August 28, 2021
From podcast: https://bengreenfieldfitness.com/podcast/andrew-kornfeld-and-amy-loftus-ibd/
[00:01:44] Podcast Sponsors
[00:04:16] Guest Introduction
[00:05:52] Andrew and Amy's Experiences With IBD
[00:13:30] Predisposing Factors That May Make Someone Susceptible To IBD
[00:17:40] How IBD Causes Drastic Consequences to Health and The Body
[00:20:55] The Best Test to Determine If You Have or Potentially Have IBD
[00:26:11] 3-Step Model to Treat IBD: Step 1: Reduce Inflammation
[00:29:45] Podcast Sponsors
[00:32:05] cont. 3-Step Model to Treat IBD: Step 1: Reduce Inflammation
[00:33:10] Step 2: Nourish the microbiome
[00:39:24] Step 3: Repair the barrier
[00:45:10] How Neuroplasticity Affects Causes and Treatments For IBD
[00:48:36] How the IBD coach program works
[00:50:00] Biggest Mistakes People Make When Diagnosing or Treating IBD
[00:52:07] The Best Diet When You Have IBD
[00:59:36] Using HRV Tracking to Consume Food Wisely
[01:03:15] The Epidemic in America That Misses the Front-Page News
[01:07:39] End of Podcast
Ben: On this episode of the Ben Greenfield Fitness Podcast:
Andrew: Get IBD patients into remission and get them to live their lives again and be able to eat what they're going to be able to eat, not worry about something causing them to go run to the bathroom 20 times a day. New synapses are being formed. Some are being strengthened. Some are being weakened. And, new brain maps are being created as learning takes place. If you come and you join our community, we will literally keep working with you until you are healed, and we will not stop until we are done.
Ben: Health, performance, nutrition, longevity, ancestral living, biohacking, and much more. My name is Ben Greenfield. Welcome to the show.
Hey, this podcast that you're about to hear is actually the second in a couple of podcasts I recorded at the Ancestral Health Symposium. You can check them out at AncestryFoundation.org. I recorded this down in Los Angeles, walking on the beautiful sunny UCLA campus, with two new friends I made down there, Andrew and Amy, who are specialists in irritable bowel–inflammatory bowel, I don't remember, the IBD word that stands for something that you'll learn about in today's show. Anyways, no, I'm not joking. It's an important topic. And, you may think you know what IBD stands for. But, perhaps, you do not. And, perhaps, I'm playing stupid, just trying to lure you into listening to this podcast. Anyways, though, it was a great chat and super relevant if you have gut issues. All the shownotes are going to be at BenGreenfieldFitness.com/IBDPodcast.
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Well, I'm at the Ancestral Health Symposium. And, you may already have heard some other content that I put out while down here at this fantastic event, but there's a couple of folks I met who are particular specialists in what's called IBD. And, I know that a lot of you have struggled in the past with gut issues. I get tons of comments and feedback about just the uphill battle a lot of people face against digestion, constipation, bowel movements, what foods, as confusing as it can be, can seem to trigger it, what foods seem to help it. And, anyways, the two folks who are out on a walk with me today–Say hello, Amy and Andrew.
Amy: Hi, there. I'm Amy.
Andrew: Hey, I'm Andrew. It's an honor to be here.
Ben: Well, I've been hanging out with them a little bit down here. And, they presented a poster, which actually makes you guys sound really smart, poster. And, what that means is they basically laid out in a really beautiful well-thought-out way, really, how to deal with IBD and how it happens, in the first place, and their unique approach. I thought that they had some information on there that I really hadn't seen before and that I wanted to unpack with them. So, that's what we're going to do for you guys today.
But, actually, before we jump in, I was asking you, Andrew, out in the lobby if you'd ever done a Rapé, the alkaloid-infused plants from the Amazon —
Ben: –that you got to huff up each nostril, sometimes, for ceremony before you'll do, I don't know, the frog poison combo.
Ben: Or, sometimes, the warriors down there. The hunters will do it before they go on a hunt to improve sensory perception. Some people do it before breathwork or before meditation or before plant medicine ceremony. But, I got a shipment of all these different varietals of this Rapé from a company called Planet Combo right before I came down here on this trip. And so, I had a few in my bag and one of the karipe that allow you to huff it up each nostril.
Ben: I did a little Rapé ceremony this morning, actually.
Andrew: How are you feeling?
Ben: Well, after the sensation of burning out the entire back of my eyeballs went away, I'm doing pretty well. But, up until about 15 minutes ago, I was seeing stars.
Ben: Whatever they sent me was pretty potent stuff.
Andrew: So, Ben, let me just say this real quick. If someone has IBD, which is inflammatory bowel disease, there's a difference between the two main types of IBD in relation to something like Rapé, because Rapé contains nicotine. Is that correct?
Ben: Yes. I think it's one of the primary active constituents.
Andrew: This is such an interesting place to just say something really weird about this disease and really weird about human health.
Ben: You mean about IBD?
Andrew: Yeah. I have Crohn's disease. And, nicotine, for someone with Crohn's, for me, it's okay, but usually, for almost everyone with Crohn's, it's really a risk factor in the disease. It makes the disease worse. People don't do well. The opposite is true for ulcerated colitis. That nicotine acts crazy, that we don't understand why that nicotine actually seems protective and that ulcerated colitis comes about often when people quit smoking.
Ben: Wow. It seems like nicotine–because I'll chew nicotine gums sometimes or use one of the lozenges, or even do the Rapé, like I mentioned, it seems irritating and harsh. I wasn't sure if it was the other plant constituents that come along with it that do that. But, the fact that it seems to do that in just a gum or a lozenge, it makes me wonder. If it makes the inside of your mouth burn, what it do to the rest of your digestive tract, once it gets down the back of your throat or whatever.
Andrew: Well, it's clear that nicotine has some immunomodulatory effect. And, I think that's probably where it's coming from.
Ben: Interesting. So, I guess, since you already have been hogging the mic, Andrew, geez.
Ben: Come on, man. I'm going to go to Amy first because what I'm curious about is if you–As you mentioned already, Andrew, you had Crohn's. What about you, Amy? Is this something that you have experienced with yourself? Have you had IBD?
Amy: So, I am one of the few people on our many person team who actually does not have IBD.
Ben: When you say our many-person team, you mean you guys' IBD coaching program?
Ben: Got you.
Amy: So, on staff, which gives me a unique perspective of a person who lives with someone who has IBD. And so, I do a lot of family support for the loved ones of our members. But, also, has some limitations, where I can see what is going on from the outside, but I have never experienced the type of GI conditions or symptoms that our members go through.
Ben: Well, you just get to rub that in everybody's face.
Amy: I have my other chronic conditions that I'm dealing with.
Ben: How come you? But I have the perfect gut.
Amy: But, as far as gut issues, I seem to have gotten lucky-draw that one.
Ben: So, is this something that you studied? Do you have a degree in or some background in health sciences?
Amy: So, I studied anthropology and have a pretty winding career with it to get me here. But, the way that I got involved with this is actually that I am married to Andrew and have lived with him for the last seven years through his condition. And so, when he started moving in the direction of helping others with the condition, it seemed like the natural thing for me to join on as well.
Ben: Interesting. And, your background in anthropology, I would imagine, has been able to steer you in the direction of the ancestral approach that you guys say.
Ben: Which we'll get into, I'm sure. Andrew, how bad was your condition?
Andrew: I almost died, Ben.
Ben: You almost died?
Andrew: It was serious, yeah, at one point, when I was diagnosed when I was about 16. So, I just want to say. Do you want us to tell people what inflammatory bowel disease is?
Ben: Yeah, for sure. Although, of course, I'm certain some people would love to hear that personal perspective on you almost died because that's crazy.
Andrew: Let's just remember that it's different than irritable bowel syndrome. This is not something that —
Ben: So, IBD is not irritable bowel disease.
Ben: What's IBD actually stand for?
