we call a liver function test [crosstalk 01:04:56]-
Elizma: [crosstalk 01:04:56] to know this.
Matt: -liver damage. If someone’s had a scan, I mean, most people find this stuff out from a scan.
Elizma: Much later.
Matt: How would we tell people now if they suspect that, or they want to improve their bile? ATP is not about suspecting shit’s bad and then finding it, and then fixing it. We want to find people that are also good and want to be awesome. If someone wants to fine tune before they’ve got gall stones, and before they’ve got jaundice, and before they’ve got all this horrible stuff, how? Where do we start?
Elizma: The best place to start it exactly what you said, Matt. It’s the symptoms. All the symptoms, it already tells you the story. The symptoms just going to be the first thing that you notice, before it’s going to show up on any test results. That would be the best place to start, but there’s other like little tell tale signs, that you can pick up through certain tests, like the organic acid test. There’s a few tell tale signs there that, ah okay, there may be an issue with not having enough bile. If you start getting the … If you do, let’s say, a Dutch hormone test, and it shows an estrogen dominance there, that should be a tell tale sign. You can do like your gut studies GI map, or whatever sort of like a digestive stool analysis you want to do, and some of the markers there like they measure the amount of fats in the stool, and they measure short chain fatty acids, and things like that, so you can start getting signs there as well.
Matt: Can you measure all the bile acid, bile pigments in your poo, and all that?
Elizma: There is I think one-
Matt: [crosstalk 01:06:26] it’s been reabsorbed.
Elizma: Yeah, but I think Genova does. It’s very expensive and I’ve not done it for that reason, but I think you can measure primary and secondary bowel acids in one of the Genova stool tests, but it’s very, very expensive.
Steve: Of course a blood test can measure bilirubin. That was a common test.
Elizma: That’s right, bilirubin.
Steve: The other thing you want to look for is in your thyroid testing, is your ratios T4 to T3. If that’s screwed up, [crosstalk 01:06:50]-
Matt: Yeah, right. Yeah, it’s the same deal, man. It’s just a snapshot. It’s generalist. Like you said, we’ve just got to drive through and … How do I know though if I’ve got a thyroid disorder, or if I got a bile disorder? How do I know if I’ve got a estrogen problem or a bile disorder?
Elizma: That’s where the symptoms come in.
Steve: Yeah, symptoms.
Elizma: That’s why even when I-
Matt: Can you have on without the other? Because with everything we’ve said here, if you’ve got an estrogen dominance, if it’s from a ovarian disorder, or dipped in petrol, or whatever, you’re going to end up with a bile problem.
Elizma: Eventually it’ll be a flow and effect. Sometimes the primary focus can differ in certain people, all right? It may start at one end and then end up here, or it might start here and end up there, but eventually, everything influences everything. Our body is not segmented to different little pieces.
Matt: It doesn’t really matter where it starts. We’re all stuck in a vicious cycle.
Elizma: We’re all stuck in a vicious cycle.
Matt: We’ve still got to try to isolate the cause and work towards it, but regardless, if you’ve got estrogen dominance, you got low thyroid, you’re going to have to manage your liver and gall bladder flows.
Matt: Yeah. It’s just a-
Elizma: Isn’t that the principle of natural [crosstalk 01:07:55]-
Matt: Holistic medicine, yeah.
Elizma: I mean, 200 years ago they were all about the gut and the liver, and we’ve sort of gotten a little bit away from it because now we focus on genetics, and we focus on all this cool stuff, which is cool, but at the end of the day, it’s really just back to the basics.
Matt: It’s too specialist.
Steve: It’s too specialist.
Matt: The problem is, is when you specialize in that sort of medicine, all of a sudden you forget the symptom picture. You start treating an OAT test … I did it again. You start treating an organic acid test, or an OAT [crosstalk 01:08:25].
Steve: I call it OAT test because it doesn’t sound right without the-
Matt: It’s stupid, the ATM machine. Yeah, so you got to treat everything holistically.
Elizma: Yeah, don’t treat the test. Treat the person.
Matt: Naturopaths can get into exactly the same problem.
Elizma: Specialist, yeah.
