28 - The Human Microbiome - The Final Frontier with Debbie Cotton

Naturopathic Clinician Debbie Cotton discusses with Leigh Brandon what the microbiome is, how it can become imbalanced, what health problems this can cause and some top tips to restore the microbiome and optimal health.

We discussed:

2:07

Debbie's background

8:06

What is the Human Microbiome

18:30

What upsets the balance of the Human Microbiome

34:40

The Gut-Brain Axis

38:40

The Gut-Skin Axis

40:45

The effects of diet on the microbiome

50:00

The problems that occur when the microbiome is imbalanced

57:25

The most common health conditions caused by an unbalanced microbiome

You can find Debbie @:
www.invivohealthcare.com
support@invivohealthcare.com

Transcript

[00:00] Debbie Cotton: They're important in our digestive processes, our elimination processes, how we deal with different pharmaceutical medications. Like, the list basically can go on and on, how they can really have a benefit for us. If we were to wipe all the microbes off your system, you'd be dead within minutes.

[00:20] Announcer: Welcome to the Radical Health Rebel podcast with your host, Leigh Brandon. If you enjoy the podcast, please leave a five star rating and a warm review. Your opinions are important, and your ratings help grow the podcast and help educate people to lead a healthier, more productive, fulfilling a happy life. This video is your thing. Please check out the Radical Health Rebel YouTube channel, where you'll find fun bitesize clips from each episode. And now, here is Leigh, the radical health rebel, with this week's podcast.

[01:01] Leigh Brandon: Debbie Cotton. Welcome to the Radical Health Rebel podcast. Thanks for coming on the show.

[01:05] Debbie Cotton: Thanks for having me, Leigh. Lovely to be here.

[01:08] Leigh Brandon: Yeah, I'm really, really excited about this episode. So today's episode is entitled the Human Microbiome the Final Frontier with Debbie Cotton. Now, the human microbiome is a subject that has really fascinated me over the last 17 years or so. And it's fair to say that we seem to be learning more and more about the microbiome at an ever-increasing rate, a subject where there's almost certainly far more to learn than we already know. And I feel that it may well be possible that we will never fully learn everything about the complex interactions that we as humans and other animals have with the microbiome and the effects we have on it and it has on us. But what I do know from my own studies and clinical practice is that the microbiome plays an absolutely vital role in our health. So I'm really looking forward to this deep dive into the world of the human microbiome with the extremely knowledgeable Debbie Cotton.

[02:04] Debbie Cotton: Thanks, Leigh.

[02:05] Leigh Brandon: So, Debbie, to kick things off, would you mind sharing a little about you, perhaps your upbringing, your professional education, your career to date, and what led you to becoming so passionate about the human microbiome?

[02:19] Debbie Cotton: Sure. So I grew up in Australia, as you can probably hear from my accent, so I spent a lot of time in the natural world. I was very lucky in that way. It was a part of my lifestyle. So for me, in my journey, I had a bit of a health crisis when I was quite young, being diagnosed with autoimmune condition and went down the medical road, as most do. And I lost kind of faith quite quickly in what that would bring me, because at that time, my prognosis was looking like wheelchairs and things quite early on in my life. So I kind of came full circle and turned back to the natural world as best as I could to try and understand. And really, as most practitioners do, you come back to this point of where you're trying to find a way to support yourself through your own proceeds. And then, of course, as I was learning, wanted to use that to kind of encourage others to take a little bit more empowerment over their health journeys. And that's not saying that the medical community isn't amazing, because it absolutely is. But what are we missing by not bringing in all of these other things that are available to us in the natural world? And that's basically my journey as a practitioner, in short. And yes, so from there, I've kind of studied in lots of things, and that keeps growing and growing and growing. And really everything I study, my whole focus is how can we encompass all of us, whether that's all of us from a psychological, mental, emotional point of view, whether that's all of us from an environmental point of view. And when we talk about all of us from a microbiome point of view, that's so important because it really involves the environment in which we live, the environment in which we grew up, and the environment that we carry within us. So that's where the microbiome fits in for me. It's taking into account sorry, the all of us.

[04:26] Leigh Brandon: Sure. What was your main kind of qualification that you started with?

[04:34] Debbie Cotton: So I started in music, actually, of all things, in early childhood education. But actually it was Advanced Diploma in Naturopathy, which was herbal medicine and nutritional medicine. It was a dual diploma. I then went on to get my Bachelor's of Health Science and then from there do quite a lot of sort of work in the mental health field. So I've got many diplomas in kind of body psychotherapy and then went on to do my Ma in integrative psychotherapy. So that's kind of my journey through that way.

[05:16] Leigh Brandon: And what was it about the microbiome that kind of grabbed you, so to speak?

[05:23] Debbie Cotton: I think the thing is that really making sense of that actually we're a part of an ecosystem. I think that's what's really always important for me is how do we relate to the natural world? And the microbiome is the natural world that we carry within us. It's this little amazing ecosystem that's within us. It's on us, it's around us, and it's those interactions and the movements of those microbes that have a really big impact on us. And it all comes down to relationships. What's our relationship like with these little creatures, basically? And that, again, is another big one for me, is our relationship with these parts of ourselves.

[06:12] Leigh Brandon: Got you. And can you share with the audience a little bit about your current role?

[06:17] Debbie Cotton: Sure. So at the moment, as well as being sort of a clinician in my own right with kind of private practice, I also am the head of clinical education for In Vivo Healthcare, which is a microbiome company. And what we do is specialize in microbiome testing and also therapeutics that help with the microbiome as well. So they're a wonderful company to work with, and they feel all my sort of ever curiosity in this area, which is great, which I'm very thankful for.

[06:54] Leigh Brandon: Yes, and obviously, as you know, Debbie, I use your services quite a lot for testing, recommend a lot of your supplementation as well, and also do a lot of your education that you thankfully provide to people like me, which has been a godsend in the last, certainly ten years. I mean, how fast the new information that's coming out about microbiome all the time. And what I love about your company is that you do all the research and package it up into a nice little package and probably save me a couple of hundred hours a year having to read through all the studies. So thank you very much for that.

[07:32] Debbie Cotton: Oh, my pleasure. And that's what I love to do, basically, is kind of get the research and trying to make it as digestible as possible and not always possible, but we try. We try our best. But like you say, it's an ever expanding area. So it's just amazing. Like, every day there's something new to learn, which I love.

[07:53] Leigh Brandon: Me too. So I guess my first question might well be the biggest question, but probably an important question to ask at this stage. But what is the human microbiome and what does it do?

[08:06] Debbie Cotton: Sure. So microbiome basically is a term that we use to talk about the conglomerate of microbes that live within us and on us in relation to us. So when we talk about a microbiome, we're talking about the microbes, which can be anything from bacteria, viruses, fungi, phages, all of these things, and the host, which is us. So the combination of them in the environment is microbiome. That's what we're talking about. If we talk about the microbiota, we're just talking about the kind of the microbial persistent part. But to be honest, we always have to talk about the microbiome, which is the environment in which they live. Because the community of microbes that live together is always dependent on the environment in which they are, and we are that environment for them.

[09:07] Leigh Brandon: And what does it do?