Andrew: So, IBD stands for inflammatory bowel disease. And, it's a condition that affects some millions of Americans. It affects millions of people around the world. It's a serious inflammatory condition that affects different parts of the gut. Crohn's disease affects any part of the gut, but often, terminal ileum, small intestine. Ulcerated colitis affects the colon. I was diagnosed with Crohn's. It was a very serious case. I was losing a lot of weight.
Ben: How do they diagnose that?
Andrew: They diagnose it usually with a colonoscopy. But, they're seeing that mine–This is back in 2006 when I was diagnosed. They're seeing that my inflammatory markers are high. They're seeing that different markers are out of whack. And, I was going to the bathroom 20 times a day.
Ben: Holy cow.
Andrew: It's a very debilitating condition. And, it can be very serious. I actually have a great uncle who, in the 1940s, was diagnosed with something they didn't know what it was back then. And, he was just pumped full of steroids. And, he passed in his early 20s. So, clearly, there's probably some genetic component to this condition. It's highly lifestyle based.
And, what happened was is that I was given powerful immunosuppressive drugs, a specific drug that goes into the bone marrow. It sensually turns off white cell. White blood cell production goes into the DNA [00:12:24]_____. It's pretty nasty medication, but it was often used as an old-school medication in IBD. It helped me, maybe, to the point that I was functional and I was no longer in, probably, the immediate danger, had a lot of side effects.
But, I was able to matriculate to the University of California. I studied neuroscience and psychology. And, we did a lot of interesting things there, but it wasn't really until I graduated and had, essentially, a very severe flare, even though I was on these very powerful medications that I was having side effects to, that I really discovered a systems-based lifestyle approach that really incorporates concepts like neuroplasticity, ancestral health, first principles, into designing a protocol for myself that, ultimately, I think saved my life.
Ben: I definitely want to talk about neuroplasticity later on because you mentioned in your poster now that's not a word you see thrown around in the context of IBD. It's actually not a word you see thrown on a cocktail parties, in general. We'll get into neuroplasticity later on.
Andrew: You're not at the right cocktail party.
Ben: I guess so. So, when it comes to predisposing factors or the reasons people would get IBD–You talked about your uncle. It was your uncle, right?
Andrew: Great uncle.
Ben: You're great uncle, your fantastic great uncle. He seemed to imply, or you seemed to imply, that it may be genetically related. But I'd love to hear a little bit more about that or any other predisposing factors that actually cause someone to be more susceptible to something like IBD. And, you guys can just tell me–Just to open the kimono for you guys listening in, I got Andrew walking on one side of me and Amy walking on the other side. So, they'll just elbow me with who wants to answer that question.
Andrew: This disease did not exist thousands–millennia ago. And, I think Amy can attest to that in her studies of anthropology at UC Berkeley. It's obviously, sure, there's probably a genetic component, but we know that there are multiple factors that have contributed to this. We see distinctive microbiome profiles. Lucy Mailing can tell you all about it. She's on my science [00:14:34]_____.
Ben: She's a gut expert. She's been on my podcast before. She's incredible.
Andrew: We can see the differences between the microbiomes of people that have IBD and those that don't. There are very distinctive markers between all ulcerative colitis, Crohn's disease. We see immunological overreactions. We know that stress, psychological stress, almost certainly plays into it. Diet often plays into it. The rise of the standard American diet, feeding inflammatory microbes, this is probably the problem. And, you know, Ben, IBD is not–It's interesting because it's not a traditional autoimmune condition. In a traditional autoimmune condition, something like rheumatoid arthritis or lupus or something along those lines, you actually–I believe, you see antibodies against tissue of the body. Whereas, in IBD, what's happening is that there's a leakage of bacterial organisms, of food particles, of the other constituents of the microbiome, and, essentially, leaking across that mucosal membrane of our guts, of that first layer of cells, into an area called the lamina propria. And, in that area, there's an overreaction by the human immune system.
Ben: Is that lamina propria considered to be in the gut? Or, is it in the bloodstream?
Andrew: So, the lamina propria is a space that's described in multiple parts of biology that's below an epithelial layer of cells. This is just a biological term that I'm using. And, what we see is there's an overreaction to these bacteria because they're inside of this first layer of cells. They're in the wrong place. And, the immune system says, “Hey, this is not right.”
But, there's obviously a reason why they're leaking across. So, sometimes, we see dysfunction in what are called tight junction proteins, which are between the cells of the gut. We see dysfunctions in certain interleukin factors, certain cytokines, one called IL-10, which is in charge of the anti-inflammatory response. And, this is really the pathogenesis of IBD. I think all of us —
Ben: Pathogenesis, meaning how the disease genesises, how it occurs?
Andrew: Correct. Look, a lot of us have leaky gut. I think a lot of this bacteria and stuff is leaking across our membranes, especially those of us that live in modern society. The difference is that people with IBD, we are those that react to it. And, that has devastating consequences because if your small intestine, where you're digesting your food, or even your colon, is so inflamed, it no longer functions. And, obviously, in Crohn's disease, me, I was extremely malnourished.
Andrew: I wasn't able to digest my food. And, it's a horrific disease. And, outcomes right now for this condition, just like other chronic conditions, are very poor in the United States.
Ben: Did you ever do a vitamin IV or some way of delivering food or what you'd be getting from food right into the bloodstream? Do people do that to just say, “I'll screw it. I'm going to pass the gut just to survive. So, I figure this out and just get IVs?”
Andrew: Absolutely, people need to do that often. It's a last resort, maybe, before surgery, before something is going to be removed. But, these days, they don't even do that. They just are very quick to take a section out. And this is the thing, is that, many of our members have joined the program, at least, two or three of them, just days before they were going to get their colon removed.
Andrew: And, they have been able to keep their colon in our program.
Ben: Oh, my gosh. Imagine that, you get to —
Amy: Literally saved [00:18:16]_____.
Ben: You're going to cut out the gut. Why wouldn't you want to get your colon remove? Explain that to people? Or, at least, not the whole thing, but they cut off a part of it.
Amy: So, each part of your digestive system really helps with the absorption of different nutrients. And so, if you would remove entire inches of this, not only are you limiting your ability to absorb the nutrients that get absorbed in that area, but, also, the colon is a host to the entire gut microbiome and all of these little beings that live inside us that help us digest our food.
Ben: Like the appendix. The appendix houses some of the information about your microbiome as well. So, if you get that removed, isn't that a similar situation, it's not a throwaway organ?
Amy: I don't think that there's anything in the body that is really superfluous. [00:18:58]_____ that.
Ben: Hair, mustaches, maybe.
Andrew: So, look, if you have your colon removed, that is the housing of your microbiome. So, someone without a colon doesn't have a traditional microbiome. And, we know from research by Lucy Mailing and other experts of the microbiome that this organ, this ecological organ now that we're calling it, synthesizes vitamins, synthesizes neurotransmitters, is involved in metabolism, helps us digest our food. The list is endless.
Ben: If you get part of the colon, take it out, does the rest take over and do those things? Or, do you really see a remarkable change in colonic floor or something like that? Do you guys know?
Andrew: In ulcerative colitis, it's rare that only a section of the colon would be removed.
Andrew: 98% of the time, they just take the entire thing.
Ben: Oh, my gosh. Wow.
Andrew: Because they're just at the point that it needs to be removed. There's no point of even saving it. And, these poor individuals are then left to essentially excrete their waste into a bag. And, it's hard. It's a hard way to live. It's no way to live.
Ben: It's a sad way to treat things. Obesity, gastric bypass, just tie it off. IBD colon, just cut it out.
Amy: Snip, snip.
Ben: And snip, snip, cut, cut. So, you mentioned something when you were discussing the predisposing factors to IBD. Andrew, you did about the microbiome and about how it's different in people with IBD. There's all these different ways to test the microbiome. We've got companies like Viome or uBiome or Onegevity doing the genetic analysis. There are other companies–And, this is usually what I find to produce more actionable information, but I don't know what your take is on this, like Genova Diagnostics that are doing the three-day stool evaluation for parasites and yeast and fungus and inflammatory markers and things like that.
But, when you talk about the microbiome being different in IBD, is there a test that people can get that says, “Oh, my gosh. The ratio of this bacteria XYZ to this bacteria ABC indicates that there are some serious issues going on here?”
