Today, I am delighted to connect with my physician colleague, Dr. Vivek Lal. He is a physician-scientist, a double board-certified physician, an innovator, and an entrepreneur. He is also the Director of Clinical Innovation at the Marnix Heersink Institute of Biomedical Innovation and Professor and Director of the Pulmonary Microbiome Lab at the University of Alabama at Birmingham.
In today's conversation, we dive into the lung microbiome, examining the anatomy and physiology of the lungs, gas exchange, and why air is medicine. We discuss the realities of lung function, looking at the lung microbiome, dysbiosis, the concept of leaky lung, and the gut-lung relationship, and explore how lifestyle, exercise, and nutrition impact lung health and how sleep deprivation and stress can lead to lung infections and inflammation. We also get into specific diagnoses related to lung health, the effects of environmental toxins, and the latest cutting-edge research on probiotics that may benefit lung health, and touch on the consequences of long-term steroid use for chronic conditions and how menopause impacts the lung microbiome.
I know you will love this invaluable conversation with Dr. Vivek Lal.
IN THIS EPISODE YOU WILL LEARN:
Dr. Lal explains the anatomy and physiology of the lungs
Why Dr. Lal believes air is medicine
How the lung microbiome compares with the gut microbiome
How the concept of real lung function can prevent secondary health issues
How lifestyle factors influence lung health
How the gut-lung axis affects lung health
How ResB Lung Support, the world's first respiratory probiotic, was developed
The benefits of using the ResB Lung Support probiotic
How probiotics can reduce the side effects of long-term steroid use
Bio: Dr. Vivek Lal
Dr. C. Vivek Lal, MD, is a physician-scientist, innovator, and entrepreneur. He is the Director of Clinical Innovation at the Marnix Heersink Institute of Biomedical Innovation, Professor, and the Director of the Pulmonary Microbiome Lab at the University of Alabama at Birmingham (UAB). Dr. Lal is the founder of Alveolus Bio, Inc., a biotech platform company that does FDA-approved pulmonary drug development. He is also the founder and CEO of ResBiotic Nutrition, Inc., a company that makes science-backed wellness supplements, and Urgent Care for Children, a Southeast US-based urgent care chain headquartered in AL.
“Stress, sleep, and exercise affect your gut microbiome, which could affect lung health."
-Dr. Vivek Lal
Connect with Cynthia Thurlow
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Submit your questions to support@cynthiathurlow.com
Connect with Dr. Vivek Lal
On the ResBiotic website
Email Dr. Lal: Vikek@resbiotic.com
For 20% off at resbiotic.com, use code CYNTHIA20!
Transcript:
Cynthia Thurlow: [00:00:02] 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.
[00:00:29] Today, I had the honor of connecting with physician colleague Dr. Vivek Lal. He's a physician scientist, double board-certified physician, innovator and entrepreneur. He's also the Director of Clinical Innovation at the Marnix Heersink Institute of Biomedical Innovation and Professor and Director of the Pulmonary Microbiome Lab at the University of Alabama at Birmingham.
[00:00:52] Today, we spoke at length about the lung microbiome, the anatomy and physiology of the lung and as well as gas exchange, why air is medicine, the realities around lung function and the lung microbiome, the impact of dysbiosis and leaky lung and the interrelationship between the gut-lung axis, the role of lifestyle, including exercise and nutrition, as well as sleep and stress leading to lung infections and lung inflammation, the role of specific diagnoses and lung health, the impact of toxins including inhalations, pollution and strategies around this, research around specific strains of probiotics that can be beneficial for lung health, why steroid use is not benign, especially in chronic forms and lastly, the impact of menopause on the lung microbiome and so many other things. I know you will find this to be an invaluable conversation. I really enjoyed this conversation with Dr. Lal.
[00:01:57] Well, Dr. Lal, I've been really looking forward to this conversation. Welcome to Everyday Wellness.
Dr. Vivek Lal: [00:02:02] Thank you so much for inviting me, Cynthia.
