July 21, 2018
[00:00] Daily Harvest Cups/GainsWave Sound Waves
[04:43] About Dr. Kenneth Brown
[10:04] Producing Methane via Gas-Producing Bacteria
[23:30] Mechanisms of Polyphenols
[34:02] Kion Serum/Blue Apron Meals
[37:15] Retraining the Gut
[53:29] Dr. Brown's Remedies for Leaky Gut
[1:03:42] Atrantil & How to Use It
[1:09:01] End of the Podcast
Ben: Hey, what's up, it's Ben Greenfield. I believe that in the past you've heard me talking about bloating and gas and constipation and all the annoying issues that a lot of people, especially people who are like me, who are foodies, have to deal with. Well I have the ultimate elixir for you, the ultimate remedy for sopping up bloating and gas, something you can pop right before a meal, and it literally gets rid of all that. I'm interviewing the doc who invented this stuff on today's show, and we take a deep dive into all things gut, even talk about how to retrain your bacteria even if you don't feel like buying a supplement, yet another supplement. You're going to learn a ton in today's show, and I do recommend that you take advantage of the fact that they're going to offer you money back guarantee on trying this stuff at the end of the show, so stay tuned. It's a real doozy when it comes to gut help, you're going learn a lot of things in the show.
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Hey folks, what's up? It's Ben Greenfield, and for millions of people, including yours truly, they have had to deal with bloating and abdominal discomfort, often accompanied by embarrassing bathroom decommissioning issues like diarrhea or constipation. Life gets pretty miserable, and there is a lot of new research that I've taken note of that shows that a big part of this is due to what is called methane-producing bacteria, and the idea is that if you don't treat it, these bacteria feed off the foods that you eat, and they make gas and the gas then makes you feel bloated and uncomfortable and creates a lot of these issues, that frankly have been a bane in my side, and I'm glad I discovered a bit of an answer to, specifically after talking with my guest on today's show. He is actually gastroenterologist, which means he knows his way around the gastrointestinal tract, as the name would imply. His name is Dr. Ken Brown. He's been practicing this stuff for over 15 years, focusing on inflammatory bowel disease, which is also known as IBD, and irritable bowel syndrome, IBS, and he's been working on these solutions using natural herbs to try and fix bloating and gas.
Now I've been using a lot of the techniques that he's taught me in my own nutrition program, and they've worked. I literally do it he says, prior to consuming a meal such as a carbohydrate-latent meal or a meal of fructose in it or a meal with say like onions and garlic in it, these so-called FODMAPS that can produce gas and bloating, and it's no longer an issue. So I want to get this cat on the show 'cause he's pretty smart. Like I mention, he knows his way around your gut and talk about what we can do to get rid of gas and bloating and complete bathroom embarrassment. So Dr. Brown, welcome to the show, man.
Dr. Brown: Ben, thank you so much for having me on. It is truly my honor to be on your show and discuss destructions of bathrooms. I like that, I like how you lead with it.
Ben: Yes, destructions of bathrooms. Not destruction, just slight decommissioning or being in there really long time and people knock on the door.
Dr. Brown: My whole day involves discussing bathroom habits with my patients, so I'm really comfortable talking about this stuff.
Ben: Is this one of those deals where you had gut issues in the first place and got interested in this like in medical school, or you just have some other reason you're infatuated with the GI tract?
Dr. Brown: Well that's one of the reasons why I went into this particular specialty because when you go to medical school, you start out you have to make these broad stroke decisions early on, your second and third year. Am I going to be a surgeon or am I going to be an internist? I was going to be a surgeon, and I realized that lifestyle didn't suit me, and gastroenterology is really the only specialty where its mouth-to-anus. The gut affects health in every other way, and then two days a week, I get to play video games and remove polyps from people and save their lives. So it fits me like a glove.
Ben: What do you mean you get to play video games?
Dr. Brown: Well people come in, and they get procedures done, endoscopies and colonoscopies, and we have the ability that you can come in and I can remove a polyp that was going to turn into cancer, and it's just a camera that I put in somebody. I had my team I’ve got, we're looking at the TV, we remove these polyps, and it's a win-win for everybody. It's the only specialty where you actually do procedures, and then you also have some big intellectual stimulation. So I call it playing a video game because it's fun for me to get in there and symbolized by removing polyps. I feel like I'm a polyp hunter when I'm out there.
Ben: You know I actually got a colonoscopy once. Have I told you this? Well two of my cousins had some really serious issues with their colons, and then I had a family member of my mom's side die of colon cancer, and so I would basically lay awake at night, wondering if there was anything going wrong with my colon. And so I wanted that piece of mind, just in case 'cause there were so many family issues going on. So I went in and got a colonoscopy, and it was actually worth it for me because (a) it's kind of a minimally invasive procedure. I mean you have some anesthesia involved, but it's not like you're on a huge antibiotic regimen afterwards and you're not getting anything really cut out, and be the peace of mind just from knowing that I was, I think the way the doctor described it was squeaky clean in there, as far as polyps are concerned. Just knowing that I'm okay gave me a great deal of peace of mind, but at the same time, one of the reasons that I got the colonoscopy was I have had bloating and gas and GI issues, and I was kind of wondering if it was due to inflammation or the potential presence of polyps in the colon. And while that isn't the case, I definitely came across some other reasons, particularly these methane producing bacteria that were causing gas and bloating and constipation in me.
So where I wanted to start with is, if you could, can you explain exactly how these gas-producing bacteria produce methane, how this all happens in the first place and how they get there in the first place?
Dr. Brown: Sure, so what we're describing here is when people feel real bloated. I do want to clarify that bloating, the way that I define bloating with my patients is when you have trapped gas. This isn't a situation where you're burping a little bit or you're passing a little more gas or even some people feel like bloating as water retention. This is when you eat, especially starchy-type foods, and then you blow up like you're three, four months pregnant, is way that all my patients actually describe it. What's happening now is there's this huge paradigm shift that we have seen. When we label everybody as having irritable bowel syndrome, and we said it was all in their head, now we realize that it's not in their head. It's probably in their small intestine. What can happen to somebody is that they can go through a very stressful period, take antibiotics or even have a very poor diet, and then what will happen is that shocks the area, and then bacteria can start to grow. I left one important cause out which is infection 'cause if you ever have an infection, that's probably the most pertinent cause, and it will shock it. So if you can think of it, normally it's a very crystal clear stream, and then now all of a sudden we dammed up both ends and allowed bacteria to start growing. So we've turned it into a bit of a sewer pipe, then whenever you eat, the bacteria can start to break it down before you can, and I know that you have talked SIBO before, but that is the definition of what SIBO is, Small Intestinal Bacterial Overgrowth.
