B (6:36)

Kind of broad stroke about the test and how it provides usable information. And so I think I'd love to go deeper in terms of what that road looks like for a parent if they were to explore this. But I guess high level, the whole idea of focusing on the gut, right? And whether it means diet changes or supplements, it sounds hard, right? Like. So I think a lot of parents are kind of reluctant to really going down this road because it often seems hard, inconvenient. Nobody agrees on anything really in terms of like all the ways you can help improve the gut. So at least from my vantage point, I know I wasn't too excited about focusing on the gut because it's. It seemed like it was murky or. And it might not be that quick. But I think what you've Learned, you and Dr. Christian Bogner, is that it's incredibly important to focus as much as you can on the gut because it is so important and it doesn't have to be really overwhelming in terms of choosing for your child what makes sense to do and what maybe doesn't make sense to do. And that's where I think your test has kind of made it very easy for a parent to get the detailed information they need in order to figure out what steps they can take. And so with that as a backdrop, I think what you're offering is something that's a easy way for parents to get information with a modest investment in order to take some actions that really can have a huge impact if they're targeted and personalized. So Alex, with that, can you tell a little bit more about what this road looks like for a parent who would want to dive in, do this test. What does it look like for them?

A (8:23)

I have a software that I designed and there's something called a pipeline. And so there's a lot of, you know, kind of programming involved and, you know, nuances in terms of the databases and, you know, amplifier, amplicon sequences and things like that. But in a sense, this program is able to look at the sequence data for a 16s type test and give some information that leads to suggestions. And historically it's had a lot of success. So for the parent that's participating, if they do one of these 16s type tests, then we can leverage this, this information, this is experience. And it leads way to, you know, specific suggestions based on the dysbiosis that we combine with symptoms. So there's kind of a charting of maybe about a hundred behaviors and symptoms that we've been able to kind of associate with certain dysfunctions that can be further supported. And you know, usually it's things like histamine, oxalates, ammonia, um, you know, it can be inferences of the, the liver or the adrenals are being taxed more than usual. Um, and that with the microbiome suggestions, kind of makes an, an overall complete plan. And then that plan is a, is a 6 to 10 week program where the doses kind of titrate up and the, the, the number of things may titrate up over those six weeks. There is an importance that's kind of ascribed to each one of the compounds. So if there's maybe 10 or 12 things that are recommended and that's just not feasible, you can decide to go with the more significant issues and maybe it goes down to six or three things. I recently just got off the phone with a parent where we gave the suggestions and they were saying, well, my daughter, she only drinks water, right? So there's no way that you can give any of this stuff. So then there's a dialogue about some solutions. There are things that they can try to kind of open up that palette. And sometimes we have to have those conversations where we say, okay, there's only three things. Give me three things, and we start with that and we can still get some improvement and then kind of take it from there. But that's basically the design of the program. Then we retest. Typically people see improvement that first round and then they're eager to want to continue. We retest and we kind of rinse and repeat. I'd say my goal or my recommendation is for most people to do at least three. Three of these rounds, if you will. And then the hope is to that with a couple of things, they can kind of keep a maintenance and keep stuff at bay, keep the improvement that they got there. And yeah, every situation is different. The dysbiosis is. There are some similarities, but then there's also a lot of uniqueness. And. Yeah, that's kind of it in a nutshell.

B (11:35)

Okay, well, I think that was great. And I probably should have prefaced at the beginning. So if we take a few steps back, okay, you're a parent, you have a child, you know that, you know, gut health is important. You know, there's a lot of different testing parents can do to kind of say, okay, well, what's going on in the body, what might be going on in the gut, you know, whether it's blood labs, urine labs, or stool testing. And so what we're talking about is stool testing as being the way that you can really kind of see what's going on, which, when you Refer to the 16s test, that's the stool test that you rely on to be able to analyze what's happening, to be able to ultimately make those recommendations. So can you talk a little bit about why a stool test versus other methods, as well as why this particular test is something that you really feel like is the appropriate one to use in terms of uncovering what's going on?

