Dr. Kay Durairaj 0:00
Hey. Well, hello. Hello, guys. You're listening to beauty bites with Dr Kay secrets of a plastic surgeon, and today on the podcast, I'm joined by Oscar Coetzee. He's a nutritionist and educator with 20 years of experience in functional type of evidence based clinical nutrition. So he's peer reviewed author. He's an international speaker. He's taught functional medicine for more than 15 years, and he also has a doctorate in clinical nutrition. He's a full professor at Notre Dame in Maryland, Maryland University, and he's vice president of education at designs for health. He's also adjunct professor at Georgetown med school. My three kids went to Georgetown yay and clinical director of nutrition department at natural healthcare center. So today, I thought it would be great to engage Oscar's all of his expertise, to talk about gi health, metabolomics, genomics, what's going on in the nutritional world that's longevity related.

Speaker 1 1:14
Welcome Oscar. Well, thank you for having me. Dr Kay, yeah, it's I'll actually be lecturing at Georgetown tomorrow, and on Thursday, there's like, an elective that a lot of the residents, you know, go to to learn a little bit more about functional medicine. So we trying to open up that gate under Doctor Hakima Amri, who's leading that whole functional integrative development at Georgetown.

Dr. Kay Durairaj 1:38
That's so good you've taught functional medicine for years, what's kind of the biggest mistake you see clinicians or patients making when they're trying to optimize their health and aging? Is it too much testing going overboard?

Speaker 1 1:52
I think everybody is trying to find answers, right? So I think sometimes the deep dive on too much testing might be an issue, but I I'm always the person that believes the more information you have, the better, right? If you're trying to investigate anything from rejuvenative medicine or anything related to anti aging or longevity medicine, I feel more is better than less. The only problem with that is, if you don't really know what you're investigating, you know, looking at those tests, and you just have a lot of information that might not be helpful, then it's a waste of money. But if you're working with a functional expert that really understands the metabolic pathways, understands the integration and the rejuvenation of the Kreb cycle and the intermediates and Krebs cycle, and what blocks it and what takes it up for better ATP production, you know, if you look at the gut, if you have a person that's always just focusing on the obvious overt pathogens or or overt opportunistic overgrowth, and all they want to do is eradicate those. You know, I think there's a paradigm shift happening in in functional medicine at the moment, where we're probably going to find in the future that crowding out is going to be the better option than necessarily, just going in there and killing them. And why I'm saying that is, is a whole new evolvement in the anaerobic Keystone bacteria space that that seems to hold a lot of prob promise in in in anti aging. I'll give you a perfect example of that. So there was a recent publication, and this is still an animal study, but they were looking at specific anaerobic strains, you know, and looking at mice where they took the fecal, you know, transplant from mice, young mice inserted into the older mice, and lots of rejuvenation on many levels, right from a from a cellular level, stem cell level, however, when they took the fecal matter from the old mice and transplanted it into the young mice, there was no movement or no change. So it's almost seeming like the microbes at a younger age or a donation or a single donor, they seem to have a more profound effect on the microbiome. And if people understand that these Keystone bacteria, they literally regulate almost 85% of a lot of our metabolism in our body. So it's really important to understand those microbes, what they do, because I feel that systemically, that is probably where a lot of the future lies. And why I'm saying that, before we go into more questions, is they seem to have an affinity to crowd out opportunistic bacteria, which is a big driver of a lot of our issues, you know, typical IBS and gastrointestinal issues. And in addition to that, they seem to really be great communicators at the rest of the microbiome. You know, our typical probiotics that we're getting in, they seem to be more effective when those keystones are are there.

Dr. Kay Durairaj 4:51
That's so interesting. You Why do you think the gut health is such a central piece of longevity and healthy aging?

Speaker 1 4:59
Well, I think it. Is literally the entry point of absorption, right? So everything that you're absorbing and extracting those nutrients, those vitamins, the minerals, the vitamin E, the B vitamins, the D, all the amino acids, all the fatty acids. I mean, that clearly has a lot to do with how well your body is going to rejuvenate on a cellular level. Because in order for the mitochondria to work and rejuvenate it leads it needs all those substrates to do it. So it's a lot more than just stomach acid, right? These microbes in our gut, they live at different levels of pH and an environment, and they all help to co feed and symbiotically extract nutrients for us that then we can utilize. So if you have a compromised GI tract and compromised absorption, low pancreatic enzyme function, low stomach acid. You might be eating a healthy diet, but you're not extracting all of it, and unless you have optimized extraction, I don't think rejuvenation on a cellular level is a is a possibility. So what am I saying? I'm saying that if a person has a compromised absorption, digestion and a simulation of food, I think that puts you at a disadvantage from a longevity standpoint.

Dr. Kay Durairaj 6:05
What are, what are some microbiome tests that you think that patients should get done, like even I for myself, I'm thinking of getting microbiome testing. There are some that are very excellent. There are others that are not so reputable. They're good.

Speaker 1 6:19
You know, I obviously have a reasonable bias, because I use these tests a lot myself, but I use a lot of the diagnostic solutions laboratory tests in the form of a GI map at designs for health. We've actually created a version of that called gi spotlight, which is a little bit more affordable, but it doesn't go into the parasitical and the pathogenic assessment, right? The spotlight gi test that we developed is focusing exclusively on the gastrointestinal imbalance, the malabsorption, the digestive insufficiency, dysbiosis, so it looks more at the things that you would want to look at in anti aging medicine, right? Because as a physician and as a doctor yourself, you know if you suspecting somebody for a parasite or whatever, you're going to run different kinds of tests, right to see if there's parasitology or or very overt pathogens like E coli or salmonella present. What we more focusing on is, how is the commensals? How are the Keystones? How are the opportunists in relation to the commensal status? What is the digestive function? Do they have permeability, you know, in the tight junctions and and I'm sure in your case, and I'm not, I don't know your level of expertise, obviously, on anti aging medicine, but I would imagine that people that have problems with aging and deterioration, they must be more permeable from a gut standpoint, than people that

Dr. Kay Durairaj 7:47
are not. Yeah, I think so. I think that that's, you know, the gut skin connection, the neuroendocrine connection, like we're inside out, the same thing. So what's going on in our gut really does manifest in the skin when you get an abnormal gi test coming back to you? How do you turn that information into a real treatment plan? Because sometimes patients get this long list of findings and they don't hardly know what to do with it. Yeah, that's

