In this episode of the root cause medicine podcast, we will be discussing guests for intestinal health, with Dr. Cheryl microbiome. It's not about our own cells, but about this bacteria that's in us. And if we were to boil humans down, we would find we'd be nine tenths, bacterial DNA, and only one 10th of human DNA. Welcome to the root cause medicine podcast. Each episode focuses on giving you the information. You need to understand the root cause symptoms and treatments available for specific medical conditions. In each episode, we'll meet renowned medical experts, specialists, and pioneers who have influenced the way certain conditions and diseases are understood and treated. I'm your host, Dr. Anthony Fauci. Welcome. This episode of the root cause medicine podcast today, we have a very interesting guest. Her name is Dr. Cheryl Burdette. Dr. Burdette has a very extensive and fascinating background. She is the co-founder of precision point diagnostics, a functional laboratory with a focus in gut based. She's also the founder of personal logics health academy, an educational initiative, and many other things. Dr. Burdette is the director of education and the naturopathic residency program at progressive medical. She's on the board of advisors for Xymogen. She also completed her residency at cancer treatment centers of America and the family health and wellness center. And while practicing in Atlanta, Georgia, she worked at a laboratory that specializes in nutritional and metabolic tests. Dr. Berg does passion is teaching around the practices of integrated and naturopathic medicine to increase awareness of evidence-based natural therapies. She's also helped formulate a new educational piece for Xymogen on I G Y, which is a powerful tool for gut-based inflammatory condition. So without further ado, it's my pleasure to introduce Dr. Burdette. Thank you so much for joining us on today's podcast. And in case I missed anything, please tell us a little bit about yourself and fill in those guests for our listeners. Well, I think you've got the highlights there. I'm also a mom of two kids and three dogs and wife. And so that keeps me busy. That's amazing. I mean, come on, you got multiple full times jobs here, Dr. Burdette. So give a round of applause for you and all the moms out there listening. Cause that's a big time thing. So thank you for doing such a great job. Today Dr. Burdette, we really want to discuss the GI and digestive and gut health because so many people are suffering with this around the world. So many people are wondering what is going on. And so there's just so many Americans, especially that are really, really dealing with this on a daily basis. And what we want to know is why do you think this is happening? Why do you think this is going on? I think that the assault to our GI system has continued to grow and grow. And this can be a, it's a lot of things that have come together all at once to really create the perfect storm. So what we used to think is that when you eat food, the GI tract, that it's a barrier and this is where we absorb things. And that's absolutely still the case. But what we realize now is that it's so much more than that. In fact inside your GI tract. And so that means all the way from your mouth esophagus, stomach, small intestine, large intestine, and out throughout that house, we that's where 85% of our immune function happens. It's where we make enzymes. It's where we make. Neuro-transmitters and they don't just stay locally there either. And so, so much is going on in terms of function. And then we look at how eating habits have changed. And we're all aware that while probably, I mean, even in the fifties, there were a lot more fruits and vegetables, a lot more prepared foods at home, and we've seen. Towards things that are more processed and when they're more processed, of course, they tend to have higher, stronger, and more salt. And they remove a lot of the nutrients. Like I always laugh at something called a wonder bread because it says it's enriched and you actually take out more nutrients than you ever put back in. And so all of these things have come together to start an assault on our GI tract. And then you add to that. The fact that even if you're trying, most of us can't eat organic food all the time you go out, maybe you're out a really nice restaurant, but that steak still isn't necessarily organic. And so add to that, the antibiotics that are in the food supply that really changes our bacteria. And we're learning more and more about this microbiome and how really, how we age is not about our own cells, but about this bacteria that's in us. And if we were to boil humans down, we would find we'd be nine tenths, bacterial DNA, and only one 10th human DNA. And so that piece of it, and then just to kind of finish it off, we are also under a lot more stress than we ever used to be and stress create. Less blood flow to the gut. And the reason for that is because when you're in a state of stress, you are in the part of the nervous system called fight or flight. Get away from the bear. You're not in the part called rest and digest that parasympathetic. And so you decrease the blood flow to the gut. And this really changes what's happening there as well. So processed food, lots of sugar, lots of stress, and all of that added antibiotics in the food supply. All of that adds up to really change what's happening in RGI. That's so interesting, Dr. Burdette, thank you. And it's no wonder talking about wonder bread. Why so many people are suffering with all of these things. So you hear about people traveling overseas from the United States to countries in places like Europe, where they can eat pasta and bread. And it's a completely different compound. As far as I know, over there versus in the United