Do I have leaky gut?

Is Leaky Gut My Problem? [Podcast Episode #081]

Leaky gut is a syndrome caused by damage to the lining of your intestinal wall. It's not generally recognized by physicians which can cause confusion...

Are your symptoms - bloating, gas, cramps, stomach upset, and even weight gain - due to leaky gut, or is there another explanation?​ Today we'll discuss how to accurately diagnose your own health issues and what treatment may work best.

Episode Resources:

Is Leaky Gut My Problem? [Full Text]

Dave Smith: Hey, thanks so much for joining me in this episode of the Make Your Body Work Podcast. As you know this show is all about helping you live a healthier and happier life. I said this before, but I really do want to say it again, thanks for taking a few minutes out of your day to invest in your health.

As we approach today's topic, because before we get into it I'll tell you my guest today, she is so passionate about this topic and is so full of information. We are going to cover a whole lot, so my challenge to you as you listen in is to think about what's that one thing that applies to you? What's one piece of advice, one golden nugget, one action step that you can take away? Today's question, it was a great one from the Nadine I'll dive right in.

Nadine wrote in she said, "Even though I eat relatively healthy and exercise regularly, I battled weight for years, recently, say in the past five years I've developed," she puts it in quotes, "princess stomach, that gets upset or bloated all the time. I was telling my friend about it and she suggested leaky gut could be the problem. I did some research and I'm not really sure what to make of it. Is leaky gut as common as people say?"

Nadine, thanks for writing in and we're going to talk specifically about leaky gut, today. We're also going to talk about autoimmunity, we're going to talk about all sorts of digestive issues.

The symptoms that you might be experiencing and Nadine, you alluded to a couple of what we're going to go into even more depth. We're going to talk about what are some specific steps that anyone that's going through digestive problems and that inability to lose weight. What can you do?

Because that's what it's all about, what action steps can you do that are going to actually give you some progress, give you the results you're looking for. I have an amazing guest and like I said, she is a real spark plug and just full of information. I'm really excited to introduce to you Doctor Susan Blum.

Meet Dr. Susan Blum

Dave: Hey, Doctor Blum, thanks so much for joining us on the show, today.

Susan Blum: Thank you for having me. I'm thrilled to be here.

Dave Smith: You know, just before we started recording here we were talking about all the work you're doing, and all the resources you're putting together, and it made me more and more excited to have you here to answer this question, because you are the perfect guest to talk about digestive issues. Maybe you can tell the audience a little bit about what your history is and what it is you are doing or you're focusing on right now.

Susan Blum: Okay. Boy, I'd love to do that. So, let's see. I am a physician. I will start with that. I'm a physician and I'm the founder and director of a big health center back east. So, in New York I have a health center, where we focus on functional medicine.

My background is in preventative medicine, that's what I'm board certified in, but I took a left turn and I started really trying to dig into nutrition, and stress and mind, body medicine to understand the foundational root causes of what really causes illness and that led me to functional medicine, as well as mind, body medicine, because I really love that, too.

The importance of understanding how stress comes into our bodies to effect our health. You know? I got lucky enough to be able to find this field about 15 years ago. I've been doing this a long time compared to the movement that's underfoot now to integrated medicine, alternative medicine whatever language you want to use.

Functional medicine has really found its day in the spotlight, because functional medicine, which is, a quick definition is rather than just treating your symptoms we're trying to figure out the cause, like what's underneath, how you got here.

The saying goes if you're sitting on attack, the answer is to not aspirin, but to find the attack and remove it. Right? We're always looking for the cause, especially for complex chronic illness, which is really one of the most difficult things to treat in conventional medicine.

If you want to heal, you need to treat the root cause of your illness, not your symptoms

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Your doctor just gives a pill to feel better, but the underlying inflammation is still there, so functional medicine offers a whole approach to how to find those attacks, and find those triggers. By doing this work and actually if we read my book, I developed an autoimmune disease called Hashimoto's, and it's a very, very common thyroid condition.

My work treating myself and figuring out my own Hashimoto's with the functional medicine approach taught me so many amazing things and after curing myself I ended up using it at my practice, working with a lot of people then I wrote a book on autoimmune disease. I guess, that's the quick sort of way to get there.

The things I learned about the foundational causes of inflammation in the body, and the things that trigger the immune system, which are actually foundational to most complex illnesses that we have are food, stress, gut health, which I know we're going to talk about a bunch today, and something I'm very, very passionately interested in and I do a lot of work in with my patients, gut health, and then of course toxins.

