 So, hey everybody. Welcome to another episode of Dr. Jill Live. I am here with one of my dear friends, Dr. Charlize Pratt. And thank you for your patience. I know we said 11 and we're just a little after mountain time, but we were just prepping and making sure all the electronics work so we could be live with you today. It was just a little glitchy. Maybe it's the weather who knows. Today, like I said, I have my friend and colleague, the brilliant Dr. Charlize Pratt. I'll introduce her, but we are going to talk today about the gut microbiome. And some of the things you may not know, like how much genetic material it actually holds and why it impacts your genes and your outcomes and your health and your symptoms, maybe even more than your genetic profile. We're going to actually bring into this webinar and this talk some actual tests from real patients. So if you have test results or you want to look at your own and kind of follow along, I think it'll be very, very insightful for that deep dive into kind of how to look at all these markers. And if you have missed any other episodes, you can find all of the rest of the episodes or wherever you listen to podcast on iTunes or Stitcher or on YouTube. So first of all, let me introduce Dr. Charlize Pratt. We're neighbors. We're both functional medicine practitioners and just aligned in so many things. So it's always fun on weekends at the coffee shop or on hikes or here live with you. If we can talk about these things, we think a lot of like on this. She's incredibly brilliant at looking at the genetics into the deep dive. So we're going to have her share her expertise today. She believes in individualized integrative medicine. Her practice in Louisville is focused on complex medical conditions relating to metabolic diseases. She uses functional medicine and her expertise in methylation and physiology to help her patients get to the root cause of their symptoms through a strategic approach. You will find she's brilliant. She's so good at looking at genes and all the details of how that affects your functioning and again, deep diving into the testing and all of the analysts, the metabolic profiles, the organic gases and things. And we're going to dive into that today. The modality she uses in her practice are traditional and specialty testing nutrition diet, nutritional supplements, botanicals, environmental medicine, classic homeopathy and hydrotherapy. Dr. Pratt, welcome and so glad to have you here today. Thank you so much for having me Jill. It's great to be here. Yeah, so let's just start and frame this. We're going to actually share some slides and some info in a few minutes, but let's frame this for people on. We've talked and you and I know how important the microbiome is, but why, why would this be maybe a first place to start with health conditions and a first place to look because it obviously affects so many systems. So the microbiome is massive. We should really consider it another organ in our body. And it's, it has a huge influence on how all the levers of all of our genes work, because there are trillions of bacteria, fungi, viruses, all influencing our expression on our skin and our mouth in each tooth in every organ of our body, but especially the GI. And so as a naturopathic doctor, you know, from the very beginning of my education, one of my first classes was the nature cure. We always talked about poop. We always talked about, you know, what we now call the microbiome, because we believe that all health starts in the gut. And now that we're getting so much rich and amazing research back about the microbiome, we are starting to see, wow, that is the basis for, will you spin into diabetes? Will you spin into heart disease? Will you have neuro inflammation that leads to a degenerative case like Parkinson's? So we have all of these microbes that are influencing us, and they're influencing our own genetics. It's, it's a big part of our epigenetics, but it's also, it's the basis of our neurochemistry, our immune system, and our hormones actually. So I don't think that we can really talk about health without mentioning the microbiome anymore. Yeah. And isn't it interesting? I think I've seen statistics where like 20 years ago, there was like maybe certain hundreds of studies, and then there was thousands. And now, if you look at the exponential curve, like the research that's come out on the microbiome, it is just literally exponential. And I remember even writing the book like leaky gut was a term that was like totally poo pooed by conventional medicine for decades. And when I was diagnosed 20 years ago with Crohn's, it was like, oh, that's no such thing. Well, now in the literature is talking about how does leaky gut and we also call it intestinal hyperpermeability effect, obesity, diabetes, heart disease. And now, as you and I both know, there is thousands and thousands of studies. I wonder if it's one of the most topic, one of the most common topics in research now, if you start to look with the gut microbiome, and even how like we think drugs work on ourselves, many of them work on our gut, don't they? Yes, absolutely. Examples or things as far as like how much that's a big part. Yeah. They've realized that cholesterol medications are more acting on the microbiome than they are anywhere else. And lots of drugs that we thought the mechanism of action was one thing. And we're finding now, wow, it's very different. Just like, you know, our, our, our drugs that we use for mood or our behavior. There's new treatments in cancer now that are specifically targeting the microbiome. And I think that to come, we'll see more cancer drugs that actually get to the actual microbiome of the tumor site, because we now know there's a microbiome that's created within where you have, if you were to get cancer, and it were to develop. I mean, you and I just saw an article and went back and forth about how at the beginning of stages of, I believe it was breast cancer, there was no fungus present. And by stage four, there was a tremendous amount of fungal presence at the tumor site. So we are starting to see the microbiome as wow, it's ever evolving, it's ever changing, and it's influencing us wherever we look. I love that. And that's funny, as you're saying, I was thinking, Oh, that study we just shared. And the study was like, literally in breast was a big one, but it was almost every type of cancer they studied and biopsied and looked under the microscope, they found fungal elements. And my question in my mind was, did that, which came first, did the cancer weakened immune system so that fungus was able to take hold, or did the fungus actually proliferate or cause worsening of the cancer? And maybe you know the answer to that, I don't know, but I'm guessing it's a twofold. I mean, I think that those are great questions for us to ask. And as functional medicine doctors, naturopathic doctors, we are thinking in those terms, right, and trying to sleuth that. But what we do know is, is mycotoxins and a lot of fungal exposure really sets us up for a lot of other health conditions, right. And so we know that there's a microbiome shift when either you live in mycotoxins or you have a lot of colonization within different tissues of your body with fungal. So I can't answer that question yet. I don't have enough scientific data to say one way or another, but I can for sure say it seems like they would be, they would be good questions to ask and keep watching. And I want to move on to your information, but I want to comment real quick on my own experience. I think growing up on a farm, a lot of the pesticides or besides things change the microbiome of the soils. And I think some of the changes we're seeing reflected in the human body are because of the lack of diversity in the soils. And we're seeing that. And interestingly, a lot of the things that are antimicrobial like glyphosate affects the bacteria in the soil. And then you get this fungal overgrowth. So I think there's this reflection of more and more issues with changes in microbiome. That's actually just part of our soil changes and our environmental changes. And you also mentioned how cancer therapies, I want to know more about that, but can maybe start to target them. But gut microbiome, 20 years ago when I had cycloposphamide, you're one of the classic chemo regimens for breast cancer, I learned later that one of its mechanisms is to poke holes in the gut and create more permeability so that then the immune system gets a whole deluge of stuff from the gut that triggers immune inflammation. So it's almost like you create this leaky gut. And again, that was one of the mechanisms in mice who knows how much it played into it. And