187. Dr. Izabella Wentz: 30+ Root Causes Behind An IBS Diagnosis

Hashimotos isn't just a thyroid disease-it may actually begin in the gut. If you've been told your thyroid labs are "normal" but you still struggle with fatigue, bloating, constipation, IBS, or autoimmune symptoms, this episode could change the way you think about your health. I sit down with Dr. Izabella Wentz, PharmD-better known as the Thyroid Pharmacist and one of the world's leading experts on Hashimoto's disease - to uncover the powerful connection between gut health, autoimmune disease, and thyroid function. Dr. Wentz explains why IBS is often not a true diagnosis, but a collection of symptoms with more than 30 possible root causes. Together, we explore why conventional medicine frequently misses these underlying issues and how identifying the real drivers - from intestinal permeability and SIBO to food sensitivities, medications, infections, and even heavy metal exposure - can help people finally find lasting relief. Whether you're living with Hashimoto's, IBS, or another autoimmune condition, this conversation offers a practical roadmap for uncovering the root cause and supporting long-term healing. In this episode, you'll learn: Why gut health is critical for thyroid function and autoimmune healing The surprising connection between Hashimoto's disease and IBS Why IBS is a symptom - not a diagnosis The 30+ root causes that may be driving digestive symtpoms How intestinal permeability ("leaky gut") contributes to autoimmune disease The biggest food, medication, and lifestyle triggers for IBS Which functional medicine tests can uncover hidden gut dysfunction How targeted treatment can improve symptoms and support long-term remission If you've been searching for answers beyond symptom management, this episode provides an evidence-based look at the gut-thyroid connection and what it really takes to restore health. Thank You to Our Sponsors Next Health Longevity Summit: Head to www.next-health.com/summit https://www.next-health.com/summit to secure your spot at the first ever Next Health Longevity Summit in Nashville on 9/12! IM8: Try IM8 today with a 30-day money back guarantee. Get 10% off your first order with code DRSHAH at https://im8health.com/drshah https://im8health.com/pages/drshah Timeline: Timeline powered by Mitopure just dropped the price. Check it out using link shop.timeline.com/DRDARSHANSHAH https://shop.timeline.com/DRDARSHANSHAH for up to 20% off when you subscribe and save. Learn more about Dr. Shah: Website: drshah.com https://drshah.com Instagram: @extend_podcast and @darshanshahmd Clinic: next-health.com https://www.next-health.com/ Learn more about Dr. Izabella Wentz: Website: thyroidpharmacist.com https://thyroidpharmacist.com Instagram: @izabellawentzpharmd Book: thyroidpharmacist.com/ibs-book-order/ https://thyroidpharmacist.com/ibs-book-order/

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Dr. Darshan Shah?

  Before we get started with this episode, I'd like to invite all of you to the first ever Next Health Longevity Summit, happening in Nashville, Tennessee, at the Conrad Hotel on Saturday, September 12, 2026. This is an all-day summit where you're going to be hearing from some of the best speakers in longevity's medicine, including Dr. Vonda Wright, Dr. Luisa Nicola, many of the podcast guests that you've heard here on the Extend Podcast, and of course, I'm going to be there, curating the entire day. We also have incredible vendors coming, so you can try the latest technologies in health, wellness, and longevity. Go to next-health.com/summit and buy your ticket today. We only have 400 spots and

• 0:39Dr. Darshan Shah?

  they're going quickly. That's next-health.com/summit. I look forward to seeing you all there.

• 0:48Dr. Darshan Shah?

  Welcome to Extend with me, Dr. Darshan Shah, a podcast dedicated to cutting-edge science, research, tools, and protocols designed to help you extend your health span. Having become one of the youngest doctors in the country at the age of 21, and trained and board-certified at the Mayo Clinic, I've accumulated three decades of practice as a board-certified surgeon and longevity expert. Over that time, I've discovered that a mere 20% of health knowledge yields 80% of the results when it comes to your health span. We are living in a new era where we are creating a new healthcare system, no longer focused on disease management, but achieving optimal health and vitality. Join me as I interview world-renowned experts, offering you a step-by-step guide to proactively avoid disease, and most importantly, extend your health span.

• 1:34Dr. Darshan Shah?

  Welcome to Extend, the podcast dedicated to helping you live a longer, healthier life. Today, we're thrilled to welcome back a true pioneer in functional medicine, Isabella Wentz. Many of you know her as a thyroid pharmacist. She's renowned for her groundbreaking work and multiple books on Hashimoto's and thyroid disease. But today, we're going to be diving into a fascinating new chapter, her latest book on Irritable Bowel Syndrome, or IBS. Isabella challenges conventional wisdom, revealing that IBS is not a singular diagnosis, but a constellation of symptoms with over 30 potential different root causes. We're going to explore the profound connection between gut health and autoimmune conditions like Hashimoto's, the critical role of intestinal permeability, and why a comprehensive workup

• 2:19Dr. Darshan Shah?

  is essential for anyone struggling with IBS. So get ready to rethink everything you thought you knew about gut health and its impact on your overall well-being. Let's extend our knowledge with Isabella Wentz.

• 2:34Dr. Darshan Shah?

  Isabella, I'm so glad you came back to the podcast. Thanks for being here again.

• 2:38Speaker 01

  Thank you so much for having me again. Just always such a joy to be with you.

• 2:41Dr. Darshan Shah?

  I know. It's so great to get to know you and see kind of your journey through life and your journey through your different books now, and just such a pleasure all the time. I always say you're one of the smartest people I know.

• 2:53Speaker 01

  Oh, my gosh, that's so kind.

• 2:55Dr. Darshan Shah?

  No, you truly are. So, people know you as the thyroid lady, right? Like, you have written so many books on the thyroid. Our last podcast was about Hashimoto's and thyroid disease, and you have a tremendously, tremendous practice around thyroid medicine. And now, all of a sudden, there's this book with your name on it about IBS. What is that all about?

• 3:15Speaker 01

  I think it's throwing people off. My branding is thyroid pharmacist. I've been talking about thyroid and Hashimoto's for over a decade now. But if you are in functional medicine, as you know, there's a big connection between the thyroid and gut health. And a lot of the work that I've been doing and advocating for and educating about for people with thyroid illness and Hashimoto's is that it starts in the gut. And many times, there are going to be consequences of poor gut health that are going to be resulting in thyroid dysfunction and autoimmunity. So, basically, with everybody that I've worked with with Hashimoto's, I'm always working on the gut. And many of them have had IBS

• 3:59Speaker 01

  diagnoses as well, or symptoms that could have been diagnosed as IBS. And conventional medicine has one-size-fits-all approach to IBS, right? It's always like, okay, you have IBS, do X, Y, and Z. And then, less than 25% of people feel better when they have IBS. Yet, there are so many different root causes of IBS 30-plus that I've found in my research and working with clients, talking to other healthcare professionals. And I was like, okay, everybody needs to know that there are various causes of IBS, but most people have been focusing on food reactions and SIBO, and putting people on

• 4:40Speaker 01

  super restrictive diets without really moving the needle. So, this is why the thyroid pharmacist is talking about IBS, I guess, is because there's a big gut and thyroid connection.

• 4:51Dr. Darshan Shah?

  I love it. Yeah, and clearing up all the misconceptions around IBS is what I'm really looking forward to talking to you about today. But I just want to unpack that a little bit more, because I think that, you know, as a thyroid pharmacist, you said that almost all of the patients that you were treating their Hashimoto's had some sort of gut dysfunction. Is that true, like, almost 100% of those people did?

