Ep. 222 Strategies for Naturally Healing the Gut Microbiome with Dr. Vincent Pedre

Cynthia Thurlow: Welcome to Everyday Wellness Podcast. I’m your host nurse practitioner, Cynthia Thurlow. This podcast is designed to educate, empower and inspire you to achieve your health and wellness goals. My goal and intent, is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.

Today, I had the honor to connect with my friend and colleague, Dr. Vincent Pedre. He’s the medical director of Pedre Integrative Health and president of Dr. Pedre Wellness. He is also a board-certified internist, and is also incorporating both a philosophy and practice of western and eastern medical traditions. Today, we spoke at length about the gut microbiome and gut health, the power of manifestation, the role of the gut microbiome in the brain, value of elimination diets, as well as why plateaus are not something to be feared. We talked a great deal about the metabolism of certain types of neurotransmitters as well as the vagus nerve. We discussed circadian biology, the role of fermented foods versus fibrous foods. The need for tapping into the parasympathetic for proper gut microbiome health and digestion, ways to support the gut microbiome in a proactive manner and his amazing book the Happy Gut protocol. I hope you will enjoy this discussion as much as I did. I look forward to having Dr. Pedre back after his next book is completed.

Welcome, Dr. Pedre, it’s such a pleasure to connect with you outside of our normal kind of social circle that we’re in.

Vincent Pedre: Yes, what a pleasure to be here with you and I really admire all your success and I’m honored to be on your podcast today.

Cynthia Thurlow: Oh, well, thank you. Thank you, likewise. But for the benefit of listeners, because I know a bit about your background. What got you so passionate about talking about gut health and the gut microbiome, you’ve written a book, I know that you’re an expert in this area, but for the benefit of listeners share with us your experiences growing up and how that kind of dovetailed into the niche that you’re in right now?

Vincent Pedre: Yeah. I mean, I think you can probably relate to this. As I entered my 30s, I knew there was a book in me. I just didn’t know what that book was and a lot of my book ideas or thoughts were about what maybe, would be of interest to people who read health books. And it wasn’t until I kind of zeroed in on something that was right under my nose and I was just ignoring, because it’s so easy. As Mary Morrissey says, “You can’t see the picture when you’re in the frame.” When you’re living it, you can’t see fully the impact or what’s going on. And I had basically been just the typical subject that I talk about in my book. I was a child with horrible constipation, painful bowel movements and that was my early years. And then what I remember is going on antibiotics, after antibiotics, after antibiotics. Every time I had a cold to the doctor, antibiotics. So, I was probably on 20 plus rounds of antibiotics through my teenage years and as a result, I can look back now with my functional medicine brain as a gut health expert, and understand that the antibiotics caused the dysbiosis that led to leaky gut. And I became sensitive to the two biggest food groups– probably any teenagers diet, wheat and dairy. I started my day with cereal with milk, every day after school, the tradition was my mom picked me up from school, we would stop at Burger King for a vanilla milkshake on the way home from school.

Meanwhile, I kept getting sick over and over. The doctors thought my immune system, maybe I’m not getting enough nutrition. They put me on these horse pill multivitamins which made no difference, because that wasn’t the issue that wasn’t the problem that wasn’t why my immune system wasn’t working. It’s because my gut was a mess as a result of having developed leaky gut and I also became reactive to other foods that were common in my diet. I didn’t discover this until I was in my 30s. I made my first initial discovery and it wasn’t like I was being educated on it. It was more kind of self-experimentation and observation when I was in medical school. I wasn’t having dairy as much as I had in the years prior, and I noticed that it wasn’t as easy for me to get sick.

Because before if I was around somebody that was sick, I was a hypochondriac, like washing my hands, because I knew I picked up everything. And that was part of my motivation I think for becoming a doctor was to figure out, “Okay, why do I get sick so often?” And how can I hack this? Well, it took me way beyond medical school to get the knowledge, to acquire the knowledge, to really fully understand that the issue wasn’t environmental. It wasn’t even just my immune system. It was my gut, and specifically my gut microbiome and the interaction that occurs in that very unique interface that we call the gut lining or the gut barrier that had been damaged. And as a result, I suffered from weakened immunity, from mental fog, from skin rashes, chronic fatigue, not being able to recover, especially when I went through my medical training and was working 100-hour weeks. We would do a month of 100-hour weeks, and then maybe, we would segue into a two-week rotation or a four-week rotation where you were working 50 to 60 hours. 