States where everything's so processed and it's not very natural. So it sounds like. Here we are on the root cause medicine podcast, trying to understand the root causes of some of these things. So thank you for diving a little bit deeper into that is really, really fast. And I think that's such an interesting issue because for so long, I'm going to have patients, for example, that can't tolerate wheat or gluten when they're here. And then they go on that vacation to Italy and they're like, but I could eat the pasta there. I could eat the bread. And so I would think, well, maybe it's that you're on vacation. Maybe you're less stressed. Maybe that glass of wine, you're just feeling a little better with it, whatever. And I think all of that can play a role, but also you're quite right. We've hybridized our grains here and we changed them here. And so one of the things that is different is that in Italy, for example, they use more durum wheat and that durum wheat has a well, an enzyme in it, a deck, a peptide, and that enzyme breaks down the allergic or the, the antigenic part of the wheat, something called And so by the time it gets presented in the GI tract. There's less of the irritant there than there is on some of that. We tend to utilize more of here. So there absolutely is a different in terms of what we choose to grow and therefore how our bodies react. So fascinating. I know there's so many people are dealing with even the wheat, sensitivities and allergies nowadays. So absolutely true. When you're looking at the root causes of GI gut health, digestive issues with your patients, and when you're teaching them, what are some of these further common things or sources that you're usually finding that? Well, why are they presenting? Yeah. So a number of things could be going on there. Like we mentioned, there could be prolonged stress and that causes a decreased blood flow to the gut that could have had a history of using a lot of antibiotics. And that changes the floor and the gut as well. And really not just antibiotics, but many medications have the ability to do that. They can alter pH or they can have different dyes and colors on the outside. The can change what's happening in it. On a gastrointestinal front, people can become over-reliant on the same foods, which eventually can cause some irritation to the gut lining. And we can end up with low level infections in the gut bacteria. Yeast or even parasites and many people think, oh, well, if I had an infection in my gut, I would know. And maybe you would, and maybe you wouldn't and then kind of check in if you experience a lot of gas or bloating, if you tend to not have well formed stools and yeah, you probably do have a low grade infection there, but. You can have a low grade infection in your gut and not even have GI symptoms. In fact, there's a lot of literature that talks about inflammation in the gut, being a reason for things like depression. And so, so many people would think, well, I can eat whatever, and it doesn't really bother me. Therefore it's not related, but not always because that inflammation that starts in the gut will affect some people the most there. Will affect some people moderately there, and some people won't feel it there at all. They'll feel it more systemically in the rest of their body. Things like joint pain, depression, and various other chronic conditions. It's so interesting. So you can have so many different types of diagnoses and also symptoms, but have no GI or gut symptoms. And then you don't think anything's wrong with your digestive. Absolutely it's because, like I mentioned, 85% of the immune system is in that GI tract. And so what happens is when you become inflamed in the GI tract, some of us are just more resistant, more robust, or that's just not our weak spot, but that inflammation that's created there there's signals. Don't stay there. So we'll, it will create signals. Things called like aisle six and TNF alpha and aisle eight, and they'll move throughout the body and then they can trigger more inflammation and whatever your genetic weak spot is. So for example, when we are inflamed in the gut and we make more of this aisle six, it sends a signal to the liver to make something called C reactive protein. And C-reactive protein is an inflammatory marker. But it's commonly looked at for cardiovascular disease and measured for things like rheumatoid arthritis. It's not typically used as a gut-based marker. And so it makes that point that what starts in the gut doesn't stay in the gut and can create inflammation elsewhere. They're sending signals to the liver or out in circulation in general. So fascinating. And like you're saying, it sounds like people are going to their doctors with certain symptoms and they're checking for these markers, but then not relating it back to the gut where it can all be starting from the, from the first place. Exactly. And the other problem with that is that if we're not really treating the root cause then people get stuck on medications. Of course, they're going to be treating the symptom, but if that gut based inflammation's not addressed, then you're going to be on that antidepressant more longterm because that inflammation that's occurring, isn't changing. And it sounds somewhat far, far removed, but we can get right down into these little nitty gritty pathways and biochemistry that really illustrate this point. So for example, in terms of depression, There's an amino acid known as trip to fan, and it's, what's high in Turkey and it's what makes you sleepy on Thanksgiving. And if all is going well, your body takes that trip to fan and it converts it into serotonin the neurotransmitter that makes us feel good. But if you've got a lot of this aisle, six floating around from leaky gut, like I