• 5:12Speaker 01

  Majority of them that I have seen had some degree of either intestinal permeability, they would have symptoms, constipation being the most common, but oftentimes bloating, abdominal pain, diarrhea. And when the gut is out of balance, various things can happen that can impact our thyroid function and our immune health.

• 5:33Dr. Darshan Shah?

  Yeah.

• 5:33Speaker 01

  Many people with Hashimoto's, usually they have low stomach acid. They might have symptoms like acid reflux, and this can result in poor absorption of the various nutrients that are required for proper thyroid hormone production, proper thyroid function, proper immune system function. And also, when we have intestinal permeability, we can end up with our immune system leading us down the autoimmune path.

• 6:00Dr. Darshan Shah?

  Sure. Yeah. So, I mean, it seems like, you know, the gut, when it's permeable, when there's a lot, when there's poor gut health, just in general, right? And you get this intestinal permeability, and then you have all these LPS and food stuffs floating around in your, around your gut epithelium, and your immune system goes crazy, and you get this chronic inflammation. That then turns into chronic inflammation throughout the body, which then leads to thyroid dysfunction and Hashimoto's. And it seems like that could potentially be one way that they're connected, in that inflammatory mechanism, right? Are there any other mechanisms that you see where the gut health could lead to Hashimoto's?

• 6:39Speaker 01

  Well, definitely if you have poor nutrient absorption. So, that's going to be impactful on Hashimoto's, right? You end up with low iron, you're going to end up with a thyroid condition down the road. You're not absorbing your iron properly because you have low stomach acid, you're not breaking down your protein properly, and so you can become low in zinc and L-tyrosine, various other amino acids. So, this is another mechanism.

• 7:04Dr. Darshan Shah?

  Yeah.

• 7:05Speaker 01

  And then, of course, it's a two-way street. So, we do know that people with thyroid dysfunction, gut symptoms are going to be present. So, we can have a person with hypothyroidism, typically, constipation is going to be what occurs, but oftentimes, they might also have diarrhea. And it is kind of a vicious cycle. So, we do need to address both things many times.

• 7:31Dr. Darshan Shah?

  It's so interesting. I mean, I think like endocrinology, I remember being in medical school, and I did so many, so much education around endocrinology and thyroid. Must have spent hours, months on thyroid disease, never once did the gut come up, you know? And it's interesting to see kind of like this shift in thinking now through functional medicine about relating the two. And what I'm really excited about is the way people would treat hypothyroidism before was just with thyroid hormones, right? And I think there was this kind of, I would say, thought that the thyroid disease was permanent, right? It was almost like, once you're in thyroid hormone, you're going to be on it forever. Is it the case that once you treat the gut disease, that potentially the Hashimoto's could get better, and you might not need thyroid hormone?

• 8:14Speaker 01

  In some cases, if you figure out what's causing the gut dysfunction, people can get Hashimoto's into remission. Most cases I've seen, we can get people into remission where their thyroid antibodies reduce, all of their symptoms go away. Some cases, people might be able to lower their dosage of thyroid medications. In few cases, they can also get off of their thyroid medications. But generally speaking, if you have had your thyroid gland removed, or if you've been on thyroid medications for many years, or have had an autoimmune attack against your thyroid for decades, and your thyroid has been substantially damaged.

• 8:50Dr. Darshan Shah?

  Right.

• 8:50Speaker 01

  It's not going to be super easy. I know there are some regenerative therapies coming down the road that might make that happen. But in this day and age, it's much easier to prevent the damage than it is to like regrow a new thyroid.

• 9:03Dr. Darshan Shah?

  Right. So, the sooner you address it, the better. So, if you have a diagnosis of Hashimoto's, please see a functional practitioner that can potentially help you treat your gut as well, and get your gut evaluated.

• 9:13Speaker 01

  Absolutely. And to your point, talking about endocrinology and gastroenterology, it's like these separate categories, like different silos of medicine. I remember when I was first researching Hashimoto's, I went to an endocrinology conference, and I had just read Dr. Alessio Fassano's paper on intestinal permeability being the common connector in autoimmune disease. So, his thesis was that every autoimmune condition has to have three factors in order for it to manifest, and it was intestinal permeability was one factor, genetic predisposition was another factor, and then having a trigger. Now, we know in this day and age, we can't change our genes. Maybe one day, we'll be

• 9:56Speaker 01

  able to. We don't always know what the trigger is. Sometimes, we can find it, and we could remove it, right? But we can always work on that intestinal permeability piece. The exciting part of his work was that if you remove the intestinal permeability, the autoimmune condition can go into remission. And I was super excited about this paper, and I went to an endocrinology conference, and I was talking to people, and I asked, have you seen this new paper that came out? And they said, no. And it was, it was a gastroenterology journal, not an endocrinology journal that published it. So, a lot of the people who were very much focused on endocrinology and really geniuses in their field, but they had this tunnel vision of like, how do you do better thyroid surgery, right? That's

• 10:42Speaker 01

  what they were learning about and focusing on, or rather than, how do we prevent this? How do we optimize people's health, right?

• 10:50Dr. Darshan Shah?

  That's so crazy. I didn't know Fassano's paper was in a gastroenterology journal. That's interesting. Yeah, it's a game-changing, mind-blowing paper on autoimmune disease. And what we found is, almost for every autoimmune condition, I would say, we see some level of improvement or reduction of their medication that they need, once we start healing the gut. It's worked very, very predictably along many different aspects of autoimmune disease.

• 11:15Speaker 01

  It's very fascinating. There's a big connection between gut health and mental health, between gut health, fibromyalgia. I've even in my research, I've seen like TMJ is related to gut health. And who would have thought, right?

• 11:28Dr. Darshan Shah?

  Yeah, who would have thought, right? I know. So what is IBS? Can you define that for people that are maybe a little bit nebulous on the term? I know I was nebulous on it even through medical school. What is the IBS?

• 11:38Speaker 01

  Irritable bowel syndrome. So it doesn't sound very glamorous, right? And so typically, the symptoms would be abdominal pain, bloating, and you can have some changes in bowel function. Some people have constipation. Some people have diarrhea. Others might have the best of both worlds.

• 11:55Dr. Darshan Shah?

  Yeah.

• 11:56Speaker 01

  And people might get that diagnosis. We talked about how it used to be a diagnosis of exclusion. So doctors would do a whole bunch of different tests and say, oh, well, you don't have this, you don't have that, you don't have this other thing. Therefore, it's IBS. Now, if a patient walks into a doctor's office and says, at least one day a week, I'm having abdominal pain with some changes in bowel function over the last three months, the doctors don't need to do any tests. They can just give them that IBS label.

• 12:25Dr. Darshan Shah?

  Yeah. And what's really interesting about that is IBS now just turned into like a constellation of symptoms occurring together. So to me, it's not really a real diagnosis. You haven't made a diagnosis on the person. You've just basically said that they have this constellation of symptoms. And whenever you have a constellation of symptoms, the next step in my mind is go looking for the cause, right? There has to be a cause for this group of symptoms coming together. And to your point, and in your book, there's many different causes of IBS, right? And I think it's worth for our audience to kind of go down the path of some of these, most of these, if we can get to them, and kind of define what these causes are. So people understand, like, don't just get the diagnosis

• 13:08Dr. Darshan Shah?

  of IBS and sit there and just say, woe is me, I have IBS and just take medication for it. Start looking for the causes.