It took me two weeks to recover from those month long, but I was eating pizza, and I was eating dumplings and things that had wheat and I had no idea. I mean, “Oh my gosh,” they would serve pizza during our lunchtime lectures in the hospital. Talk about basically causing a food coma, the wrong food but it’s so ingrained into our culture that it’s normal to eat a slice of pizza, for example, or to eat a piece of bread when you go to a restaurant. It’s so normal then when you discover that this just doesn’t work with your physiology, you suddenly find yourself going against the grain and facing judgment, as a result and it was really initially my journey of healing my gut, changing how I ate, educating my family on my gut health issues. Who did not understand, like my sister, for example, was still offering me a croissant for breakfast? Six years into me telling her that no I can’t have gluten, like that’s poison for me. It just wasn’t clicking for her until her son developed hives and I diagnosed him with gluten sensitivity as the cause of those hives. He took gluten out of the diet, and the hives disappeared. When her son got it, she finally understood, “Oh, you can have pasta.” [laughs] 

Finally, it took quite a while and I really treasure the journey because as a result I became really fascinated with gut health, started taking care of patients, really listening intently when they told me they had gut symptoms, or they had gut symptoms and migraines, gut symptoms and asthma, allergies, hives, eczema, or autoimmune disease. And I started looking at all the interrelationships between what the patients presented with, what happened if we worked on their gut, what other things improved that were unexpected. Suddenly, your mind is clear or now you have more energy than ever. For me, I was working 12-hour days in my clinic and you know as a health practitioner the patient at the end of the day doesn’t care that you’re tired. You need to be as on and as fresh for that last patient of the day as you were at the beginning of the day. When I was eating wheat, gluten, and dairy, I was not. I was dying for a nap. I could have taken a one-hour nap somewhere in the afternoon and it was a struggle to get through the day and when I started healing my gut, I suddenly had this burst of energy and I realized I did it first as an experiment for myself and I do this with people too because sometimes if I tell them, no you’re not going to be able to eat wheat for the rest of your life. Like, “Oh my God,” they’re going to look at me like a deer caught in the headlights, so I did it for myself too. 

I’m going to do this for a month. Let’s see how I feel in a month. I was feeling better within two weeks. So, at the month I thought you know I’m going to do this for another two months so I went to three months. Then at that point I decided, one of the best ways to evaluate food reactions is one to be really tuned into your body to really understand how you’re feeling before you eat and how you feel within minutes of eating, or within an hour, two hours later, and to really become a student of yourself. And this is what I try to teach people is, I try to teach them to be their own doctor to really become intuitive about their eating and to really listen to their bodies. So, at three months, we go to brunch, and I decide, I love rye bread, so I’m going to have a side of rye toast with brunch, I’ve avoided gluten now for three months. Maybe I’m fine now, maybe I can have gluten, within minutes, I kid you not within 10 minutes, I develop a rash on the inside of my wrist very faint, so if you’re not observant, you would miss it, but I noticed as I was eating, that I started feeling itchy on the inside of my wrist.

I just was curious as a scientist observing like, “Okay, this is strange.” I’m going to avoid gluten for another three months, I made a decision at six months, tested it again, same thing. I had never had this when I was eating wheat gluten before. When people asked me, oh, no, now, I became more sensitive now, I’m having these new symptoms. No, you have created such a blank slate that your body can give you an immediate feedback and it might come in a way that you never had before. I never had itching or rash on the inside of my wrist, but now I’ve seen it twice. So now you see a pattern, so that’s one of the things I try to teach people is, be observant of your body, look for patterns. Also understand that the body is not black and white, the pattern may not always appear every single time because your body is not the same body day to day. Some days, it might be a little more reactive than others. But overall, you’ve got to look at the pattern and that’s how you understand how your body is interacting with food and how it affects your body.

So, I became really fascinated with the gut and started working with patients on their gut health issues. And they would refer a family member, they would refer a job colleague, they would refer a friend. And before I knew it, I kind of used Dr. Mark Hyman’s phrase, I became an accidental gut expert because I wasn’t planning on it. I was just doing what was fun. And at that point, I realized, “Wow, this is just the tip of the iceberg. ” So many people and we can go into the why are coming up now with gut issues, that maybe didn’t have them 10-20-30 years ago. Well, now we’re, this is years later. So now we’re talking several decades and they don’t know what to do. They’re lost, and they need guidance and that was the inspiration for writing my book, Happy Gut, after years of having figured out that what I thought for myself was going to be a life sentence to just accepting alright, Vincent, you’ve got a sensitive stomach, sensitive gut. Yeah, sometimes you’ll go out to dinner, you’re not going to feel so good. You might have to run to the bathroom during dinner. Like, this is just my matrix, my body composition and I found that that wasn’t the truth. I was eating the wrong foods, when I changed my diet rebalanced, my gut microbiome, healed my leaky gut and I was able to become a real normal person and not have all these gut issues. Now, you ask my sister, she might disagree because [laughs] she one time commented, we went to an Italian restaurant out of all places, which of course for someone who can’t eat gluten limits your choices, and she looked at me and she’s like, “You have eating issues.” I’m like, “No, I eat a lot of what I know is good for my body and I don’t eat anything that I know is bad for me,” with exceptions because I like sweets once in a while, but you know what I’m saying that I think, what started as an experiment, became a lifestyle and then became my life passion.

Cynthia Thurlow: I think it’s really interesting, how our own personal experiences, the power of the N of 1 can be so profoundly impactful. And I think most of the listeners know that I was treated for Lyme in my 20s, I had the classic bullseye rash. I always say there was a doctor in the student health clinic who probably saved my life by diagnosing me properly. I didn’t realize that the antibiotics I went on to treat Lyme appropriately, then would create leaky gut, which then led to psoriasis. And it was probably five years later, I was talking to an integrative medicine doc, and back in my 30s there weren’t as many of them as there are now. And she said, “Well, you realize why you have psoriasis, right?” She started connecting all those dots for me. And I said, “Well, let’s do an experiment. I’m going to go gluten free and I’m going to heal my gut.” And so, I went gluten free. My dermatologist can corroborate all of this, she kept saying, “I cannot believe how severe your psoriasis was and now you have none.”