mentioned, It completely blocks that pathway and nail that trip to fan doesn't make serotonin. It makes these other neurotransmitters that make us a, can make us not feel well and totally changes what that nutrition would have done in our body. And so you can take an SSRI and feel better from. Something that increases serotonin and feel better from that. But you're going to continue to need that support unless you get rid of the root cause why the serotonin was lower in the first place and it can be traced right back to gut based inflammation. So important, obviously, always wanting to get to the root issue. Otherwise, as you're saying, these symptoms will fester and fester until one day it gets so bad that the point of no return becomes a present. So Dr. Burdette, you've mentioned this term leaky gut, and I think some people have heard about it, but it's such a funny term. Can you break this down for everybody? So we kind of know what you're talking. Absolutely. And it does, it strikes you as odd and it, and I can remember exactly where I was sitting in school. The first time I heard about it, who was talking about it. And I remember thinking that sounds made up to me. I'm going to go to the research. I'm at a place called pub med where all the peer reviewed medical research is. And I was like, I'm going to look this up. And unless I find something on there that I know that this isn't a real thing. And at that time, which was. Um, a few years ago, at least you did not find anything referring to leaky gut on pub med. Now, if I did the same thing today, we'd find hundreds, even thousands of publications around that. And so leaky gut and maybe one of the ways that it really became quite apparent overall. Is that what we learned was that you could actually measure things that modulated it. And so, for example, and it's a marker that we do at precision point labs. There's something called zonulin that you can measure in your blood and Alessio, Fasano, a researcher. Who's now at Harvard, he popularized this idea. And so zonulin is a molecule that tells they're called tight junctions and they hold your GI cells together. I always think about Lincoln logs. And so when zonulin goes up, it tells these tight junctions to open and these tight junctions are hold together. What are called kissing points? I always like, I liked that too, because it sounds attractive. So Zombieland comes into the picture. These are your tight junctions open up and now your fortress wall is no longer intact you're permeable. So we could call this permeability to if we wanted to add some syllables in there, but at the same thing. So the gut becomes permeable. And now, instead of being this barrier that decides you stay out and this comes in, things begin to leak through and they leak through intact and so larger pieces of food, larger bits of bacteria. And when this comes into our body, our body goes, whoa, that is not something I am used to. That is foreign. I'm going to treat it like a pathogen. And so we start to Mount this attack to it. We increase inflammation, our white blood cells get going. They make more of this interleukin six and interleukin eight, and it creates this inflammatory process. And so. Leaky gut. It explains why the gut can become such a source of inflammation for the rest of the body. And when we kind of just say it a slightly different way, it means when we treat the gut successfully. Best ways to calm down inflammation in the system. And so that inflammation might be causing depression or joint pain that inflammation might be flaring your lupus or your rheumatoid arthritis. It's a sure it's nonspecific. It will reduce inflammation in general. But that can, inflammation can be the fire behind so many different pathologies out there. And so it's a natural way of decreasing inflammation in the body. And it's something that doesn't have side effects. When we think about some of the medications that might do this glucocorticoids, they are successful. They just also come with a pile of side effects as well. And so. If there's an inflammatory component working on gut-based health can be part of calming that inflammation down and helping people feel better. Absolutely. And I think just remind all the viewers, when you're saying the inflammation, we're talking about this chronic silent inflammation that breeds from Bruce for years and years until one day you develop symptoms. And that's why so many people are only looking at symptoms. And when this has been going on for a very long time, And in Dr. Bet, you were talking a little bit about the testing for leaky gut. Can you kind of dive a little bit deeper into that for us? Yeah. So this was a real breakthrough moment when Alysia Fasano, Dr. Fasano helped us to understand that you could measure something like zonulin and that, that was telling the gut to open up because it really. Validated. This is a concept for years and years and years. Those of us in integrative medicine and functional medicine had talked about this concept. And then you would go to maybe some other doc and they'd say, well, because it does, it sounds funny. That's not a real thing. You know, let's get you on this antidepressant. Let's get you on this. Anti-inflammatory. Let's approach this from more of a pharmaceutical type of approach. And first of all, there's nothing to say that we can't both use a pharmaceutical approach and treating root cause at the same time. And then the idea is that you need less and less of a medication and often you're able to wean off. But, so this was a great breakthrough moment when we learn, oh my goodness. There's a biomarker. There's something that we can measure in the blood. That correlates with pain or with, with leaky gut throughout the body. And so when that went up, the gut became more