Episode 207: Building a Resilient Gut
Functional Medicine Expert Will Cole on The Impact of Inflammation & Chronic Stress on the Microbiome, Building a Health Plan with Limited Time & Resources + Conscious Consumption, Coping with Stress & Embracing Imperfection
My guest is Functional Medicine Expert, Dr. Will Cole. We get into all about his book called Gut Feelings. I appreciate Dr. Cole’s work because he understands all the complicated things around chronic inflammation, mitochondrial function, your microbiome, and on and on but he has the great ability to make it simple. In his book, Gut Feelings, we talk about the microbiome. I know that we hear this all the time, the importance of the health of your microbiome. There are trillions and trillions of these bacterial cells and we know about maybe 500 of them do.
Listen to the episode here:
- Our Gut Feelings
- What Stops Us to Change
- Your Relationship with Alcohol
- Being Informed
- The Emotional Side of Health
- Parenting Healthy Kids
- Grace and Wellness
- Maximizing Gut Health
- Food is First
- Impact of Movement on our Gut Health
- Gut Health Trends
- Gut Health Information Source Recos
- Getting Back to Health
- On Apple Cider Vinegars and Bitter
Welcome to the Gabby Reece Show, where we break down the complex worlds of health, fitness, family, business, and relationships with the world’s leading experts. I’m here to simplify these topics and give you practical takeaways that you can start using today. We all know that living a healthy balanced life isn’t always easy. Let’s try working on managing life a little better and have some fun along the way. After all, life is one big experiment and we’re all doing our best.
Dr. Will Cole: “Inflammation is the commonality between about all health problems but the question is what’s causing the inflammation? That’s where I get into gut feelings because it’s both physiological and psychological for many people. Underlying gut problems will spike inflammation, that’s where 75% of the immune system is. Inflammation is a product of the immune system. On the feeling side, chronic stress, and unresolved trauma impact inflammation levels as much as a food that doesn’t love you back and just as much as the wine. It’s going to impact it. It’s not just about what we’re feeding our body; what are we serving our head and our heart on a daily basis?”
Gabby Reece: My guest is Functional Medicine Expert, Dr. Will Cole. We get into all about his book called Gut Feelings. I appreciate Dr. Cole’s work because he understands all the complicated things around chronic inflammation, mitochondrial function, your microbiome, and on and on but he has the great ability to make it simple. In his book, Gut Feelings, we talk about the microbiome. I know that we hear this all the time, the importance of the health of your microbiome. There are trillions and trillions of these bacterial cells, and we know about maybe 500 of them do.
How do we positively feed our guts, support our gut health, get into discovering if our gut’s not working correctly, and how can we fix it and heal it? He does a great job of explaining not only step-by-step but maybe some of the things to approach. If we’re not feeling our best, maybe we have chronic inflammation from either lifestyle choices or stress. Don’t kid yourself. This is something I look at all the time. I do a pretty solid job in my lifestyle choices but I internalize a lot of my stress.
He even unpacks this idea of there are things in our life that maybe we haven’t dealt with and no matter how great we eat and exercise and get to bed early, if we don’t deal with these things, how can it impact our health, our overall health, and our guts? We talk about tests you can take on how to analyze what’s going on and foods you can eat to soothe your gut.
Dr. Cole is great at getting at the heart of things but also saying that there’s no way to separate our physiology and our psychology and how, when we are seeking wholeness and wellness, we can ignore also some of the things that are more invisible. It’s not just about food and exercise but it’s about all of us and that we don’t land there. This is a constant thing. This is a practice. This is being a human being. He is an author and a functional medicine expert and he has a podcast, The Art of Being Well. I hope you enjoy our conversation.
Dr. Will Cole, thank you for coming on my podcast again. We were saying that you’ve been busy at your clinic. How many children do you have?
Two. I’m doing all the things. I’m running the telehealth clinic. I have two golden doodles.
How did you guys survive COVID with teenagers? How did that go for them?
It was a horrible time for a lot of people so I don’t want to gloss over that. A lot of silver linings for us. We got to spend more time together. We started one of the first functional medicine telehealth centers over thirteen years ago. My job changed 0%, other than not traveling. What was nice is my kids were home more and I got to spend time with them. I loved it. I still came to the telehealth center. We played more board games, we spent more time together, we watched more shows, and hung out. How about you guys? What was it like for you?
