Recently I interviewed Dr. Vincent Pedre, and we chatted about his new book “The GutSMART Protocol”. If you would prefer to listen the interview you can access it by Clicking Here [1].
With me, I have Dr. Vincent Pedre, and we are going to be chatting about his new book The GutSMART Protocol. Dr. Pedre is the medical director of Pedre Integrative Health, founder of Dr. Pedre Wellness, and CEO and founder of Happy Gut Life. He has worked as a nutraceutical consultant and spokesperson for NatureM.D. and is a functional medicine certified practitioner with a concierge practice in New York City since 2004. Dr. Pedre believes that the gut is the gateway to excellent wellness. His newest book The GutSMART Protocol, featuring a 14-day personalized gut healing plan based on the GutSMART Quiz, is the culmination of years of research and clinical experience as a functional gut health expert. Thank you so much for joining us, Dr. Pedre.
Dr. Vincent Pedre:
Thanks for having me. I’m excited to have this conversation with you.
Dr. Eric:
Same here. Excited to talk about your new book. Before we start that, can you give a little bit of your background? How did you start doing what you’re doing? You wrote a first book. What led you to write this newer book?
Dr. Vincent:
For one, the research that has come out on the gut and the gut microbiome has just exploded in the last couple of years since I finished my first book, which was over seven or eight years ago. I really wanted to consolidate all the new knowledge that we have but also take everything that I’ve learned, the feedback I’ve gotten, and write a new protocol for gut health that really puts together all of my experience with dealing with gut patients and realizing that there is no one size fits all when it comes to gut health. The approach to healing the gut, especially when it comes to nutrition, has to be personalized.
The biggest distinguishing factor between the books, aside from the GutSMART protocol being a 14-day program versus a 28-day program in Happy Gut, is the GutSMART protocol is powered by the GutSMART quiz, which personalizes the program to the individual based on the score that they receive on the quiz. The quiz is not just looking at gut health issues but also what I call gut related health issues. I talk about that in the book, the difference between a gut centric issue and a gut related health issue, which can happen in all different parts of the body, like the brain, the skin, the lungs, the airway. I wanted to educate people on the interconnectedness of how gut health is really the foundation of the rest of your health.
The update in the research, some of the most recent science, and a personalized protocol not only distinguishes this book from Happy Gut, but also distinguishes it from the majority of the books out there that come out with a prescriptive plan that is a one size fits all. I don’t think that’s right for everyone, especially when dealing with gut health issues, from my experience treating patients now for over a decade with gut health issues using a functional medicine approach.
Dr. Eric:
I agree. It’s funny because one of the questions I have prepared is is there an ideal diet for optimal gut health? I guess you already answered that. No, there is no perfect diet.
Dr. Vincent:
There is more that we can dive into. There are several things we can look at. There was a study done as I was writing the book that was published at Stanford University, where they took a small group of women and divided them into two groups. It was about 16 women per arm. They did it for 10 weeks. They looked at a high fiber diet versus a high fermented foods diet.
They were looking at some important markers, like immune function. We know that 70% of the immune system is all along the gut lining and is very much controlled by what’s happening in the gut. We learned that during the world pandemic, how important the gut was in determining whether people ended up being hospitalized with COVID and how severe COVID they got. They looked at the differences between them, and they also looked at 19 inflammatory markers. Very objective measures you can take from a blood test. They also looked at the stool microbiome. They looked at the diversity of bacteria in the gut. They tested before, and they tested at the end of the program.
Even within the personalization, we can make some general assumptions. What was surprising is if you hear people talk about gut health, you will hear fiber, fiber, fiber. It’s so important. It’s important for the health of the colon. That’s true. What they found was that fiber was a very powerful immune modulator. What does immune modulation mean? It means that your immune system is in balance. It’s not working too much, but it’s also not underactive.
What was surprising though is you would think by everything we have learned about fiber and how it gets gobbled up by the bacteria in the gut, and then they produce all of these incredible post-biotic nutrients. We know short chain fatty acids have effects all over the body, including the brain. You would think that that’s what creates microbial diversity, feeding the microbiome fiber. It didn’t.
