A (1:35)

I mean, obviously I've been aware of, like, the emerging research, but I would say the last two or three years on the podcast, I just felt like every time I had a researcher or a clinician that was talking about it, and I was like, huh? There's all these connections that no one's making together. And so when my editor reached out and said, do you have an idea for a second book? And I was like, well. And I kind of pitched it, and she said, oh my God, run with it. So it was, it was definitely like a game on, you know, topic and very, very timely.

B (2:00)

Yeah. And everyone's guts destroyed these days because of everything, right? We dive into all of it.

A (2:05)

But yeah, standard American diet, antibiotics, stress, all of it.

B (2:08)

Yeah, chemicals. And it's affecting our kids too. That's what they're finding out.

A (2:12)

And that's, it's like there's that epigenetic signaling. So you have like parents who might not be totally healthy, who go on to have kids who have like this imprinting of less health. And yes, it just does this massive trickle down effect. And it's interesting because I look at my kids and their friends and the conversations that we're having with other parents and it's like, oh my gosh, you know, we, we have to be thinking about it more proactively because it ultimately ends up picking up and being addressed in other generations.

B (2:38)

What are the biggest things you're seeing impacting the gut health?

A (2:42)

I would say, without a doubt, you know, inappropriately prescribed antibiotics. And I want to be very clear, I mean, there's a time and a place for them, but I think that antibiotics are used over judiciously and that, you know, one dose of antibiotics can impact the microbiome. I think your rate of, with one dose of antibiotics, your rate of depression can go up by 25%. One round of antibiotics, that's crazy. So antibiotics, number one, I would say, you know, our toxic food culture, I mean, we have a very ultra processed food culture. We know that, you know, even when we consume ultra processed foods, as an example, we consume 500 to 500 to 1000 additional calories. So over time that really is quite significant. I would say the other thing is just chronic stress. You know, since the pandemic, I think all of us would make the argument that, you know, trying to manage the pandemic and the post pandemic, what came out of that, jokingly, people say you either became a hunk, a drunk, a drunk or a chunk. And some people have just kind of continued with these kind of maladaptive patterns. But chronic stress, whether it's about people being stressed, about politics or economics or tariffs, you know, and that's at a very like, you know, upper level. And then just, you know, the dynamics that people have in their day to day life, I think stress plays a huge role and we can unpack what stress actually does to the gut. But you know, chronic stress, cortisol will lead to more leaky gut, leads to more immune system depression. You Know, if you. You know, I think about, like, college students around exam times. Why do they get sick? And it's because their stress levels are high. They're probably not eating the way they should, they're not sleeping enough, and certainly can make you more susceptible to opportunistic infections. And the other thing is, stress is catabolic, so it's breaking down muscle and lots of health issues that people aren't thinking about. But I would say those are probably the top three. And then maybe we loop in toxins like endocrine mimicking chemicals and things like that.

B (4:31)

Yeah.

A (4:31)

Glyphosate.

B (4:32)

Yeah. I used to always get sick around final season, and now when I fly, I get a runny nose. I wonder if that's stress related, too.

A (4:38)

Yeah, I mean, it could be. I mean, it could also be, you know, just the stress of travel.

B (4:42)

Yeah.

A (4:43)

You know, I think about, you know, you can get, like, vasomotor rhinitis where you just get a runny nose. But I also think that travel can be incredibly stressful.

B (4:51)

So I'll say within the U.S. yes. Because TSA is, like, up your ass. People are screaming at you with your luggage. I just traveled overseas, and it was, like, super chill.

A (5:00)

Where did you go?

B (5:01)

I went to Maldives in Australia.

A (5:02)

Okay.

B (5:03)

No one was yelling at me at the airport. Never felt like I was in a rush.

A (5:06)

Yeah, it's a big difference. I mean, I think TSA PreCheck and Global Entry help enormously, but sure, I would agree with you. You know, I live in a smaller city in my state, and so I know it's rare that I get direct flights anywhere. And I was saying, like, you know, if your flight's delayed and then you're rushing through an airport, that's never fun.

B (5:23)

Yeah, that's the worst.

A (5:24)

Yeah. It's like, travel can be very stressful just for that purpose, or you just get around, you know, people who are like, I sat next to a woman flying to D.C. and she was literally, like, cockeyed in her chair. So, like, I was scrunched like this, and, you know, she was on her phone the entire time, and I literally was like, her leg was, like, clearly in my feet. And I was like, seriously, like, just be cognizant of where you are in time and space. And it wasn't that she couldn't not be in her own seat. She just.

B (5:52)

That's wild.