Andrew: Yes, absolutely. I think, though, that we are at the point where these microbiome tests are more interesting than they are actionable right now.
Ben: But, what about–I guess what I'm asking is what bacteria would you actually be looking at?
Andrew: So, we see that certain keystone species–And, I'm going to ask Amy for some pronunciation here. We know that fecal bacteria in [00:21:37]_____. I think that's pretty good. Right there, we see that almost very, very low in Crohn's disease and ulcerative colitis, acramensis [ph]. That's another one that Lucy talked about in her talk. Very highly implicated in ulcerated colitis.
So, yes, it's important that we get the microbiome tested and we see that eventually, but right off the bat, that's probably not the most important thing to do right now, because when people come into our program, they're flaring out of control. Often, they're running the bathroom 20 times a day, they're on a lot of medications. And, we help them to, essentially, build a robust and comprehensive, holistic, multidimensional protocol, working in collaboration with their health team and other factors to make it happen. But, the microbiome tests becomes more important as they become more advanced. But, a lot of the time, it's confirming what we already know. We see the patterns that are already documented in the literature. So, initially, it's safe to just assume, obviously, this person has an altered microbiome.
Ben: You're bleeding out your butt. We don't need to test that type of thing.
Ben: So, you mentioned genetics. If somebody's got a 23andMe or some other genetic tests, is there a SNP that you could look at that you would see and it would show you that you might have higher susceptibility?
Amy: Yeah. So, I think the parting line usually is that there's over 200 genes, whatever that means, implicated in predisposition for IBD, but none of them are a defining factor. You wouldn't be able to get the same details from your genetic profile that you would for something that is a lot more targeted. And so, knowing that there's over 200 genes potentially implicated in this condition, it becomes more important to pay attention to environmental factors.
And, we see that a lot, that people who come to us and people that we interact with in the IBD space have other stuff going on in their life, whether it's intense acute trauma or they're overworked, or we have a lot of people who are in caretaking professions, like teachers and nurses, who tend to get this condition. There's definitely something there.
Ben: I have talked to so many people who had great guts till they were 25 or 27 or 30. And then, they have a house fire or a relationship breakup or stressful traumatic event, and all of a sudden, they have IBD. And, that's just something that seems to materialize as a response to stress, in many cases, rising. Is that what you guys have experienced?
Amy: Absolutely, that on top of the standard American diet, on top of the lack of nature that we all get out. A lot of these factors play into it.
Andrew: So, let's think real quick about fight-or-flight and the stress response and why that might cause chronic conditions in general or inflammatory bowel disease. Again, we look at IBD as an entrance point to human health right now. But, why would the stress response cause or worsen IBD? Well, Ben, if we're walking here, transported back in time, and we run into a California grizzly bear —
Ben: Or, big scary UCLA frat boy.
Andrew: Exactly. We're going to be having a lot of stress hormones that are pumping through our body, cortisol being one of them. Let's just remember cortisol, my understanding is that it's, essentially, a resource-driven hormone. And, we're taking away resources in the form of glucose and adenosine triphosphate, ATP, that you all learned about in AP biology. We're taking those resources away from organs of the body that we don't need in an immediate fight-or-flight situation. What are those? We don't need to be fighting microbes if we're trying to run away from frat boy. We don't need to be digesting our food if we're trying to run away from frat boy.
Ben: We don't need to make babies.
Ben: So, you see all the endocrine system downregulation.
Andrew: Exactly. We don't even need to be storing memory in the same types of way. So, there's actually brain damage that's occurring —
Andrew: –in the hippocampus of the brain. So, obviously, there's a dysregulation of the immune system. And, a disease like IBD or any other autoimmune or inflammatory condition will tend to spiral out of control when under a lot of stress.
Ben: That actually makes me think of something I saw on your poster as a potential treatment strategy. You guys list vagal nerve stimulation. And, I know that that's something that people have like amped-up nervous systems seemed to benefit from, some type of vagus nerve work, including the use of such stimulators.
But, perhaps, I'm putting the cart before the horse because you actually have a whole three-step model that you guys use. And, I would love for you to get into what the three steps are and what people can do.
Andrew: Sure. So, we looked at IBD, and we looked at it from a scientific perspective, and we looked at the current treatments. And, what I noticed is that the science doesn't seem harmonious with clinical practice. As in such many chronic conditions, there's a disconnect between the researchers and between what's actually happening. And, the most common mechanism to treat IBD right now is to intensely stop the inflammation by blocking certain cytokines, the most notorious being tumor necrosis factor-alpha or TNF.
So, what we see essentially is that there's a lot more than just the inflammation. So, in IBD, we see that there's, like I said, microbiome imbalances. There's barrier issues. And, there's also inflammation. So, our first step is to, of course, stop the inflammation. You have to stop it in some type of way. Sometimes, they —
Ben: And, that's always step one?
Andrew: It's got to be step one. If your inflammation is high, we got to get that down in some type of way. And, we can throw all the amazing anti-inflammatory foods and all these other things. But, at the end of the day, sometimes, pharmaceutical therapeutic interventions are needed here, either in the form of Prednisone or in the form of biological therapies, if the patient doesn't respond.
Ben: Well, what about peptides? There's that one body protection compound that they say is actually found in the human gut. Some docs, even though the FDA seems to be cracking down on these, using TB-500 or thymosin alpha. Have you looked into peptides as a potential?
Andrew: Absolutely. And, I use BPC 157 from time to time. I've noticed a lot of benefit from using it. But, again, like any supplement here, it's just part of the picture. It's part of a much more complex and multilateral, multi-dimensional approach that we take to this condition.
Ben: Are there any real foods or herbs or spices you would work in to downregulate inflammation?
Andrew: Yeah, sure. I'm going to let Amy take it out.
Amy: Our go-to anti-inflammatories tend to be things with turmeric in them. Though, that's an important thing to remember with people with IBD, that turmeric can contribute to more bleeding, if bleeding is a thing that your body is currently prone to.
Ben: And, correct me if I'm wrong, but when turmeric is consumed along with bioperine, the active component in black pepper, which can increase its absorption, I think it can be even more irritating because of the pepper component.
Amy: I've definitely heard about the black pepper thing and wanted to know what the latest was on it.
Andrew: It's a controversial–I think, adding the black pepper, there's a lot of debate on it, even among GI doctors who are using this, of whether to put the black pepper in the turmeric.
Ben: Well, I guess the word on the street is, from the research that I've seen, is that turmeric combined with bioperine, or black pepper, extract increases absorption and allows for a better systemic anti-inflammatory action of the [00:29:25]_____ and the tumerosaccharides and everything. But then, if you don't combine it with black pepper, apparently, it stays in the gut longer and has more anti-inflammatory activity localized in the gut.
Amy: Well, I just learned something new. That makes a lot of sense. And, I want to look into that more. So, that sounds really actionable for our folks.
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Ben: So, we got turmeric, what about ginger?
Andrew: Ginger is really, really helpful. I think the one that we're finding to be, I'm not going to go so far as a game-changer, but in terms of inflammation, this quercetin just seems really, really powerful as both an antioxidant and also an anti-inflammatory.
Ben: It's super. Quercetin and oleuropein and a lot of functional medicine docs I know, they're prescribing those peptides I talked about for long haul COVID and even for a lot of the acute inflammatory reaction to the initial onset of COVID. It would make sense that if they're that powerful at quelling that inflammatory firestorm, that they could potentially be beneficial for quelling the inflammation from IBD.
Andrew: And, there's a lot of other supplements. But, I do want to just emphasize that people tend to have this notion of supplements that they're going to be these magic fixes. I'm just going to take one of them. And, they are supplements. If you're not practicing a robust dietary strategy and a robust lifestyle protocol, stress-reduction protocol, don't even bother with the supplements. We're not even there yet.
Ben: Yeah. I want to get into diet in a little bit, but then–So, we stop the inflammation. And then, what's step two?