Living in the toxic soup we're in, what can we do to protect ourselves and sort of reduce our toxin loads, so that it doesn't damage our immune system. Functional medicine not only helps us identify what might be your cause, or what might be your trigger, of your immune issues, but it also offers tools and an approach to treating people, so that we can actually reverse this. You know? We can fix the gut and then the immune system gets better.

Dave Smith: You know what's really neat? And, I'd say this is true for a lot of the guests that I have on the podcast is their specialty or their area of focus stems from a personal experience. When you started talking about your own personal experience, so when you started talking about your own personal experience, now that's become part of your passion, right now, I'm not surprised. I think that's awesome.

Susan Blum: I know. I'd have to say that I agree with you and doing this for a while I pretty much know everybody out there, my colleagues, we go to conferences together and hands down the majority of us working in this field found our way here because of our own health issue.

I think that's fantastic, because that gives us the end of one, as we say in science, it's this study of one, we know that it works, because we did it on ourselves, but I think it's really important, it brings a lot of compassion and understanding to the work we have when you're working with someone, because, hey, look I did this.

I know it's hard. I know it takes a while. I know sticking to a food plan you wish you didn't have to do that, I wish I didn't have to do it, but I know how crummy I feel if I don't follow sort of eating this way. It really gets, I think its an important compassion, and relatability and it allows me to support my patients better, but it definitely feeds the passion, for sure. I agree with that wholeheartedly. Yeah.

Finding Your "Ah-ha!" Moment

Dave Smith: I agree with you, and personally speaking, and my audience they've heard this a million times, but I've gone through horrible digestive issues over the years.

Susan Blum: Yes.

Dave Smith: Really have gone through experimentation process to figure out what foods work and, which don't and when I started I remember specifically someone suggesting to me to take dairy out of my diet. My answer to them, you probably hear this all the time was, "I cannot take dairy out."

Susan Blum: Yeah.

Dave Smith: I love dairy.

Susan Blum: Yeah.

Dave Smith: Having gone through it and realizing for me what a change, a positive change it was, and now I think, oh, jeez I cannot imagine drinking a glass of milk.

Susan Blum: I exactly know what you mean. You probably inspire a lot of people, because of the work you do and because of the work you've done on your own health. I think that's the best we can do is try to inspire others for change, because change is not easy, so what I try to do is, especially when it comes to food, like for example the dairy, your dairy story, I try to invite people to do an experiment.

Like, asking you to, if you knew in advance that you were not going to be able to eat dairy the rest of your life, so dramatic like that, it would feel very overwhelming.

To ask somebody to just, can you imagine not eating dairy for three weeks? It's just an experiment, what do you think? To see whether or not you can do it and I think anybody can do an experiment for a few weeks.

My goal is always to do these experiments with people and to invite them to sort of create their own ah-ha moment. Right? For you, you had this ah-ha moment because you realized that dairy wasn't good for you, and you felt it, and you knew it, it wasn't me telling you not to have it. Right?

Dave Smith: A 100%.

The best way to know what works for you and why it works is to experiment. Test, test, test

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Your Experimentation Process

Susan Blum: Right. As a physician, I see myself as more of a facilitator, guide. My job is to facilitate and to help sort of meet people where they are, and encourage and give a lot of education.

I mean, I spend two hours with my initial people when they come into see me because I'm doing so much education, and discussion and explaining, to help bring them along and inviting the experiments, because if I can help someone feel better, initially, learn to understand that changing their diet they feel better and then even with the experiment goes into two parts.

Actually, you remove the food for three weeks, and then after three weeks you reintroduce each food you removed one at a time, very slowly and you see if it triggers a reaction.

Sometimes people don't know whether they feel better when they remove the foods or not, sometimes people will be like, "I'm not really sure I feel better, or I feel different," but then when they eat the food it triggers a whole bunch of their symptoms and they have this ah-ha moment, I call it.

I think that in helping people have that ah-ha moment, and make that connection between food, and how they feel that's how you stick to it. You know? Like, for you, like you just said about dairy, now you can stick to it, because you know what it does in your own body.

Dave Smith: Yeah. I can tell already, we've only been talking for five minutes and I can tell that are philosophies are so similar, because that ah-ha moment is going to be stimulated by something different for everyone, so-

Susan Blum: That's right.

Dave Smith: Everyone listening you don't necessarily need to go off dairy, but that experiment might be worth your time.

