 Leaky gut could be causing your depression, brain fog, and anxiety. And fortunately, there are some simple treatments like probiotics and gut supporting nutrients that can help fix the source of this problem. This is Dr. Ruscio, and let's discuss. Hi everyone, let's talk about the connection between your gut and your brain health. And this is admittedly a video I've been putting off doing for a while because there's so much evidence documenting this connection that it's... kind of a lot to get through, so I've been putting it off. But let's jump in and we'll go through the evidence in the following order. First, we'll establish that there's an association between leaky gut or problems with your gut health and depression, anxiety, and brain fog. Then we'll connect this to a mechanism and we'll finally show you what therapies are available to help you improve your gut health so you can improve the cause of things like depression, brain fog, and anxiety. So, starting, this study, I'll put the abstract up here on screen, major depression model induced by repeat and intermittent lipopolysaccharide administration, long lasting behavioral neuroimmune and neuro progressive alterations. So essentially, I'll just summarize for you here. In this study, this experimental study, they couldn't do this in humans because it'd be cruel to inflict harm and also unethical to inflict harm to humans. But unfortunately we can do this in rats and what was done in this study essentially was LPS or lipopolysaccharide, which is a fragment of bacterial cell walls, was injected into these mice and it was found or it was shown a correlation between LPS levels and depression. And so I'll come down here to the conclusion. Our results support the validity of the chronic LPS lipopolysaccharide model of major depression and additionally shows its translational relevance with respect to neuroimmune and neuro progressive pathways. So essentially what they're showing here is that when we inject mice with LPS, they have negative changes in their brain and LPS will become higher in humans when you have a leaky gut. So this is showing that if we essentially facilitate the same mechanism of leaky gut in mice, those mice have degenerative changes in their brain health. Now that's mice, right? I show you that just to show you the mechanism, but let's see what happens in more of a real world setting. So next study, fatigue, a distressing symptom for patients with irritable bowel syndrome. So those with irritable bowel syndrome, gas, bloating, constipation, diarrhea, loose tools, they will ostensibly have leaky gut or at least they have an increased prevalence of leaky gut. And in this study, a total of 160 patients with IBS completed a questionnaire and the conclusions from these researchers, fatigue is a distressing symptom which occurs in a sizable proportion of patients with IBS. It affects life in multi-dimensional ways with poor bodily stamina being the most prominent feature, fatigue along with sense of coherence or another way of saying brain fog, depression and anxiety need to be assessed, confirmed and targeted for interventions. So we're seeing IBS patients have more of these brain-based symptoms. Another study, intestinal infection associated with future onset of anxiety disorder results of a nationally representative study. So this study essentially looked at what happened to people's depression over, or anxiety rather, excuse me, over time and I'll come down here to paraphrase them, overall intestinal infection increased likelihood of later development of anxiety. So even more evidence and further yet still another study gluten-induced cognition or I'm sorry, gluten-induced cognitive impairment, brain fog and celiac disease and essentially skipping down to their conclusion. Thus, cognitive impairments associated with brain fog are psychologically and neurologically real and improve with adherence to a gluten-free diet. Now that isn't a model of those with celiac. We can't necessarily extrapolate that to say everyone needs to follow a gluten-free diet but it's certainly something to consider. Now, we've looked at the association between problems in the gut and brain fog and we hinted at the leaky gut mechanism before. Let's go over one or two more evidence points substantiating that leaky gut is kind of the cause or the underlying cause of these brain-based symptoms. Our self-reported gastrointestinal symptoms among older adults associated with increase intestinal permeability and psychological distress and their conclusion, older adults with GI symptoms expressed increased plasma levels of zonbulin, a marker of leaky gut, which might reflect an augmented intestinal permeability. In addition, this group suffers from high physiological distress, I'm sorry, high psychological distress compared to general older adults and senior orienting athletes. So we're seeing here fairly compelling evidence that in those with more psychological distress, there is a higher distribution of leaky gut in that population. Okay, moving on. Another study, increased zonbulin is associated with hyperactivity and social dysfunction in children with attention deficit hyperactivity disorder. And essentially coming down to the conclusion here, in this sample of children with ADHD, elevated zonian levels were associated with increased symptoms of hyperactivity and impaired or impairment of social functioning. So we see in adults, in older, I'm sorry, in children and in adults, we see this association, we see researchers able to replicate this in the lab with rats, and we see that those with IBS have a higher predilection toward these brain-based symptoms. So there's a fairly clear case here that if there's something wrong in the gut, it's going to connect to your brain. This is the gut-brain connection. So now what do we do? How can we take this understanding that problems in the gut can manifest as anxiety, depression, and brain fog, and then treat that? Well, fortunately, we have some evidence here showing that probiotics and gut-supportive nutrients can help. This first study here looked at the effect of probiotics and they found probiotics led to improve depression, anger, anxiety, and also lowered the stress hormone cortisol. So that is pretty compelling. Another study here, effect of probiotics on depression, a systematic review and meta-analysis of randomized control trials. So this is arguably our highest level of scientific evidence. To quote, we found that probiotics were associated with a significant reduction in depression, underscoring the need for additional research on this potential preventative strategy for depression. Another meta-analysis of 10 clinical trials looking at over 1,300 patients, and I wanna paint one important nuance here. So