 Hey everyone, this is Dr. O'Shoh. Let's discuss what to do if you go gluten-free, but you still don't feel any better. Really, one of the first things that you should do is investigate if there's dysbiosis in your gut. Dysbiosis is a general term that means imbalances in bacteria, fungus, or some of the other life that lives inside your gut. Now a recent study looked specifically at how much fungus those with celiac disease have in their gut compared to how the controls. And I'll put this study abstract here in the screen and give you a few quotes here. That's at 45 celiac patients versus controls. And they detected that the patients with celiacs, 33% of them had Candida type of fungus, whereas only 0% of the controls had it. And for Saccharomyces, another type of fungus, 33% was found in the celiac group, and only 10% was found in the controls. And there was also no difference in any of the parasites that were mentioned. So what this shows us is that there is significantly more of different types of fungus in the gut of those with celiac compared to how the controls. Also that the amount of parasites between celiac and those with controls is actually the same. Why this is important is sometimes, especially at certain circles on the internet, you get this narrative that parasites are the underlying cause of everyone's problems and especially gut problems. And if you can't improve your gut problems, it's because you can't clear this parasite that just can't be found and can't be tested and can't be eradicated. And I think that that's an erroneous assumption. It was something I think from several years ago that was a well-intentioned thought, but it's really not something that is bore out in my clinical experience nor is highly reflected in the research literature as we see here today. So those of celiac have more fungus. So what does that mean? Or why does that happen? It likely happens because of two general reasons. One, when you have celiac, and we can potentially make this argument for also non-celiac gluten sensitivity where people have an intolerance to gluten that's not a full-blown autoimmune response as there is in celiac. So when you have this intolerance to gluten, it's going to do two general things. One, damage your intestinal cells and that damages the immune system in the gut that makes it harder for your immune system to regulate things like fungus and bacteria. Also, when the intestine is damaged, it can't secrete as many enzymes needed to break down carbohydrates. And when you don't break down carbohydrates, they're left kind of lingering in the gut and then the carbohydrates feed bacteria and fungus in the gut. So if your intestines don't break these things down and then allow you to absorb them, the carbs hang out in the gut, feed bacteria and fungus, and the bacteria and fungus overgrow. So what should you do? If you've improved your diet, you know, now taking gluten out of your diet is not the only thing. You want to have a generally healthy diet that's devoid of processed foods, artificial sweeteners, added sugars, and focus on fresh whole foods, healthy meats, healthy fats, vegetables, fruits, maybe some grains if you don't have any problem with grains. If you've done that and you're not feeling any better or you're only feeling slightly better, one of the next things you should do is have a thorough evaluation for any type of imbalance in your gut, including dysbiosis. Dysbiosis could look for small intestinal bacteria overgrowth via a breath test and things like fungus, which can be tested via saliva, blood, or stool. And then if there is an imbalance, treating that according to some of the clinical literature and certainly in my clinical experience can certainly help you. So it's not the only thing to do, but it's one of the next things to consider should you go on a gluten-free diet and not notice that you feel much improved. So great study here that shows that those with celiac, and I think this would also apply if we do this study on those with non-celiac, gluten-sensitivity to some extent, have an increased level of fungus in the gut, something to consider if you've changed your diet and you're still not feeling much better. This is Dr. Ruscio, and I hope this information helps you get healthy and get back to your life. Thanks.