leaky. Another really fascinating thing about zonulin is what Alysia personas research showed us is that that goes up in the blood. Before the onset of various autoimmune conditions. So we aren't born with lupus. We aren't born with rheumatoid arthritis, so it's not entirely genetic. Of course there can be genetic tendencies, but there's some type of trigger that sets that off. And so what his research showed us was this marker zonulin, as it goes up. Tell us the gut to become more leaky. And that's the trigger that causes those genetics to express itself. So we can measure this phenomenon now and zonulin opens up those tight junctions and it's one way we become leaky. We can also become leaky because you just wear down the gut lining you, just, it just eating things that are not very helpful, or you're taking maybe insides. And we know that. If someone takes too many insights, you can wear down the gut lining so much you ulcerate and you believe that's a very leaky gut, but it's not mediated by zonulin. And I tell people think of that more like just the sledgehammer. So the first way zonulin that's the elegant way. That's the key. I put my key in the keyhole and I open up the tight junctions. That's one way to get it. The less elegant way as I just show up with my sledgehammer and I start beating at those tight junctions and eventually they wear down and open up. And so that's atrophy. And so another way that we can look at that, some testing markers that help us do that are to look at things that we make in the gut lining. And an example of that is an enzyme called diamine oxidase. And this enzyme, we make it right there in the gut lining. And so as it goes down, What we know is that our gut lining is wearing down to the second thing that happens. First, you get leaky. And now second, that enzyme has a function of its own. It's the enzyme that degrades histamine. So as we wear this away, you have less and less of that enzyme. So you can't break down histamine anymore. So histamine happens when we're around pollen or ragweed and we have allergies, but there's also histamine in foods you eat. If you drink a glass of red wine that has histamine, if you drink champagne, that has histamine that's part of the hangover on new year's. But if you eat a tomato or a strawberry or an avocado, Those things also have histamine. And so you no longer can tolerate histamine as most people do. And so you present kind of, you react to all different kinds of things. You take foods out, you may get a little better, but you don't get completely better because unless you're on a low histamine diet, then we would expect symptoms to still be there. And then. There's still a third category of way to get leaky. And that is from certain bacteria and these bacteria shed something called lipopolysaccharides or bacterial endotoxin. And that, that toxin is now like, Dumping acid all over the lock and the door. It will erode it too. And it will open that way. And so the endotoxin from bacteria can cause these tight junctions to not work well. I kind of think like bent up puzzle pieces. They don't fit like they shut anymore and LPs is sneaky. It can come through the cells as well, but that's, so those are three different ways that we can become leaky. And when you become linking, it sets off that inflammatory cascade. And like you mentioned, you don't always feel it. So that CRP that I mentioned is a marker that we look at in the blood. It's an inflammatory marker it's associated with cardiovascular disease. You may feel fine, but your CRP is high. It's a marker of inflammation, but your joints don't ache or. Your belly. Doesn't a homocysteine is another cardiovascular marker. It's a marker of inflammation. You don't feel it, but we know inflammation is going on, that will affect the heart. So it depends on where your inflammation is occurring, whether or not it's sending that nerve signal that you feel are not inflammation can cause many different things and different areas. Yeah, it's so important. And I think some of these markers you're discussing are often on general annual lab visits and wellness exams, but often are not related back to these root issues of potentially autoimmune conditions, which I think over 50 million plus Americans are suffering with or any other digestive issues. And so I really love your analogies of the different types of reasons why leaky gut can occur. So hopefully everybody understands a little bit more, but I think most people want to know is if you get leaky, Can you fix it? What do you need to do to fix it? Yeah, absolutely. And so I work with a number of different tasks. Some of those things that I mentioned I'll measure those I'll look at foods that can be wearing a gut lining down. I'll look at stool testing that tells me, do you have nice, healthy, protective bacteria that. And the reason we look at these things in fact is not to take foods away for forever. In fact, the idea is take them away for a period of time, calm down that inflammation, build the gut lining back again, and now you should be able to bring them back in. And the idea is that over time you should actually be able to. More foods without inflammation, not less. Now, some people will have to keep a couple of foods out more lifelong, but that is a rarity and more of an exception than the rule. Most of us, if we figure out the root cause of why the inflammation is there and then treat it, there are lots of things we can do to build the gut lining back. There are. Various amino acids. Glutamine is a great example. It's the preferred fuel for Intero sites for gut-based cell. So using higher doses of glutamine probiotics are another thing that helped build back the gut baselining. I'm a big fan of immunoglobulins. Like you mentioned in my bio, something called it's a