[09:09] Debbie Cotton: Another great question. The microbiome in itself is a thriving community of microbes that are trying to do their own daily things, their own metabolism, their own reproduction, trying to get food, all of that sort of stuff. They want to grow and flourish as well. Now, because they live with us and on us as the host, a lot of the microbes in the different communities that live within our body generally confer us different benefits. And they can be a whole number of benefits. Whether it's some of the by-products they make from their own metabolism, they might kick out things that we need. So that could be things in the gut, say, like vitamin B twelve, or by-products known as stock chain fatty acids. All of these things we can use as a human being. So sometimes they make things for us just by the presence of them being there. They stop the colonization of pathogens. So that's microbes that are generally what we know called germs that are trying to cause illness, so they can prevent sort of illnesses in that way as well. They're really important. Just their mere presence is really important for our formation of our immune system and our immune tolerance and has a really big communication back and forth with how our immune system works. So that plays a really large role there as well. They're important in our digestive processes, our elimination processes, how we deal with different pharmaceutical medications. The list basically can go on and on, how they can really have a benefit for us. If we were to wipe all the microbes off your system, you'd be dead within minutes. Okay? You wouldn't survive. We are microbes. We cannot live without them.

[11:09] Leigh Brandon: Yeah, which just reminded me of Solves at the gym this morning. And there's people at the gym that walk around with antibiotic sprays in their hands, and they soak the machine before they use it. They're on the machine for a few seconds. They're not sweating. They get off, and they pick up their spray, and they're spraying down the machine. And it's going everywhere. It's going into the air. And it's just like you don't realize what you're actually doing, which you can't say anything to people because people have been so frightened into killing germs in the last three years. But, yeah, that's another kind of worms that we won't be going down today. Can you talk a little bit more about short chain fatty acids and how they work?

[11:57] Debbie Cotton: Sure, if we focus on I'll just back up a little bit, which is basically we have many microbiomes in our body, so we've got one in the mouth, one up the nose, one on your eye, under your armpit. But the one that has received a lot of attention is the microbiome in our gut. And the reason for that is because it's a very diverse microbiome, because there's so much food matter that we obviously eat that goes into there. Now, the composition of that microbiome is really dependent on what you got given by your mother, how you got fed as an infant, did you have pets or not, what environment you were brought up in, the people you've been around, but also the food that you eat. So all of those things go into making your gut microbiome. And like I mentioned earlier, a lot of these microbes in your gut as you eat your food, they tend to digest it. They like little kind of portions that come out of your food. And often what they poo out is something that can be beneficial for us. And these are known as the metabolites. Short chain fatty acids are the metabolites that certain bacteria in our gut make when they get hold of fiber. Now, fiber is indigestible to us as a human. You eat it. We don't have the enzymes ourselves to break it apart, so it goes out the other end. So it's really good for pooing but fibers also, depending on the linkages that make them, can feed certain types of bacteria and they can then make short chain fatty acids and some really common ones of these. Butyrate is a well known one, but proprietary lactate. There's lots of other different fatty acids and there's a lot of beautiful research out there how important these short chain fatty acids are for, first of all, our gut health. So the cells in our epithelial layer in our gut require butyrate for fuel. So isn't that a beautiful symbiosis that the bacteria actually make the fuel for the health of our gut lining, but also butyrate has been shown to be used around the body for many metabolic processes. It's important in babies for brain health and development. It plays a role in sort of normal metabolism and sort of how we metabolize glucose and things like that as well. It can be anti-inflammatory, so it's used by lots of different processes in the body. And like I said, what you need there is two elements. You need fiber, so you need to eat the fiber and you need the microbes that can then digest it to be able to get hold of them.

[14:45] Leigh Brandon: Awesome. So you've mentioned a few already, but what are some of the key microbiomes in our bodies, if you like?

[14:59] Debbie Cotton: So I would say all of them are key, but it's the ones that are the most researched at the moment that we have the information upon. So we've got the oral microbiome, which is very key for obviously oral health, but it's remembering that the gums goes straight into your bloodstream. So a really important barrier between it's a really important communication barrier between you and the rest of the body around the metabolites that can get in, but also pathogens. So the health of the oral microbiome is quite important. We've got the gut microbiome and that consists of different niches as we go down from the stomach to the small intestine to the large intestine, all look a little different because it's slightly different environments and that plays a major role in our health. We've got the vaginal microbiota, which plays a major role in women's health, but also in fertility. We've got the male penal and seminal microbiome, which again plays a major role in males health and kind of fertility and things as well. And obviously there's a skin microbiome which is ever so popular at the moment when it comes to antiaging and kind of skin health, but also aesthetics and those sort of things as well. But, yeah, if you can think of it, there's a microbiome for it, basically.

[16:26] Leigh Brandon: Yeah, but in terms of what you've read up about, if you were to say, I don't know, there's a key three or five regions of microbiome that's the most important to health. What what would you say?

[16:41] Debbie Cotton: Ah ‘em.

[16:43] Leigh Brandon: So I'm backing you into I'm backing you into one now, Debbie yeah.

[16:46] Debbie Cotton: Trying gut number one, oral and vaginal. Vaginal penile, actually, here I'm going to cheat in the vaginal. I say the genital, urinary. So the bladder and the ****** and probably the skin, the lung, I don't know. I can't decide there. They all have a significant contribution. That's the thing. Leigh it's like the gut would be number one, though, because of the amount of metabolites that we have to deal with and how it has an impact on all of our body systems from what comes in and what goes out there.

[17:26] Leigh Brandon: Yeah, and I suppose the lung has been obviously one that's been very prevalent in the last three years as well, with obviously the pandemic.

[17:34] Debbie Cotton: Absolutely.

[17:35] Leigh Brandon: So that's been right up there. So, yeah, you definitely can't not have that in the list for me. The skin is a really important one for me personally, because, again, I don't want to bore my listeners, but I had severe acne for 18 years, so that's an area that I've delved into quite a lot myself. But, yeah, I would say in terms of overall health, I would probably put the lungs above the skin. But obviously, the skin is our outer immune system. It's our first line of defense, so to speak.

[18:07] Debbie Cotton: It's a very important barrier. And also it's about how you feel in your body, which is really important, too.

[18:14] Leigh Brandon: Definitely. So, got another really tiny question for you here.

[18:19] Debbie Cotton: Yeah, sure. Go on, Leigh.

[18:22] Leigh Brandon: What kind of things can upset the balance of the microbiome?

[18:26] Debbie Cotton: Oh, brilliant. So many, many factors. Basically, if we think of microbiomes within us and also in our environment as really delicate ecosystems, we can then make parallels with what's going on around the world. When we Deforest or when we take apex predators out of an ecosystem, when we pollute the water, all of these things totally changes. We know the animals that live within an ecosystem. That's true of the microbes as well. Okay, so the microbes in an ecosystem change. So if we then bring that sort of same parallel back within us, we need to think about often what are we doing in our own ecosystem as the host? What are we changing? What are we damaging? That, in turn, will damage the microbiome. And what's well known is things like antibiotic use. Now, antibiotics are obviously really important if you have an infection, but they're overuse, and especially in the food chain. And things like this will create a change in the overall ecosystem of the.

[19:36] Leigh Brandon: Microbiome, which is in sorry, when you say the food chain, you mean the fact that they're fed to animals, farm animals.