then for me to get Crohn's year, actually six months after chemotherapy, it's totally connected, right? Because that chemo causes more leaky gut, cause more dumping of product into my immune system. And then my genetics may be prone to the self auto inflammatory reaction. Side note, but it's interesting because it's exactly what you're saying with it. Well, and what we see is that, you know, leaky gut or any, whether it's drugs or antibiotics, whether it's foods that are causing that, but whether it's a microbiome shift, these things are causing auto immunity or other levers to be turned in our own genetic expression. It's called the epigenetics, right? And so I absolutely think that's fascinating. And although it saved your life, there was other work to do on the other side because it pushed too far in one direction, right? Where we are always trying to create balance right and harmony. Let's talk a little bit about the immune to autoimmune disease. And I think we're seeing a tsunami and epidemic of auto immunity. And because of siloed, we have the rheumatologists for arthritis, we have the gut, you know, gastroenterologists for Crohn's and colitis, we have the neurologists for MS. And so often we don't think of it as one big hole. I know you and I think holistically, but let's talk a little, do you want to share a little about why does auto immunity in the gut matter? Why does the gut matter to auto immunity? Because that's kind of ground zero, isn't it? Where? Sure. I mean, we believe that there's a lot of inflammation that starts and what we need to do is run tests often to know is it their butyrate propanate acetate? Are those short chain fatty acids off? Are we do we have are we missing keystone species that we're going to talk about today that are influencing that cause more inflammation? So it's not just about the foods being because it used to be that when we talked about leaky gut, everybody ran an IgG food sensitivity panel. And I think you and I rarely run those anymore. Would you agree? Because because that's not the answer. It's usually we have to go to the microbiome and see what is inflaming the gut. And it could be driven by a food like gluten and dairy. Like but a lot of our patients, Jill and I see a lot of motivated patients that come in and they're already on an AIP diet and they're still battling auto immune and inflammation in the GI. And that that's when you have to take it to the next step, right? And figure out what what is it? Is it an infection within the GI? Is it other latent infections like Lyme that have poked holes? Is it mycotoxins that they lived in or they they they didn't even know they were exposed to that they completely changed the microbiome and made them more susceptible to inflammation within the gut? I mean, that's the detective work, right? That that we as doctors have to figure out for the patients that are really medical mysteries. Nobody can really figure out what's going on with them. Exactly. And so did that answer your question about auto immunity in the gut? I mean, LPS and it's it's triggering more inflammation to come from the brain because the vagus nerve gets involved, right? When that LPS dumps it, it makes actually something called interleukin six that hits the brain. It hits the vagus nerve and goes right up to the brain and causes neural inflammation at the same time. So and then the brain comes back to say, oh, we're inflamed. We're inflamed. Like what should we do? Battle down the hatches in the in the galt, which is exactly where our lymphatic system lives. And 70 percent of our immune system comes off of the GI. So it gets really confused when we have these leaks and gaps. I think everybody on your channel pretty much understands what leaky gut is, but these larger poly molecules get in causes the immune system to flare. And then we tip into auto immunity or some other inflammatory condition. Correct. Love that. You framed it perfectly. And I wanted to mention the food because if you're listening and you have like an IGG food sensitivity profile, I love that you mentioned that. I wanted to just clarify. It's not that those aren't real sensitivities that you could be experiencing systemically, but you and I agree, Dr. Pratt, that it's a it's an innocent bystander. What happens is say you have these holes. I always say it's like your gut becomes like Swiss cheese. So all of a sudden you have all these holes and you eat corn. Your corn antigen goes through and all of a sudden it's in the bloodstream where it should never be as a whole molecule in the body. It's like, what the heck is this corn doing here? Creates antibodies to corn, antibodies to soy, antibodies to wheat. So you come up on your test like a Christmas tree, everything lights up with, you know, the sensitivities. And it's not that those foods are the culprit to causing your illness. They might contribute inflammation because they're poking the immune system. But to you and I, Dr. Pratt, it's a symptom of a leaky gut, right? So when we see that light up whenever they're sensitive, like if you looked at my gut since I had Crohn's, it has all kinds of sensitivities. And that's not because the foods are the main culprit. They contribute. But it shows that I have a leaky gut or that someone has a leaky gut. So I love that you and if anything, when I do order it, it's more just to prove to myself and the patient, hey, there is leaky gut here, right? We need to take care. We don't need to bastardize the foods. We need to say, why is that happening? And how can we get you eating more foods and less, less restrictive, right? Well, I mean, you're singing to the choir here, because what we really want to do is expand your diet eventually, because when you have that light up like a Christmas tree on that IGG panel, it's probably because there may be a few on there that you have to continue to avoid, Rachel, like gluten and dairy are pretty hard. Correct. Once that gets going, and if you have certain genes like HLA genes, you know, in your genetic report, you probably should never eat gluten ever. Yes. Because that's going to continue to create a problem in the gut. But you can bring back foods. That's that's that's what Dr. Jill and I want to want to listen or everybody to know is that these foods can there are certain foods that can come back. You don't have to be so restricted for the rest of your life when your microbiome and your GIs is rebuilt. Love it. Love it. Love it. We could do the whole talk. I think we kind of did on the food. Let's dive in then. I don't know if you want to frame anything else or if we could dive into maybe you have some case studies for us. Yeah, I mean, what I want to mention is, yes, you may have been born in by cesarean and not been fed some of your mother's microbiome going through that canal. But all the mothers that are kind of preparing for this, I just want to remind people this is one of the benefits your child will receive by going through that vaginal tract is getting colonized. And I want to I want to tell people there's plenty we can do to rebuild the gut if you have a cesarean. But if you can take some of that that colonization and put it on their skin after a cesarean, it does make a huge difference because how we absorb iron is forever imprinted by having a vaginal birth and also the colostrum that we receive from breastfeeding. And again, there are people that can't have a vaginal birth and there are people that can't breastfeed. But anything we can do to help the microbiome in those early days by supplementing in the ways that I just spoke about. I just want to mention that, you know, that's that's something that I just want more new mothers to know. What about you, Joe? More absolutely. And it's getting we know there's emergencies. That's why cesarean section saves lives. Yes. But if it's scheduled around your doctor's golf schedule, maybe ask for another doctor because that's the kind of thing where like, oh, come on, you know, like, I don't like that. And we can change that. Or, you know, reinoculate them. You know, it doesn't have to be complicated. Yeah. You just go ahead and give them that that that that culture from yourself. So, yeah, antibiotic use. A lot of people have a lot of antibiotic use in their life. You can rebuild from this. If it's earlier than the first two years of life, it's a little harder, but there's still things that we can do. And so running a good microbiome test or understanding how to rebuild the microbiome, which can be easier than you think. It's not expensive to rebuild the microbiome, right, Jill? That's one of the like foundationals and it's wonderful because you and I can't see everyone, but anyone can listen to this or watch