215 - The gut-brain connection | Michael Gershon, M.D.

[@PeterAttiaMD]

In this episode, we discuss: -Intro [0:00] -The basics of the gastrointestinal (GI) system [3:45]; -The very early development of the GI system [9:30]; -The unique properties of the blood supply and portal system in the GI tract [12:45]; -An overview of gut anatomy and innervation [16:30]; -Turnover of the epithelial lining and why cancer rarely develops in the small intestine [26:45]; -Nutrient and water absorption in the small and large intestine [30:30]; -Ways in which the gut and brain communicate [34:30]; -The gut's role in the regulation of appetite [43:30]; -The impact of gastric bypass surgery on satiety signals [51:15]; -How varicella-zoster virus (VZV) can infect neurons in the gut and create issues later in life [54:30]; -The relationship between autism and gastrointestinal illness [1:02:45]; -The important role of serotonin in the gut, and the impact of SSRIs on serotonin in the gut [1:09:45]; -Defining “leaky gut” and its most common causes [1:16:45]; -The gut microbiome [1:30:45]; -Fecal transplants: use cases, limitations, and how they illustrate the importance of gut microbes [1:40:45]; -Gut microbiome diagnostic tests: why they aren’t useful outside of special cases such as cancer detection [1:50:30]; -Nutritional approaches to a maintain optimal flora in the gut [1:55:00]; -Prebiotics and probiotics, and getting your GI system back on track after a course of antibiotics [2:02:30];

[@tinale8228]

I want to ask Dr Mike that I have constipation whole my life as I’m 40 now. Which probiotic can I take to help me with it? Thanks. I have tried everything even exercise but nothing has been working yet. My mum told me that I did not poo for 4 weeks in my first month of my life. Am I born with constipation?

[@eugeniebreida]

@@tinale8228 Have you tested a very high (meat) fat diet? Maybe adding lipase to enhance absorption?

[@jobrienchem1]

(Unrelated to this particular episode) PLEASE! Do an episode focused entirely on cortisol. It's such an important and destructive molecule. It could be a full episode focusing only on the physical effects of cortisol. There have been episodes you made about ways to manage cortisol, indirectly, through mental health and stress reduction. But, there has not been an episode focusing *specifically* on the cortisol molecule and everything surrounding the physical health of this molecule. Thank you.

[@rob2050c]

Thank you Peter and Dr Gershone. Fabulous discussion. I'm so grateful for content like this on Peter's channel.

[@colinfarrell6444]

Brilliant, brilliant, brilliant. Absolutely loved listening to this discussion. Thank you so much

[@simonpc123]

Absolutely wonderful shownotes Dr Attia and team. Thank you so very much. As a dyslexic I really appreciate the time taken to find such excellent diagrams. Again, thank you all.

[@AnnTsungMD]

He is indeed amazing and God given.

[@briantanzer5599]

i remember reading his book, The Second Brain when it came out in the late 90s. I had just finished an M.S. in nutrition and was totally blown away by the content.

[@alysonsmith8046]

Great podcast! Listed to it 2x already and will listen a third time. Packed with lots of great info!

[@bke07]

Hands down *the* best interview I’ve ever heard, and Peter has had some great ones. Also, I hope I’ll be as sharp as Michael when/if I get to his age, which I assume to be around 80 since he has a 60yo son.

[@stirred.spirits]

My favourite episode yet! Mark has to be protected at all costs ❤️

[@AnnTsungMD]

i like this episode a lot as well.

[@shelchicago8997]

This doctor’s introduction to the gut blew my mind

[@Pohgg-c9o]

I have lost some weight this year, only change I made was to start making/eating fermented foods in general but specifically with meals that have carbs. Not very scientific but I am also a shift worker with a sub optimal schedule swinging back and forth from days to nights every work week. Take what I can get where can get it.

[@Lisa-ny2mr]

Thank you, I learned a lot from this podcast. As a NICU nurse, I know it is suspected that necrotizing enterocolitis may have a bacterial component to it, but the cause is not completely understood. I now have a better understanding as to why. There also have been some trials with probiotics for different indications but with, so far, to my knowledge, little efficacy.

[@lindaw140]

Thank the guest so much. Also enjoyed having Peter asking relevant questions learning the subject together

[@healthyteddy]

The probiotic he was trying to remember is solid by the name Florastor. I've been using it when necessary for my family and it has always worked great for us.

[@retvrntotradition]

One of the best episodes you've had. Super informative!

[@premp7907]

Thank you so much for this wonderful podcast. Didn't think I would watch the entire video in one sitting. It was so engaging and informative.

[@mariadelgado4393]

Love your sharing medical foundational knowledge, as undergraduate in Health Science, your ideas and information help me grasp such interesting scientific material. Thank you!,,😊

[@robertkraychik1884]

incredibly interesting, informative, and ACCESSIBLE. thanks to to the attia team and gershon for this overview and introduction to the gut.