[19:43] Debbie Cotton: So when they're fed to farm animals or used in kind of any farming scientist situations, basically, antimicrobials like you were saying about the gym, those sort of things. When we expose an area to lots of antimicrobials, you're going to change the microbial environment, the microbial diversity. And we interact with that and there's an exchange all the time. And if there's a change, there's going to be a change within us too. Pharmaceutical medications can have a really big impact on our microbial environment. What we do or don't eat can both impact our microbes. So remembering that they need to be fueled, so they do need access to fiber, they need access to even other microbes in the environment. The microbial healthy microbial matter on food from, say, fermented foods and things like this. Part of that, an extension of that, is infant nutrition. Exposure to breast milk is an amazing way of increasing the diversity of the ecosystem of a microbiome interactions with our environment. So there's lots of research around where you brought up in a city, where you brought up in the country, where you brought up on a farm. All of these things will change the way your microbiome looks because of what microbes you've associated with as you've grown up. And then therefore, what if it's become a part of your community? A lot of things like emulsifiers and additives and things that are added to food have been shown to damage the gut microbiome. So that's also quite well known as well. Yeah. So the list, unfortunately, can go on and on, but there are lots of factors that we know does damage the microbiome. And the trouble is, and Martin Blazer, for anyone that's interested in reading his work, sometimes we haven't taken stock of what we've got to know, what is missing. So I think we're at the point now with humans that we know there's a lot of microbes missing, but because the measurement scales have only just kicked in kind of really recently of identifying some of these microbes, we may be already missing microbes that we didn't realize are gone. And we don't know what the overall impact of that is going to be on human health.

[22:05] Leigh Brandon: Yeah. And can you talk a little bit about childbirth and infancy and how that is affected?

[22:11] Debbie Cotton: Yeah, absolutely. So we have a vaginal microbiome, which is generally very lactobacilli rich, but there's other microbes in there as well. And when a baby is in the womb, it's getting exposure of microbial metabolites from mum, and that's from the oral microbiome and the gut microbiome. It's getting bathed in the metabolites. Sometimes there's also translocation of bacteria. As far as we're aware that this science is a bit new. There's possibly a placental microbiome, you'll have two schools of thought around that. There's two research schools of thought ones, but actually the microbiome might start before you're even born, basically from your mum. But then when you're birth, you've got the two roots out, which is either vaginally and with a vaginal birth, you're going to get all those microbes from your mum's ****** pushed up your mouth, your nose. Often there's a little bit of poo involved in birth, which again, is a bit of an inoculation of your mum's microbiome into you. And there's really clear research. Again, if that's not the mode of delivery that you've come out via a C section, you're more likely to be colonized with first kind of room bacteria, the type of bacteria that would be on the surgeon's hands, so on and so forth, would be you're kind of colonizing early bacteria. So there's a very big difference between motive delivery around what's going to be the first bacteria that colonize your gut and then to go on to feeding. So access to the breast and breast milk, because breast milk contains really, really special what we call oligosaccharides, you could almost say it's a type of fiber that we make specifically for microbes. It only feeds microbes and it will feed things like bifidobacterium. So being access to breast milk will grow the microbiome in a certain way, whereas access to formula will grow the microbiome in a slightly in another way. So it's just all of these sort of little things in your growing up will have an impact on how your microbiome looks as an adult.

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[27:08] Leigh Brandon : Once you're eating right for your metabolic type, you will begin to see changes in how your tummy feels. And we will also uncover all the necessary blocking factors that you may have. And you'll be taught how to reduce, replace or eliminate all the factors that are causing your digestive problems. Ultimately, this program will enable you to achieve a flat, calm and comfortable tummy every day for the rest of your life. For more information about how to improve your gut health and to claim a complimentary no obligation gut health consultation, please go to www.bodychek.co.uk that's BodyChek and fill in the request form at the top of the homepage and we'll be in contact to arrange a convenient time. Now back to the podcast.

[27:56] Leigh Brandon: So if we had someone who had a normal birth or breastfed, how may they compare to someone who was born via a C section and bottle fed?

[28:09] Debbie Cotton: So generally, what you see in the research is a slightly different diversity of the big families that take up residency in the gut. So when we're looking at microbiome research, it's tricky. It's never a simple thing to kind of look at. Normally what we're looking at is things like diversity indexes, which is like, how many microbes have you got in there? It used to be linked to the more microbes, the better. But sometimes diversity is complex because it's very much linked to the next thing, which is the types of families. So you can have diversity of the wrong types or diversity of the right types. So there's a little bit of two things that need to go together. We do need diversity, but we need a healthy diversity. And the microbial communities within these two different people can look very different. Like maybe the overall, there's still a lot of microbes in there, but one might have a higher percentage of, say, bifidobacterium and one might have a higher percentage of, say, streptococcae. So the overall kind of balance within the community looks very different. And then when you go on and link these with kind of human health again, a lot of the research is it's hard to kind of pin it down, but we're looking at how these communities and the balance within the communities then have an impact on human health and disease. So that's kind of how we're kind of trying to track all of these things.

[29:44] Leigh Brandon: And in terms of diversity of different types of microbes, I'm guessing that's 100% environment or is there a genetic component there?

[29:55] Debbie Cotton: There's a slight genetic component when it comes to the microbiome and what that genetic component is that basically we secrete some parts from our immune system and that can actually interact with the microbiome and sometimes even feed the microbiome to a certain extent, especially through breast milk. And so certain genetic propensities will make slightly different linkages. So you can be what we call a secretary or a non secretary. So you might kind of be better at feeding, say, bifidobacteria than someone else. That's a non secret, if that makes sense. So genetics have a small role to play, but the major role, like you just said, Leigh, and you've nailed it on the head, is environment. It's kind of and it's that process of all the way through the environments that you interact with and then what assaults you've had on that environment. So again, going back to the research of Martin Blaser and others, they've shown the earlier that you've had exposure to antibiotics increases that sort of propensity for problems with health later in life because of that early knocking of the diversity of the microbiome. Whereas if you have antibiotics kind of more in your adult life, you're generally a lot more stable and you can deal with it and recover a lot better. And again, doesn't seem to be linked with the chronic health diseases that it does when it's timed in early life. So it's that thing of realizing that actually there are windows of opportunity of growth of the microbiome that we're only just trying to get our head around developmental windows basically, where the microbiome is rapidly setting itself and they're important points where we want kind of a good interaction with the environment as best as we can.

[31:52] Leigh Brandon: So just listening to what you were saying there, I was thinking I had life saving surgery when I was six weeks old, so I would have had antibiotics. I was bottle fed and I was on antibiotics for 18 years. So I'm guessing it's no surprise I've been fighting against the tide a little bit for the last 20 years, but managed to keep on top of it.

[32:16] Debbie Cotton: And that's the amazing thing about the microbiome. It's robust as well. It's evolved, even with all those factors, to still be as helpful as it can be for you. Does that make sense? It also speaks to the resilience of us and our microbiomes as well. But yes, unfortunately, you would have been fighting the tide of unfortunately it's that winning the microbial lottery or not. Sometimes.

[32:48] Leigh Brandon: Yeah. I mean, I'm not complaining because without that surgery when I was six weeks old, I wouldn't be speaking to you.

[32:54] Debbie Cotton: Absolutely. It's life saving, like you say.