What increased diversity was a high fermented foods diet. That was about 2-4 servings of ferments per day. And I think even more importantly, what they found is when you increase diversity, you also lower 19 inflammatory markers. It lowered inflammation. That was a very surprising finding from the study. It’s a small study. It’s not a big group of people. It has to be repeated in a bigger cohort to see if it remains true. But I think it does lead us in a certain direction.
If you take my GutSMART quiz, and you score Severe as your score, what you will find is when you go into the food list, you’re not allowed to eat fermented foods. When you have severe gut dysfunction, you won’t be able to tolerate ferments. I always think of it like the old days when we use transparencies in school. You put one transparency on top of another. You have to interlay, okay, we understand, yes, eating a good amount of fermented foods on a weekly basis is good to lower inflammation and to improve microbial diversity.
For anyone who is listening, microbial diversity is the holy grail. The more diverse your microbiome is, the less inflammation, the better your gut barrier is. It’s what you want. The problem is that in our modern world, we are losing diversity, starting from a very early age. Kids are exposed to too many rounds of antibiotics unnecessarily for viral infections.
Even for ear infections, a number of years ago, the standard used to be if a child has an ear infection, you automatically give them an antibiotic. Then they found that you actually don’t need to do that unless it’s a severe ear infection. The problem is that we are already getting exposed to antibiotics from an early age, and it’s damaging the diversity of the gut microbiome. There is a theory that the diversity never fully recovers.
For me, I was on 20+ rounds of antibiotics from the age of 10 through my late teenage years. That is extraordinary. It destroyed my gut microbiome; it led to leaky gut and food sensitivities, and my immune system was shot. I just kept getting sick. I was a hypochondriac. Part of the reason I went to medical school was I wanted to biohack how not to get sick. I wanted to understand my body. Little did I know that was going to lead me down this rabbit hole of gut health, gut microbiome, fixing my gut, working with hundreds of people on their gut health issues, seeing whole hosts of health issues improve and get to this point.
Just to circle back, we can say fermented foods are good, but it depends on your gut type, which is what I determine using the GutSMART quiz. You can figure out is it okay to incorporate ferments? Do you have to wait for some gut healing to happen, and then you can start incorporating them?
Dr. Eric:
From what I understand, at least according to the study, which like you said, a smaller study, probably needs to be repeated in a larger setting. But it sounds like fermented foods are superior to fiber when it comes to diversifying the gut microbiome. But if you have certain gastrointestinal disorders, such as maybe SIBO, which a lot of those people have issues with fermented foods, then they should avoid fermented foods. The good thing is it sounds like your quiz will guide them in a direction to tell them, “Now is not the time for fermented foods.”
Dr. Vincent:
Exactly. What happens sometimes is the nuances get oversimplified. You might read an article that says ferments are good for your health, but maybe you have an underlying SIBO or SIFO (fungal overgrowth, candida). You start eating ferments, and you feel horrible. You get more bloated. You get inflamed. You don’t feel well because it’s not the right time. What I did with my book is try to get through those nuances to help people understand when is the right time to eat those foods? What are the right foods, depending on your gut type or GutSMART score, as I call it?
Dr. Eric:
You mentioned candida. Different trains of thought when it comes to fermented foods. If someone has candida overgrowth, do you typically recommend those folks to avoid fermented foods completely?
Dr. Vincent:
It depends on the person. Sometimes, what I find is they can have such a powerful die-off from incorporating a fermented food that it’s overwhelming, and it makes them feel horrible. That’s where you really need to be working with a functional doctor/naturopath who understands how to match things together. If you have one of those issues, you might just start with a quarter teaspoon of a ferment and test it out. Then slowly increase from there.
I talk about that because I think in our magic bullet philosophy in America, with pharmaceutical-driven medicine, you hear something, and you think, “Well, if a little is good, then a lot is even better.” But that’s not the case. I talk about that in my book. It’s really important to start slow. Test the water. Then slowly increase over time.
Now candida treatments can get more complex. When you’re killing off candida or yeast, you’re going to release toxin. It’s helpful when you’re doing that type of treatment to use binders that will help bind the toxin and keep it from entering your body. You can use things like activated charcoal, bentonite clay, but also, I personally like, if the person has no objection to them, using SBIs (serum-derived bovine immunoglobulins) because they bind those toxins.