A (5:53)

A portion of my seat.

B (5:54)

You didn't speak up.

A (5:55)

I literally was like, thank God this is a short flight, because this is obnoxious.

B (5:59)

That's wild how people don't have that. Just self awareness.

A (6:02)

Right. Well and it's like, just like the same people that speak on speakerphone on a, on their plane, like on the plane on their phone. You're like, seriously, like she was literally

B (6:09)

on a phone, y', all, until the

A (6:11)

stewardess came up and said you need to get off your phone.

B (6:13)

That's crazy. Get some AirPods or something, please. Or not even AirPods because those have EMF, right? Get the wired ones.

A (6:20)

Now my kids laugh at me because I'm wired for everything. Like I'm the person that like plugs into my iPad with my earbuds. They're like, what are you doing?

B (6:26)

I'm like, I only use wired, I don't care. Yeah, it's actually cheaper too.

A (6:30)

Yeah, exactly.

B (6:30)

AirPods are expensive and you lose them so easily.

A (6:34)

Yeah, well, and it's like I have like a child size ear so they don't even fit in my ears. Yeah.

B (6:39)

You still eating a lot of protein every meal?

A (6:41)

Definitely a lot of protein. 30 grams still 30 to 50 grams is, is the goal. And a lot of that has to do with the fact that we need more protein with aging and not less. So when my 18 and 20 year olds can have 10 grams of protein and stimulate muscle protein synthesis, when you get older you need more because we're more catabolic. So we're our bodies readily kind of breaking down muscle.

B (7:00)

That makes sense. Yeah. There's a lot of debate on social media with how much protein you need right now, especially with vegans and carnivores. And they're saying, the vegans are saying you actually don't need as much as I guess carnivores eat.

A (7:10)

But yeah, I mean, and I always say like respectfully, I think people can, can be rigidly dogmatic about their own nutritional paradigms that they fall within. I think it's better to be nutrient dense whole foods, a combination of animal and plant based protein, you know, a good amount of fiber and vegetables and fruit I think are reasonable. But I think when you get rigidly dogmatic, you sometimes just forget that what works for you may not necessarily work for everyone else. And so, you know, if someone goes from a standard American diet to vegan, that's great, they're going to be eating healthier than they were before. If someone has an autoimmune condition, a lot of gut issues, maybe going carnivore is going to be beneficial short term.

B (7:47)

Yeah, that's something I got to figure out my recent blood work, they might, they Said I might have an autoimmune.

A (7:52)

Oh, okay.

B (7:53)

So I got to figure out with, when it comes to diet, what to eat for that.

A (7:55)

Yeah, I mean usually it's, it's more like nutrient density. I mean, and it's also like kind of tracking of if certain foods provoke symptoms, like if you get bloating or digestive issues, you know, kind of tracking it to what it might be.

B (8:08)

I have the mthfr, so I think certain grains do that to me. Bloating?

A (8:12)

Are you homozygous?

B (8:14)

What's that?

A (8:14)

That means you have two copies.

B (8:16)

Oh, just one?

A (8:16)

Yeah. I mean most of the population has at least one. So I always tell people like, it might mean you might need a little bit more help with detoxification, but I, I don't know. So there's necessarily a clear cut indication between a particular SNP and developing autoimmune. We know that autoimmune can be related to like leaky gut. And so it's like going back to like, did you ever dose of antibiotics? Like a lot of people. Yeah. Get traded for Lyme and then they end up developing leaky gut. And so that's really what it speaks to, is at some point you had a leaky gut.

B (8:46)

I think I ruined my gut when I was on antibiotics for sure. But also, what's the one for acne? I forgot the name.

A (8:53)

Where to do Accutane. Yep.

B (8:55)

Yeah, I was on that for seven months.

A (8:57)

Wow.

B (8:57)

They had to test my blood once a month to make sure I wasn't like dying. Basically.

A (9:01)

Yeah. It's pretty toxic. Like I know when young women are on it, they have em on two forms of birth control because it's so teratogenic. So teratogenic means has the potential to cause birth defects. But yeah, those are, that's a pretty serious drug.

B (9:12)

Has there any been any link with birth control and gut issues?

A (9:16)

In fact, there is.

B (9:18)

Doesn't surprise me.