The same thing. It would be hardest if you had little kids. Our kids were a little bit bigger so there’s that level of independence. I’m not going to lie, I too, as they get older, realize how precious the time is even though you’re like, “Get out of my house. Wait, don’t go.” There was a bit of that for us where they got this independence, they could go outside and do their thing but then we have more quality time.
We have it easier that way. I hear horror stories from people on my team that are like toddlers working at home. That seems horrible and tough, working at home with little kids.
You wrote this book, Gut Feelings. You talk to a lot of patients. I’m wondering, is it because this is showing up over and over that gut health and your microbiome is important? What is it that you thought, “I’m going to dedicate time to this,” what showed up for you?
The book is born out of my clinical work with patients here. I wanted a deep dive discussion on what I see clinically and what is in the research between gut and feelings, our physiological health, and mental, emotional, and spiritual health. I’m having a discussion in the book about how mental health is not separate from physical health. Mental health is physical health. Underlying gut problems are like other physiological things, other sources of inflammation. We deal a lot with mold toxicity and chronic Lyme disease.
Whatever you’re dealing with, physiologically, how that can impact your mood, impact things like anxiety, depression, brain fog, and fatigue. Conversely, a large part of the book is the feeling side of gut feelings where I’m talking about things like chronic stress, unresolved trauma, and how these mental, emotional, and spiritual facets will impact our physical health. It will be stored in our body and ourselves impacting something called methylation, which impacts inflammation levels, our hormone health, and our neurotransmitter health.
When you talk to people with autoimmune issues, hormonal problems, fatigue issues, and things like anxiety, these are the facets that are at play. It’s both and either or the gut and the feelings that need to be talked about. It is an important conversation when you look at the statistics, the amount of people that are dealing with those health issues.
It was interesting because you talk in the book about autoimmune sometimes maybe not connecting fully with self. When people hear that, they do want to keep it separate. It’s like, “This is my emotional health. This is my physical health.” When you tell people, “You might have to tackle some internal things going on with you that will then favorably impact your physical health.” How do they respond to that?
One of those chapters in the book, when I talk about how the researchers refer to autoimmunity, even if you think about it on a purely physiological level, when the immune system has something called molecular mimicry, it’s when the immune system has a case of mistaken identity. There are over a hundred different autoimmune conditions but it could be Hashimoto’s disease against the thyroid or it could be the myelin sheath for MS or the gut for ulcerative colitis or Crohn’s and rheumatoid arthritis with the joints, and so on and so forth.
The researchers have this terminology that they talk about as the immune system losing recognition of self, that molecular mimicry. I thought, “How deep is that concept when you think of someone losing recognition of self?” Yes, it’s happening on a cellular and mechanistic standpoint. We also know from the research of shame and unresolved trauma, how there’s so much loss of recognition of self on that side of things, and how these mental and emotional things facets for many people can trigger, can be the precipice, and can be at least a component to why people have these flareups in the first place.
We have to look at the feeling side of that gut feeling’s duality to understand things like autoimmunity and not just with autoimmunity but inflammatory problems as a whole. We should not relegate mental health, emotions, experiences, and trauma impact on our physical health because it’s linked to just about every chronic health problem we’re faced with as a society.
People feel overwhelmed more than ever. We all talk about it all the time. There are a million podcasts and there are articles out there about our technology, the pace of our lives, and always being connected, but yet it feels like we still aren’t figuring out how to deal with it ultimately. We’ve never had more information and the tools to figure this out. What is it from your side? Because you talk to people all the time, what are the things that get in the way of people making changes?
In many ways and on many levels, we’re at a massive precipice in f the way that people digest and utilize information in our world and a lot of old systems are being threatened because of it. There used to be a lot of gatekeepers when it came to health information and it was the man in the coat that you saw once a year, twice a year, and everything they said was gospel. You didn’t have access to the internet where you could go on PubMed and read the research for yourself.