• 13:14Speaker 01

  Yeah, absolutely. And the conventional medicine path is very much focused on, we give you this label, and then you can try these medications. And I'm a pharmacist. I love medications. In pharmacy school, I had a shirt that said, I heart drugs. And I fully meant that, right? Proper medication use can change lives. But with IBS, less than 25% of people get better with the conventional approach. And they still can progress to autoimmunity. IBS can happen five, 10, 15 years before an autoimmune condition develops. And if we don't treat the gut, then we're just going to end up having more and more symptoms down the road and other types of illnesses. So I'm super passionate about

• 13:57Speaker 01

  finding the cause, not just, I think, not just giving somebody a label. Label is very convenient. It's like, okay, great. I was wondering what that was called, right? Like, I'm running to the bathroom and I'm having abdominal cramps.

• 14:07Dr. Darshan Shah?

  Okay, IBS, I get it.

• 14:09Speaker 01

  Thank you for the name. Wonderful. And now, now we have to figure out what's, what's the driving factor behind these symptoms?

• 14:16Dr. Darshan Shah?

  Yeah.

• 14:16Speaker 01

  And it's not, spoiler alert, it's not always like one thing. So not everybody with IBS needs probiotics and bone broth, as, you know, functional medicine or the wellness space might make you believe. And not everybody with IBS has small intestinal bacterial overgrowth, although that can be a relevant factor for some people.

• 14:38Dr. Darshan Shah?

  Yeah.

• 14:39Speaker 01

  And so I went through looking the latest research, and I learned about some causes that I had never seen clinically. And I've also had some, seen some things clinically that I had never seen in the research. I've come up with over 30 different causes of IBS. And it can start with the foods that we're eating, how we're digesting our foods, what kind of environment we're living in, what kind of environment is within us. So what kind of bacteria we have, what kind of viruses, what kind of microbes live inside of us, as well as various toxic reactions. And so I feel like if somebody has gotten

• 15:21Speaker 01

  this diagnosis, they really deserve a comprehensive workup to see what is causing their symptoms.

• 15:28Dr. Darshan Shah?

  Yeah. And what would that comprehensive workup include?

• 15:31Speaker 01

  There are definitely red flag symptoms. If people have, unfortunately, I've seen people misdiagnosed with IBS when they have had very serious conditions like colon cancer and inflammatory bowel disease, conditions that require different set of tools, right? Then the different root causes of IBS might. And so if somebody had like rectal bleeding, if they had significant weight loss, if their symptoms started after age 50, this would be, as well as any kind of a fever, right?

• 16:04Dr. Darshan Shah?

  Yeah.

• 16:05Speaker 01

  This would be a reason to get referred to a gastroenterologist and do a workup. So colonoscopy, endoscopy might be part of the workup. It might be testing for infections just to make sure, you know, testing, figuring out if somebody has cancer, just to make sure we're, we know what we're working with.

• 16:25Dr. Darshan Shah?

  Yeah, we're not missing something big, a major diagnosis like that. CAT scan, colonoscopy, always a good place to start, especially if you have rectal bleeding, for sure. You got to rule that out first. But then, say, all that's clean, where do we go next?

• 16:39Speaker 01

  Yeah, if all of that, you know, you've done, even if you've done all that.

• 16:43Dr. Darshan Shah?

  Because a lot of people stop there. Because they'll see a gastroenterologist, and they're like, this is a specialist in the GI system. They should know what to do about my IBS. And they'll get the colonoscopy, and that's it. It's clean, nothing to worry about. See you later. It's just IBS.

• 16:58Speaker 01

  Right. So you can check off that box, right? And if you don't have those symptoms, you might not need a colonoscopy. So now I would encourage you to look at the foods that you're eating. I am a big proponent of nourishing your body properly and of eating a varied diet. But when you look at which foods trigger you, this can be a clue. For some people, it might be foods that are high in fiber and raw veggies. This could be a sign that you might have small intestinal bacterial overgrowth, or you might have some dysbiosis in your gut, because our gut bacteria are the ones that ferment our fibrous foods.

• 17:38Dr. Darshan Shah?

  Right.

• 17:39Speaker 01

  If you have issues with fatty foods, this could be indication that something is going on with your gallbladder, or that you might have enzyme deficiencies, such as pancreatic enzyme deficiencies, or perhaps a bile deficiency. If you are sensitive to carbohydrates and certain fermented, fermented foods, that might be another indication that you might have something like small intestinal bacterial overgrowth. These are some of the foods that I would say most people should eat, should be able to eat without, you know, they're not like bad foods, right?

• 18:13Dr. Darshan Shah?

  Not like ultra-processed garbage.

• 18:15Speaker 01

  Yeah.

• 18:15Dr. Darshan Shah?

  Exactly. These are foods our bodies are designed to eat.

• 18:19Speaker 01

  Right. Like, we don't want you eating no fat, right? If fat triggers your symptoms, that's a sign that something is out of balance internally.

• 18:25Dr. Darshan Shah?

  Got it.

• 18:26Speaker 01

  Then there's also like, okay, ultra-processed junk foods. So amazing, incredible research has been done on food additives, erythritol, all of these sugar alcohols. As, you know, you know, from pharmacology, they work as osmotic laxatives, right? When you dose them up correctly, there are a lot of these food additives, artificial sweeteners, food preservers. They can actually cause a disruption of the gut microbiome, and they can lead to IBS and also inflammatory bowel disease.

• 19:01Dr. Darshan Shah?

  Right.

• 19:02Speaker 01

  So definitely, I'm not a proponent of eating these kind of foods. This might be something that triggers you and really look into that. Another category of things I would like to look at is medications. I am a pharmacist, so I'm always like looking at the meds, like, what, what is going on? So metformin can cause diarrhea.

• 19:19Dr. Darshan Shah?

  That's true.

• 19:19Speaker 01

  Right? So there's so many different side effects of medications. When I was in pharmacy school, it was like, we had these multiple choice questions. And it was like, what side effect does this drug cause? And if I didn't know the drug, I would always guess that it caused GI symptoms.

• 19:34Dr. Darshan Shah?

  Yes.

• 19:34Speaker 01

  So constipation, diarrhea, abdominal pain, talk to your pharmacist, talk to your physician, and see if perhaps one of your medications is contributing. Do you need to be on that medication? Can you switch to a different medication, right? Because the thing that I hate to see as a pharmacist is the prescribing cascade. So you get on one medication for this symptom, and then this causes additional symptoms. So you get on another medication, and so on and so forth, right? And so you don't want to be on dozens of medications when sometimes lifestyle change, different medication, potentially an herbal remedy or a nutritional remedy can make all the difference. One particular medication that I feel like is very relevant for IBS is actually birth control. The drusperinone containing

• 20:19Speaker 01

  birth control pills, like Yaz and Yasmin were some of the brand names back when I was in pharmacy school. These can actually have been now clinically studied to cause irritable bowel syndrome.

• 20:32Dr. Darshan Shah?

  Really?

• 20:32Speaker 01

  Yes. So there is research behind that. So switching birth control pills might be something that might be relevant. And of course, we know GLP-1 medications can slow down our motility. So this is a great place to think about, especially if you can time and correlate that your symptoms started after starting a medication.

• 20:52Dr. Darshan Shah?

  Yes, yes.

• 20:57Dr. Darshan Shah?

