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Pioneering Gut-Brain Axis and Digestive Support with Kara Siedman 4/9/24 @ 3pm ET

Alright. Hi. I'm Siobhan Sarna, and I have written a book. It's called Healing SIBO. If anybody's trying to figure out what to do next for their small intestine bacterial overgrowth, this is a great place to Sarna.
Step by step, recipes, research, definitely. My story, but mainly it's about you. And we, then we have courses, doctor Allison Siebecker, cocreated the SIBO Recovery Roadmap course with me. If anyone is a pro in this webinar and you're interested in professional training, then definitely go to SIBO SOS and look at that or her website, siboinfo.com. So that's Siebecker Land.
This is everybody land. This is if you have a mood, if you have a brain. Thank you for being here. Yes. I appreciate it.
We're gonna be talking with, Sarna Seidman, who is a registered dietitian. She's also one of the elite trainers at Microbiome Labs. Like, they could have anybody, honestly, if you think about it. And I have Kara. 1 of one of a few.
1 of but but it's it's like a very small special group, so thank you for being here. She's gonna be talking about that gut brain connection and the newest developments Sarna research in psychobiotics. Like I said a second ago, I wish I had actually named this, like, mood and strains, which if we ever do this topic again next year, I'll probably do that. I need to make a mental note of that because the word psychobiotic, I think, is a little bit almost too new. But for those of you who are, like, super nerds, civilian scientists, welcome, and just glad you all are here.
Quickly, I had a bout of food poisoning. I woke up the next morning with no joy, and I thought, oh my goodness. What in the world is happening to me? Because I'm a joyous Allison, but I really felt a difference. It happened a couple of times.
So because I started to notice it. And, of course, that goodness also, it came back. My joy came back, like, within a few days, but I thought, oh, this is a very, very clear example of the gut brain access Sarna what it can do to your moods. And I thought, oh, what if it was like this all the time? And I know there are people that must live like that, and that struggle is real.
And so my heart goes out to anybody who's ever experienced it longer than, like, a day, and even that was very scary. I'm gonna hand things over to you so you can go ahead and get into the presentation. We do have a 15% off coupon for everything at Microbiome Labs, including the stool test and the vaginal microbiome test, which I highly recommend both of those. And it's very rare to have that kind of a discount, so please take advantage of that. Clorist will put it in there, but the main thing is let's all learn together and get these noggins feeling good.
Okay. Thank you, Sarah.
Well, thank you so much for having me on it. Let me share my screen. Okay. So everyone can see the slides. Correct?
Yes. Yes. Yes.
Perfect. Thank you. You never know what these these computers these days. So I love this topic so much. I mean, I think that you just hit the nail on the head.
We've Can you go full screen, though, my dear?
Oh, am I not full screen? Let's see.
Funky. It's a little funky.
Okay. Let's stop the share. Somehow I always have issues.
Yeah. No big deal.
I know. It's what happens. Okay. Let me share my screen again.
Okay.
How's that look?
Nope. I can see all your fun notes. There you go. You got it. You nailed it.
Okay. We should be in just the the screen. Yes. You're good. You're good.
Good. So this is exactly what we're gonna be focusing on today, this gut brain access Sarna all the conditions and and really honing in on the conditions that are associated with having this this dysfunction along the gut brain access, so especially things like IBS and placebo. And we know that, obviously, either ourselves, we have friends that have dealt with this, or we see this so much in clinical practice. In fact, it's one of the most common conditions in people under the age of 40 5. So there's really a huge clinically unmet need and something that hasn't been addressed, you know, in a way that's impactful for people.
So that's what we're gonna go through today in focusing on these innovative innovative strains for people that are suffering from this gut brain dysfunction.
Hey, Sarna. Your audio is a little funky, honey bunny.
My goodness.
I know. It's a little in and out. I don't know if anyone else noticed that. If you didn't, then I'm fine. I can certainly
Okay. You'll let me know if there's any other problems. I have good I have good Internet connection. So, hopefully, it's just
Might be the placement of your mic. You may have to hold it. Okay.
I'm striking out here. Okay. So first, I wanna review something called disorders of gut brain interaction. And this was previously termed this is what we would call functional GI disorders. So, functional GI disorders encompass dozens of disorders.
It occurs in over 40% of adults and children. And in 2016, the term disorders of gut brain interaction or DGBI replaced functional GI disorders. And it was really due to the misconception that the word functional implies lesser legitimacy compared to other disorders. Now, obviously, we know that that's not true and and the term functional was often being associated with either psychiatric or more undefined conditions. So that led to this stigma and a perception of just being less real.
And I would have patients all the time come to me and say, oh, they don't know what I have, so they're just saying that I have IBS. And, obviously, you know, we know that there's more there's more to the picture. And so disorders of gut brain interaction, that's really the term now that reflects our current scientific understanding without having that stigmatization. So these disorders are classified by having any combination that's affecting motility or visceral hypersensitivity, mucosal immune dysfunction, altered gut microbiology or dysbiosis, and, of course, having altered central nervous system processing. And it's that altered central nervous system processing that we so often see these mood disorders co occurring.
And there's a statistic. In fact, 76% of people with functional GI disorders, with these disorders of gut brain interaction also suffer from depression, anxiety, chronic stress. And so this really highlights the gut brain axis. We know that the gut and the brain are so intimately connected, and they form essentially two parts of the same system. And we know that the tissues in the gut lining resemble the same tissues in the blood brain barrier, showing the direct influence of gut activity on brain function.
And so the gut brain access is there to maintain gut balance. It links our emotional and positive areas of the brain with our gut function. And many essential brain substances and and hormones and peptides, like serotonin and dopamine, GABA. These are all predominantly produced in the gut. And a key component of this is the vagus nerve.
So the vagus nerve being our our rest and digest regulator. In fact, 90% of signaling through the vagus nerve is from gut to brain, and this is what regulates digestion and, hunger signals and regulates inflammation in the gut. And especially those with gut issues when we have inflammation that's present in the gut, this actually begins to weaken this the vagus nerve, and we'll explore that further. So it brings us to this question, is it gut brain or is it brain gut? And, obviously, we know this is bidirectional.