Andrew: So, step two is to then, essentially, really look at the microbiome and see, this might be a chance for us to do a test right there, but to help clients to nourish that microbiome through eating different prebiotic foods. We know that flavonoids are prebiotic. Quercetin's probably prebiotic as well, as anti-inflammatory certain fibers and resistant starch can be helpful.
Ben: But, I'm going to interrupt you because I do a really good job derailing people. And, that's exactly what I'm doing to you, just messing with your head. See how all that neuroplasticity is coming for you. But the–Now, I just derailed myself. The thing with the resistant starches is those seem to give a lot of people really bad gas and bloating, like inulin and chicory root and stuff like that. Are there resistant starches or prebiotics that don't seem to cause as much bloating or fermentation?
Andrew: So, yes, a lot of people–Let's just remember that IBS is a different condition than IBD. And, yes, there's a lot of comorbidities between them, between those two conditions, but we see more of the gas and bloating in IBS. That's not to say it doesn't happen in IBD. But, there are probably, actually, some things that people with IBD. I don't have IBS. I just have IBD.
Ben: So, for you, it's not bloating, gas, constipation.
Ben: It's more just pain, inflammation, that type of thing?
Andrew: Absolutely. We need to–Diet is a crucial, crucial factor.
Ben: What kind of probiotics do you use?
Andrew: I really use the term, “Pandora's box,” when I think of probiotics. And, I think Lucy's teaching has been–
Ben: Lucy Mailing?
Andrew: Lucy Mailing. Her teaching has really been, look, just because there's a specific species does not even necessarily means maybe it's the same species you see written on the probiotic bottle because there's a strain difference. And, companies, they're not even required to tell you what strain they're using. And so, really, when we're looking at the scientific evidence and even the practical evidence with IBD and probiotics, it's all over the map.
With that said, I would say that, probably, most probiotics tend to work a little bit better in ulcerated colitis rather than Crohn's. Crohn's is a little bit more mysterious in some ways than ulcerative colitis, a specific probiotic called Visbiome.
Ben: Is Visbiome the brand name, or is that the bacterial strain?
Andrew: It's also used to be referred to as VSL#3.
Ben: I've heard that one before. There was some sort of lawsuit.
Ben: What happened?
Amy: There is some lawsuit and some sort of drama. And so, it's important that what you now see as VSL 3 is not the same as what it used to be. So, Visbiome is the new name.
Ben: I think it was Dr. Rhonda Patrick who was a big fan of VSL 3 for the biome. So, anything aside from you said Vizeum?
Ben: Visbiome. By the way, for everybody listening in, I'll make shownotes and I'll put them at BenGreenfieldFitness.com/IBDPodcast. That's BenGreenfieldFitness.com/IBDPodcast. So, I'll make sure I get the spelling right, and put it on there for you, guys. Any other specific probiotics?
Andrew: There's a couple of specific strains. There's actually a form of E. coli called E. coli nissle that might have some positive evidence in IBD. But, it's very hard to get. Bacillus coagulans, certain sub-species of that, maybe, promote fecal bacteria in [00:36:40]_____. Again, I would just say it's probably a better idea to just get your probiotics from sauerkraut or from kimchi or something fermented, given until we really understand what the [BLEEP] is going on.
Ben: What about swallowable poop pills or fecal microbiota transplants, actually getting the stool from a healthy donor up your backside, or, because I've heard that this can be as effective, using an oral capsulated fecal from a healthy donor.
Andrew: Amy, do you remember that time that I was just super sick, and I was like, “Baby, will you give me your poop? Can we try that?”
Amy: [00:37:20]_____ about it.
Andrew: [00:37:24]_____ I would say.
Amy: What a date. It's definitely still too early to tell. I think the importance of it being a very healthy host is really key here because you could be —
Ben: Well, duh.
Amy: What is healthy me?
Ben: That's true.
Amy: What's healthy for you mean something different than for my body. I don't have IBD, so–
Ben: It's like playing with fire. I've always thought of it CRISPR gene editing. It's like, “I don't know. We really don't know all the downstream and implications of somebody else's entire biome replacing or getting added to yours.”
Andrew: There appear to be super donors. There's these super donors that have way better of an effect than everyone else. And, that's what the studies are showing. But, we don't know how to identify the super donors. The only way is to start testing them. So, I think, if we were going to really pursue [00:38:13]_____.
Ben: I'd be honest with you, actually. Look at the shape of their butt. They're a super donor, for sure.
Andrew: We need an Olympic training program for these people. You know what I mean? They need to be microbiome Olympic athletes. You know what I mean? And then, they also need to be tested in practice and see how their shit affects people with IBD because it does appear that some people just have some better composition, and they just tend to–Higher percentage of time, we see a positive correlation impact.
Ben: I could totally see that happening, us actually having facilities for super-duper healthy people live or identify, that you go to them for your sperm, for your poop, for your fecal matter, or for your kidneys.
Andrew: Imagine if you got paid 750 bucks every time you went poop. How cool would that be?
Ben: Amen, amen.
Amy: The important thing, though —
Ben: I'm totally [00:38:58]_____, Amy.
Amy: It can scan it, too, for the quality.
Ben: They actually are making smart toilets now that can analyze your stool.
Amy: That makes sense, that tracks. But, some of the early evidence that we are seeing with people with IBD is that people with ulcerative colitis would be in the population that would have slightly more chances of success, whatever you call that, than with Crohn's disease.
Ben: Got it. So, we stop the inflammation. Then, we rebuild the microbiome using a lot of these bacteria and prebiotic type of strategies that you talked about. And then, what's step three?
Andrew: Step three is to repair the barrier, Ben. And, this is the part that's just completely ignored by mainstream medicine. And, yet, all of the science says, “Hey, there's a barrier issue.” The latest science from Mayo Clinic, the latest science from Stanford, from Harvard, all these are like, “Hey, there's a barrier issue. There's bacterial organisms that are leaking across the barrier.” Okay, guys. So, why are we not doing anything about this barrier? How can we give anything that's going to support this barrier?
I think one really powerful compound to repair the barriers called phosphatidylcholine actually made it to a phase-three trial in ulcerative colitis.
Andrew: That's correct.
Ben: Cool. I take a lot of supplements, not a lot, but I take some of the supplements from Quicksilver Scientific. They're liposomal formulations, but a lot of them have phosphatidylcholine. And, they actually have actual phosphatidylcholine. And, there's a doc. His name is Dr. Goodenowe. He just wrote a book about treatment of Alzheimer's and dementia. And, he has a test called a Prodrome test that actually measures a lot of, I guess, the upstream building blocks for some of these cholines and other amino acids in the body that he calls them–I think it's proteoglycans, but something like that.
Anyways, I did a test with him that showed some of my levels were low for these so-called plasmalogens. And so, I actually supplement with phosphatidylcholine for a while. And then, I retested, and it gave me all the building blocks back.
Andrew: That's beautiful. I think, in the studies, it was done in a delayed-release capsule, or if you have ulcerated colitis or Crohn's colitis, meaning that it's in your colon, you could do it in enema form.
Ben: Phosphatidylcholine, you mean?
Andrew: Yeah. Again, as part of a very comprehensive, multi-dimensional protocol, that might be of extreme benefit in repairing the barrier. Just one example, obviously, the most powerful way we can repair the barrier is to stop the inflammation, is to nurse the microbiome. I think all of your listeners probably know by now that certain carbohydrates feed the microbiome. Potentially, they are essentially transitioned, transformed into short-chain fatty acids, like butyrate, that then feed colonocytes. And, when those short-chain fatty acids, like butyrate, feed colonocytes or enterocytes, which are the cells of the small intestine, colonocytes are the cells of the large intestine, we see the barrier begin to repair, we see what we call deep mucosal healing.
Ben: Now, would that be better, because I've always thought about this, if the issue is in the colon, would it be better to do an enema with probiotics and butyric acid or butyrate capsules that you'd break open into that and then, maybe, some phosphatidylcholine or something like that, and just basically mainstream it straight towards needed?
Andrew: We have several clients right now and several members who are experimenting with enemas. There's a protocol for enema —
Ben: By the way, I do a coffee enema once a week.
Andrew: Yeah, you do. I like it.