I haven’t needed to be on steroids or anything for more than 10 years. I think for listeners, understanding that foods that seem fairly benign, in the wrong person, like you had been on antibiotics, I had been on a couple rounds of antibiotics. Not a lot, but enough that it had created this hyperpermeability of the small intestine, and then led to the sensitivities which to this day, I have remained gluten free, because I think it’s so important for me to not eat gluten. But let’s talk a little bit–

Vincent Pedre: I want to also– 

Cynthia Thurlow: Sure.

Vincent Pedre: Can I mention one thing about that, which I think is relevant, is a lot of people go on gluten free experiments, and they do it for a month. And they think, “Oh, I don’t feel completely better. I’m just going to go back to eating gluten.” What I learned from myself, and also through seeing patients, is that the level of healing that I felt that three months was not as great as six months, and was not as great as a year. And it really surprised me because it wasn’t always linear. It was sometimes there was just a sudden– there was one month, where suddenly I just felt the quantum change. And realized, “Wow, it really does take a dedication, but also a bit of faith.” That because there were moments during that time where things just seemed to flatline and you think, I’m not going to get better. I was just reading a post by a friend who had gone gluten free and they were saying that it took two or three months of not losing weight on a gluten free diet, before their body finally reduced inflammation enough, and then the weight just started dropping. I think about that because a lot of people, they don’t have the patience to continue. Can you imagine if you’re at three months, and you haven’t seen results yet, like, well, why am I going to continue this, but we understand now that gluten increases gut permeability across the board, for people who are normal, people who are celiac, and people who are non-celiac, gluten sensitive. So, it takes a while for the body to unravel that inflammation and to process all of those metabolites that can hang around. So, because you said that and I was thinking of even your own journey going gluten free. I’m sure that you weren’t free of psoriasis one month after you went gluten free?

Cynthia Thurlow: No. I think it’s important we have this society that is very focused on instant gratification. So being patient, understanding that even if you’re not seeing scale victories, if you want to refer to it as that, that there’s a lot of profoundly powerful things that are happening under the hood, if you will. And trusting in the process because I was just talking to a young woman, we had done a GI-MAP and I was looking at her anti-gliadin antibodies, and we were talking about the significance of that and why hers were high and explaining to her that, I don’t want you eating gluten, and I don’t want you having grains because there’s this issue with cross contamination. And we already know you’ve provoked an immune response and she said, “I never realized, why it was so important to be mindful of foods that we introduced into our diets that we think of as being so benign.” 

And how many people are listening. and perhaps they’re a little disconnected from their bodies. Perhaps they’re not as intuitive yet, and that’s something that we can absolutely talk about. But leaning into that an intuition that the body’s trying to tell us, because I think even for myself, even though I retrospectively think about, yeah, I would get bloated maybe when I had gluten, but much to your point working in a healthcare setting, where there’s pizza and pastries and doughnuts, I’m trained in Baltimore, and that’s like Krispy Kreme heaven there. I’m not a donut person per se but any break room I was ever in if I worked overnights in the ER or for cardiology, there was always a proliferation of highly processed, hyperpalatable gluten-containing goodies just about everywhere you went. And because we were at work, and I think a lot of people thought of it as being very benign. So, I appreciate you kind of interjecting that very important point without giving it a time.

Vincent Pedre: I mean even if you think of the old Roman emperors like Julius Caesar, his thing was he gave bread to the people. What does bread do? It makes you docile. The gluten gets converted into gluteal morphine, morphine like compounds, they go to the brain and just make you feel relaxed, make you feel sleepy, so even back then I think they realized that it was a means of control. [laughs] 

Cynthia Thurlow: Yeah–

Vincent Pedre: What it does? It modifies what’s happening inside the body.

Cynthia Thurlow: Oh, absolutely. So, for the benefit of people that may not be as familiarized with the gut microbiome and talking about this bidirectional communication that goes on between our gut and our brain, and how it’s so profoundly impactful. There was a recent study that just came out, I don’t have it in front of me, but it was talking about the fact that, we’re looking at neurotransmitters, that the bulk of them are actually comprised in the gut microbiome as opposed to our brains. And yet, all these antidepressants, etc., are largely not as impactful as they could be because we’ve been looking at the wrong focus. So really, the gut is far more important than, certainly, during my training, probably during your training as well, I think about it very differently now. So, let’s talk a little bit about the gut microbiome, the importance of it, what the role is, and really thinking about food is mood so we talk about that, what does that mean, and really explaining to people that if we’re eating a nutrient dense Whole Foods diet, we are less likely to have issues with promoting and producing healthy neurotransmitters, mood disorders, etc.