this on your YouTube video or all the different platforms you're on. And what I want to tell people is you don't have to make a hundred thousand dollars in shop at Whole Foods every day in order to shift your microbiome. There are some simple easy ways to do it. And yes, you will get more if you can stay away from pesticides and herbicides and glyphosate. I have to say that. But I just want to mention some of these things before we dive in because we're going to talk about dietary changes. My slides are kind of like I'm just showing you the test and I'm going to, Jill, you chime in, please chime in. Do you want to do you want me to bring that up? Yeah, yeah, perfect. And while you're doing that, I just and I'd love your opinion, but you said some foundations. We know spore probiotics can help diversity. So that could be a good foundation for adults. And when you mention children, mothers milk, of course, colostrum, but you can give Bifidobacter species to infants. Do you have any comments on what you might give a newborn baby who is cesarean or, you know, one year old or two year old for probiotics or for what would you do for that baby? Well, I really like Nigel Plummer's work. He I think he makes probiotics from Pharmax and Steroil and he has an infant formula and he has one for breastfed and one for non breastfed babies. And I love that age. I think it's a HLC baby infant and that's a great formula, in my opinion. Perfect, perfect. Yeah. And he has a more Bifidobacter, right? Are you able to? Yes, I can't share it. I just click permission. There you go. OK. So everybody can see this and I'll put it into the presentation. Oops, we got a little far ahead about that. OK. OK, that's me. So what I'm going to show you today is my favorite microbiome test. And let me say a little why I like Biomefx. I've run. All of them really. I've run. The diagnostics, I've run doctors data for years. I ran great smokies all the way back. I ran Genova. And although I like these for, you know, gallbladder function or how we break down our proteolytic enzymes, how they're functioning for our pancreas. I don't think they do a great job at the microbiome there. If you took and tested yourself five days in a row, many of these other tests would be different each five days. Whereas this Biomefx kind of it's Cosmet has figured out a way to make it way more reliable. And I don't know, Jill, if you've run very many of these, but I totally agree. We're getting to the next level and what's happening is some of those other companies that you're mentioning are starting to get on board. And I think they're going to like there's another company that should be having a Genova is having one similar. But this is right now the leader. I would agree with you. And so it's good at what it's good at. And it's not what it's not good at. So it's not great at pathogens. There are other companies that are better for pathogens. But this is going to tell me those keystone species. It's going to tell me about sacroletic fermentation. We're going to go through all of these things. And it's going to tell me about diversity. So the first thing that you look at on this test is it kind of gives you a general idea of all of these these other markers in one kind of score. And what we really want is that score to be close to 30. And the further it is down from 30, the more work we have to do. So this isn't this isn't a patient that's really far off. And I'd have to say that most of my patients that I run this they're not really far off that from 30. Every once in a while I get one that is and there's more work to do. But I just want to say you might think your microbiome is really off. And we're going to talk about how this particular young man even though he's 48 he's a young man. 48 years young. He's had tremendous GI issues and weight issues and and struggled with what to eat. And and we really figured out by this test what was going on finally. So he and his wasn't that far off from the mark. So alpha diversity is the number of species within your microbiome and beta diversity is the differentiation within those species. So we really want alpha and beta diversity. Right. We want plenty of different the number of species to be very different and then within that species we want all of them to be very different too. Right. Diversity is key. So I am our richness has to do with the resilience of our GI. OK. And there's a lot of environmental influences to this. So this is the time where I'm not going to talk a lot about resilience but you know how are you taking care of staying trying to stay away where you can of pesticides herbicides mycotoxins you know infections but also E.M.F. We know that that significantly changes microbiome. So no laptops on your lap near your GI. It's one of the wonders we wonder if that's why colon cancer rates are just sky rocketing because we've had cell phones and computers on our lap for the last 20 or pockets in our lap. Yes. Totally. So we there's there's a whole lot I think you and I talked about E.M.F. at one point that it is influencing the microbiome. So you should know this. So all those all out if you haven't heard our previous if you look at my past lives Dr. Pratt and I have a live where you presented Dr. Pratt about all the E.M.F. stuff and it's really good. So go back and watch that episode again. So but in the microbiome it's sensitive to these things it's sensitive to the amount of exercise you get sensitive to the amount of sleep you get. It's it's it's it's sensitive in all regards right. So the E.M.R. richness is the resilience of the microbiome pathogens again. I'm not going to spend a lot of time talking about pathogens this test isn't amazing at it but what it is great at is these keystone species telling you okay acrimanthias low. Yeah. Why is that a big deal Jill tell me why because you know that is my favorite keystone species when you mentioned keystone all that means is like these are a bigger marker of diversity than anything else. So literally if you have loads of acrimanthia versus zero that alone can predict your diversity. And so diversity I always say it's like back in the Ireland when they all all the farmers like hey this potato grows great let's get the same seed and they grew all the same seed and then a blight came I don't know what happened but they all lost their crops because there was no difference in the types of seed of the potato. So wiped everything out and you can think about that as your microbiome because if you have multiple strains and multiple diversity you're going to be more resilient to disease and auto immunity and things. So this is just one marker that's a really big deal with diversity. And it also basically influences the amount of mucin you have protecting that microbiome. Correct. So because acrimanthia is responsible for helping keep that level so that the right things can get down and influence the GI lining and other things can't. So having low is going to throw off what's influencing the the galt or the immune system of the GI as well as the integrity of the GI. But I also like stand back and say OK Bifidolongum Bifidoladolescence which one thing we should all know is I don't know if it's it's the antibiotics that we've used for generations at this point but Bifidobacterium Adolescence is really getting rare in younger populations. They don't have it anymore. So we really want to create more of this if we can. Right. These Bifidol species and the lactobacillus species and you're going to see more about that when we talk about short chain fatty acids. But if you see this particular gentleman he has very low keystone species and many of them are missing. Right. Which will you know foreshadow into why metabolic issues are at play here. So and then functions we're going to get dirty in these functions so we don't have to go through all of them right here. So again these keystone species as Jill said are so important to diversity but specifically also they produce the things that well butyrate right butyrate is so important to our metabolic health. It's it's not only our our glucose metabolism and our hormones but it also influences our mitochondria which is the organelle in our cells that makes energy and that organelle is one of the most important pieces to watch in health. Right Jill. 100% I was just going to mention to you I'm teaching you cardiovascular microbiome which you might think how are those related right heart disease and butyric acid or short chain fatty acid production is one of the biggest indicators of whether or not you have serious heart disease. So it's connected to other organ systems as well. Right. So these these little these keystone species that Jill and I talked