Try this 3-Weeks Elimination Diet

Susan Blum: That's right. I do want to say another thing for those people who listening that might want to do a little experiment, if, which on the food topic, and if you have digestive symptoms of any kind and this is reflux, IBS, noisy, gassy, gurgley tummy, any kind of gas from flatulence or burping, acid indigestion, you know, you name it.

The very, very first thing you do instead of eating what you want and then taking a purple pill, or a Zantac, or something like that, which we know there's so many studies about the long-term negative health consequences of taking those medications.

The very first thing is food and I would say two, thirds of people you could fix your problem by changing your diet. It's not like the acid reflux diet, it's what we call an elimination diet to figure out which foods are the culprit.

The classic elimination diet, which I'm going to tell you, so you can do this yourself is just like I said, for three weeks you're going to remove a little list of foods, and then you're going to see if you feel better and then you're going to reintroduce them one at a time.

The biggest culprits are often gluten and dairy. Here's my other analogy with the attack, some people try to negotiate with me and like, wow you think I can just do only one, it's too much I cannot do gluten, dairy, soy, corn, and eggs that's like five things, that's too much it sounds overwhelming.

But think of this, if you're sitting on five attacks, let's say you have five different foods that are probably, and you're sitting and using my analogy of the attack, you're sitting on five attacks, if you only remove one of them you're not going to feel better, because you still have four other attacks you have to remove. Right?

It can be misleading if you're only remove dairy and you say, "I feel fine. That didn't do anything. I still don't feel good," it could just mean that you also need to remove a second food. I really encourage people to do the experiment this way, remove all five, which is gluten, dairy, soy, corn, eggs, three weeks.

After three weeks you introduce one at a time every three days to see if any of them trigger symptoms and you sort it out that way on the reintroduction, not by eliminating only one at a time. If you can only do two, then do gluten and dairy, but every new patient that comes into Blum Center for Health they all get the, unless they are really too stressed and it feels too difficult then we'll renegotiate. Right? We have to meet people where they are and that's okay, but I encourage people to do all five as part of the experiment.

Dave Smith: Which, when you describe that it does sound like a little bit of work, but it all depends on what symptoms you're facing, because for someone that has maybe a little bit of gas and they burp a little bit after a meal or whatever, that might not seem powerful enough of a motivator to go through that process and actually try to eliminate these foods.

But when you talk to someone like Nadine who wrote in and she says, "I've been battling weight for years, I have all these stomach issues," she uses the term, she's got a princess stomach. When you get into these more serious symptoms, then it is worth it. All you're asking for is three weeks of experimentation.

What's Happening to My Immune System?

Susan Blum: That's right. Especially if someone has, if you have significant digestive issues you really need to do this to see if you can feel better. The other thing is to know whether you need to do this is if you're taking antacids, you're taking Tums, you're taking Zantac, you're taking Prilosec, Prevacid, any of those things, that's how you know that it's bad enough that you need to figure out if food could be a culprit for you.

Dave Smith: Mm-hmm (affirmative).

Susan Blum: What if you could fix it with your diet, and you didn't need to take any of those things? Our society, we have such easy yummy sugared, you know, dairy is addictive, there's all sorts of compounds in there that trigger the cravings, there's actually sort of brain active substances in dairy that some people convert in their brains and it makes them feel good, so there's actually reasons why people don't want to give up dairy.

You can fix the vast majority of your health issues by changing your diet. Fix it with food

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I understand, but if you are suffering and you have gut issues, and here's the thing, and I'm going to circle us back to immune health, 70% of your immune system lives in your gut.

Right below the intestinal lining lies, all this, 70% of your lymphoid tissues, which is where your army, which is your lymphopoiesis that help you fight the invaders that might come in. Right? Are all lining your intestines, and you have 100 trillion bacteria that coat the surface, and then you have the cell lining, which is the epithelial cells and right below that is your immune system.

The bacteria in your gut, talk to your immune system, it's the singlest most important place where your immune system develops, you either have a healthy immune system or an unhealthy immune system.

What can happen to your immune system? You could just be getting sick a lot. Recurring illness, viral illness is just not working good. You could end up with sort of an over active allergy, asthma kind of situation, and you could also end up with autoimmune disease.

Autoimmune disease is one of the most prevalent, complex inflammatory conditions that we have right now on the rise and it's an interesting field autoimmunity, because there's not one specialist, that autoimmune diseases can be in many different specialties, so it hasn't had a very unified approach. Right?