We have more than ever before an educated and informed populace that we have to do better for. We’re a part of that. We want to ask questions and not be medically gaslit when we ask questions about our health and wanting to have informed consent and to have informed consent. You have to know the ins and outs and what’s at play here. What does the research say and what does the research not say? What can we have? How can we have agency over our health? That’s a large part of it when it comes to understanding what’s at play for our health.
Sometimes it feels like paralysis by over-analysis. There is so much information and we’ve gotten so far from our nature. We are in this shift and we haven’t learned how to drive the car yet so to speak. I also almost feel like we’re in this weird quagmire too.
There is a paralysis of analysis. I’m a fan of the democratization of information. I’m a fan of the decentralization of information so people can have information and take what they want from it. Not everything is applicable to everybody and that’s okay. We have to have discernment on what is relevant for us and be savvy consumers of information, what we read, what we hear, and what we see. You’re right, there’s a lot of knowing and there is a lot of information out there.
The unsexy part of it is the doing and the consistency,whichis a human problem, especially in modernity. We are programmed. The benefits of technology is we get great information but also the drawbacks of technology are it distracts and numbs us from doing things that matter, which is typically offline. What are we doing on a day-to-day basis? It isn’t so sexy and there’s not so much dopamine hits when it comes to the day-to-day grind of showing up for yourself.
Let’s start there. Let’s say you’re the king of the castle and you get to move all the pieces around for us and you say, “For a starting point.” For the sake of this conversation, let’s use the gut because everyone talks about gut health and microbiome being connected to your sense of well-being, even your brain function, your personality, and all these things. Simultaneously, there are trillions of microbes and we only know 500 of them and what they do.
People have heard this a lot but they don’t know, “X is the starting spot.” If someone comes to, maybe their health is not off the rails yet, but they go, “I would like to put more energy into this.” Where would you start? You get to say it however you want. My hope is, in this conversation, these are people with real lives, and these are not people who live on a mountain in a tent alone and can dedicate their entire life to this. They’ve got kids, they have jobs, and they’re trying to fit it all in. Where do we start on this?
That’s the majority of people that I talk to. The vast majority of patients I have are 9:00 to 5:00 people, people who work regular jobs. Statistically, I see a lot of nurses, school teachers, entrepreneurs, and engineers. I found that those people have a common love of spreadsheets and getting to the root cause. We love spreadsheets and functional medicine too. We want answers. What’s the data say? How can we get to the root cause of why we’re dealing with our health issues?
I have to be pragmatic when it comes to how we optimize our health no matter where we’re at on that inflammation spectrum, whether it’s mild fatigue, weight loss resistance, maybe some anxiety depression, maybe digestive problems, and all the way to extreme chronic fatigue syndrome, panic disorder, autoimmune issue, type 2 diabetes, and everything in between. We have to be pragmatic.
If you’re looking for the most needle-moving things, you have to start with food. Most of our patients, by the time they met us, they already have done that, and we’re there to refine that, optimize it, and get more granular as far as what’s relevant for them. Even healthy foods, what works for one person may not be right for the next person.
If somebody is like, “They know this theoretically but haven’t taken action.” By this, I would say consistent action. It’s not going to be 30 days of something. If you’re dealing with a chronic health problem, even if it’s mild, the gut can take 6 to 24 months, depending on how severe the issue is with a lot of different variables to consider. It can take months and not weeks to get to the place of resilience and turn the corner.
Many people will tell me, “I did this thing with food for a few weeks and it didn’t do much. I gave up this whatever and it didn’t do much.” I tell you to empty that bucket when the bucket is overflowing. Sometimes it takes months. More oftentimes than not, it takes months and potentially even years to turn a corner. I know that’s talking in generalities but we need to look at food. What I call the inflammatory core 4 is if people want specifics, if they haven’t looked at these foods’ relationship with their body, does this food love me back or not? Gluten-containing grains would be on that list. It’s not necessarily one but it’s some people’s number one. It’s going to be things like wheat, rye, barley, and spelt but mainly looking at wheat.
It’s complex. Is it wheat or is it what we’ve done to it? It’s a bit of both. It’s over-consumption of food. It’s feasting on famine food. It’s stored well historically from an ancestral health perspective but we’ve also hybridized it. We’ve also sprayed it with glyphosate and we’re overconsuming it and not preparing it properly as far as fermentation and sprouting it and the origins of it.