So I like to always explain this as having, you know, people either having a bottom to top presentation. So how many of you, if you think about patients or you yourselves or people you know, have ever said that, you know, I've never experienced this level of anxiety or this stress like I have now before my GI issues that set it. And we know that, you know, 76% of people with GI issues or irritable bowel syndrome or dysfunctional GI disorders have psychological comorbidities, but there is a top down presentation. And we see this in in people who've had traumatic brain injuries. We often see IBS and SIBO co occurring.
Autism spectrum disorder, 70 to 90% of people have GI comorbidities. So we know that stress influences gut motility, stress influences, you know, gut secretions and as well as mucin production. So, obviously, factors related to pathogenesis vary, and we mentioned a few visceral hypersensitivity and dysbiosis. But the bottom line and what we're really gonna focus on today is IBS and mood disorders Sarna result of having this dysfunction along the gut brain access. And that's a result of dysbiosis, tryptophan dysregulation, as well as having an altered HPA access function.
So what is it? I just I love this schematic so much. This was a study, that was done in 2022, that was really looking at the small intestine. Because most of the research has been primarily focused on investigating immune abnormalities within the colon when it comes to irritable bowel syndrome or dysfunctional GI disorders disorders of gut brain interaction. So this was a study that was done in 20 to 22 that focused on the immune abnormalities that are actually taking place in the small intestine, and that that really needs to be considered as a place of of ideology or pathophysiology.
And that's because the small intestine is the major site of, obviously, nutrient antigen exposure, but really where we establish that immune tolerance or immune homeostasis against food and commensal microbes. So just to review really quick, our large intestine immune system is focused on tolerating large number of commensals, where our small intestine immune system is focused on really discriminating something that's harmful for us, so harmful foods or harmful bacteria from what's safe. And so if we combine increasingly being explored as that site of pathology. And we also know that IBS patients have greater basal levels of immune activation compared to their healthy cohort. And so we know that this is a huge factor related to the pathogenesis.
So just to review, immune tolerance is established that once something enters into our immune system, our antigen presenting cells, like our macrophages, dendritic cells. They're the first cells that basically take a sample to determine whether or not something's good or bad. And if something is determined to be fine and okay, well, this releases or upregulates what's known as our regulatory t cells and that promotes the production of interleukin 10, which is our anti inflammatory cytokine. So remember that, we're gonna we're gonna talk about that a lot. Whereas in irritable bowel syndrome, we have altered permeability, we have increased antigen contact, altered microbiotic composition, altered mucus layer composition.
So once something comes into the small intestines, it activate activates our t cells, and this produces inflammation, pro inflammatory cytokines, and that's essentially the driver behind visceral hypersensitivity. So a lot of what creates that dispension bloating. So when we have a dysfunctional gut, this can in turn lead to disruptions along the HPA axis. And so chronic stress disrupts the microbiome Dr. dysbiosis, and so Mark, essentially perpetuating this this sort of harmful cycle.
So it activates our pituitary gland for our adrenals to release cortisol. Cortisol and especially excessive cortisol production over time drives leaky gut. And leaky gut, we know, creates an inflammatory response. So we have this this dysbiosis, we have, bacteria that can be harmful, and essentially, we get this production of these inflammatory cytokines. Now specifically, interleukin 6, which is a specific inflammatory cytokine, this activates the h p a access even further.
So if we have this chronic production of pro inflammatory cytokines, then essentially, this chronic activation of our HPA access will down regulate what's known as our glucocorticoreceptors, and this inhibits that negative feedback loop. So what does that mean? The glucocorticoreceptors are receptors in the gut that help bind cortisol, and it's that binding of cortisol that creates this negative feedback loop. So essentially tells our body to, like, chill out. You're okay.
Everything's fine. You can calm down. But if we have this down regulation, then essentially it turns that off and we just stay in this Sarna of perpetual loop. And so that's why chronic stress is really this sort of maladaptive process. Now over time, this will lead to a desensitized HPA Allison, and that results in what's known as a blunted cortisol awakening response.
So when we wake up in the morning, we should get a surge of cortisol, and that's essentially what gets us up and going. But people who suffer from IBS and these disorders of gut brain interaction, a hallmark feature is this blunted cortisol awakening response, and it's usually associated with the worst cortisol awakening response, the worse the GI issues. So once that once we have this inflammation and this inflammation is present, whether it's from hypercortisolemia, so increased cortisol production, leaky gut which drives inflammation, This will dysregulate or affect the path that tryptophan tryptophan travels. So tryptophan being an essential amino acid that we get from our food. So inflammation activates an enzyme that turns tryptophan or metabolizes tryptophan into what's known as quinolinec Allison.
And quinolinec acid is neurotoxic, so this is what drives poor sleep and decreased resistance to stress. And this makes tryptophan less available then for its neuro diet, so which is, again, solely obtained from the diet, 95 diet, so which is, again, solely obtained from the diet, 95% of tryptophan is metabolized this pathway. So if we're in a pro inflammatory state, if we have, dysbiosis and we have this, h p a access, dysfunction, we have leaky gut, all of this is gonna then disrupt the path that tryptophan trap tryptophan traps. So how can we circumvent? How can we imp how can we, impact the the inflammation that that this is having on the gut and the brain?
So not only addressing, you know, inflammation in the brain, but inflammation in the gut. And this is where we come to our 2 unique strengths, our bifida longum 1714, well as our bifida longum 35624. So this is where it's important to know. We're we're talking about bifida longum, which is the species. But as we get down to that strain level, this is where it's so it's so important to intricately know these microbes because, even though it comes from the same species, their functions actually change once you get down to that strain level.
So bifidolongum 1714, this is our psychobiotic. So I just love this term and it is a it's a a newer term. And essentially what this means is it's, a probiotic that exerts benefits specifically on our mental well-being. So this is just one study. We have over 7 studies on this one strain.
So this was just one study that looks at bifida longum and its ability to modulate, brain waves during acute stress. So everyone in this study, they were put into a stressful scenario. I think it was like a game of cyberbull. And, essentially, what they found was that the b longum impacted our brain wave activity during that stressful scenario. So during stress, that b longum group, so the 17 14 group, there was a significant increase in theta wave activity, which are associated with the release of neurotransmitters.