Cynthia Thurlow: [00:02:04] Yeah, it's interesting and very serendipitous that our paths kind of crossed and I got acclimated with your research, given the book that I'm writing right now, which is really laser focused on the gut microbiome. But I think most listeners probably do not realize the anatomy of the lungs and probably the physiology. So, let's start there. Let's talk a little bit about, the upper airway, the lower airway, and where this microbiome piece all fits into the lungs so uniquely.
Dr. Vivek Lal: [00:02:34] Absolutely. So, our upper airways, that is the nostrils and the nasopharynx, the oropharynx connects to the trachea, that goes into the lungs. It has these larger airways and then smaller airways which end up in the alveoli deep in the lung. Alveoli are the building blocks of the lung where the gas exchange happens when you breathe in something, the air goes deep into the lungs. We take in oxygen that diffuses through the blood vessels which line these alveoli and then enter the body. So, essentially, we are breathing in things which are going deep into the lungs, and there is a thin layer there where the gas exchange happens and your whole body is getting the oxygen. It is so serendipitous that even myself, we never thought about the lungs.
[00:03:30] We eat three times a day and we say food is medicine, but just imagine how many times a minute we breathe. Almost 28, 30 times. So, what we breathe in is important. So, why not air as medicine. So that's where I really started getting interested in the lung field and being a physician scientist, we started studying lung health or lung biology around 15, 20 years ago. We started looking at single molecules and then understood that it is such a complex organ that single molecular studies don't really work as much. So, that's when we started going after newer technologies like omics, systems biology, microbiomics, microRNA omics. You hear these fancy words, transcriptomics, proteomics, metabolomics, etc. But 15 years ago, the problem was economics. These were so expensive. [laughs]
[00:04:24] But I soon realized for such complex organs, you have to do an unbiased approach. And that's when I stumbled upon the microbiomics that maybe there is something to do with the lung microbiome. NIH came up with the Human Microbiome Project in 2006 or 2007. I don't remember the exact date, but lungs were not an organ, as you rightly said, gut, trillions of bacteria, the vaginal microbiome, skin microbiome, etc., but the lungs were not a target organ because we historically always thought lungs as sterile. So, our lab and some other labs around the world started studying the lung microbiome, how the lung has an innate microbiome itself, how that communicates with lung homeostasis. But on top of it, how does the microbiome of the gut communicate with lung health through the gut-lung axis.
Cynthia Thurlow: [00:05:20] Yeah, it's so fascinating to me because a million years ago, when I did all my medical training, the microbiome was not something that we discussed. So, for listeners to understand that, this is why it's important to remain current as a clinician, but to understand this complex interrelationship, the body is interconnected. In traditional allopathic medicine, we tend to think about organs as a system. Like if you work in pulmonary critical care, you're really focused in-- you're focused diffusely, but really focused in on lung function and cardiology, very focused on the cardiovascular system. And then you understand these microbiomes ensure that everything is interconnected, whether or not we are willing to accept this or not. I very humbly sit back and I'm fascinated even more so now than I was 25 years ago with how we function as organisms.
[00:06:08] And I think in many ways when I was considering our conversation, it was how do I present the lungs in a way that's very tangible for listeners because we do have quite a few healthcare providers that listen, but also for the lay public, how can we make this information accessible so that they will start considering why this is so important? So, back up a little little bit, so, we talked about some of the physiology, a little bit of the anatomy. How do you like to measure lung function? So, if we're looking at lung function, so there's probably people listening that have a loved one that has emphysema or a larger class COPD or even asthma. And so when we're looking at lung function to determine whether or not someone has healthy lung function from a broad-based perspective or unhealthy lung function, what are some of the more common ways you like to investigate this?
Dr. Vivek Lal: [00:07:00] You rightly said, there are ways in allopathic medicine, taking one organ, suppose lung at a time, and then there are the bigger things, taking the whole holistic human being into perspective. I being a very evidence-based and research-focused allopathic practitioner, never thought about it 15 years ago. But over the years what I've realized is we don't know anything. We are such complex beings and they're just touching the tip of the iceberg as far as scientific knowledge goes. Having said that, lungs and lung function, I think it's a very complex issue. Yes, in the traditional way, we could measure forced expiratory volumes, FEV1, vital capacity, etc., through these measurements. Those are objective measures of lung function.