Ben: Yeah, and that makes sense, the part about infection 'cause you kill off good bacteria and allow for the overgrowth of bad bacteria, and the same, of course, would make sense for antibiotics. They'd kill off the good bacteria and allow for overgrowth of bad bacteria, but the part you said about stress, I'm familiar with stress as being a cause of ulcers, but I hadn't heard it before used in the context of bacteria. How would stress cause this issue?
Dr. Brown: Stress causes it because we change the motility of the intestines. When you're in this high cortisol state, the fight or flight, your intestines are slowed down a little bit, and that can really alter a lot of different things. So when people go through a very stressful environment, it's like insult to injury. Many times I'll see a patient, they'll unfortunately have a death of a loved one or go through a bad divorce, and then they're really messed up in their GI tract from then on. I know that you have had extensive experience due to endurance training with triathlons and such. I have a lot of triathletes that come see me because the stress and the extreme amount of training that happens can actually do the exact same thing, and then when you stop using different things like fructose-based energy Gu and stuff like that, it can really mess with people.
Ben: Yeah, I was going to say part of it would be, of course, I know the gut becomes more permeable during endurance exercise. A lot of these folks are exercising in the heat as well, but then in addition to the stress, of course, there's the idea that it's traditionally a pretty heavily carbohydrate-fueled sport, and even if you're eating a low-carbohydrate diet or doing a ketosis diet to hack endurance, so to speak, they're still present in most of these gels and sports drinks you're consuming during the activity, highly-fermentable compounds like you mentioned, fructose, maltodextrin. I think I heard it described by a physiologist I had in the show named Alan Lim is releasing a bunch of like screaming demons of death into your gut, holding tiny, little cluster bombs or something along those lines. A highly scientific explanation of the digestion of maltodextrin, but ultimately, yeah, I mean when you combine stress with these highly-fermentable foods, it seems to blow up even more, and I went for years. I mean honestly I would say 10, almost 15 years, thinking that it was just normal to walk around all day with copious amounts of gas and hop on a bike ride or to go for a run and literally just be farting the whole time.
Dr. Brown: [chuckles] My initial background, I was doing pharmaceutical research, and during pharmaceutical research, looking at using a poorly-absorbed antibiotic to help with people like this, and this is a venture how I developed Atrantil, but one of the things I did is I submitted a whole study proposal to Salix Pharmaceuticals, which is now owned by Valiant, where I knew the whole process. I had all these athletes that were coming in. After I would treat them, they would say, “man, I did really good in this last race, I did really good in this last triathlon. I didn't have to use the bathroom, I didn't feel bad.” I submitted a whole protocol where I believed that if we fix people's guts, many people that do these endurance training can actually have a personal best, and they felt it wasn't a big enough market and rejected my study proposal, but I still have it. Once we get a little time, I would love to sit there and try and find all these athletes that have a known average for a time to finish in a certain race, treat a handful of them and then do placebo on the other, and just see if the objective times change. My belief is that you can get the bacteria to go, so that when you do take in these highly-fermentable carbohydrates, you get to break it down and absorb it instead of the bacteria having a little party every time you do it.
Ben: I guarantee you got a good database of listeners who’d probably want to be part of the program. As a matter of fact, when I first started this podcast 10 years ago, almost every interview was with a professional triathlete or marathoner or swimmer or cyclist, because I was heavy into endurance sports. That's all I was doing, and I initially designed a podcast just to help people become better at endurance. I was running a physiology lab, I was traveling around the world, competing in triathlons and coaching triathletes and putting out triathlon camps, and so we kind of started off this podcast, even though I eventually forward into biohacking and longevity and general health and fitness. It began with a big bent towards insurance sports. I know a lot of those people, God bless them, still remain a part of the core listener base.
Dr. Brown: I'm trying to get my company, my Digestive Health Associates at Texas, DHAT. We're very large group; we've got almost 90 people. I'm currently working with the head of research. We do a lot of pharmaceutical research, I want to build a whole, natural functional arm, so that we can start getting some data on these kind of things. You always do a real deep dive. I always laugh because we always talk about “the end of”. So my experiences, and in the scientific terms is the number, so it's number needed to treat, NNT, and these are all statistical ways that people refer to things. I have to laugh because I've seen a lot of the stuff you've done. It's almost like it's not the end of one, it's the Ben of One that's going out there and doing it himself before he tells everybody else to do it. So I call it the Ben of One whenever weird stuff starts.
Ben: I like that.
Dr. Brown: Yeah, it's the Ben of One where my wife's like, what did you order? Oh, I heard this podcast and something shows up, and there I am doing the content of ribosides and things.
Ben: I'm going to see if benofone.com is actually taking off, I'll look that up. I'm going to go to Go Daddy after we talk, see if we can grab that. Okay, so we know that bloating is occurring from the presence of these bacteria. How do you test for this? For a while I thought that doing just like a stool test would allow you to elucidate bacterial imbalances, and it can discover the presence of yeast and fungus and parasites and even with these newer testing services like Viome for example do the whole microbiome, but from what I understand, that's not really the best way to determine whether or not you actually have this bacteria present in the upper GI tract, like up around the small intestine.
Dr. Brown: Correct, so unfortunately, we all know how important the microbiome is. If there's one thing your listeners could get out of this, I always tell my patients, I said if you see a pregnant woman, she's eating for two you. You should be eating for one hundred trillion because our microbiome is that important. Testing the microbiome is not going to tell you if you have dysbiosis or a change in the bacteria in your upper intestinal tract. So I always say that it isn't that bacteria are good or bad, it's that they just happen to be living in the wrong place. Testing your stool will not be able to tell you that, so we have to find some other ways to try and figure how people have bacterial overgrowth. And unfortunately, there is no real perfect test that you can do. There are different breath tests that we can do, we use lactulose or glucose, and we can see if people are producing methane or hydrogen. Unfortunately, there's a lot of heterogeneity in how these tests are done and how they're interpreted. So I basically use that as something to try and put another piece of the puzzle, there are some institutions that will do culture of the small bowel, but that's really invasive and it's still not very sensitive nor specific.