Number two would be industrial seed oils like vegetable oil, canola oil, and soybean oil. Is it the oil or is it the overconsumption of it? It’s more the overconsumption of it because the modern Western diet is pro omega-6 and those ratios of those omegas, polyunsaturated fatty acids, are important. The ratios of omega-3, 6, and 9 are important. The modern Western diet is very pro-high omega-6, which can be pro-inflammatory.
Third would be added sugar, which is a no-brainer, most people know that. I would even look for nicer-sounding euphemisms for sugar that can be hidden. Look at the grams of added sugar. The fourth would be conventional dairy. You can get A2 dairy, cultured, and fermented dairy like yogurts and things like that. That will break down some of the caseine protein to make it more digestible. If people looked at that inflammatory core 4 and then the plus one would be alcohol, which gets me no friends when I say that. alcohol is also going to be a problem when it comes to people’s chronic health problems.
I did this speaking engagement once and I was in Canada. With part of your crew with Goop. I was doing this whole thing and everyone was on board. I could see they were with me. I was like, “Exercise, sleep, and all these things.” Right at the end, I was asked, “Do you drink alcohol?” I was like, “No, not really.” I’d lost them. I don’t know what it is about alcohol because it sounds naggy. The thing is, sugar used to be the naggy, like, “Added sugar.” I feel like we’re past that.
Alcohol is the one less, like, “What are you taking from me?” I sometimes wonder what the bigger question is. I understand taking the edge off. Since the beginning of time, they can make it from potatoes, rice, or whatever. The bigger question is, where did we get that? It was strange when you didn’t drink alcohol. It’s a big one. No one wins a popularity contest. The other side of that is people can go, “The stress you relieve by having that glass of wine, is that better?” I’m sure you’ve heard it all, “Stress is the number one killer.”
It’s a neurotoxin. There’s no way around it. I’m a pragmatist. I’m not a puritanical teetotaler when it comes to these things. I have to give people a pragmatic, “If you’re going to drink, pick the least offensive, which is going to be low alcohol.” The least neurotoxin, low sugar, dry, biodynamic, and organic wine probably would be on the list for most people. If you can have a healthy relationship with it. There’s the physiological impact. It can increase leaky gut syndrome. It’s hard on the liver. It impacts many different systems in the body.
There’s the emotional component of it where you need it to deal with your background anxiety or these unresolved things on a mental, emotional, and spiritual level. Is that the best tool within your toolbox to address these issues? There’s a physiological, mental, emotional, and spiritual conversation that I had in gut feelings in the book around these issues. You’re right, that’s the thing, a big percentage of it is because it is glamorized even in the wellness world, like, “It’s mom-juice culture.” It’s not healthy as good as they make it look like it. It’s an issue.
I see people that are better off because they are eating better than the average American. They’re working out and they’re taking care of themselves but they can’t understand why they can’t get past this plateau. I can’t tell you how often it is. It’s a matter of taking alcohol out. When you do that, you move past that plateau.
You have to ask a personal question, are you okay with where you’re out health-wise? If that thing is keeping you back from what you want, what do you want more? There’s a way to have alcohol that does love you back more but normally, it’s going to be a lot less than what you’re drinking and a lot less often than you are drinking. We have to find that sweet spot if you still want it in your life and you can find a threshold that it still loves you back or you’re not noticing the negative impact as much.
There are all these terms for things that people might have with gut health whether it’s SIBO or leaky gut, which you mentioned earlier, and things like that. If someone comes and they say, “I’m going to commit. I’m going to look at the nutrition.” We won’t even call it diet, we’ll say what we’re consuming, eating, and drinking. To your point earlier, there is no way around it, there’s no way to hack it, and there’s no way to shortcut it. You have to deal with what you’re putting in your mouth for one.
Someone says, “I’m on board. I’m going to figure out the best way for my personality and my lifestyle to eat the best that I can and I’m committed. I’m going to make this my new practice.” They come to somebody, they come to you, is there a test? Blood work is always a good thing to do, general blood work. Get a look under the hood. Is there a specific test where someone goes, “I’m not feeling good in my gut. There’s something in there, I know.” Is there a test that they can do that will get in there and get you more information?