Ben: I feel amazing.
Andrew: Probably, not necessarily–I'm not against coffee for people with IBD. You saw me drinking a cup of coffee this morning. No problem. You saw me drinking a cup of coffee and eating some red meat that you gave me.
Ben: That's right. I gave you my leftover US Wellness Meats ribeye steak for breakfast.
Andrew: You literally fed me breakfast. I was so appreciative.
Ben: Actually, you fed yourself.
Andrew: So, look, again, I just want to emphasize that these enemas, these supplements, we've talked about them, they are not panaceas. They're not. And, people tend to look at them like that of, “Hey, this supplement didn't work for me.” Well, what's the relationship between that supplement and your other protocol? What's the context? What's the brand? What are the inactive ingredients in that supplement? What things could have disrupted the barrier?
There's a lot of complexity here and there's a lot of contextual factors. And, it's too much for sick patients to do this all on their own. That's why we have this ecosystem that we're building, that hopefully can be applied to a lot of different conditions one day. We're starting with IBD.
Ben: What about some of the other ones that people talk about a lot, particularly, glutamine, bone broth, glycine. And, colostrum is another really popular one. Do you guys work in anything like that?
Andrew: I'll comment on glutamine. Glutamine tends to be more helpful in Crohn's disease. It tends to be more helpful in the small intestine. I think colostrum–I'm still learning about that one. But, again, just people who are sensitive to milk. Any people who are sensitive to milk, we find that, maybe, that one is just a little bit more difficult for them to digest. But, they could take one that Lucy Mailing often recommends called serum-derived bovine immunoglobulin, SBI Protect, which is I believe–
Ben: It's just got a lot of the immunoglobulins that colostrum would have in it.
Andrew: I found that as a game-changer, colostrum.
Ben: I think colostrum, people who can tolerate it, because I love it. And, I get a tricky gut sometimes. And, colostrum is my number one thing I go to, because it's got growth factors, and it has lactoferrin, and it has some things besides the immunoglobulins in it. However, I think that if people are cautious around dairy, they can just try it and see if it works for them. I don't do well with dairy at all, unless it's fermented. I do fine with colostrum. I think, it depends, I guess. But, coming full-circle, basically, yawing the inflammation or shutting down the inflammation, you are feeding or restoring the microbiome, and then you are repairing the barrier. This begs the question about the stuff that might not be in the gut, particularly, something you mentioned earlier, neuroplasticity.
What's this have to do with either the nervous system or the brain? Why do you talk about neuroplasticity?
Andrew: Well, I think this–I'll give it just a short amount of context that I was very lucky to grow up with my parents exploring places like the Esalen Institute in Big Sur, California, where the notion was that humans have an incredible potential and they can do a lot of things. That's in many places where the human potential movement was born.
Ben: That was a lot of hippies plant medicine and stuff like that back in the day.
Andrew: Correct. Sitting in hot springs, talking about how to make the world a better place. Probably, doing some of the initial psychedelic psychotherapy there. So, naturally, I studied neuroscience and I became very interested in the foundations of the brain. And, I think that is where one entrance point that is extraordinarily powerful for us to influence chronic health conditions is by helping to inspire people, helping to educate them, to teach them biology, and then give them the tools to actually design their own protocol, in collaboration with their medical and health team. And, that's all accomplished because their brain can change, and that new synapses are being formed. Some are being strengthened. Some are being weakened. And, new brain maps are being created as learning takes place in different areas of the brain, as they learn about the different interventions, and as they learn their own body, and as they go through a trial-and-error process to see what's working for them and what's not.
Amy: So many people come to us, and the experience that they've had up to this point has been people telling them what to do, doctors telling them what to do, the internet telling them what to do. And, instead, by way of empowering them with the knowledge and empowering them with the belief that they do have an innate sense of healing within them and cultivating that, then they were able to be informed and make their own choices, in collaboration with their medical team. But, no longer are they sitting and waiting for something to happened to them. They can take action.
Ben: Do you guys actually do things as part of your coaching program to increase neuroplasticity? Are there actually brain games or biofeedback programs or things like that that you're having people use?
Andrew: I think we take a less literal approach to neuroplasticity to that, is that we know that this is just a huge concept in helping them to understand it. I wrote my thesis on how psychedelics potentially induced neuroplasticity. And, I was actually with Jim Fadiman. I was one of the first person —
Ben: He's on my podcasts.
Andrew: We love Jim. Jim is my mentor. And, we proposed that these compounds activate neuroplasticity. And, he's not a biologist. So, I put the biological explanation there. And, we published a textbook chapter. Now, it's been essentially proven that this happens.
Ben: You mean the classic use lion's mane and psilocybin to grow your brain, that type of thing?
Andrew: Sure, or even in a more powerful therapeutic experience. But, what we realized here is that it's not the psychedelic that's causing the neuroplasticity. What's happening is that the psychedelic is lowering barriers of resistance to allow changes in the brain to occur. And, you don't even need the psychedelic. You don't even need that. You need a transformative experience for people. You need a place where people feel loved and held and said, “Look, if you come and you join our community, we will never give up on you. We will literally keep working with you until you are healed. And, we will not stop until we are done.”
Ben: So, your guys' program is called IBDCoach. And, how does it actually work?
Amy: People come to us. And, we get people from all ranges of their experience with their IBD. Some people who are newly diagnosed, some people who've been struggling with it for decades. But, they come to us because they're ready to take action. And so, we have a three-part program that includes an educational experience, getting people back to high school, learning their biology, workshops that we host with experts in IBD, microbiome, diet nutrition. We're starting one on women's health this month.
And so, building that community is that third part where a lot of people with IBD do not have someone else in their life. Increasingly, everyone I talk to seems to know somebody, but it is a really isolating disease. It's not something that you want to talk about at a party, per se. And, we know, also, that IBD is a lifetime condition.
And so, through these three arms of our program, by educating people, empowering them, building a community around them, but also giving them access to expertise, we find that people are able to achieve results that they weren't able to achieve on their own.
Ben: I want to throw you guys a few curveballs, but I always mean to be respectful of my guests and their levels of fitness. And so, are you willing to walk it under loop with me and go through one more series of questions?
Amy: Let's do it.
Ben: Alright, cool.
Andrew: Of course.
Ben: Everybody's got this [00:49:56]_____ Gatorade hydration station.
Alright, so what are, in your opinion, if you could name the biggest mistakes that you guys see people making when they're trying to manage their IBD, either fed by myths in the nutrition or health or diet industry, or just lack of knowledge or ignorance? Is there any big mistakes you see people making over and over again when they have IBD?
Amy: Yeah. So, one of the biggest things that we do when folks come to us is, when you have something like IBD or any type of gut condition, it's really common for food to become this really tenuous relationship. I don't know if the thing I'm about to put in my body is going to hurt me. So, when I find something that works for me, that doesn't hurt me, I'd lean really hard into it.
Ben: Cauliflower rice for breakfast, lunch, and dinner.
Amy: Always, always. So, we get folks who have really, really limited diets. And so, a lot of what we do, actually, is undoing some of that dietary trauma, frankly, and helping them open up. Because, the extra vigilance and stress that comes with such a restricted diet is just compounding whatever else is going on in the gut because there's not direct relationship.
Ben: That happens with a lot of gut issues because I talked to a lot of clients and they're just afraid of food. They just don't know what to eat. And, it gets super stressful. They're not even able to go to parties and stuff without just being awkward and pulling your packet of, whatever, baby food on your purse.
Amy: It's really hard to watch people go through that. So, that's one thing. Andrew, do you have another?
Andrew: Again, I think it's the–to jump off what Amy said. It's that they believe —
Ben: [00:51:36]_____ is the word you're looking for.
Andrew: That's correct. That's correct. That people think there's a silver bullet, that this one medication is going to work, this one supplement going to work, this one diet is going to work. It's this you got to get out of this mindset of that there is a silver bullet for this condition. And, there's clearly not. For most individuals, it takes a nuanced approach. It takes a complex approach. And, it takes some trial-and-error. There is no allergy test that's going to tell you what the optimum protocol is for this condition.