A (9:18)

Yeah, I mean, so you're, you're giving yourself essentially an endocrine mimicking chemical and can alter the terrain of the microbiome quite significantly. And let me be really clear, like these aren't necessarily things that we knew before. Certainly my generation and myself were on oral contraceptives for years, but now that we know more about it, it's like contraception is very important. I don't want that not to be the message, but understanding that certain medications can definitely alter that terrain and do it so quite significantly. Like we know, even the research suggests that women that are on oral contraceptives actually won't pick. Like it alters their, their pheromones. And so they might not attract the partners that they would, that they would have if they weren't on birth control. So you think about, like, you know, people that maybe when they partner up and get married, they're on oral contraceptives and then they go off and they're suddenly looking at their partner going, huh, that's.

B (10:10)

That must suck.

A (10:11)

Yes.

B (10:11)

Like, you think he's the one.

A (10:13)

And you're like, nope, not the one.

B (10:15)

Wow.

A (10:15)

Hopefully that doesn't happen all that often, but if 50% of divorce, 50% of marriages ended divorce, I mean, the potentiality certainly exists. Definitely.

B (10:24)

Yeah. I remember girls in, like, high school and college were pumped when they got the prescription to get, to get on those. You know, they were excited.

A (10:30)

Well, it's, I mean, I understand, like, people want reliable birth control. And if that's, you know, your ability to be able to utilize that and, and feel comfortable and confident that you're not going to get pregnant, I think that's important.

B (10:42)

Yeah, well, they said it helped with periods too, right?

A (10:44)

Yeah, Well, I mean, yes, it does. I mean, you're, you're giving a synthetic hormone, so they keep the hormones really low. So essentially you're kept in this very low estrogen state. But for a lot of women, they've got really heavy, painful periods or they're just not getting cycles regularly. And it doesn't per se fix it. It just kind of masks it. And, you know, I think for a lot of young women, it's like they've got too many things they want to do. I get it.

B (11:06)

Yeah. I'm hearing a lot because my wife has female friends. They're talking about their cycles being messed up. Like sometimes they'll skip a whole month. Crazy, right?

A (11:15)

Yeah. I mean, some of that can be stress. I mean, there's a lot of things that can contribute. You know, a lot of women are, you know, overly restrictive of food. There's a lot of things that can contribute while they can get alterations and cycles. But I think that's why, you know, the pill has been so popular, because it can be used for, like, acne. You know, some people take certain, certain birth control, oral contraceptives that help with their skin.

B (11:38)

Makes you wonder with all these prescriptions, whether it's the pill or anxiety medication, like, what's happening to the gut. Just taking this stuff every day, you know.

A (11:46)

Well, and there's this very strong, like, vagus nerve connection between the gut and the brain. So we talk about the gut Brain access. And so whether it's alterations in sex hormones like estrogen, testosterone, progesterone, or, you know, taking like a medication, like an antibiotic that is going to alter the neurotransmitters. So the bulk of our neurotransmitters are produced in the gut. And yet a lot of the medications we give, like the SSRIs, Paxil, Prozac, work in the brain on those neurotransmitter pathways. So I think in a lot of different ways, there's many things that come together that will develop, that will cause someone to develop mood disorders, whether it's depression, anxiety, OCD can be mitigated by a lot of different things.

B (12:24)

Wow. Yeah. One out of two kids now getting diagnosed with a mental health disorder.

A (12:29)

I think, I think it's so many different things coming together, but I think the food has a lot to do with it. And then, you know, rampant overuse of antibiotics, as I know I mentioned. But that's a huge problem. Like, antibiotics are there when we need them, but we shouldn't be using them indiscriminately.

B (12:43)

I. I would. I was thinking about it. I was probably on them at least once a year from, like, elementary school

A (12:48)

to college for probably like ear infection,

B (12:50)

ear infection, throat infection, anything. Like, even during COVID I got prescribed

A (12:57)

them, you know, and I mean, it's become. It's become something that's normalized. Like, if people go to urgent care, they expect to get an antibiotic. People go to the er, they expect to get an antibiotic. And a lot of the symptoms that people get, like, I'm coming off of having, like, a cold virus. And I was saying, you know, back when I was seeing patients all the time, if they got a cold, they expected a prescription to take away their symptoms. And I would say more often than not, it's a virus that's driving your symptoms. If it lasts a week, it gets worse. Then, you know, maybe we need to think about antibiotics. But, yeah, there's a lot of consumer demand for antibiotics. Geez. Because they want to shorten the duration of symptoms.

B (13:33)

Just for a cold, though. Cold, you gotta just let.

A (13:36)

Right. Gotta ride it out, ride it out.

B (13:38)

Take vitamin C, vitamin D, rest, hydrate. Why would you want antibiotics for a cold? No, it blows my mind.