So ultimately I just take a really good history. If you're the kind of person, you come to me and you say I was training for Kona Ironman and really training hard. I started to get sick, and then I ended up getting really sick and I've never been right since, and now every time I eat, especially starchy foods, I blow up. You look like a duck, you walk like a duck, and you can quack like a duck. I'm going to treat you first because we don't have a perfect test yet. So the history is everything.
Ben: One of the things that I've noticed too is when you look at a lot of these foods that produce a lot of gas and bloating particularly, and I don't know if you'd agree with me on this, you're the doctor and I'm not, FODMAPs. A lot of these, fructans, oligosaccharides, monosaccharides, disaccharides and polyols, particularly garlic and onions, two of the biggies. Because I used to be like the Whole Food, salad bar fiend who would go in there. Make myself the big Whole Foods vegetables, and within two hours after my big ass thirty-dollar salad from Whole Foods, I could almost see my stomach bloating. But one thing I'd do on that was I would usually do either (a) the big container of the red onions, just for a little extra flavor, or even more consistently, the roasted garlic that they have there, like a huge spoonful of it, easily the equivalent of a full bowl of garlic, and I would just be bloated as hell for hours, and I would find that while garlic and onions were two of the biggies, wheat, which falls in that category of a FODMAP, that was another one. Apples were another biggie, and so I think that if you eat those kind of foods and you get a whole bunch of bloating from them, it can be a pretty big clue without you having to go out and do one of these, for example, breath tests are often mentioned as one of the best ways to test for something like SIBO. But for me you know, if I'm talking to somebody, they say every time the garlic or onions, they get a lot of bloating and gas. I think it's a pretty good sign there's a lot of methane-producing bacteria present in the upper GI tract. Would I be on the right track with that?
Dr. Brown: Yeah, totally, so the FODMAP diet, F-O-D-M-A-P, is the diet that a lot of my colleagues would recommend for people. I think that there's a lot of other diets out there, but they all do the same thing. They take away these slightly more difficult to digest molecules, so that you're not feeding the bacteria. You're essentially trying to starve the bacteria, and if you're not giving them a buffet every day, then slowly the amount decreases. There's the SCD diet, there's the elemental diet, there's the elimination diet. All these diets do the same thing which is that they essentially starve of the bacteria, and the hope is that you're not always just allowing the bacteria to have this great little party in your belly. Although garlic and onions can be actually very good for you because the polyphenols in them, for some people, they are hard to digest and they create a tremendous amount of bloating and discomfort, and it sounds like you're one of those, especially if you're having a thirty-dollar salad, that's a big salad.
Ben: I don't know, Whole Foods, it's not huge, honestly. At Erewhon in LA, that's like the size of a tiny little mayonnaise container, so I was just saying. That's reality these days, but it's annoying, the FODMAP diet. The FODMAP elimination diet because while eliminating garlic and onions is doable for a lot of people, once you get rid of really just about any fruit is off that diet, just about any cereal, grain, bread, biscuit, pasta, a ton of nuts, cakes, a bunch of different condiments, anything fermented. You got to get rid of kombucha, most alcohols are out and most dairies are out, including yogurt and goat milk and a lot of these good ones. So that was another very beneficial result of my ability to be able to hook up with you and some of these polyphenols your creating was I can eat some of these foods, and that's what I want to get into next is these polyphenols and how they actually work. So can you get into the mechanism, 'cause a lot of people are familiar with polyphenols as just the bright antioxidants that you find in darkly-colored fruits and vegetables, but I hadn't realized how much of an impact they actually have on gut bacteria? So can you talk about polyphenols and how those would actually work in the gut?
Dr. Brown: Sure, so if we think about polyphenols, these are phytochemicals or these are molecules that are found in plants. Just like you said, it's these molecules that are on the skin of vegetables and fruits, and they give them these deep rich colors. Actually they're everywhere, but we're probably just don't take in enough here in the western world, in the US, we probably need a lot more polyphenols. What's really cool is the science of polyphenols is taking off, and there's tons of great bench research that's actually going on. Broadly they’re broken down into four broad categories. The one that most people talk about are flavonoids, and that's the largest subset. Now this whole class of molecules are really potent antioxidants, anti-inflammatory, anti-aging molecules, this is what makes the Mediterranean diet anti-inflammatory and anti-aging. So when you produce these oxidative stress or these reactive oxygen species, these cause damage to lipids to proteins. It's this oxidative stress that's been linked to all these pathologies, but when you have a reactive oxygen species, you actually decrease your nitric oxide also, and so you don't have as much blood flow to the area, so you allow this whole process to keep going.
So these polyphenols are fantastic molecules that actually decrease the inflammatory process. Now when we developed Atrantil, we realized through some animal data that we had a very, very specific thing that we were trying to accomplish with these polyphenols and flavonoids, and that was to get rid of these methane-producing bacteria. So we put three polyphenols together to actually do one specific thing which is get the bacteria to go back to where they should.
Ben: So the polyphenols, in terms of their impact on the actual bacteria, you're saying that it's purely an anti-inflammatory process that were infecting the bacteria?
Dr. Brown: Actually no, the polyphenols that we put together. So when we think about polyphenols, in general, when you eat a polyphenol, the skin of a vegetable, it'll actually go through and some gets absorbed, some doesn't. A lot of it would go to the colon where your colonic bacteria will break it down into beneficial molecules for you. There's a new term on a study that's just about ready to be published, I don't think it's out there quite yet, but I saw that it was accepted for manuscript where they looked at post biotics. So we've discussed probiotics, which is where you take in live bacteria and hope that they help you out, then you take in prebiotics which is essentially indigestible fiber that feeds your bacteria. This research team has now shown that we can start looking at the post biotics. The post biotics are the molecules that are broken down by our own bacteria. The molecules produced from breaking down polyphenols, and these guys are trying to figure out how do we develop some toilet paper or a toilet that'll don't show you what post biotics you have. This way, you'd have to look into it and say okay, well I'm lacking this, so I need to eat more of this to feed those bacteria. That's the general polyphenol look.