about are so important to the downstream effect of how our physiology unfolds and what's turning on genes or turning off other genes and we can actually manage this we can change this. So acetate producers. What does acetate do? Jill, do you remember? I'm trying to remember. I think that has to do with another anti inflammatory and anti inflammatory. There might be more. But anyway, each one of these different short chain fatty acids perform like they so we need like lactobacillus in order to make lactate, right? Which is another part of our metabolism. Exactly. So I'm just showing you how it's connected and for this person they really struggle. They have very little butyrate, very little propanate and very little acetate. So their ability for their immune system to function correctly for their hormones and their their weight management is being influenced by this. So we want to feed these these bacteria so they make the butyrate for us. And I think, Jill, you do use some butyrate in your practice. I typically try to give them the food that the bacteria likes so that I can try to bring them back. But have you found that giving butyrate is helpful? I do. And especially in the cases like a severe Crohn's colitis or someone who's in a really bad shape where they may not be absorbing foods as well. I want to hear more about because I always feel like food is better than supplements. So I can't wait to hear what you have to say about that. I think that's the first step. But if you're not making it or you're in even post COVID long COVID, some of the guts the spore probiotics, the bovine immune globulins and butyrate is kind of the my three things that I like to use for really like inflamed guts after an illness or after some insult. Yeah, one other thing I want to bring up about cropenate that people may not understand. And I don't know. I haven't seen propoenate high on other labs, but I have seen it on the biome effects. And I don't know if you've seen the research that suggests that high propoenate can increase the risk of autism in that mother. Yeah. So if you are thinking about having a baby, you know, in three, three years or two years or six months, it might be really good to run some of these tests and start using, you know, bovine immunoglobulins, you know, some of the some of the resistant starches or prebiotics to help manage that propoenate and that acetate and that butyrate. So again, acetate. I just thought it is also really important in integrity of the gut. Yeah. So yeah, I would say these whole short chain fetus, which are propoenate, acetate, all of these we're talking about as a group. They're the fuel for the cells that line the gut. So if you have damage, you have the Swiss cheese gut, this is one of the ways where you can regenerate your leaky gut, your problem gut. So I just want to frame that because this is kind of the fuel for those cells that line the gut. So these are the foods that they love. Great. So I thought I'd bring up this slide and just again, these resistant starches, plantains, green bananas, beans, if you're not lectin sensitive, of course, in peas, lentils, whole grains or whole oats. Again, try to get it without glyphosate. Oh, I don't know, Jill. A lot of people are going to oat milk these days and the amount of glyphosate that's in oats. I could not agree more. I didn't. I just thought I was going to mention the glyphosate because I saw another thing on beer and wine. And if you're not really careful about hopefully you're not drinking a lot of alcohol because that's not great for your gut either. But that is loaded. The parts for there was so much in the California wines and the beer. But then like you said, oats and oat milk and the Quaker Oats was one of the higher. I'm just going to name them. It wasn't the highest foods with glyphosate out there. So if you're getting oats in your diet, you must pick organic. This is non-negotiable. It's not our oat milk that is organic, right? Make your own maybe. Or make your own. Quick question. All those gums. Yeah, exactly. So quick question because we have a lot of people who are like for one reason or the other on like a paleo, like a grain-free diet. There's lots of grains and lots of, you know, not paleo foods. What kinds of things like they could do green bananas? But what would you say would be our best sources if you are kind of grain-free or legume-free because there's clearly some still some good things there? Well, I think they can do the onions, the leeks, the asparagus, the chicory. Perfect. They can do Jerusalem artichokes. They can do garlic. And we're going to talk about the situations that they can't do some of the higher sulfur foods. What else? Well, they might be able to do plantains or green bananas because those are very low in sugar. Perfect. And then if they don't have a lot of mycotoxin exposure, they can do some of these beta-glucans as well, rashi, mentaki, shushaki. And if they don't have a dairy sensitivity intolerance or caseomorphin experience going on in their brain, they might be able to tolerate yogurt or things like that. Absolutely. And actually, the SCD and the GAPS diet both use that like homemade yogurt as a huge source of healing. So when you're not in the well caveat, there would be if you're super histamine-sensitive fermentation tends to be higher histamine. So you got to know that piece. But if you're not, these homemade yogurt can be really powerful. Do you have your patients do some of those like GAPS types of things? Yes. I mean, but the majority of my patients have sulfur intolerance and histamine intolerance. I know, right? Me too. So they're like no yogurt, which they're so happy when I run this test because this test finally validates what they've been feeling. Oh, see, yeah. And I'll show you in the markers. And so I just went over this test with another patient, not this patient, but another patient yesterday or two days ago. And and they said, what can I do? Because I am so histamine-sensitive and sulfur-sensitive. So, you know, we picked it apart, bamboo shoots. You know, we're looking for a prebiotic, which there's some there's some prebiotics that are not made of corn and milk out there. Microbiome labs, which is an easy choice. That one does have corn and dairy in it. But switching to dandelion chicory tea can or or eating dandelions. That's great. If you're again, we have to watch the oxalate content for some of our type of patients with histamine issues. But it's just it's opportunity. We're just trying to get different things through to feed these wonderful bacteria that we want to thrive. I want to emphasize something else that you're saying here without saying it's flat out because all the time you and I have patients, I can't do oxalates. I can't do salicylates. I can't do histamine. I can yes, I can't do grains. I can do and every time I love that you're saying this because so often I get on my blog or somewhere. Well, I thought we weren't supposed to eat mushrooms, right? And I'm always like, no, it's it's individualized. So what I wanted to emphasize with what you're saying is part of why people see you and I is because every diet is different, right? Like, even if I say what I eat, it's not a classic paleo. I have some things I can't eat like I eat quinoa, but I can't eat X, Y or Z. So yeah, very individualized. And this is the kind of testing that can tell you to help your patients to be so individualized because it's complex, isn't it? It's there's no one size fits all. There is not. And the more that I dive into the microbiome, there are things that you can tolerate today that you maybe couldn't tolerate two years from now. And there and there may be things that you can tolerate tomorrow. And it's surprising like you may tolerate a high soul for food like bok choy or or or arugula. But maybe we need to limit the amount of Brussels sprouts. So a lot of times I see people that are really sick and they get afraid of things. And what I want to do is rework that mind to broaden to know that a little bit here and there might be actually good for us unless we see markers on this test that I say, OK, really, we need to avoid those for a little while. But we can't stay away from sulfur and our foods forever. Rachel, I completely agree. And I love that you're saying this because so many people get in these boxes of like I can eat eight foods and that's it. And guess what that does? That starts your microbiome. So we're trying to get diversity here. If you stay on the diet for 20 years, your microbiome is going to shrink down to not diverse. So I love that you're saying that because I think that's so important because you do get people get afraid and rightfully so because they've