Speaker 1 8:13
a very good question. I think to me, again, that's the load of information. But what's the first step that you that you need to look at. So generally speaking, the most important thing and the most common thing that I see, apart from the obvious Zonulin or tight junction or leaky gut stuff, you are definitely going to see a lot of people with low elastase, one, which is a digestive indicator of pancreatic enzyme function. So that's a very common thing. For instance, we we speculate or theorize that you should have that number over 500 hypothetically, and the average person is running at about 231 40. You know, that's where those numbers come in. And these people seemingly don't have any kind of official diagnosis of diseases, but they're all suffering from some sort of an intestinal bloating, kind of imbalance. I'll take it even one step further. I feel if you if you eat foods and you immediately bloat and you look like you're six months pregnant, it's a pretty clear indicator that you're not absorbing the nutrients that you're eating, because there's clearly a battle going on in your stomach. I've told many people this, that if you are following a food elimination diet, and you're doing that just to improve symptomology, you're not fixing the problem, right? Eliminating foods is not fixing a problem, because theoretically, a healthy gut should be able to tolerate anything grown on this planet, right, any real food grown on this planet a healthy gut should tolerate.

Dr. Kay Durairaj 9:41
Can you talk a little bit about akermansia, which is very trending and popular right now? What if people need to know about that? And why is it so beneficial for our longevity and health?

Speaker 1 9:51
It's an amazing strain of bacteria, akermancy, at so many tentacles. Well, first of all, akkermansia, as many people might, might have heard a. Akermansia produces some very important short chain fatty acids. And short chain fatty acids are the byproducts that really we utilize as humans. So the two that akermansia produces propionate and acetate, and these particular short chain fatty acids actually trigger on the L cells in the epithelium or the intestinal lining to produce endogenous GLP one. So akermansia is literally one of the ways that you can get a natural endogenous production of GLP one. And there's other areas in the gut that also stimulates GLP one production, but it's all systemically, coming from the fibers and the foods you know, that we're eating. In addition to that, akkermansia also works on very strong receptors when it comes to the immune system, one of the byproducts from from acromancy, acetate and propionate drive a lot of immunological associations in the gut, called Secretory IgA. So it's just a incredible downstream effect of immunological and metabolic up regulation that akkermansia provides. Here's an interesting point for you. We looked at 17,000 data points of stool testing, right, and we found that 65% people are low in akkermansia. That's an astonishing number, yeah, and that's at a functional level, right? We're talking at a functional level of parameters. But if you look at akermansia, I always tell people that akermansia, to me, is kind of the mothership of the bacteria, because it has such an incredible correlation and involvement. So akermansia, again, producing those two short chain fatty acids. It actually cross feeds a lot of the other Keystone commensal bacteria that I spoke about, like, for instance, anerostipes, which is a major butyrate producer, eats the acetate, you know. So it's this little interrelated relationship that it has. The other thing about akermansia That's really amazing to me. So akermansia macinophila is just what the Word says. It eats mucin, right? So this bacteria eats mucin, and the byproducts from this mucin actually acts on a receptor that then helps the body to activate progenitor cells and create more goblet cells. So these goblet cells in the epithelial is where we store some of these mucus molecules. So it's literally the thing. Can feed itself. It can work in its own way. But if you think about it, this microbe has the ability to to activate progenitor cells that make other cells. So if you're talking anti aging, maybe there's something

Dr. Kay Durairaj 12:41
right, yeah, that actually stimulates more mucin production,

Unknown Speaker 12:45
correct? Yeah. So becomes a

Dr. Kay Durairaj 12:47
feedback loop

Speaker 1 12:48
100% and what we're starting to see is a lot of these interactions between these different microbes, and if you, if you give them more than just acromancy, so I'll talk about a couple of other ones, right? So akermancy is a really important one. That's probably the one that's the highest touted in the media, for good reason. You know, as I've just mentioned, it has so many tentacles downstream. But the other players that are seemingly very important, and you're familiar with them, are the other ones that are on, you know, normal stool test. It'll be rose Berea and PHY Kayla bacterium prausnitsiae. So those two strains are big butyrate producers, and the butyrate for the listeners is really what we use to make sure that our intestinal lighting improves with less leaky gut or less permeability. Apart from that, it has butyrate has many other involvements. It stimulates dendritic cells, antigen presenting cells. It's highly involved with the immune regulation in the body. And as a species, there are very many reasons that we lower in akermansia, F prow and rosberia, and the main ones is long term antibiotic use, long term PPI use, pesticides, herbicides. Modern diets, as a matter of fact, people that go on FODMAPs diet too long can affect those microbes. People that go on carnivore diets for a very long period of time can affect those microbes. Now, am I saying that a carnivore or a FODMAP diet is the wrong thing to do. That's an individual's decision. All I can tell you is that without the diversity of fibers and polyphenols and colors, we tend to lose out on the rejuvenation of these microbes. And what I like to tell people is, if you really want to look at these Keystone microbes, look at them not as bacteria living in your gut. Look at them as an accessory organ system. Look at them as a kidney. Look at them as a heart, you know, so you're not going to deliberately, you know, destroy your kidneys, or deliberately go out of your way to do things to hurt your your cardiovascular system. It's the same thing with with with these. Microbes, and the sooner we we start to realize that we have this highly intellectual capacity in our gut lining that can rejuvenate all sorts of metabolic and rejuvenative cellular criteria, we should really consider supporting it, you know, and feeding it the right thing so that that organ system is healthy.

Dr. Kay Durairaj 15:20
I guess people don't realize that their body itself is composed of 60, 70% of the body is bacteria. It's a crazy number when you think about it, but, but that means you really want the right species living happily and comfortably inside you. Is there a natural way to get more akkermansia, like certain dietary things that have high load of fat or probiotic, prebiotic.