[32:58] Leigh Brandon: And that's what our medical system is really good at, saving lives in acute situations. Just early. You were speaking and something came to mind, and I'm sure you're aware of it, is the studies where they take people from westernized cities and they plant them into hunter-gatherer families in Africa, and they live with them and they eat their food, and over time, their microbiome starts to shift to be very similar, if not the same as the hunter-gatherers.

[33:27] Debbie Cotton: Yes, there's also some really interesting research that goes the other direction, which is actually really disturbing as well, where people have come from the hunter-gatherer societies. Or there was also a good one, people that had emigrated from Thailand. I think. And they'd emigrated to the states and basically within three months they'd lost a lot of the kind of bacterial families that they were using a lot in kind of Thailand to digest certain foods had kind of very quickly had come to reflect a microbiome of the Western sort of style diet. And that's a combination of diet. But the research were also saying and environment. It's not just it's both, it's the environment in which they've moved to as well.

[34:20] Leigh Brandon: Yeah, dr. Zach Bush talks a lot about that as well, doesn't he?

[34:24] Debbie Cotton: Yeah, he's fabulous if you get a chance to listen to him. Anyone out there?

[34:27] Leigh Brandon: Yeah, hopefully I'll get him on the show at some point. My next question, I guess, really is in your wheelhouse, I guess. Can you explain a little bit about the gut brain axis?

[34:42] Debbie Cotton: Sure. So this is a really interesting one. Basically, our gut is linked really intrinsically with our central nervous system. We've got the interact nervous system, so there's a lot of feedback that goes between our brain to our gut and that's about the processes that are going on in our guts on and so forth. But there's a lot of feedback that goes gut to brain as well. And a lot of the early research was just looking at that kind of nervous system connection around what's going back and forth, kind of sensory and sensory wise. But equally, there's a lot of feedback that goes back to the brain from the gut via the metabolites that go through from microbial kind of decomposition as well. And those metabolites, again, we're talking about short chain fatty acids earlier, but some other metabolites that are made are things like even neurotransmitters, which are normally in our brain to kind of communicate between two neurons, are also made not only in the gut but also by some microbes as well. And they can have an influence on those kind of the nervous what's the word I'm looking for? Signals that go back towards the brain and kind of the information that's going that way also some of those metabolites can go through the bloodstream, different ones and they can then get picked up by the brain, the central nervous system and have an influence on how our brain functions. And another really big way that kind of our gut influences our brain is that I spoke at the beginning quickly around how microbes have a really big role to play in our immune system and microbes in the metabolites and also their sheer presence can either do one of two things they can say to the immune system hey, all is well. Chill out. There's nothing to worry about. Or in the case of kind of disruptive bacterial communities or the presence of pathogens or communities that are growing too large, they can actually send inflammatory signals. And this can inflame the immune system, which in turn all of those kind of by-products from inflammation from the immune system have a direct on the central nervous system and can be linked with things like depression and bipolar and so on and so forth. So our gut and our microbes play a really big role in our sort of balance when it comes to our mental health. Now of course, it's not the only thing trauma and all these other things play a role as well. But the interesting thing is when you look at those papers, like people that have suffered from childhood trauma often have different microbiomes and it's just very interesting how all of this stuff really links together in that sort of holistic viewpoint.

[37:39] Leigh Brandon: Yeah, I guess it would be quite exciting to see if medical doctors, rather than just handing out pills for people with mental health issues, actually looked a little bit more holistically at the problem.

[37:54] Debbie Cotton: Yeah, there's some great research, I don't know if you know, Felice Jacka and the Food Mood Center in Australia doing some wonderful research on how food interventions change the microbiome but also can be helpful in depression. And these guys are really trying to get that sort of idea into everyday health services. Not kind of high for leading ideas, just really simple changes that can be made to change the microbiome, to change gut health. That and therefore can have an impact on mental health as well as the other support mechanisms that are needed as well.

[38:34] Leigh Brandon: Can you tell us a little bit about the gut skin axis?

[38:40] Debbie Cotton: Again, it's a very sort of similar kind of story to the one of the gut brain axis around that our gut is the most important place for where we take everything in, but also where we eliminate things. And it's an important barrier like the skin is to our immune system, for our immune system. And again, if we have that kind of dysbiosis in our gut, which is the term to say imbalance, where we're tending towards more pathogenic bacteria or maybe not enough of the bacteria that do make the good metabolites for us, we can then skew the immune system sorry, towards that more pro inflammatory state. And again, all of those metabolites can impact our skin. And if we're having trouble with elimination, again, that can really the skin is another area where we try and detoxify so that stuff can push through our skin if we're struggling with kind of different kind of metabolite build ups in the body as well. So, yes, definitely. Like in your case, I'm sure you've had your own experience around this, around how important it is to look after your gut, microbiome, the immune system in your gut, the health of your gut in general, if you want to work with your skin, it's that working from the inside out is so important.

[40:09] Leigh Brandon: Yeah, and I guess probably even more important from immune system views will be eczema and psoriasis as well. Even more than acne, I would say.

[40:18] Debbie Cotton: Yeah, I guess with acne, there's also a big hormonal link often in many cases, isn't there? Again, elimination of hormones and microbes can play a really big role in that. So again, it does come back to how the gut is functioning and how.

[40:38] Leigh Brandon: Our microbes are now, we've touched on it a little bit already. But in your experience, what effect does diet have on the microbiome if you can go into a little bit more detail?

[40:50] Debbie Cotton: Diet especially, there's many, many factors that influence the microbiome. The one that we have more control over than anything else is diet when it comes to how our microbiome flourish. So it's not always going to be the whole answer in many cases, but it's going to be a big one because it's something we can do. We can't necessarily change where we live. We can't change our birth story. We can't change if we've had antibiotics in the past. Those things we can't change. But we can change how we feed our microbiome today. So the more access we have to fresh fruit and vegetables that are really, really high in fiber, that have got a lot of different phytochemicals in. So that can be seen by the different colors of the fruit and vegetables that you're working with, things that have been eaten with different cooking styles because that will give us different metabolites that microbes can use, things that have been exposed to fermentation because, again, you're exposing yourself to bacteria or sometimes dead bacterial matter or metabolites. All of which can have a really big influence on your microbiome. Second to that, after diet would be your house environment. Again, you might not be able to influence where you live, but you might be able to influence some of the things that you use in the home. And if you're using antimicrobial sprays or if you have got access to green space, all of these things can be a way of kind of really increasing your kind of microbial matter and health and diversity.

[42:35] Leigh Brandon: Yeah. Can you talk a little bit about the research that's been done in terms of different types of diets and the types of microbiomes that we tend to find in different types of diets.

[42:45] Debbie Cotton: Sure. So again, it's this thing about patterns, is what we see in the microbiome. So if you feed your microbiome at certain foods, you're going to grow it in a certain way. So you'll find that if you're on a ketogenic diet, you're going to have a certain looking microbiome. If you are on a plant based diet, you're going to have a different looking microbiome if you're a pescatarian, again, and of course, there's going to be variances within that, but we like to kind of pull out the patterns. And again, what's generally thought to be the most helpful is the one in which there is a healthy diversity of good bacteria, not the pathogenic ones. But again, these different diets can be good interventions for different conditions, basically. So, yes, it can be a really big impact on what type of diet you're doing to what your microbiome does look like.