been hurt by foods. They don't feel well. But you and I are saying what we want to do is heal the root problem and get your diet extended, not contracted. Exactly. So this particular patient you're going to see, they thought they were histamine sensitive. They thought that they could never have sulfur foods. I won't skip ahead. But the bigger problem was lactate. Like look at how high their lactate is. That's incredibly inflammatory for that GI. And we can convert it if we can we can convert it to something useful. We just have to have the right producers, the right utilizers. And you know, the big one for lactate, Jill, I don't know if you tell your patients this is deep breathing. They need to lose the stress. They need to calm down. That makes so much sense. So part of this is not necessarily just in what they eat. It's also taking a deeper breath and stress management to bring down lactate. Love it. Yeah, when you blow off CO2 you're blowing off lactic acid. Yes, yes, which is taking your overall lactate down in the blood, specifically. Because you're very acidic. This person has it everywhere, right? This person has it everywhere. So there are things that can bring down lactate. Again, eating some of these higher fiber foods also help. But this particular patient, if you look, the type of bacteria that they need in order to reduce this lactate, they've got a ton of it. It's almost like their body knows. Wow. And it's trying to keep up, but the stress needs to come down. Yeah, that makes sense. I love that you're bringing it too, because we can talk about probiotics and foods and stuff. But if we're not addressing sleep and stress and mind, body and hiking and the nature or whatever, those things are critical too. Which I tell people all the time the terpenes and the amine or the oxidative antioxidants that you get in nature far outweigh anything I can give you. Yes. So any time we can get access to nature, reduce our stress, help exercise, all of these type of things help the microbiome in ways that there's no other answer. So again, this person was trying to avoid all sulfur food. They were basically thinking that they also had ammonia problems. But look at this test. And when it does show up, man, we have to change it. And one of the things I will say, if you have high ammonia, which the next organic acid test we did doesn't have high ammonia. So I want to say it now is that you need to help with protein breakdown. You need to either take bitters. You need to do apple cider vinegar before your meals or you need to do some kind of lemon juice. If you're not histamine sensitive to try to get digestion of protein to work better for ammonia production. Would you add anything to that, Joe? I totally agree because it is. It's like and on the other kinds of stool tests we talked about, sometimes you see protein in the stool and that's another. Or on organic acids, you can see some of these things as well. So they're kind of there's multiple places. You can see them, but I would totally agree. I've heard that NAC, NAC and magnesium can also help with the metabolism of excess ammonia. And ammonia literally is a neurotoxin. So people with really bad excess ammonia can often have some pretty bad neurological issues. So the patient I saw yesterday, we went over herds and her ammonia was very, very high and it's causing brain fog, severe brain fog, but it's not the histamine she thought it was. Yes, I love that. Because again, like you said, things is one thing and it's actually more complex than that. Right? So if you have a very high hydrogen sulfite, let's just say this real quick because this particular patient doesn't. But if you did have really high hydrogen sulfite, you might trial maybe two weeks off of high sulfite foods, you know, the cruciferous vegetables, leeks, onions, garlic, eggs can be high in sulfur, even your high sulfur supplements. Glutathione and DMSA and NAC and what else? Glucose or- MSM. All of these are going to also influence that. So you really want to take a break from those supplements as well when you see that. Yeah. So helpful. Oh, one of the little tip with sulfur sulfites, because I know this personally, molybdenum can help you process that. Yes. You know, you use it as well, but I often, that was my, and I'll tell you, for me personally, I had lots of pain when I had excess sulfur. As soon as I did the molybdenum, it was like a pain pill, it wasn't a pain pill, but it took care of that sulfur that was causing the pain. Now I'm fine because I've done the work. I can take NAC, I can take Glutathione, I can do those things, but I still take a little bit of molybdenum and that's a huge factor there, isn't it? Oh, thank you so much for bringing that up, because yes, if you actually look at how sulfation works, one of the rate limiting factors is enough molybdenum to actually go through the sulfur pathway. So that's, you know, anybody with a sulfur issue is gonna benefit from taking molybdenum and there's some great options out there. You don't have to take 500 micrograms at once. You can take 25 micrograms in drops or in a pill. There's lots of offerings from different supplement companies. I know about the caps, but what about the drops? Do you have a company that you like? Yeah, Seeking Health has something called, what's it called? I think it's Sulfex. Oh, cool. With an X at the end. And it is molybdenum and it's only 25 micrograms. Brilliant. Yeah. So as you see, this patient had been categorized as SIBO over and over. And I'm not saying that they probably don't have some of the bacterial overgrowth in the wrong area, but they're not, this test didn't show methane producers and it didn't show high hydrogen sulfite. So I'm trying to work this gentleman's brain around. We can sample more of those foods. We have data. Perfect. Love it. So did you know, did do all these people know how much the microbiome makes of your neurochemistry? And GABA is really low in this individual glutathione. Production is low. Here's the histamine because that's considered a neurotransmitter actually. Indole is low. Again, helping this diversity of microbiome, the keystone species, feeding them what they like to eat, focusing on stress, all of these things will help write this ship. I want to mention to histamine, I love that you said it's a neurotransmitter. It is, and we know now, see people are all afraid of histamine. Histamine is bad, mast cell bad, right? Yes. Histamine makes us smart and sharp. So you want to, you don't want no histamine. There's studies with IQ level and histamine level, then they correlate. So histamine is not all bad. And so I love to frame that because people think, gosh, I shouldn't have any histamine. You want some or you won't be able to think straight, right? And don't want too much. Exactly. And sometimes we, I think histamine gets blamed for a lot of things these days because of mast cell activation has become such a stamp on so many people that are in our space. And sometimes I try to, I try to wiggle them out of that a little bit to show them no ammonia is here. We've got maybe some hydrogen sulfate. We've got a lot of lactate in your gut. We've got other fish to fry here. We can't just blame histamine. So this also checks for estrogen phase three detoxification, which I love, love, love because I, you know, we'll run a Dutch for the first two, but knowing, you know, how phase three is operating and whether they need to keep that conjugation or they're unconjugating their estrogen. This is, this helps us see that and this is a good test to see it. So that is not happening in this individual, but their B vitamin synthesis is very low, right? B1, B2, B5, B6, B7, they're all kind of all over the map, but mostly low, B9, B12. This person has a very hard time with managing. They also have foot two, which is a genetic snip. They are homozygous. So their ability to absorb B12 is impacted by that bifidobacterium, right? Being low. And you can see it. And you look at that ferrofolate and those are methylated. So it's different. Yeah, they're not methylating well in their gut. They're not methylating well anywhere. So this patient has a lot to do with, we have a lot of work to do with methylation, but they, we do supplement. We are gonna supplement some of these lower B vitamins because they're too low. We're not, the microbiome is not making enough. The good news is K2 looks great here. Yeah, so. Heart and exercise and all those good things for. Exactly, and D, and how they're metabolizing their D, despite this person that has VDR snips and B-O-C-O-M or B-C-O-M, which is vitamin A snips. So again, those fat soluble vitamins, those minerals are the first to go when you have leaky gut and