Speaker 1 15:42
Yeah, this is, there's several things. I mean, obviously akermansia, by itself, is just like any of these other keystones. It loves inulin, it loves resistant starch, it loves polyphenols, it loves, you know, all sorts of different, you know, galactoligosaccharides and fructoligosaccharides. So it's literally feeling of some of the fibers and the sugars that are, you know, readily available in our diet, and if you restrict yourself on those Now, I understand, you know, people go on a low carb carbohydrate diet for the reason of of blood sugar regulation, because they want to be glycemically more controlled, or whatever. But we have to understand that completely voiding, you know natural carbohydrates is literally starving. You know these guys. So if you eat seasonal you eat the colors of the rainbow, you eat more fiber you're going to be feeding these guys. But that doesn't necessarily mean that you're eating enough of the things to feed them. And I'll give you an example. The average American in the United States of America is eating about 17 grams of fiber a day in order to

Dr. Kay Durairaj 16:45
feel like 60 or 80 or something, exactly so.

Speaker 1 16:49
So you're at a loss there already. So now we can understand why akermancy is so low in these tests, right? In this kind of a study that we looked at internally at a diagnostic solutions laboratory by looking at 17,065% low in akkermansia, I think 35% were low in FY kaylebacterium prausnier, definitely pre prebiotic and dietary related.

Dr. Kay Durairaj 17:14
I definitely think people are interested also in things like lactoferrin and colostrum. Can you talk a little bit about those? Those are trending social media things that,

Speaker 1 17:25
yeah, yeah. I mean, look, colostrum is clearly kind of the ignition switch of our immune systems, you know, at a young age, and that's the first thing that you get exposed to in breast milk, and then lactoferrin, which is the iron binding component of that that's kind of also involved with the immunological regulation. And I think there's another byproduct of that, called lacto ferrissin, which is even more involved. So just look at that as the immune immunological light switch. So it's interesting that you brought that up, because there is technology in so first of all, the argument that a lot of people might have against colostrum is that it's from a bovine source, right? So a lot of people would argue that, hey, you know, are you really getting the same thing as you would get in human breast milk by doing the colostrum clinically? I don't know about you, but I've seen success with utilizing colostrum and an immunocompromised individual or a person that you know, maybe wasn't breastfed or vaginally birthed, you know early in their life. I've seen benefits of that, but I will tell you that right now, there's technology that actually we as a company have been looking at, and I can't say too much about it, because it's still an IP thing, but it is a yeast harvested form of lacto ferret lactoferrin that isn't from an animal origin that matches the human lactofelarin A lot more closely. So there's huge amounts of of good things about that, but the argument is always going to be, you know, is the bovine versus the human really comparable? Anecdotally, I would say, yes, you know, success so far, but it's interesting to see once this releases and we can look at more human data and clinical data if there is a difference. You know,

Dr. Kay Durairaj 19:18
yeah, my own daughter was asking me, Mom, is this colostrum thing good for you? Is it for real? So bovine colostrum can be beneficial for people with, I think,

Speaker 1 19:31
yeah, because, I mean, you know, we're designed as a species to obviously extract important componentry from from animals, right? That's what we eat, right? But, but, but when it comes to look, nobody has ever been able to really duplicate breast milk in a formula, right? I mean, it's just something that we not very successful at. So there's got to be something to that. Now, I think there's a big psychological component to that. I think there is the connection with a mother to. Baby, and, you know, maybe the bacteria involved with that whole process that we're not taking into consideration, you know, because the mom has bacteria, the baby is receiving bacteria. No, you know, there's, there's, there's a lot to be there's a lot to be said with that. But if, if I am dealing with a person with long term gastrointestinal issues, very low, immunological Secretory IgA indicators in a test, which, for the listeners, that's an indicator on stool test. It tells us about your gut immune system that has an effect on your, you know, your normal immune system. I would not be opposed to doing colostrum, you know, in a case like that,

Dr. Kay Durairaj 20:42
yeah, I think there's also a lot of connection between the gut and mood. Or, you know, I think anxiety and neuropsychiatric disease. Can you talk a little bit about that? Like, what is, is it the bacteria that are creating the metabolites that give us anxiety sometimes, or is it the brain that changes how the gut functions and then it manifests on the skin

Speaker 1 21:07
that that's that's another fantastic question, and yes, there is a huge connection between the microbes in your gut and mental health. Let's start with the first one. The first one would be these bacteria produce what is called aromatic amino acids. So what that means is these bacteria produce things called tyrosine, tryptophan and phenylalanine. Now for most of the listeners, they've heard of tyrosine and tryptophan, right? So tyrosine is a precursor to making thyroid hormone. Tryptophan converts to serotonin, makes us happy, and then to melatonin that helps us sleep right? And in those phases, there's certain vitamins that you need to have those conversions happen. But just think that the bacteria in our gut make these pre happy chemicals that we can use for ourselves. And if you lower in those microbes, you're not producing those aromatic amino acids. And guess what is the thing that destroys this pathway that makes these aromatic amino acids. It's mostly herbicides and pesticides in foods. They chelate, so they extract these metals out of this pathway, and then this pathway collapses. So I honestly believe that that is a big component of it. In addition to that, if you look at the studies on certain strains of Bifidobacterium, for instance, especially one called Bifidobacterium longum, huge amounts of clinical data available on Bifidobacterium longum as it relates to mental health and feeling less anxiety and even major depressive disorder. Now, you mentioned earlier, what is it in the bacteria? Well, first of all, they produce aromatic amino acids. That's a good precursor. But in addition to that, they also have these weird things called exopolysaccharides, which is these little tentacles on the outside of the bacteria. And that used to be seen as junk sugar, which it is like, like our bodies actually utilize these exopolysaccharides. So they now hypothesize that it's these exopolysaccharides that you find on certain Bifidobacterium longum strains that actually is recognized by the body to help calm those those centers. And the whole mental health thing is so interesting. I actually am a psychologist by trade, originally, and I kind of evolved more into what I call the psychoneutrogenomic field, which is psychology, nutrition, a little bit of the genetic components of mental health. And I can tell you that with the microbiome being optimized, having those keystones, having a good lot, a huge amount of the commensals, you see very few people with depression and anxiety issues. Now, I'm not saying this is related to sexual abuse and post traumatic stress related things, right? I'm talking more about dysthymia, you know, mild depression, mild anxiety. The person that goes to work every day, they have a decent life, a decent job, a decent but they don't know why they're anxious. They don't know why they're nervous. And I literally feel it's because these microbes are so low and we're not getting those aromatic amino acids the way we used to.

Dr. Kay Durairaj 24:06
And then can that be exogenously supplemented?