Because if you have MS you go to a neurologist. If you have a thyroid, autoimmune thyroid you go to an endocrinologist. If you have rheumatoid arthritis, or lupus you go to rheumatologist. Right? It's split up.

It's a little behind in really having its day in the sun of really making a singular approach to working with all autoimmunity, because at the end of the day repairing your immune system is part of the healing your gut. Right? In order to have a healthy immune system you have to heal your gut. Let me say that the right way.

Dave Smith: Mm-hmm (affirmative).

The Truth About Stomach Acid

Susan Blum: That's one of the main triggers, so I'm circling back to this whole thing about if you're taking antacids, or if you're lowering your stomach acid by any of those pills we talked about and you're using that to control your symptoms, you're actually causing a major change in your gut microbiome.

We call it downstream, your mouth, you have like a river, your mouth goes to your stomach, you know your esophagus, your stomach, your small intestine, large intestine, and then out of your body and it's like a river. It all flows in one direction.

Your stomach is supposed to have a Ph of 1.5 in acid, a very strong sterilization compartment, so that when you eat sushi with all those live little things swimming around, you sterilize it and kill it. When you eat food that has a little mold on it, it sterilizes it.

Not only that, that PH, that acid goes into your small intestine and sets up sort of the environment for the rest of your, all the bacteria that live in your intestines, because the good bacteria love an acid environment and the weeds that might overgrow in your inner garden, as I call it, they get killed by the acid, so the acid prunes your inner garden.

Without that acid you can get what we call dysbiosis, which is an alteration in your gut flora, and that can cause something called leaky gut, which is when the barrier function of your gut isn't intact as it needs to be and there are little holes in your whole lining and that's when your immune system starts being exposed to all the contents of your stomach and bacteria in there and that's when autoimmunity can develop.

We really, really want you to not have any of those upper digestive symptoms and take those Proton pump inhibitors and those antacids. We want you to have a healthy gut.

Dave Smith: If I can just jump in there, because you brought up leaky gut and that goes right back to Nadine's question and she says, "All my friends suggested to me that maybe it's leaky gut-"

Susan Blum: Yes.

Dave Smith: Are there specific symptoms that someone would recognize if they actually did have leaky gut?

The First Symptoms of Leaky Gut

Susan Blum: Yes. I sort of just explained what it is. Right? Leaky gut is increased intestinal permeability, normally there's supposed to be a firm barrier between the contents of your intestine lumen and your body, right, there's a barrier, a wall.

If there's holes in that wall there's something called tight junctions that get leaky and then you can get the contents coming in, and the most common thing that people experience is probably sort of this general symptoms like, well, there's symptoms and then there's diseases, so autoimmunity is associated with leaky gut, for sure, but symptom wise I would say food sensitivities, because this is how you develop food sensitivities. Right?

You're digesting all your food and the little pieces of food leak into your body, you're not supposed to see pieces of food like that, your immune system in your blood stream shouldn't see pieces of food like that, and so this is how people with a really bad leaky gut have a lot of food sensitivities.

What does it mean to have a food sensitivity? It's when you eat certain foods you can develop sort of, that's the brain fog, and I just don't feel good, and I'm tired, and I cannot concentrate, so it's that general sort of cannot explain what's wrong with me, but I don't feel good. You know?

Fatigue, brain fog kind of stuff is sort of the classic food sensitivity, systemic, low grade inflammation that you get from leaky gut. Then, as it gets worse, that's when the immune system, if it goes on for too long the immune system stops working properly.

It just is too overstimulated by all of the on slot of what's coming in through the leaky membranes. The immune system starts becoming, I call it, dysfunctional. I wouldn't say it's over active or under active, it just stops working right.

What does that mean? It means it might turn on and then it doesn't turn off. It might mean that one part of the army of the immune cells are working right and another part isn't.

You might start getting sick a lot or you might develop autoimmunity, but the immune system is really at risk for not working right as well as sort of ongoing inflammatory conditions, like arthritis for example. My next book that's coming out at the end of this year is on arthritis.

Arthritis, all my gosh, I just spent the past four, or five, six months reading all the, reviewing all the literature on the gut, and the leaky gut, and arthritis, and the microbiome and the importance of good bacteria.

There was so much research now, I mean, it's exploded in the past five, six, seven years on the whole gut and the relationship between gut health and systemic inflammation, so if you have joint pain, any kind of arthritis you have to really tend to your gut.