We would run a comprehensive blood panel for our telehealth patients, it’s based on health history so the individual biomarkers can vary. We’d want to look at the metabolism as a whole. Statistically, that’s a problem for a lot of people. When you’re looking at glucose, in functional medicine, we want glucose to be under 90 for the optimal range. Most of your readers know this already but the reference range on labs is largely based on a statistical bell curve average of people who go to labs.
People that go to labs aren’t the healthiest group of people, sadly, that’s why they’re going to labs. In functional medicine, we’re looking at, “Where does the body function the best? Where does optimal reside? Where does vibrant wellness live?” If you’re not there, let’s get you there. What do we have to do there? We want to put the labs in context, of course, with a health history and other labs. We’re looking at optimal, not average.
A lot of things can be hidden in the gray areas because they think, “I go to my GP. I go to my PCP. Everything looks normal.” They’re not looking beyond the surface. If you don’t feel normal but the labs are coming back normal, either they’re not running the right labs, they’re not interpreting the labs appropriately, or both. We want to look at, “Why do I feel the way that I do?” Do not settle for it. You don’t have to settle for feeling fatigued, anxious, bloated, and inflamed. These are largely overcomeable, healable, and reversible things. Why would we want to settle for anything less?
Looking at glucose, under 90, that’s your blood sugar. We get very granular with patients if we need to be. We will run CGM. We will have them wear CGMs and track the data and optimize nutrition based on that if we need to and give them guidance on it. The A1C, which is a three-month average of your blood sugar, we want that to be under 5.5. Everybody should be running a comprehensive metabolic panel plus an A1C, which will include these. Looking at glucose A1C, insulin, adding insulin if it’s not included, and looking at your metabolism, your liver function, looking at AST, ALT, and GGT.
These liver enzymes, because so many people are struggling with metabolic issues, the body is storing glucose or blood sugar as circulating fats or triglycerides. Fat around the liver can become a fatty liver disease, which you’ll see spiked AST, ALT, and sometimes GGT. That’s basic looking at the metabolism. I would say a full thyroid panel if it’s relevant to the health history is insightful because thyroid issues, especially amongst women, are ubiquitous.
You cannot hang your thyroid health on a TSH alone, which is the thyroid-stimulating hormone. We want a full thyroid panel, Total T4, Total T3, Free T3, Free T4, and what are called thyroid antibodies, which are thyroid peroxidase antibodies and thyroid globulin antibodies. Autoimmune thyroiditis or Hashimoto’s disease is the leading cause of low thyroid function in the West.
We’re scratching the surface. We talked about metabolism and the thyroid, which impacts your metabolism. Those are good places to start. If I’d add two more things, inflammation, looking at those, is a surrogate into what’s going on from an inflammatory standpoint. High-sensitivity C-reactive protein, we want it to be under one. Homocysteine is another Inflammatory protein, we want that under seven.
What was the one about this high-sensitivity protein? What does that mean?
High-sensitivity C-reactive protein is an inflammatory amino acid. We all make it. It’s normal to make it. We don’t want high levels of it. The American Heart Association and CDC have low average or high what they call relative risks for cardiovascular events. They run hsCRP to look at potential heart attack and stroke risk factors. There are a lot of things that spike hsCRP. We see a lot of people that have rheumatoid arthritis, other autoimmune problems, and other flare-ups of inflammation. hsCRP is what they call a surrogate lab for different types of interleukins, which are pro-inflammatory cytokines.
Inflammation is the commonality between about all health problems but the question is what’s causing the inflammation? That’s where I get into gut feelings because it’s both physiological and psychological for many people. Underlying gut problems will spike inflammation, that’s where 75% of the immune system is. Inflammation is a product of the immune system. On the feeling side, chronic stress, and unresolved trauma impact inflammation levels as much as a food that doesn’t love you back and just as much as the wine. It’s going to impact it. It’s not just about what we’re feeding our body, what are we serving our head and our heart on a daily basis?”