Speaker 1 24:09
Yes, absolutely, absolutely what we just remember this, that most typical probiotics are transient in nature. Now, what that means to the average listener is it goes through your system, so it's very effective while you're using it, but it's not really repopulating to build a community there that can self regulate. That's more where these other Keystone commensals come in. They have the ability to engraft and then they can communicate better with all these other bacteria. But, yeah, there's benefits I can I can show you hundreds and hundreds and hundreds of studies. As a matter of fact, some of my doctoral students said, you know, a review article that we wrote on all the probiotics that have an association and major depressive disorder and anxiety disorders. Well. Astronomical, right? I mean, there's clinical data that clearly supports that, but the clinical data is not supporting that once you stop taking the probiotic, that there's improvement. Now, my theory is, is it better to take a probiotic the rest of your life to have mental improvement than maybe to take some very advanced psychotropic medication that could have side effects? Yeah, I think it's a good trade off. If that helps you, however, it would be better if you can learn how to re establish the microbiome, and then intermittently have to take these to kind of just go into the gas station and get a little extra gasoline.

Dr. Kay Durairaj 25:34
I think that's so interesting. I love the Well, I love taking probiotics, but like when you talk about it like that, it does just flush through your system. So in terms of prebiotics, then you mentioned inulin and other non soluble fibers. What are some great things we can do to improve that, just like the living environment, so that we get those?

Speaker 1 25:57
Well, if you eating, you know, a lot of these, if you take, for instance, resistant starch, you take potatoes, you take rice, and you, you know, leave it overnight, and it cools down. It's that cool down effect that has the effect on that. And if you eat that, there's a lot of resistant starch in that, not to mention, you know, just about any vegetable, any fruit on the planet, that is in its natural form, is going to drive that. But if you're not a vegetable and a fruit eater. There are nutraceuticals and supplements on the market that really drive that. As a matter of fact, we're doing a little bit of research currently on exactly what is it that feeds these individual strains, right? So we know that fibers and polyphenols and inulin, but that's been the general consensus, but nobody has ever really gone in to see, hey, what's exactly feeding rose Beria, you know? Is it greens? Is it reds? Is it blues? Is it purples? Is it xos, you know? So, so we're working with some microbiologists right now to get a little further into the weeds in that because, as you said earlier, you need 50 to 80 grams of fiber. Nobody on this planet at this point is going to be able to eat that in food sources. So we need to be able to find that in a in a natural fibrous, probiotic supplement or prebiotic supplement that you can add to a smoothie or you can sprinkle on your salad or or something like that. So anyway, we ran it on this one particular strain of an anaerobic Ana roaster piece, okay, and we found that that greens and reds makes it extremely excited less than other fibers. So there's certain components that we found, if you take these with this particular strain, they seem to engraft more. So the best analogy I can give to the listeners on probiotics versus anaerobic strains that engraft would be, I go out and I buy a bouquet of flowers, because I love flowers. I love the smell of it. I love the look at it, so it has this, you know, aroma and smell in my house, and it gives me a psychological excitement. But unfortunately, those flowers wilt after a week, and then you have to go buy new ones. That's a normal probiotic. Okay, so it does a great job, but you're going to have to keep buying the bouquets, right? The alternative to that is, Okay, why don't we plant our own flower garden, right? So we can grow our own flowers, and then we can snip them whenever we want to, or we might need to. We just look at them in our own flower garden, but that clearly takes what fertilizer, water, nitrogen, bacteria, fungi, all these things play a role to manifest that. So the objective for us, I feel, is to grow your own flower garden so you can have the benefit of the flowers, but you're not having to spend all the money all the time to put new flowers in your in your home. That's literally how engraftment works. So can bifida, bacterium and lactobacillus truly engraft in a person's body? Don't think so, because they are more working with the other bacteria. So if you eating yogurt, you're getting Bifidobacterium and lactobacillus in your system. So they produce lactate or lactic acid. The lactic acid feeds the anaerostippies, which is the deep down guy to make butyrate. So clearly, if there's more anaerostas around, there will be more bifida bacterium hanging around, because they will make that feedback cycle going. So we're starting to understand how all this stuff really ties in from from one to the other. And if you have an optimal microbiome, digestion and absorption, no leaky gut, I would find it very hard to believe that you are not optimizing longevity from you know, whatever genes you have, you have, but you clearly epigenetically going to override a couple of things in that particular status. So I think that is kind of the key take home.

Dr. Kay Durairaj 29:51
That's interesting. I think there are also some bacteria that are implicated with more happiness, like, can, you know, lactobacilli route. Cherry elder cherry. I think that that's a super interesting one too, that people talk about increasing that to, like, get more happiness. That gets

Speaker 1 30:08
back down to the aromatic amino acid production. You know, any other Bifidobacterium, lactobacilli, that's their main job. But I think what we we looked at that as one component of the mental health picture, yeah, but what we didn't look at is okay, these guys are major lactate producers, so they feed the anarostippies in the Rose barium or they make more butyrate. When you have better butyrate, you actually have better ability to not have inflammation and neurocognitive LPS or endotoxins escaping into your bloodstream that drives more mental behavior. So I think we know the aromatic amino acids play a role. But please understand that when we fix the gut lining the gates that open and close, and there's not a lot of endotoxins coming in that cause neuro cognitive inflammation, that also helps. So I think the mental health thing has aromatic amino acid components, but also permeability, for less neuro inflammation. And when you reduce neuro inflammation, if we're talking anti aging on a neuro cognitive level, clearly dementia, Alzheimer's, you know those particular neurocognitive disorders will diminish or or become less prevalent.

Dr. Kay Durairaj 31:27
So it's a dementia strategy too, yes, yes, for elderly patients, because they also lose the dietary variability, and they end up eating tea and toast and just, I think that that maybe contribute so much.