Matt: It’s not a medical thing, or a specialist thing. It’s just the way you look at things. You must relate all objective measurements to subjective feedback to know what it’s doing in that particular person, and even if it’s relevant, or a totally dodgy test.
Steve: Exactly. To simplify things, [crosstalk 01:08:58]-
Matt: Hey, I went to the doctor the other day to get a test for a quest thing, so I didn’t pay for it. It wasn’t until this lady was arguing with me about my symptoms, and then told me as a truck driver what I need to be aware of, before I realized that she had the wrong file open. This whole time, and you know it’s just going, oh my gosh. If someone’s just looking at test results, and looking at files, and not listening and asking, it’s bloody dangerous. Eh?
Elizma: It is.
Matt: [crosstalk 01:09:34] drugs that she wanted me on. That guys off chops. Truck, I can’t believe he’s driving trucks on that [crosstalk 01:09:39].
Steve: It’s a bit scary, a bit scary.
Matt: I took the script. No.
Steve: No, no, no, right, right. Ketamine, was it?
Matt: Right before the gym.
Steve: It’s sort of like this someone who comes in, who’s carrying too much body weight. Let’s just say that’s the case. It doesn’t really matter how they got overweight. The treatment is kind of the same. They got to prove the diet, and prove the exercise, so how they got all the symptom picture is interesting, but we’ve still got to … Like, if there is some dominant clues, they’re overweight for example,-
Matt: Because it is stuck in a vicious cycle. You got to still manage the symptoms.
Elizma: Yeah, you still got to look at the diets, to look at the environment, lifestyle, all of that. That’s where you start.
Steve: Knowing how the car works is an easy way to fix it, and that’s what Elizma’s great at just knowing how the biochemistry in yourself. You’re better than you give yourself credit for I think.
Matt: Oh suck, I don’t need anymore patients.
Steve: No, no. To understand what’s going on under the hood means you can diagnose the problem better, and that’s what this is all about. That’s what this podcast is all about. It’s considering bile,-
Matt: That’s fine tuning too, yeah.
Steve: -because I’ve never heard medicine consider bile as important as this. In fact, I [crosstalk 01:10:36].
Elizma: That wouldn’t remove it. It’s a wasted [crosstalk 01:10:39].
Matt: Yeah, it’s not even doing it. They’re just removing the sac that was holding the bile, that would squirt it out later and then saying, “Oh, you’ll be fine now. Off you go. As you were, soldier.”
Elizma: That’s right.
Steve: We want to keep our sex, don’t we?
Elizma: We do want to keep it.
Matt: Yeah. You’ve only got a little bit of sac left. You got to keep all of it. He was telling me about … I haven’t seen his sac. He was telling me.
Steve: I’m 50 now, you know? Atrophy, you know?
Matt: I thought it went the other way when you’re old? Get off the gear, Steve.
Steve: Oh okay, that’s what it is. All right.
Matt: [crosstalk 01:11:11] raisins.
Steve: This is a great time to finish this podcast.
Matt: Probably even a couple minutes earlier than this point. We probably should finish it. Yeah, so have you got anything else that’s fucking awesome and mind blowing?
Elizma: I always have stuff that’s [crosstalk 01:11:24].
Steve: Oh, you’ve got some awesome stuff.
Elizma: I think one interesting thing, just because we talked about bacteroides and Firmicutes, and all of that, is that Clostridia is one of the main species in the small intestine that’s involved in converting primary bile salts into secondary bile salts, and as long as it’s in balance it’s okay because Clostridia again is not a bad species. You do need it, but if it’s an overgrowth, you’re going to get more of those secondary bile salts. I think it’s specifically dioxycholic acid, I think is the one, and that’s responsible for the diarrhea effect, that you get when you have Clostridia overgrowth. You can see how the Firmicutes and the bacteroides play actually huge important roles in the whole bile regulation thing in the gut. [crosstalk 01:12:06].
Matt: Yeah, that is really interesting.
Steve: C. diff is the one that caused a lot of deaths in the hospitals too, Clostridium diff, and it also is one that is implicated heavily with autism, because it has amazing effect on the brain as well.
Elizma: That’s right.
Matt: Yeah, exactly.
Steve: That’s why when they give fecal transplants to autistic kids, they improve dramatically. C. diff is a really big one in that process. Clostridia diff is what C. diff [crosstalk 01:12:28].