Sarna? Yes. I'm having a piece of toast while you're talking, but we do have a request for slowing down talking.
Yes.
Breathe. You're good. It's fine. You've been a little bit longer than our 29.5 minutes. No problem.
Perfect. It's the Jersey girl in me. Sometimes you just get going. Okay. So during this stressful event, what they found was there was a significant increase in theta wave activity.
And theta waves are associated with, the release of neurotransmitters. So theta waves will release serotonin and acetylcholine, and these are all linked to more relaxation states. They're linked to creativity, to memory, and then there's an they found an increase in our alpha waves, and these are associated with more calmness. So alpha waves are what's more active when we're in a state of meditation. And so they found an increase in both of these waves during that stressful event.
Now interestingly enough at rest, the b long group, so the 1714 group, there was an increase in those theta waves, But Mark importantly, there was an increase in those beta waves. So beta waves are your high frequency waves. These are what keep us focused. They keep us diligently working, they keep us, you know, entrenched in what we're doing. But when we encounter stress or we're in a stressful situation, we really don't want those beta waves to be expressed.
We really want those low frequency waves, like your theta waves and your alpha alpha waves. Because this essentially will help you relax into a matter relax into the situation and work through a stressful event, just in a more relaxed way. So how does this do this? So what what specifically is this strain? Well, this strain increases our anti inflammatory cytokine, what's known as interleukin 10.
So we mentioned interleukin 10 before. We're gonna mention it again in in a few more slides. But what the bifidolongum group does is it has this knockdown effect to decrease inflammation. And what do I mean by that? So when we have inflammation, whether it's inflammation from having an altered H access, we have lots of cortisol because we have this chronic stress, whether it's inflammation because we have leaky gut, whatever in inflammation is there, bifidolongum 1714 comes in and it basically turns off or shuts down what's known as this n f kappa b.
Basically, all you need to know is n f kappa b, it's a transcriptase factor. It's on immune cells and immune complexes. This turns on inflammation. It's like a master switch. So let's say I walk into a room and I only wanna turn on the light in my kitchen, but I turn on a switch that turns on every light in the house.
We don't really that we don't want that. It's a waste of energy. So if NF kappa b gets turned on, then it produces these inflammatory cytokines. Many of these can cross the blood brain barrier, and that's what promotes inflammation and drives symptoms of anxiety and depression. So 1714 comes in and it actually shuts down that process by increasing interglucan tent.
So it establishes a a healthier tolerance. And that essentially shuts down or knocks down inflammation. We're blocking that inflammation. So it's not the bacteria. Right?
The bacteria is not going to our brain. That would not be good. But it's what the bacteria are doing and it's the production of the anti inflammatory cytokine that travels and traverses our our vagus nerve and can travel to the brain and cross the blood brain barrier. So going back to our tryptophan dysregulation, if we take 1714, this psychobiotic, then that interleukin 10 blocks n f kappa b, that master switch, so we're not turning on inflammation. And if we can shut off inflammation, even though we have inflammation present, right, we have an altered h p a x, if maybe we, you know, dysbiosis.
We have all these things we've been discussing within the gut brain access. We can stop the turning on of IDO, which prevents the production of quinolineric acid, and this allows now tryptophan to be available to create serotonin and melatonin. So allows tryptophan to travel this neuroprotective pathway. So let's switch gears and talk about bifidolongum 35624. So this is a really interesting probiotic.
It's for a healthy digestive system. It's been studied for the past 20 years. It's been over 85, probably more than 9 90 publications at this point, and really focusing on symptoms related to these disorders of gut brain interaction, symptoms related to IBS. And it's the immunomodulatory benefit, so this improvement in inflammation that makes this strain so powerful. And in fact, the World Gastroenterology Organization has reported this strain, the 3 5624 strain, had the best evidence base for efficacy in IBS.
So it's pretty pretty cool. So this was just a study that we did, most recent. So this was just published in August of 2023 looking at exactly that. What does this strain do specifically in people suffering, with symptoms related to IBS? And, essentially, what this strain found was over the course of 8 weeks that this strain was associated with significant and clinically meaningful.
So what do I mean when I say clinically meaningful? It means someone who maybe suffers from symptoms 5, 6 days a week now goes down to 3 or 2 days a week, which, you know, has a huge impact not just on our quality of life, but in turn, can obviously impact our our joy in life. Right? Because as Siobhan said earlier, right, when we don't feel well, obviously, you know, we know it affects our mental state. Now we're seeing what it's doing clinically.
So that was really interesting over the course of the 8 week that there was, people went from mild or moderate IBS to mild and severe to more moderate. So people found that to be extremely helpful. So how is this doing this? So, again, coming back to our immune tolerance and and what's taking place in the small intestine. So, again, keep in mind, immune tolerance is when something comes in.
Our antigen presenting cells, right, they they boost immune responses. They they show that something's potentially beneficial, and they release that interleukin 10, right, that anti inflammatory cytokine. But when things are altered for a multitude of reasons, then we activate. We increase those t cells, the t helper cells, and that's what essentially produces inflammation. So that's how we get those symptoms related to visceral hypersensitivity, the distension, the bloating.
35624 also downregulates or prevents the production of those pro inflammatory cytokines, and it does that by producing interleukin 10. So it's all about that anti inflammatory cytokine. That's why we say this is a, an immunomodulatory strain. Both these strains are neuromodulatory. It's because of that ability to shift inflammation, and that essentially prevents hypersensitivity or knocks down that effect of of visceral hypersensitivity.
So what do we get when we combine these two strains? Well, we get targeted support to the gut brain access. So Zenbio Dual, this is a to me, this is one of the coolest products. And I like this because it's it's 2 strains that are very, very similar actually, but it's those small differences that change the functionality of those strains and they're unique. We're gonna talk about that unique aspect.
But we have a strain that's targeting the GI tract, and then we have a strain, our psychobiotic 1714, that's targeting inflammation. And what's more important to mention here is that these strains have compatible modes of action. So what do I mean when I say that the they're compatible modes of action? So this is data that was presented. Now this to me was just mind blowing when I first learned of this data.