Speaker 1 31:41
And I think the reason for that is, as we age, we get more into a state of hypochlorial, low stomach acid. You know, you don't have the mastication anymore, because you might not have the teeth that you used to have, so you cannot bite and chew those feet when they come into the gut, the bacteria is better able to utilize what you've masticated. So I think a big part of the aging concept is we lose the ability to extract the way we used to as younger people. I don't believe on a cellular level, maybe you can tell me I'm wrong, but I don't believe on a cellular level, your cells necessarily understand what aging is. They just want to have the nutrients, you know, and the fatty acids to rejuvenate every day. But if you not chewing well enough, you have lower stomach acid, you don't have enough microbes. It can't get what it wants. And that, again, gets back to that study with the old mice giving their stool sample to the young mice, and then the bacteria in the young mice is like, what are we going to do with this? This is like, no good, you know, but we'll give you some of ours, then it'll rejuvenate, rejuvenate you. Now, on that point, I don't want people to think that fecal transplantation is the only way to do it. As you know, the reason that people do fecal transplant is for a C Diff overgrowth in a hospital setting or or something to that effect. But what if, just just talking generally, what if you can get the benefits from a fecal transplant without all the yuckiness and the dangers and the risk of the association that comes with a fecal transplant poop exposure, right? So that is now called microbial ecosystem technology. So they basically take stool, extract the right strains of the bacteria, they lyophilize it, which to the average person, means they really freeze, dry it, so they are able to extract these bacteria without the yuckiness of the stool transplant, but still getting the benefit of that community of bacteria that have worked together in a young single donor to get into our systems. And that's where the technology is currently on anaerobic bacteria.

Dr. Kay Durairaj 33:52
How far are we from getting those kind of fecal transplants, like for you know, if I want to repopulate my colon with youthful bacteria from a healthy, really hearty,

Speaker 1 34:05
you're talking about these things that I'm talking about now, yeah, like, yeah, they're available. They're available. April 6 to 22,026 literally, yeah, we literally launched the first anaerobic strain about six months ago, and you know, had done, you know, quite a bit of publications and some Kay series and things to that effect on humans. And seen great, great results. And the other strain has just been launched now, and we have the first strain ever that contains Rosebery and FY Kayle bacteria and prasnya ca, that's never been done before, and that's all because of this lyophilized mechanism. So a person can literally, now buy a capsule to insert these strains of bacteria in your gut, and if you then take the right fibers and things with it, you're going to plant your own flower garden. So that's that's available now, Wow, that's incredible.

Dr. Kay Durairaj 34:59
Can. That's a very positive thing we are in the skin industry. So we so much. We see so many manifestations of, I think, gi dysbiosis on the skin surface with our rosacea patients or acne patients or generally, just aging concerns in general. What are your thoughts on how we can improve external skin with internal diet.

Speaker 1 35:23
Well, it's funny you say that because I I just stumbled upon something in the research when I was doing an educational webinar the other day in the literature. So PHY Kayla bacteria and praus Nita is one of the bacteria we're talking about. It produces salicylic acid. Salicylic acid is highly involved with the improvement in acne and skin lesions and things to that effect, as you well know, so, so you literally have this endogenous ability to increase the salicylic acid. Then from the inside, would would have an effect on that. Now, I don't know how far that's going to go, so I would love to at some point with you, say, hey, put a couple of your patients on the complete commensal, which is the strain that we're talking about, and see if there's improvement. You know, in that category, theoretically there should be, because the kay kaylebacterium prausnier is also the one that produces the shechemic acid that makes that pathway for the aromatic amino acids. So that's why PHY Kayli bacterium, perhaps Nietzsche, is so important. So I think the microbe that has the most effect on the skin is, is the F pro so interesting?

Dr. Kay Durairaj 36:34
And how would we get that dietary just more well, you don't get F

Speaker 1 36:39
Prowl dietarily, because it's a, you know, it's an endogenous human microbe that is there, or it there

Dr. Kay Durairaj 36:44
in low either you have it or you don't have it,

Speaker 1 36:47
yeah, well, you have it, but probably not in the levels that you want it. So the the probiotic will set them there, but then you need to eat the the colors and the fibers and and the things with it to be able to for it to flourish, make sense?

Dr. Kay Durairaj 37:03
Yeah, there's no shortcut you need the Mediterranean diet and the rainbow. Eat the rainbow, the accidents, right?

Speaker 1 37:09
Exactly like I will say to you, if you follow the strict guidelines of the Mediterranean diet, you will feed your microbiome, yeah, but you got to go by the traditional Mediterranean diet, not the modernized version, where people extract the wine as a positive only. Or, you know, that's not really what it is. The majority of the Mediterranean, first of all, the lower tier of the Mediterranean diet has nothing to do with food. It has to do with eating in a relaxed state, with people not on phones, right? That's the community related thing. That's very, very much, if anybody's ever traveled in Europe, in small towns in Europe, like Portugal, Spain, Italy, people eat lunch for like, two hours. I mean, they just go out and chill out, and there are no interferences, right? So if you have that, and then the second tier of that is obviously the colors for the fruits and the vegetables and that. And then the third tier is the fish. The fourth tier is a little bit of meat and cheek, and the first tier is desserts and wine. So it's, it's, it's primarily relaxates, a relaxed state of eating, the colors, the fibers, the omega three fatty acids. That's about 70% of the entire diet. You follow that principle, you'll be golden.

Dr. Kay Durairaj 38:25
And throw in some yogurt.

Speaker 1 38:27
Yeah, yeah, yeah, because the yogurt, again, is going to bring those Bifidobacterium and lactobacilli that's going to produce acetate to feed the anaerostapi. So I will say this, if you and this is maybe what we didn't know, maybe the reason that people have a benefit from perfo bacterium and lactobacillus in yogurt is because of the lactate production, sorry, not acetate, the lactate production, and then that lactate feeds the anaro and the Rosebery and F Prowl, and those are the guys that really are doing the job. So the benefit from that was kind of secondary, and this is just stuff that is now becoming clearer to us in science, you know, because we all obviously have decided to dig into this microbiome, but it is a very complex, you know, understanding of these microbes and their communication. But at the end of the day, what I'm starting to really see from the literature, from the studies, is that it's a very intellectual thing. Like, if you give these guys the right components, they'll sort it out. You don't have to worry, you don't have to be strange specific. Just give them what they need, and they will go crowd out the bad dudes, and they will kind of figure out what they need. And I think, like you say, a skin condition is normally an indicator, properly that, hey, you could be low in those butyrate producing bacteria, so maybe just taking a butyrate supplement. I don't know if you've ever done any work like that, but I always believe now it's better to get the thing in there that makes the butyrate so it can self. Regulate if you just taking butyrate by itself, you just pumping butyrate in

Dr. Kay Durairaj 40:05
your body. Misogynist ketones, for example, when we drink those ketone shots that pumps the butyrate through but doesn't last, correct.