Ben: Now, what about the diet? Is there a diet that just over and over again seems to do really well for people who have IBD?
Amy: We love this question because, unfortunately, for those who want that answer, there is not one. There are definitely strategies that tend to —
Ben: You're never going to make any money on a diet book, Amy.
Amy: I know. It turns out that the problem is a little bit more complex than that. So, there are a few strategies that have good patterns throughout populations. But, what we really do is think of food not just as food lists, but really the context of the food. Is your food cooked? What texture is it? What time of day are you eating it? How much of it are you eating? In combination with what other factors?
So, gluten tends to be pretty aggravating for a lot of folks with IBD and without. But, what if that gluten came with a giant pile of fruit? Then, this proportionate that it would be causing would be potentially mitigated. And so, being able to personalize that approach and really build an intuition around food, because there is no one diet.
Ben: Which diet is the closest? Which diet is the closest? Give us something.
Andrew: So, look, there's something going on with complex carbohydrates and IBD, almost certainly, and eliminating processed foods. So, the first diet to identify that is called the specific carbohydrate diet.
Ben: Yes, I know that one. My friend Steven Wright and Jordan–I forget is last name, but yeah.
Andrew: But it's similar. It's very similar to ancestral diets. It's similar to AIP. It's similar to other dietary interventions. But, the reason why we don't really like to name certain ones is because people get caught up in these dogmas, of that foods are legal and illegal. And, Amy can even speak to that more because that's where she specializes.
Amy: Food is not a moral situation. We really think that–I really think that the language that we use has a lot of impact on how we move through the world. And so, calling something illegal is just not going to give your brain a good experience when you're confronted with the opportunity to make a choice about that food. So, we don't call it cheating. We call it a food exploration or food adventure.
Ben: I think that, to a certain extent, it becomes tricky because we have a very recent podcast, a guest of mine would have called a molecular herbalism approach to food, particularly, plants, instead of ancestral herbalism approach. Meaning that, taking into account the electromagnetic energy of that plant, its connection with–now, I'm going to get all woo, your heart, your brain, your own electromagnetic field, how that plant is speaking to you when you hold it and whether, intuitively, there's something that you feel as though you should or could eat. The sacredness of food, I talked about in my talk, it's something people gather around. It's not just macronutrients, like carbohydrates and fats and proteins. It's energy. It's life. It's tradition. It's how many photons of sunlight it carries.
And so, it's super-duper important, foodists. And, I would imagine, it's a really tricky balancing act when you have IBD of breaking down food real scientifically into what's going to be good for you and what's not, but also acknowledging the deep sacredness of food. It's not as though food isn't important. But, I guess, it's the type of importance that you place upon it. Does that makes sense?
Amy: Yeah, that makes sense. I would just read something my friend mentioned to me, too, recently, that we don't have a tendency, we don't have acculturation to smell our food before we eat it, per se. And how much we're missing pieces of information that come through–Now, we have hyperpalatable foods. And, that is a whole other conversation. But, Andrew has this almost six sense with food that he eats, where he'll put it in his mouth. Within a few seconds of just holding in his mouth or smelling it, his body will tell him, this is a yes food or this is a no food today.
Ben: When I recorded a podcast with Paul Chek about intuitive eating, I added that into the way that I selected foods. And, sometimes, I will literally hold, in many cases, it's packaged foods for this, but I'll hold some supplement or some bottle or some can or some package of something. And, my body very, very quickly tells me whether or not I should be taking that, even if that's something I've been taking consistently for the past week, I'll wake up one day and it's almost as though my heart is telling me, “No, this is not for you today.” Does that make sense? Does that ever happen to you guys?
Amy: Yeah, I've definitely heard a form of that intuition called muscle testing. And, call it what you want, but your body has an internal wisdom to it. It knows what it needs, if we can tap into that.
Andrew: I think the idea is to get IBD patients into remission and get them to live their full lives again and be able to eat what they're going to be able to eat, not worry about something causing them to go run to the bathroom 20 times a day. You know what I mean? You're setting off something. For example, I looked through your cookbook, Ben. I could eat every single thing.
Ben: Yay, even the donuts.
Andrew: Even the donuts. I've specifically looked at the donuts, and I was like, “Oh, man.”
Ben: They're pretty damn good.
Andrew: I'm stoked to make–I love cooking, too. I'm stoked to make those.
Ben: That's awesome.
Andrew: And, that's what we want for every IBDer in our program, to be able to just pick up a cookbook like yours that's healthy, that has real beautiful gourmet food in it, and be able to be like, “I can eat 90% of what's in here. Or, I can modify something very easily in order to make it fit with my diet.”
But, I'll just say, look, a lot of we–I think another piece of diet is the movement away from dogma. People come in. They're fully vegan or plant-based. And, we slowly help them to–We don't push it on them, but we help them incorporate animal products in a really responsible way, if they're willing to do it. If someone really wants to be plant-based, then we'll flow with it. It's there. We work for them.
Ben: I think the main problem is identifying with it and becoming attached to it.
Ben: Like a CrossFitter, a CrossFitter vegan. That's their identity. I'm totally getting beat up by all my CrossFitter friends now. But, all my vegan friends because they're pacifists and loving and they'd never beat me up.
Andrew: I love my vegan friends. And I also love my carnivore friends.
Ben: I know. I posted on Instagram recently me shooting my bow, getting ready for hunting season. But, I asked all of my vegan and plant-based followers, what do you guys plan to forage this year? What mushrooms? What plants? It's not as though there's not a real, again, a sacred appreciation for food and even an adventurous and explorative aspect of food and, especially, a well-comprised plant-based diet that, hopefully, includes someone out of foraging or, at least, a few farmers' markets here in there.
Andrew: You can find incredible foods right in your backyard. Amy and I lived in the Oakland Hills. And, she and I brought back 24 pounds of oyster mushrooms.
Ben: Oh, geez.
Andrew: Just in our forest, just right there. Everyone ignored it. Everyone walked past them. No one saw them. They were delicious.
Ben: Geez. Oh, my gosh. Olive oil, salt, mushroom, party at your house.
Andrew: They contain beta-glucans that are prebiotic, anti-inflammatory things. And, actually, there's actual data with beta-glucans in IBD. So, again, you can find a lot of the foods. Please, be very careful with mushrooms. They can kill you. Please, be very careful. But, a lot of these foods are available to us. The huckleberries that are growing nearer house, packed with anthocyanins and flavonoids. There are so many different aspects that are just available to us, even in semi-urban environments.
Ben: There's something that you brought up earlier. And, this might be the last little avenue that we explore. We've brought up stress a few times and how much an overactive sympathetic nervous system can drive digestive distress. We talked about the olfactory receptors and just smelling your food before you eat it. But, one thing that we do at our house before we eat is we typically do anywhere from one to two minutes of breathwork, just deep in through the nose, out through the mouth, usually dwelling upon something that we're grateful for today, usually finishing with saying grace over the meal. And, essentially, preparing the body to receive food is the way I often put it. But, really, it's downregulating the sympathetic nervous system a little bit.
And, I think that for some people who are very stressed around food, it would be interesting to see how they might respond to some biofeedback. Meaning, there are devices you can wear that will tell you when your HRV is too low, your heart rate variability is too low, and then have some a vibration or a cue that then, it's usually tied to an app on your phone, and it brings you through just a short cycle of breathwork to get your HRV back into rhythm.
I think that people with gut issues, if they just made a rule for themselves for the entire week that they were not going to eat food if their HRV was low and actually determine using something like that, how to breathe themselves into a relaxed state before eating, I think that could be really helpful tool.
Andrew: I do agree with that. I think the larger issue here is just that there are just so many interventions. You know what I mean? And, there's just so many things that people with chronic disease can do. And, how do we help people to be in a mindset that they can take these overwhelming opinions that are all over the internet, even at this conference? You know what I mean? Everyone has their own sort of thing, that it's all omega-6, or vitamin D is so crucial. All these things are so important, but they are one —
Ben: Everybody has their hammer.