Dr. Brown: It's really fascinating stuff, so what you're seeing is this shift. Everybody's trying to learn about the microbiome. Possibly just looking at stool is one level, and then looking at what these bacteria produced, the post biotics is the next level, and we do know that when these bacteria break down different things, it can do all kinds of cool stuff. I was talking to a researcher where he was showing me that when you break down a certain flavonoid, these guys all are in labs, all over the world. So everybody's slowly putting the pieces together, it'll eventually all come together. So when these bacteria break it down, they can do different things like vasodilate, or we've learned that this molecule can actually increase BDNF in the brain which is Brain-Derived Neurotrophic Factor. So trying to be myopic about it and say oh, well we just need this one thing, meaning pharmaceutical industries that always try to have one molecule to do everything, this whole complex Mother Nature, the way that these polyphenols work is what makes them so effective.
Ben: This is super interesting because basically what you're saying is like the post biotics, you could almost consider this. When you eat something, you would use the restroom and you'd poop it out eventually, and what you're saying is that these post biotics are almost like the waste product of bacteria that your body winds up being able to use for other beneficial activities.
Dr. Brown: One hundred percent, so we know that these bacteria will break down certain things into short chain fatty acids. That is the fuel that our colon uses to keep all the cells healthy, so these post biotics are actually the result of what the bacteria really wants. So take it one step further, we know that if you eat a diet that is very rich in processed foods, sugar, so on, the bacteria that like that will proliferate more, and then they're showing that they can even send signals to create some of these cravings that people have. So you may be at the mercy of your own bacteria and not realize that you're doing what they want by sending signals, so when you look at the post biotics, I could sit there and go look, Ben, you don't have enough of this one particular molecule that when a proanthocyanidine which is a type of polyphenol, gets broken down, then we know that that's not going to decrease TNF Alpha over here because we've show that molecule does that. So let's increase this in your diet, that will help these bacteria proliferate, and ultimately, you'll have decreased inflammation in your body.
Ben: Okay, so when we look at like mechanisms in the gut that are associated with obesity, like the firmiside-bacteria ratio, that's one that you see quite commonly talked about. What you're saying is that we can actually alter the ratio of that, and from what I understand, that ratio is also associated with things like your craving for carbohydrates and other things that happen when you eat say like a diet high in carbs, or you over feed on calories for a long time, the bacteria in your gut, from what I understand, can actually become dependent on that diet or generate cravings, literally neurotransmitter-based cravings in response to that diet, and you can actually alter that ratio and fix those issues by feeding the bacteria what they would need to produce certain post biotics.
Dr. Brown: Correct, and they've actually looked at some twin studies on this. So they've looked at twins where they said okay, are you are you strictly a product of your genetic background, or can we look at this? And they're looking at stool studies in twins and doing different things and realizing that one twin that has a healthier lifestyle versus the other one, when they look at the post biotics produced or the molecules that are being produced, they're showing that 60% is not in the genes at all. It's what you're doing to manipulate your own bacteria, and everybody keeps trying to take probiotics to throw at it. I'm here, no they're on probiotics. I just know that the data isn't real good on it, but I do know that data is really good when we look at countries that eat a high polyphenol content. So we just got our NSF certification which is certified for sports, it's kind of a big thing. I'm extremely proud of that, and we're going to be a sponsor the CPSDA which is the Collegiate and Professional Sports Dietitian Association. I'm submitting myself, so hopefully, I can give a lecture and talk about some of these things, but when we were there, someone from our team actually listened to one of the lectures, and it was fascinating to see these dietitians talk about polyphenols. There is a PhD named Dr. Joan Bowtell that you're going to see a lot of the publications that she's been involved with, but she's the one that went into detail about how these polyphenols work to help athletes.
What it does is it helps with recovery, she had some great data showing that if you take somewhere around 550 milligrams of anthocyanidines and proanthocyanidines which are the really big complex polyphenols, they can do all different kinds of stuff, including increasing your VO2 Max, decreasing your CK production after exercise, increasing ATP so that you recover quicker. So now we're seeing all these professional associations looking at polyphenols to try and help the athletic performance. The one thing that she did bring up is that, unfortunately, it would take quite a bit to try and get this. You take a thousand milligrams per day for three days, before and after competition, they show that you can have increased recovery, enhanced training, shorten the lag time and the healing time, but you'd have to eat like five big cups of blueberries several times a day, and so that's where the concentration of polyphenols, which is what we did with Atrantil, put the three together, then you end up getting 550 milligrams, three times a day, reaching that amount, and that's what's so cool because we didn't do the original research on this. I'm going to conferences and listening to brilliant people tell me about my own product. That is cool.
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Ben: That's really cool, and what I would suspect, and correct me if I'm wrong on this, would be for people who are say addicted to carbohydrates or have eaten a poor diet for a long period of time. Once you actually switch to a healthier diet, and perhaps eliminate a high intake of carbs that the inclusion of polyphenols and their ability to be able to adjust that from a side-to-bacteria ratio would potentially retrain your gut to be able to better respond to the diet that you're feeding it?
Dr. Brown: Oh yeah, we were both at Paleo f(x), and I gave a lecture talking about this sort of the Venn diagram of IBS, diet and leaky gut, and I have a slide in there. It's funny because I took my whole family to Spain last year. I'm going to family that's obsessed with tennis, and I'm walking around Spain and I'm looking, and everybody still smokes and they eat what they want to eat, and then they eat dinner at midnight, and everybody says oh, it's 'cause they're relaxed. We did go out to the suburbs also, and people drive cars, and they live normal lives, and I started looking back. They eat 10 times the amount of polyphenols that we eat over here, and they have less diabetes, less coronary disease, less dementia, and I realize that that's part of the whole Mediterranean diet aspect, but this is probably why. So when you have people that have a high sugar diet and they're trying to radically switch, all those almost addictive molecules are going up to the brain saying we want more, and I've had patients tell me flat out that it's like they could not stop eating it. So getting them to try and shift there and say okay look, you just have to do a little bit. Let's get your bacteria to help you, let's feed your bacteria. Maybe consider a fast before so that we can go into this thing and then open that up.
Ben: This is fascinating, and a lot of people are talking about post biotics, but it's really interesting. So basically you've got your prebiotics that would feed the bacteria, so these would be inulin and high-fiber foods like dandelion greens and asparagus, and people talk about slightly under-ripe bananas and things like that as prebiotics or even as resistant starches, and then you have your probiotics. So you're eating like whatever, yogurt and kefir and cultured vegetables like sauerkraut or kimchi, and then you would not only be allowing the bacteria with the inclusion of the prebiotics and the probiotic-rich foods to be able to produce post biotics, but then you can also enhance post biotic production even more by including some of these polyphenols.