  So I'm 52 right now, but I'm still pushing all of my limits. I'm running long distances. I travel across many time zones to support my work and I just want to live my life to the fullest. Staying active as I age isn't just about willpower. It's about supporting my mitochondria, the powerhouses of my cells with the energy that they need to recharge my muscles and recharge my brain. Mitopure is a supplement that I take. It's backed by solid research showing that it can boost cellular energy, increase muscle strength and support overall healthy aging. Personally, I take Mitopure every single day. It's helped me continue my active lifestyle, whether it's a high intensity workout or keeping up with my kids.

• 21:39Dr. Darshan Shah?

  So if you are looking to support your body and want to feel younger from the inside out, my friends at Timeline are offering you a 10% discount on your first order. Go to timeline.com/DrShah to get started. That's timeline.com/DrShah. Your future self will thank you.

• 22:01Dr. Darshan Shah?

  So with the foods, jumping back to that, you know, I think one way to kind of discover which foods are causing your symptoms is to do like an elimination diet, right? So you eliminate most things and you slowly reintroduce. And if your symptoms come with a new food that you reintroduce, you can kind of pinpoint it to that food. Is that one technique that you use when you're trying to sort through what foods could potentially be leading to symptoms?

• 22:25Speaker 01

  Absolutely. So elimination diet can be very, very helpful. And I just want to warn people, if you go on an elimination diet, that does not mean you have to stay on that diet forever. The point is to see which foods are causing stress in your digestive system. And then getting off of these foods temporarily, and then we can also work to get those foods back. So I do have protocols in my book, IBS, on IBS, on how to figure out which foods are causing you reactions and how to get rid of the various food sensitivities. Typically gluten and dairy are some of the most common reactive foods in IBS, but also like fibrous foods.

• 23:07Speaker 01

  And I've seen like raw veggies, lettuce and blueberries, like really healthy foods that can be potential triggers for some people. It might be excess caffeine. Coffee can make, give some people diarrhea, a lot of these high fat foods. So doing an elimination diet can be very, very helpful. There are some people who have a hard time with that and maybe they feel like it's overwhelming. And in that case, I might recommend food sensitivity testing. In my experience with IBS, thyroid dysfunction and acid reflux, I've used the Ola test, food sensitivity test, their IGG. And that does seem to correlate for symptoms.

• 23:50Speaker 01

  I know when I throw out the word food sensitivity test, there are a hundred opinions from different people who say they do not work or don't waste your money. They're not evidence based. And, and I agree with all of that because there's a hundred different tests on the market and all of them are different. So from my experience, this one particular lab seems to produce results.

• 24:11Dr. Darshan Shah?

  Yeah, yeah. I hear what you're saying about food sensitivity testing and I agree with you. There's so many different tests on the market. The one that we use is from Vibrant and we get IGA and IGG. IGA being more of a antibody that relates to inflammation of the gut wall as well. And IGG more systemic. And I found it to be a pretty good starting place when people come in with gut health issues because I find elimination diets are really difficult for people to execute on, especially in our modern day environment. Like, you know, you go out to eat one time to the restaurant and the elimination diet is like done, right? And so you have to be really faithful to elimination diet for it to really give you good data. And people have problems with that because they're hard, right?

• 24:53Dr. Darshan Shah?

  You're eliminating all these foods and then you have to like slowly reintroduce foods back. And people just cheat on that all the time. So I use it more as like a starting point. I don't, I don't use it for a definitive diagnosis that this is the food. But like we start there and if that doesn't give us any results on making your, your symptoms go away, then we go to a more aggressive form of elimination.

• 25:16Speaker 01

  Yeah, I find that some people just need to see things on paper, right? And so that's when a test might be helpful or they're just, they really struggle with elimination diet and it's free. It's the gold standard. It's like the best thing you can do, but I do admit that it can be very tricky for people, especially if you're trying to do it for 21 days to eliminate all the foods properly. Sometimes it helps to have like a template. Let's just say, why don't you try the autoimmune paleo diet or the paleo diet, which eliminates some of these common foods. I would say if a person was like overwhelmed and didn't want to spend money, one of the things they can do is a low food additive diet and eat at home if you can,

• 25:58Speaker 01

  or eat at healthier restaurants that don't have a lot of food additives. That can be actually healing for conditions like inflammatory bowel disease. That can get an IBS, that can, that can be it.

• 26:11Dr. Darshan Shah?

  Yeah, absolutely. So other than food sensitivity testing and the food piece of this, what is the next test that you sometimes have people get for looking at IBS?

• 26:23Speaker 01

  Well, if they have done the, the food route, and I, I work with a lot of clients who are much healthier eaters than I am, right? They eat a perfect diet and everything's organic and home cooked and whatnot. And they still have symptoms, right? And so at that point, we're thinking about, well, why are you not able to eat these beautiful foods? Like what's happening in your body? And it could be digestive enzyme deficiencies, right? And one of the tests, it's not really a test that I do, but it's more like a trial where they might try some betaine with pepsin, which is a digestive enzyme,

• 27:02Speaker 01

  especially with acid reflux and people that have a lot of fatigue and feel very heavy after their meals. Taking this protein digestive enzyme with your protein containing meals can help with digestion. And so you get fewer food sensitivities, your food doesn't feel so heavy. You're not going to be as bloated. You're not going to have that abdominal pain. That might be a place to start with people or doing some broad spectrum digestive enzymes, encouraging them to like chew their food properly, have some apple cider vinegar diluted in water, not straight up, please, to help with their digestive process.

• 27:42Speaker 01

  That can be very helpful for a lot of people and a really great place to start and can really change things as far as digestion and symptoms go. But again, if they're already doing that, I've got, I've got some, some clients that have, have already done that. They're like better at their digestive enzymes than I am and they, they eat when they're relaxed and they say their prayers and meditate and all of that. But if, if that was like you're, you know, you're kind of doing the diet, you're have a relatively great eating environment, then I would think about doing some stool testing and potentially some breath testing. I love Vibrant America's gut zoomer test. I know you and I are both fans of that. I have not done their food sensitivity test.

• 28:26Speaker 01

  I have to do that next. So I'm excited to try that out. But the gut zoomer test can be incredibly helpful to figure out what's out of balance. It can look at if somebody has low fecal elastase, for example, which can indicate that they're not going to be breaking down their fats, right? And so they might benefit from pancreatic enzymes. They might benefit from Oxybile. They might benefit from various bitters, dandelion that can help with breaking down fats. It could look at if they have a dysbiosis. So if they have beneficial bacteria that are too low or pathogenic bacteria that are too high, it could look at whether they're reacting to gluten.

• 29:11Speaker 01

  It could look at whether they have low levels of something called secretory IGA, which is the gut's immune barrier. And when that is low, that means we're not going to be keeping that barrier intact, that we're not going to be keeping the piece of the microbes in our gut. And that can also find some of these chronic infections, chronic low grade infections that conventional medicine doesn't even think about. Could be viral infections. I've seen people with nor virus after years of having an infection.

• 29:44Speaker 01

  Right? And it's still there and it's still symptomatic, right? I've seen people with protozoa infections. They said 10 years ago, I, you know, traveled to South America and I got dysentery or whatnot. And I got antibiotics and you know, the infection is still there.

• 30:01Dr. Darshan Shah?

  Wow.

• 30:02Speaker 01

  From a food poisoning or situation that they had five, 10, 15 years ago. And that can lead to inflammation and IBS down the road.

• 30:12Dr. Darshan Shah?

  Yeah.

• 30:12Speaker 01

  So I really love to do those kind of tests because sometimes we can find these like hidden pathogens.

• 30:18Dr. Darshan Shah?

  Right.

• 30:19Speaker 01

  Hidden imbalances that could be throwing off the gut wall. And then small intestinal bacterial overgrowth testing.