Speaker 1 40:13
So you want to get to a point, at some point where the body, like your heart, is pumping every day by itself. You don't have to pump. Yeah, you need to get the microbes to be doing the same thing. You know, working?

Dr. Kay Durairaj 40:26
Yeah, exactly. So if I see a patient who's got severe inflammatory rosacea breakouts, like, what's my first move, testing their GI microbiome, or just automatically getting them on this, you know, I think

Speaker 1 40:40
for us being selfish as clinicians, I'm sure that you want to do the testing to see the, you know, the opportunistic bacterial overgrowth, because I'm sure there's pattern with skin conditions there. And then you want to look at the level of the commensals. But I will tell you, if you put a person, let's say for from what I've seen. Okay. Now this is totally anecdotal statement from your from your side of of expertise. But I think if you put a person on a commensal strain of probiotics, these anaerobes, you give them those Mediterranean diet and you let it run its course for three months, you cannot not have a positive somewhere you know whether it's immediately going to show in your skin, or if it's going to show in the emotion or the mental health or the gastrointestinal health, or the person might have less food sensitivities, there will be something shown. I have a question for you. Do you think people that have more food sensitivities have more skin conditions?

Dr. Kay Durairaj 41:37
Yeah, definitely. And I wonder about it too, because I see people who are lactose intolerant. You wonder about milk allergies and gluten allergies and all of those things that I think that they grew up without a lot of microbiome exposure, like they're the asthmatic children and the children who are kept indoors and didn't plan dirt correct, maybe never got the microbiomes, and now they're super sensitized to everything. And also they have maybe parents who made them avoid milk products, so they never developed the enzymes to break down lactose. And it's interesting, but a vicious cycle. So yeah, I definitely think those, yeah, tolerances jump into the skin itself.

Speaker 1 42:16
So here's an interesting one for you that anaristapes, Kay, which is one of the Keystone strains loves lactose. If you have that strain in your gut, you have a much smaller chance of being lactose intolerant, because this thing eats the lactose before it becomes a problem for you. So I'll give you an example. We had a we had a case study of a person. We actually it's in a peer reviewed journal right now. The person came to us with gluten sensitivity and dairy, lactose and casein intolerance. So whenever she ate it, she bloated, she had skin breakouts. She didn't have celiac, but you can almost say there was like a dermatitis, her pitiformus, looking, you know, breakout from, from, from the gluten. So we put her on this anaerobe, and she, she always cheated. She wasn't able to completely void gluten and dairy, and within eight weeks, her symptoms completely dissipated. Now the good thing was that we had a pre and a post stool test on her right. So we had a stool test at the beginning, and the stool test at the beginning indicated opportunistic overgrowth, quite severely in I think it was Morganella Pseudomonas species, maybe some clebsylla. So there was a large amount of opportunistic overgrowth, and her akkermansia Was detectably low. And we didn't work with her with akermansia. We worked with her with anarostis, because the research on this strain is completely related to food sensitivities and intolerances. That's how this particular strain was discovered. It was discovered in babies that weren't milk intolerant. So they found that the kids that were milk intolerant and the kids that weren't milk intolerant, they found this strain much higher in the kids that were milk tolerant. So clearly, they extracted the strain and they started doing some animal studies, blah, blah, blah, to make a long story short, after 12 weeks, this person was able to eat dairy and gluten, no food sensitivity, reactions and acromancy and normalized. And we couldn't figure that out for the life of it so, but then we started to understand, but wait a minute, if you're being a big butyrate producer into the gut, it activates some genetic exposure or release of information that then drives the mucin cells to start producing mucin, and then akkermansia can start feeding on that. So we add this feedback loop started to appear. So that's when I started to realize, wow, this stuff never works by itself. Yeah, it's in there, exactly. And our opportunistic bacteria completely normalized. Wow, that's so there was no more opportunistic overgrowth. See microbial sorry,

Dr. Kay Durairaj 44:57
all these different special bacteria. How can we. Get a hold of them, like if, for example, your lactose intolerance, and you want to try this bacteria.

Speaker 1 45:05
How do we get it? So there's two, there's two forms of bacteria currently, or anaerobes, currently, on the market that will cover everything that we've spoken about today. The first one would be a probiotic that we have. It's called anaerostapis. Kay, go on our website and you put in anari steppes, and it's spell A, N, A, E, R, O, S, T, i, p, s, word, but anarista piece and the other one is called complete commensal Okay, so those are all combining this fakelibacterium, prosnesia that I'm mentioning, the rose barrier, the salicylic acid producer, the shemic acid producer, the acromancy stimulator. They all in those particular probiotics. If you take those two probiotics and at the same time, you progressively transfer your eating habits to a Mediterranean diet, you will not only get that probiotic to do a benefit, which will show pretty much immediately, but it'll engraft, will start growing by itself, so that you potentially down the road would need to take the probiotic every night.

Dr. Kay Durairaj 46:08
So would you do like, one month course of that, or three months, probably three months.

Speaker 1 46:13
I think three months is a good way to start, because most of our guts are kind of a little bit of a mess, as you know, and then after that, you know, you kind of do it intermittently. So let's say you decide tomorrow you're going to go on a cruise and you're going to give up all the good things that you do. You know, probably when I come back, I would probably do another, another cycle of this. But I think three months is kind of what our data is showing. We currently have several human case series trials going on with different kinds of conditions as it relates to these individual microbes. So at some point I can come back and tell you what the outcomes were that we're about eight weeks away from looking at all the findings on those but what we see so far is symptom improvement in almost everybody, whatever they were dealing with. I imagine

Dr. Kay Durairaj 46:58
they get eczema improvement and that maybe even allergic rhinitis and environmental allergies probably settle like everything probably gets better. And I think

Speaker 1 47:09
that's correlated mostly to the improvement of the tight junctions, you know, with the butyrate. So I think, yeah, in answer to your question, absolutely, there's improvement in we've had several people that we didn't publish on that have told us, you know, itchy skin gone, dry skin not there anymore. And I used to do a lot of topical Vitamin E or whatever, which I don't think is a bad idea, but you're not really fixing the thing from the inside, right? That's kind of where, you know, everything on the skin is kind of coming from the inside, right? It's not like we stick the stuff on top of each other, like glue, all those cells the epidermis and all that stuff comes from the inside up. So if you're well nourished in there, you know, I think it's, it's definitely a positive outcome. But I

Dr. Kay Durairaj 47:50
do think the skin barrier, or the microbiome of the superficial skin, improves, and we give it the right lipids and the right moisturizers and things like that there. There's, are there some ideal skin microbiome that we want to cultivate? And how do we do that?