Dr. Brown: Exactly, and the people that I've talked to about this, it's usually a PhD somewhere that's gotten some grant, and he's looking at one particular molecule. I will sit there with some of these PhDs. We're working with some guys in South America right now, and they will have a gas chromatograph which is like in organic chemistry, you run it through a machine, it has different spikes and then that's like a fingerprint for the molecule, and then you can build the molecule from there. They will show the complexity of what your bacteria can do, and they do this in animal models, and it is so fascinating, so overwhelming and so complex that there's no way that you could sit there be like oh, I'm going to manipulate this one thing to produce this one molecule. That's kind of what I got at when Mother Nature is there. So for instance, the polyphenol that we're using which is a pro-anthocyanidine called quebracho. That is a massive macromolecule that happens to be stable in acid and base.
So this thing basically works to stay in the intestinal lumen and make its way to the colon, where the colon, the colonic bacteria, then we'll just start cleaving it off, chipping off little side molecules, and when these guys show me these gas chromatographs of how many different beneficial molecules come out, it's truly overwhelming, and you realize hey, we're never going to be able to replicate this in a drug because, using Mother Nature to do it and using our own bacteria to do it, you team up, and it's a symbiotic relationship, and that's the really coolest. And this is one of the reasons why we were able to get a patent on Atrantils because this novel concept that nobody ever used quebracho, and the reason why it was so effective is that it's the acid and base environment that it's actually stable and it doesn't get absorbed.
Ben: So that one's called quebracho? Do you like how I did it, with the trilled R?
Dr. Brown: I love it, but yeah. We're one of the only people that put quebracho in something, and this all came about because I realized when I was doing clinical research that there was a doctor. His name is Dr. Mark Pimentel, the strangest smart man that came up with the original concept of bacterial overgrowth. This was 10, 11 years ago, and he and I were talking. He had all these mouse models and he had fantastic studies on how he could show that he could put them through stress, and then 20% of them would end up developing bacteria in their small bowel. He said but you know what? It will never be able to help the bloated, constipated person because they are producing nothing, and the type of bacteria, it's actually in its own kingdom is called an archaebacter. The archaebacter, there in their own kingdom, but what they do is they take the hydrogen that's being produced by other bacteria, and they put it through an enzymatic process, and they spit out methane. And then what the methane does is it slows everything down. It works as a local paralytic. So now you've taken that little sewer pipe earlier, and we're going to slow it down and we're going to make a bigger sewer pipe allow more bacteria to grow, and that's how come you have this vicious cycle. There's a recent study out of Cedar Sinai in fact, it isn't published also. Out of the Mather labs there, you can look this up, it's really cool. They show that those people that had methanobrevibacter smithii or this type of archaebacter, they did it in mouse models. They showed significant weight gain, and that's something that I see all the time. I have people come to me and they're like, I don't get it. I'm eating less, I blow up like I'm four months pregnant, and I'm gaining weight.
Now we realize that it's the inflammatory process that's going on, it's the bacteria breaking down these foods before you can get it and the methanobrevibacter smithiis producing methane, and the methane slows everything down so that more bacteria grow and you ultimately can absorb more calories per bite. So it's this vicious cycle.
Ben: Wow, okay, so what's this quebracho stuff do?
Dr. Brown: Quebracho is actually a tannin. It's a pro-anthocyanin tannin, and it comes from the bark of a very, very old tree. What it does is it doesn't get absorbed, it goes through the lumen, and it works like a sponge, absorbing all this hydrogen. It happens to have a natural defense against archae species and fungi. So what it does is it weakens the outer wall of these archaebacter, the M. Smithii, and it has a natural defense against them. We don't have any antibiotics that can do that, so this particular bark does that. Then the next ingredient, which is the concord tree, which is also polyphenol but it has something called sap in it, so that works like a little soapy mixture with bacteria. It happens to be able to kill bacteria, but it works specifically to shut that enzyme off, and it's the MCR reductase enzyme that produces the methane. So basically the quebracho absorbs the gas, weakens this archaebacter, one-two punch, the concord tree comes in and shuts off the enzyme, that's how it works.
Ben: Wow, okay, so the quebracho, that's the tree, and that one, is that a polyphenol, the quebracho?
Dr. Brown: Yeah, it's a polyphenol. It's a pro anthocyanin which is a large tannins, large complex molecule, and that's what all these nutritionists and dietitians are now discovering that helps with the recovery from exercise.
Ben: Okay, so that one bonds to hydrogen, and that allows for reduced methane production, and it actually destroys the bacterial layer in the stomach or in the intestine?
Dr. Brown: Yeah, so basically it doesn't get absorbed, it doesn't work in the stomach, if you have it high enough, I guess it could sit there in the stomach, but specifically we did it so that it could work in the small intestine. So what it does is that basically weakens it, gets rid of the bacteria, and then it will eventually make its way to the colon where your colonic bacteria will break it down. That's where the polyphenol benefit comes in.
Ben: Interesting, so you're getting two things. You're getting the breakdown in the colon, and then you're also getting the activity in the intestine?
Dr. Brown: So when we initially did our studies, we got two published studies, one in 2015, one in 2016, and we consistently showed that four out of five people are going to get better, and we did that with just the SIBO population. What we didn't anticipate is that all these people that we treated kept coming back saying I'd like some more. I'm like dude, are you still bloated? They're like no, I'm not bloated, but I just feel better on it, and we haven't really gotten into the overall health benefits of polyphenols yet 'cause I was focusing on the one aspect, and now I realize why so many people just want to continue to take it, because they end up feeling overall significantly better. My theory is, because now we're starting to cultivate bacteria that can do good things with it, so like I said, it’s a moving target. There's a lot going on right now.
Ben: Okay, fascinating, but that one is basically soaking up hydrogen gas, and that's the fuel that the bacteria would need for methane, and then it would also attack the cell wall of the archae bacteria you're talking about?
Dr. Brown: Correct, absolutely.
Ben: And this next one that you mentioned, you said it was the horse chestnut?