SBIs have been shown to bind endotoxins released by bacteria in the gut, which protects the gut lining and can help the gut lining start to heal. Inevitably, if you have SIBO or candida overgrowth or dysbiosis, you’re also going to have leaky gut. That’s where the problem is. The leaky gut is like having a leaky border that is allowing all these inflammatory substances to get into the bloodstream. They have done tests where they have shown bacteria and bacterial DNA gets into the bloodstream. We know that endotoxin, which is released by bacteria, causes a whole host of inflammatory cascades in the immune system, the brain, the liver, muscle tissue. It increases insulin resistance and leads to weight gain.
Dr. Eric:
Very interesting what you said about the SBIs. If someone were to use SBIs, they wouldn’t need activated charcoal or bentonite clay? Do you usually recommend a combination?
Dr. Vincent:
Sometimes, I might use the SBI by itself. It depends. If you’re working with a practitioner, you might incorporate different types of binders because they all have different binding properties, depending on what you want to bind. Also, SBIs tend to constipate. If you are working with a patient who is already constipated, then you have to be really careful with an SBI because you could really stop them up. You need to make sure you are going to give them some sort of support so that they are going to the bathroom regularly. Again, it depends on what type of SIBO they have. You want to make sure they are getting the right amount of fiber, but you have to be careful not to give too much fiber. It will get fermented, and they will get really gassy, bloated, and uncomfortable.
Dr. Eric:
Makes sense. Going back to the fermented foods. I have two hopefully quick questions. Would you recommend a diversity of different types of fermented foods rather than someone eating sauerkraut every day? Do you recommend on top of that a probiotic supplement, or if someone is eating fermented foods daily, would that be sufficient?
Dr. Vincent:
In this study, for example, the participants were not taking a probiotic supplement. They just added ferment, and it did improve the diversity of the gut. In my clinical practice, when I’ve worked with patients with severe dysbiosis, with candida overgrowth, sometimes you really need to use a high potency probiotic as well to get in there and help reset the microbiome.
There are different types of probiotics, like soil-based organisms that are spore-based that actually produce their own antimicrobial peptides. It’s like having little, tiny, antibiotic-creating factories that are delivered specifically to where they’re needed, but they’re actually not going to kill off your good bacteria. They will increase the diversity of your gut microbiome. There is a place for that as well. That’s really important.
In terms of the types of ferments, I think diversity is kind of like the key to happiness in life. If you start doing the same thing over and over, you will get bored with it. Maybe your body will get bored with it. I really think rotating the types, so sauerkraut, pickles, yogurts. I think for a lot of people, because dairy sensitivity is very high in the population, and even just lactose intolerance is super high, it’s probably better to go with a coconut yogurt or non-dairy yogurt. Sometimes, it can be helpful to use a kefir that is made from organic milk, grass-fed cows. Or even goat milk kefir. It depends on your sensitivities and what’s going on in your body at the time.
I’ve personally used kefir as a way to help my gut recover from having had a parasite. During the pandemic, I went to Guatemala, and I ended up getting giardia. I was really, really sick to the point that it became really hard to eat. The two things that helped me recover were kefir and bone broth. It seems strange, and I can’t explain why I thought. Of course, I also took a probiotic. Intuitively, it felt like that’s what my gut needed at the time. That’s something that I know is hard. How do you doctor yourself?
I talk about intuitive eating and really understanding before-meal intuition, during-meal intuition, and after-meal intuition. It’s important to understand before you eat, how hungry are you? Intuitively, what is your body craving? There is an intelligence there. Your body is going to let you know. Over the last 20 years, as a doctor, I’ve had for example women come in who eat very little red meat and then might say, “My body is craving red meat for some reason.” If you’re going to eat red meat, eat grass-fed beef or bison or lamb. Very humanely sourced meats. There is a wisdom there. Usually, if that’s happening, there is iron deficiency, and the body knows.
It could be that you’re craving a big bowl of vegetables. If you have severe gut dysfunction, then it’s going to be hard for you to digest non-cooked vegetables. Raw vegetables are going to be really hard, especially if you have leaky gut. You might have pancreatic insufficiency, so it will be hard to break down vegetables. If you see a salad green in your poop, automatically you can assume you’ve got some element of leaky gut. You’re not digesting your vegetables properly. You’re probably not making enough enzyme, so you have to revamp your diet.