[@mv4098]

One of my all time fav podcasts!!

[@kathyirwin5518]

Mind boggling! Both the body and this man’s knowledge of it.

[@AnnTsungMD]

really an amazing man.

[@DoloresGeyer]

Excellent episode. I am on an antibiotic and my doctor prescribed Florastor which contains Saccharomyces boulardii lyo mentioned in this podcast. Thank you!

[@caseyhynes24]

Yes, one of the better ones. I want to be like Mike. I was working out while listening this and started cracking up in the middle of a lift when Mike referenced going to the John three times. Great listen.

[@k...5853]

What killed me was him referring to some non-professional fecal transplants as "home brews."

[@AtypicalPaul]

Wow. So great. The inside of your gut is outside the body! This is such a simple but impactful statement.

[@DaboooogA]

Great discussion thanks

[@Joy80JJ]

So much interesting info. So enjoyed this interview. Thanks Dr. Peter for always providing great show notes.

[@eugeniebreida]

Thoroughly enjoyed this very relevant discourse, and shall be back to this video to catch the nuances on the second pass. Thank you Dr Gorshan! And Peter!

[@AnnTsungMD]

such a very insightful episode.

[@yuriventura6467]

"I think now they vaccinate kids for chickenpox" "Yeah, my wife made that vaccine" "Oh woah, anyways.." The level of casualness in this exchange was hilarious

[@blueberry4082]

They don’t vaccinate kids for chickenpox

[@roughywatcher]

Not at all an antivaxxer but I am still concerned about this [59:21]: "Lets call it a sequestered virus and it sits as a piece of DNA inside of your body and your immune system can’t see it because it’s not expressed on the surface of the nerve cells that have it. The immune system has a very good look at it when it reemerges and you attack it, kill the cells in which it reemerges. The pain can continue. What we’ve discovered much to our chagrin in that the enteric nervous system can be infected by this virus when you have chickenpox or when you get the live virus vaccine. It can establish latency within the intrinsic nervous system of the gut, in the enteric nervous system and when it rearises, even if it gets killed by the immune system, it’s killing nerve cells. And so you get diseases such as pseudo obstruction in which the gut simply loses the ability to work and just becomes totally paralyzed or if the virus emerges and gets into the mucosa the gut can perforate." "And what’s the frequency this happens?" "We don’t know. It’s just been discovered." Note especially this disease can arise: "...when you get the live virus vaccine." Is that the one his wife developed?

[@bikerfreak714]

Amazed how sharp Dr. Gershon's memory is. I can barely remember my kids' birthdays

[@lars-goranehn3961]

Thank you for a most informative and entertaining interview! Why not try to get hold of Stig Bengmark for an interview! It seems to me that the two of you could have a fruitful conversation, not only about pre-/pro-/symbiotics but indeed about longevity. Thanks again.

[@lucylou5766]

Incredibly generous sharing of knowledge by Dr Gershon. Not a young man any more, two hours plus and no waffle. Kinda surprised at the host here. It felt he was pushing the boundaries a bit in extending the interview with way too many questions. And he mentioned his guest’s name only once. I mean, it was two hours long! How bout giving your guest the credit, Dr Attia? Not very professional.

[@drsaintdc]

Is there video of this?

[@tukity]

The story of prof mike's son is unbelievable. So much dense info in this podcast.

[@lifeinsuranceguru]

Great video with lots of good information! I'm a little disappointed that he doesn't look at the diet from an evolutionary perspective though. His recommendation to simply eat a "balanced" diet ignores the fact that our human diets have only included grains for the last 10,000 years out of 4 million years of human existence. Take away all those foods that would not have existed 10,000 years ago and tell me what a balanced diet looks like. I'll bet it's largely carnivore with nuts and tubers in extreme cases of potential starvation. Who in their right mind would eat a fibrous tuber when they can eat meat?

[@lyndao7356]

Wow. Just wow. So many thanks.

[@CoachKolton]

I didn’t catch that over the counter product in the show notes. Did anyone else?

[@karencatlin950]

Dr. MIKE and his doctor wife must have interesting breakfast discussions!

[@TastyPieyay]

An interesting thing to note with the sterile baby animal stuff is that inside the womb is not actually a sterile environment. There are multiple different bacteria present in the fluid surrounding the embryo, and on top of this I also believe that some bacteria are shuttled to the foetus via the umbilical cord. I don't know the specifics, but definitely an interesting topic if you want to read up on it!

[@fBrunPeressin]

peter can I reasonably expect the bacteria in my AG1 to be alive after first opening ? what can a few molecules of oxygen do at a time do ? please just tell me. I do refrigerate it.