Matt: Yeah, yeah, yeah, yeah. That’s people right there that if I’ve heard of antibiotic associate diarrhea, that’s usually that sucker.
Elizma: Yes, that’s the one, that’s the one.
Steve: Incredible stuff.
Matt: Well, that is wild, man. I mean, I can’t wait to do more on it. This isn’t freaky because it’s something … Like I said, it’s involved absolutely everything.
Elizma: It is.
Matt: If you consider that your liver gets every drop of blood, every hour through your body, it’s ability to process the toxins out of that and put it into bile, along with … It’s so bloody important. Then if you have a look at it as well, we talked about the ability for the liver to regulate our gonadal hormones, our stress hormones, our thyroid hormones, and then every process that it does has a residual effect for your bile. Then by that bile, it can affect every other system. Most of us only ever see it after drinking at one end or the other. That’s that yellow stuff you vomit up when you’re really crook.
Steve: [crosstalk 01:13:21].
Matt: Then this is the … Most people only ever think, “I’ve had my gall bladder removed,” or “I’m drunk and there’s bile.”
Steve: Or my poo’s a funny color, and that’s about it. [crosstalk 01:13:31], yeah.
Matt: Well you know, but it’s something that’s … Now if you look at the [inaudible 01:13:37] and [inaudible 01:13:38] herbs, and the things that just generally support that, and how powerful they are in all of these different hormonal pathways, we mentioned the herb Amatas but then we’ve also got all the dandelions, we’ve got the yellow docks, we got globe artichokes, you got the Schisandras. All those things indirectly will affect every other part of the body. I’ve told this story multiple times how Schisandra is one of my favorite herbs, purely because I used it to cheat to get through my assignments, because when they’d say, “Five herbs for the liver,” I’d go, “Schisandra.” Five herbs for the lungs, Schisandra. Five herbs for the brain, Schisandra. It didn’t matter what it was and you see, the mechanism of Schisandra mainly working in through that liver, and through that bile flow, and everything like that, it’s fascinating to see how many things link.
Matt: We think they’re working over here, which they are, but they’re also working here. That’s what I love about natural medicine, how holistic it can be on so many different systems. Sometimes it’s freaky, you see the patterns of a herb and what it’s capable of doing. You go, how can one herb have that exact combination of stuff. You know?
Steve: [crosstalk 01:14:33] and of course, saying that all [inaudible 01:14:35] medicine doesn’t consider the bile, it’s very [inaudible 01:14:37]. I mean, the gall of that fucking use [crosstalk 01:14:39]. Did you like that? Was that a good joke?
Elizma: Yeah, that’s a good one.
Steve: SAMe finish [crosstalk 01:14:42].
Matt: It was good. It was better than my water joke I suppose.
Steve: Here’s the FAQs, all right? Now this is an interesting one. It’s a GutRight product review. Basically it said reduced sugar cravings?! Wow, all that sort of marks. I did one round of GutRight after a heavy course of antibiotics. I experienced no nasty symptoms from the bacteria die off, as the antibiotics had probably killed most already. As you mentioned, that would be the case. At the end of the three times of a day for 10 days, I was definitely less bloated but something I was not expecting at all was my usual sugar cravings had dramatically reduced. Even my usual breakfast of porridge seemed to turn off, and instead I found myself craving proteins and fats.
Steve: Also on that note, I don’t know why everyone is saying that it tastes so horrible. Just tastes like a currant cinnamon to me. Stella, who mentioned that by the internet. That’s a pretty good review. Isn’t it?
Elizma: That’s a very good review.
Steve: [crosstalk 01:15:39]-
Matt: [crosstalk 01:15:40] pronounce cacao wrong.
Matt: [crosstalk 01:15:42] do it the ATP way.
Matt: Thank you.
Steve: Cacao. Well, here’s the first [crosstalk 01:15:47] from Harriet. I dated the first bit. It says, “Hi, Elizma, Jeff,” Oh, you got it wrong. It says, “Hi Matt, Elizma, and Steve.”
Matt: Just read it, Steve.
Steve: “Love your work.” Yeah.
Matt: You just totally-
Steve: I’m trying to butcher it up.