I took your question and went on a whole tangent on intuitive eating. I think it’s important because even when you’re incorporating ferments, start at a quarter teaspoon, then go to half. A lot of it is dependent on the person listening to their body. The one thing I learned over the years from working with patients is that for some reason, people don’t know how to listen to their bodies. They just are not listening to the signals. Sometimes, I used to think, “I’m just a body whisperer. I’m just telling people what their bodies are telling them and helping them learn how to listen to their body.” That’s why it’s so important to have that after-meal intuition where you’re tuning into your body and seeing, “I ate this meal. I now feel really sleepy and tired and bloated. I’m not feeling so great.”
I had a professor I listened to give a lecture, and he said, “We should be eating for our microbiome.” I also like to think that I eat based on how I want to feel and the time of day. There is a Circadian rhythm to what your gut is doing and how your body will respond to different types of food.
Dr. Eric:
You mentioned leaky gut a couple of times. I want to cover this. Especially when it comes to testing, I used to do testing all the time for leaky gut. Then I just saw most people were positive, so I assumed people have a leaky gut, and that’s what I do these days. A lot of practitioners do testing. Maybe your quiz points them in the direction of whether they have a leaky gut. I wanted to get your approach.
Dr. Vincent:
If you end up with moderate or severe dysfunction, you pretty much can confirm you have a leaky gut in the background. I agree with you. The testing for leaky gut is not foolproof. The lactulose mannitol test that can be used for leaky gut is really only picking up leaky gut in the small intestine. If the gut is leaky in the large intestine, it won’t pick that up. It’s much harder to pick up. For example, patients with Parkinson’s tend to have increased intestinal permeability or leaky gut more in the large intestine than in the small intestine.
I did the testing for a while. Sometimes, I do food sensitivity testing. If someone lights up across the board, lots of high sensitivity, moderate sensitivity reactions, you can assume they have leaky gut. If I do wheat metabolite testing, looking at different wheat breakdown proteins in metabolites, and look at antibodies to zonulin as well as antibodies to actin or vinculin, which are basically cytoskeletal structures that hold the cell together and help create those tight junctions between the cells, you can assume that if you have developed antibodies to those structures, you have leaky gut.
We are working like Plato. We are looking at the shadows against the wall. We can’t exactly measure it directly. You could put somebody under an ultrasonic endoscopy, where they can do micro ultrasound and look at the gut lining. We’re not going to do an invasive procedure on every patient that we suspect has leaky gut.
Just like you, after testing for a while and seeing how people even just react to putting them on a leaky gut protocol, I decided that I am going to go by the clinical because it’s very obvious who has leaky gut and who doesn’t have leaky gut and how they respond to these interventions.
Dr. Eric:
It sounds like the test you use is similar to- I’m sure you’re familiar with Cyrex Labs. I used to use the Array #2.
Dr. Vincent:
Yeah, Cyrex does that. Vibrant America also looks at wheat metabolites, food sensitivities, dairy metabolites. The thing is that it’s like you’re building the evidence, and it’s nice to have data. I’m very much into collecting data on patients, but there is a point where the data is not perfect anymore. I know there are labs that are looking at stool PCR patterns, so microbial patterns that might be indicative of increased intestinal permeability or leaky gut. Even that I think we still don’t 100% know. We are just making assumptions. As we get more pooled data from more stool analysis and start seeing what patients with leaky gut microbial makeup look like, maybe we will start seeing a microbial signature that identifies leaky gut. We also know that there are different microbial signatures even depending on what part of the world you live in and what your diet is like.
Dr. Eric:
Another flaw of the test is they don’t tell you what is causing the leaky gut. Are you eating gluten on a daily basis? Do you have a gut infection? Is there another factor?
Dr. Vincent:
Absolutely. I know you had a question about gut pathogens and infections. The thing is that when you find them, depending on the pathogen, you always have to line up the test result with the story of the patient. If we’re interlaying those transparencies, I hate medicine where you just treat the test result, and you’re not taking into account the person. You’ve got to overlay that we have this test result. Does it make sense with what’s happening with the person, with the story, with the symptoms, with how they’re presenting? If it does, then you treat. We have to be really careful about being trigger happy and treating everything that appears on a piece of paper. Sometimes, it doesn’t quite honestly correlate with what’s going on with the person. Some people may be able to tolerate having certain imbalances better than others.