[@EmeranMayerMD]

Great episode!

[@richfisher7000]

Correction - according to the WHO annual cholera deaths per year are 21,000 to 143,000 not 3 million.

[@AtypicalPaul]

Great conversation

[@bennguyen1313]

Any thoughts on the akkermansia gut bug? It seems strongly correlated with Parkinson's/dementia.. but is there any evidence that suggests the relationship is causal? For example, the Braak Hypothesis suggests severing the vagus nerve will dramatically slow the progression of disease, presumably because less abnormal alpha-synuclein are able to travel from the gut to the brain. However, the other Parkinsons/gut connection is constipation.. the only symptom that is common amongst ALL Parkinsons patients, and develops decades before any tremors. For example, at the 1h2m mark, it's mentioned that the VZV causes systemic symptoms when first exposed (chickenpox), but once it goes latent inside a (skin or gut) nerve cell (invisible to the immune system).. it can re-activate throughout life (as it escapes the Dorsal Root Ganlion). The primed immune system will kill it, but as you age, the VZV can get the upper hand (shingles), so is it possible that If the immune system has destroyed enough enteric gut neurons, that this is what causes the constipation and/or a different flora makeup (increased akkermansia)?

[@hoikiuip3062]

There are gut microbiome tests which show the amount of bacteria down to the species level. How reliable are these tests?

[@LawrenceAugust_]

His claim at 32:05 of "perhaps 3 million people a year die of cholera" is quite a bit off... Per CDC: "An estimated 1.3 to 4 million people around the world get cholera each year and 21,000 to 143,000 people die from it."

[@14nst3w4rt]

53.00-54.10 - so if I take a (calorific) protein shake instead of lunch this is not good?

[@shelchicago8997]

Excellent!

[@litlp33]

So good. Thank you for this

[@harsh_nehra2010]

Sir i appreciate your efforts but if you would have recorded it live ; like you 2 sitting together and having the conversation it would've been even better It was slighlty difficult to keep on going to understand everything.

[@LawrenceAugust_]

“They vaccinate people for chickenpox now, don’t they?” “Yes, my wife invented that.” “Oh wow.” Helluva moment, lol

[@21972012145525]

Any eczema connection with the gut?

[@ceaseoccupation]

sharing wealth thank you

[@waliaowee]

Can anyone pls help me the probiotic brand that Dr Michael is mentioning. Will b a life saver to me. 🙏🙏

[@davidsalvador6031]

Florastor

[@healthdoc]

VSL#3 is one of the best on the market.

[@machhca]

Brilliant! Thank you.

[@tomservo75]

Anyone heard of Keto or Carnivore diets? I've heard that's supposed to assist with microbiome issues. I've been taking probiotics lately which have provided some relief, but not complete.

[@blacktaxi2d]

love when he was shilling for Activia yogurt, then mentions he's a consultant for Dannon. lol.

[@StoryThyme100]

I am appreciative of this interview AND Dannon settled a 45 Million FTC lawsuit in 2010 due to it's false advertising claims regarding Dannon Activia and Danactive dairy drink.

[@blacktaxi2d]

@@StoryThyme100 amazing 😂

[@bogasixtyeight5153]

Best yogurt you can have is kefir. Buy the grains and ferment it yourself. Saved me from bloody stools due to my colitis.

[@Philly1958]

He is outright wrong on c-dif treatment. Vancomycin is a poor treatment and guidelines suggest fidaxomicin as it’s proven to reduce reoccurrence. You may want to make this cottection

[@Lewistoneb]

Nice Diastema

[@thepatternforms859]

You must be a dentist. So here is a test to see if you are… what % of the time will MB+2 be present in upper 1st/3,14?

[@Lewistoneb]

@@thepatternforms859 ask any endo and they'll say 100%

[@FeFeronkaMetallica]

I wanted to love this one but when he completelly failed on the topic of cholera I dont know if to take this seriously.

[@parapoliticos52]

a walking library

[@AtypicalPaul]

Factory farming has such a huge detrimental effect on the human species and all the animals being so horribly abused.

[@gillmelbourne07]

First one here!

[@MyronLuis]

🎉

[@amychien5746]

Amy watch later

[@arpitsharma8947]

you have to do plenty of homework before you can understand this

[@tommyjoe4310]

Too deep in the weeds

[@Ethan-sg9cm]

He lost me at "balanced diet". Avoid grains, legumes, seed oils and processed sugars. Avoid chemical emulsifiers like guar gum. Get lots of gelatin for bowel health and skip most fiber unless you like gas, bloating, and big poops. Be in ketosis sometimes rather than rely on short chain fatty acids from bacteria. Fiber just isn't essential.

[@bradfordlangston836]

I'll be sure to rely on your expert opinion

[@legaltenderradfem]

I learned SO MUCH ! Thank you