[00:07:47] But why is that you and I could look totally healthy today and I get COVID and you get COVID and I end up in the ICU and you are walking around absolutely fine. Why is that you and I could look totally healthy and we eat the same, etc., but you have severe allergic asthma and I have nothing. So, it is much more complex than what we feel. So, at a baseline level, your lungs are either predisposed or resilient to a second hit. That's what I call real lung function.
[00:08:19] So, how well can you not only contribute to your daily activities with healthy lungs, but also how well can you prevent a second hit, whether it is an infection, whether it is smoke injury, whether it is all these wildfires that we are inhaling, whether it is an infection you get, or whether it is allergies, etc. So, that's where I think complex issues like lung microbiome or the gut-lung connection, or the basic immunity or immune response in the whole body comes into play. So, that's what I call real health function, which we absolutely don't think about because unless you have a problem, why would you think about a lung function? So, but at baseline, we as human beings are either predisposed or susceptible to either a worse lung outcome or a better lung.
Cynthia Thurlow: [00:09:08] Are you still practicing in the ICU or are you doing more research these days?
Dr. Vivek Lal: [00:09:13] So, I'm a double board-certified ICU physician. I don't get time to do much clinical, but that was my first love. I always believed the real ideas come from the bedside and I take these bedside to bench and then from bench back to the bedside. So, I do see patients, I try to do at least one day, one night a month in the ICU, just to keep in touch and I love taking care of patients.
Cynthia Thurlow: [00:09:37] Yeah. What I came to find being in cardiology for such a long period of time, working alongside our pulmonary critical care fellows and physicians and other providers, is that there's a degree of complexity with those cases. There's a personality type that gravitates towards that type of medicine in terms of you probably like the rigor of the medically complex patient. Do you find now that you are doing more research, more entrepreneurial based, do you still feel like that's your first love or do you feel like you have a different perspective now that you're more on the research entrepreneurial side?
Dr. Vivek Lal: [00:10:12] My first and the last love is making an impact in healthcare. I went to med school to make an impact in healthcare, soon realized that yes, I can fix one patient at a time, but in order to make a larger impact, I have to do research. So, went into research and started doing NIH-funded research and whatnot. But soon again realized all of this research, more than 90% of it doesn't get back to the consumers or the patients. I was publishing in high impact journals, getting these grants, etc., but most of the time it's to please your bosses or to get a promotion or to get a big high impact paper.
[00:10:49] But what is real impact, if I could take those findings, get it back to the patient or the consumer, that's when I decided I need to take it into my own hands. And that's where the entrepreneurship started 15 years ago, 10 years ago. I did not know business, so had to learn it in order to commercialize it. People equate commercialization or industry as a bad thing in academia, but I think it's a real impact if you could actually take the finding from the bench or from the research back to the consumers through commercialization.
Cynthia Thurlow: [00:11:17] Yeah, I think many listeners may not realize that a lot of the research goes on. It can take 10 or 20 years to trickle down into clinical practice. So, what you're really speaking to that making an impact is making an impact now versus 20 years from now still important. But you're probably feeling like the work that you're doing now, you're able to positively impact a larger group of individuals than you were previously. Now, when we're talking about the lung microbiome, it lends itself to have a discussion around the topic of dysbiosis. And so, my listeners are definitely familiarized with this term and helping people understand that they've heard the term leaky gut, you can actually have leaky lung. And so, let's talk about some of the habits that can contribute to an unhealthy lung microbiome. Some of these are probably not surprising, but others may be.
Dr. Vivek Lal: [00:12:08] Yes. So, our bodies are inhabited by trillions of bacteria. Just for context, like every human cell in the body, we have more than 10 bacterial cells in the body. So, we have nothing but a bunch of bacteria. So, lungs also have a microbiome, but the biomass, the quantity essentially of that is much less than what you find in gut or other organs. Because in gut it's a nutritive environment for these organisms to grow fast. Lungs, it's not a very nutritive environment. So, lungs or our own immunity does clear these bacteria themselves very frequent, but there's still a little bit of biomass or microbiome. So that microbiome, when we started doing studies in extremely premature infants who develop chronic lung disease.