great immunoglobulin and that immunoglobulin actually blocks zonulin from binding to that receptor. So we don't open up tight junctions that way as well. It will also help to normalize some of that immune response. So there are all kinds of therapies and I can just go on and on and on. And I could list 20 therapies, 40 therapies, 60 therapies, but that becomes not realistic. We don't want anyone to have to take 60 therapies. So this is why the testing can be so useful because it really does. What's the problem. Is it a problem in terms of a bacteria? Is it a problem in terms of a food is a problem, and those are basically your two big categories of why you start to wear down the gut, some of the outside of maybe stress, but even as some of the more sweeter processed foods, what would show up in that area. But basically if we're trying to conceptualize it two basic ways that the gut becomes leaky eating foods, that aren't the best for you. Sometimes these are very healthy foods. Like just the food tests that I helped to develop at precision point diagnostic labs. My partner just ran into a patient at the clinic and parking lot and they ran up and said, oh, I just want to tell you how much better I'm doing. And she was having migraines, I'm feeling fatigued. And the thing that came back positive for her. Was broccoli. And so we, I would have never told her to take broccoli out of her diet. I would have told her to eat more broccoli because it's so good for you. So sometimes we can be eating healthy foods and those can be a trigger. And that's why the testing can be useful. But I just say that to say in general, your two big categories of why your gut gut leaky eye food that you're eating, or an imbalance of the bacteria in your gut. So two tasks that will often be useful are food sensitivity testing, and looking at a stool test. And then sometimes some of those other markers of leaky gut. It's so amazing. And you brought up some really good points, because as you're saying these tests and the testing that you can utilize for digestive health and overall wellness, health are so important. And people, once you get the testing, many people get so many answers to why they've been suffering for years and years and years. And then they're able to finally take the steps necessary to regain their health. So really, really important. And it's manageable. And if I measure zonulin and I know it's high, and then somebody says to me, well, how long do I need to stay on these things? Well, now we have a real benchmark to be able to gauge that until the ambulance back in normal range, because now I know that those tight junctions have closed and your gut lining is back in place. And so rather than just kind of guessing. We have a very specific roadmap of what to do, what to do next. If you're not responding, like, I think you should looking at those things again. Oh, zonulin hasn't come down at all. Let's change these therapies up. And so you're just not shooting in the dark as much, so true. There's that old saying of what you measure you can monitor. So we always want to stick by that because it's really, really important for these chronic health issues. And you were talking a little bit about gut imbalances. You know, a lot of people have heard of the term microbiome, but can you explain this for everybody? So everybody understands this a little bit more. Like, what does it mean? Why is, why is it important for us to know about the microbiome? Yeah. So simply put your microbiome are bugs that are in the GI tract. And we want these there. And like I mentioned, there's more bacteria in your gut than there are stars in the Milky way. And so we are largely made up of bacteria, but in your case, And friendly bacteria that really helped us out a lot. Like there are certain vitamins that friendly bacteria make a fiber gets really converted into some very powerful, vital nutrients in the place of this bacteria. This bacteria can help determine whether or not we're going to lose weight or gain. But it turns out it's not just bacteria. There can also be helping he's even healthy viruses there that we're learning more and more about. So it's that ecology that's inside our gut and what, and it's the study of looking at the things that should be there, the foreign invaders and then things that are just out of balance as well. And so when we measure that that's typically measured through. Doing some stool testing and you can get a picture of all of this bacteria in these various pathogens and really be able to tell, okay, is this a reason that someone's not feeling well? And right back to that example of depression, which we often, you know, you think that's here, not here, but it turns out some of that same healthy bacteria. Lactobacillus makes serotonin bifidobacter makes Gabba. And while we used to think that just stayed in the gut and didn't affect anything here, we now know that you absorb. And when it goes past this area, the blood-brain barrier, there can be some diffusion back and forth. There's some transport mechanisms there. So we aren't, these static divided, compartments, all of these things interact. And even if that seems far-fetched to you. The the neuro-transmitters we make in the gut. I mentioned one called Gabba. That's our inhibitory neurotransmitter. It helps with rest and relax. It calms the brain down stops racing. Thoughts helps us focus. If you were to take different anxiety medications, they work on those same receptors that Gabbo works on. And the Gallup. In our gut, we'll send a signal. There's something called the Vegas nerve to our brain and say, everything's okay down here. We can feel better here as well. So there are multiple ways of the gut communicates with the brain. And so the neurotransmitters that are in the gut. Don't