• 30:27Dr. Darshan Shah?

  Uh huh.

• 30:28Speaker 01

  Unfortunately, you can't see that on a stool test.

• 30:30Dr. Darshan Shah?

  No.

• 30:31Speaker 01

  There might be some, I guess, soft markers, like if you see certain bacteria are high. Or, you know, if you would do a blood test and people have low levels of B12 or low ferritin, you might suspect that if they're very bloated after meals. But the breath test is going to be the gold standard. Such a pain to do.

• 30:49Dr. Darshan Shah?

  Yeah.

• 30:49Speaker 01

  You have to do it over a few hours and, and whatnot. But SIBO, small intestinal bacterial overgrowth can also be a contributor or a root cause of IBS.

• 30:59Dr. Darshan Shah?

  Absolutely. And I think what I've also seen is some people with heavy metal toxicities, they sometimes have SIBO associated with it very frequently as well. So if you do a heavy metals test and you have many heavy metals that are elevated, look at, look at SIBO as a potential diagnosis as well. Just a quick little clinical tip there. Have you seen that?

• 31:19Speaker 01

  No, but it makes so much sense because when our gut is compromised, we end up hoarding all of our toxins.

• 31:26Dr. Darshan Shah?

  Right.

• 31:26Speaker 01

  So our gut is one of those elimination paths, right? And so gut is a great way to get rid of heavy metals, toxins.

• 31:35Dr. Darshan Shah?

  Even microplastics now they're showing.

• 31:37Speaker 01

  Microplastics. Sweat is another great way to get rid of it. And in my thyroid patients, clients, I see that they're not sweating. They never complain about not sweating, right? Cause it's like, who wants to sweat? Like, it's great. So they're not eliminating through their skin, through their sweat. And they're also not eliminating through their gut.

• 31:56Dr. Darshan Shah?

  Mm hmm.

• 31:56Speaker 01

  And so they end up becoming very, very toxic.

• 31:59Dr. Darshan Shah?

  Yeah. The breath test for SIBO, I don't know which one you use. The, I usually, when I suspect SIBO, there's one on Amazon. They just have them get the ships to their house. They, they drink the stuff, they send it in. And I found it to be pretty good, actually, just the Amazon test. Do you have a test that you recommend for that one?

• 32:17Speaker 01

  There's a Trio Smart one.

• 32:19Dr. Darshan Shah?

  That's the one, Trio Smart, right?

• 32:20Speaker 01

  Yeah.

• 32:20Dr. Darshan Shah?

  That's the one, yeah.

• 32:21Speaker 01

  Ooh, it's on Amazon now?

• 32:22Dr. Darshan Shah?

  It's on Amazon. Anyone can get it from Amazon, yeah.

• 32:24Speaker 01

  I did not know that. I was using Rupa.

• 32:27Dr. Darshan Shah?

  Ah.

• 32:27Speaker 01

  But I love, I love Rupa because people can order labs there. And it's like, comes to their house and any kind of lab they want, they can get from that, from that and empower themselves.

• 32:38Dr. Darshan Shah?

  Yeah.

• 32:39Speaker 01

  Any functional lab, I should say.

• 32:40Dr. Darshan Shah?

  Right. That's a, that's a really great tool to get labs just done at your house. And then your practitioner can look at it with you and interpret them for you. But yeah, I think, you know, people have so much better access now to kind of go down the rabbit hole of, of, um, lab testing. But also I think it's also really good to work with a functional practitioner like yourself, who can guide them on what to do first, based on their symptoms. So they don't waste too much money. I see a lot of people just buying so many labs on their own and trying to figure this out because they're frustrated. They've seen their doctor, the doctor can't figure it out. And they go out there and buy thousands of dollars worth of labs. And I just feel like finding a good functional practitioner can save you a lot of money.

• 33:19Speaker 01

  Yeah, absolutely. So I've, I see people spending money on special foods, diets, supplements and all of this, right? And labs, I would say food sensitivity labs, you can probably interpret them yourself, right? It's like, oh, this is like a three plus or this is in red, so you can avoid eating that.

• 33:39Dr. Darshan Shah?

  Right.

• 33:39Speaker 01

  The gut tests get a little bit more complicated to interpret yourself and to try to figure out a protocol. I know ChatGPT and Claude are popular tools these days, but I've, I've seen them take people down a rabbit hole of stuff that doesn't exist.

• 33:56Dr. Darshan Shah?

  Right.

• 33:57Speaker 01

  Conditions that don't exist, like protocols that don't work. So definitely work with somebody that's experienced. And then, yeah, organic acid test is another test that I love to do. That one I would say is like, you definitely want somebody that's seasoned and has been at it for like five, 10, 15 years. Cause I, I've been using that test for 10 years plus. And I feel like I'm still learning things about it every other day. I'm like, oh my gosh, this is interesting.

• 34:21Dr. Darshan Shah?

  What do you use that test for?

• 34:21Speaker 01

  Organic acid test. So this can be very helpful to see if somebody has candida colonization or if they have mold colonization, if they also have mitochondrial dysfunction.

• 34:34Dr. Darshan Shah?

  Mm hmm.

• 34:34Speaker 01

  In some cases, or if they have oxalate issues, soliculate issues. So there's a lot of different types of random weird things where I see these wonderful individuals that follow me online. And I've written so many books that tell you exactly what you need to do to feel better, including my IBS book.

• 34:56Dr. Darshan Shah?

  Yep.

• 34:57Speaker 01

  And have resources online on how to, free articles that people can read. So a lot of people are very knowledgeable about like nutrition and diet, just from reading, right? But they end up with some of these random obscure things where they could be eating a very healthy diet. And it turns out that they actually have mold toxicity. Or they have soliculate toxicity, or they have oxalate issues. And so their green smoothies are causing damage and causing them to have irritable bowel symptoms, insissocial, cystitis symptoms, you know, bladder issues, joint pain and so on and so forth. So I love to use the organic acid test to find some of these nuanced things

• 35:38Speaker 01

  that when a person has like done the gut test and they've done a lot of the wellness things.

• 35:44Dr. Darshan Shah?

  Yeah.

• 35:45Speaker 01

  But they're still struggling with symptoms. This can uncover a deeper layer, right? And I wouldn't say everybody needs to do this. But again, if you've been on this healing journey for quite some time and you're like, okay, I've done this, I've done that, but I'm still struggling. Then that might be an opportunity to, to do a urinary organic acid test.

• 36:04Dr. Darshan Shah?

  Right, right. Yeah, that's definitely another valuable test, I think, when you're going further down the rabbit hole and you've gotten, you haven't made, had a diagnosis made yet, or you don't still know the root cause for sure. What do you think about parasite testing?

• 36:17Speaker 01

  I love parasite testing. I will say that a lot of the gut tests on the market don't do it well.

• 36:24Dr. Darshan Shah?

  No.

• 36:24Speaker 01

  And so a person will say, oh, I was tested for parasites and my test came up negative. But it's kind of like, okay, they don't shed in every stool sample.

• 36:35Dr. Darshan Shah?

  No.

• 36:36Speaker 01

  And it depends on the diagnostic methods that are used. I used to use this old school test that had people collect four to five samples over four consecutive days. People hated it.

• 36:46Dr. Darshan Shah?

  Oh, yeah.

• 36:47Speaker 01

  But it

• 36:47Dr. Darshan Shah?

  It doesn't sound like fun.