And this was presented in 2016, at the International Scientific Association For Probiotics and Prevites, their big group, iCELL. And, basically, what this study was looking at, what the research were were wanting to understand was kind of this archaic or what this thought was as far as probiotics went. Take as much as you can, take as many different strains as you can, and and hopefully, something works. So what they did was they looked at an arthritis model, and you can see here the clinical progression, and that's this blue line, right here. Now strain a is that 3 5 624 strain, and strain b is another bifida long strain.
It's like DPC something, I forget. But you can see each strain individually has shows clinical improvement in it, and it actually shows improvement over the natural course. So this graph over here looks at what happens when those strains are combined, and that's the purple line here. So you guys can see my mouse. To me, this is my look.
Because what are we seeing that those strains that were effective individually, when combined, completely negate. So they completely knocked out those benefits to making them both ineffective. And so they had competing effects. So it's important that we start to challenge companies, we start to question our probiotics, especially when it comes to the research, because we don't wanna take strains that are combined that are potentially knocking each other out. So this to me just really changed a lot of my thinking of when I am prescribing or when I am taking probiotics, and it just, you know, demonstrates some of the problems that we can see with some of these multistream probiotics.
So Zenbio Dual was clinically mapped. It was full genome mapped to show that compatibility. And this is just one of the studies that we did that looked at that, the combination of the 2 over an 8 week period in people suffering from irritable bowel Allison. And we measured everything from, irritable bowel symptoms, depression, anxiety. Also, look at cortisol output because of that blunted cortisol awakening response that we know is is a hallmark feature in irritable bowel syndrome.
We know that that indicates an impaired stress response, but we also looked at inflammatory factors. And, essentially, what they found was over the course of the 8 weeks, there was clinical improvement in symptoms. 82% of patients, in fact, had clinical had clinically significant improvement. But I wanna just make note that symptoms started to gradually come back when the supplement was stopped. And this just really brings us to the understanding of of the difference in the types of probiotics that we take.
The scientists that who discovered the strain are bifida and lactose strains. They call them torus because they're not polymers, and they're not changing the microbial landscape. If you're familiar with Megaspore, that's one of the unique benefits about our spores is that they actually can change the microbial ecology. These next gen probiotics, our bifido strains, our lactose our lactobacillus strains, these are having very specific effects on targeting very specific components. In this case, targeting symptoms related to the gut and symptoms related to neuroinflammation.
We saw improvement in depression and anxiety, sleep quality improved, and then we also saw that cortisol awakening response. So here you can see there's that blunted cortisol awakening response, so we're not getting that surge when people wake up. And then you can see that once this the probiotic was Sarna, that we started to get improvement in that. And then following the course of dual strain probiotic, we had restoration of that cortisol awakening response, which, is important because we saw the GI issues improve as well. So we know they're they're closely related.
This was just the one other study. This was a real world evidence study. So real world evidence is a sort of new wave of research. We love this because it's just people in the real world taking, the probiotics without changing much else, so we are really just kinda seeing people in their normal day to day life. And these were 55 adults with IBS.
And I just wanna make note, 85% 100% had GI issues and 85% had psychological comorbidities, and they were given the dual strain probiotic. And, again, similar outcome measures as far as looking at IBS symptom severity, so abdominal pain and bowel habits, but also looking at stress and fatigue and overall impact to daily life. And what they found was over the course of the 4 weeks that there was, oops, that there was significant improvement in pretty much much every clinical outcome from stress, fatigue. You see here that mood goes up because they're measuring good mood. So the increase is obviously positive.
So we're almost done, and I always like to kind of focus on what makes these strains so unique. So what is the magic about these strains? Because they are 2 very unique strains. And what's so unique about them is they contain what's known as this exopolysaccharide layer. And it's this EPS layer, we call this Harry Potter's invisible cloak, and I'll explain why.
But it's this layer that really separates these bifidolongum strains from other bifidolongum strains or other other bifidobacteria strains in general. So the magic of the exopolysaccharide coating. So the EPS layer has immunoregulatory effects. So it also Sarna you can see this here, the EPS layer here versus, a non EPS, and you can see that EPS can produce interleukin 10. Interleukin 10 being our anti inflammatory cytokine.
So that EPS layer, you'll see the bifida longab strain over here. It's this sticky outer coating, versus other non EPS strings. So it's lit literally like a kinda sticky coating. And it's that production of interleukin 10 that provides extra immunoregulatory effects, and that's what really helps to knock down that inflammation. And it's because of that EPS layer that it brings us to this unique question is, what does it mean when we say a probiotic is silent?
This was a study that we did that looked at the bifida longum 35624 strain and compared it to a non EPS strain. So just another bifido strain. It was a bifidolactus strain, so a strain that's really common in, yogurts. And so they wanted to compare the effects of what this bifida longum 35624 strain and that EPS layer has on inflammation. And, essentially, what they found was that the strain that was in the yogurt had a much more stimulatory response, had a greater stimulatory stimulatory response than bifida1135624.
You could see here, this is interleukin 10, they both produce that, but you can see the yogurt strain also produced other inflammatory cytokines. So what this is saying, to kind of put it simply, is other probiotics, especially ones that don't have this level of EPS, can have a mixed tone, meaning you can turn on everything. So once something gets presented into the immune system, everything gets turned on, inflammation and anti inflammation, and, hopefully, the anti inflammatory components outweigh the inflammatory study. Whereas just the bifida longum 35624 has just an anti inflammatory tone only, meaning it's only producing interleukin 10, which is allows it to sort of go incognito. So once it gets presented into the immune system, that EPS layer is like Harry Potter's invisible cloak, so it can't be seen.
So it only turns on those t reg cells to, turn on or induce that interleukin 10. So bifidobacterium lactis produced anti inflammatory cytokine, but it also upregulates proinflammation. And this is this is problematic in someone who's already inflamed. Someone who already has a lot of inflammation, you can turn on inflammation which can potentially worsen inflammation, not just in the gut but beyond. And this may be why some people who take probiotics feel worse potentially, because if they're already in an inflamed state.