merely affect the gut. They affect the rest of the body as well. So fascinating. That's the microbiome. Okay. There we go. So, and you were discussing some of the stool testing, but there's so many stool tests on the market today. We see them all over. Now, can you dive a little bit deeper for that? Like what makes each one of them different and which ones you think might be the best and. Yeah, there are a lot of great ones out there. There is GI maps and there are some other diagnostics out there. I use a lot of the GI 360, and the reason that I have landed on that is because we were back and forth with this debate about what is the best way to do it. Should we culture it out and grow it? Or should we. To PCR and look at the genetics. And so on one hand you go, oh, well, wow. Looking at the genetics will allow us to capture so much more and we'll see things that we might've missed otherwise because when you grow it out, the strongest ones are the ones that are going to survive. And certain things don't grow as easily on media. If you do grow it out culture as that's called now, not only can you culture, but you can get a specific sensitivity. So I grow it out and then I put antibiotics next to it and I put natural subs, natural antibiotics next to it. And I see what kills it the most. If I'm just looking at DNA, I haven't grown it. So I can't put anything next to it to see what kills it the most. If you see sensitivities done. With DNA testing. They're just saying in general, this bug usually responds to that. Whereas this is this bugs specifically in your body. This is how it's reacting to things. So on one hand, probably one captures more of the microbiome. On the other hand, the other would give us more of a picture of what we can use to treat most specifically. And so the GI 360 combined, both these technologies, they do both PCR and culture. And so I think that that gives us a balanced perspective. And so culture's come a long way. People tend to think of like back to their microbiology class. Streak the ag our plate, and then watch what grows and, and that's a very rudimentary culture, but what's being done in terms of GI 360 is more blasting down to bits of RNA and then running those through some profiling to look at so much more sophisticated than just what we did and microbiology 1 0 1. Interesting. Interesting. Yeah. So there's lots of different kinds of tests, but I think the bottom line is for many of these tests that you're talking about, you're able to find things like parasites and knees and worms and bacteria. Is that correct? And correct. Another part of doing both the culture and sensitivity, is it that if you're only doing PCR testing, Then one of the things that gets you don't get some of the other pieces. So, and there are many tests that will do these things together, but I only on a stool test. Yes, it will tell them, show me the microbiome. But I like to see not just the microbiome, but something called secretory IGA. That's that 80% of the immune system I've been mentioning. And we can tell if that's worn down, your gut lining is worn down. If that's worn down, your immune defenses are worn down. If that's sky high, your immune system's reacting to some type of infection. So it gives us some great information. If we're just doing genetic tests. You're not getting a picture of short chain, fatty acids. And those are breakdown products from Beiber, and there are associated with things like decreased colon cancer. They're associated with things like decreased cardiovascular disease, increased auto-immunity those short chain fatty acids also can be absorbed and send some signals to our brain. So there's some brain communication there as well. And if you're just doing genetic testing of the bugs, you don't see that other things that I like that to look for on a stool test, the digestive enzymes, or another piece of that, and then some of the inflammatory markers as well. So, and there are many out there that will cover both the gut bugs as well as kind of the state of health, the short chain fatty acids, the immune system that the inflammatory markers. So look for kind of those things together to get the most complete picture. That's so important because you know, the standard, a stool. Used to be the ova and parasite. Correct. Can you kind of dive down that difference between the stool test that you're kind of discussing now and that standard O and P tests that you know, someone might get, uh, 20 years ago say or something like that? I even today, because if you were to travel abroad and go to. Many clinicians, you travel abroad, you ate something and you haven't felt right since then. And so you've come back and someone goes, okay, maybe that's a parasite. And what's still routinely going to be done is an O and P and the other part of that name, and that stands for ova eggs, P the parasite. And it's an O and P times three, that's what they call it. And I mean, they do it three times. And why do they do it three times? Because it's notoriously bad at picking up parasites. So they say, well, we'll at least do this three times. So we'll increase our chances of seeing it. In addition to that, it depends on what. Or so most of those tests are only going to look for a handful of parasites. Now this was a place where the genetic testing really shines because the reason the OMP is so difficult is because the bacteria that's easy to put a little bowel next to something. And it's very easy for that bacteria to grow, but there's not really an easy, medium to once we're down to eggs of parasites, there's not some various. Easy medium to put that next to that causes it to divide and grow. That's very hard to do so you're looking at it under a microscope to see if you see it. And so you can see how that would be difficult