The new paradigm of curing gut disease (forever)

44% of people have SIBO relapses.

Patients treated with the standard approach of antibiotics or antimicrobials to treat Small Intestinal Overgrowth (SIBO) have nearly a 50% chance to have relapses in their conditioning after 9 months.

Our gut is one, if not the most important organ system, which is f***ed up in our society.

I assume that 80% of people have issues arising from their gut:

• Acne

• Reflux

• Fatigue

• Bloating

• Brain Fog

• Depression

• Mood issues

• Constipation

• Loose/ Dry Stool

• Endocrine diseases

This is a long (not yet exhausted) list of common problems people have to suffer from on a daily basis.

All of these arise from the gut.

All.Of.These.

I myself dealt with the myriad of health problems listed above, like SIBO, bloating, constipation & brain fog.

As I was a little (not comparable to now) into holistic medicine I looked out for “holistic" or “natural” concepts to get rid of this problem.

Quickly I found a gut “reset”, lasting 4 weeks, focussing on the pillars of traditional gut cleanses:

• elimination diet (like DASH, FODMAP, Keto-ish)

• herbal antimicrobials like oregano oil

• binders like pectin

• leaky gut supplements like Glutamin

You probably heard all of those from your average naturopath, who is somewhat interested in health topics.

Now, I (un-)successfully did the 4 weeks proposed by this system.

I felt great. I really did.

For like 5 weeks?

Then I relapsed.

Symptoms came up again. Bloating. Constipation. Brain Fog.

SIBO, the enemy, was back.

I was one of those 44%.

This was all because I used the wrong framework to heal my gut.

The Natural Paradigm: Why they regress

As I said, most of you reading this tried the natural route. But if you analyze closer, it is just band aiding.

It is symptom management, rather than causal approach:

Natural antimicrobials, just like “real” ones, are there to kill your gut microbes.

Yes, there are differences in the different compounds (e.g. nigella sativa vs oregano) but the mechanism is the same:

They try to “heal” SIBO, by killing the bad bugs.

Sounds good right?

But the facts speak for themselves (remember the 44%)

Why do so many relapse?

Because they do not approach it from the right perspective.

Holistic or natural health portrays a picture of herbs, supplements & compounds helping your problem, but at the end, it is just a natural form of medication.

Of course, better to take apple cider vinegar to increase stomach HCL than to take PPIs, but at the end they are all one thing:

Symptomatic Band Aids

Natural Healing regresses because they, just as standard medicine, fail to ask one question:

Why?

Why does SIBO, Reflux, IBS,… occur in the first place?

What mechanisms are at play?

What is the missing piece?

Here is where we gotta start!

The root causal approach

So, where does the root causal approach differ?

Why is it better at solving pressing GI-issues forever?

It is simple:

Because it takes a look at the disruptive biomechanics of an unhealthy system

Look SIBO for example:

“Natural" Approach: Too many bugs? Why not kill them off?

Root Cause Approach: Why is there dysbiosis in the first place

In the case of so many issues arising from the gut, the issue simply stems from insufficient metabolism pathways of key organ systems:

• hypothyroidism

• disrupted bile metabolism

• low exocrine pancreas function

• destruction of gut protection layers

• insufficient stomach acid production

Now, you got a hint to as of how we approach this:

Look at your problems, look at symptoms & dig into the key organs involved in this problematic pathway

You have IBD? Look at where the inflammation stems from

You have reflux? Look at insufficient stomach acid production

You have SIBO? Look at bile flow, mucous layer & migrating motor complex issues

Now I will give you the framework I use with with my clients to heal their GI-system sustainably.

Phase 0: Data

You cannot start if you don’t know where to.

This phase is simple:

Trying to gather data about your

• symptoms

• root causes

• environment

• disease onset

• disease progression

• background (genetic, profession)

The most simplest way to do this is to ask questions. Over and over again.

Why? What? How? When?

These simple questions will give a lot of answers.

Take out a pen & paper, spent 30-60 minutes just dumping down everything you think is important.