Dr. Eric:
I don’t know what your answer to this question will be, but I kind of think I do based on what you just said. There are some practitioners out there who will treat everybody for parasites. I have interviewed people who do that. It sounds like that wouldn’t be your approach because that’s-
Dr. Vincent:
It depends on the parasite. For example, Blastocystis hominis, one of the most common parasites worldwide. Very common in India, but I’ve seen it in patients in the United States many times. If you do a Google search, you will find literature saying it’s a benign parasite. You don’t need to treat it; ignore it. If you dig a little deeper, you will find research studies connecting Blastocystis hominis with leaky gut. We know leaky gut is the first step down a chain reaction that increases inflammation, overactivates the immune system, can eventually lead to autoimmune disease and other chronic degenerative disease in the body.
Always putting it in context of that, who the patient is, and figuring out what is the right thing for that person? If they have amoeba in their stool, of course I’m going to treat that. It’s incredibly inflammatory. It’s invasive. If they have any other sorts of parasites, yeah. I tend to err unless there is evidence that the person is not showing any signs of any issues, including blood markers, having elevated C reactive protein and other things that are important.
Something like H-pylori is a great example of a “pathogen” that infects the majority of the people in the world. When they first found it, they connected it to peptic ulcer disease and said, “If someone has H-pylori, we need to treat it.” Of course, the pharmaceutical industry is on top of that, coming out with all sorts of regimens including Clindamycin, which is one of the worst antibiotics you could ever take because it increases your risk for C. diff diarrhea, which is a very bad diarrhea that can even lead to what we call mega colon and, in the worst case scenario, death or ruptured colon. You’re increasing the risk of that by going on these antibiotics for H-pylori. We know there is also increasing antibiotic resistance.
The fact is that’s an example where say you find H-pylori in a person. Could be just a colonizer. Is it an active infection? It depends on the way that it was tested. Is the patient symptomatic? If you do an endoscopy, do they have an ulcer, or do they have metaplasia, like signs of precancerous changes in the stomach, which can be caused by H-pylori? If they don’t have that, probably shouldn’t treat the H-pylori because it may be serving a certain purpose in there. Taking into account the risk/benefit ratio of putting the person on this crazy two antibiotic regimen plus a proton pump inhibitor, which can then lead to SIBO and all sorts of other problems that I have seen. Yeast overgrowth, it depends on the situation, the person’s particular individual case. What they might be at risk for or the other underlying issues they have at the same time.
Dr. Eric:
That’s pretty interesting. H-pylori doesn’t always cause symptoms. If they have ulcers or reflux, that might be an indication to treat H-pylori. How about if they have an autoimmune condition in the presence of H-pylori, but no symptoms? It sounds like even in that case, you might not decide to treat them just because they have an autoimmune condition.
Dr. Vincent:
Yes. You have to think the treatment itself is putting them at risk for developing a severe dysbiosis, leaky gut, which is only going to aggravate the immune system and possibly make their autoimmune condition worse.
Dr. Eric:
I agree with the antibiotics. I should have mentioned taking an herbal approach for example for H-pylori.
Dr. Vincent:
I’ve seen and used different herbal approaches. They’re not incredibly successful. I say the phrase “50% successful” with people. If a person has it, then I think you have to be judicious about deciding is this something that we should treat, or is it “Okay, we found it”? Instead of treating it, because you have no symptoms, let’s work on improving your microbial diversity through the diet. Let’s improve gut permeability, so let’s reduce leaky gut. Let’s reduce inflammation in the body. Let’s work on it from a different angle. Rather than attacking, we want to rebuild the gut and the immune system.
Dr. Eric:
Just one more thing with parasites. There are a lot of practitioners who will treat parasites. No stool tests, no symptoms, they just assume everybody has parasites, and they treat for it. It sounds like similar to H-pylori, you wouldn’t treat for parasites unless they have a finding on a stool test. There is a possibility of false negatives. Maybe they have a false negative, but they have symptoms that are indicating they have a parasite.