Matt: -[crosstalk 01:16:02] and you missed words somewhere.
Elizma: Oh, butcher or-
Steve: Well, it says Jeff and Jeff’s not here, so I tried to … I butchered it. I butchered it. All right.
Matt: You misquoted it, Steve.
Steve: I misquoted. Absolutely.
Matt: Bloody hell.
Steve: I’ve been listening to your podcast for over a year now and that completely opened my mind to natural health and understanding my body. I’m 27 years old and have been suffering with a number of chronic symptoms for the past couple of years, and most of them remain undiagnosed. After listening to your podcast, I’m looking at my symptom picture. I seem to have all the classic signs of estrogen dominance and slow thyroid, however I’d love to hear your professional opinion.
Elizma: She just got a whole hour of professional opinion.
Steve: I know, and it’s incredible. “This is a quick overview of my medical history. I suffered anorexia when I was 20 years old and dropped down to 39 kilograms at 5 foot 2. Because of this I had amenorrhea for over two years. I slowly gained over 20 kilos and my periods came back. Last April I had a CST, and it came with a high risk of HPV, which is human papillomavirus. After a colonoscopy and a follow up CST, six months later I was given the all clear, but have to go for a [P 01:17:12] checkup in November just to be sure. I have been taking Citalopram, which is of course an anxiety drug, for the past six years for anxiety. I am currently on a 20 milligram dose, which seems to keep my anxiety under control most of the time.” That’s a fairly low dose of that one.
Steve: “The main symptoms I’m currently experiencing, so low energy, fatigue, headaches, hair fall out, mid cycle spotting, which has happened off and on for the past 18 months, so recently lasting for 10 days. I’m not on the pill and never have been due to family history of blood clotting, so my doctor thinks it’s relatively normal, but I just feel that my hormones are not operating as they should.” Of course you can’t take the pill when you’ve got blood clotting issues, particularly the generation three ones if you’re wondering, for those listening.
Steve: “I struggle to switch off at night and although I exercise six days a week and lead a relatively healthy lifestyle. I also find it very hard to shift stubborn fat, especially around my knees, lower abdomen, and upper back. I’ve tried using Alpha Venus and Cort Rx, but don’t change my symptoms. I took one capsule in the morning and two at night of each. Am I using the incorrect doses or are the products not right for me? I would love to hear your advice. Thanks, guys.”
Steve: There you go. That’s an interesting one. That will go to you [crosstalk 01:18:28]. It’s an interesting one.
Elizma: It is.
Matt: That’s right. We talked a lot about these patterns, so as we go through there, those weird abnormal cells are usually associated with estrogen dominance, and most of those, even now, most of those symptoms are associated with estrogen dominance. You’ve done well. When you see the cycle spotting, when you see the mid cycle spotting, that’s when we know that we’re suddenly, the progesterone’s not adequate. Okay? The progesterone’s job is to hold that in and stop that from spotting. Now with Venus you said you used one in the morning, two at night. That’s not so bad for the estrogen detoxification. Okay? There’s two parts to the Venus. One is estrogen detox, and in that instance, two in the morning, two at night is the recommended dose to remove estrogen dominance.
Matt: However, the herb Vitex that’s in the Venus, for it to work on increasing progesterone and stopping the mid cycle spotting, you need a consistent strategy of interacting with the pituitary gland to do that. The best way to do that is to take four in the morning. Okay? That equate … Four, Elizma, is a gram of Vitex. If we get the four of the Venus, we get a full gram of Vitex in the morning, and then that will basically work more with your pituitary gland to regulate your menstrual cycle. You’re still going to get the same dose of your estrogen detoxification ability. That will be there floating through your bowel for the over the night. Do it four in the morning and you’re going to fix that mid cycle spotting much faster, and it’ll still work on the estrogen dominance.
Matt: We’re going to do the Venus for that. You could even throw in a T432 plus at one capsule three times a day, just to support the thyroid and see if we can use that to drop off that estrogen excess as well. I’m not going to add too much, because I’m predicting that Elizma will add some stuff too, but Venus, do four in the morning, T432 one capsule, three times daily. Just now most of those symptoms of estrogen dominance and potentially sluggish thyroid as a consequence of that as well, but we talked about vicious cycles where if your thyroid’s slow, your estrogen’s going to be high, and if your estrogen’s high, your thyroid’s going to be slow. We kind of, to break the cycle, we just hit both of them just in case we hit the wrong one.