So this EPS really alerted the researchers that, hey. This is unique because it's not having the same effect that we can obviously see in other probiotics. So it can go incognito. Harry Potter's invisible cloak. And that's what makes this this probiotic but also these two strains so unique.
And so Zen Bio Dual is the combination of these two strains at 2 capsules per day. We do wanna take it with a meal, and and and I always tell people because of that study that was done on strain combinations, unless the two strains have been studied together, I always encourage people to take your probiotics separate. Don't take them all at the same time. Because what if they compete and they essentially knock out the benefits that each one of them is having? And so when it comes to IBS, when it comes to these functional GI disorders or disorders of gut brain interaction, a lot of the treatments out there, a lot of this the management is just around symptom control, and a lot of them, you know, aren't as successful, especially when you get into the pharmacological world for IBS.
And so this just really offers a unique and innovative adjunct or part of our you know, part of your protocols or part of your treatment that you do for these patients in not only helping to alleviate symptoms, but really getting down to the inflammation and and focusing on, obviously, those immune and and neurotransmitter modulation and the effects that it has in reducing that that inflammation. So thank you. Hopefully, you've got some Yeah. Some little nuggets there.
A lot.
It was
a lot. I mean, it's great.
It's great. It's great. Unique. Yeah. It's they're really unique.
Yeah.
To get your brain around. We do have some questions, and then Clarissa's gonna put the link in if anyone wants to try it or anything else, including Megaspore, which I know you referred to. Mhmm. And the stool test, the vaginal microbiome test, all everything at Microbiome Labs is 15% off. Clarissa just put it in the chat for you.
So let me get you some questions for you. Can you describe one more time hold on. I just lost it. Where are they? Yep.
The Harry Potter slide, the EPS. Yes. Just just one more time. Say what that is again?
Yep. So x exopolysaccharide layer. So that EPS layer is essentially this sticky outer coating. It's this outer layer that's with that's on, these this bacteria particularly, and it's that EPS layer that again, that's what we think of as almost like Harry Potter's invisible cloak that allows these strains to sort of go silent through the immune system to only turn on our anti inflammatory cytokine. So it's it's unique in that it allows these these strains to just have anti inflammatory, benefits, but the EPS layer itself also has anti inflammatory components.
You're almost getting a double whammy with these with these strains.
Okay. Speaking of which, would taking other probiotics be contraindicated?
It's not contraindicated, but I wouldn't take other probiotics at the same time.
Exact same time. Okay.
And and I just always say, this is why I think we need to challenge just research and research around strains and strain specificity and what those strains are doing. So that's why I always say, like, the fetal lung of 356241714, They come from the same family. They sound like they're related, and they are, but they're 2 very different people. They have 2 very different personalities.
My sister and I are very different. I'll just say that. She's great, but different. Okay. Let's see.
Can you repeat what you said about down regulation of the glucocorticoid Yep. One. Say
it again. Glucocorticoreceptors.
That's the one. Thank you.
Yep. So when we have this HPA axis dysfunction, right, which we know is is very, very common, in the in the gut brain world, right, so dysbiosis, leaky gut, we get this, production of interleukin 10. Interleukin 10 is one of our inflammatory cytokines. An interleukin or Sarna. Interleukin 6.
All these numbers. So that production of inflammation activates the h p a axis even further, And it's that constant activation that it sort of perpetuates the cycle that we get this downregulation of our glucocorticoreceptors, which essentially, if you're not binding cortisol, then you're not getting that negative feedback loop. You're not getting that feedback that says, hey. Chill out. Everything's okay.
And it's that downregulation of these receptors, you know, through this inflammation and specifically through this interleukin 6 that you don't get that negative feedback loop. So you're essentially in this vicious cycle.
How long to wait to take another probiotic after taking DUAL?
That's a good question. This is, you know, sort of preliminary speculation from our researchers. As we always say about 4 hours, and it actually has to do, if you remember that picture of the small intestine where I had those dendritic cells or the antigen presenting cells, that it can take sort of, you know, 5 hours. So we usually stay at least 4 to 5 hours apart is good, just to give time for things to be presented into the body and then for the body to figure out, hey, this is this is something good or to not negate any of the effects of those. So I say about 4 or 5 hours.
Okay. And how to take DUAL with an antibiotic?
2 at least 2 hours apart from an antibiotic. Yep.
Okay. Is Megascore okay to take with ZenBiome Dual?
So, again, I think they work. Space. As long as it's spaced out, I think they're extremely complementary. You know, for me, I always say Megaspore is kind of a a foundation, and that it's actually changing the microbial landscape. It's actually supporting the growth of your beneficial bacteria.
We're dual. We're we're using this to achieve specific effects in reducing the GI symptoms and and reducing anxiety and depression.
And sorry. My cat is just, like, so distracting. Could this help in, tamping down a COVID cytokine storm?
Oh, for sure for sure. If you ever do any biomeffects consult with me or ever talk to me, I think anyone that has inflammation, sort of benefits from this strain even if you're not suffering from, you know, gut brain dysfunction. And in fact, they did do some studies on the 3, 5, 6, 2, 4 in other disease states like ulcerative colitis and psoriasis, and they showed a decrease in those pro inflammatory. So I do. I think there's just an anti inflammatory tone to this program.
Alright. So would this reduce abdominal pain since it would lower hypersensitivity?
Absolutely. And that's and that's one of the outcomes that we measure in all of the studies. Yep. Yeah. Absolutely.
Okay. I'm gonna ask everyone to please put your questions in the q and a box. So I know some of you are new. It's great to have you here. I just bring it on home over to the q and a box because if I start to monitor the chat, I I get distracted, and I just wanna keep it here in the q and a box.
Thank you. Thanks, Clarissa. So some people who wake up slowly may need a cortisol boost in the morning. That's a question.
So, usually, we get usually, when we wake up, we do get this increasing cortisol because that's essentially what gets us up and going. Yeah. I mean, I know for me, I'm like, I don't wanna press news, so I need that cortisol boost. But what happens with people who have this blunted cortisol awakening response, which is a hallmark feature in these disorders of gut brain interaction, they're not getting. So it makes them have more fatigue or why symptoms, you know, often start shortly after waking up.
It's because they're not getting that that they have that blunted cortisol response.