Dr. Vincent:
It’s a bit of a rabbit hole. If you start investigating, most of us have some sort of parasite. We could have a worm parasite. Parasites might actually serve an immunomodulatory purpose in the body. If you look at India, where people are colonized with parasites, before they started introducing more antibiotics and more of a Westernized processed foods diet, India had very low rates of autoimmune disease. If you track what’s happening in India throughout the 1900s, as antibiotics are introduced, more of a Westernized sugar, processed foods type diet, you start seeing autoimmune disease rising in India. That might be an example where having some level of parasites in the gut actually serves a favorable purpose. It’s part of microbial diversity.
The other thing I would say about it is if you don’t know what the parasite is, how do you know that you’re treating it correctly? To make it even more complicated, we have all these tests, the stool PCR, stool culture. Some of these tests are really poor at detecting parasites, especially if it’s a culture. PCR maybe will detect the parasite. Not always. I think it’s great when you find one. Whenever I’ve found a very specific parasite, and I can do a targeted treatment for that patient, patients always improved in some way, whether it’s their energy or joint aches that other doctors thought were due to an autoimmune disease. When you find a parasite and can do a targeted treatment, where you know you are treating exactly what you have, that’s very helpful.
I have a doctor friend who sends stool samples to Africa in a lab in Nigeria, where it gets analyzed under a microscopy. They find parasites that are missed by other labs. The question is are we using the right testing to look for these parasites? Do the patient’s symptoms correlate with a parasitic illness?
On one side, you could say you can assume people have parasites. It might not be a bad thing to do a parasite cleanse. It might clear you up. If you do that, and you don’t feel better, then maybe the treatment didn’t kill off the parasite. Maybe it was the wrong parasite. Maybe it was the wrong treatment. Maybe it wasn’t for long enough. Like anything in medicine, there is never a black and white, “Yeah, do this. Don’t do that.” It’s a matter of understanding each individual case.
Dr. Eric:
On a stool test, if you see some opportunistic bacteria, like commonly you will see Staphylococcus, Streptococcus, Klebsiella, Pseudomonas, are those usually not a concern? Is that something you usually address?
Dr. Vincent:
It totally depends on the full clinical scenario of what’s going on with a patient. Let me qualify it by saying that over the years that I have been taking care of gut patients, I went from being much more aggressive to being much gentler in my approach. Now, if I see that, I might say, “Okay, let’s build up the gut. Let’s work on leaky gut. Let’s work on microbial diversity. Let’s use a spore-based organism that is going to go in there and fight and claim territory away from these pathogens. Let’s approach it from a different direction.” That’s where I’m at now. Being gentler with people and having an approach that maybe is a little bit slower, but long-term, it actually works better for them.
Dr. Eric:
Makes sense. I agree. You don’t want to be aggressive with everybody. There is a time and place. Treating everybody who has increased Staphylococcus or Streptococcus, especially if they aren’t having symptoms, is probably not a good idea.
Dr. Vincent:
Certain things we do understand. Say you have an E.coli infection, and you have campylobacter. That will give you massive diarrhea, and you will feel horrible. Because of those situations, sometimes we apply that reductionist thinking to all of these fancy stool tests that we can get. Whole genome sequencing.
What we don’t understand is when you find that in a patient who is not having acute diarrhea or any other acute findings, what is it actually doing in the balance of the entire microbiome? Is its presence pathological, or is its presence part of the normal background? All you need to do is a little tweaking to improve it.
I think that’s kind of where I’m at more now: restoring gut microbiome diversity and letting the gut rebalance itself rather than thinking. I just see people treat people with strep or staff, and sometimes it goes well, and sometimes it creates more problems.
Dr. Eric:
I have one more question. I can’t let you go without asking about gluten. I assume you have people avoid gluten, but I also heard on another podcast you were talking about why some people avoid gluten. They might have not had issues with gluten, but then they avoid it and reintroduce it. All of a sudden, they are reacting to gluten. Or maybe it’s a different food. If you could expand on that?
Dr. Vincent:
Totally. Gluten is one of the most inflammatory substances. It’s been found to trigger a molecule called zonulin that is found inside the cells that line the intestine. It controls gut permeability like a dimmer switch. They have looked at gluten and its effect on people with Celiac, non-Celiac gluten sensitivity, and normal individuals. They found that depending on the degree of disease, gluten is going to have increasing effects on the person, but it is not neutral for a normal person. Even for someone who is normal, it will cause a slight increase in gut permeability.