You have to go and take a look and see what's going on, because it's that important, I've created this really great online program to help you sort it out and there's a whole questionnaire and the other thing is not only is my online program good, it's a, but I wrote a book, The Immune System Recovery Plan, step three is repair your gut. That's been out for four years, we're actually rereleasing it in hardcover February 21st.

It's still coming back out and I wrote a three-month guidebook, the second edition of the book has a three-month guidebook to take you step by step, by step to repair your immune system, but in the book are all these assessments.

Do I have leaky gut? Do I have dysbiosis? What do I do about it and a whole treatment plan. I've really worked very hard to help people, because I know who important repairing the gut is for overall health.

What changes are you willing to make in order to start your own healing process?

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That's a very long answer for your question about the leaky gut, but remember food always comes first. See how far you get with food and if the food doesn't help take care of your symptoms then you have to consider that your gut flora is not in good balance, that you either have an overgrowth of weeds in the garden, or you don't have enough of the good stuff.

The weeds could be yeast, like candida. It could be parasites. It could be too much of the good bacteria. This condition called small intestinal bacterial overgrowth. I don't know if you've talked about that on your show.

Dave Smith: Just in general terms. If I could just jump in here really quickly.

Susan Blum: Yeah.

Dysbiosis: An Imbalance of Gut Flora

Dave Smith: I want to mention to the audience, because you've gone through a lot of very valuable resources, so for the audience, if you go to, eight, one, I'm going to have links to Doctor Blum's website, as well as to her book, and her Facebook group and I know just some of the stuff we've been covering really quickly, but you can definitely read more about it there. I do want to ask a specific question, if we can just stop on the leaky gut for a second.

Susan Blum: Yes.

Dave Smith: You talked about brain fog. You talked about fatigue. Then, you said those are sort of like the initial stages. Are there symptoms that start to appear as leaky gut becomes more problematic or more present in someones digestive system?

Susan Blum: Yes. I would say that's when you might start experiencing inflammations. Like, all of a sudden you have plantar fasciitis. All of a sudden you have an achy joint.

You have leaky gut and you don't even realize it and you have no symptoms until your doctor does a blood test and tells you, you have Hashimoto's thyroiditis, or another autoimmune condition.

I think systematically it's any kind of inflammatory condition and I think we all notice it in our muscles and joints. If you're getting really sore, although post exercise I wouldn't say that would be my first thing in terms of the soreness from after exercise is not the same as having something like fibromyalgia, where you have tenderness in your muscles, all the time. You know? I'm saying exercise that's not leaky gut. Right?

Dave Smith: Mm-hmm (affirmative).

Susan Blum: It's more conditions where you have sort of pain and swelling somewhere in your body. Like, a joint or a muscles. That's when you know, or out of the blue your doctor tells you through blood testing that you have an autoimmune condition, or your thyroid, you have an autoimmune thyroid condition.

I think that's probably the first thing in terms of knowing you have a leaky gut, but we're skipping over actually gut symptoms. Right? That's systemic symptoms for a leaky gut, there's also digestive symptoms. The woman that called in, she talked about princess belly, I think that means feeling like you're pregnant, like a bloaty kind of belly after you eat, I'm not sure what that, I've never heard that term before.

Dave Smith: I've never heard it before. I was hoping you'd be able to tell me.

Susan Blum: I will say that there's a condition called SIBO, small intestinal bacterial overgrowth, which is too many bacteria in the small intestine and right after people eat they experience feeling, within the hour, like the first hour after eating, a lot of symptoms like a noisy, gurgley tummy, but also feeling like they're pregnant.

I've got women who come in and say, "Oh. My God. My belly I look like I'm pregnant a half hour after I eat," and that's a very classic sort of SIBO pattern, we call it. People with SIBO have a leaky gut. If you're very symptomatic in your belly, if you have chronic diarrhea, even chronic constipation, like really badly where you poop once or twice a week.

That can really alter your gut flora, because you have to be moving your bowels. Digestive, IBS and inflammatory bowel disease, all of those digestive health conditions are associated with an imbalance in the gut flora, a condition called dysbiosis and dysbiosis causes leaky gut.

Dave Smith: How-

Susan Blum: If you have a lot of digestive systems that's a tip off, as well.

Dave Smith: How related are all these digestive issues to weight? Because a big focus of this podcast is talking about helping people manage-

Susan Blum: Yes.

Dave Smith: Sustain a good weight, or lose weight. How connected are the two?