It’s such a hard point to believe because we think, “I’m trying to get my exercise in.” I think about this a lot because I have my own level of intensity that sometimes I know that I internalize things and I go, “I wonder how much of that I’m processing in the correct way and how much of that is going to come to bite me later.” Even if you prescribe to doing the right things and you then say, “Also, I’m going to try to be brave, chin up, grind through, stoic,” or whatever the words are, that can have positive connotations behind them. Being conscious about not eating that stress or those feelings is an everyday paying attention practice.
I have a good friend in particular that I’m thinking of that, on a lifestyle, off the charts, does everything perfect and came up with cancer. It wasn’t able maybe to deal with something from childhood and also weren’t particularly good at letting people help them or do nice things for them. I want to maybe visit that area. There’s meditation and therapy. Are there things when you’re dealing with a patient that you say, “Would you be open to adding these things for the emotional side of your practice that you see people do have the time and have gotten so many benefits from?”
It’s huge. When we were talking about food and when I was talking about people’s relationship with food or relationship with alcohol, in many ways, for many people, that stuff will be a lot more effortless, a lot more intuitive, and a lot more unimpeded whenever you deal with more of the feelings side of things.
It’s not that you have to have it completely resolved or entirely healed. Life is always healing. We’re all human. Healing is non-linear too with these issues. At least starting that journey and being more conscious and having more mindful awareness around your body and body awareness and food awareness and life and presence, you will make more mindful and intuitive decisions and be more conscious about foods and drinks that love you back and those that don’t love you back.
The feeling side of the Gut Feelings paradox or the bidirectional duality there both needs to be addressed. A lot of the book is talking about the science-backed things that I’ve seen clinically be effective to deal with what’s called the neuro immuno endocrine axis, the intersection between our nervous system, our immune system, chronic inflammation, and the endocrine system, our hormonal system.
Every day, there’s a practice that I show people in the book to bring into their life and they can lean into the ones that are the most resonant with them. One of them is breathwork. Breathwork, we hear about it, maybe we’ve dabbled in it. It’s like going to the gym and you can’t say, “I went to the gym once and it wasn’t for me.” We didn’t do anything. That would be ludicrous. Nobody would say that’s normal. People will say that with meditation. They’ll say that with breathwork and they’ll act like it wasn’t for them.
What we have as a culture on an individual basis, we are a nation of poor vagal tone and weak vagal tone. That’s the largest cranial nerve in the body that innervates and impacts the gut-brain axis, and the connection between the gut and the brain. It’s the master regulator of our parasympathetic nervous system, our resting digesting hormone balance grounded regulated state. We have hyperactive, sympathetic, fight or flight, and freeze-inflamed state.
We’re going to suck at breathwork. We’re going to suck at meditation when we have a weak flabby vagus nerve. That’s why you keep showing up and do things that don’t come naturally. Make your weak parts your strong parts and that’s only going to get strong with consistency. Welcome to the club if you’re not good at meditation and breathwork but that’s why we need to do it. The people that are the most visceral against it are normally the ones that need to do it the most.
It’s true. Maybe we could visit there for a second. I love breathing because it’s the essence of life and yet most of us are doing it incorrectly. Let’s say someone is sitting at their desk or a mom driving a van full of kids to a sporting practice. What would be something that they could implement in their breathing practice? You do give a lot of nice examples in the book to even start to practice and bring that awareness.
Most of us have shallow breathing, we’re breathing out of our chest, and that’s part of that sympathetic overactivation and underactive parasympathetic. We could assume some level of poor vagal tone or weak vagal tone, which we want to strengthen to regulate resting and digesting. Breathwork is one way to tone that vagus nerve.
I talk about in the book a beginner practice is belly breathing, lying on your back. You can’t maybe necessarily do that in the van when you’re picking the kids out but maybe you could get out on a little grassy knoll and do it there or lay in the back of the van. Put one of your hands on your belly and have your stomach move and breathe like babies breathe. If you’ve ever seen a baby or toddler breathe, they’re breathing naturally with those deep belly breaths that we lose over the course of our lives. It’s retraining our bodies to breathe these deeper breaths.