Vincent Pedre: I think one fascinating piece of information or way to look at it which I think is quite interesting is that our unicellular gut bacteria produce neurotransmitters as byproducts of metabolism and release them. So, like serotonin for example and neurotransmitters are meant to stimulate nerve impulses, nerve cells that are then communicating to other cells. I’m sure that bacteria probably have some cross communication that happens. The fascinating thing is that the superhighway between the brain and the gut is the vagus nerve and at the end of the vagus, which innervates almost the majority of the digestive tract along with all the internal organs are almost like these little finger-like projections that are all along the gut. And they have 5-HT receptors, so they have serotonin receptors and when those receptors get stimulated, they send a signal from the gut up to the brain and it goes to different parts of the brain. And some of them are stimulating, some of them release GABA, which is an inhibitory neurotransmitter, so it’s controlling, it’s giving your brain feedback on what’s happening in the periphery.

Another really fascinating tidbit of information is that there are more enteric neural connections, so enteric meaning in the gut, than they are in the brain that speaks to the fact that when we talk about intuition, we talk about gut feelings, your gut intuition. The gut is not only digesting food, its digesting information, and it’s giving that read back to your brain. So, we understand that depending on the bacteria in the gut can affect the barrier as well as the signaling back to the brain. One interesting study found that fermented foods ferments can help increase in essence, vagal tone. And it’s really fascinating because we talk about, what’s going to create a healthy gut microbiome so that you can have a healthy gut brain access and blood-brain barrier, because when your gut becomes leaky, the protected circulation to the brain also becomes leaky. And then the brain is subject to all sorts of potential toxins and toxicity which can affect it in many different ways especially coming from the gut.

There’s something called endotoxin which is also known as LPS. You might hear it as lipopolysaccharides, it’s released by gram-negative bacteria type of bacteria. There’s gram-negative and gram-positive bacteria in the gut, and that gets absorbed, you’re going to get more influx of endotoxin if your gut is leaky and it can go through the blood-brain barrier, and then it actually there are receptors for it in the hypothalamus, which turned on inflammatory signals, there’s receptors in the liver in the muscle, pancreas, so it creates this whole scrambling of signaling in the body, which can then lead to things like weight gain and fatigue, and that apple shape where you’re putting on too much fat in the middle.

But there was another study, I wanted to mention that was done by Stanford University last year, where they looked at what would happen if you give somebody a high-fiber diet versus a high-fermented foods diet. And what happens to the gut microbiome in these people? And anybody who’s in functional medicine would probably think that a high-fiber diet is probably the best. We talk about eat prebiotic foods, that’s good for your microbiome, eat the rainbow, create diversity in the gut microbiome was interesting in this study, and a bit unexpected is that fiber is still important and good served as a way to modulate the immune response of the person. But it was the fermented foods diet, the high ferment that increased diversity and lowered 19 different inflammatory markers. 

So, it’s a bit backwards from what we were thinking and I think what can explain this is the crosstalk and cross-feeding that happens between probiotic bacteria in the gut microbiome. So even though a fermented food like a kefir, a yogurt, it’s not going to have a huge amount of different strains of bacteria, and it might just have a lactobacillus, but that lactobacillus creates postbiotic products, metabolites that feed Bifidobacterium. So, actually they go into the gut and they help increase the population of other good bacteria, and they help outcompete simply by taking up real estate, other bad bugs like yeast from taking over. And we know a lot of people have yeast issues, whenever you have an imbalance between good and bad in the gut. By the way, everybody has some “bad.” It’s part of the makeup and it actually is part of the way that the gut is able to be healthy is to have this diversity. 

So, everybody’s going to have about 10% to 15%, “bad bacteria.” The problem is when that percentage increases and you lose the balance, because it’s almost like, think of it like a rain forest with predators, but a rainforest is in perfect balance. Until something goes out of balance, if you have too many predators, then it loses its balance, they seen this in Yellowstone Park, when they I guess, they were trying to get rid of the wolves. And they found that by removing the wolves, which were predators that actually then allowed other animals to retake and cause soil erosion and all this stuff and then the beavers were affected, and you would have never thought that wolves serve this very important purpose in this entire ecosystem. It’s the same in the gut, we have a very complex ecosystem. I dare to say that the gut microbiome is the most complex ecosystem on the planet with 100 trillion different bacteria comprising 500 to 1000 species. If you think about it, there’s only 400 billion stars in the Milky Way galaxy so 100 billion bacteria in your gut, it’s like you’re carrying a galaxy inside your gut. Do you think of it that way? 

Cynthia Thurlow: No. I love thinking about it that way, I’m actually glad that you brought up the role of fiber, because it was one of the areas, I was hoping we would touch on. And I think that in our kind of westernized mindset, we want one thing to solve all the problems. So, I’m thinking about how many of my cardiology patients struggled with constipation, largely from medications we had them on, they were all on MiraLAX or Metamucil or Benecol. And how many people believe that fiber is the one thing and it’s not to suggest it’s not beneficial, but the point that you’re making is that the ferments were more powerful. One thing I do want to mention, though that I think is one of those like nerdy fun facts is, I’m doing research and prep for these kinds of conversations that I think it was, I don’t know, 1000 years ago, a long time ago, 100,000 years ago, we used to consume because this was way before there were grocery stores and convenience stores and Uber Eats, and things like that, and people had to actually forage and what they found is what they ate, that we used to eat a much higher diversified fibers diet than we do now.

Vincent Pedre: Yeah. There were less processed foods. 