In the gathering phase I normally look for functional testing if theres a budget for that. It is highly recommended to do at least some testing of important biomarkers:

Blood work with markers like:

• Iron

• CRP

• Ferritin

• Copper

• Vitamin D

• Liver Panel

• Magnesium

• Thyroid Panel

• Homocysteine

• Whole Blood Count

These serve as a good basis, but can be individualized.

Further more, a stool test is pretty good at determining where in your gut lies the problem.

I really love Genova Diagnostics for testing the GI tract. Although they cost a bit, they are totally worth it, as it serves as a north star for therapy.

If we got gathered all data points we are set for…

Phase 1: Fundamentals (4-10 weeks)

Fundamentals is the first and most vital part of this approach.

A definition of this phase would be:

What did he say?

Let’s rebuild that piece by piece.

1) Providing key nutrients for biomechanics

This one is one, if not THE KEY difference between the “natural” & root causal approach.

We heal the gut, by providing the key nutrients it needs to provide its functioning.

This is done via increasing our dietary micronutrient intake. For that, we modulate the diet for the most amount of nutrients, with the least amount of trigger potential.

The most nourishing foods, with the least amount of trigger potential are:

• Game Meats

• Seafood & Fish

• Saturated Fats like EVOO, Coconut Oil, Ghee

• Grass Fed Ruminant Meat

• Grass Fed Organs

• Berries

• Avocado

• Low GI Fruit

• A2 Dairy (Sheep/ Goat preferred)

• Raw Homemade Kefir = GOAT

While ditching stuff like:

• Seed Oils

• Processed Sugar & Food

• Additives

• Grains

• Legumes

• Fiber

Fiber is a tough one, as some people might tolerate it up to a certain point. This is stuff to work out for yourself.

When stumbling across nutrients, many now jump onto the train of supplements.

Let me tell you: Supplements are a double edged sword

The problem of false supplementation

My philosophy uses supplements, but in the right way & context.

Supplements of Phase 1 involves stuff like:

• Glycine

• Taurine

• Collagen

• Vitamin C

• Vitamin B1

• Electrolytes

• Mag-fucking-nesium

With some exceptions, these are ALWAYS good to be taken into account. Compared to other strategies, this is a really short list of supplements.

And the simple reason is dependency.

We do not wanna create a dependency on a supplement. We build long lasting change.

Now if we hop directly onto the train of TUDCA, BPC-157, Sodium Butryate,… WITHOUT addressing proper gut biomechanics, we will create a dependency, as these supplements cover symptoms of improper digestive function.

Simple as that.

2) Environment is key

Now, micronutrients are good. Better said, they are necessary.

BUT

In a wrong environment, key nutrients might support false biochemical pathways in our body.

This is the second piece to the puzzle:

Providing bricks (micronutrients), with the proper instructions (lifestyle & environment).

This stuff is fundamental and will never change.

NEVER. EVER.

It is the key to resolve gut issues & any other disease there is.

Lifestyle & Environment all combat these areas:

• sleep

• purpose

• happiness

• sun exposure

• toxin exposure

• circadian rhythm

• movement & exercise

• blue light environment

• stress (mental & physical)

If we got those in check, every small thing you do will be better.

You will heal faster. You will be happier faster. You gain energy faster.

It is simple, right?

Phase 2: Individualize (8 weeks)

After 4-10 weeks of setting the fundamentals right, we hop into individualization of current GI specific issues.

As you know, are multiple systems involved in digestion, like

• stomach

• pancreas

• bile

• microbes

• mucosa

There are plenty more. Although your symptoms WILL 100% be improved if done right, there still might be something which we should account for.

Everyone’s different and this phase will aid specifically in this instance.

So how is this phase constructed?

1) Adjusting Diet

We start modulating diet, as we might incorporate food we could not before.

Biggest lever here might be an increase of good fats (SFA & MUFAs) because we improved bile metabolism by providing the proper building blocks (Glycine, Taurine, Vit C & D)

Another one might be a slight increase in fiber, as we now can tolerate more.

Fiber is crucial as it is a prebiotic, serving as food for commensal bacteria in your gut to produce the holy trinity of healing molecules:

• Acetate

• Butyrate

• Propionate

These things deserve their own newsletter episode, but let me tell you:

They are life changing

Here is also a good time, if not done before, to incorporate organ meats, as we now have filled the empty nutrient reserves.