[00:12:57] So, if they had a specific expression of bacteria, specific microbiome at baseline, they would either be resistant to or resilient to or susceptible to a second hit like an oxygen injury. And then we started doing it in other models like smoke injury. So, what your lung microbiome represents could make you susceptible to develop a COPD if you smoke versus not develop a COPD, even if you smoke a whole lot. Similarly, because we see all of these people walking around, smoking packs and packs, and they don't develop many of the diseases many people do develop even with very little toxic inhalation. So, why does that happen? I think lung microbiome has a vital role to play in that predisposition or resilience.
Cynthia Thurlow: [00:13:52] Well, I can tell you I had years of patients that would be in the ER that had smoked two or three packs a day for 50 plus years and they had no clinical evidence of significant lung disease. And then I would have another patient who would smoke for five years and then unfortunately have a genetic susceptibility like alpha-[crosstalk]
Dr. Vivek Lal: [00:14:13] Antitrypsin, yeah.
Cynthia Thurlow: [00:14:15] Thank you for I just had a brief moment. I was like, it's on the tip of my tongue. And then you would see other people and could it have been that they have this different lung microbiome that is perhaps in some instances protective and in other instances is not protective. It makes them more susceptible to these types of disorders and diseases?
Dr. Vivek Lal: [00:14:35] Absolutely. And we saw that in the first study we had conducted in these extremely premature infants right at birth, if you had a specific microbial milieu that made you predisposed or resilient to developing the disease, not only the lung microbiome, but the gut microbiome. Because of this gut-lung connection, it is a little counterintuitive. How can the gut connect to the lungs? And I can talk more about it, but the gut microbiome could be affecting your lung health, brain health, and other things through these connections called the gut-lung axis or gut-brain axis. I call it the gut X axis. X in algebra is any unknown. I firmly believe that the gut connects to every unknown in the body through the gut X axis. In this case, the gut-lung axis.
Cynthia Thurlow: [00:15:25] Well, and it's so interesting because I recall being taught, the lungs are a sterile environment, so how could there be this interconnectedness? Can you speak to this? Because for me, as I was prepping, I was like, “I have so many questions.” Because so much of what I was taught, granted many years ago, we're starting to realize there's more to it than that. It's this nuanced conversation that I think is so valuable.
Dr. Vivek Lal: [00:15:48] There is much more to it for sure, the gut-lung connection. So, not only does the lung have its own microbiome, the gut communicates with the lung through the gut-lung axis. The gut has this rich capillary network and the lymphatic network. So, anything we eat or the microbe of the gut produce these metabolites which gets absorbed into the blood circulation through the gut and then travels to different parts of the body, including the lungs. So, if it goes to the lungs and does something anti-inflammatory or reduces some inflammatory markers that is affecting the lungs through the gut-lung axis. So, these lymphatics and blood vessels carry important metabolites which are anti-inflammatory into the lungs and decrease the lung inflammation.
Cynthia Thurlow: [00:16:38] That's so fascinating, really. I mean, I sit back and this is where I humbly say this is why we as individuals are meant to evolve, shift and change and we are meant to learn new things. And I hope my listeners are leaning into this perspective because it is so fascinating. What is the research suggesting about the net impact of lifestyle on lung health? So, obviously beyond the smoking piece, but much like other microbiomes, stress, antibiotics, steroids, things like that, what is it doing to this very delicate ecosystem?
Dr. Vivek Lal: [00:17:13] All of these stress, exercise and especially diet does impact lung health. The small chain fatty acids which are extremely useful for inflammation in general, are also useful in lung inflammation. If you have specific kind of microbiome in the gut which increase your small chain fatty acids, those small chain fatty acids do travel to the lungs and decrease inflammation. Similarly, I don't want to get too technical, but things like MMP9 metalloproteinase-9, which create a lot of inflammation. If you could somehow decrease that, through specific probiotics or microbes that can decrease your lung inflammation. So, diet especially is extremely important. Stress, sleep, exercise similarly affect your gut microbiome, which could affect the lung health.