when you don't have the right environment. So it's something that in, when we look at a microbiome test, if we see a lot of leaky gut or we see a lot of inflammation gel, right? We oftentimes will say we need to support, especially if we know you have genetic snips that you're not getting enough of your fat soluble vitamins. Absolutely. In fact, that's one thing I say, you know, say you're just doing serum labs and that's all you can start with, something through insurance and you get K, A, D, E, those are fat soluble, B12, your ferritin, some of these things, not all of those can indicate, but many of those are malabsorption symptoms. So if you have all of these, fat soluble, B12, iron issues, often there's a gut issue. Yes. And a gallbladder issue. Yeah, yes. So this wraps up that biome facts, but I do, I really am a huge fan of this microbiome test. And I can't say that I felt as excited about some of the other ones. I totally agree. And I'm gonna try to do for those listeners, I believe that you can order this direct as a consumer. So if I can get a link for that, I will add that to wherever you're watching this. I'm not gonna promise, but after I'm done recording, I'm gonna see what I can find because I think you can order this directly as a consumer. I think you can. And again, it's not that biome effects to do the real work in between, you really don't need to run that as often as maybe twice a year at most, maybe once a year, if you're working on it and making progress. This is not a test you run every three months, that biome effects. Now this test you could run every three months, this organic acid test, because this is kind of showing your phenotype, how are your genes expressing themselves? So I happen to be a biochemistry nerd, like I really like this kind of stuff. And Jill- You and I for fun, are we on the weekends? Yes, we do. Like talking about this. We do. We're nerdy in a quality shop. And if people overheard us, they'd be like, wow, they just don't stop. And it's just never stop. This is one reason why it's so amazing to have a friend like you. And we have multiple of them in our circle, but it is, like as we get high in a joyful place, we're talking about microbiome and not to help our patients. Exactly. And we so benefit from one another because we all have different pieces that we all bring and it's just really beautiful. So this particular gentleman, this is not my patient, this is Jill's patient. I mean, it sounds like from what I understand, exposure to mycotoxins loves high carb, pretty high carb diet has sweet cravings, which I can see right here on this first page. What else would you fill us in, has intermittent diarrhea with different exposure to probiotics? Yeah. Definitely the carb cravings of mold exposure, which again, we can see, and you can explain that about why we see that. Interesting, we'll talk later about clostridium, but I think that can manifest as dopamine driven activities. He likes adventure and kind of those kinds of things. Also, that can be incredibly intensely focused. And I think somewhere in that, that can relate to the gut microbiome too, surprise, surprise. Generally good mood. I think that we see behaviors that try to increase serotonin as we were talking before when we reviewed this. So often if you are craving at night, like after dinner, you need something sweet, you wanna go get cashew ice cream or you wanna have a little chocolate or often that's a behavior because those carbs will increase your serotonin. So if you're like really wanting to make more serotonin and you're not naturally making that, you'll often have those kind of like, I need some carbs or you feel a little down or a little discouraged or not great if you don't have enough carbs in your diet. Any other comments on that kind of serotonin seeking behavior because I bet a lot of people listening can relate to that. Well, he is a Mao, a homozygous. He's fast metabolizer of serotonin. So he's looking for serotonin. So it would only increase the likelihood of having fungal overgrowth and fungus really messes with our serotonin. I don't know, Jill, if you find this in your practice, but anytime I'm pulling people off or treating fungus and pulling people off of eating so many carbs, I usually have to supplement with 5-HTP and B6 to help their serotonin. Otherwise, they feel like I can't do this. This is way too hard. How about, Chris, you mentioned B6 and the can't recall dreams. That's another interesting thing. And that would really mess as well because the B6 is probably low and being used up by those fungal metabolites and stuff. And then also, because dream recall is often related to serotonin and the metabolites melatonin and serotonin and also B6, right? Is there any of that with poor dream recall? Magnesium. Yes. Zinc, probably. But you're gonna see in his neurochemistry, there's definitely things afoot. So before I get going here too, there's no part of this test to say, but he does have HLA, DQ, SNPs. He has a heterozygous SNP. He really shouldn't be eating gluten. He's got BCMO1, so vitamin A deficiency is kind of common for him, probably. So looking for that chicken skin, those bumps on the back of your arms or bumps that get on the adult or child's cheeks is often a vitamin A deficiency. Again, we don't wanna overload the system. This is a fat-soluble vitamin that can damage the liver if it gets too high. But many, many people have a SNP here and they don't absorb it well to begin with. And I believe this particular gentleman probably has a gallbladder issue as well because of the mycotoxin exposure, because he's colonized, which now we'll get to this test, he's colonized in one, two, three, four fungal species, probably different species. These are metabolites. And we know both of the exposure was aspergillic penicillin, among others, but that's what those two, the furans, that number is, right? And I wanna talk about oxalates too, because tender tissues, he mentioned he had gotten a massage and it was so painful, he hated it. And that can be oxalates in the tissues, right? And we see the fungal motel that's contributing to oxalates. And when you show the next page, eventually there's a load of oxalates. So I wanna talk about oxalates as well. And he has genes that make him AGXT. He's homozygous, which makes him, it's harder for him to manage oxalates, with genetics. But again, just cause he has that SNP, did not set him up that he couldn't have KL or these things. It was also bringing in this exposure to fungus. Correct. Which creates even more of a tidal wave of oxalates. One of the things that people are listening to are like, okay, oxalates, do I have them? What's the issue? Tell us a little bit about what would you see in a patient who had oxalate issues for symptoms and stuff? So pain, pain in their body, just in general pain, vulvodynia pain in that area of a woman's body, else, kidney stones. Yes, bladder. That's the most obvious one that I tend to like, oh yeah, kidney stones because that's so obvious. That was how we learned about oxalates. Jill and I at probably a medical school. So, but their glyphosate increases oxalates. So the more glyphosate you're getting, more oxalate issues as well. So to bring in that piece. And I think at the same time we did this test, the glyphosate was like even the 80th percentile, so pretty high, which makes sense. So it's not one, we can't just blame high oxalate foods. And this again, I'm constantly telling people, it's not just the food. Usually going on a low oxalate diet will cause a massive oxalate dump, which then they feel awful. So the whole point is actually to manage the fungus, to diversify the diet, and to reduce the infection that's causing this. Absolutely. I love that you said that. So you're like, oh, no low oxalates. And again, if you went from 100% oxalates to 50% or 20%, you're gonna dump and feel horrendous. We recommend like five or 10% reduction if anything. And then like you said, the big factor is you have to go to the root, which is fungal overgrowth in this case. So he's colonized, you see these are pretty, I mean, tartaric, it's supposed to be under 5.3, he's at 39. Arabnos at 72, I would expect it actually to be a little worse with craving cashew ice cream and sweets as much as he does. So I can see he's trying to keep ahead of this, but he's got some serious fungus here, but his bacterial markers are also very high. And that clostridia is causing some issues here. So there's definitely a microbiome piece to this. And what I was saying before we jumped on today, we had talked about some of these results before. I think this person should probably increase those fibers that we talked about to help scrub the GI, to