• 36:48Speaker 01

  It does not sound like fun. I didn't love recommending it, but I loved seeing the results because for a lot of people with digestive issues, we'd be able to see that they had an infection.

• 36:57Dr. Darshan Shah?

  Yeah.

• 36:58Speaker 01

  The gut suimer is a pretty good test for picking up parasitic infections. There's also peril wellness research, which people can self-order.

• 37:06Dr. Darshan Shah?

  Hmm.

• 37:06Speaker 01

  It's like a retired physician with a microscope that like looks at stool.

• 37:11Dr. Darshan Shah?

  Yeah.

• 37:11Speaker 01

  That can reveal more of these parasitic infections. Giardia, uh, beaver fever, not to be mistaken with, with the singer Bieber.

• 37:20Dr. Darshan Shah?

  Yeah.

• 37:20Speaker 01

  Um, this is something that can cause diarrhea for, for many years. That can, it's been tied to chronic fatigue syndrome, um, a lot of conditions. And people can pick it up from hiking, they could pick it up from dog licks, they could pick it up from contaminated water. I believe this was found in Los Angeles water somewhere in the last 10, 15 years at a, at a certain point. So, you know, a lot of times people think you need to travel to a developing country to get a parasite. That's not necessarily the case.

• 37:53Dr. Darshan Shah?

  True, yeah.

• 37:53Speaker 01

  Another common parasite is Blastoceps hominis.

• 37:57Dr. Darshan Shah?

  Mm hmm.

• 37:58Speaker 01

  This has been tied to chronic hives. It's been tied to Hashimoto's as well as irritable bowel syndrome. It's controversial in conventional medicine. Some doctors will say you don't need to treat it if you have it in your system, but the research consistently shows that if you do treat, if you have IBS, you have that bug, you treat it, that your IBS symptoms go away. And so I'm a big proponent of like really doing the deeper testing for people if they're symptomatic and then figuring out what's driving their symptoms.

• 38:29Dr. Darshan Shah?

  Is that last one, Blastoceps, Blastoceps, is that, is that what you say, Blastoceps?

• 38:34Speaker 01

  Blastoceps hominis.

• 38:36Dr. Darshan Shah?

  Blastoceps hominis, thank you. Is that also detected in the vibrant test?

• 38:41Speaker 01

  The vibrant test can detect that as well.

• 38:43Dr. Darshan Shah?

  Great, great.

• 38:43Speaker 01

  Yeah, it's one of the tests on it. And it's not like a giant tapeworm or something.

• 38:47Dr. Darshan Shah?

  No.

• 38:47Speaker 01

  You know, it's, all of these are, a lot of them are protozoa. So you can't see them with the naked eye. You're not going to be seeing them in your

• 38:53Dr. Darshan Shah?

  Stool sample, in the toilet, right?

• 38:54Speaker 01

  They're going to be swimming around your toilet.

• 38:56Dr. Darshan Shah?

  Right, right, right. So I think the moral of the story here is that there are really good tests available, like the vibrant gut suimer, the, um, organic acids test, the food sensitivity test. And these are all tests that you can do if you're experiencing these symptoms and you can't find relief just with food changes and avoiding foods and also maybe taking some digestive enzymes. And so it's worth doing these further investigations to see if you can find something.

• 39:27Speaker 01

  I mean, yeah, sometimes it's, it's that $300 test. I know testing can be very expensive, but that test can be, give you the answers.

• 39:36Dr. Darshan Shah?

  Right.

• 39:36Speaker 01

  For why you've been feeling off. And it might be digestive issues that you're having now, but it might be additional issues in the future. With the example of the Blastoceps hominis, I've had clients with chronic hives for decades.

• 39:50Dr. Darshan Shah?

  Right.

• 39:50Speaker 01

  And we treat that, their chronic hives go away, their IBS goes away. And some of my clients, their thyroid antibodies have gone away from treating that. Their food sensitivities go away. And I wish every person just had one cause and it was that for every condition. But there are 30 different causes like that. And so that's why testing, educating yourself is going to be important.

• 40:13Dr. Darshan Shah?

  Yeah, absolutely.

• 40:17Dr. Darshan Shah?

  Hi, Dr. Shaw here. I want to take a minute to talk to you about cellular health. So in my clinics, I've actually seen 30-year-old people with cells that look like they're pushing retirement. And I've also seen 60-year-olds with cells that look like they're 40 years old. So what's the difference? It's really about how fast their telomeres are breaking down. Your cells, you see, are like phones, and they have limited cellphone battery. Poor sleep, stress, processed foods, all of these things can drain that battery way faster than it should. So this is the reason why I partnered with IMA. IMA powers that cellular battery. It's not just another multivitamin. It's a comprehensive 92-ingredient formula designed specifically for cellular health and longevity.

• 41:02Dr. Darshan Shah?

  I'm talking 900 milligrams of vitamin C. That's like 20 oranges worth of DNA protection. The clinical dose of CoQ10 that you need to power your cellular engine. You also get zinc, selenium, vitamin E, alpha lipoic acid. All of these work synergistically for cellular repair and protecting your telomeres. So instead of taking a handful of pills every day and all these supplements, IMA actually gives you everything that you need in one scientifically formulated system. And this isn't just a theory anymore. IMA had partnered with Oxford University, the International Space Station, San Francisco Research Institute, and they've done studies and they've gotten this NSF certified to truly power your health. Most people are aging twice as fast as they should, unfortunately.

• 41:48Dr. Darshan Shah?

  You don't have to be one of them. Try IMA. I actually have a discount secured for you if you go to drshah.com/ima or go to imathhealth.com/discount/drsah and you can get 20% off with my discount code, DrShah. You can also find the link below.

• 42:08Dr. Darshan Shah?

  So I think the next kind of fact that people need to know is that once you find the cause and you treat it, there's still another step. Like you're going to get better, obviously, but the next step is actually healing your gut, right? Your gut has been assaulted, basically, by whatever the cause is for probably a very, very long time. And what happens in your gut cells is that they become unhealthy. They separate, the microbiome layer has been depleted, the mucus layer has been depleted. So there's various layers here that you need to treat and heal so that you get, become strong again. And one of the ways you know that your gut is healed, well, there's tests you can do, but also symptoms of immunity go away as well. Your chronic inflammation goes down, maybe your Hashimoto's gets better.

• 42:53Dr. Darshan Shah?

  Like you said, hives might go away. And that's why it's so important to get your gut healed. And I would love for you to talk about, like, what is the gut healing protocol that you like to use?

• 43:03Speaker 01

  So it takes about two months for it to properly heal. I think about if you were to fall off of a bike and you scrape your knee, right? You put something to wash the bacteria off, but you're still going to have that scrape, right? And you're going to wait, it's going to take some time for your body to heal. I love to utilize L-glutamine and zinc. I love zinc carnecine to help with healing the gut and giving the gut cells an opportunity to restore themselves. These are two wonderful ingredients. I love using mucilaginous herbs as well. They can really be helpful in the healing process. Butyrate can be incredibly helpful for feeding our beneficial microbes.

• 43:48Speaker 01

  Using probiotics, I love bifidobiotics, spore-based probiotics, sarcoma, bulardie. Like, I love them all, right? Probiotics can be a big part of the healing journey. Bone broth can be very helpful for people. Fermented foods can be incredibly helpful. And utilizing that over the course of two months can be game-changing. It can really accelerate that healing. You're going to see a lot of the inflammation going down in your body. You can look at yourself and see, wow, I'm looking in the mirror and I'm seeing my skin looks better. My hair looks better. I'm just so much less puffy, right? With utilizing these kind of protocols, but they do take time.