within, but now with the GI 360 and some of the other genetic tests that are out there, they'll look for genetic pieces of these parasites. And so they picked up a whole bunch more. Than some of these conventional measures. And I always think, well, just her name tells you, it's not that great a test. Cause it says you got to do it three times to even have some chance of capturing something. So if you fall into that category or somebody who traveled somewhere, I never felt the same afterwards. And you go, yeah, but I did a stool test, probably not one like this, those that you might have done, maybe look for some parents. Probably didn't look at bacteria, certainly didn't look at town viruses or yeast and even more. So didn't look at literally thousands of those all at once. In addition to that, what you're experiencing now might not even be the bacteria or the pathogen anymore, but it might be that it eroded your own healthy flora and your healthy flora make these things called mucins that coat the gut and make us feel better. So if it knocked down your good guys and they're still not back to where they should be, you could still be feeling awe and infections, not going to show up. Yeah. Guarantee that nobody, they, these tests do not look at your own healthy, natural flora. All of those are reasons that you could hurt. And so if you've done something very basic and it didn't give you the answers, now it's time for a much more extensive workup. And it's a shame that these aren't more routinely done because not just you traveled and you felt that. But this what's called dysbiotic bacteria or bad bacteria can be connected to things like cardiovascular disease, diabetes, and many other chronic conditions. And so if you're not looking for them, you're never going to know to treat them. Yeah, that's so important. So I mean, this, we could call it the old school stool test versus the new school stool test ton tester there, where the old school is really just, it's a more of a limited amount of markers and that the newer test with the DNA PCR methodology, it's really able to not only identify your ova and parasites, but bacteria and a number of these other immune markers that are so important to identify in the body. If someone does find that they have parasites yeast or warms in this DNA, uh, new school type of testing, what are some of the steps that you take to help resolve them? And, and how long does that process usually? So we can use various pharmaceuticals. We can use various botanicals and we can use those even in combination or one or the other. But the good news is, is that this is something that you treat and can go away. And so a patient that I was working with, eh, her diagnosis was all sort of collide. I said, you know, based on some of the other things I'm seeing on your lab work, it looks like you had an infection when you went to the hospital and they told you ulcerative colitis, let's do the stool test. Let's see what we see. And so we do it. There's an infection. We begin to treat it with them, different botanicals, that thing compounds from garlic compounds, from things like golden seal and different berberine's that are antimicrobic. We eradicate it and her symptoms go away and she says, well, do I have ulcerative colitis? Because that's what they told me I have. And they said I would have that forever. Well, that's a very interesting question. How about someone who had diabetes, but they got their blood sugar down and their insulin down. Do they still have diabetes? And so. I think that the way we look at this is that she probably always will have a tendency towards a weak or got something that could get out of balance. But does she constantly cramp and bleed and have symptoms from this? No. And so a standard of care would say, we don't know what causes ulcerative colitis. And now you'll just take anti-inflammatories lifelong to manage that. Whereas we were able to see what was the cause of the ulcerative colitis. It was a bug that wasn't looked for and they ran some cultures on her, in the hospital, but just, you know, just a handful and they missed it. And so we run a bigger profile. We identify the cause we treat it. And I like to talk about permanent remission. I like that word, permanent remission. It is possible to put something into permanent remission. Absolutely. Especially if you're able to identify and search for the root issues of the problem. So important. So Dr. Burdette, you talked about some really great information that you can get aside from knowing whether there's bacteria, fungi, yeast parasites, in these stool tests like overall immune health. So based on some of these additional markers that you can get information get from this. Why would you think someone or everyone could benefit from getting one of these on say a yearly basis as part of their annual wellness or yearly examined? Yeah, because not only can it be related to pathology, but the major thing that determines our rate of aging is an immune. If it were like a multiple choice now, and I said, is it cellular health? And the mitochondria, the powerhouse that makes energy, is it the cell membrane? I could see good rationalizations for picking those answers, but actually what they've tied to our aging, even more so than our own cells. It is what is happening with the bacteria in our gut, that microbiomes. And as that microbiome begins to decline as we lose diversity, as the number of species are not as strong anymore. That's one of the major things that drives aging in our own system, they signal say, okay, we're wrapping up here. And another way to look at that is when they did studies and they looked at people from various areas from Spain in Ireland and Portugal and the us, et cetera. The hypothesis of this study was that where you