help bind some of the mycotoxins. Can this person take binders, Jill? Can they do activated charcoal or? They can charcoal every day. So that's great, yeah. And I love the idea you mentioned earlier, saccharomyces bilardi, I think that's a good idea. And I think what else? He does take a little NAC and charcoal and probiotics so far has not tolerated. So we'll have to figure out a way to get those in. But could we consider an eighth of a cap of saccharomyces bilardi? Yeah, absolutely, I think this is trying to. Or an eighth of a capsule of Megasporbiotic or an eighth of a capsule of HU58, which is the bacillus species. Those, again, a lot of people can't do a whole cap. And so sometimes we have to open them up and just sprinkle, it's just like a dusting. And that actually is a way that you can slowly shift. I think I'm quoted in your book. Yes, you are, you absolutely are. Sometimes we don't have to do things in a massive way. Sometimes it just can be a little bit. You're quoting it. You can be a delicate. Yes, sometimes you can be a delicate flower and a bad ass. That's right. That's right. I love it. You're a bad ass, even in the moments, you're delicate. So anyway, I think clostridium is a big piece here and saccharomyces bilardi. If we can do that, it goes after the fungus and it also helps the bacteria and it also helps clostridium species, which we saw on a GI map was also an issue. So sorry, if you're live with us, I had someone who's on live just asked and said, hey, am I stooled and I have yeast, but I have tons of oxalates. What else could I do? And I actually mentioned this test. This is called Great Plains Oat Test. This is a great test, is when I just responded to you, if you're listening out there still, this is a really good test. And what I find, Chelys, I'd love to know your opinion. The stool doesn't always pick up what's in the small bowel, in fact, it rarely does. So if you're doing a stool test, you may not see the fungus or the yeast as much as you would on organic gases, which this is a urine test that looks for metallides in the body. And so you almost need both sides to diagnose this. 100%, thank you so much for pointing that out. And it's also one of the reasons why it's nice to see these back to back. I wish they were the same patient, but they are not, they're two different patients. But oftentimes you can't find fungus even on the BioMFX. Exactly. It's really amazing at hiding that biofilm that it creates, but somehow organic, the organic acid picks up on the metabolites, not the fungus itself or the DNA of the fungus. It's looking at what it produces. And we see that time and time again, where we can actually get to it or see it. Yeah, totally agree with you. I always do, I always just do, always do organic gases and serum. Like that's the one, two, three punch for every new patient. I, again, this is not this patient, but a different patient that has actually seen both of us had been concerned that they had fungal issues, fungal issues. And they said every time they came home, they thought it was the mycotoxins that were in their house. And what we found actually that it wasn't the fungus, because their oat looked beautiful and they were so frustrated because they kept treating as if it were fungal. And guess what? It was hydrogen sulfite. So it was the fact that every time they went home, they ate a ton of cruciferous vegetables. And when they were out traveling, they just didn't have access to the amount of cruciferous vegetables. So they'd feel bad every time they came home and it wasn't actually fungus anymore. So anyway, that's side note. You know, to help helping, because these two tests can help a doctor really see a lot of different perspectives. Like, so we don't keep banging on the same door. And I remember you mentioned like cruciferous vegetables, some of the most healthy things in the world, leafy greens, but if you don't know that you have oxalates, for example, this patient that we're talking about now drinks fresh green juice all the time. And that's wonderful. Like he literally makes his own green juice, but he's high oxalates. As you can see here, number 21, it's off the charts. So that green juice, if it's the wrong components and high oxalate may not be the best thing every single day for him. And again, I would say green juice, but specifically lower oxalate greens, right? So N-dive, watercress, parsley, cilantro. I'd put a green apple in there and some lemon and fennel. And that's all low oxalate, I believe. Brilliant, love it. So you can still do it, just not your kale and your spinach maybe. I think if you Google Dr. Pratt Spring Smoothie, I think that's the one that comes up. And sometimes I put avocado in it as well, if they don't have an issue. I will share that link. You send that to me everywhere you're listening to this. I will be sure and share your link, Dr. Pratt. I know my website is a little perky today. It's gonna be fixed on Monday, but I think you can get to that. I think if you put that in. Anyway, oxalates, definitely an issue here, but do I wanna put him on a low oxalate diet? No, that would make him worse right now. What I wanna do is what we talked about. I wanna go after the fungus and help the microbiome. I wanna reduce oxalates, but not take them out completely. So then we get to mitochondrial markers and his lactic and peruvic looks pretty good to me, right? Would you say the same, Joe? And then we get to succinate. And succinate is in the Krebs cycle. And at the bottom of the, or not the bottom, but the midway point of the Krebs cycle is succinate. So he either is having more issues getting to succinate and some of the cofactors needed. It could be heavy metal, heavy metals slowing this down. It could be pesticides, it could be mold. It can be toxins, what I'm saying, really influence succinic acid. So if this were my patient, I probably would wanna run a tri-test. I'd also wanna run a GPL tox, which I think you might have actually done. I do. And while you're getting that, I can pull that and tell you if there's any big factors there. Okay. But in either which way, this is telling me that there's some significant damage happening to the mitochondria, which brings me back to his genes, which he has several genes, one of which is MTHFR Homozygous C677. Now everybody needs to understand that doesn't mean something bad necessarily. But in a case where I see a lot of oxidative stress, I'm thinking, oh, well, he does have a Homozygous C677 and that is slowing down his ability to detox. He also has CAT-CAT, which is heterozygous, which is very inflammatory. He's prone to inflammation and oxidative stress. So these toxins are influencing turning these genes on. He also has BHMT, which the more oxidative stress he gets, the more it can mess up his glutamate to GABA and his ability to manage his glutamate. And then let's see, ATM heterozygous is more, the more he's exposed to oxidative stress, that's influencing that gene. PEMT, the more he has gallbladder issues, he's prone to them, he's prone to fatty liver disease because of this PEMT. You do good on choline, right? Some choline stuff. And so choline might be helpful to help with methylation and also help with fatty liver, but also eating a lower carb diet is pretty important for this individual for the risk factors that they have. But foot two, again, he's Homozygous as well, also low in those lactobacillus species. And eventually we probably need to pepper that something like Zenbium Cope in there. And then what other, well, BCMO1, if you don't have enough vitamin A, that creates more oxidative stress as well. So I'm just looking out for the mitochondria saying, okay, there's genes at play here, that the more oxidative stress and the more toxins he has, which we know mycotoxins are one of those, all these bacteria are also producing toxins, right? And it's microbiome. So we wanna protect the mitochondria. And just a little backstory on, I just looked at the other test results. So he did a metals un-keylated. So we have tin and nickel that were moderately high. So that's interesting. We could look for sources of that. And then on the glyphosate, I think I told you it was above 75%. There was only one other toxin that was high and it was called acrolean, which can be from clostridia. Now it can be from gas, but I'm like, I wonder if that's from the clostridia in his gut that's actually producing that acrolean. Cause that's the only one that was really, really isn't the 95th percent per toxins. And then on the mycotoxin profile, there was very high ketomoclobosum, which is one of the worst of the worst. And also mycophanelogacid, which is immune suppressive, probably part of the fungal connection. So