Hey, Ruxana. Would this help individuals with shrinkage of the pituitary gland? Oh my.
Probably not. Yeah. I don't that, I I don't know. Would be interesting, but it wouldn't be contraindicated. Okay.
Yeah.
How does it differ from bb536?
So I would have to look up some of this very specific research on bb 5, but this is again, it just goes back to really intricately understanding the modes of action of all these different probiotics, which is why even if we look at a different lactobacillus acidophilus, you know, strains, they don't all function the same way. So I would look up that strain and kinda see what research has been done on it, but I can't say for sure because it's not one of our strains. I haven't delved into the research.
It says please remind me of the pro inflammatory cytokines and the non inflammatory.
So inter interleukin 10 is our anti inflammatory cytokine. Cytokine. And then other pro inflammatory cytokines that you'll read about, interleukin 6 Sarna t and f alpha, interleukin 1 beta, I mean, there's a lot. Interleukin 8, you know, these are all more pro inflammatory.
Catherine's saying, how would you answer a patient's question? I wanna start taking a probiotic because I hear they are good for you. And which should I take even though I don't feel bad? Oh, I have I have such a comment on that. Go ahead.
Well, so do I. And, of course, I'm do. Of course, I'm biased because and and I I'll say this even before I started working for microbiome labs. I've worked in the GI space. I've been a practitioner forever, and what got me to microbiome labs was Megaspore.
And the reason for that is because of the research that has been conducted on it in showing how Megascore really supports the entirety of the microbial landscape that it's actually it's like giving your garden a more nutrient dense soil versus adding in those specific nutrients one at a time. And so that's why I say we almost have 2 separate paths. We have what's actually shifting the microbial landscape, supporting diversity, which is one of the key characteristics of having a healthy microbiome versus if I have someone who is really suffering from sleep and abdominal pain, then, yes, I might start them on dual because I want them to feel better, but you're still not necessarily getting down to the root of what's driving some of the dysfunction within the gut.
Okay. I Sarna, you guys are having a side conversation in the chat, and I wish you would just put your questions in the q and a box. Here's why. Because I'm gonna go with what doctor Siebecker says about the probiotics as there is a question about this also in the in the q and a. So what she says is doctor Seabecker is a world renowned Siebecker expert and specialist and probiotics help with IBS and SIBO.
Okay? Mhmm. And then clinically, sometimes that doesn't line up, and we could say that about everything. Right? What she does say is to do the probiotics prior to getting a negative SIBO breath test.
Meaning, oh my gosh. You've done the treatment. You're you're doing your I'm doing a treatment. I've not started my probiotic yet. I get a negative SIBO breath test, and then I start my probiotic.
What she's saying is do it beforehand. And then after you get a negative SIBO breath test, just go ahead and continue with your probiotic. But don't do it as a new thing after. I hope that makes sense. That is their suggestion.
So it it really it really is something for you to try. This has a lot I love that it's got all of the IBS benefits Sarna it's got the brain benefits, and you have an opportunity to try it. I think it could be an answer for a lot of people. I know that it's been an answer for me and my family, and so it's an opportunity. There you go.
That's what I have to say. Can it help Absolutely. Is it right? So can it help people with IC, interstitial cystitis?
So interstitial cystitis is an immune condition. And as much as, you know, I can't make a claim that, you know, this is gonna help all autoimmune conditions, I just think having something that reduces inflammation. We also see IBS co occurring with IC all the time. Yes. So I think to help manage some of the symptoms, I think this, you know, is obviously a great complement to whatever you mentioned.
Anne, I wanna just, also say hold on. Micro do you know this other lab? The MicrogenX, I think what it is, is they, specialize look up UTI Free. Live UTI Free. And it's a whole, like, what I am to Siebecker and my nerdiness Sarna getting information out, they have a whole thing about IC and UTIs, and they also work with a lab that cultures for so much more than your typical urologist does.
Like a friend who had a UTI for a year, several rounds of antibiotics, bless this neurologist's heart. They had in the office a brochure for this I think it's called MicroGenDx or something like that. And, I'd already known about it, but couldn't remember the name. Still not doing a great job remembering name, but something like that. Anyway, we sent the the pee off, and she got the proper culture.
She got the proper antibiotic. Bob's your uncle. Done. So anybody who has that, look for Liv UTI free. Okay.
I will look up Liv okay. Good. And yes. Yes. Yes.
Yes. Do they need to be refrigerated? Yes. They're in pill form.
Actually,
Please do go to the microbiome website lab, microbiome lab's website so you can investigate the stool test, the microbiome, vaginal, test. And I've tried to take Megaspore as the instructions say, and I get the runs. Will this new dual probiotic probably do the same? Kim, everybody's got a snowflake of your very own microbiome. Also, did you titrate up on the megaspore just a little bit?
Go ahead, for that.
Yeah. You know, I always say we often hear that, and I've obviously seen that in clinical practice too. Megaspore, because it's truly coming into modulating the microbiome, it's really shifting things around. We can get that die off and that irks reaction. And as bacteria die off, it can create more bloating and it can create more discomfort, it can create diarrhea.
But, no, we haven't I haven't really seen it. In my patients, I haven't really noticed any negative effects. But anytime you're doing any type of modification, there can sometimes be obviously changes. But we've for the most part, I have not heard of any negative, changes and only improvement.
Okay. Let's see here. Okay. I'm gonna just get rid of some of these other comments, guys, just because I'm I'm it's making me a little bit nervous of a couple of things. Okay.
Since they are bacterial strains, how does it not alter the microbial environment? I'm just wondering, is is there any possibility of it worsening bacterial overgrowth? One thing I just wanna say is this. When we've talked to doctor Mark Pimentel about this, I specifically asked him a lot of these questions. And one of the best things I've heard, like, in years was the following response.
Once you reduce the bacterial overgrowth with a treatment, whether it's the prob whether it's, excuse me, the antibiotics, the herbals, or the elemental diet, the microbiome comes back into harmony to a certain extent. So what was so cool about that is that these bad players that are overgrowing, because they're still present in a healthy microbiome, but, when these particular organisms overgrow, small intestine bacterial overgrow, when they get under control, the rest of the microbiome is allowed to and repopulate. So I wouldn't I understand where you're thinking. I understand where you're coming from. I would not overthink this.
