Jun 12, 2018
In today’s episode, Dr Nirala Jacobi welcomes back Dr Jason
Hawrelak, to talk about Microbiome Restoration.
Dr Hawrelak is a researcher, educator, naturopath, and
nutritionist with over 16 years of clinical experience. He
also practices at Gould’s Natural
Medicine - a 135-year-old natural medicine apothecary and
clinic in Hobart, Tasmania, Australia.
Dr Hawrelak completed his PhD examining the capacity of
probiotics, prebiotics, and herbal medicines to modify the
gastrointestinal tract microbiota. He is the senior lecturer
in Complementary and Alternative Medicines at the University
of Tasmania’s School of Medicine where he coordinates the
evidence-based complementary medicines programs. Dr
Hawrelak also teaches the gastrointestinal imbalances unit, within
the Masters of Science and Human Nutrition, and Functional Medicine
Program at the University
of Western States, in Portland, Oregon.
Topics discussed include:
-
The SIBO Doctor courses
- Regrowing vs killing in the microbiome.
- Colonic collateral when we are dealing with SIBO, and the
necessity to restore the colonic ecosystem as part of the SIBO
treatment.
- How do we learn to interpret the DNA readings and PCR reports?
- The SIBO Doctor Microbiome Restoration course
- A discussion of the modules offered in the Microbiome
Restoration course
- Module 1 - Testing
- The difference between different labs
- Culturing vs DNA techniques
- Assessment, Interpretation, and Diagnosis
- Module 2 - Beneficial Bacteria, including
- Akkermansia
- Faecalibacterium prausnitzii
- Butyrate-producing microbes
- Hydrogen sulfide gas producers
- Module 3 - Pathobionts
- The good, the bad, the ugly
- Hydrogen sulfide producers
- Methanobrevibacter smithii
- coli
- Bacteroides
- Triple antibiotic therapy (for conditions such as H. Pylori and
Blastocystis Hominis) and the impact on the colonic ecosystem
balance of symbionts and pathobionts.
- Dietary changes vs probiotic supplements to elicit change in
the gut microbiome.
- The complications between advising prebiotic nutrition for
optimising microbiome restoration, whilst clients are on
therapeutic diets such as the Low FODMAP diet - how to
reconcile?
- Hydrogen sulfide breath testing - coming soon.
- High-fat content diets in SIBO, and how this can eventually
feed hydrogen sulfide producing bacteria.
- Symptoms such as food reactivity and visceral sensitivity as a
consequence of dietary choices in SIBO treatment, in regards to
hydrogen sulfide producing bacterial blooms.
- The therapeutic benefits of Soy Isoflavones in relation to
Methane and Hydrogen Sulfide producing SIBO patients.
- Equol producers - patients who have bacteria that convert soy
isoflavones into the bioactive component, Equol.
- Adlercreutzia levels in people who eat soy products as a
long-term dietary choice.
- Is there a connection between histamine intolerance, salicylate
intolerance, and oxalate intolerance and microbiome
disturbances?
- Post SIBO treatment food sensitivities - the colonic microflora
patterns to observe.
- Hydrogen sulfide gas and how it causes visceral sensitivity,
gut leakiness, and inflammation in the nerves.
- Dietary changes with people with sensitivities - a reiteration
of start low, go slow.
- Is there any clinical significance to oxalobacter formigenes
being elevated?
- What is the dietary impact of the extinction of oxalobacter
formigenes?
- Testing levels of Proteobacteria to uncover the innate
endotoxin load (proteobacteria - gram-negative bacteria that
secrete proinflammatory endotoxins).
- The systemic repercussions of endotoxemia - leaky blood-brain
barrier, gut damage, insulin sensitivity impacts, systemic
inflammation, Alzheimer's, anxiety and depression links.
- Endotoxin (also known as Lipopolysaccharides - LPS) absorption
and high-fat
- How do different Phyla respond to different diets?
- Potential outcomes of the ketogenic diet depending on the
dietary nuances - decreased microflora diversity, increased
hydrogen sulfide gas-producing bacteria, and increased numbers of
proteobacteria.
- Akkermansia and constipation - why are these often seen
together?
- Gut inflammation and mucus tend to increase Akkermansia if it
is there - it is a mucin eater.
- Gut markers of inflammation, such as calprotectin.
- The vocabulary to use around probiotics - not re-seeding, but
rather restoring.
- The importance of lactic and acetic acid production adjusting
the pH of our microbiome to be hospitable to beneficial
bacteria.
- D-Lactate considerations.
- Biogaia effectively reducing methane production, and also being
used alongside proton pump inhibitors (PPIs) to prevent the
development of SIBO.
- PPIs - when to use and when not to - listen to
Dr Steven Sandberg-Lewis’ podcast on SIBO and Functional GIT Exam
Skills.
- Plantarum LP8 is being used in research to decrease
Desulfovibrio, increase butyrate and bifidobacterium - can we use
other strains of L. Plantarum to elicit similar changes?
- Plantarum strains to use in gut rehabilitation.
- Reuterin production.
- Dr Hawrelak’s antimicrobial and dietary recommendations for
treating Desulfovibrio.
Resources
Dr Hawrelak
The SIBO Doctor
Microbiome Restoration Course with Dr Jason Hawrelak [Opens 13
June]
The SIBO Conference New Orleans - speakers mentioned
- Dr Richard McCallum
- Dr Matthew Bohm
Labs mentioned
Dr Satish Rao
- SIBO and comorbid SIFO
- D-Lactic Acidosis researcher
Dr Steven Sandberg-Lewis