Another easy thing that you could do while you’re waiting for the kids is box breathing. I have to pick up my daughter from dance or my son from something. She’s driving now. Shout out to all the parents that have kids that are driving now. It’s scary as heck but you don’t have to be an Uber driver. It’s a bittersweet moment. Breathe in for four seconds through your nose, hold for four seconds, and then breathe out through your nose for four seconds.
Repeat that, you’re holding for four, breathing in, breathing out, and alternating between the two. That is box breathing. That is easy, accessible, and completely free. Do it for 5, 10, or 15 minutes. Start off low and slow. It’s like you’re going to the gym, you’re not going to go to an advanced class if you’ve never worked out before. You meet your body where it’s at and then be consistent with that practice and then progress from there.
The science of breathwork that I talk about in the book is something called holotropic breathwork, which is born out of psychedelic research. It’s the opposite of breathing through your nose, which a lot of breathwork practices are through nasal breathing. Holotropic is done through the mouth. It’s not so much a grounding experience but a deeply somatic and visceral experience to elicit some of the similar mechanisms of our nervous system as psychedelics do.
A lot of people that are learning about wellness have heard about the research around psychedelics and when it relates to trauma, stored trauma in the body, and different inflammatory autoimmune problems. Holotropic breath work is parallel with psychedelic research as a way to endogenously naturally help to metabolize stored trauma, which is pretty powerful but we have control over it. We have control over it from the breath because breathing through your nose is like the breaks, it slows down that holotropic experience. Breathing through your mouth can be the gas pedal that speeds that up.
You would do that with a class practitioner until you can get equipped with the skillset set of it and then you could do it on your own, potentially. It’s typically done in a class setting. People can have spasms in their arms. It can get freaky. It is life-changing for people that have trauma, anxiety issues, and autoimmune problems.
Breathwork can be huge and not just breath work but let me open it up to other somatic practices. I’ve seen it be a game changer for our telehealth patients, the ones that are consistent with it. Stubborn digestive problems, stubborn mental health issues, stubborn autoimmune flareups, and food sensitivities, it’s a massive needle-mover for those problems when they’re consistent with strengthening the vagus nerve in that way.
I love this because it’s hard for us culturally to accept that something that we can do for free once we learn as a tool could be one of the single most beneficial things for our health and sense of well-being. I’m going to be honest with you, I have to remember this myself. If somebody has an exercise, a bike at their house, all of a sudden, you never use it but you would somehow go to a spin class. This idea of also doing with other people makes it easier to have that consistency in your life. I utilize the people that come to my house to train or I use Laird. If he’s going to go do breathing, instead of looking at it like, “I can do that anytime,” I go, “This is an opportunity for me to jump in there.”
There is something to be said for collectively breathing together. Is it a form of rhythm, tribalism, and all of those things too? It’s a beautiful thing once you get over it. People get self-conscious or let’s say you’re going to make noise. It’s interesting, you’ll see people laying on the ground and they will not go into their tummy. We’ve been taught so much, like, “Suck it in.” It’s like, “No, let that thing out. Be soft. Let it open.” You instantly relax. It’s beautiful.
You’re right, there is something healing. Even removing the actual science of the holotropic breath or any type of breath work, there’s healing and being awkward in a community and breaking those barriers. Research has shown even fa being face-to-face, whether it’s online or, I would assume that when you’re talking about breath work, being in person has a different human-to-human healing catharsis. That itself can improve vagal tone.
You look at the epidemic of loneliness, that’s a whole other topic of what that’s doing to human health. There’s ultimately no true replacement for in-person contact. I’m in telehealth but I still will get my patients out in their community because it’s so primally important. It’s decreasing that chasm between genetics and epigenetics. Our genetics haven’t changed in 10,000 years so we’re acting like our DNA is living in a brave new world but the reality is, this mismatch, we’re paying the price for it in the form of chronic health problems and mental health issues.
How are you dealing with that with your kids? This is a selfish question. In a way, they live in a different world than you and I was raised in. I find myself not understanding especially my youngest daughter. My older two seem to have a grip on their relationship with technology. Sometimes I joke but it’s also because of my fear, I’m like, “We’ve lost the youngest one to the experiments.” I’m like, “2 out of 3 is not bad.” just wonder, is there a practice in your house? Have you figured something out in this way to help your own children because it’s tricky?