Andrew: –they're one piece of a puzzle of a complex puzzle. And, how do we help patients with chronic conditions to accomplish that? And, I'll let Amy comment on this. And then, I can tell you a little bit more about where we're going and how we plan to accomplish that, if you want.
Ben: Anything in there, Amy?
Amy: Yeah. So, such an important piece of what we do is helping people who tend–It's interesting that there tends to be a personality overlap with this condition of doerness and overachieverness. And I also am an overachiever. So, I really have a lot of empathy for that.
Ben: “Driven,” he's the author of a book called “Driven.” Doug Brackmann describes it on my podcast, the driven personalities.
Amy: And so, there's a tendency, especially, in such an area where there is so many things that people can be doing, that when they're not feeling well, they're like, “But, I should be doing more.” And, a lot of should come into that self-talk. And so, helping people get a little bit more distance from it, we're like, “Well, IBD isn't something that you caused. It is what it is. And, all that we can do is take one day at a time. And so, getting a little bit more inner peace with, sometimes, there are good days, sometimes there's not so good days, there is always more that you can do so you can't do it all. Sorry.
Ben: Anything you were going to add in there, Andrew? You said you want to say something before Amy.
Andrew: Sure, sure. This has been awesome, by the way. And, Ben, I'm a newer follower of yours. And, I've just really appreciated all of your work. And, your book is just like, “Oh, my God. This is just like a reference book.”
Ben: Thanks. I'll send you a royalty check later.
Andrew: I really appreciate it. So, look, there's a huge problem right now in the United States and around the world. And, it's unseen. Sure, we see COVID, we see environmental devastation. We have in California now, we have a fifth season. It's the smoke season. And, it hasn't even hit yet, luckily. We see these big problems. And, one that I feel we don't see is the prolific rise of chronic health conditions. And, we see it every day. This is an epidemic. People are being diagnosed with inflammatory bowel disease and other diseases at increasing rates every single day, every single month, every single year.
Ben: [01:03:55]_____ family members.
Andrew: Absolutely. So, how can we–Obviously, the legislative solution to our healthcare system has been stalled for a very long time. And, that obviously needs to happen. But, how can we, as private citizens, as business owners, entrepreneurs, as philanthropists, help this situation? And, what we see is creating environments for people with chronic conditions to empower them, to teach them science, to give them the resources to allow them to build robust protocols that they can try on themselves, that they can act.
We actually deepen the connections with mainstream GI doctors. We help patients follow doctor's orders. And, we also help them to ask questions when they're just prescribed medication out of the blue. And, sometimes, even most of the time, the doctor says, “Hey, that's a really good question. I didn't even think about that. Maybe, I shouldn't prescribe this really powerful drug right now when all these other things are available right now.” And, I was waiting for the pushback from our program from mainstream GI doctors. It has not come. And, they historically have told their patients that diet doesn't matter. They've been very, very positive with us
Ben: That's awesome. And, it's called IBDCoach, right?
Andrew: It's called IBDCoach. And, I think the direction that we'll go here is we want to really explore IBD. We want to show that this works with people with this horrific condition. And then, branch out with this approach to other conditions, build physical spaces, retreat centers. And, the big goal here is to get this covered by world governments and by insurance companies. And, everyone can win here. We have calculated that we have already saved insurance companies collectively over $1,000,000 in our program.
Andrew: So, everyone can win here. Everyone can make money. And, we can save lives, and we can transform people's lives. That's our message.
Ben: Well, I've got one more million-dollar question for you. You get 20 seconds to reply, max. You're shoving off to a desert island where you'll be for a year, what food are you going to bring?
Andrew: Amy first.
Amy: No, I don't have an answer to that quite yet.
Ben: You're stuck. You're kicked off the island. You don't survive. Nothing? You got any in there, Andrew?
Amy: I'll figure out when I get there.
Andrew: I think I would bring a really amazing steak. And, that's such a controversial thing to say with people with IBD. But, I've just been feeling the power of [01:06:30]_____ meat.
Ben: It's pretty nutrient-dense. Had dinner with a friend last night at US Wellness Meats. And, he has a lot of issues. He started eating just meat 10 weeks ago. And, he said he's never felt better. I think I would just probably bring some worms to catch some fish with. I could always eat one [01:06:44]_____.
Andrew: Oh, my God. Ben Greenfield is going to live longer than a lot of us on that island.
Ben: Well, for everybody listening in, what I'm going to do is I'm going to link to Andrew and Amy's grams and websites and everything else that you need to stay in touch with them. I'm going to put all the shownotes at BenGreenfieldFitness.com/IBDPodcast, where you can go and leave questions and comments and feedback. And, a lot of times, the people I interview will sometimes jump in as well, which is fun. And, I know this is a big issue for a lot of people. So, Andrew and Amy, thank you for making the poster, for doing what you do, for doing IBDCoach, for filling people in, for going on a sunshine walk with me. It's been amazing making new friends.
Andrew: Thank you.
Amy: It's such a pleasure to be here. Thank you so much.
Ben: Alright, you guys. I'm Ben Greenfield, signing out with Amy and Andrew from IBDCoach. Catch you on the flip side.
Well, thanks for listening to today's show. You can grab all the shownotes, the resources, pretty much everything that I mentioned over at BenGreenfieldFitness.com, along with plenty of other goodies from me, including the highly helpful, “Ben Recommends” page, which is a list of pretty much everything that I've ever recommended for hormones, sleep, digestion, fat-loss, performance, and plenty more.
Please, also, know that all the links, all the promo codes that I mentioned during this and every episode helped to make this podcast happen and to generate incomed that enables me to keep bringing you this content every single week. So, when you listen in be sure to use the links in the shownotes, to use the promo codes that I generate, because that helps to float this thing and keep it coming to you each and every week.
While recently in Los Angeles at the Ancestral Health Symposium, I had the pleasure of a long, sunshine walk with several of the speakers and presenters. Perhaps you already heard my chat that I recorded with Chris Kelly as part of that trip.
But I also met a couple of new friends who are real ninjas when it comes to something called “IBD” (inflammatory bowel disease).
On my left side during the walk was Andrew Kornfeld ([email protected]), who holds degrees in Neuroscience and Psychology from UC Santa Cruz and is an award-winning educator, organizer, and published author. Andrew has Crohn’s disease, and over the course of a decade and a half has developed a tailored and evidence-based protocol that allowed him to achieve robust, lasting clinical remission from his IBD. Andrew founded IBDCoach so others with Crohn’s disease and ulcerative colitis could benefit from the strategic lessons and research he has conducted in his personal pursuit of health.
And on my right side was Amy Loftus ([email protected]), who holds a B.A. in Biological Anthropology and an M.A. in Education from the University of California, Berkeley, and works alongside Andrew to run the operations and educational arm of IBDCoach. Amy combines her decade of K-12 classroom teaching experience, her work as a software engineer at a Silicon Valley health tech startup, and her years as an IBD spouse to empower IBDCoach members and their families with the resources they need to achieve their remission goals.
Founded in 2019, IBDCoach is the brainchild of Andrew and Amy, who are on a mission to change healthcare by tackling inflammatory bowel diseases including Crohn’s disease and ulcerative colitis in a capacity never attempted before. In their program, members work to achieve long-lasting remission through immersive science education, community support, and a unique form of health coaching that emphasizes strategic, patient-driven, and patient-empowered actions. IBDCoach is the first program of its kind to provide comprehensive scientific information in one accessible location as an essential adjunct to standard medical care. Initial results from dozens of clients are highly positive including amelioration in symptoms and disease activity, reduced inflammatory markers, lifelong friendships formed, and lives changed for the better. The founders of IBDCoach, Andrew Kornfeld and Amy Loftus, have both personal and professional experience with inflammatory bowel diseases.
If you or someone you know is struggling with inflammatory bowel disease, you can check out Andrew and Amy’s work at ibd.coach.