Speaker 1 48:06
I don't know that one yet. I wish I did. I don't know exactly which microbes, but that's probably the next step. You know, if we start seeing improvement in this, they might be a probiotic skincare product that might be a transfer

Speaker 2 48:19
from a youthful skin individual, we

Dr. Kay Durairaj 48:22
can get their microbiome and get our

Speaker 1 48:27
I totally agree with you, you know, I think a lot of people probably have success from from things like coconut oils and things like that, because they contain certain short chain fatty acid or medium chain triglycerides that a lot of these bacteria, you know, get excited about. And I think the reason that we end up where we end up is, you know, a lot of people are so, like you said earlier, they so focused on on being antibacterial and so clean. And, you know, we, we don't have any kind of space for competition. And let me just say this, you mentioned eczema earlier. I don't know if this is true. Maybe you you know more than me, but I read an article a while back that eczema was not a very common thing in, you know, some of the the native countries, especially in Africa, where I'm from, it just wasn't something that was common. Skin conditions weren't that common. Obviously, from the from the outside, you know, the Kalahari Bushmen look like they've been out there a long time, but then really brutal sun, but the health of the skin is a general rule. Apparently, no real eczema. And they hypothesize the reason for that is because a lot of the communities there actually still have helmets and protists in their system. So they have these kind of worm like and other bacterial strains in their gut that we've completely lost, right because of our clean, antibacterial approach to life. So what that has done that's left like, what they call a niche space. So it left, like this gap in the middle of our gut. But that unfortunately, because we're eating more processed food, the opportunistic bacteria started to just grow. So want people to understand that opportunistic bacteria aren't pathogens. So they're not necessarily bad guys. They can be bad guys when there's too many of them. So they like weeds. In my opinion, if you look at a field that has been really terrible in the soil, the first thing that you see coming up are weeds. And sometimes those weed come up just to fix the soil, you know, because they bring more pollenizers, they bring other things to the nature to fix the soil. So our job is not always to go and kill the weeds or kill the opportunistic bacteria. It's more like it's telling us, Hey, you have got more bad guys in your niche space than good guys bring the good guys back in and they'll crowd

Dr. Kay Durairaj 50:45
them out. I like that idea. We didn't even talk about fungus or yeast or candida overgrowth. But is there a way to combat that, like that's also part of that empty space that gets filled in with highly Yeah.

Speaker 1 50:59
So if you have that empty space and you have a propensity to have Candida overgrowth, and you eating a high sugar, high refined flour diet, you're going to feed the Candida and it's going to grow in that space, right? But the interesting thing about the anaerobes, it seems like they mutualistically crowd them out and just tell them, Hey, you guys are no longer allowed to be here. We're moving you out, but we still need you. I want people to understand that fungi, yeast and candida, is a very natural component of the human gut, just not at the level that it is there, but going to an antifungal approach for long term is going to only allow more opportunistic bacteria to growing. So there's got to be this, this happy medium. And I was guilty of that myself. You know, when I saw a candida overgrowth in an individual, I put them on an antifungal diet. I sometimes even recommend Diflucan or, you know, I will do something, you know, six to eight weeks of fungal reduction, and then something else happens. So I've moved away from that philosophy in my life, where if I have a fungal overgrowth, it will be more short term intervention, and then try and do more of a mediation thing to to crowd out and let the body take care of itself.

Dr. Kay Durairaj 52:14
And periodically we will have to go on antibiotics here and there. Is there a strategy for repopulating? Are we going to go back to three months of resetting the gut after that? Yeah, I think

Speaker 1 52:25
it's very important, though. The Repopulation thing with transient bacteria is not the strongest. The Repopulation with anaerobic, commensal Keystone, commensal bacteria is definitely where you want to go. Yes, and you remember we were talking about mental health earlier, right? Biome. So here's an interesting factoid for you and the listeners. So if a person goes on an antibiotic, there's a 50% increase in in mild depression and anxiety. When people do longer term, like two to three months, there's a 75% increase. And if people are on long term antibiotics, there's even indications of psychosis. And that makes total sense, because if these things make the the aromatic amino acids, like we say they do, to help mental health, and they not there, clearly there's going to be a problem. And if they enhance more permeability for more endotoxins to escape and cause neuro inflammation, that's going to cause more of a problem, but I totally understand the need of an antibiotic. I'm not anti that concept at all. If you have to take one, you have to take one, but it's more how do you fix it? And the good thing about this, I don't necessarily think that you should be completely void of a prebiotic or a probiotic. You're an antibiotic use. A lot of people will tell you what's just killing everything. These anaerobes have been around our bodies for a long time, so they're going to go hide, you know what? I mean, for a while. So I think it's good stimulating them while you're doing the probiotic, because it actually might enhance the the the benefit of the probiotic, because you're not only getting that kill off, but you're also having a regrowth and then and crowding out. I think it'll be a cohesive relationship.

Dr. Kay Durairaj 54:10
Some people say it's like stepping on the gas and the brakes at the same time. If you do antibiotic and probiotic like it's gonna but you're probably right. It does hide and reflourish when it

Speaker 1 54:20
went, Yeah. I mean, I want everybody to understand that nobody is sitting on this call listening to us. And they have no acromancy, they have no F prow, they have no rose barrier. You have it. You might have detectably low levels, but it's not like you void of it completely. If you were void of it completely, you probably would be a very sick person. It's not a chronically ill individual or the typical pre diabetes metabolic syndrome. You know, maybe we will learn eventually that voidance of these strains of bacteria is probably where you become most susceptible to cancers and things like that. You know, maybe that's what we learn in the future more than anything. But your body is innately. Pretty rough and tough, and it wants to rejuvenate. I believe that your cells wake up every morning saying, Hey, Dr, Kay, where's the vitamin B, 12, where's my vitamin E, where's my vitamin K. I need that stuff to build this stuff. I want to get to work. Why aren't you giving me the things that I need? I think literally, every cell in your body feels that way. You know, they don't want to just sit there and say, Oh, great, we've taken the day off again. That's awesome.