Many of the no no’s of diet stay though (probably should forever).

2) Individual Supplementation

But wait, didn’t I say supplementation creates dependencies?

Yes, they do, if our system is fucked up hard.

We prepared our body, so that we can use the power of modern supplementation to fuel our healing.

So here I play around with the protocol.

Reflux? Potassium, B1, Betaine HCL, ACV

Leaky Gut? BPC-157, Sodium Butyrate, Aloe Vera

Bile issues? TUDCA, Vitamin D, Choline, bitters & herbs

You get the gist.

The supplements can all be classified into stuff our body either

a) can make endogenously → wanna provide a temporary surplus

b) positively adjust certain pathways → e.g. bitters & herbs

We also adjust diet to these special problems. Let’s say you still have bile issues, then maybe more MUFAs are good, as these are metabolized better.

You have to see the big picture here and adjust diet, supplementation and also

3) Lifestyle & The Gut Accelerator

Lifestyle changes can also be done if we see problems with certain issues.

If you feel like your pancreas is not producing enough enzymes, there could be a good case for you to lower stress & increase vagal tone for example.

But the biggest lever here is the gut accelerator:

Fasting

Fasting is a miracle (if done right).

If you are in the sphere of X you might know that Ray Peat Disciples will demonize fasting.

And they have a case for that, IF

WE DO NOT PROVIDE PROPER NUTRIENTS BEFOREHAND

Fasting will increase your healing capacity by 5x at least. The Why & How is reserved for another newsletter episode, but let me tell you that fasting is a non negotioable for anyone having gut issues.

A good strategy I got from a fellow X Bro Alejandro A.D. (Adastra) is alternative day fasting for 14 days:

Basically eating 24h, then fasting for 24h.

This will super charge the reparation of your gut mechanics.

But, only do this, when all micronutrients needs are matched.

Magnesium, B1 & Electrolytes need to be maxed out.

Also increase of saturated fats prior to the fasting days will lower beta oxidation of PUFAs, so naturally there won’t be a problem with lipid peroxidation (bye bye Peaters)

Phase 3: Specification

If you came here, you probably healed your gut or are on the edge of it.

No more bloating, no more constipation, no more problems.

BUT, there might be other things pressing you.

The last phase of gut healing is reserved for specific issues the individual has. Here we widen the scope and not only look at the GI tract.

We use the healed gut as a vessel to improve other issues.

Specification deals with individual, long term topics the patient has to deal with

• Genetic Dispositions → Adjustments

• Low Sulfuration → Sulfuration support

• Low methylation → Methylation support

• Mold exposure → Focus on mold detoxification

• Athlete → Matching dietary needs with burden of sports

• Metabolic Syndrome → Insulin Resistance, Estrogen & Toxins

• Type 1 Diabetes → Creating an insulin sensitivity protocol (life long)

You see, there are many things we can adjust for. This phase is not a phase per se, but rather the intro to your new healthy life.

Healing in todays world is often not done with the GI system only. And that’s okay, as long as we account for it.

At this stage, health is only reinforced by positive feedback loops, so implementation of this stuff is fun, makes you happy & most importantly:

Will make you healthy, energized & transcends you to new heights.

Ditch chaos, bring order

You ever heard of the chaos theory?

Let me give you an example:

If you boil water, the water basically stays the same for 99 degrees celsius. Then, suddenly, it starts to boil.

This all of a sudden change from order (water) to chaos (boiling water) is what chaos theory is about.

But what has that to do with health?

A whole lot.

You are healed. After half a year of gradual changes, you are healed.

Isn’t that cool?

And if you are like most, you wanna stay healthy, as you now tasted the fresh blood of this life.

Here is where chaos theory comes into play:

You gotta find out how to maximize health, while minimizing the friction, work & hustle it needs to maintain health, otherwise you are on the brink of chaos.

Know what leads to chaos, know what leads to order.

This is how you life a holistic life:

Find out the big levers of health (I’ll spoiler you right here):

• sleep

• movement

• purpose & path

• sun environment

• low stress & toxins

• local & seasonal nutrition for YOUR gut

This is brings order.

Cheers

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