Cynthia Thurlow: [00:18:06] Yeah, it's so interesting to me because I think we're certainly in a time now where all these connections that are being made with lifestyle, I think when I was first practicing as a nurse practitioner wasn't as much emphasis. In fact, I was still telling patients to avoid saturated fat and eat, the Brummel & Brown and vegetable oil spreads because butter was bad. And thankfully now I know better. But when I think about not just lung disease, but lung infections and things like that. So, if someone were to get, let's just arbitrarily say, a bad pneumonia, I'm presuming that is not just a reflection of the lung microbiome, but also the gut microbiome. Because as you're talking about short chain fatty acids, these protective molecules, I start to think about like why are some people more susceptible?
[00:18:52] Even if we take the pandemic out of it, why are some people just more susceptible to getting more significantly sick, needing to be hospitalized longer rounds of antibiotics and it's interesting even looking at things like pleural effusions, pneumonias, there's an outbreak of tuberculosis in Kansas right now, which we haven't seen numbers like we are 60 plus people with confirmed TB and I think there's 70 plus that have latent TB, which is not infectious but still concerning. So, I start to think, why are these things kind of transpiring?
Dr. Vivek Lal: [00:19:25] There is absolutely a role of microbiome in predisposition of these diseases as I alluded to earlier. There's a lot of research which still needs to be done. Just remember it's only a 15-year-old field, especially lung microbiome. It's just a 10-year-old field. We are all actively working because microbiome in general was discovered after the 16S technology. These are genomic technologies where you could actually find that not just culture methods, but you could find out about other microbiome through these genomic methods. So, it's still very early. I don't think we know enough. I even don't claim that I know enough.
[00:20:02] We’re all actively pursuing knowledge, but what we know for sure is yes, the lung microbiome and the gut microbiome does increase your predisposition or resilience towards lung diseases, whether it is TB, whether it is COPD, whether it is just smoke inhalation and some inflammation and allergy from that.
Cynthia Thurlow: [00:20:23] Now, in terms of things that we can be doing proactively to support our lung microbiome, walk us through some of the higher-level concepts and then I know you have some products that have been created, but for people that are listening, that are curious, what is the research suggesting is of greatest benefit to nurturing this microbiome?
Dr. Vivek Lal: [00:20:45] Absolutely. So, I think the biggest thing coming out now in recent years is how do you make sure you're breathing the right thing? Inhalation of toxic fumes, toxic substances, pollutants, etc., does harm your lungs. Even if you don't see it, you may see it years later. Eating the right food and enriching your gut with the specific probiotic strains does affect your lung health. Even if you don't have a disease, that doesn't mean that it cannot decrease the predisposition to disease. Whether it is in people who have established chronic lung diseases, or whether it is athletes who want to optimize their lung health, or whether it is people who work in environments where they're inhaling smoke or wildfire smoke, etc.
[00:21:40] Or if it is just a smoker or person who consumes some marijuana, who wants to do something proactively for their lung health, even if they don't have a problem. So, all of these are personas who could benefit from better gut microbiome, which could affect lung health. So, our running joke is, “Who can benefit from lung probiotic?” Anyone who breathes can benefit from lung probiotic. [laughs] That's a running joke. But that makes a lot of sense for us. That's why we spent several years in creating the world's first respiratory probiotic. That's called resB Lung Support.
Cynthia Thurlow: [00:22:20] So, I think about post 9/11 and the EMS workers, firefighters that were exposed to the toxins just from burning jet fuel and the breakdown of the buildings. I'm thinking currently about all the fires that were in LA area. As a pulmonologist, critical care physician, what are some of the concerns, when we talk about those toxins that people are inhaling, what are some of the bigger concerns that you have? Exposure to specific chemicals that can be very lung toxic?
Dr. Vivek Lal: [00:22:53] Absolutely. I think the biggest concern with these wildfires was the particle size of what they were inhaling. Usually particle size less than 2, 2.5 microns can go really deep into the lungs. And that's what happened with these wildfires. You won't immediately see the effect. If you're seeing the effect immediately, like you burning eyes, coughing, etc., that's very obvious. But many of these effects show later. If you consistently keep inhaling these toxins, you could have the effects later. Like in developing countries, many places where they have high pollution levels, high equality index consistently for months and weeks, they have really worse lung outcomes. I know because from the commercial side, we get a lot of demand from China, India, these Asian countries where pollution level is very high. Having a wildfire and inhaling that is nothing different from that. So, it's the same thing. You're inhaling all that and even more of a reason to take care of your lung health proactively in that sense.