A (12:31)

With respect to my kind of journey with my son and feeling kind of privileged because we did a lot of things. We did a lot of things that I would say were kind of wrong. You know, that's. That's the way you learn. But, you know, one of the things that became very apparent is, and many of the tests out there are geared toward this, is that there's something negative. You know, there's. There's a bad guy on the scene, and, you know, here you kind of, kind of have to get rid of it. That's the reason why there are some symptoms and you have to kill this thing, and then that's going to bring you some level of improvement. And in some sense there's some truth to that, but it's really not painting the whole picture. And there's a lot of similarities in nature to kind of how society functions. And really what I've kind of learned is that. And this is borrowing from another gut guru, Keith Bell, from his gut group, but he has this phrase where he says, you can't kill yourself. To a good microbiome, there is some benefit that you get in damping Some of the pathogenic microbes, and people can see that sometimes with antibiotics and stuff like that, there's a completely different benefit that you get from restoring the beneficial ones. And then there's the component of, if you've gotten rid of the bad ones, what keeps them from coming back. And the kind of history and experience has shown is that unless you have the beneficial ones to keep those bad ones from coming back, then you're just kind of chasing yourself with antibiotic after antibiotic, or killing method after killing method, and leads you down this path of being frustrated and finding nothing that really works. So for me, it was learning that process. And the 16s test gave that opportunity to, in terms of insight of the whole picture. So 16s test has been around for a fairly long time relative to some other technologies that are out there that are newer, like shotgun type sequencing. And what the 16s test means is that it's looking at the 16s gene on the bacteria, the microbe there, which is conserved. And you know, if, if this gene gets mutated in some other way, the bacteria is not able to function. It's ribosomal DNA, it's very critical to the, to the host, so you can actually use it to categorize. And that's what has been used probably for the last 20 or so years. The databases for 16s type testing are very relatively complete, meaning that, you know, how do you identify a microbe? You kind of have to catch it, you have to grow it, which is a challenging problem in itself, and then you have to sequence it. So imagine if you were kind of building a dictionary or a language, an encyclopedia for a language that you didn't know, some historical language. You're building it one word at a time, right? Oh, this word means this. It's the same thing in terms with sequencing and microbes. You know, you have this plate of bacteria, you'd have to be able to isolate one of them and then grow it. So you need to know what it grows in what medium, and then sequence it. And then once you have that, then you can then go out and do a test on someone, say, well, I found the sequence. It's this microbe. That process takes a long time to do. And with 16s, the other advantages are, at least when I started to get into this, is that it's relatively inexpensive. So the test is about $150, give or take. It provides you with this raw data, which you can then kind of do some analytical stuff to figure out what's going on. Even when you have A microbe that doesn't exist in your database, there's a little bit of carryover kind of redundancy. So you can say, well, I know that this microbe is not in my database, but the similarities of it put it into the Bacteroides genus. So I know it's this particular thing. Some of the newer technologies, you can't do that because rather than looking at 250 base pairs or 1600 base pairs, which is the full length of that 16s gene, you're looking at hundreds of thousands. So there's so much uniqueness between microbes, there's no way to know what it is unless it's in your database. So because of that reason and a couple of other reasons, you know, the simplest analogy to kind of compare 16s to some of the newer technologies is like the 16s would be kind of equivalent if you were looking to buy a home. I showed you a photo of every room in the house. It might not be the clearest photo, but you could at least see every room where something like Shotgun where it is now, it give you a higher resolution photo of the room, but it's not going to show you all of the rooms potentially. And sometimes up to 20% or 30% of the microbiome is not able to be matched on shotgun or through the denoising process, gets thrown out. It's a much more challenging problem. With shotgun, you get the DNA of humans, you get the DNA of protozoa, fungi, viruses. It's all thrown into one big puzzle. And there's a lot of complex math and things that goes involved into kind of decoding that. It's much better at definitively identifying a strain or a species of bacteria, fungi, if you know if it exists in your database and if that's what you're looking for. But most of the literature is actually based on 16s. That's where we get most of our information, our suggestions, our history. And even with that additional precision that Shotgun gives you, I don't know that it makes a clinical difference in terms of if I knew if it was this particular strain versus that strain, I don't really have a therapeutic that's going to act on one versus the other. So far, we've been able to do pretty good at resolutions at the genus and the species level. And I think in the future, really the best will be combining both of them. And that's what we're looking to do. Take the information that we take the dictionary that we have in this language and then map it to this Other language which has some basis in history, and then really get a full picture of the history. There's, you know, where one misses and the other one picks up. And that's gonna take some time to do, but it's exciting as kind of we get there.