What might be going on because- I don’t know if you have gotten into this in other podcasts, but how wheat has been hybridized. The gluten content in the wheat, especially here in the U.S., is 30-50% greater than it was 50 years ago. We are being exposed to gluten at a much higher rate than our digestive system can handle. It’s a very different molecule to digest and break down.
If you have leaky gut, and you have partially digested gluten molecules that didn’t get bound to an enzyme called tissue transglutaminase, then you get these chimeric molecules that your immune system will look at and say, “This is foreign.” Then it has molecular mimicry that can cause your body to attack things like your thyroid for example.
I think it’s a stepwise hit problem. Maybe you start off normal, but then you go on antibiotics. Your gut permeability increases a bit. You’re eating a lot of bread, pastries, things like that. Your diet is not perfect. There is an accumulation over life issue that eventually you can reach that threshold, where it causes disease in the body. That’s the same theory for all disease in the body. We need to apply that also to gluten.
Why is it that maybe during your 40s, you were not gluten sensitive, but in your 50s, now you are starting to find that you don’t feel so good when you eat gluten? You get achy and mental fog. I think it’s that multi-hit hypothesis over time. It could be genetics, genetic expression that changes over time. Our genes are controlled epigenetically by the foods that we eat. I think that’s a dynamic process. It’s not something that is just set in stone.
We used to learn that Celiac disease was a disease that was diagnosed early in life in pediatrics. We learned about Celiac in medical school. This was only 20+ years ago for me in our pediatric rotation. Now, we know that Celiac disease can evolve later in life. You might have the predisposing genetics, but it’s a multi-hit exposure after exposure after exposure to gluten that eventually just cracks the camel’s back, and then you get Celiac disease.
My oldest patient with Celiac disease who also had Hashimoto’s, which is very much linked to Celiac, I diagnosed her with Celiac at age 52. She had positive markers. No other doctor had picked it up. I think also it’s because I asked the question, and I thought, this is not what I learned in medical school, but what if she has Celiac disease? She would get sick whenever she ate anything that had wheat, gluten. She would get nauseous.
I think we have to have a really broader understanding of how disease evolves over a lifetime. Even if you were fine when you were younger, what I like to tell people is that your body is like a board game that changes the rules, but it doesn’t tell you that the rules have changed. You have to find out that the rules have changed by playing the game. You have to figure it out. If you can be astute to that and understand that your body, your blueprint is slightly changing as you get older, your body is going to get a stronger read of what’s going on.
Say we find that you’re gluten sensitive, and you take gluten out of your diet. You create this blank slate. When you were eating a lot of gluten, it was overwhelming your immune system and causing immune complexes that maybe weren’t allowing for the full expression of the effects that gluten was having in the body.
For example, you mentioned that one patient where she had taken gluten out. She was feeling great. A month in, she went out for a pasta dinner or something, and she broke out in full body hives. She was upset. She was wondering what happened. Did I make myself gluten sensitive by taking gluten out of the diet? That’s not what happened. What happened was you create a blank slate. When you reintroduce gluten, now your body is going to give you a very clear read of what that gluten is doing to you. It causes this massive activation of the immune system that led to hives in this person. I think that’s something important for people to understand.
If you follow my GutSMART protocol and do the protocol for14 days, then retest, do the quiz, and see if you can progress, or if you are still on the same level. Say you progress from severe to moderate, and you can start to introduce new foods into the diet. I tell people there is still a powerful individuality that goes into what your body can tolerate. Even though I have determined these are the foods that are okay under the moderate, I still want you to be intuitive and listen to your body. What might be right for one person might not be right for everyone.
Dr. Eric:
Thank you for talking about that. Definitely agree. Where can people find out more about you? I know you have a free gift as well.
Dr. Vincent:
I’d love to share a free chapter and some special surprise bonuses from my book. If you go to GutSmartProtocol.com/gift. If you want to learn more, go to GutSmartProtocol.com. You can learn more about the protocol and the benefits of doing it and what people have found from following it.
Dr. Eric:
Awesome. Thank you so much for your time, Dr. Pedre. Appreciate it. Learned a lot. I’m sure the listeners did as well.
Dr. Vincent:
Thank you. It was great being here.