Cynthia Thurlow: Yeah. So, you think about it now the average American consumes 8 grams of fiber a day. [laughs] Maybe back during that other timeframe I was alluding to it was 100 grams a day, or if you look at indigenous cultures in Africa. And so really understanding that taking that one supplement is not going to undo all the other poor choices that you’re making and that’s an important distinction to make. I do love ferments, I’m a huge fan of fermented vegetables because I’m dairy free, but I probably have and my family thinks it’s bananas, I have probably 15 different kinds of fermented vegetables in my fridge and I just have a couple tablespoons every day. And I’m like, I’m doing all these good things, my recent favorite was a fermented okra. But when we’re talking about these things, I think the other thing that’s important when we’re thinking about the net impact on the gut microbiome is the impact of our lifestyles, because if the past two years have not taught us a lot, and hopefully we’ve all been paying attention, the net impact of lifestyle on our health is profound. And yet, there are still a lot of people that are very unwilling to consider the possibility that some of their lifestyle choices no longer serve them in a way that is beneficial. Like you can’t live like you were 18. Like I have a nearly 17-year-old, and I remind him, I live very differently than I did at your age, for a variety of reasons. A lot of its I’m much smarter now, but with that being said, what are some of the common lifestyle aspects that can impact our gut microbiome in very negative ways?

Vincent Pedre: Yeah. I’ll start by saying that you cannot out-diet and out-supplement a stressed-out type A lifestyle that doesn’t have a stop button. And that’s something that has been an emphasis in what I’ve taught, what I wrote about in my first book, Happy Gut, and what I’m writing about in my second book. Because over the years, I have the privilege of working with so many patients healing their gut issues, and really refining diet using the right types of supplements, probiotics, powders to help with the gut lining support for leaky gut, and what I noticed is that you can’t fully heal the gut if you do not get the body into more of a parasympathetic state and it ties into– Parasympathetic meaning rest and digest like relax and it really ties into vagal tone. 

A lot of people walking around in this fast-paced world especially pre-pandemic world were running really fast, not getting enough sleep, not allowing enough time for relaxation, for enjoyment, and that causes vagal nerve malfunction, you lose vagal tone. And if you lose vagal tone that by itself increases gut permeability. Now, on top of that when you’re stressed, your body’s producing stress hormones catecholamines and catecholamines are an attack on your gut. Cortisol, which is a stress hormone, when it stays high for too long, it’s going to alter the makeup of your gut microbiome. So, it’s really fascinating because there are things that affect us that are related to our food choices, but they’re also really important things that affect the physiology of the body, and also what’s even going on outside of our body in that symbiotic system of the gut microbiome. That’s really because of what’s circulating in our bloodstream, stress hormones, and whatnot. So, part of what I teach for people who are embarking on a gut healing journey is that they need to meditate, they need to go and do things that they enjoy, get out in nature, lower your cortisol levels, go to the beach. I always try to find, what is it that you enjoy out of all these things? You don’t have to do all of them but you need to choose some of them and bring some joy and enjoyment things that you know, I say, that nurture your soul that are going to put your body in not just that rest and digest but so that your body feels safe because when your body feels safe then it can actually heal itself. If your body is in constant state of alarm it’s going to be very difficult to heal the body, and even to heal the gut, which to me is the foundation of everything. If you think of like you don’t build a house without a foundation, you can’t build your health without the foundation of gut health.

Cynthia Thurlow: It’s really important for people to consider some of the terminology that you’re using. So, when we talk about the autonomic nervous system and the parasympathetic which Is the rest and repose. That’s what allows us to digest our food and detoxify and our bodies feel safe versus sympathetic. And I would argue that most if not all of us are probably more prone to being sympathetic dominant, the constant to do list, the rushing, there’s a great book called Rushing Woman’s Syndrome that I’ve got a whole group of mine reading right now, because I said, every single one of you have or struggling with this, fantastic book by Libby Weaver if you haven’t read it, but I think it’s so important for us to understand that this vagal tone is so beneficial. And so back to my cardiology brain, because we would have people that would pass out, we would have people that they would go to have blood drawn. Usually, this happened to men more than women that was my observation as a nurse and a nurse practitioner, but they could have blood drawn or they would urinate and they would pass out. 

So, they would stimulate the vagus nerve at a time that it would lower their blood pressure. I mean, it would just do all these things physiologically to protect itself under fear of duress, probably not with urination. But the point that I’m trying to make is, that this vagal tone is so important to maintain. What are some of the simple ways– that when you’re working with your patients, and you’re talking about vagal tone, what are some of the ways that you retrain it? Because I learned from one of our shared friends, Sachin, that whistling and humming and all these things can be helpful for strengthening that vagal tone, like easy things to do that don’t require any extraneous equipment that you can do all by yourself at home.