B (19:32)

So I appreciate that. And especially with everything is evolving so quickly. But what you've been seeing, though, with parents you've been working with is that this particular test, right. Of the stool with 16s gives you really useful, detailed, comprehensive information about knowing where to focus. You have your own way of analyzing and ultimately, again, doing the hard work to come up with what are the right moves for that unique person. Because it's so complicated in terms of what's going on in the microbiome. So I think if a parent's wondering, what does this road look like? Everything you just talked about is more behind the scenes about what test. But from their standpoint, it's just a stool test, you know, very affordable, easy to submit. You've done the hard work of how do you take that and then ultimately come up with these recommendations. And once the parent has that for their child. Right, those recommendations. Can you talk a little bit about the types of things that would be coming back in terms of what actions a parent can take?

A (20:36)

Yeah, I mean, there's some general suggestions, not for everybody, but I'd say often are kind of in there and critical. And there are certain compounds that we've identified that are very helpful for a lot of the kids. And, you know, the first, I think delineation that you need to make is that is the child or adult constipated in any way? Because that could be very severe. I mean, there's some children that are, you know, constantly visit the ER for this situation. Or it could be very mild constipation or could be the complete opposite where they're going multiple times a day. The problem with constipation is that if you start to make some shifts in the biome, you can make the traffic jam potentially worse. And then there's a lot of reactivity that comes with constipation. There's a lot of symptoms that are exacerbated by it. So knowing that up front, and then we have a bunch of tools that we can work with, there may be 10 different things that are helpful. Sometimes you need one or two of them. Sometimes you need to cycle through all 10 because they all work in different ways. But that's really kind of the most important thing to me, just making sure we don't run into that wall. But you know, outside of that, there are certain prebiotics that have found to be very helpful, that they work very broadly and they work to rebuild some of the deficits and they're safe in the sense that they're not going to cause a lot of reactivities and strife and lead to non ideal situations. One of them is a prebiotic called sun fiber active compound is partially hydrolyzed gargon P H E g and it's a prebiotic that very slowly acts to kind of bring up some of the butyrate producers in the gut. It helps with motility, it helps to bring water into the colon to make the stool easier to pass. And you know, just overall it's a tasteless powder and you know, if you start slow, you shouldn't have any issues. But it really, you know, kind of helps to bring some of the things that are a deficit back into the equation, which help you keep some of the bad things at bay. The next I'd say, you know, kind of go to prebiotic depending on whether or not it's needed. But it's often needed is bimino gos b I m u n o and it's in several of the products that we have. But this particular prebiotic, it's a sugar that comes from dairy and it helps to feed bifidobacteria in a safe way and very effectively. And Bifidobacterium happens to be a genus that I'd say probably at least 75% of the time significantly depleted in the, in the cases that I see and by restoring seems to translate to a lot of clinical improvements. You know, one of the things that Bifidobacterium is associated with is the ph in the colon. And that might, that in itself can drive a lot of the environment for things to grow and fester, you know, pathogens and so on and so forth. Those are some of the two things that, you know, I think you can really do no harm with. And they can go a long way. But you know, in terms of the suggestions, it could be something like olive leaf, it could be something like cinnamon, it could be something like fennel seed, it could be something like, you know, wormwood, it could be something like cranberry or tart cherry. There are some compounds that are helpful in helping with the mucosa integrity and acetylglucosamine and sync carnosine and stuff like that. So depending on what's going on there, and there might be some probiotics that are specifically designed to bring things up, bring things down. It'll be a combination of those things. I've tried to develop the program to keep the components that taste the worst, to keep the most feasibility in there. I mean, certainly they're going to be some things that are, that have no taste at all. And there should be pretty easy to get in there. Some things have a worse taste. But, you know, if there's something that's really strong, like I don't use any, I don't suggest for any thyme or oregano. Those things tend to have more of a destructive thing on the biome in general. But they're extremely, extremely strong in terms of their taste palette. And most children can't swallow caps or most of these kids until they get much older. So it has to be feasible. So I've kind of scrubbed the suggestions to make it so that these things are things that people can take.