Steve: All right. I think we [inaudible 01:20:37] Elizma, but do you got anything to add to that?
Elizma: I think what Matt sort of recommended is great. I guess the only thing that I would like to add is that I think this probably would be a very good podcast for her to listen to, because everything sort of seems to have started with the anorexia when she was 20 years old, and obviously that not eating would have affected the whole gall bladder function as we’ve talked about. Also, she wouldn’t have had enough nutrients and for methylation and all of that. [crosstalk 01:21:06]-
Matt: Genetic expression, this is … Sorry to interrupt. You know when we talk about genes, and we talk about genetic expression, so often we’ll see someone with men estrogen dominance. We might say, “Go look at your mother fucker gene. Look for the methylenetetrahydrofolate reductor as a bit of saddened case they cut out, mother fucker.” We would look at that gene, and then that person may or may not have it, but if [crosstalk 01:21:30] we ever look at a situation where that, for someone to get a polymorphism in the MTHFR gene, the gall of that, or the positives that come from that is recycling your hormones for fertility, recycling your stress chemicals for short term survival, and fuel your anxiety. If someone’s done something like anorexia, can they then get the genetic expression of that polymorphism? Are there body manifest those things? Is that what we’re talking about?
Elizma: Well, definitely, like the diet and environment are the things that changes genetic expressions. We put a lot more weight into genetic expression than genetic polymorphisms. Regardless of whether she has a genetic polymorphism or not, she would have been very severely nutritionally deficient. She wouldn’t have had the B vitamins, and the fall out, and all of that to make as co factors for a lot of those enzymes to function. Not just in the methylation, so about many other cycles as well. She would have had dopamine dysregulation, which is associate with the anorexia as well, but definitely that fast stage, she wouldn’t have eaten any fats, not eating at all, which would then have that flow and effect on the gall bladder as well.
Elizma: Then that can sort of like trigger I guess a gut dysbiosis like what we’ve talked about. That gut dysbiosis can then go onto sort of like trigger anxiety in the brain through the vagus nerve and the [inaudible 01:22:52] receptors. Then she may … I don’t know what her gut profile would be like now in terms of what bacteria is growing and what is not, but if she’s struggling to shift stubborn fat, that could be again part of the Firmicutes and the bacteroides ratios. It’s a probably a little bit of a mixed bag. I think she’s on the right track with the Alpha Venus and the Cort Rx, but I think the T …
Matt: Yeah, 432 plus.
Elizma: Yep, is another great addition there.
Matt: One other thing, you mentioned dopamine, and it just reminded me that Vitex also has a large dopaminergic effect. Now the problem is is when I say to take four Vitex, sorry, four of the Venus in the morning, maybe with that medication, the Citalopram for the anxiety, I don’t know if I said that right …
Steve: That’s perfect actually.
Matt: [inaudible 01:23:43] truth, fluked it. I would work with your doctor and pharmacist on that. Basically if you are doing Venus like one now, maybe ease into it. Go two for a couple of weeks and see, because you’re going to have an interaction with the dopaminergic effect of that, and I don’t want to manifest anxiety symptoms, or screw around with the emotional state for us to fix her progesterone. Just work with the doctors, but make sure there’s no real major interactions there, and also just do it under supervision.
Steve: Yeah, and I want to ask you a question, Matt, just quickly about-
Matt: [crosstalk 01:24:15] you didn’t write it in.
Steve: Damn. Shift stubborn fats,-
Matt: You got to wait three months. Give it a [crosstalk 01:24:20] and wait three months. I don’t know.
Steve: It’s really too much. She’s carrying fat around her knees, lower abdomen, and upper back. Now she’s estrogen dominant so the million dollar question is, is it more of a sub cut or a block E3 sort of treatment. If you wanted to go, just trying to throw that out there.
Matt: When I see the estrogen dominance systemically and isolate to those areas, I usually go for the block E3.
Steve: Yeah, I thought so. [crosstalk 01:24:46]. That’s good. No, just sort of-
Matt: [crosstalk 01:24:47] put it on. Yeah, most of it’s PCOS, and then if it’s PCOS I usually go for the sub cut.