I would try it. I would get my SIBO treatment going and then take it from there. That that's that's my advice to you from being around all of this for so long. Should it be taken long term? I'm gonna just say this.
Maybe you can add to it, of course. Our ancestors went out to the ground every day and got their potatoes and their carrots and their veggies, so they were reinoculating themselves every day with their spores and probiotics. We typically don't do that. So, like, do I need to do it long term? I'm going to.
What are your thoughts? How do you answer
that? You know what? That's always one of the big questions we get because no one wants to take anything forever, and that's why we have to understand the difference between getting down to the root of what's driving your condition like SIBO or IBS and fixing patching up the holes in the foundation versus something that you're taking to achieve a very specific effect. This is a these are strains that are really targeting your symptoms. So what we found in the studies where when you stopped the dual strain probiotic, when you stopped the 1714 and or the 3564, symptoms return because they're not getting down to what's driving the dysfunction in the first place.
And that's where we have to look at root cause medicine, and then we have to look at next gen probiotics as part of the management. But so, yeah, technically, I I would say if someone, you know, has a lot of inflammation, this is a good one and very safe to take long term. Yep.
Catherine, we're doing a webinar next week with Kiran Krishnan. Hold on. 16th at 3. That's a week from today. And he's gonna be talking about his SIV, which is his, topical acne serum based on probiotics.
It's very cool. The results are amazing. So, Catherine, be sure to look for your email, for that because you were asking what's a good strain for acne. I'm gonna send you there. If your SIBO treatment has been resistant for over 3 years, could it worsen the overgrowth?
This is I think you're ask I understand why you're asking that question. I think there's a bigger picture at play here. So what is your underlying cause? Are you, what are the treatments that you have tried? Are you on a prokinetic?
Did you do the SIBO breath test with lactulose versus glucose? Was it 3 hours? So come to cbosos.com Sarna, check out some of the freebies there because that can guide you through that. I it says anonymous attendee, so I can't tell who you are if your first name or name I recognize from the community. But go go to cbosos.com.
There's lots of free things there for you. Okay. After many X rays, shall we use probiotics and iodine?
Probiotic and iodine? Iodine.
I don't know, Floris, where this is coming from. I know you've asked this in a couple of ways, so I know this is really in your heart and on your mind, but I wanna answer that. But I don't know what that I
I just would say defer back to your provider in regards to iodine because not everyone's a good a good candidate to take that. But I always you know, again, anytime we have heavy metals, anytime we have environmental exposures, this is something else that can drive dysbiosis. And if you already have dysbiosis, it can potentially worsen it. So I think always looking at the gut and always using the microbiome and and focusing on the microbiome as part of your foundation is gonna be helpful, especially when trying to emphasize lipids.
I I'm so sorry. I have my little finger up because I forgot to do something really important.
Oh, yeah.
If you it's [CVV_1]. I'm sorry. I usually do this, like, 20 minutes ago. Sorry. I I have a realtor calling me.
I have 2 Instacart orders going out to people that I care for, so I got a lot going on today. Sorry about that. I wanted to let you know that if you decide to buy the, ZenBiome Dual, I'm really okay. We'll do anything for Microbiome Labs within the next hour, so let's call it 4 o'clock EST almost, so 5 o'clock EST. We will be sending you a session, that we did with Kieran Christian, who's the cofounder of Microbiome Labs, I will show it to you very quickly.
Let's see. This is you would have to send your, proof of purchase to info atcbo, sos.com. Right? Right, Clarissa? Help me out there.
Alright. This is you. Oh, here we go. Zoom. Share screen just real quick.
Boom. So it's probiotics from a microbiologist standpoint with Karen Krishnan and, one one of my team members, like, are we sending part 1 or part 2? I'm like, you gotta send both. You can't just send part 1. So it's a 2 parter, and it's a wonderful, wonderful conversation had with Kieran.
Refrigeration, about probiotics, myths in the industry. So if you wanted to receive that for free, usually, we charge for that, then go ahead and after you place your purchase within the next hour at microbiome labs, send us your proof of purchase info@sivosos.com, and then we'll send you the link. There you go. Yes. We're gonna send out the presentation today, in the replay email that'll come out in a little bit.
Patrice has been asking, are you familiar with Presidium Biotics with lactose and longum to shield EMF impacts? Have you heard of this? And it's okay if you haven't. It's okay.
I have not. I would say I'll have to look into.
So I actually did a webinar with the gentleman that, created it. It's very, very interesting, Patrice. Awesome. I I after listening to him for an hour, I'm a believer. I it was really fascinating.
So there you go.
It's just more to come as we're finding more strains that have these unique properties, and that's, you know, the next gen world. That's why we call that next gen world.
Exactly. Lisa, you're getting ready to start XIFAXAN. When can I incorporate ZenBiome after the XIFAXAN treatment? I would actually do it before or during. That's what doctor Siebecker was saying.
Like, you don't wanna do it after?
No. I would do it during.
Okay. Right. Okay. How long does it take to see improvements? Karen's asking.
So what I asked you before we Sarna,
is Yep. So in this so in the studies, we we see improvements by 4 weeks, generally speaking, and that's, you know and and then some of the so pretty significant Shivan improvements at 4 weeks Sarna then, further improvements by that 8 week time period.
Okay. Alright. And everybody's different. That's the whole point. Right?
I mean, I've had some people that told me they felt better within, you know, a week of starting it. So you do you just everyone is very different.
Okay. Alright. I have a patient history of degenerate digestive discomfort. Methanecebo 2021, chronic stress, bloating, and discomfort. Need a holistic practitioner who can help resolve the the the which oh, don't be overwhelmed, but I understand, Linda, why you might be.
Clarissa, can you reach out to Linda with the list and with some some resources there? Okay. Catherine, what is good? I did that one. Anne, I'm so glad you're here.
Man, I'm excited for you about that UTI business there. Okay. For clarity, dual zen or ZenBiomeduo plus Megaspora Biotic or just duo? So go ahead.