let me quote, there was no significant difference in mood between the treatment and placebo groups post-intervention. So after the intervention, the treatment of placebo group, there was no difference. So this is important, right? Because if there are people who are looking to be contrarian and say probiotics are complete BS, this is likely what they will study. But that would be a misrepresentation of the data. Because if you read further, you see a subgroup analysis of the studies conducted in healthy versus depressed individuals found significant improvements in the moods of individuals with mild to moderate depressive symptoms. So what this is telling you is that if your mood is fine, then you don't seem to get any happier or any additional improvement above a normal level. But if your mood is depressed, that's when the probiotics seem to have benefit. This would make sense. It's like saying that if we use a weight loss intervention in people who are at a normal weight, it doesn't show effectiveness. Well, that would make sense. These people don't need to lose any weight. But if we apply that same intervention to a group of overweight people, then we can see effect. So that's kind of the concept there. Now, another report here, a systematic review to quote, the majority of studies found positive results on all measures of depressive symptoms. However, the strain of probiotic, the dosing and the duration of treatment varied widely. Now that in my mind is actually a good thing. Researchers don't like this because researchers like to be able to say, well, this is the one strain of probiotic. It has to be used for this long. And this is the exact protocol you should follow. My feeling is that probiotics are not like drugs. They don't need to have a certain dose or certain duration. They're more of a global support for your gut. They can possibly impact your gut milieu. And I do not think that the strain is highly important, but rather I like patients to use the three probiotics that we've developed in our three category system so that you can personalize the probiotic protocol to your gut. I'll put a screenshot up here in the screen. Here are the three probiotic categories that I recommend. Allactobacillus bifidobacterium blend, a saccharomyces bilardi, and a soil-based probiotic. If you look at all the probiotic research, you can organize every formula that's been used in their research for the most part into one of these three categories. And they've all shown benefit. Now, not everyone will react well to every category of probiotic. So you can try all three at once, or if you're really sensitive and reactive, try one at a time. And keep using whatever formula feels good to your gut. If all three feel good, great. Now, instead of using just one probiotic, you're using three to give your body this nice, broad probiotic stimulus. For some reason, you have a negative reaction, which happens sometimes. It's wherever this happened. Then you can discontinue whatever probiotic seemed to not sit well with your system and then use the other one or two formulas. So moving on, another trial here, and this is very compelling, a randomized control trial with a placebo control arm, of course, found that probiotic administration in patients with major depressive disorder for eight weeks had a beneficial effect on the Beck depression inventory, essentially a questionnaire to assess depression. And then finally, another randomized control trial, finding that probiotics tend to make people happier. So some pretty compelling evidence there for probiotics. Now, I wanna also be careful to say that probiotics are not a panacea, they're not a cure-all, and you will see, unfortunately, nefarious marketing claims on the internet regarding probiotics. So I understand why some have urged caution regarding probiotics. For example, weight loss, you will see some probiotics marketed as a weight loss probiotic. There is documentation that probiotics can lead to weight loss, but the effect is very small. So that would be kind of a misleading claim to say, well, a research study found that probiotics can help with weight loss, true, but when you're looking at about two to three pounds in obese subjects, that's not really anything to write home about. It was mathematically significant, but it wasn't what I would call clinically meaningful. So the other treatment here that I wanna point out to you are gut-supportive nutrients. In this final study, normalization of leaky gut and chronic fatigue syndrome is accompanied by a clinical improvement, effects of age, duration of illness, and the translocation of LPS from gram-negative bacteria. So essentially, they assessed in a group of patients that serum concentration of LPS, that lipopolysaccharide that we discussed before. And they looked at the essentially LPS, the measure of leaky gut before and after, giving this nutrient cocktail, it's supposed to support the gut, including glutamine, enosidyl cysteine, and zinc. And what they found was there was a reduction in these markers after administration of this gut-supporting cocktail. So again, in summary, patients with leaky gut use a nutrient-supporting cocktail for a number of weeks when the leaky gut markers are retested, the leaky gut improves. So this is another therapy to consider adding in. Now, this always should be done after someone, or in conjunction at very least, with a healthy diet and lifestyle. So sleep, stress, exercise should all be attended to, and healthy diet is kind of a relative term. You could use a paleo-like diet, a Mediterranean-like diet, a vegetarian-like diet, if that's your preference, as long as you're focusing on whole, unprocessed, unadulterated food. Depending on what's going on in your gut, you may need to personalize that. I do give quite detailed recommendations for how to figure out what diet's best for your gut in healthy gut health for you if you need a resource there. But if you're struggling with depression, anxiety, and brain fog, remember that your gut could very likely be the cause. It's not a guarantee, but it's fairly likely, especially if you have digestive symptoms. And probiotics and gut-supportive nutrition can help with repairing your gut and thus remedying the cause of the anxiety, the brain fog, and the depression, your gut. So this is Dr. Ruscio, and I hope you find this helpful, and I really hope you act, because as someone who suffered with brain fog, I know how debilitating and unpleasant it can be. Don't go another day not feeling conditively normal. Take these simple steps to improve your gut health and improve your brain health, and then be able to be happier, more engaged, and sharper in your day-to-day life. So again, I hope this was helpful, and we will talk to you next time.