Cynthia Thurlow: [00:23:54] Yeah. Do you look at things like and we'll touch more on the probiotics, but do you think about N95 and filtering things that can be of benefit? I have many, many friends that have been impacted by the wildfires. And they've expressed a lot of concerns just because they can't see it doesn't mean that it's not problematic. And so, I would imagine as a lung specialist that you probably share some of those same concerns.
Dr. Vivek Lal: [00:24:20] Yes, this was very concerning what happened recently and then last year also. Because it's the invisible enemy as you said. Yes, N95 does help, I think monitoring the air quality index, although air quality index is also not the most accurate as we have learned in the last few months and doesn't cater to the remote areas, etc., which don't come under those monitoring, but at least gives you some guesstimate of is it bad or good. Monitoring it carefully, wearing an N95 whenever you can has been recommended because for what it does prevent those small particles from entering your airways, etc. So, that has been helpful proactively taking things which could decrease lung inflammation. Like these respiratory probiotics or antioxidants etc., which are available. So, those things have been recommended. Yes. The real impact, we will find out in a few months or years, I guess.
Cynthia Thurlow: [00:25:25] Yeah, I know that my heart goes out to so many hundreds of thousands of people that were impacted in many instances losing their homes, for many of them losing their schools and their places of worship. Now when we talk about these probiotics, which strains are actually beneficial based on your research and the work that you and your team are doing?
Dr. Vivek Lal: [00:25:47] Yes. So, there are specific RSV strains, resBiotic strains which we isolated from humans and then tested. I was also founder of a drug development company. So, we had these drug development labs—FDA-approved drug development labs where we tested 10 years ago, if you would have asked me, I was never into supplements as a doctor we have been always brainwashed. These things don't work. This is all snake oil. And the industry is also to blame because most of it is snake oil because it's not tested. So, we decided, more than 60% of the population is anyways on some kind of supplement. So why not use our drug development expertise and the actual scientific medical expertise to try to scientify the supplement industry. That was the rationale behind creating this.
[00:26:35] So, these specific strains were Lactobacilli strains, three strains which we first tested in human cellular studies. Then went on to animal models of lung diseases over next two or three years. Then we went into clinical trials. So almost a drug development like trajectory for testing in a consumer product.
Cynthia Thurlow: [00:26:55] It's really exciting because most supplements don't go that route. But probably with your significant research background allows you to kind of look at it from lower level all the way up to human clinical trials. And what have these lactobacilli probiotic products, what have they demonstrated in terms of efficacy and results for human subjects?
Dr. Vivek Lal: [00:27:19] For human subjects, I think the three main, again without making any disease claims here, the biggest things we have noticed is improvement in FEV1 that is forced expiratory volume and in customers who smoke, customers who have some kind of chronic lung disease or even apart from that we have seen improvement in mucus, cough, etc., based on the consumer responses. We can leave all the research aside, but the most satisfying part is when you get calls from these customers that their lives have changed. They've been on steroids for years. They've been on oxygen for years and their lives have changed. That's the most satisfying, I guess.
Cynthia Thurlow: [00:28:00] One of the things that might be helpful for listeners to understand a short course of steroids, not a big deal. But when you're taking long-term steroids, what are some of the chronic side effects that you will see? So, they help reduce and quiet inflammation, but they can also create a whole host of other side effects that you know, many people may not even be aware of when they're started on these medications. In many instances, they may be necessary at least on the short term. But the side effects related to chronic steroid utilization.
Dr. Vivek Lal: [00:28:34] There have been so many side effects demonstrated with chronic steroid utilization right from metabolic derangements, from weight gain etc., to bone density loss. There's a whole spectrum of side effects you see with chronic steroid use. Your overall innate immunity goes down. So, immunity, you get more predisposed to illnesses, infections, etc. So, steroids are not safe in the chronic use case scenario. Of course, they are effective in the short term to bring down the inflammation acutely, but it comes with its baggage of side effects.