B (25:29)

All right, great. No, that's pretty clear to me. And I think when you talk about the actions a parent can take, and let's put it all under the banner of supplementation of some form, it sounds like prebiotics, as you mentioned, are really key, perhaps probiotics, other supplements. And it seems like everything that you mentioned is more of a natural type supplement. So we're talking about overall. Right. More natural ways of helping to restore more balance of the gut. Correct?

A (25:59)

Yeah. None of these things that are gonna be recommended are prescriptive, I'd say, with the exception of. So there is one prebiotic that in the States, so it's called lactulose in the States. It's actually a prescription and it's used for the indication of constipation primarily. It's also used for things like non alcoholic fatty liver disease. But in most other countries, lactulose is actually over the counter, which has been something that I've, I'm, I'm trying to actively lobby, you know, RFK and his team to, to kind of change because there's some other alternatives out there that are really bad over the counter that we have here that do some damage. But lactulose is an unsung hero in the prebiotic world. It's very helpful at bringing down proteobacteria and helping to kind of reduce transit time and things like that. So there are ways that you can obtain it without having a prescription. It's, it's actually probably ideal to get it from outside the US because in the United States, for some reason they add a dye to it unless you get it at a Compounding pharmacy, and then they add an additional sweetener. But with the exception of Lachulose, everything else is either a probiotic, prebiotic plant herb. Some. Very rarely there's a homeopathic suggestion in there. But yeah, these are all kind of feasible, safe things. You know, things that come from the earth, they might come from, you know, different parts of the world. There's a. There's an herb called codaenopsis, also known as dan sheng, that comes from the Asian area. And it's really helpful for different types of sibo desulfibrio, hydrogen sulfide overgrowths. But these are things that are. People have used for a thousand years, you know, or 2,000 years in that area of the world. So there's a lot of medicinal properties. There's some things like mastic gum that are very helpful and, you know, that come from the Mediterranean area. So trying to exploit everything that has a medicinal property that's safe, that's a plant, you know, or an herb or something like that.

B (28:16)

And I think as you're talking, I'm thinking about for every child, let's say, or whoever you're doing this test for, you know, there may be some, you know, kind of some things you may recommend that most everyone can benefit from. But largely, though, especially since you've worked with hundreds of families, right, the specific guidance that's going to come out of this test is very personalized for exactly what's going on with that child, right? So that's where the game plan for it's going to differ significantly from person to person, which is the benefit of this personalized approach because per the title of this episode, right, it's about rebalancing and that's going to look different from person to person, right? There's. There is no one size fits all. Just do these things. So. So if assuming that's the case, when we use the term rebalance, what are you referring to? Is it this balance of the good versus the bad and just getting more harmony or how would you define rebalancing?

A (29:20)