How Leaky Gut Can Prevent You From Losing Weight

Susan Blum: It's interesting, you know, my friend Mark Hyman wrote a great book about, Eat Fat, Get Thin, or something, but he talks about the diabesity, he does a lot of research in his book about the connection between the microbiome and metabolism.

I think there's some really good emerging research about the connection between obesity and the microbiome. It looks like certain kinds of bacteria extract more calories out of food. This is multiple ways.

This is one way. There's some connection between certain bacteria that extract more calories out of food, so that the first thing. The second thing is that in general you're going to have a devil of time losing weight if you have inflammation in your body,

What's inflammation? It's a very confusing term for people, so I'm going to help here. Inflammation refers to, think of them like chemicals, almost, but there are molecules that are released by your immune system and other cells too, but when they're poked, when your immune system is poked, it releases these chemicals and compounds and molecules that zip around your body causing irritation on the inside.

When you think about inflammation in your joint, you can see it's heat, redness, swelling, and pain. Right? Those are the four signs of inflammation. In medicine, we define it there are Latin terms for them, but it's redness, swelling, heat and pain and you can see it on the outside of your body.

But when it happens on the inside of your body, it happens in your organs and in your cells these irritating released compounds are triggering damage and impaired function in your body. One of the places these inflammatory compounds go is to your fat cells. They cause inflammatory fat and the fat becomes very resistant, it becomes resistant to signals that tell it to lose weight.

Inflammation of any kind in the body undermines your ability to lose weight. For weight lose it's really, really important to find all sources of inflammation, and quiet them. Put the fire out. You know? Quench those flames. How all those cute sayings we want to say, but we need to put the fire out all over. The place that the fire originates is in the gut, because I just told you about the whole connection with leaky gut.

What I'm saying about leaky gut, and thank you for helping me make that connection, we talked about leaky gut and you asked me about symptoms and I was saying about places where inflammation shows up, like the joints and the muscles, inflammation shows up then in places you may not feel it as symptoms, but it's inside you, so you get inflammation in your fat, in inflammatory fat, you get inflammation in just even your organs, like your liver, your detox system won't work as well. Your tissues, they just get inflamed. Your hormones and your endocrine organs. Inflammation mucks things up all over.

The Role of Toxin Exposure

One of the strategies we use for weight loss at Blum Center for Health is to evaluate and see where those triggers of inflammation might be. For weight loss, one of the big places that we also look is, look for toxins, because toxins are stored in fat cells.

When toxins end up, toxins like pesticides, or mercury, or heavy metals, when you ingest those toxins and we all do because we are all exposed, you cannot live in a bubble in our current environment, they make their way throughout your body.

If you have chronic ongoing exposure that your body cannot immediately clear out, it stores in your fat cells. It triggers inflammation in those fat cells. That makes that fat really resistant to weight loss, too.

Dave Smith: For someone who is in that position and they have been exposed to toxins, or whatever the causes or triggers were of inflammation, particularly in the fat cells, what is the next step? Okay. We're there, now what?

Susan Blum: When it comes to toxins, the next step is to figure out, it's a two step process, you always look for your exposures, try to understand where you're getting them, and then help your liver do a detox, and then we'll come back to what that means.

Some sort of detox program or there's a way to liver detox lifestyle, and I do this in step four in my book. Right? There's a whole questionnaires on am I toxic? Where my toxin is coming from? Here's what you need. Here's some supplements suggestions for how to support you to healthier liver, clear out the toxins.

You want to do an assessment, and you can do it yourself, and I'll help you with that in a second, and then you have to eat in a way and take some supplements you can take that will help your liver do a better job of clearing out toxins, because at the end of the day, we have a liver, and nature gave us a liver to manage all of our exposures.

Look, we have our own, end of our metabolism everyday we're making, like our hormones, for example, we make hormones every day and they have to get metabolized in the liver, so the liver metabolizes a lot more than just the external toxins.

It's there to process the end products of everything that happens in our body, as well as what we take in. The liver has to deal with it, and the liver needs a lot of antioxidants, which is all those colors in the fruits and vegetables that you should be eating.

This is why eating the rainbow and filling your plate up with two, thirds vegetables at every meal is how you support your liver and you also want to make sure that you're not eating foods that are very rich in pesticides.

My recommendation is always to eat organic when possible, but I know that it's not always possible because of cost, so there's a great website called, The Environmental Working Group, which Dave you might have recommended to people already, in the past.

It's a common, familiar website, but it's called and you can go on there and you can find the clean 15 and the dirty dozen. I tell people, the dirty dozen, those are the foods that you should avoid, and only eat organic. The clean 15 are the safer ones.