Vincent Pedre: Yes, singing in the shower [laugh] especially if you’ve ever had any vocal training, understanding raising the palate and really creating the vibration there in the vocal cords because the vagus nerve travels on both sides here from the brain, and then innervates all the internal organs. But because it’s really close to the vocal cords, so any sort of vibration that you can create here, will then be registered by the vagus and its good way to turn it back on, but you can also do it by gargling that’s another way. Gargling for 30 to 60 seconds, once, twice, three times a day, if you can, especially for people who have constipation, it can be very helpful for that. Humming, chanting, oming all those things are really great for vagal tone. And then the things that we don’t think about is really working on rebalancing the gut microbiome, and incorporating ferments. And that can also help stimulate the vagus from the other direction from the gut because your microbiome is producing those neurotransmitters that are then activating the vagus. And really making sure that you’re getting enough sleep, like paying attention to your circadian rhythm, getting the right amount of rest for your body, and bringing enjoyment into your life. Like you just said, “Like not feeling like you’re rushing everywhere, not being in the state of alarm.” And some of that just requires just very slight modifications in the way that you do things. When I was younger, I don’t know why I like this, but I didn’t like waiting at the airport, so I would leave at the last minute possible. But then stressed if there was traffic, if I was going to make it on time than running to the gate, and then getting on the plane right as they’re boarding. And as I got older, I realized, “Okay, that creates an internal state that is extremely uncomfortable.” Why not just replan, little more planning, leave earlier? Okay, it’s fine if you have to wait when you get to the airport, you can just relax, listen to a book, read, whatever it is, but I think a lot of people, they don’t do that executive level planning for their lives. So, they’re constantly trying to catch up, whereas if all they did was do just a few little modifications, they can actually then create a greater state of relaxation within their bodies, just by modifying the way that they approach life and appointments, and things like that.

Cynthia Thurlow: I’m laughing because I recently had a conversation with my husband who likes to get to the airport at the very last minute, and I’m completely the opposite, I’d rather wait on the other side, I’d rather get my book out, listen to an Audible book. But I think there’s a message in there that we can kind of rewrite patterns and this is important. I think we’ve been through a very stressful last two years and for many of us, we have changed the way that we live our lives on purpose because we found out certain things were no longer serving us. We picked up and left a very big city to go to a much smaller city. We have a lot less stress, a lot less traffic, everyone here is friendly. That’s obviously beneficial, It’s good for the parasympathetic, the autonomic nervous system. 

Now, I would love to kind of dovetail and pivot a little bit and talk about some of the unique properties of our digestive system that are really relevant. So obviously, my listeners are familiar with intermittent fasting and what goes on in the body when we’re in a fasted state. One of my favorite aspects of the digestive system is the migrating motor complex. Like I completely nerd out on this, it’s in my book, I talk about it a lot. But when we’re in an unfed state, what are some of the things that go on in the digestive system that are of such importance. And let me let me just backtrack one second and say that our bodies are designed to eat less often, we’ve been conditioned probably over the last 100 years that we need to have snacks and mini meals and probably exacerbated over the last 60. And I really think this has been at the detriment of our health, our metabolic health in particular. And so, when I’m talking about aspects of our digestive system that really benefit from not eating as frequently, one that is a particular importance is this amazing kind of migrating motor complex, really thinking of as the janitor that comes in to kind of sweep things forward in our digestive system. But I’d love for him to come and get your perspective because I think this is such a unique and fascinating aspect of our bodies.

Vincent Pedre: Yeah. Also getting exercise very important part of the equation for stimulating the migrating motor complex or the MMC. Well, I’ll start with saying what happens or what can happen in the gut, for or a lot of people when they eat, we all get some level of transient, what they call endotoxemia, post meals. So, every time you’re eating, and depending on the state of your gut microbiome and how leaky your gut is, you can have a level of endotoxemia, where there’s an influx of inflammatory substances into the bloodstream. And that’s what can happen while you’re eating. So why fasting is so beneficial, one of the reasons is it lowers inflammatory signals coming from the gut. It also allows time for the gut lining to repair itself. If you’re constantly bombarding that lining with work, with having to break things down to digest food, you’re not giving it the time, it also needs to repair itself. And for those, the proteins in the structure and the interconnections between the cells, that tight junctions to make sure that they’re repaired, and that they’re functioning properly. And that’s part of the work that happens when the gut is in the fasted state. I think it’s really important.

The other thing is that a lot of people don’t realize this, but there is a circadian rhythm to your gut microbiome. You’re controlling that circadian rhythm primarily by when you feed, but if you’re feeding constantly or haphazardly and one day you eat at 9 AM, then you eat at 1, then the next day you eat at 10, then you eat again at 12. You’re messing up that circadian signaling in the gut, which is actually controlling the circadian rhythm of your gut microbiome, and influencing the type of bacteria that are metabolically active at different times of day. That is a really underappreciated aspect of the gut.

I thought this was really fascinating. I think you’ll find this study fascinating. So, they did this in Israel, they took mice, they basically simulated flying from Israel to San Francisco then returning in three days. And they wanted to see what happens with the gut microbiome with these circadian rhythm disturbances, and what was really interesting is that the gut microbiome shifted, because of these disturbances to microbiome that would scramble insulin signaling, was causing weight gain. And then, I read that study and I started thinking about my patients who travel overseas and they can’t lose weight and they’re wondering. They’re trying to do everything right, and I realized you could do everything right, but if you’re scrambling your circadian rhythm on a constant basis, it actually turns your microbiome against you. And it makes it into a microbiome that can then lead to weight gain as a result.