[43:47] Leigh Brandon: Yeah. And you've just led me on to what I was going to ask you next very nicely. So one of the things that we're seeing quite a lot of now, and I think it's probably Michaela Peterson that probably is to blame for most of it, but I don't know if you know the story of Michaela Peterson. That's Jordan Peterson's daughter, and she had really severe autoimmune problems and she was in a lot of pain. And over a period of years she was trying all these different elimination diets and eventually the only diet that she could eat that got rid of her pain was a carnivore diet.

[44:24] Debbie Cotton: Right.

[44:27] Leigh Brandon: Well, I'm certainly seeing I don't know why, but I'm certainly seeing a lot of people posting on social media how they've now gone carnivore. I know Joe Rogan did it for a little while and he sort of said, oh, I lost lots of body fat, and et cetera.

[44:39] Debbie Cotton: Jake Grills has gone that way, hasn't hesitated.

[44:41] Leigh Brandon: All right, I didn't know. But I'm just wondering if you've seen any kind of research on carnivore diets and what your thoughts are generally in terms of its effect on the microbiome, because people do certainly seem to be having at least short term benefits from.

[44:56] Debbie Cotton: A carnivore diet, any major dietary change. So whether that's carnivore, keto, vegan, whatever it might be, will have an impact on the microbiome. And if you had a dysbiotic microbiome in the first place and you apply these diets, that short term impact of the microbiome change may be a really helpful one for you and your condition. What is the kind of question and concern about many of these different diets that cut out factors out of our diet is that we don't have the long term sort of research on how that change in the microbiome is good for kind of a chronic health perspective. Does that make sense? So we often find a shock to the system of any description. And that could be, I don't know, the grape diet, the cabbage only diet, whatever, can sometimes temporarily fix a problem, especially because it often takes you away from the original problem, which is a Western diet, or it's removed some sort of microbe somehow by basically starving it out. But that may not be the best thing for the overall ecosystem in the long term. And that's where I think any of these things. I think when we've got a radical diet like the carnivore diet or anything along those lines, that's amazing that people are getting benefits. And what we don't have is a long term research around what that looks like in 50, 60, 70 years. And it will come. Hopefully it'll come. All this research unfortunately, takes time.

[46:50] Leigh Brandon: I guess one thing you can do is look back at evolution, and I guess there are certain parts of the world where they would have had very little access to plants all year round. If you lived near the North Pole, you would have had very little access to bananas and oranges and all other kinds of plants.

[47:10] Debbie Cotton: Absolutely. But they did have access to certain berries at certain times of the seasons that they'd binge on and things like that. So you would have seen kind of.

[47:19] Leigh Brandon: They'd also eat the contents of the stomach visceral of the animals that would have eaten seaweed and things like that as well.

[47:28] Debbie Cotton: And this, again, speaks to the amazingness of humans and the resilience of humans that actually we can survive in lots of different environments under lots of different conditions with lots of different diets. And I think what we need to remember is how we do that is the development of the microbes that we have a relationship with. So if you look at the Japanese population, they actually have specialized microbes for a lot of the kind of the soy and the seaweeds that they eat that help them digest them. To us over here will have different kind of specialized microbes that will help other things that we digest. So it's again, that co evolution, and I think this is where we need to get away from. We all would have looked the same because we never have. We look like humans that co evolved with microbes in that particular area to eat a certain way. A really beautiful example of this is I've just come back from Australia is Koalas. In the natural world, if anyone else is trying to attempt to live on a gum leaf, diet would die pretty quickly, or any other animal as well. But they've evolved the microbes that can help them digest them and not be toxic to them. Amazing. So it's that coevolution that we always need to keep coming back to.

[48:49] Leigh Brandon: Yes, I mean, the research that I've read around diet and microbiome, I just want to get your view on it because the kind of essence of most of the research I've seen tends to say plants good, meat is bad. Have I interpreted that wrong or what's your views on that?

[49:12] Debbie Cotton: I would more say not necessarily meat is bad, it's more that fiber is good and fiber is normally linked with plants. So it's that thing of actually having access to fiber is actually quite important for the microbial communities.

[49:29] Leigh Brandon: So in your opinion, it's not that meat is bad and obviously some meat is bad if it's been raised very badly. But the key is that you're getting adequate fiber for what your needs are.

[49:42] Debbie Cotton: And if you look at the research around that, you'll see that most of us in the Western world don't meet our fiber requirements daily. So even though we have so much food available to us, we're not meeting the fiber requirements that are thought to be needed to maintain a healthy microbiome.

[50:00] Leigh Brandon: Yeah, got you. So again, we've kind of touched on this already, but if you could go into a bit more detail, what would you say are the main problems that can occur when the microbiome is unbalanced?

[50:15] Debbie Cotton: So again, I guess it depends on which microbiome we're speaking about. But if we start with the obvious, which is the gut, the first and foremost, often people will get local symptoms. We can think about that with all the micro bones, the mouth, the gut, the ******, the *****, there will often be local symptoms of the imbalance. So whether that's pain in the area, when it comes to the mouth, it might be tooth decay. When it comes to the gut, it might be IBS. IBD, sort of uncomfortable symptoms in the gut. In the ******, it would be pain and inflammation in the ******. So that's the local problems that can happen. And then again, when we come back to the gut, then we have to think about it as because so much goes in and out by the barriers there, how it then links to our immune system, how it plays a role in what goes in and what comes out. And that can change things like our hormonal balances, it can change things like how our immune system works, how like different kind of metabolic processes like blood glucose, metabolism, things like that can all be disrupted. So then you have all the secondary knock on effects, basically of kind of the local damage that happens. Does that make sense?

[51:41] Leigh Brandon: And what would just be some examples of more systemic conditions that could be caused by an imbalanced microbiome.

[51:49] Debbie Cotton: So basically, an imbalanced microbiome has been linked with most chronic diseases so that's everything from metabolic syndrome to autoimmune conditions is a very big one. There's lots of links with different autoimmune conditions, skin conditions, if you mentioned earlier, such as eczema and atopic dermatitis and psoriasis and even chronic sort of cardiovascular disease conditions and so on and so forth. So again, it may not be the only causative factor, but it's generally what we call a very, very big mediator of a lot of these problems.

[52:26] Leigh Brandon: Yeah, I know. The oral microbiome is linked with heart disease, isn't it?

[52:30] Debbie Cotton: Yeah, absolutely. Heart disease. Big one. With rheumatoid arthritis as well, the oral microbiome as well as obviously local problems too.

[52:40] Leigh Brandon: Yeah, I was just thinking that heart disease is the biggest killer in the Western world. And how many cardiologists have a discussion with patients about their oral clean, lesser microbiome? I'm guessing it's probably not that many.

[52:55] Debbie Cotton: Yeah.

[52:56] Announcer: The Radical Health Rebel is also available on YouTube. Fined bite sized clips from our episodes on the Radical Health Rebel YouTube channel.

[53:04] Leigh Brandon : Just a brief interruption to this podcast to talk about adult acne. Now, did you know that 40% to 54% of men and women older than 25 years will have some degree of facial acne? And that clinical facial acne persists into middle age in 12% of women and 3% of men? I know only too well the devastating effects that acne can have on your confidence and your self esteem and how it can easily destroy your social life, your career and your relationships. I know this only too well because.

[53:35] Leigh Brandon: I suffered from severe cystic acne from.