Dr. Brown: Yes, a horse chestnut is another polyphenol. It works because it does have some flavonoids, but it's also got these things called saponins in it. Now these saponins work to get rid of bacteria by forming almost a scrubbing-cleansing type of mixture with these bacteria, in the lumen and small bowel, but like I mentioned, what's super cool is that we found in these animal studies. Now this is all based off of significant animal studies where States, like Nebraska and Iowa, were trying to mandate in cattle to decrease methane production because of the whole greenhouse effect and everything. They were trying to realize that cattle ruminants have a lot of these type of bacteria, and when they eat, they produce a lot of methane, and they belch it up. So one of the theories was if we have all these cattle, we can decrease the methane production. That's where we ended up figuring all this out was actually through these animal models, and so what they figured out was this horse chestnut. A molecule in it is super cool 'cause it was found that it can actually block this thing called this methyl coenzyme reductase or the MCR enzyme. This is the enzyme that the archaebacter used to make the methane. So here I was looking at all this great animal data going wow, somebody did all the heavy lifting for me. This is beautiful, and that's how we ended up putting these three things together.
Ben: Okay, so the horse chestnut then is not killing the bacteria, it's reducing the actual methane production?
Dr. Brown: It has some anti-microbial activity, but we have it there to actually block the methane production. So each one of these is specific there. We also threw a little bit of peppermint in there. I'm using peppermint leaf. You'll find that many other supplements will use peppermint oil, but I wanted the leaf because the leaf keeps the polyphenol intact. What that does is that has menthol in it, and it can actually inhibit the calcium channels and it slows contraction, so it buys me a little time for the other two ingredients to work better, and it helps me get some histamine, the acetylcholine and a lot of other cool things, but the main reason why we put that there is so that it slows down the area, so that the other two ingredients can do their thing a little bit longer.
Ben: So you want the leaf, not the oil?
Dr. Brown: I wanted the leaf. Everyone goes for the oil because they're going for the anti-spasmodic effect in the stomach. I needed to get to the small bowel where all the action is happening. If you look at polyphenol accounts, peppermint is really high, it's crazy. We shouldn't really be just attracting the oil, let's use the whole plant.
Ben: Oh yeah, I love peppermint. Mild mint grows all over on my land out here, but we also grow peppermint in the garden, and I put it in almost everything. I put it in salads, and I'm obviously, when I'm using Atrantil, I'm getting in that too, because I use this compound that we're talking about, but I love just the pure taste of a fresh peppermint leaf. I mean it's an amazing little herb.
Dr. Brown: Yeah, the actual leaf is really good for you.
Ben: Okay, so you put peppermint in this stuff, you put quebracho in it, you put horse chestnut, would all of those be considered post-biotics in addition to being polyphenols?
Dr. Brown: Well I would consider them prebiotics that the bacteria will turn into post-biotics because the post is the breakdown of these molecules.
Ben: Okay, got it. And when you put all these three together, do you combine with anything else? It's in a capsule that you're placing the stuff, but what else is in the capsule, aside from quebracho, horse chestnut and peppermint?
Dr. Brown: Actually those are the only three ingredients. In the supplement industry that we have we use gelatin, vegetarian capsules, so that it's gelatin, but it's vegetarian, so there's no animal products in there. This is gluten-free, we're NSF-certified, as I mentioned, so everything that's on our labels in these capsules and just a couple of other small things to make sure that the dosing is right. But other than that, those are the three ingredients. Everything else is just a small exhibit to make sure that the milligrams are exactly the same.
Ben: I mean you talk about these individual ingredients being studied, but have you actually looked at clinical research in terms of what happens when you combine these three together?
Dr. Brown: Well, the only studies that have ever been published happen to be studies that we have done. We're currently trying to do very large multicenter study to just go head-to-head with large pharmaceutical industries, but it just requires so much money. We're growing, and we were initially working with Texas Tech, and then we got our Canadian NPN, and some people from Canada have contacted us, and they would like to help with doing a study. And if I can get my gastronology company to open up this whole functional arm, yeah we'll do this. We've got two studies that are published, one was a randomized, one was a study where we treated people that failed everything else, and both times, we consistently showed that four to five people would get better. It's a little bit more than the bend of one, but it's not a multinational study which is ultimately what I would like to do. I certainly believe that I'm bridging the gap between natural treatments and traditional medicine, and one way to do that is to have robust studies where you can say look, it's a randomized trial. It's non-bias, this is what it is, but it takes time and it takes money.
Ben: Yeah, well at least you know it's not going to make aliens pop out of people's chest, based on the limited studies that you've done so far when you combine these three things together, but a lot of people who have eating a high FODMAP diet or a high-carb diet or of taking antibiotics, like you talked about earlier, and had small intestine bacterial overgrowth or bacterial issues from that or you talked about stress and infection. So a lot of these people have leaky gut who have had to deal with that, and a lot of times, I'll recommend things like glutamine or colostrum or this lignite extract made by Dr. Zack Busch, who I interviewed a few episodes ago, as always that you could help to potentially heal the lining of a leaky gut. Are you recommending combining some of these polyphenols that specifically get rid of the methane-producing bacteria with some of those items, or have you found these particular things actually work by themselves to address leaky gut? What kind of stacks are combinations have you found or noted to be effective with something like Atrantil?
Dr. Brown: So when we think about leaky gut, just remember that there's three main causes. One of them is infection and bacterial overgrowth, the other one is a molecule called zonulin which is a molecule that our bodies produce when it's exposed to gluten, and then the third one is diet where you eat a lot of processed foods because that has a lot of the different chemicals that they do for the GMOs, all those other things. They're showing a lot of evidence that all three things can cause leaky gut. So once you start seeing this tremendous rise and autoimmune disease, meaning your body attacks itself that is actually because of leaky gut. So we see more SIBO, more growths, more colitis, more Hashimoto's thyroiditis, there's a lot of evidence showing that it all comes down to intestinal permeability.
So, I think it's so important to protect the lining, all health begins and ends in the gut, in my mind, and you have to be able to go from cradle-to-grave there's evidence to show that the rise in autism is due to intestinal permeability. There is evidence to show that the rise in dementia is due to intestinal permeability. That's our life span, so I know that it's a moving target. I've got introduced, I've not met Zach Bush yet, but him and I've been trying to connect at these different meetings that we go through, but I've heard I think it's fascinating that he did his research on leaky gut. I have been stacking. When people fail, I'm trying to heal, and as a physician, that's what I get now. I get people to fail everything. I'm kind of a last. I'm a third or fourth consult. I basically treat all these people that failed everything, so I listen to my patients, I listen to colleagues I listened when I go to meetings. Like for instance, you know you know Robb Wolf, don't you? The author.
Ben: Yeah I know, Rob. Who doesn't know Robb?