Dr. Kay Durairaj 55:24
I don't think that's the way. What do you think about the whole GLP, one revolution, because people are not eating to the point where they're I mean, is fasting bad for the microbiome? And then aren't they kind of in starvation mode?

Speaker 1 55:38
Actually, there's, there's two, two ways to look at that. Yes, the way I will go about that one, if you're doing fasting and your body is already in a catabolic state, I think that's a problem. If you're doing fasting and you're not really in a catabolic state, your body is more anabolic. You're eating, you know, maybe once a day or or something like that, but you're eating enough nutrients and your body's absorbing it, that's good plastic for the microbiome. As a matter of fact, intermittent fasting has shown to improve akermansia status. However, if a person is catabolic, that's a totally different game, right? So that person is kind of feeding off itself to stay alive. So there's definitely very strong benefits to fasting. But I think people start that process too quickly. You know, people that are chronically ill, they have very high permeability. They have many food sensitivities, they have hypoglycemia, they jump on a fast, and all of a sudden they just crash and burn. I think it's very important to go fix blood sugar first. And, you know, make sure that you glycemically control, take small steps of that before you get into any state of intermittent fasting, out of shape, metabolically damaged individuals should not be doing it, but that's my opinion, clinically, right? I just don't see the benefit of that. And why I say that is, I've run many programs in my life where I've seen people crash and burn when you start giving them real food, which should theoretically be the opposite, right? But you're giving them so many things to fix problems that that inflammatory curve spikes because the body's like, Finally, you're giving me what I need to activate these inflammatory cytokines to go fix that problem, right? So you're having this surge of of almost too much electricity in the plug at too quick of a time.

Dr. Kay Durairaj 57:26
That's so interesting. Do you think that there gi changes that come with menopause too? Like the gut has hormones?

Speaker 1 57:35
I definitely think so, which again, and I think that is probably a secondary factor. And I think if you improve the digestion, absorption and the diversity of the gut, maybe that'll improve menopausal symptoms. I have a I have a colleague of mine, Danny Arnold, who sometimes does podcasts with me. She's really expert in the female categories. I suggest you bring her on to talk about the whole thing. But yeah, I do feel that there's a connection. Do I feel that that connection is inevitable? No, I feel that that connection you can fight by giving it more of the younger. So remember the study on the mice with the young to the old, yeah, keep some young in there while we're going through menopause. What? What's the worst thing that can happen?

Dr. Kay Durairaj 58:27
Yeah, exactly. Well, this has been so fascinating, I feel like I could keep talking for another hour of some more questions for you. Maybe we do part two. But I honestly think that your work has been really terrific, and I want to recommend everybody. This is not a paid promotion, but designs for health does have some really incredible pre and probiotic products, so hopefully we'll be able to link those in the podcast notes and Oscar, I hope to get to meet you in person one day one. Invite you to come lecture at some of our meetings. On the longevity, wellness, esthetic side, I think we have so much to learn from each other, like skin and gut. Yeah, we gotta stay friends. I think

Speaker 1 59:09
once we have all the data from the research that we're running right now on all these interrelations. For instance, just before you go, I have a group of of patients at the moment with skin conditions, varied skin conditions that we are doing this complete commensal on, and we have the pre and the post testing. So just for everybody, pre testing, low, low anaerobes, high opportunists. So a lot of bad guys overgrowing, a lot of good guys low. We put them on this, but we've changed nothing else. We told them to keep eating what they're eating. We told them to keep doing what they're doing. So that makes it easier for them, because they're all they have to do is take one small, little capsule a day, and then we're going to retest them. And once we have all that data, I'd love to come back and tell you, Okay, here's what we found. You know, here's how the microbiome shifted. Because the more data i. Come back with you, like that one case report with a woman with a lactose and the gluten problem, I can come back and give you the mechanistic explanation of that and why I think it's working and why isn't it working. You know, this is all the data points that we get, but to all the listeners, you cannot go wrong taking a keystone probiotic for at least three months only be beneficial, right? Because there's nobody that I have seen that I've run a stool test on that has ever come back perfect category, right? We all compromise to a certain extent. We just make sense with our lifestyle and environment. And doesn't matter how much organic you eat, you're always going to be exposed to something that affects you. But yeah, I'd love to come back.

Dr. Kay Durairaj 1:00:45
Yeah, I would really love to follow up the conversation. There's so much to learn, and it's such a it's a brand new field, honestly, like it's really in the last 1015, years that this has started to really grow, maybe in a good last five years.

Speaker 1 1:01:01
So since we've now got the technology to actually extract these anaerobes, because that so, so you're talking five years, I'm talking probably the last year, because this wasn't, you know, until you saw akkermansia the first time, right, that came out, that's an anaerobe now there's more of them, because we now have the technology to extract that. So I think the next five years is going to be dramatically different, right? So for skin conditions, complete, commensal with the PHY Kayla bacterium parasitia with a salicylic acid, I'd be very interested from your side to see how that turns out in your experience with your patients, if you put them on that probiotic with all the other things that you're providing them to see if there's alterations, or maybe the process goes a little quicker, you know, than than what you've normally experienced.

Dr. Kay Durairaj 1:01:52
I would love to do a study with that, so we will end on that note. But Oscar, where can people find you? Or how do they reach out if they have questions,

Speaker 1 1:02:01
yeah, it's very simple. I mean, they can take my first initial and last name, which I don't know if you can see it on the screen. It's O, C, o, e, t, z, E, at designs for health.com so first initial last name at designs for Health com, and they can email me there, or alternatively, if they just want to go on the website and play around with these probiotics and prebiotics, we have a lot of educational material on there. We have a lot of links to little videos that can explain exactly what this probiotic is about. So my suggestion is go play around with that read a little bit because we have patient facing pieces of information and practitioner facing pieces of information. So go learn a little bit more about exactly how this came about and and why we are going down this road as an industry.

Dr. Kay Durairaj 1:02:50
Yes, super fascinating. It's been such a great podcast. I really appreciate you coming on. Don't forget, yeah, you guys can check out my Instagram and find me on Instagram at Beauty by Dr Kay, D, R, K, a, y, and our website is the same. It's www dot Beauty by Dr kay.com and we're going to have a designs for health shelf where I select some of my favorites, and I'm going to be sure to put some of these gi products on there. That's it for now. Guys, stay beautiful. You. You.

Transcribed by https://otter.ai