Steve: Good. Well, here’s one from Kim. It says, “Hi there. I’ve been listening to your podcast nonstop for four days.”
Matt: Strict [crosstalk 01:24:59], Kim.
Steve: “Have gone through 11 episodes and I admire everything you guys are doing. I’m learning so much. My partner, 32 years, and I, 24 years, have recently cut meat out of our diet and now vegetarian. After watching a documentary called What the Hell, I don’t know if you’ve heard about it, but it basically tells you that all animal products are bad, and can be linked to causing cancer. We would love to hear your thoughts on animal protein and if it really is bad for the body or not. We are very physical, work out five times a week. My partner has recently started losing his muscle, and we’re wondering if he’s not getting the required amount of protein, the amino acids after starting this diet.”
Steve: “Normally a day of us eating would be stir fried vegetables, half an avocado for breakfast, fruit salad for the morning tea, buckwheat tossed in tomato pureed with vegetables and olive oil drizzled over the top for lunch, a variety of nuts and seeds, cashews, walnuts, macadamia nuts, pumpkin seeds for afternoon tea, and for dinner, brown rice with baked sweet potato and steamed vegetables, and olive oil drizzled over the top.” That’s pretty descriptive. “Also, I have a really stubborn pocket of fat right on my lower abdomen, and no matter how or what I ate I just can’t budge it. I have the implant on, which is of course a contraceptive, for almost a year, but even prior to that I still couldn’t seem to move the fat. I’m 165 centimeters tall, weight 50 kilos, so I’m quite skinny in every other area, other than my mid section. Do you have any tips on how can I overcome this stubborn fat? Thank you, both,” or three of us, “So much for all that you’re doing.”
Steve: “We love your podcast. Please keep up the good work, and look forward to hearing from your response. Thanks again. Matt and Kim.” There you go, there’s another Matt there.
Matt: Awesome, double team that too.
Steve: Yeah, it’s a double team, so that’s really good. [crosstalk 01:26:55]-
Matt: I only answer questions to single Ts.
Steve: Nah, that’s right. We’ll just –
Matt: [crosstalk 01:27:00].
Steve: [crosstalk 01:27:00] Elizma, to see what she says, what’s your thought on this one? It’s an interesting one. I love the diet description too.
Elizma: Yeah. I’m glad she described the diet, because vegetarian can mean these days so many different things. Some people say they eat fish, and they’re still vegetarian, so you just never know. Look, probably going to be a bit controversial here, I’m not a huge fan of strict vegan and vegetarian diets, because you do need proteins for many reactions in the body, and it’s been shown that if you short term it’s fine, but if you do it for a long term you can sort of run in lots of deficiencies. You can start affecting genetic expression. There’s been a lot of Britain news about very popular vegans who have stopped being vegans, with lots of Instagram followers because they got into early menopause, because of the vegan diet. It’s in balance. I guess for me it would be everything in balance.
Elizma: Yes, if you have a predominately high meat diet that can play a role in bowel cancer if you don’t eat enough fiber, so it’s all about just common sense. It’s common sense, and balance in everything. I guess something that I sort of noticed, is a lot of the foods again is on that highish oxalate kind of side, so you just, a lot of vegans and vegetarians have to be really aware that they can tend to have maybe too much oxalates in their diet, so like the buckwheat, the sweet potato, and the nuts, just to be careful there. That’ll obviously may put some more demand in other areas of the body.
Elizma: This pocket fat around the abdomen usually indicates more I guess liver kind of fat if it’s around the lower abdomen. Again, it’s been shown that and a lot of studies show that if you go on a vegan or a vegetarian diet for more than three months, it can lower the amount of SAMe in the liver, which is involved in methylation reactions and can then be predisposed to fatty liver, and stuff like that. Whether that is the case I don’t know, but that’s sort of some of the patterns and the possibilities that could be yours. I guess it’s just having some protein, even if it’s just three days a week, having some protein. It doesn’t have to be a predominately meat diet but I would probably look at more of a moderation kind of approach in that respect.
Steve: That’s interesting. Matt, what’s your take on this?