It's really just looking around you and try to get a sense of your toxin exposure. Avoiding using pesticides in your garden, not spraying, because of the solvents you're using in your house. Plastics. It's all of that. It all adds up. People who play a lot of golf, and live on golf courses, I mean, there's pesticides, golf courses are the number one place where pesticides are used, and the body can accumulate that.

Then, we have the mercury in the fish. I actually limit all my people, especially if you're concerned about losing weight or your immune system to fish maybe once, maybe twice a week, because all fish has mercury, even if you look at the high mercury fish list, which you can see at the I test it. I measure mercury levels. People still have mercury, even eating regular, fish that's not on the high fish list. I think all fish has mercury at this point.

In general, we have to be careful of that, too. I think, clean up your environment and I think detox, I think some sort of liver support detox program is a great way, that's how we start all of our weight lose programs, because it really helps. It's a liver boost. It's just a very liver focused, give your liver all the nutrients it needs to do its job and you just unload the body of a whole bunch of toxins and it helps the fat release it's toxins that way.

Dave Smith: Isn't it interesting, you used a really good analogy at the start of the show, talking about a river and starting with our mouth and our esophagus into our stomach and through our intestines and out of our body, and everything that you just described really reinforces that. Is the symptoms that we're feeling, whether it's weight gain or any of these other symptoms it all starts at the source of the river, which is our food.

Susan Blum: Yeah. We're back to food. Yeah. It's true.

Dave Smith: You cannot get away from food.

Susan Blum: We really cannot. People want to, they wish they could. Our world is too tempting. We live in a lot of temptation. It's not easy.

Make Your Body Work Takeaway

Dave Smith: What would you say, we'd like to wrap this show up with what I call a Make Your Body Work takeaway, and that's just one action step that someone in Nadine's situation could start with. For Nadine, she writes in, she says, "I've got digestive issues. I'm battling weight. Someone said maybe I've got leaky gut." What would you say, Doctor Blum to someone like Nadine, how can they start, today?

Susan Blum: I really feel very strongly about doing an elimination diet, because that's another thing we do to help people lose weight, because those foods that might be triggering your digestive symptoms, might be triggering inflammation in your body and undermining your ability to lose weight that way.

I really would encourage a full elimination diet. Gluten, dairy, soy, corn, eggs, and sugar, which if you want to lose weight, sugar is very inflammatory, too. I-

Dave Smith: I like how you just threw that in there.

Susan Blum: I should have said that at the beginning, but sugar needs to be on that list, especially, for reflux it's not as perhaps the focus-

Dave Smith: Yeah.

Susan Blum: But, for systemic inflammation, weight loss the sugar has got to go. I would really encourage you to try it that way, to start with an elimination diet.

Dave Smith: Quick recap, so let's eliminate those five, plus sugar for three weeks and then introduce a new one back into your diet every three days. Just be really conscious, be mindful of what's happening to your body. What's your body saying to you?

Susan Blum: Right. If you notice that you really don't feel great when you bring one of those foods back, then you should remove it again for six months.

Dave Smith: After six months, try and reintroducing it again?

Susan Blum: Then, you can try reintroducing it again, but chances are, like for example my people who I've been working with for years and years, they know that, let's say if we use dairy as an example, they discovered dairy was an issue back when and what happens is after six months you end up on a 90% rule, or 95% rule, you know what, I can have a little goat cheese once a week, and that's it, but, I'm not drinking milk again.

It's sort of what you said, David, at the beginning, maybe you said that to me before we got on, but about, "I don't drink a glass of milk anymore," but there's certain things you probably might not, shouldn't go back and do again, but there are certain ways that you could bring it back in, in a very moderate way that won't give you symptoms.

Certain foods that you should avoid can still be eaten in moderation without causing any harm

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Dave Smith: Particularly for people who are looking to lose weight, we all know how much of a battle it can be. That's actually the word that Nadine uses, it's been a battle for her, so if you can-

Susan Blum: Yes.

Dave Smith: Win that battle by eliminating some of these inflammatory foods, or foods that just don't do well through your body, who is going to want to go back?

Susan Blum: Right. That's the other important point is that people that are trying to lose weight, the whole idea of battling it is so frustrating, you know, I think that instead of thinking about counting calories, it's what we're really moving to in the world of functional medicine, functional nutrition, sort of the next era of understanding food is that food has function.