are from will dictate your bacteria. If I eat the same tomato you eat, there's the soil and the bacteria from that will have similar floor will have a similar microbiome. And while that was true, where you were, did help to determine similarity. It wasn't the thing that was most predictive. And the thing that was most predictive was your state of health. And so if I were afraid and sickly and 18 years old, braille and sickly and 81 years old, our flora looked a lot a lie, but if I were healthy and robust and 18 years old, but healthy and robust and 81 years, Those people's flora looked a lot of life. And so what they learned was as your flora declines as your microbiome declines. So do we. And so if we could look at this once a year, we'd have such an opportunity for her pension and wellness. Like the Sonos work taught us what happens first is the leaky gut. Then the onset of pathology. So if we can stop that in its tracks, we could stop pathology in his tracks. And that's exactly what he says. He says, if we remove the environmental trigger, we are no longer sitting around destined to have these conditions that our mom or our grandma had. If we can remove the environmental trigger, we can stop the assault to the cells. So they don't express these genetics that result in various pathology. So interesting. The transformations and the advances in technology today in science and health are so vast. And as you're talking, it's so important for us to, again, identify those root issues. And so with the future of GI health, there's many different types of treatments. Now, everything from, uh, obviously stool testing to fecal transplants that are now people can undergo. What do you think the future looks like though in terms of uncovering the root causes and as a whole for death just of health patients much better because if we're having this conversation even five or 10 years ago, And then some of the PCR technology, wasn't quite where it's at and think about kind of what computer from the fifties that took up an entire room compared to something like computer like this that we just carry around in our hand phone. And the same is true Berlin and able to look at organisms in the gut and understanding our relationship to pathology. Our knowledge of that. Really exploded. Not only has our knowledge exploded, the technologies that you utilize to do that, but like technology only as the price continues to come down. And so instead of being thousands and thousands and thousands of dollars, we're talking hundreds of dollars, which is a much more real. Price point for looking at these things on a regular basis. And there are more people that are looking at it and there's more data and there's more evidence about that. And so what that means is it's more likely to be an option presented to a patient, not as often as it should be quite yet, but if we're having this conversation 20 years ago, these bugs would be harder to identify people wouldn't be as aware of them. And so there'd be much more push just to say, well, Stay on your prednisone. That's your anti-inflammatory. And that's what you're going to need to do to keep this ulcerative colitis and partial remission. So, so important for the future of GI health to continue to monitor those things. As you're mentioning again, what we can measure, we can monitor. So getting the proper testing is the first, I think, ultimate stuff there as you've been explaining. So Dr. Burdette, I have one final question for you today. If you could give one or a couple of tips to someone listening with GI health issues, what would it be? Find someone who is going to listen and he was going to keep looking. So if you have gone to someone and you've tried something and you're still having symptoms six months out a year out, it's time to look for a different approach. And so I think the message is pretty as hopeful actually, because there's a reason these things are happening in your body. There's this term in medicine called idiopathic. And it means we have no idea. And so this was what they would say about things like irritable bowel syndrome or ulcerative colitis, or even some depressions they're idiopathic. Well, I think we're, as we are learning more and more and as technologies improve, we're learning, oh no, there are more causes to these things. So when I would say is keep looking, you are the expert on yourself, and if it doesn't feel right to you and you need to keep asking the questions and find a practitioner that will work with you to help you. Ask the questions and find the answers to them as well. That's so important. Thank you so much, Dr. Burdette for coming on today, it was such a pleasure to have you here. I really enjoyed your different analogies for leaky gut, helping us understand the reasons why that can occur as well as the other imbalances that occur in the microbiome. So people get a little bit more of a foundation understanding of what it is that is going on inside the body and how it can impact other areas that you might not think are related to that. But it is a direct result of overall gut health. So I think that's really going to help our listeners and hopefully they learned a lot from this. So thank you again. Oh my and I, if we can touch one person, then it's a job. Well done. Agreed. Likewise. Well, we look forward to seeing you next then pick care. The root cause medicine podcast is brought to you by Rupa health to find out more about us and how we are changing the lives of patients and practitioners across the U S. To Rupa health.com and then make sure to search for root cause medicine in apple podcasts, Spotify, or anywhere. Good podcasts are found. Make sure to click subscribe. So you don't miss any future episodes on behalf of the team here at Rupa health. Thanks for listening.