Matt: The sames. Have a chat … There’s a mate of mine, Simon Hill does a podcast called Plant Proof. He’s a buff vegetarian. He’s a big fellow, but he can … A lot of this stuff he talks about how to look at your macros, and make sure that you’re hitting your numbers. There are ways of doing it if you understand it.
Elizma: Yeah, you’ve got to be-
Matt: There’s some things that are just not found in plants, such as hydroxyproline, which is a massive … We’re finding now the need for hydroxyproline to build the fascia, the sarcomas, the connective tissue, everything we need to hold the meat, and the meat basically being protein and carb sort of thing. The hydroxyproline is unique to collagen, and when you go vegan, vegetarianism, what you’re doing is you’re getting pretty much proline out of your vegetables, and then your vitamin C, and making hydroxyproline in your body, it’s just there is no hydroxyproline coming. We’ve got data that’s showing that it doesn’t take long on one of those plant based diets for your ability to generate collagen to drop by about 30%. Wasn’t it? The [RNI 01:30:23] and that collagen production significantly dropped off because of the inadequate levels of hydroxyproline.
Matt: If you’re a big dude, or you want to maintain muscle mass and that sort of stuff, you can supplement with hydroxyproline. We made it in … Oh, the tub’s gone. Something else they knew … Don’t touch that, it’s not vegan, if you’re a vegan, that collagen. We made a vegan collagen basically. What are we talking about? All the benefits that come out of the collagen, we’ve broke it all down of what was happening. A large amount of it comes from hydroxyproline directly feeding collagen. What we did is instead of taking hydroxyproline out of an animal’s collagen, and giving it to the vegans, we basically thought, well what does a herbivore do to make collagen. To make hydroxyproline, well they eat these foods, and then they hydroxylate their proline in vitamin C to make it. We did that and made it available for the vegans,-
Elizma: That’s awesome.
Matt: -so they can eat hydroxyproline directly without having to deplete their vitamin C and proline levels to make it. You can do that. You mentioned methylation significantly drops off. Again, in the sporting world, creatine inside our muscles which generates our ATP for our power, our strength, and holding water in our muscles, is made through a methylation process. If you got methylation defects, you can take creatine. Some of the earlier studies on creatine, by Rich Crider, he was NFL player, footie player, and they were told to eat a steak everyday. When they had a lot of steak, they’d perform better. All the players used to talk about it and he analyzed steak and found, okay, so it’s branched chains. Everyone’s talking about branched chains.
Matt: What was the study? You’ve gotten branched chains. You got plant based and your branched chains dropped by how much, by how far, and how quick?
Steve: It was quite a bit. It was very significant. I can’t remember the amount.
Matt: That’s pathetic, Steve. Quite significant. Bloody politician. You’re supposed to be my walking encyclopedia.
Steve: That’s why the vegan aminos are full of branched chains as well.
Matt: Yeah, so what we’ve found is when you’ve got a plant based diet for the athletes that were meat eaters, what they had lost was hydroxyproline directly, and that was sudden, branched chains dropped really quickly, and further more their inability to methylate, or to control their creatine levels. If I was a body builder, a plant based body builder, I would be supplementing with plant based versions of those, so plant based branched chains to maintain your muscle mass, but I’d also work with a coach that could determine what macros you need, follow people like Simon with these plant proof podcasts. They talk about how to actually do those foods. Simon’s writing a cookbook and that sort of stuff as well, and showing you how to get the macros right.
Matt: There are other ways to do it, it’s just that what you can’t get, the only other thing is it’s not in the plants-
Elizma: Taurine is another one.
Matt: Taurine, tryptophan is another-
Elizma: I think [conatine 01:33:04] as well.
Matt: [Conatine, yeah, conatine 01:33:04] also bloody low, so you basically miss out on all those suckers, and then you got to just make it. It’s possible, you just got to work a little bit harder, that’s all. What I was going to say, glucosamine, unless see, herbivores, herbivore mammals normally eat insects, but the vegans and vegetarians choose not to. You need to get the chitin.
Elizma: [crosstalk 01:33:28] insects?