Cynthia Thurlow: That’s scary and unfortunate. I think for anyone who’s listening, the circadian biology and looking at these internal clocks that we have in our guts, and we’re talking about insulin sensitivity and how that shifts and changes throughout the day. Not to mention depending on where someone is in their life stages that can also be impactful that you may lose some insulin sensitivity as women, as an example are heading into perimenopause and menopause, really literally food for thought. When you’re working with patients that are doing a lot of bicoastal travel or they’re traveling overseas. What are some of the things that you can do to help lessen the likelihood that you will impact your gut microbiome in a way that you start becoming weight loss resistant, you start to struggle with that aspect because for a lot of listeners, weight loss resistance is a big focus, and so I’m sure their ears probably perked up when they heard that.

Vincent Pedre: Yeah. I mean, first hydration very important, people get very dehydrated on flights and the number one thing that happens with flying is constipation for a lot of people. And when you’re constipated, you’re not getting rid of toxins. So, if you want to lose weight, constipation is the enemy of weight loss. You do not want to be constipated; you want to be moving things. And a lot of people have to be careful for those liquid calories because you fly then maybe, a lot of my patients might end up in business class, because they’re flying for, their work is flying them. And then it’s very tempting to have a glass of wine, then have another one, then have another one and the airplane food. So, the hacks that I tell people are, if you can fast on a flight, while making sure to drink plenty of fluids, if you’re not fasting, bring your own snacks, watch out for the traps, the snack traps on airplanes, the chips, the granola bars, the cookies, they’re all loaded with sugar, they’re all or metabolize into sugar, they’re going to make you hungry, or they’re going to make you want to eat more. And you also have to be careful with, when you’re traveling, I think if you’re still, let’s say you’re trying to eat three meals a day, that can easily get messed up and your eating times can get messed up so trying to kind of stick to your eating times, even when you’re flying, especially cross country, I think is really important or fasting and just drinking plenty of water on the flight. Those are some of my hacks, I think it’s really tough when you’re flying against the clock from west to east, especially on those night flights where they feed you and then the next thing you do is, you’re supposed to go to sleep. So again, for that I think it’s better eat at your normal time, and do your overnight fast. For anybody who’s a gut patient, I try to aim for at least a 12-hour overnight fast. I know there’s a lot of different permutations which you talk about on intermittent fasting. But I say minimum for gut health 12-hours is really good and also, to remember that you should fast between meals as well, to give your gut a chance to recover and for the food to move down the gut.

One thing, I wanted to mention is that there’re certain types of Bifidobacteria that are often found in probiotics, that signal in gut actually stimulate peristalsis. So, the gut microbiome is involved in so many things. And you mentioned earlier if someone’s constipated, they say “Eat more fiber.” When you were saying that I was thinking, well, but the gut microbiome also helps with peristalsis with the movement of the guts, you have to think not just fiber, fermented foods, maybe probiotic, you want to make sure that you’re not– And I think this is the danger with some people out there is that they come out and they’re like, fiber is the cure all. Eat fiber that’ll fix everything or don’t eat lectins that’s going to fix everything. My approach is a bit more balanced and nuanced based on what I’ve learned about the gut and the gut microbiome and really, it’s about having a variety of things. 

Yes, Americans don’t eat enough fiber, like you said, 8-10 grams, we should be getting 25 to 35 grams, indigenous people are getting around 50 grams per day of fiber. We’re really behind right before I went on, right before the pandemic started, I actually had the opportunity to go to Africa and stay for three days and two nights with the Hadza, hunter-gatherer tribe in Tanzania. We went hunting with them, we went foraging with them in the forest, we found honey inside a tree, like there’s these honeybees that actually create the honeycomb inside of the bark and cut it open and we had the honey there on the field. We found tubers in the ground that they eat, really great source of fiber. And the amazing thing was I was so fascinated with them and jumped on the opportunity to go on this trip was because they’ve studied their gut microbiome and diversity of the gut microbiome, and it’s quite diverse. Even though they’re not really eating the rainbow, they don’t eat the rainbow, they do eat a lot of fiber, they do get exposed to a very broad microbiome because they don’t have the level of hygiene that we do.

So, we didn’t talk about exposure to dirt to the outdoors, all that but that’s also another way that diversifies the gut microbiome. But what is really fascinating about them, is they don’t have diabetes, they don’t have obesity, they don’t have cancer, they don’t have heart disease, they don’t have high blood pressure. So, there’s something to learn there, about you started the podcast, we were talking about modern life, and how we’ve kind of a bit lost connection with our humanity, and everybody’s in this more stressed-out state. If you’re on your smartphone, you’re being bombarded all the time. And that’s causing certain neurotransmitter releases in your brain, which is okay, certain amount of time, but you don’t want to deplete those neurotransmitters, we need more balance. And I think gift of the pandemic and the quarantine was that we were forced to pause. We’re forced to create a pause and I think in that pause a lot of people realize how important or how much their lifestyle before that was impacting them in a negative way. And how important it is to intentionally shape your life in a way that is just more livable.