It became very apparent to me. It's kind of somewhat how I got into this too, is that when doing the 16s test, you have access to this raw data. One of the simplest things that you can do is you can kind of just map the abundance of the microbes in the sample. So, I mean, it's akin to if you were to walk into the lunchroom at your school and you find out that every, you know, maybe 75% of the people are wearing a red shirt. That day. And you'd be like, for the normal person, if that were to happen, like, okay, what's going on here? There's some kind of joke, right? Why are three quarters of the people wearing a specific red shirt? Something is, you know, there must be a reason or something's not right. You know, it's not typical, it's not usual. So I think that that was kind of a shocker or kind of an aha moment for me. Whereas I was doing some of these other tests and looking for, you know, the bad guy on the street, but not realizing that, you know, three quarters of this microbiome would be taken up by this one microbe that wasn't really on the offender list per se. And so if the goal is to get to some level of balance, and if the goal is to get some kind of level of normality, then I think that starting there, you know, I might have a better shot. So in terms of trying to, you know, figure out, because there's a lot of unknown things in the microbiome and that's really one of the main feedbacks that you'll, you'll get from microbiome researchers. I recently went to, you know, there was one of these Maha esque type meetings and one of these microbiome researchers stood up there and said, well, we just don't really know what a good microbiome is. And to me I find that, I mean, that kind of statement I just find to be somewhat the product of the Ph.D. that's kind of looking for the solution to the problem. Whereas I think there's a much more elegant way to kind of solve that unknown. And it's basically by just looking at the distribution in the population. When you have 10,000 or so different microbes of possibilities in there, if you have a lot of samples that you can leverage against, One of the easiest ways to kind of get to that normality or stay out of trouble is to just do what the guy in the middle is doing. So going back to that lunchroom type analogy, if it was your first day at school and you're kind of scared, you're in the sixth grade, you don't have any friends, you know, what do you do when you walk into that lunchroom? Just do what the guy in the middle is doing, right? Less chance that if you do that, that you're not going to get into trouble, so to speak. So that's the way that I approach many of the microbes that don't have a lot of literature behind them. And we don't know what they are, what the function that they do. Right. If this is significantly overgrown with respect to the rest of the population, try to find compounds that bring it into balance. So the idea is just whatever species that you have, just try to bring it closer to what the median value in the population is. And the hope is there is that being in the middle might not be the best microbiome, but it's significantly better than being in the 90th percentile or the 5th percentile for a microbe. And that really has been the approach then, combining that with what we do know. So we do have some expert practitioner experience that says, okay, well, these things are bad and these things are good. We can kind of pay a little bit more attention to them. There's a little bit more that goes involved into it. But I would say generally that's kind of the concept of balancing is that don't look at three rooms in the house that you want to buy, look at all of them. Because that's really what if you have that checklist in front of you and that's what a lot of stool tests do. These are the things that you look at in buying a house and all of a sudden you go to that open house and you find that there's a toilet in the middle of the kitchen. That checklist, that's not on my checklist typically. But if you saw a toilet in the middle of the kitchen, you probably wouldn't be buying. It's weird, right? And that's where the 16s test can kind of figure that out and show you. Well, this is kind of odd. Let's work on this.

B (34:03)

No, I appreciate that analogy. And simply put, there's a state that's happening right now in your child's gut, and there may be some significant outliers which, if identified and with simple actions, if you can bring that more into balance, I think that's very understandable to me that it may not be ideal. The average of the population may not be the ideal state, but at least a really great first step is to do something about the significant outliers, which it doesn't take much to know that those outliers are going to cause some inflammation, stress, dysregulation, whatever the case may be if left unabated.

A (34:47)

Yeah, yeah, exactly.

B (34:48)

Yeah, an odd analogy, but I think a very effective one. So I appreciate that. And again, people can go to your website, learn more, But I wanted to have this episode because this is a very powerful way of understanding what's going in the Gut leading to very practical things that a parent can do, all in an affordable way. So I think this is dynamite. What you've developed in partnership with Dr. Bogner. Well, Alex, is there anything else that just, you know, having again, having worked with so many families, anything else that you would want to share with parents, whether they're have a newly diagnosed child or they've been on this road for a while, anything else that you haven't shared yet that you think would be useful for a parent to take away?

A (35:32)

Yeah, just know that, you know, there's light at the end of the tunnel. There's, you know, there's certainly a lot of frustrating times and things and challenges and you know, I think trying to be as open as possible with your partner and getting as much support as you possibly can is really important. And just knowing that there may be some medical components going on that are explaining the behaviors and the cognitions or the apparent cognitions and the functions and that if you do just a little bit, you know, it might have a big impact in quality of life and it's not too late. You know, we have people that are, I have to think the oldest person that I'm working with is 56 years old and she's, you know, been able to come out of a group home because of some of the work that we've been doing with her. So, you know, if you have the resources, you know, this is relatively inexpensive. You know, take a look and see if you can make some improvements there. But know that, you know, there's things that you can do, there's other people in the same boat and even just communicating with some other parents too sometimes can really give you that sense of community and support too.

B (36:50)

All right, well, I think that's some sage advice and that's a phenomenal case study that you mentioned. Again, there's so much that's possible if you're focusing your energies on meeting your child where they are. And this gives, I think, a very powerful way for parents to be able to discern that. So again, thank you for everything you're doing. We'll look forward to having you on again down the road. Thanks so much.

A (37:10)

Thanks, Len. Appreciate it.

B (37:12)

Your child needs you running on all cylinders now. And the fastest way to rise is with personalized one on one support. Get started today. Go to elevatehowyounavigate.com.