A (13:44)

Yeah, no, I mean, and it's interesting. Like, my youngest son is taking, just finishing up antibiotics for Lyme. And because he has confirmed Lyme, it's like three months of antibiotics. He said the other day to me, he's like, I Feel like I'm developing anxiety, and it's not normal for him. And so we got on the phone with his provider, and, you know, there's a particular IV that they give that helps, like, replenish the cells. And so we're fortunate that he goes to a functional med. Integrated med physician. But I was like, this is exactly that statistic. I just said, you 25 of people, 1 round of antibiotics are going to develop depression. And so you just start to think, like, domino effect of what are the long term effects.

B (14:24)

Three months is crazy.

A (14:26)

And that's kind of standard for, you know, for Lyme. So they're retesting him, and hopefully he's been eradicated.

B (14:32)

Wow. Did you have Lyme too?

A (14:35)

Many years ago. I got it. And ironically enough, this was so long ago that I actually was seeing my. My college, like, college physician, and I had a bug bite. And she looked at me, she was like, I don't want to talk about what you came in for. I want to talk about that. And so I took a month of doxy. And it probably saved my life because back then there just wasn't as much awareness about Lyme. But I had the classic bullseye rash. Most people don't get that.

B (15:00)

Holy crap. So I wonder if it was passed down to him or.

A (15:03)

No, no, no, because they for sure knew that I had cleared it. But my son was, you know, like most kids in the woods with his friends playing and stuff, and probably got bit by a deer tick and didn't know it.

B (15:13)

Damn.

A (15:14)

So we're endemic. Like, where we live in the country is endemic for Lyme.

B (15:17)

Yeah.

A (15:18)

But they're seeing it now in other parts of the country, like, everywhere. Now that and Lone Star tick, which is a whole other.

B (15:24)

What's a.

A (15:25)

It's a. It's a. It's another tick. But a certain percentage of people that are bit by a Lone Star tick will actually go on to develop a mammalian meat allergy. So imagine. Yeah. And so I had some patients, actually, University of Virginia, which was close to where I practiced, they started making that connection between the meat allergy and getting bit by this tick. And so it's not every person, but I had some patients who couldn't have surgery because they couldn't actually get heparin and other drugs that are derived from pork because they were worried they'd have an anaphylactic reaction. So imagine if you suddenly couldn't eat mammals.

B (16:00)

That sucks.

A (16:01)

Yeah.

B (16:01)

And that's permanent. They haven't figured out how to fix that.

A (16:04)

Well, I mean, in the cases that I've seen, yes, because it's been so significant. But I'm sure there are people researching it right now to figure out ways to address it.

B (16:12)

That's awful. I love meat.

A (16:14)

Yeah. I would be. I would be devastated.

B (16:15)

I'd be. Yeah. How do you get protein at that point?

A (16:17)

Yeah. I'm like, I don't like chicken or fish enough.

B (16:19)

I already have an estrogen issue. I can't eat tofu and soy.

A (16:22)

Oh, interesting. How did you find that out?

B (16:25)

On the blood test?

A (16:26)

Yeah.

B (16:26)

My estrogen levels were high.

A (16:27)

Oh, yeah. You definitely want to stay away from it.

B (16:30)

Yeah. I don't know what was going on with that because I don't even eat

A (16:33)

soy, but could have been just estrogen mimicking chemicals. So, like, water. Thinking about other things in your plastic, too, right? Plastics, water. Yep.

B (16:42)

Yeah. Who knows? Is. Is the book you mentioned earlier, is that out yet or are you still working on it?

A (16:47)

No, the Menopause Gut will be out on April 26, actually. Sorry. April 28, 2026. So it'll be out in four and a half months. It's hard to believe.

B (16:57)

Wow. Books take a long time, huh?

A (16:59)

Yeah, because the manuscript was officially submitted in March. But then there's like this back and forth process over time about, like, the copy editors go through and, like, everything you think is perfect. And then they're like, no, this grammar of this one sentence and this word is redundant. And so the experts come in. The word experts come in and have revisions. And then you're waiting for book endorsements from people that, you know, you respect and value. And so things all kind of fall into place. But the book is effectively done. It's just. It'll be final stages. Yeah, final stages.

B (17:29)

Well, thanks for your time, Cynthia. I hope you crush your talk. Anything else you want to end. End off with here?

A (17:33)

No. Thanks for having me.

B (17:34)

Well, we'll link your socials in the video. Thanks for coming.

A (17:36)

Thank you. Absolutely.

B (17:37)

See you guys. Thanks for watching. All the way to the end, guys. Please hit like and subscribe. It helps us grow the show and helps us get bigger guests. Thank you so much.