Dr. Brown: I know, well he was taking for same thing. He was taking Atrantil, and he did better on that, but then he added saccharomyces boulardii to it, and so he e-mailed me and said hey, I'm having better results when I combine the two. I'm like that's fascinating, so then I went to a meeting, and I bumped into a naturopath from Australia who had done her research on secretory IGA and how saccharomyces boulardii can increase that, and then it was like this oh my gosh, that's beautiful. So the combination can sometimes help, and then you know some people go through that die-off reaction, and I was on a radio show with a guy named Carl Lanore who do a superhuman radio.
Ben: Oh yeah, I know, Carl. I've been on his show before, he's great.
Dr. Brown: He's a great guy, and he called me when I was out of town at the time, and he said, “Hey man, I'm on a horrible die off reaction.” Die -off reaction is something that can happen when these bacteria, specifically, these are archaebacter. When they start dying, they just release their toxins, and it can give people a really horrible feeling. They just don't feel good, they feel like they have the flu, symptoms get worse, and we're always trying to figure out different ways to try and mitigate this die-off reaction that can happen in about 5% of the people. Carl calls me up and goes hey, CBD oil works great for this.
Ben: Oh, no kidding.
Dr. Brown: Awesome, yeah, so he had great success by taking CBD oil to block the die-off reactions.
Ben: I talk to a lot of people, and I also do well with CBD oil, and they even sell CBD oil as a topical that you can… I've done this with peppermint essential oil as well, you can actually rub it topically on your gut, and it even has an effect then when you have gastric irritation after a meal or you feel as though you have a little bloating or stomach upset. CBD oil works really well for that as well.
Dr. Brown: Yeah I'm a huge fan of CBD. I'm having a really good result putting people on Atrantil plus CBD oil. I like it so much that I want to add this to another one of our research arms because it's the CBD, the way that it affects the CB1 receptor and CB2 receptors. CB1 is a nerve, CB2 is in the immune system, so all these people that have revved up a new immune systems, you can just kind of just chill out a little bit. Let's just take it down a notch, and I'm showing that people's reactions that have autoimmune disease really starts going down. Also the colitis, Crohn's and so on.
Ben: Got it, so CBD oil, saccharomyces boulardii, those would be a couple that you'd consider including with something like this?
Dr. Brown: Yeah, I would, and I would totally use that Bush's stuff. I've heard that's really good also, and that's specifically their glutamine that you brought up is an amino acid that helps restore the intestinal barrier. All those things are fantastic. I sometimes will stack it with some other herbal antibiotics like berberine, had some success with that.
Ben: Yeah that's another one that grows outside in my house. I've got peppermint, so wild mint grows outside and then also organ grape, and organ grape if you dig up the root, it basically contains the same bioactive component that you find in berberine. So it's one of those deals where, even though, I travel a ton, I love better living for science, and I use the Atrantil that we're talking about. I also love the idea that you can often, in just ten acres surrounding you, if you're out in the wilderness, find a remedy for just about any issue that exists, including gut issues?
Dr. Brown: Isn't that so fascinating? And I keep mentioning the same thing over and over which I just don't think that the pharmaceutical industry will be able to keep up with Mother Nature. There's been a precedence that's been thrown down with a company called GW which is a pharmaceutical industry, and they filed with the FDA to make their CBD isolate a drug. So it's the first company, it's a shot across the bow to say we're going to make CBD a drug. Everybody got a little scared about that, and everybody is wondering what's going to happen. I love it 'cause it'll bring up awareness, but it's very myopic in the sense that they're trying to isolate one molecule from traditional, hemp-dried CBD oil will have lots of different polyphenols in it, flavonoids, turpines. All these other great molecules that do a lot more for our bodies, so I guess I commend the pharmaceutical industry from trying to produce a drug out of something that you really can improve on by taking one molecule out. So let them continue to do that for awareness, we'll continue to do what you're saying. Go out and dig up the organ grape root, and there you have berberine.
Ben: Yeah, the other thing is that Thorne. I don't know if you've heard about Thorne, they actually have a new hemp that's the seed and the stalks. They've taken the cannabis sativa, and then they blend that with a clove extract, with a black pepper extract. They put hops in there which makes it more bioavailable and then rosemary extract, and that's a new gel cap that Thorne does. They're one of the few companies that I think can go to bat against some of these bigger pharmaceutical companies, but that's one that I've got in my refrigerator now is a gel cap. I was in the CBD business for a while. I had my own blend of CBD that I produced blended with…
Dr. Brown: Oh you did?
Ben: Yeah, it was ashwagandha, lemon balm, magnesium and a really good water soluble CBD that had curcumin added to it to make it more bioavailable, but unfortunately, the government and payment processors are so hard on CBD manufacturers in terms of limiting everything from payment processing capabilities to you having to switch URLs. I have like you know my business, Kion, which is super-duper clean that I wanted to keep separate from anything related to CBD just because, despite it being an amazing molecule, it's just something that makes regulators super-duper nervous, but this Thorne stuff is actually really good, if you haven't tried that out. What I'll do is for everything that Dr Brown and I are talking about, for those who are listening, I'll put a link to it over at, here's a good URL for you, bengreenfieldfitness.com/gas. That's bengreenfieldfitness.com/gas to check that out.
Dr. Brown: Gas, I like that. Yeah I was actually contacted by Thorne also, and they threw in something else that's really cool. I think they put in Omega-3 in there which they've shown that the Omega-3 can be symbiotic with CBD. I'm actually still passionate about this, I have seen so many of my Crohn's patients and all sort of colitis patients get better, and I've been able to keep them off from really toxic medications. I'm doing all those regulatory things you're talking about that is super hard to do, and we're going to white label my own CBD, and it's going to be physician back, going through all the proper channels, making sure that the interchange and all that works. It's costing a lot of money, it's taken a lot of time, but I'm that passionate about it that if you've got one of these autoimmune diseases, I really think that you can be helped with it. And clearly you've had the same success with that, and this is a broad spectrum, fido-cannabinoid therapy. So that's unfortunate, you got out of it.
Ben: Have fun being in the CBD business, man. It's a beast, but I wish you the best. I wanted to ask you too, about the use of this Atrantil. Do you recommend taking before pretty much any meal that you have during the day, is it one of those deals where you would just take it before carbohydrate-containing meal? How would that work exactly?