[53:38] Leigh Brandon : Age 13 to 31 over an 18 year period. I visited my doctor on many occasions and his only suggestions were acne creams, harsh cleansers and antibiotics that weren't working and were actually making my skin worse. After 18 years of struggle and thousands of pounds invested in treatments that didn't work, through my professional education, I began.

[54:01] Leigh Brandon: To learn that what my doctor had.

[54:02] Leigh Brandon : Told me was untrue and that diet was directly related to acne, plus other factors such as food sensitivities, toxicity, hormones, and balancing the body's microbiome. Putting what I had learned into practice, I managed to rib myself of acne over 20 years ago and have been helping others to do the same for well over a decade. By teaching people what foods cause acne, what food sensitivities each individual has, how to optimize their detox pathways, how to reduce environmental stresses and toxins, and how.

[54:38] Leigh Brandon: To balance hormones, especially those related to.

[54:41] Leigh Brandon : The mTOR pathway, a major causal factor with acne. I've been able to help many other adults overcome their acne nightmare too. So if you would like more information on how to overcome your adult acne, please go to www.skinwebinar.com. That's www.skinwebinar.com, where you can also request an Acne Breakthrough call with me to.

[55:07] Leigh Brandon: See if you are suitable for my.

[55:09] Leigh Brandon : Eliminate Adult Acne Coaching program, where you could once and for all learn how.

[55:14] Leigh Brandon: To overcome your adult acne.

[55:16] Leigh Brandon : Now, back to the podcast.

[55:18] Debbie Cotton: And as you know, Periodontitis is some really clear papers around. Periodontitis, which is inflammation of the gums with microbial imbalance basically is very much linked with cardiovascular disease and increases the risk. So, yeah, it's definitely worth seeing your dentist.

[55:35] Leigh Brandon: Yeah. And also root canals are also connected with heart disease, because what you're doing I don't know if you've looked into this, Debbie, but when you have a root canal and obviously you're blocking the root canal, what happens is the microbes that live in the tooth, so you have thousands of miles of tubules in each tooth and you have aerobic bacteria. And when you block off the oxygen, the only way they can survive is to mutate into anaerobic bacteria, and then they start producing really potent toxins. And that's been linked to heart disease.

[56:11] Debbie Cotton: Yeah, p gingavalis is a really big one that's been linked. There's also some of the streptococcai and also what's the other one, the intracoccai, which are really quite common intracoccus for Carlais especially, it's quite a common bacteria that's linked with sort of root canal failures and abscesses and things like that that can all play a role. Basically.

[56:39] Leigh Brandon: I'm guessing menstrual issues would be related to the vaginal microbiome.

[56:46] Debbie Cotton: Can be menstrual issues. Obviously there's a big story around those because that can be the gut microbiome as well, actually. But yes, there is a vaginal microbiome, there's an endometrial microbiome, so lots of reproductive issues. There can be imbalances there as well. So, again, it might not be the only causative factor, but it might be a mediating factor in what's going on.

[57:14] Leigh Brandon: Got you. So, as a clinician yourself, working with clients, what's been some of the most what would you say are the top, most common conditions that you've seen related to the microbiome?

[57:27] Debbie Cotton: Autoimmune, I guess, is one of the things that really, I think, requires a lot of work with the microbiome, especially the gut and the oral microbiome. Working in female health, like looking at the vaginal microbiome just from kind of a local standpoint about how that's not talked about enough and how that can really play an impact on kind of women's comfort. But also infertility, I think, is a really important one to kind of get familiar with and work with and know how to intervene upon. And obviously, from a mental health point of view, I do really think that the gut microbiome is really, really linked. And often there's often a lot of symptoms of gut imbalance and gut pain, and when it comes to mental health and how to gently be able to support both is quite important too.

[58:19] Leigh Brandon: Yeah, I guess autism is an example of that as well, isn't it, that often you get children with autism, they normally have some kind of gastrointestinal problem and obviously they've got a brain issue. They generally come hand in hand, aren't they, with autism?

[58:34] Debbie Cotton: Yeah, it's quite interesting. The research around that is what they're not sure of is if the microbiome changes are due to the limited diet. That also can happen in autism, due to the sensory processing problems and the fear of different textures and things like that as well. But yes, there's often problems with the gut from day one in autism, and that can be both kind of genetic familial and also microbiome as well, related. So it's often, like you say, an ongoing issue for them to be able to work with that. Because I think in anyone that's got any sensory processing issues or kind of anxiety, I think if you realize if you've got pain in your gut, it's another layer of information that's coming into your nervous system that you have to deal with. And I think if we're looking at sort of triggers in your day of what can send you into an anxiety spiral, if you've constantly got pain in your gut, it can worsen different behaviors and anxiety because it's just this background noise that you always have to try and your nervous system is trying to deal with. So definitely trying to keep on top of the microbiome and the gut pain can be helpful in kind of making sure there's energy to spare to manage other daily triggers in people's lives as well.

[01:00:01] Leigh Brandon: Now, what's interesting that we're almost an hour in, and we haven't even spoken about irritable bowel syndrome or irritable bowel disease. Do you want to talk a little bit about those?

[01:00:13] Debbie Cotton: Yeah, I can do. So irritable bowel syndrome is an interesting one because basically it's a label for a conglomeration of different ways in which you can get bowel pain or bowel disturbance, let's say. So just because you've been labeled with IBS doesn't necessarily mean it's all the same for everyone. Everyone's got their own flavor, basically. And generally, in many, many cases, the microbiome is involved. There often is links with Dysbiosis. In some people, there is very overt pathogens that can be present that haven't been picked up. But in many cases, it's more subversive than that. It's generally just general imbalances and not being able to digest certain foods properly that can cause problems and so on and so forth. So there is a very big link. But when you start reading the literature, it's not like, I've got IBS, so I've got this microbial pattern because, like I said, it comes in many flavors. So it's basically, I've got IBS, I might have this pattern, this pattern, this pattern or this pattern. And then it's really how then do we work with that to bring back an overall state of balance? And it's going to be different interventions for different people. And this is why not one intervention will always work for one person when it comes to IBS. And it's not always just one microbe to blame. It often can be, my IBS might look different to yours. It's that sort of thing. And the story about how we got there, the microbial story, as well as the physical story.

[01:01:54] Leigh Brandon: And that's obviously where testing can be very useful, which we'll come on to. So can you just talk about the kind of symptoms that people generally experience with IBS?

[01:02:02] Debbie Cotton: Sure. So normally a very big one is bloating those. So they'll complain of bloating changes in stools so either constipation or diarrhea. It might be multiple stool movements during the day and often can be linked with things like anxiety. And often there can be a lot of pain both locally and again, can be linked with joint pain and things like that as well. And often these kind of flares at IBS when there is the pain, the bloating, it can be linked with sort of anxiety and mood changes and things as well. So there's often a very kind of systemic kind of issue that can go on. There often can sometimes be linked with things like fibromyalgia, so pain in the muscles as well, insomnia, so lack of sleep. Again, everyone's going to have a different flavor of what it looks like for them and how it impacts their lives.