Yeah. I like both. I mean, again, Megaspor has a different mechanism of action. We know we've done studies on increasing microbial diversity, which is such an important aspect to having a healthy microbiome. Whereas ZenBiome Dual, I would target for, obviously, anyone suffering from any disorder of gut brain dysfunction and IBS and SIBO and mood disorders, anyone who obviously have a lot of inflammation, and just be sure to take it, you know, separate.
Okay. Bonnie, I wanna make sure you've got the right links because the coupon number doesn't work. It's not a number. It's nobloat15, and you have to kind of go register for account, which is, like, name and email basic. Then you then you'll have a patient direct code, which might be auto populated, and then coupon code no bloat 15.
Okay. Eileen, I would if you're in Phoenix, you're looking for a functional gastro, I would go to Mona Morstein. She, I think, is in Phoenix. Mona Morstein. Wonderful.
Tell her we said hi. And then there's Clarissa just put it in the chat. Okay. If someone we're almost done. If someone has an existing sensitivity to tryptophan and cannot eat tryptophan producing foods without getting ill, like, I guess, turkey, Does this probiotic help with balancing tryptophan?
My son has become ill on 5 HTP in the past, and it has been recommended that he not be given SSRIs. I've been trying to find how to regulate naturally produced tryptophan in his body as possibly affecting his mood and behavior.
Absolutely. And I've been too much for this conversation here, but I think there's a lot of people who don't react well to things like 5 HTP or l Glutamine, and it has a lot of it does reflect back on this tryptophan dysregulation. And so, essentially, if there's inflammation, any tryptophan that's being ingested, right, because we know it's an essential amino acid, this this strain, the 17 14 strain, is gonna help to make sure that the tryptophan that's coming in is being is being, shuttled down its neuroprotective pathway to be able to produce endogenous serotonin and melatonin. So it's not, like, taking the end product. It's taking the strain that's gonna hopefully encourage a better product production of serotonin.
Alright. Bonnie, can you reach out to, Clarissa? And she's in the Siebecker SOS support. Bonnie's having a hard time ordering. She's saying that it said expired.
Has anyone else had a problem ordering? Usually, I hear about it by now. So thank you, Bonnie, for letting us know. It said expired. Sarna, can you just confirm with, y'all's y'all's come come customer service to make sure we're okay?
You got it.
Please. Thank you. Alright. Thank you all so much. Sarna, great job as always.
Thank you for having me. I love this topic so much, so it was fun to
Really? I couldn't tell.
I just say I'm such a nerd when it comes to the science of it. It's so unique. So, hopefully, you guys got some little nuggets.
I mean, this really is cutting edge. This is like we're doing the next gen. This is that next gen, and it's right here for you. So, definitely, email us at info at CboSOS with your proof of purchase, within the next hour. Okay?
So really seriously within the next hour. This is a webinar only bonus. Thank you for that, and then we'll get you the the Shivan Krishnan, presentation as a, you know, in in webinar purchase bonus even though I'm sending it an extra hour spending an extra hour with y'all because, I forgot to to say that. And thank you very much, and, we'll see you next time.
Yep. Thank you for having me.
Okay. Take care. Bye bye. Bye bye. Bye.
Alright. Thank you very much, Clarissa. Appreciate you. And, Floris, so I would definitely try this, but I would definitely also look at a treatment for your methane and hydrogen SIBO. We do have SIBO recovery road map course that takes you through all of this every step of the way.
Also, my book talks about it. So that's $20. The course is, like, 2.90 7, I think. We also have small group coaching with doctor Allison Siebecker, which is a premium pricing. But I just wanted to give you the 3 choices so you can really get a lot out of the book.
You can also join the Cboe SOS Community Facebook group where that's free, and there's tons, like, 30,000 people, and they're talking Cboe every single day. Thank you all so much for joining me today. I really appreciate you as always. And, just in terms of upcoming on a week from today, so that'd be April 16th, 2023, we do have Sarna Krishnan coming back to talk about SIV, his new Sarna care serum that is, a spore based probiotic acne and skin care antiaging serum. He sent me some.
I have a small psoriasis patch on my leg, and it changed it. So that is huge. I mean, most topical things you put on psoriasis doesn't change it. The before and afters of this product for acne are phenomenal. They're doing other studies for enlarged pores and all of that.
It's wrinkles. I mean, it's wild and so exciting, and it's not just like taking Megaspore and putting it in the serum and slathering on. There's a special formulation to it, and it's actually not that expensive. It's, like, super crazy good, and we have a discount for you that day. So, that is next Tuesday.
What else am I doing? This Thursday, I'm doing a presentation with Sinclair Kineli on parasites. Good time I've had by all. If you want information about that and you haven't received the invite yet, you can email us at info@cbosos.com, and we'll definitely be emailing about that on, tomorrow. Okay.
Thanks, everybody. Alright. Thank you. Hugs to Petunia. She sends her best.
Thanks, Clarissa. Alright. Talk to y'all next time. Bye. Thank you.
I'm excited for you.

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// About: Kara Siedman

Kara Siedman is a registered dietitian, clinical liaison for Microbiome Labs, and certified diabetes educator with more than 13 years of clinical experience. Most recently, Kara spent the last 8 years working in a large gastroenterology practice having built a program focusing on integrating functional medicine and nutrition into their patient care model. With a strong focus on the microbiome and overall health, Kara has guided many patients on a journey to reclaim their health and well-being. She continues to grow her knowledge in this evolving field with a goal of not only providing the tools for patients but also offering up-to-date and current research surrounding all things microbiome-related.

Shivan Sarna is the author of Healing SIBO, TV host, and the creator of the SIBO SOS® Summits and Community, the Digestion SOS® documentary series, the Gut & Microbiome Rescue Summit, the Lymphatic Rescue Summit, the Dental-Health Connection Summit, and Chronic Condition Research, a 501(c) 3 non-profit to further research under-funded medical conditions. After a lifetime of struggling with health issues, Shivan made it her mission to demystify her own health struggles - and to share that information with others who were struggling. Her special skill is finding and connecting with the leading expert doctors and connecting those experts with the people who need their help. Her personal mantra is SOS: Save Our Selves, and that's what she has helped thousands of people do! 


 

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