Matt: What happens, because I used to do a lot with animals. I used to work with race horses, and they always used to have a lot of problems when they’re in the stables, because when they’re out in the pastures … When everything goes to shit for a racehorse, we go spell them. They run them around and they pick out all the insects in the paddocks, and eating out all their insects with their weeds, and all of a sudden they’re starting to regenerate, getting those glucosamine and chondroitinal like compounds. An insect is basically the exoskeleton of an insect is made up of chitin, which is our glucosamine, chondroitins, and it’s all stuck together with hydroxyproline.
Matt: In a plant based diet, you’d be consuming a lot of insects that would give you the chitin and the hydroxyproline. That’s what a natural grazing, that’s what a natural herbivore would do. You said there’s vegetarian and veganism means a lot of things. For having a highly processed diet, then you’re missing out on all of those sort of aspects. The cobwebs in the broccolis and all that sort of stuff, we’ve lost all of that and they’re very important components for our tissue.
Steve: Incredible. Of course, I’m glad you raise the question because watching documentaries is probably not the best way to get your nutritional information.
Matt: No, but it’s … You can get a lot of out of it, you just take bits and pieces. The other thing too, is go organic. If you’re going to go plant based, all of a sudden you might be consuming shit load of xenoestrogens. You might be taking in a whole heap of glyphosate, you might be doing all that sort of stuff. If you’re going to go plant based, make sure it’s the stuff in the inside that we promote with a plant based diet. Just be careful of what’s on the outside. If it’s all sprayed with shit, you could be getting xenoestrogens, then you’re going to hold fat and fluid.
Steve: Also think about Cyanocobalamin or B12, because even Simon has talked a lot about that,-
Elizma: Yes, B12.
Steve: -just to [crosstalk 01:35:15]. That’s really good advice. Of course, with her little pocket of fat in the far right hand side-
Matt: I forgot all about it.
Steve: -yeah, as far as [inaudible 01:35:24] concerned for her, I’m thinking sub cut, but are you agreeing or not? [crosstalk 01:35:28]-
Matt: I’m agreeing because I totally forgot that section.
Steve: Oh, okay.
Matt: At this point I can’t even see it. What am I looking at? What is this, skinny … Oh, hang on. I weigh 56, so I’m quite skinny in other area, other than my mid section.
Steve: She’s just got a really stubborn pocket of fat right on my lower abdomen and no matter what I do, it’s kind of just have a little bit of fat here. It sounds sub cutty to me.
Matt: Yeah, I’d go sub cut status.
Steve: That’s good. That’s sort of-
Matt: There a main reason why? Sorry, I’m not going to talk for too long. I know every ones like looks at me every time I … The main reason why is because at this point in time you don’t know if this person’s potentially got polycystic ovarian syndrome, and I don’t want to be rubbing [inaudible 01:36:07] from the Block E3 onto their abdomen to maybe access their ovaries, you know, sub cut’s the one for the …
Steve: Right. Well, that’s excellent. That’s exactly all we’ve got time for.
Matt: We’re going to send her some vegan aminos anyway. Aren’t we?
Steve: We are.
Matt: Is that MST? Because you mentioned the oxalates, so they can have a bit of the magnesium citrate to help pump it out.
Steve: [crosstalk 01:36:27].
Elizma: Yes, yeah, great. Excellent.
Matt: They could use a shitty calcium to block it from absorption, so calcium carbonate or something stops your absorption of your oxalates, to magnesium citrates [crosstalk 01:36:35].
Steve: They did say they’re vegetarian, and not vegans though.
Elizma: Yeah, but the diet’s sort of like they didn’t really … There’s no eggs in there, I didn’t see any. Yeah.
Steve: Yeah, it was vegan.
Steve: Okay, that’s good. Well, that’s great. Well, perfect. You got two great practitioners there talking about it, so that’s all we got time for.
Matt: And Steve.
Steve: Yeah, and me.
Elizma: And Steve. Let’s not forget about Steve.
Matt: [crosstalk 01:36:55] how quickly I flipped it.
Steve: Yeah. Well, thank everyone. This has been great fun.
Matt: Thank you, Steve.
Steve: I love talking bile, I love bile. I can’t get enough of it.
Elizma: Yeah, a favorite thing.
Steve: It’s awesome and thanks for the questions, everybody, and we’ll see you all next week. Thank you.
Announcer: Thanks for listening and remember, question everything. Well, except what we say.