Food has a way it behaves in the body, and depending on your situation, and especially like your gut, her gut, and our guts for example, food can trigger inflammation, and we must identify, each person must identify their own personalized food plan, so instead of counting calories it might just be that you'll notice a huge different just by not eating corn, for example.

Dave Smith: Mm-hmm (affirmative).

Susan Blum: I mean, I have one patient, she eats corn and she cannot walk the next day. She has terrible pain in her feet. It was the corn, was the trigger. Who would have thunk? You know? I think that you just don't know these things.

I think that it's a lot easier to follow a food plan rather than worrying about your calories if you just knew there were certain foods, groups that you need to avoid, and you understand why. You know?

Learn More About Dr. Blum

Dave Smith: And, of experience, the improvement. Once you've experienced it, jeez like we've said many times, you don't want to go back. Doctor Blum, I know there's probably a lot of listeners out there who have additional questions, or would like to read up about the work you do, where is the best place for them to connect with you?

Susan Blum: I would invite you to come to my, I do Facebook Live every week, every Tuesday, it's east coast time at one o'clock, so sorry if you're west coast, you're going to be a different time zone than me, but it will be earlier for you, but at one o'clock every Tuesday, at one o'clock I'm on Facebook Live on my fan page Doctor Susan Blum.

You can go like me there. I take questions. I do 50 minutes of talking on a topic and then I answer questions. You can definitely connect with me there and I will answer your questions you leave behind, if you leave comments.

That's the best one on one way to find me, which I really have fun with and I look forward to meeting anyone who wants to come find me there. I also like you are going to put up, I have a great website,, which really gives a lot of information and a lot of support for people trying to do these programs.

Information about the book. Information about healing the gut. I have a great online gut program to help support people in their journey, and health coaching that's available to help people do it.

Dave Smith: You give a really great download that I'll include, again, in the resources section, so for anyone listening if you go to, eight, one, you gave a great download that's free, it's called, Ten Steps to a Healthier You.

Susan Blum: That's right. Actually, let me just say something about that, those are ten steps for all the things we talked about are in there. It's all about how to look for toxins in your environment and chose food. It's all about doing elimination diet.

I actually, it's really the 10 steps to sort of cleaning up your world, choosing healthy food, getting a good night sleep. All the things that will help you discover some of these important things about yourself. I forgot I did have that there. That's a good place to get started, for sure.

Dave Smith: Awesome. That's what we're looking for is practical steps. Thanks for-

Susan Blum: Yeah.

Dave Smith: Providing that download. The Facebook Live, I'm going to tune in and hopefully a lot of listeners will as well, because you've got a lot of energy and I just want to hear more from you.

Susan Blum: Okay. Thank you.

Dave Smith: Yeah. Thanks for being on the show again, today.

Susan Blum: Okay. Thank you for having me. It was fun.

Dave Smith: Thanks, again, Susan for joining us on today's show, and just for sharing some really neat education about leaky gut and other problems that we could potentially have with our gut and most importantly some specific action steps that we can start to take, today, to heal our gut and to feel more energetic, lose weight and just process our food and extract nutrition so much better, so thank you for all of that.

Thank you to everyone who tuned in to today's episode and you could probably guess what I'm going to say, or what I'm going to ask you, what's one thing that you can take away from our talk today about leaky gut and digestive health? What's one thing you can do that will help improve your life? Make you a little bit healthier. Make you a little bit happier.

What's that one thing? You know what? I would love to hear from you. What is that one thing that you started to do or are going to start to do, today? Email me. Here's a challenge, pick that one thing, send me an email. It can be a one sentence email, Dave, this is what I'm going to start to do, and sign your name and that's it. You can just write to me at I said this before, but I just love hearing from you, that's why I do what I do. It's to help you, again, live that happier, healthier life.

Next Week’s Episode

Next week, I have a really great episode, and you might have noticed recently there's a couple of episodes that have sort of been touching on the cognitive side of healthy living. This one in particular we're going to be talking about depression and anxiety, and how that can contribute to us living a life that is less optimal from a health perspective, a physical health perspective than we would actually like.

If you have ever had bouts of depression, or been through tough times from a mental health prospective, or if you know someone who has, this will be a great episode for you to tune into. I think that would be a really great episode, next week.

That's it for today, but as you know if you ever have a question for the show or just want some help, or some guidance, again, write me anytime. I read every single email that I get and respond, personally to every single email that I get. My email address, you know it, it's Have a great day, today. I cannot wait to see you here, again next week.

Thanks for joining me today!

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