Cynthia Thurlow: [00:29:16] Yeah. And if anyone is taking chronic steroids, we are not suggesting in any way, shape or form to change what you're doing, but just to be informed. I have a loved one who had a renal transplant over 40 years ago, which is incredible and she is sharp as a tack mentally, but what it has done to her body, I mean, we jokingly say we're going to wrap her in bubble wrap and duct tape because she breaks bones so easily and so readily. And that is a byproduct of chronic long-term steroid utilization. For her, that's been her biggest issue. She's actually been pretty healthy otherwise. But the osteoporosis in the setting of a menopausal female is quite significant, especially with long-term steroids.
[00:30:00] Now, has your research looked at the net impact of shifts in immunity vis a vis the lung microbiome for women that have made that transition from perimenopause into menopause? Because we know women in particular, that loss of estrogen is a quite significant and profound impact on our innate and acquired immunity.
Dr. Vivek Lal: [00:30:22] For this product, resB Lung Support, we have conducted several consumer analyses. The biggest consumer persona is women greater than 40 years old who take this and initially when we were creating the product, we thought that people who have some issues will take it. But what we saw is based on the retention analysis, people who start taking it don't stop it. Like my mom, like my wife, me, we all take it just because it just gives you that sense of immunity for that second hit, because over a period of time, you realize that you're not getting as sick as frequently as you used to. You're not getting those colds and sniffles and coughs as you used to, you're not getting those allergies in spring or fall as you used to. So, many people stick with it.
[00:31:14] And most of the consumers are women over 40. Actually, we just won an award from one of the top women magazines on this.
Cynthia Thurlow: [00:31:22] Yeah, that's amazing. Well, and it doesn't surprise me because I think women get to be, whether it's over 40, over 45, their kids are a little older, if they have children, they have a little bit more bandwidth to actually educate themselves about, where they are health wise. And all of a sudden, they become much more vested in taking care of themselves. Maybe it was harder when their kids were younger, they get a little bit older, their kids are a little bit more independent, and suddenly they're like reacquainted with selfcare and taking care of themselves. So, I'm not at all surprised.
[00:31:49] And I think certainly from my perspective, when I'm looking at the things that can be most beneficial to be conscientious about, immune function and immune support is an enormous aspect of this perimenopause to menopausal transition for many individuals who suddenly find that they're experiencing more and more concerning recurrent infections. And again, it goes to these microbiomes that shift and change with these shifts in estrogen. Now, in terms of products that you like to use, obviously you've created this product, talk to me a little bit about, you have resG and resM. Talk to me about these different products and the benefits specific to them.
Dr. Vivek Lal: [00:32:39] Yeah. So, at resBiotic, res stands for restoration. Our mission and goal was how do we restore health for people who have either chronic health issues or who want to avoid chronic health issues. So, restoration from chronic health problems is the motto of the company. And I talked about the gut X axis, how the gut communicates with different parts of the body. And we started with the gut-lung axis, pioneered the first respiratory probiotic in the world. And then as a next step, we wanted to go to the other axis of the body. So, we looked at the gut-energy axis. So, we created the first microbiome friendly clean energy drink in prebeet. Pre stands for prebiotic and beet stands for beets. So, it is a prebiotic beet drink which not only increases clean energy, increases the nitric oxide boost.
[00:33:29] It also has vitamin B12, which gives you that cellular energy and on top of it increases your Akkermansia and bifidobacteria of the gut, which are great for metabolic health. And recently we found out it boosts GLP1. So, it's a pretty robust energy and metabolic drink. That is resG prebeet G stands for gut, resB, B stands for breath. And then the third product we just launched is resM. M stands for metabolism, where we are targeting the gut-metabolic axis with similar research products.
Cynthia Thurlow: [00:34:03] It's interesting, as I was writing the book, nitric oxide is something that I've known a lot about. My very first anatomy and physiology teacher in college used to talk about nitric oxide all the time. And the irony is, as we're losing estrogen, women are making less and less nitric oxide. Depending on your genetic makeup, if you have MTHFR, which is a [unintelligible [00:34:23] SNP, which I have two copies of, my body already, is more challenging to make enough nitric oxide. But what I found really interesting in the research is as women are navigating this perimenopause to menopause transition, we're making less and less and less nitric oxide. And what's interesting is for listeners, nitric oxide is a vasodilator. So, within the blood vessels, it's helping to dilate the blood vessels. What's the number one killer of women? cardiovascular disease.