• 44:28Speaker 01

  So a lot of times people think you eliminate the infection and things will go back to normal. They can, but it's going to take a lot longer. If you can utilize some of these healing foods and nutrients, herbs, supplements that can accelerate your healing.

• 44:44Dr. Darshan Shah?

  Yeah, so the idea is to reinvigorate your normal, natural gut flora by feeding fermented foods, by, like you said, also using butyrate, maybe, to help feed them as well. And then maybe even taking some probiotics to re-inoculate the area. And then as far as the gut cells themselves go, glutamine powers the gut cells to heal and can get them in a much better place. You said there's some herbs that you can also recommend?

• 45:15Speaker 01

  Yeah, I love like marshmallow, not marshmallow, slippery elm. These can be very helpful and very soothing for the gut layer. I didn't mention this, but serum-based immunoglobulins can also be very soothing and nourishing, too.

• 45:29Dr. Darshan Shah?

  Serum-based immunoglobulins, where do you get those from?

• 45:32Speaker 01

  You can get them from, well, let's see, for full script.

• 45:37Dr. Darshan Shah?

  Oh, okay.

• 45:38Speaker 01

  So.

• 45:39Dr. Darshan Shah?

  So this is like a, this is a, this is like supplement?

• 45:43Speaker 01

  Yeah, it is considered a medical food.

• 45:46Dr. Darshan Shah?

  Oh, okay.

• 45:46Speaker 01

  So enterogram is the prescription version of it, but you can also get it from Orthomolecular Products, is one company that makes it.

• 45:54Dr. Darshan Shah?

  I didn't know that, okay.

• 45:55Speaker 01

  It works really, really well. It can be helpful for IBS. It can be helpful for getting inflammatory bowel disease into remission as well.

• 46:02Dr. Darshan Shah?

  What do you think about colostrum?

• 46:04Speaker 01

  Colostrum can be incredibly helpful. Serum-based immunoglobulins work in a similar fashion to colostrum.

• 46:10Dr. Darshan Shah?

  That's what reminded me about colostrum, yeah.

• 46:13Speaker 01

  For some people that are super dairy-sensitive, colostrum might be an issue. Serum-based immunoglobulins are not dairy-derived, so that's always helpful.

• 46:23Dr. Darshan Shah?

  Yeah, got it. Yeah, I think healing the gut is, I found it to be very successful when you go after it with multiple, you know, multiple different tools at the same time. And I think that it can get a little bit overwhelming for people, having all these supplements that they're taking and doing all these things. But I think the moral of the story is you don't have to do all this forever, right? It's like you said, it's about a two to three-month process. And then, once you start feeling better, your inflammation goes down, you can cut back and get back to normal.

• 46:55Speaker 01

  Yeah, I own a supplement company. It's called Root Ecology. And there's 30-some products in the portfolio. And people sometimes think that I recommend taking all 30 supplements at once. And I'm like, no, never. You want to take like five to six supplements at a time for two weeks to two months, generally speaking. That's how long you're going to take most of the supplements, right? Sometimes, you know, there might be maintenance supplements that you might want to utilize long-term. Probiotics, for example, if you have had a history of gut issues, you might want to do a probiotic rotation. So for a month, you might take bifidobased probiotics. The next month, you might take bulardie-based probiotics.

• 47:36Speaker 01

  Another month, you might take spore-based probiotics to kind of prevent from new things to occurring and to improve your gut diversity. I think one of the challenges I've seen from the wellness space is long-term elimination diets, like the low FODMAP diet. They can really reduce your gut diversity.

• 47:55Dr. Darshan Shah?

  That's true, right?

• 47:56Speaker 01

  Right? And when you have infections, they can impact your gut diversity. So doing probiotic rotations can be helpful for that.

• 48:03Dr. Darshan Shah?

  Yeah. I want to talk a little bit more about leaky gut. I think that, you know, a lot of people don't know that we actually have a blood test now for leaky gut and a few blood tests, actually. So I'd love for you to talk about them and how they can be helpful and what they mean.

• 48:17Speaker 01

  I primarily have used stool tests and I would look at zonulin as a marker. Is there a blood test that you're utilizing?

• 48:25Dr. Darshan Shah?

  Yes, you can do a serum zonulin level as well. And we also utilize anti-LPS as a blood test as well. LPS, for the listeners, is a bacterial fragment that can be measured in your bloodstream and it usually comes from gut permeability. And so we measure that. And zonulin is a protein marker that holds those gut cells together. And so when it starts floating around in your bloodstream, it means that your gut cells are separating and the zonulin is in your bloodstream now. And so where it should not be, it should be there, holding your gut together. So yeah, those are a couple of ones that we check. And you can actually check a level so you can see it like reducing over time as your gut gets better.

• 49:08Speaker 01

  I love that. And I think a blood test is going to be much more accessible than the stool test. I do love stool tests. I will say that they take a long time to get back.

• 49:18Dr. Darshan Shah?

  Yeah, it takes a long time to get back. And it's about 50/50 if someone actually does it sometimes.

• 49:23Speaker 01

  Yes.

• 49:24Dr. Darshan Shah?

  Yeah, they're tough to do. They're not fun to do.

• 49:27Speaker 01

  No, I've had people like call me very panicky and they're like, what do you want me to do? What do you want me to do? And then, you know, there's like the walk of shame to the post office or whatnot with. With your box of poo.

• 49:40Dr. Darshan Shah?

  Right.

• 49:40Speaker 01

  So it's not very glamorous to do a stool test, but it's really important to do that. It's not super glamorous to talk about your digestion, but it can be a game changer for your health and your longevity and your vitality.

• 49:53Dr. Darshan Shah?

  Absolutely. One of the other tests that kind of indicate to me that someone is having gut health issues, or, you know, one of the indicators of gut health issues that are pretty severe is when you get chronic inflammation. And so some of the tests that we use for that is a blood test called HCRP, which if it's over two, I'm really concerned. And I really want to get people to get their gut evaluated. Almost all the time, they have either symptoms of diarrhea, constipation, like IBS type of symptoms. And if they don't have those symptoms, we still evaluate the gut, but we also go looking in the oral cavity because your gut starts in the mouth, right?

• 50:31Speaker 01

  Oh, absolutely. And an interesting thing is the H. pylori infection.

• 50:36Dr. Darshan Shah?

  Yes.

• 50:36Speaker 01

  So this can be related to constipation. This can cause thyroid antibodies. Brian Johnson recently talked about how he has

• 50:45Dr. Darshan Shah?

  Autoimmune gastritis.

• 50:46Speaker 01

  Autoimmune gastritis. There's a large percentage of individuals where H. pylori causes that.

• 50:52Dr. Darshan Shah?

  Yeah.

• 50:53Speaker 01

  And so if he were to treat his H. pylori, his autoimmune gastritis could go away. Brian Johnson, if you're listening to this, a little clinical pearl here.

• 51:02Dr. Darshan Shah?

  Right.

• 51:02Speaker 01

  And H. pylori can have a res- this is something that we can test for on stool tests with a breath test. Some of the stool tests might be more sensitive for it. And we can use triple antibiotics for it. We can use different herbal remedies for it. But the tricky thing is it can also have a reservoir in the mouth. And so some individuals might need to treat their mouth.

• 51:28Dr. Darshan Shah?

  Yes.

• 51:28Speaker 01

  They might. One of the things I recommend is that people throw their toothbrush out every week when they're on an H. pylori protocol as well, because you can easily reinfect yourself.