[01:03:05] Leigh Brandon: What's quite interesting for me because I've been working with athletes and I've been working with clients with injuries over the years. And I don't know if you're aware of this, but if you have any kind of inflammation in the gut, what it does, it creates what's called a visceral somatic reflex, and it actually inhibits the type I muscle fibers on the muscles that are innovated by the same nerves as the organs. So if anyone's got any kind of inflammation, what it does to people that are active, it actually creates instability in their lumbo pelvic region, which means they can't stabilize their limbs, their lower legs, they can't stabilize their upper arms, they can't perform to their best, and their likelihood of injury is significantly increased. So when I'm working with people that are in pain, or it could be their sports injuries, or even an athlete just wants to win a gold medal at the Olympics, gut health is right up there at the top of the priorities because without that, you just can't operate at your best.

[01:04:15] Debbie Cotton: Yeah, that's really interesting, isn't it, how all these things are interlinked.

[01:04:21] Leigh Brandon: So one thing we still haven't mentioned is irritable bowel disease. Do you want to talk a little bit about irritable bowel disease?

[01:04:27] Debbie Cotton: Oh, inflammatory bowel disease, yes. So inflammatory bowel disease is a little bit different in as much as it's an autoimmune kind of based condition in which the wall of the bowel is basically attacked and it can present in different ways. There's crohn's and osteopolitis, the most common, but there's also microscopic colitis and other types as well. And basically it's where you break down of the barrier between your microbial world and the rest of you, really breaks down and you end up with painful ulcers within the gust. And again, the symptoms are generally increased stool movements, a lot of pain, bleeding via the ****, all of these sort of things. And obviously problems getting nutrition in so can lead to other conditions as well. And these can be quite serious, can hospitalize people and really put people at risk of other conditions as well. And the problem is then the patterns of. Microbes are actually quite clear with ostravcliitis and crohn's, we can see really quite distinct changes to the microbiome and there's quite a clear pattern that is happening in that dysbiosis. But obviously the problem is you've broken the barrier between your gut and the rest of the body. So you can also have problems like sepsis where you're taking on too much microbial matter and stuff as well. So it's a bit of a tricky situation that needs often sometimes medical intervention as well when it's at its peak to be able to make sure that you don't develop sepsis or anything along those lines. But definitely working with the microbiome in between flares can really help people keep people out of remission and be really important for kind of managing times of flares and things like that as well.

[01:06:24] Leigh Brandon: And I guess not completely linked, but slightly linked. Can you talk a little bit about celiac disease and non celiac gluten sensitivity?

[01:06:34] Debbie Cotton: Sure. So celiac disease again is an autoimmune condition and it's when basically the body attacks, again the microvilli, this tiny little projections that are in your small intestine and that's upon exposure to gluten which is found in kind of wheat and other gluten containing grains. So the only solution to that problem is taking the gluten out of the diet. There are some people that are not full blown celiacs, so they don't necessarily have the whole sort of autoimmune condition going on, but they might have a genetic propensity where they really do struggle with gluten and the digestion of gluten, and again, can present with things like irritable bowel syndrome or kind of problems with digestion and with their microbiota as well. So there are some people that do tend to be better off gluten. There's a crossover though. There is gluten non ciliate gluten sensitivity, but also some people in general that have got what's known as SIBO, which is small intestinal bacterial overgrowth. That's when you have too much of the wrong community of bacteria in your small intestine. Often when you remove gluten, you're also removing what's known as FODMAP grains, which are generally good for you. They're kind of the different types of fiber basically that can feed bacteria, but if you've got the bacteria in the wrong spot, it can be feeding them in your small intestine causing bloating. So sometimes you'll find that people are not it can be what was the problem, was it the gluten or was it actually that you've removed the fog mats and you had undiagnosed SIBO? That was the issue. So it's a very fine line there between which was the problem and you can sometimes only work that out through you can do genetic testing to see how you go with gluten in general. You can do other types of testing as well. You can do breast testing for SIBO, microbial testing for your gut dysbiosis in general, but it's often working with a really good practitioner and working through these things systematically to work out, oh, was it this or this that was the issue or both? If you're unlucky.

[01:08:54] Leigh Brandon: Yeah. SIBO is something that I see a lot in clients. Certainly last two or three years, I've seen a lot of SIBO clients. I don't know why I'm attracting them. Maybe the universe is trying to tell me something. But I've certainly seen a lot of those in the last few years.

[01:09:08] Debbie Cotton: Yeah. And I think it is more common in our day and age as well, the lifestyles we live.

[01:09:15] Leigh Brandon: Yeah you mentioned testing there. Do you want to talk a little bit about the testing that you do in vivo?

[01:09:22] Debbie Cotton: Sure so we have our own microbiome lab in Bristol here in the UK, where we specialize in qPCR, so quantitative PCR, which what we're testing is the bacterial DNA, which makes it very accurate looking at the sort of the bacterial matter that you have in your stool. And we offer different microbiome testing, we offer gut microbiome, vaginal microbiome, oral microbiome and more recently urinary microbiome as well. And what we're trying to present is sort of that ability of not just looking for pathogens, which is kind of the old medical story, but it's looking for pathogens, but it's also looking for your healthy or commensal bacteria and the patterns in which have been linked basically towards health. So these testing is really a tool to use alongside with your clinician because it's really important that you have someone help interpret these tests because there's a lot of information in them. But basically they're a tool to kind of take a nice sort of little litmus test around your gut health in general or whatever it is you want to look at. And then working with a clinician to look at lifestyle interventions, occasionally you might have to look at kind of more severe interventions like antibiotics, but hopefully not very often. But we're always trying to work towards what can we do to create a more healthier microbiome in certain areas that will then have an impact on someone's health. So our testing always keeps that, we always want to keep it very, very scientific but equally we want to make more information available than just pathogens alone, which is what you would get in standard medical testing. So we want to keep that sort of that utilization of how can I become better, how can I work towards a more helpful microbiome in these particular regions?

[01:11:27] Leigh Brandon: Yeah and I have to say, without the test that you provide, I'm convinced that some of my clients would never have got the results because as a check practitioner, we have a saying that if you're not assessing, you're guessing. So if you don't know what's going on with someone's microbiome, how do you know what to do with it? Yeah, I mean, you can guess but it's probably going to take you a much longer time to get any kind of result because you're going to have to probably try so many different solutions before you actually find one.

[01:11:59] Debbie Cotton: Yeah. And thank you, Leigh, because it's really touching, because this is why we do what we do. And in vivo, obviously, we're a company, and like any company, we're out there to survive and grow. But our main focus is the people. We want people to have access to this information so they can make informed choices in their life. And I think, as it sounds like you as an informed patient that's come a clinician, me as an informed patient that became a clinician. This is all I ever wanted access to was I want to be able to make decisions with someone else that can help me interpret it. But I want to make decisions of what might be good in my life on real information that's in front of me. And this is, again, any vivo, what we're always trying to think about is what information would I want to see and how can I then use that to kind of plan not just my what needs trading, but my journey back to health, which is so important.

[01:13:00] Leigh Brandon: Yeah, definitely. I do absolutely love the values of in vivo. They kind of sit very closely with my own. So we've got quite a symbiotic relationship, which is always good for microbiome and for companies.

[01:13:15] Debbie Cotton: Yeah. And we wouldn't be who we are without wonderful practitioners such as yourself, Leigh. So thank you.