Cynthia Thurlow: I don’t think I could have said it better myself, I think for so many of us the gift of the past two years, because I like to reframe things, is that we realized for our family, we were not an environment that was conducive to all of us being happy. And a lot of it had to do with exterior pressures and traffic and a multiplicity of different things, and so when people ask me why we moved, I always say, “Well, we were now in a place where our stress levels are lower, we’re not in that toxic traffic, we’re surrounded by different types of people.” Everyone here, I actually have to condition myself when I leave my house, it takes me longer to do things, and but not in a bad way. People here are so genuinely interested in who you are as an individual, they actually want to ask you about yourself, they want to ask how your day is. It’s delightfully wonderfully slowed down in a way that has benefited all of us emotionally, vagal tone is definitely better. I can trend all my data on my Oura ring. 

Vincent Pedre: If you think about it that’s such a brave thing to do that a lot of people are afraid to do and yet, it’s such an important aspect of health. We’ve been talking about the gut and the gut microbiome, but in essence, the way that I approach health, and I talked about in my books is Mind Body Spirit. And I think it’s really important to realize that your surroundings also affect your state of health. So, I’ve sat in a room with a patient and talk to them about their job and how much they hate it and how they dislike their boss. And then talked about plan on how they’re going to find a new job that they really love. And to me, there’s no disconnect. I know I’m a doctor, I’m not a career counselor, and I’m not telling people, I tell them don’t go quit your job. [Cynthia, laughs] But let’s talk about how you can manifest the job that allows you to live in a way that’s more congruent with a lifestyle that you want. A lot of times when I’ve done that, either things because they shift, things suddenly get better at their work, or they actually start believing, and they go and they manifest job that they thought was not a reality. And then all of these other health issues, including gut issues get better, because now they’re more relaxed, they’re happier in their lives. So, I don’t see for me, it’s all a continuum or outside environment, how that affects us, our internal world, the gut microbiome, I mean it’s our biggest inside outside world, inside our gut. So, I think it’s very important for anybody listening that we’re not just what we eat, what we breathe, what we touch, we’re also affected by our environment, by our surroundings by our work environment, and if it’s not working for you, find a way to choose what does.

Cynthia Thurlow: That’s beautifully stated. Please let the listeners know, how to connect with you, how to get your amazing book, what types of testing they need to be asking and advocating for or even connecting with you and your team to work with you directly.

Vincent Pedre: Thank you. Yeah, I’m very active on Instagram as you know. So, @drpedre, post a lot of free content there to educate and inform and empower people on how they can live healthier lives through the foundation of gut health. They can go to my website to learn more about me happygutlife.com. They can also you know, I even believe it or not, go into my DMs on Instagram, and I’ll answer people, myself–

Cynthia Thurlow: I love it.

Vincent Pedre: –because I really like connecting with people. And, and look, I can answer a health question. Sometimes people give me their health history, I’m like, I can’t do that, but go to pedremd.com and if you’re interested, I will do a consultation. We take limited people because we really want people who are ready and dedicated and willing to make the changes that are going to make a positive impact in their lives. But honestly, just as I’m sure you feel you did with your book, I put my wisdom and a lot of what it’s almost like having a consultation with me reading my book. And in my book, I actually have a section that I think is really powerful because I wanted to empower people and I tell them, look, take this to your doctor, I have symptoms, and the types of functional tests that you should think about, if you have these symptoms. Because there’s so many things that we don’t think are gut related, like I talked about hives, migraines, asthma, allergies, skin rashes, autoimmune disease, neurological disease, these things are rooted in gut health as well. But they may not present, you may not even have any gut issues. You might be presenting with joint pains and be diagnosed with an autoimmune rheumatological disorder, but not realize that the real issue is dysbiosis, parasites, leaky gut, and maybe, yeast overgrowth, and if you fix the foundation, which I have done for people, then miraculously, the other things get better. So, I put that into my book, and there’s a guide on, what tests to do? And for anybody who would love my tips, I can give you my link for my top 10 tips that you can put in the show notes for people to download. My top 10 tips for a healthy happy gut and it’s really kind of like the CliffsNotes to my book.

Cynthia Thurlow: Perfect. Well, I look forward to connecting with you again and hearing more about this current book that you’re working on.

Vincent Pedre: I’m really excited. It’s going to be a very different book. It’s still on gut health. But it’s probably one of the few, I don’t know many books that are based on a quiz and the quiz personalizes the plan to you. So basically, recognizing that not every gut patient is the same. And so, I wanted to create something that was tailored, depending on the level of gut dysfunction. I’m really exciting. It was a huge undertaking, and it’s going to come out next year.

Cynthia Thurlow: That’s exciting. We’ll definitely have to have you back, because as I said, I haven’t had enough gut health experts. And obviously today this conversation–

Vincent Pedre: I feel like, we’re just the tip of the iceberg, where there’s so much more we could talk about. 

Cynthia Thurlow: No, exactly.

Vincent Pedre: I really appreciate it.

Cynthia Thurlow: No, the irony is as we were talking, I was like I have five pages of notes, my listeners know I really prepare and I was literally like shit like circling one thing we touched on one page, one on another. I’m like there’s so much that we could talk about. So, having you back again will of course be a pleasure.

Vincent Pedre: Thank you. Yeah, this was a great to be here, and thank you for an engaging conversation.

Cynthia Thurlow: Awesome. If you love this podcast episode, please leave a rating and review, subscribe and tell a friend.