About Michael Ruscio, DC
Show Notes
03:15 Maybe 20% of us have IBS. About 40 to 50% of us with IBS have SIBO. Hypothyroidism impacts 2 to 3% of the population.
04:07 Some of us are diagnosed with thyroid issues when it is actually a gut issue. This is due to somewhat fictitious lab ranges and the pursuit of various medications. Fatigue and mood disruption associate to IBS or thyroid.
08:45 Some of us on thyroid meds will poorly absorb the medication, possibly because of an ulcer or H. pylori. By correcting the GI issue, patients see a stabilization of their TSH and have a reduced need for the dose. Almost all of the supplemental thyroid hormone is absorbed in the small intestine.
09:32 Those of us with SIBO have a slightly higher risk of thyroid autoimmunity.
10:37 Your liver and gut play a role in converting T4 into active T3. About 10% of patients do not respond adequately to T4. There could be genetic or lifestyle/dietary contributors to this.
14:03 SIBO/Small Intestine Bacterial Overgrowth is too much or not the right type of bacteria in the small intestine.
14:17 The small intestine is where the largest density of immune cells from the entire body reside. It is where 90% of caloric absorption occurs. It is a primary spot for nutrient absorption. It is most susceptible to leaky gut.
14:57 The SIBO breath test tells you if there is too much gas and thus too much bacteria. It does not tell you what bacteria.
15:47 Most of the bacterial overgrowth is from the upper GI, a study discovered.
16:15 Hypothyroidism is predominantly an autoimmune condition. Only 9 to 19% of those who have thyroid autoimmunity become hypothyroid.
17:07 There is an overlap to potentially having autoimmunity to the cells of the stomach that produce hydrochloric acid, in those with thyroid autoimmunity.
17:19 About 20 to 30 percent of those with full blown hypothyroid may also have diminished stomach acid secretion, opening the door to SIBO.
18:03 If you are over 65, have Hashimoto’s hypothyroidism and have a history of anemia, you have a 50% chance of doing well with HCL. If you don’t feel better, discontinue use.
18:53 The antibodies in the stomach are called antiparietal cell antibodies.
20:13 The leaky sphincter hypothesis: Sphincter dysfunction is a symptom of inflammation or dysbiosis.
27:42 Measuring gastrin is a useful, but imperfect marker. H. pylori infections or PPIs can skew the results.
28:20 Don’t just treat labs. Health history, symptoms, presentation, response to therapy and lab markers collectively should be used to make an informed decision.
31:01 A low diversity score may be found on someone with IBS or IBD. However, the lower diversity is likely a result of inflammation and an aggressive immune system. Increasing diversity may not be beneficial.
34:07 Those of us with IBD/IBS seem to respond well to a low FODMAP diet and those of us with IBD respond well to elemental diets (liquid diets with no fiber). IBD/IBS patients report responding poorly to fruit, raw foods and fiber in their diets.
35:08 Diversity is the end result of the immune system. Bacteria feed on prebiotics and fiber. Those of us with immune imbalances flare from prebiotic and high fiber foods.
38:12 The claim that healthier people have more bacterial diversity, is observational correlating. Cell data and animal data are the lowest quality. Next is observational data, then a single control trial, then a meta-analysis or systematic review.
41:07 SIBO can interfere with the function of bile. Dysbiosis creates symptoms that look like issues with bile. Supplemental bile may help, but does not treat the cause.
42:12 Bile acid malabsorption can cause bile acid diarrhea. If there is inflammation in the terminal ilium or SIBO, bile is not reabsorbed.
43:07 Thyroid hormone supplementation suppresses the need for the gland to make hormone and lowers antibodies. Perhaps the gland can then work on repair. The same may be true with higher dose bile supplementation.
44:27 Helminth therapy results in adult patients have not impressed Dr. Ruscio. He tests his patients for parasitic worms, but they are uncommon.
46:37 FMT/Fecal Microbiota Transplant Therapy shows a notable positive effect upon IBS/IBD in many studies. Work with someone who is experienced.
50:07 FMT is viewed as an end of the line therapeutic.
51:37 Testing is the least important thing, not the most important. Testing can take you down incorrect paths and may do more harm than good.
54:05 A SIBO breath test can be helpful. Dr. Ruscio uses Aero Diagnostics glucose or lactulose.
55:42 Stool Testing: The Doctor’s Data stool GI 360 stool test tests for pathogens and functional markers as well as a dysbiosis index is Dr. Ruscio’s favorite. GI Map from Diagnostics Solutions uses DNA testing, and runs the risk of false positives.
59:07 Probiotic supplementation can help with upper respiratory tract infection prevention and shortens the duration. Try a good probiotic protocol with a good safe brand and see if you find improvement. Find your minimum effective dose.
01:02:37 We should all be nose breathing as much as possible.
01:03:22 With the Corona virus, it is not just about being exposed, it is about the duration and density of the exposure. Masks may have a benefit in the setting of a public place where you cannot socially distance for a substantial period of time.
01:04:07 Herd Immunity: It is viable to let the virus run through the population to develop herd immunity and the protect vulnerable.
01:06:27 Immune development of children is likely being compromised by lack of exposure to other children and the outdoors. There is a window for immune development in children.
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