[01:13:22] Leigh Brandon: Thank you. So this is probably my toughest question, because it's such a broad question now, if anyone's listening to this, and we've mentioned a symptom that they have, the chances are that they need to improve the balance of their microbiome. So what would perhaps be some top tips for helping people achieve an optimal microbiome?

[01:13:49] Debbie Cotton: So I would say starting with the diet is a really good one. And it doesn't have to be rocket science. Just try and go to the supermarket and add in another vegetable you haven't tried before, or play with lentils or introduce something preferably plant based that's new into your diet, if that's possible. Explore the options of fermented foods, whether again you buy it from the supermarket or you might want to try making some at home. Try making your own pickles or making your own sauerkraut or these sort of things. So this is where I would definitely start. Another easy place I would start is looking around your home to see what are things that maybe going to be harming your microbiome in your home that you don't really need? Are you using harsh antimicrobial sprays? Could you use something a little bit more natural when cleaning the house? Yes. You still need to wash your hands after the toilet and all these sort of things, please. We still don't want to be spreading pathogens, but we also don't want to be doing overt damage to the environment in which we live. And the other big one is I'd say is, are you accessing green space? It's really important, especially if you live in a city or in a flat or anything along with those lines that you get out into green space where you can breathe in microbes often. So I'd say a really big thing is see if you can just divert one of your gym sessions out into the park once a week, or can you access a forest every now and again? Or can you join that local gardening sort of community group that might have a little community garden and do some volunteering there because you get access to the soil? Can you borrow someone's pet? All of these things are little ways that you can make an influence on your microbiome. And yes, you might not go from today to tomorrow feeling better, but all of these little increments will make a big difference over time.

[01:15:59] Leigh Brandon: Yeah, that's really great. Really simple, easy things that people can do. What if someone's suffering from something a little bit more serious? What would your advice be?

[01:16:11] Debbie Cotton: To book in and see you Leigh no, I joke about that, but I don't because basically, I think we all need support in our journeys. And I know myself we can all be the most informed patient series there are, but it's so nice to have someone holding your hand and go, hey, have you considered X, Y and Z? And it's okay. You didn't make that dietary change this week, let's try it next week. But someone that's on your team. So I would say finding a practitioner that really is going to support your journey towards health. And again, don't expect things to change overnight. They might you might be really lucky and within a week you might feel better in many cases, but it's remembering the journey to getting where you were and the journey of getting out of it. They take a long time. And it's about just having that person on your side. And it's someone like you that can offer help with microbiome testing, microbiome supplements, if you needed something more really targeted. But like I said, I think those simple things make a big difference too.

[01:17:23] Leigh Brandon: Yeah, and I really relate to what you're saying about things take time. So generally, if people want to work with me, I actually say to them, you have to commit to six months of coaching because especially if you're in a position where you've got some kind of health challenge, there's not going to be a quick fix. It doesn't work on the same kind of paradigm as the medical system. Take a pill, we'll be better. This is about building health from the ground up. So I completely agree with that. Something that you just mentioned as well was supplements. And again, you've got a fantastic range of supplements that I do use with my clients. Do you want to talk a little bit about your supplement range?

[01:18:09] Debbie Cotton: Sure. So we're kind of a bit unique here at Mvivo that we have the lab, but we also have a therapeutic arm as well, which is our supplements. And when creating mass supplements, it really was thinking about what are the things we were looking for in clinical practice that we wanted to use? Because a lot of us in vivo, our clinicians, ourselves or have been in the past. So it was like, oh, we need this because we know it's going to help. And we've seen the evidence and the research on it. When it comes to altering the microbiome, So all of our supplements are generally a mixture of probiotics, which is healthy bacteria, or prebiotics, which are types of fiber that feed the bacteria, or botanicals that have been shown to have an impact on the microbiome or prosthesis around the microbiome. And they've all been considered in that way, basically around what are things that might make a targeted impact for certain areas of the microbiome. So whether it's someone with Dysbiosis or someone that needs to grow a certain community of bacteria or so on and so forth. And again, when we're kind of making those and when we're putting them together, we're really thinking about the ecosystem and things like sustainability and things like that in mind.

[01:19:27] Leigh Brandon: Yeah, I said I use them with my clients, but I use them myself as well, so I really love your products, particularly the partially hydrolyzed guar gum.

[01:19:38] Debbie Cotton: Yeah, no, it's a favorite of ours as well. It's just such a great kind of fiber that you can add to your lifestyle, can't you, to feed your healthy bacteria, basically. It's such an easy one. Easy wins, that's what we like.

[01:19:54] Leigh Brandon: Definitely. And I was really pleased to find out the other day that my American clients can order Direct from you now as well, which is great because I didn't even realize they could. So having not to go onto websites and source supplements in the US is going to save me a lot of time and also mean that my clients can get their hands on your supplements as well.

[01:20:21] Debbie Cotton: We can do direct consumer as well as ordering on our website these days too, which is easier.

[01:20:30] Leigh Brandon: Cool. So what's next for Debbie?

[01:20:33] Debbie Cotton: For me? I don't know. I was trying to set my goals as you sit down this year, probably. I'm a big fan of cycling, I do a lot of BMXing and I do quite a bit of mountain biking, so I had quite a few goals on there about different. I want to be able to clear certain tabletops and stuff this year.

[01:21:00] Leigh Brandon: Wow.

[01:21:01] Debbie Cotton: But hopefully I'm not on the next podcast with a broken arm. My thing is they're around looking at kind of microbial and gardening. I love gardening, so it's around how I can kind of really diversify my microbiome from the amount of food I can grow myself. So they're my kind of simple goal. So far. I don't know about my sort of I've got lots of other goals of what I want to study and things like that, but I think my husband might have something to say about that. No PhDs this week.

[01:21:43] Leigh Brandon: Where can people find you online?

[01:21:46] Debbie Cotton: They can find me in vivo, so you can email me directly. The best way is support@envivohealthcare.com, and it gets me. But it also gets all of our team of clinicians that are amazing at kind of answering questions around the microbiome. We've got Emily Blake and Leslie Harper and Naomi Jones, who are all brilliant. If you ever need to have a chat with anyone about the microbiome, they're always there, willing to help as well. Or you can get me kind of directly on my email as well, which.

[01:22:21] Leigh Brandon: Is Debbie Cotton@invivohealthcare.com and the web address for in vivo?

[01:22:26] Debbie Cotton: Oh, good question. Think it's www.invivohealthcare.com, I hope? I'm pretty sure it is. Yeah, that's something I should know the answer to.

[01:22:38] Leigh Brandon: That's what I thought it was, but I wanted you to say it, thankfully. Awesome. So, Debbie, thank you so much for taking your time out today and to share your wisdom with the Radical Health Rebel listeners and viewers. And to all the Radical Health Rebel tribe, if you know someone who would benefit from watching or hearing this episode, please make sure to share the love and forward it on to them. After all, the mission of this show is to help people lead a more fun filled, healthy, productive, fulfilling and happy life. And if you'd like to support the podcast, you can for as little as one. Takeaway coffee, then head over to Patreon.com Radicalhealthrebel, where you can also receive lots of other exclusive premium content for no extra fee, including unedited full length, ad, free video episodes, monthly, Ask me anything, Q and A sessions, and discounts on my coaching programs. So that's all from Debbie and me for this week, but don't forget, you can join me same time, same place, next week on the Radical Health Rebel podcast.

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