Dr. Brown: So when we look at dosing of it, we've got a 90 count, and in all the studies that we did, if you are a chronic sufferer, so if you've had, whenever you eat, you bloat up, we really suggest that you do this as a full course. So you take two capsules, three times a day with food. Really with or without food, but I just suggest taking it with food, for a full 20 days minimum. Sometimes it takes longer, sometimes it happens a whole lot quicker, but it's two, three times a day. And then on a regular basis, you can just take it as needed or on a daily for the polyphenol effect. So there's people like me where I'm gluten-intolerant, and I always have it on me whenever I travel, just so that I can take it if I'm in the little gluten. If I'm out traveling in a meeting or something, it's hard to avoid some of the foods which are going to affect me. I can take it and not have any issues with gluten, so there is the chronic group, there's the food sensitivity group and then there's just-take-it-on-a-daily-basis-for-the-polyphenol-effect group.
Ben: Okay, got it. So how many capsules?
Dr. Brown: Two capsules, three times a day until you feel better. Then it's just two to three capsules every day.
Ben: Okay, super simple. In terms of the need to load, the need to take consistently, do you get to a point where, and I realize this as a tough question of you being in the business where you're selling this Atrantil, but do you get to the point where you've knocked out all these bacteria and you can step back on the dosage or stop taking it all together?
Dr. Brown: So yeah, we have a lot of people, and I feel very unfortunate for all the people that try to come off of it and they can't, but almost, most people will take a round of it and then just take it as needed. I only say that because if my CEO was listening, it makes it a little difficult to make it a subscription because people get better.
Ben: Well what I did was I started off taking a whole bunch, sorry to interrupt. So I was taking three before every meal, now I take two a day before dinner which is my biggest meal of the day.
Dr. Brown: Yeah, that's pretty much what I do also.
Ben: Yeah, and then if I hit the Whole Food salad bar, I just have one book bag. So if I decide, I may go off to the garlic and the onions and all that. I mean it's like those gluten-digesting enzymes that you can take, the gluten polypeptidases. If you do decide to have a pizza, they can limit some of the damage or the lactase that you can take to digest some of the lactose if you happen to have a bunch of dairy and you're lactose intolerant. Same thing with this, like if you decide you want to have your garlic and your onions and all these fermentable compounds, you can at least pop a couple to sop up some of the damage.
Dr. Brown: Exactly, there was a recent article, not to geek out too much, but there was a recent article I just came across where they were looking at the molecular process that happens when you take these polyphenols, and it looks like two things are going on. It decreases the amount of the enzyme that digest it, so you're not absorbing as much, and it forms like a weird matrix around the gliadin, so it's not as easily absorbed which would totally explain why I can eat gluten as long as I take Atrantil with it.
Ben: Interesting, I didn't realize you could use it for gluten, too. Good, I'm going to add that to my protocol, then I'll be hitting up the pizza parlor tonight with my Atrantil.
Hey, this has been really interesting, man, and I know we have a discount for folks set up. It's a 15% discount that you get on Atrantil. I'll put a link over in the show notes at bengreenfieldfitness.com/gas, but we've also got a great little link for you as well. It's lovemytummy.com/ben. That's lovemytummy.com/ben, and if you go there, you can enter the code “Ben” and check out. That will automatically get you 15% off, and you'll be off to the Atrantil races, getting rid of your gas and bloating. Again, I would say GI issues have been like my personal biggest issue, so anytime I come across something like this that really moves the dial. I'm a huge fan of letting you guys know about it, so that's it. Its horse chestnuts, peppermint, quebracho. It was designed by the great wonderful Ken Brown. Ken, thanks so much for coming on the call and sharing this stuff with us.
Dr. Brown: Yeah, totally. Hopefully some of your listeners are still doing the endurance competitions. Maybe we'll get some personal records after they take it for a bit.
Ben: Yeah, and by the way, if you guys take it and you have questions or thoughts or feedback after you use it or anything else, just go to bengreenfieldfitness.com/gas. You can leave your questions there, and over there, I'll also link to some of those other things we talked about like the Thorne hemp and the microbiome test that you can get, a good sheet with a FODMAP diet and some other resources that Dr. Brown and I talked about. It will all be there bengreenfieldfitness.com/gas, and in the meantime, Ken, thanks for coming on the show, man.
Dr. Brown: Hey, man, thank you. It's totally my honor.
Ben: Awesome, well folks, until next time, I'm Ben Greenfield along with Ken Brown signing out from the bengreenfieldfitness.com podcast. Have an amazing week.
For the millions, including me, who have had to deal with bloating and abdominal discomfort alone or accompanied by constipation, diarrhea or both, life can get pretty miserable. New research shows that the problems start with methane-producing bacteria. Left untreated, these out-of-place bacteria feed off the foods you eat and create methane gas that leaves you bloated and uncomfortable.
Dr. Ken Brown, today's guest, is an expert at how to permanently fix this issue. He received his medical degree from the University of Nebraska Medical School and completed his fellowship in gastroenterology in San Antonio, Texas. He is a board-certified gastroenterologist and has been in practice for over 15 years with a clinical focus on inflammatory bowel disease and irritable bowel syndrome. Dr. Brown declares that his mission is to bridge the gap between medical and natural science.
For over a decade he has been conducting clinical research for various pharmacologic companies. Dr. Brown recognized an unmet need for something natural that could help his IBS patients find real relief. After developing the only all-natural, clinically proven answer for IBS and bloating for over 6 years, ATRANTIL (ahh-tron-teel) launched in the summer of 2015. Dr. Brown developed Atrantil to help those suffering from the symptoms of IBS which we now know are caused by bacterial overgrowth.
During our discussion, you'll discover:
-Why bloating occurs in the first place…10:00
-The very best test to determine the source of your bloating…18:00
-The mechanism by which polyphenol would get rid of bloating, and the fascinating action of “postbiotics”…24:00
-The South American herb “Quebracho”, and how it can disrupt hydrogen production and kill archaebacteria in the gut…42:00
-How horse chestnut and peppermint work together to get rid of bloating and gas, and also to heal the gut…47:30
-Whether the three ingredients in Atrantil have been studied for efficacy in the gut…52:00
-The best way for people to get Atrantil and how long to take it…1:03:45
-And much more!
–Daily Harvest Get 3 cups for FREE using promo code “BEN”.
–Blue Apron Prepared Meals. The leading meal delivery service in the U.S. Use my link and get $30 off your first order!
Resources from this episode:
–Get Atrantil here – enter code “BEN” at checkout for 15% off of your purchase
-Viome Microbiome Test