• 51:37Dr. Darshan Shah?

  That's interesting. That's a great clinical pearl there, too. Yeah, I think H. pylori, the discovery of it changed medicine in a very big way, because I'm a surgeon. We used to be treating people gastric ulcers all the time and gastric cancers. And for a long time, people just thought it was too much acidity. But then when they discovered this bacteria in the stomach called H. pylori and treated that, the ulcers went away. So it was actually the bacteria causing the stomach ulcers. And so it's a really important thing to get tested for. Like you say, you can test for it with a stool test or a breath test.

• 52:09Speaker 01

  Yeah, it's very tied to different cancers, ulcers, Hashimoto's antibodies, constipation, food sensitivities. It lowers your stomach acid.

• 52:21Dr. Darshan Shah?

  Yeah.

• 52:21Speaker 01

  And so if you have that, then you're not going to be able to digest your foods properly. So then you end up with deficiencies in iron and B12, protein deficiencies. I've seen people with like muscle wasting when they have H. pylori. And that's like, that's part of it, right? The other part of it is then you become more susceptible to these buggers, infections like protozoa or Giardia, because part of what our stomach acid does is it clears, cleans up our food. So if we're eating a beautiful sushi dinner and there might be some pathogens in that sushi, if you have enough stomach acid, the stomach acid is going to kill off.

• 53:06Dr. Darshan Shah?

  Yeah.

• 53:06Speaker 01

  The pathogens, and then you're not going to get infected. But if you have low stomach acid, then those pathogens can easily get passed into your digestive tract and build a home there.

• 53:16Dr. Darshan Shah?

  Yeah.

• 53:17Speaker 01

  Which we don't want.

• 53:18Dr. Darshan Shah?

  We don't want that, right? For sure. Wow, we've gone through all of the different, well, not all of them, because there's 30, but we've hit on the big ones, right? I think is, did we miss any of the big ones?

• 53:27Speaker 01

  Did we miss any of the big ones? We talked about food sensitivities. We talked about enzyme deficiencies. We did talk about different infections. I did want to mention inflammatory bowel disease.

• 53:41Dr. Darshan Shah?

  Yes.

• 53:42Speaker 01

  About 10% of people who have the IBS label actually have inflammatory bowel disease. And the treatment approach for this can be a little bit challenging, but, and people think they might have to have their, their colon surgically removed, or that they're going to be at greater risk for cancer. Some individuals I've seen struggling with it for decades. And there is actually a functional medicine approach to getting inflammatory bowel disease into remission. It can be really different than what you would use for IBS. So high dose probiotics, for example, might aggravate inflammatory bowel disease.

• 54:24Speaker 01

  Berberine, which I love for various pathogens and for SIBO and for metabolic health. And I don't know if I could say weight loss, but it can help with weight loss, right? That can actually inflame somebody with inflammatory bowel disease and make them feel worse. However, people can utilize serum-based immunoglobulins, Boswellia, high dose fish oils, turmeric, a partial elemental diet. And I've seen cases of inflammatory bowel disease going into remission within months. My, my husband was diagnosed with inflammatory bowel disease.

• 54:59Dr. Darshan Shah?

  Really?

• 55:00Speaker 01

  Two weeks after we had our first son.

• 55:03Dr. Darshan Shah?

  Oh, my gosh.

• 55:04Speaker 01

  And thankfully, we were able to get him into remission. And so I have a chapter on inflammatory bowel disease in the IBS book that goes over the details and the different protocols.

• 55:15Dr. Darshan Shah?

  Can you tell the audience, what is inflammatory bowel disease? Why does it occur?

• 55:19Speaker 01

  Inflammatory bowel disease, this is going to be something that presents with somewhat similar symptoms to IBS, but perhaps more intense. So a person might have GI bleeding. They might have excessive weight loss. They might be that person with, with a fever. A lot of times, people might have additional symptoms as well. But it is, tends to be autoimmune in nature, right? And so it's the, the body attacking itself. A lot of the same driving factors as IBS, as other autoimmune conditions. But we do need to tread more gently with it. So many of them use salagenous herbs. Might be a place to start.

• 56:03Speaker 01

  Like typically with a person with IBS, we might do, you can do some of these herbs and probiotics right away, and they will feel better. And a person with IBD, that can make them feel worse. And so you might want to start off with a more gentle approach.

• 56:17Dr. Darshan Shah?

  Got it. And how would someone get diagnosed with inflammatory bowel disease?

• 56:21Speaker 01

  The gut seamer does have a marker on it called calprotectin, which can, which will be elevated in inflammatory bowel disease. It can also mean other things. So if you have had a test like that and your calprotectin was elevated, then I would recommend seeing a practitioner. But essentially, you, you would want to get, go to a gastroenterologist and get

• 56:47Dr. Darshan Shah?

  Biopsy, right? A gastroenterologist will do a colonoscopy and do a biopsy. And they'll look at it under a microscope and they can see inflammatory bowel disease. A lot of times, yeah.

• 56:57Speaker 01

  Definitely. But tricky part is some people get misdiagnosed with it.

• 57:01Dr. Darshan Shah?

  Yes, that's true, too.

• 57:02Speaker 01

  Where they are, the tricky part is some people are told they have IBS when they have IBD.

• 57:08Dr. Darshan Shah?

  Yeah.

• 57:09Speaker 01

  And then they end up suffering needlessly, right?

• 57:12Dr. Darshan Shah?

  Yeah. Yeah, it's, it's, it's very nuanced and is, the gut is complicated. We know that. And however, you know, with practitioners like yourself, the ones that we have here next to self, we can definitely help you sort through everything and get on the right treatment program and not take two steps backwards instead of two steps forwards, right? Yeah. I love it. I think this is like a great masterclass, but also a start point, starting point in inflammatory bowel disease for anyone out there suffering from constipation, diarrhea, bloating, other gut symptoms. If you have these symptoms, please pick up a copy of Isabel Wentz's book, IBS, right? That's the name of it, just IBS?

• 57:51Speaker 01

  There's a big IBS on the front, and it's Irritable Bowel Syndrome, Finding and Treating the Cause.

• 57:56Dr. Darshan Shah?

  I love it. I love it. And it's on bookstores now right now, right?

• 57:59Speaker 01

  Available on Amazon, yep. And Barnes and Noble and everywhere that fine books are sold.

• 58:04Dr. Darshan Shah?

  I love it. This is definitely a fine book. And where else can people learn more from you?

• 58:09Speaker 01

  I am all over YouTube, Instagram, Facebook, TikTok. I have a podcast called Thyroid Pharmacists Healing Conversations. I had a wonderful guest on recently. And my website is thyroidpharmacist.com.

• 58:25Dr. Darshan Shah?

  Thank you. Thank you so much for all the incredible information, as always. And look forward to the next thing you do and having you back on again.

• 58:31Speaker 01

  Thank you so much for having me. It's been such an honor.

• 58:33Dr. Darshan Shah?

  Thank you.

• 58:38Dr. Darshan Shah?

  Thank you so much for listening to the podcast today. Please remember to subscribe if you liked this episode and give us a good review and share a link with your friends. It really helps to support all of our efforts. I also want to remind you that the information shared on this podcast is for educational purposes only and is not intended to replace professional medical advice, diagnosis or treatment. Please consult with your healthcare provider or physician before making any decisions or taking any action based on what you hear today, especially if you have any underlying health conditions or on any medications. Your doctor knows your personal health situation the best, and it's always important to seek their guidance.