[00:34:50] So you just start to this domino effect. And as I was reading about these products I was like this is so interesting. And Akkermansia, this keystone bacteria, so important for mucus production, endogenous GLP-1 production, short chain fatty acids, butyrate production. So, like all of these really interesting things. And is this something like-- the beet juice product is this something that people take daily or is this a couple times a week? How does that work?
Dr. Vivek Lal: [00:35:17] We have many consumers who take it multiple times a day, the recommended dose is daily. We have quick stick packs for daily usage. But people including me, we take it multiple times a day as a pre-workout drink. It's pretty tasty also. So, could use one to two times a day is our recommendation. Yeah.
Cynthia Thurlow: [00:35:36] Yeah. It's so interesting because my 17-year-old, he loves to weight train and he takes a nitric oxide product before he works out and he talks about “the pump,” how he feels like he has a lot more stamina and energy and why that's so important. So, I'm really curious about trying these products. So, when we're looking at who the products are designed for, it sounds like as you mentioned anyone who breathes. But have you found other than middle-aged women, are athletes using more of the products? Is it kind of a diffuse-- It sounds like it could really apply to anyone. But in terms of your market research, where are people utilizing the products most frequently?
Dr. Vivek Lal: [00:36:14] So two major personas that we have identified. One is the chronic condition warrior, who are the 40 plus people who either have some chronic conditions or just because of aging process or in the process of getting something chronic. There are so many people with some of the other chronic conditions in the country. And then the other persona for the younger people is the health optimizer. Believe it or not, the Gen Zs are taking care of the health. They are thinking proactively about holistic medicine and overall health in a preventative capacity. So, they are huge users whether they are-- for example for resB as a lung product. A lot of these young people who smoke are on resB just so that they can proactively do something to prevent any kind of lung issues.
[00:37:06] Many of the young people who are athletes take both prebeet and resB to optimize their lung health. So yes, there is a use case for the Gen Z and then there's the 40 plus people who use it.
Cynthia Thurlow: [00:37:20] Well, I can tell you I have one kid who loves to try different things, to optimize his workouts and recovery. And I agree that they do a lot of research. They follow people on TikTok as an example. He comes home from school and has conversations with me and of course I look at all the information before we allow them to start things. But I do agree that this is a heavily influenced generation based on social media. And so, it doesn't necessarily have to be an influencer. It can just be someone talking about benefits that they see very organically and then that suddenly starts to create this trickle-down effect.
[00:38:01] Now, in terms of where your research is going, are there things that you're working on now, things that you're working on in development that you can share that may be of interest to listeners as well?
Dr. Vivek Lal: [00:38:10] As a matter of fact, we are developing resW for women, [Cynthia laughs] we just categorize women as one category but it is far more nuanced. We are targeting the perimenopausal age women for specific needs and more to come in the next few months here. In addition, we have another couple of products in development. We have vertically integrated R&D team here which is constantly innovating, constantly reiterating and trying to do novel things.
Cynthia Thurlow: [00:38:43] That's really exciting. Well, I can't thank you enough for your time today. Please let listeners know how to connect with you outside of the podcast.
Dr. Vivek Lal: [00:38:48] Absolutely. I'm happy to take any questions from anyone and answer to the best of my abilities. You could reach our website at resbiotic.com but outside of the podcast, you could reach out to me by email vivek@resbiotic.com that's V-I-V-E-K at resbiotic.com.
Cynthia Thurlow: [00:39:07] I mean, when someone gives you their email, that is impressive. Thank you so much. This has been such an interesting conversation. I know it will not be our first.
Dr. Vivek Lal: [00:39:15] Thank you so much for inviting me here. It has been a pleasure.
Cynthia Thurlow: [00:39:20] If you love this podcast episode, please leave a rating and review, subscribe and tell a friend.
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