In this episode, you'll discover:
-Andrew and Amy's experiences with IBD…07:00
- Rapé contains nicotine
- Nicotine for someone with Crohn's disease is problematic (Andrew has Crohn's)
- Opposite is true for ulcerative colitis; nicotine acts as a “protective”
- Amy does not have inflammatory bowel disease (IBD); unique perspective
- Amy got involved with IBD treatment by way of marriage to Andrew
- Amy's background in anthropology steered her in the direction of an “ancestral approach” to IBD treatment
- Andrew nearly died because of his IBD
- IBD is different from IBS
- IBD is a highly lifestyle-based condition
- Andrew discovered a systems-based lifestyle approach that incorporates concepts like neuroplasticity, ancestral health, and first principles into designing a personal protocol that ultimately saved his life
-Predisposing factors that may make someone susceptible to IBD…13:30
- No distinct genetic component
- Distinctive markers in the microbiome
- BGF podcast with Lucy Mailing:
- Diet feeding inflammatory microbes
- IBD is not a traditional auto-immune condition
- Overreaction in the lamina propria
- Pathogenesis: how the disease begins
- People with IBD react to things like leaky gut
-How IBD causes drastic consequences to health and the body…17:40
- Vitamin IVs to bypass the gut to get proper nutrients are an option
- Treatments today are very quick to remove parts of the body, like the colon
- The colon is host to the gut microbiome; someone whose colon has been removed won't have a traditional microbiome
- In most cases of ulcerative colitis, the entire colon is removed
-The best test to determine if you have or potentially have IBD…20:55
- Most tests are more interesting than actionable
- Microbiome isn't the most important thing to test right off the bat
- Over 200 genes implicated in predisposition of IBD
- High stress or traumatic life events often are a precursor to IBD
- Stress response causes or intensifies IBD
- Cortisol is a resource-driven hormone
- Don't need to fight off microbes, digest food, reproduce if running away from a UCLA frat boy
-3-step model to treat IBD:
-Step 1: Reduce inflammation…26:11
- Science is not in harmony with clinical practice
- Most common mechanism to treat IBD is to block cytokines; TNF-A
- IBD has microbiome imbalances, barrier issues, and inflammation
- Three-step model to treat IBD
- Stop inflammation
- Look at the microbiome
- Repair the barrier
- Peptides as potential treatments
- Turmeric with Bioperine (active component of black pepper); black pepper extract increases absorption of turmeric
- Ginger is very helpful
- Quercetin is a powerful antioxidant and anti-inflammatory
- Supplements will be of little help if you're not eating and living right
-Step 2: Nourish the microbiome…33:10
- IBD and IBS are two different conditions
- Diet is a crucial factor
- Andrew looks at probiotics as a pandora's box
- Probiotics (use code BEN15 to save 15%) work better on ulcerative colitis rather than on Crohn's
- Visbiome (new name for VSL 3)
- E. coli nissle (hard to get)
- Bacillus Coagulans
- Best to get probiotics from fermented foods such as sauerkraut, kimchi, etc. until the issue is really understood
-Step 3: Repair the barrier…39:24
- Phosphatidyl Choline from Quicksilver Scientific (use code GREENFIELD10 to save 10%)
- Dr. Goodenowe and Ben's Prodrome Scan test results
- Breaking Alzheimer’s by Dr. Goodenowe
- The most powerful way to repair the barrier is to stop the inflammation and nourish the microbiome
- Certain carbohydrates feed the microbiome; transformed into short-chain fatty acids like butyrate that then feed colonocytes and enterocytes
- Colonocytes are the cells of the large intestine
- Enterocytes are the cells of the small intestine
- Barrier begins to repair, known as deep mucosal healing
- Glutamine is more helpful for Crohn's disease; in the small intestine
- Colostrum may be helpful for those with milk sensitivities
- SBI Protect: Serum-derived Bovine Immunoglobulin
-How neuroplasticity affects causes and treatments for IBD…45:10
- People become their own teachers vs. taking marching orders from doctors, websites, etc.
- Esalen Institute
- Cultivate the innate sense of healing within one's self
- Andrew's thesis was on how psychedelics induce neuroplasticity
- Microdosing For Sports Performance, Microdosing Stacks With Psychedelics & Plant Medicines, The Best Microdosing Protocols & Much More With James Fadiman.
- Psychedelics don't cause neuroplasticity; lowers barriers of resistance to allow changes to the brain
-How the IBD coach program works…48:36
- Three-part program:
- Educational experience—re-learning biology
- Workshops hosted by IBD experts, microbiome, diet, and nutrition
- Building a community of people with IBD
- Giving people with IBD access to expertise to enable people to achieve what they cannot achieve on their own
-Biggest mistakes people make when diagnosing or treating IBD…50:00
- A tenuous relationship with food
- Thinking there's a silver bullet or quick fix to the condition
-The best diet when you have IBD…52:07
- Specific Carbohydrate Diet is the closest to a compatible diet for IBD
- How You Can Stop Digestive Problems, Gas And Bloating From Controlling Your Life, with Steven Wright
- Molecular herbalism approach to food:
- BGF podcast with Paul Chek on intuitive eating
- Shameless plug: Andrew says that he can eat everything in the Boundless Cookbook
- Move away from dogma when it comes to what to eat and what not to eat
-Using HRV tracking to consume food wisely…59:36
- Driven by Doug Brackmann
- Driven: Understanding and Harnessing the Genetic Gifts Shared by Entrepreneurs, Navy SEALs, Pro Athletes (& Maybe You), with Dr. Doug Brackmann.
-The epidemic in America that misses the front page news…1:03:15
- The prolific rise of chronic disease conditions
-And much more!…
Resources mentioned in this episode:
– Andrew Kornfeld and Amy Loftus:
- Is A Ketogenic Diet Bad For Your Gut, Should You Eat Resistant Starch, How Exercise Changes Your Gut Bacteria & Much More With Lucy Mailing.
- Microdosing For Sports Performance, Microdosing Stacks With Psychedelics & Plant Medicines, The Best Microdosing Protocols & Much More With James Fadiman.
- How You Can Stop Digestive Problems, Gas And Bloating From Controlling Your Life, with Steven Wright
- Evolutionary Herbalism: Part 2 – The Fascinating Science, Spirituality & Medicines Of The Plant Kingdom With Sajah Popham.
- Evolutionary Herbalism: Part 1 – The Fascinating Science, Spirituality & Medicines Of The Plant Kingdom With Sajah Popham.
- The 3 Key Steps To Intuitive Eating, Ego Dissolution, Raising & Educating Children In A Modern Era & More With Paul Chek.
- Boundless Cookbook by Ben Greenfield
- Breaking Alzheimer’s by Dr. Goodenowe
- Driven by Dr. Doug Brackmann
– Other Resources:
- Turmeric With Bioperine
- Probiotics (use code BEN15 to save 15%)
- Mutaflor (E. Coli Nissle) Probiotic
- Bacillus Coagulans
- Quicksilver Scientific Phosphatidyl Choline (use code GREENFIELD10 to save 10%)
- SBI Protect
- BPC 157
- Dr. Goodenowe
- Lamina Propria
- Join me and my wife Jessa at The Gathering. Click here to grab one of the very limited spots we have open to the public for The Gathering (October 7-9, 2021).
- Las Vegas Keto Expo (October 15-16, 2021). Ben will be speaking at the Las Vegas Keto Expo along with 13 other keto experts. The first 300 guests to register here will get a free drink chip for the poolside party and a free t-shirt.
- Keep up on Ben's LIVE appearances by following bengreenfieldfitness.com/calendar
–Ra Optics: Purchase a pair of Ra Optics Day and Night Lenses to optimize sleep quality, energy, levels, and health in the modern, electrically-lit world. Receive 10% off your order when you order through my link.
–Paleo Valley Beef Sticks: 100% grass-fed AND grass-finished. Keto friendly and higher levels of Omega 3 Fatty Acids. Receive a 15% discount on your order when you go to paleovalley.com/ben
–Kion Oregano: One of the best oregano oils I've ever been able to hunt down. When you use my link, you’ll also get 10% off your first purchase.
–Organifi Green Juice: Now you can get all your healthy superfoods in one glass…with No Shopping, No Blending, No Juicing, and No Cleanup. Get a 20% discount on your entire order when you use discount code BENG20.