those are a little bit of other pieces. So we're not sure which or all or probably the medley of the bucket, that that sits in, that is making this mitochondria unhappy, but this shows me oxidative stress. Is that what it shows you, Jill? Absolutely, totally agree. And we have a little CoQ10 on board and after that fixes the whole problem, but it actually helps a little of that succinate pathway. CoQ10 would help that be 12, magnesium, selenium might help this a little bit and well, fully. Thanks, perfect. So what should I believe this is, is he vegan? Yeah. Okay. So probably need more because one, two, three, four mitochondrial markers out and then this number 32 is getting near the end there. So. So methylated bees, mag, CoQ10 and then maybe some changes in diet. We'll see about it. And choline and choline getting back to the choline. Okay. So now we're talking about neurotransmitters. Now Jill alluded to this or foreshadowed, there's clostridium at play. So it could be driving up his markers, right? HVA can be influenced by clostridia. He did not have a calm T-SNP. I was kind of shocked, like, okay. So it could be though that he's grown accustomed to feeling this much dopamine though. Yeah, yeah. Which I'd want to weed him down for that because what we know about high dopamine in too long of states is that it is actually, it works against us after time, right? This is. Brain damage, doesn't it? It causes brain damage. It causes cognitive decline. So, and we're seeing this in the gaming community, right? The kids that are the adults, the game for hours and hours at a time, their neurotransmitters look a little like this too, with or without clostridium at play. Or, I think we talked about this before, or they take quercetin. Yes. Screen T extract. Jill told us the last time Jill and I did this Facebook live, she told me she took five quercetin at one time. You probably came up here to meet this patient. You probably would have had a really fun mountain climbing experience or something. That's so funny, I have to tell you that. The rest of the story, so this is like a year or two ago when I had more estrogen and I had more dopamine. And I literally, I had an allergic reaction, which is also antihistamine. Like, oh, five. One's good. I forgot that I was a delicate flower. Yeah, delicate flower. And I always say, you know how like, when right after you get into car accident, you're just like literally internally just totally traumatized and shaking from that adrenaline rush. I'm driving home from work and I'm like, why am I so shaky? And like I felt it inside of me like this buzzing and I'm like, oh, the quercetin, it blocked the breakdown of norepinephrine and epinephrine. And I was like in this total adrenaline state, it felt horrible. It wasn't good. But what's funny now, Dr. Pratt, is I can take like the one, and I usually take one a day. And because I'm lower in neurotransmitters, the drenals are way lower now. The estrogen is lower. It actually helps. So you can use it at times in your life. It's all about balance, right? And so some of the things that like, this person should not take quercetin probably right now. Agreed. But what I don't like, what I really don't like is the quinolinic acid. That is a neurotoxin. It means that he's got, he's stressed enough and B6 deficient, right? Will also cause you to fall back from making serotonin, which he's looking for for that mal A and mal B. He really wants serotonin, but instead he's taking that tryptophan and tipping back into the chinearine down IDO1. And he's making both chinearic, number 40. See, that's pretty high. But the quinolinic acid is way too high. And that is a neurotoxin. Yeah. That's the one, that's the one on this whole, you see that high? I want to just emphasize, that's my most scary. I'm like, do not like that one. Cause that is literally neuro, it literally burns out the neurons, if we can say it in kind of a generic way. Yeah. Yeah. No, it's, and it can cause irreversible damage if it stays high for a very long time. So all my kids on stimulants or adults on stimulants, I run out organic acid to check quinolinic acid regularly on them to make sure we're not tipping, tipping into this. So when I see this, the first thing I want to do is give them glutathione, magnesium, B6, right? Again, to help that quinolinic acid breakdown. All right. But I will say shockingly, this patient does not have, it doesn't look like they're deficient in glutathione. But again, you said another marker showed you that clostridium was a play. I think this is driven by clostridium and the bacteria over. And what we're doing, and I love your thoughts on this, you can do obviously heavy hitter meds like metronidazole or vancomycin or the new deficit, but I don't like to go that direction. I will say there's some studies in children with pulse dose, THANCO or pulse dose. So if you can use that in this patient, we're using black human seed. And I'd love if you, and he can't tolerate a lot, but he takes a little bit every day. Any thoughts on other ways to help that clostridium besides all the stuff we've already talked about? No, I think kind of wanting to come back to just a little bit of bacillus. Yep. A little bit of spore-based bacillus and a little bit of saccharomyces. I agree. We're gonna try that next. But just a little. And then we just build up, we build up to a fourth of a cap. Perfect. And then I'd like to work on protein digestion where he does get protein and I want him to get more from it. Bitters would be a fantastic addition to help that gallbladder, to help that vagus nerve, to help reduce stress, right? But also help break down proteins and the proteins that he is getting from his vegan diet. Fantastic. So that was the cases. Wow, we just did a huge role in deep dive like we wanna do. If you're listening out there, I hope you enjoyed this. And what I love, I mean, if you have the biomeffects or you can get that or the organic gases, you can come back and listen to this because as you have your test, you can like walk through alongside what we just talked about and maybe get some things out of this talk. Cause we went deep dive like we would with a patient and Dr. Pratt, this is so fun and you're so full of knowledge and I'm so grateful not only for your wisdom but just that I get to call you a friend. Like what a blessing. Which we have to bring up our other friend who wrote a book on the microbiome for kids. She wrote Sarah Morgan. Take your screen down so you can see that. I wanna go to see that nice and big. There we go, yeah. So yeah, so Sarah Morgan, a dear friend of Dr. Kernahan and I wrote this amazing book for children to help them understand kind of what we talked about today, Rachel. Yeah, yeah. And it's Christmas time. Maybe get them a copy of Buddies in My Belly. It's a great book for little kids. I'll put a link there so you can get your buddies in your belly and again, great friend of ours. But what we loved is she brought, just such an entertaining story because if you wanna teach your kids and have them start eating some of these foods like the prebiotic foods and the fibers and stuff, you can start them really young and they'll be your best helper. I have a close friend who works in my office who beats her kids and she's like, okay kids, and they can't wait. They run into the kitchen to get their probiotic and their stuff and it's liquid. So they like take it on a spoon and she'd send me a video the other day. It was awesome because I was like, oh my goodness, this is so great because the kids are like, mom, mom, can we have our treat? You know, it's the medicine, it's the probiotics, it's the good stuff. So you can teach your kids really young to start doing these things. What a awesome, we've just dove right in and it was great. Leave your questions here. Go back and watch the other one we did on EMFs. And Dr. Fred, thank you. Let's leave one takeaway. What would be one takeaway for all of this, you know, one takeaway point that people can have for practical? Increase fiber in your diet. Feed your bacteria that what they want to eat. Like whether it's like a green banana and if you can't do that chicory and dandelion tea, if you can't do that bamboo shoots or hickama, some of these things can shift your microbiome within days if you start to eat more fiber. Love that. Hickama is my new favorite. I'll chop it up and put it in salads and like walnut, little strawberry, hickama. And so you can like throw these things in foods that you wouldn't necessarily, you don't have to eat a whole hickama. So love that. Thank you again for all your time today and your expertise. Oh, it was lovely to be here and it's always fun to share time with you, Jill.