Even with the breathwork and all of this stuff, I’m right there with everybody that’s reading. They call it a practice for a reason. It’s because we don’t have it all figured out. We’re all humans, we’re all subject to the same entropy, distraction, busyness, laziness, and sometimes procrastination. I’m not some sort of wellness guru prophet. I do this for a living so I want people to give themselves grace and lightness to their life and all of these things.
When it comes to parenting, the same thing. I look back and I’m like, “Dang.” It’s like Maya Angelou, “When you know better, you do better hopefully.” That’s how I feel, like, “My kids are teenagers now. I wish I would’ve started so much younger and so many different things.” They’re great kids and we did the best we can with the information we had at that time. It’s a cliche, the days are long but the years are short. It’s deeply true.
People are trying to get through the day. We’re constantly marketed to have all the things or do the things. We made a decision intentionally for us. I’m not saying that this is the right way. Our kids did not have technology until 2023. My son did not have a cell phone until 2022. He was the only one though. I realized we’re unicorns in that way. Of course, he didn’t have social media. He may have had a cell phone the last year before that but just could text. He could not communicate other than texting because it was pragmatic. He was at sporting events or whatever. He did not have social media until this year. Now it’s just Instagram.
I’m not saying this because my son is an amazing kid. He is amazing but that’s because I’m his dad and I’m saying that. I feel like it’s created a mindful awareness so he came to us and said, “Dad, can you put on time limits on this because I can’t stop? Once I’m in there, I’m constantly scrolling. I don’t like the way it makes me feel.” There’s more mindful awareness around it.
I do feel like that, for us, we started early. He, in a way, grew up the way we grew up. This wasn’t always a part of his life. He had TV, Netflix, and a computer. It’s not like he was Amish. He wasn’t Wally on that Pixar film staring at a screen all day long where. That’s what it is for his generation. My daughter, the same thing. She’s not on social media. She has a cell phone to text and that’s it. She’s at dance class and she needs us to pick her up. That’s what we use it for.
Does she push back? Boys want to maybe play games but with girls, that social component of the technology. Is she pushing back harder or there’s no room for that?
She’s not. This is such an interesting thing with parents, we know our kids. Every kid is going to be different. As you said, “The third one. 2 out of 3 ain’t bad.” Some are easier in some areas and some are harder in the same area. For her, she’s fine with socializing with her friends in person. She has what she prefers. She doesn’t need the other stuff. She wants to hang out with her friends. It’s a lot of Uber driving with us taking her to hang out with her friends, which is annoying but I’d much rather have that than her on TikTok or Snapchat.
That’s an important point.
It’s tougher. It’s more difficult. I get it. It would be so much easier for me to say, “Whatever they wanted on technology, I’m going to give it to them.” I want them to live in a modern world but I want them to have a conscious awareness of how they consume the modern world.
When you get the chance to mature a little bit, then you do have perspective on where this plays in my life.
Some kids are better at regulating than others. My son will be the first to admit and has said publicly on my podcast is he’s not as good at it. My son could play video games forever and he doesn’t like how he feels after that. My daughter doesn’t need anyone to pair her with that. She can get up and leave and be fine. we all know our kids, we just need to be there for them. Kids are, in many ways, screaming for healthy boundaries and we need to give that to them when they need that.
That’s a good point. It’s such an interesting thing when you’re unsure about parenting, you go, “Is this too much? Is this not enough?” I feel like it’s that constant calibration of knowing when to push a little harder and when to lay off. It can be so tricky. You’re a busy person doing a lot of different things. Let’s say your daily practice is buttoned up, what you eat, when you go to bed, and all these things. What about the stress? what do you do with the stress? Is it meditation? Is it breathing? Does it ever get to you? How do you manage that stress of, “9,000 things and I still got 4,000 when I go to bed,” how do you deal with it?
For me, it is these practices that I still need to be better at and showing up and not being perfect and being okay with not being perfect. A big part of Gut Feelings is infusing grace into wellness practices. You don’t have to be an aficionado or pro at all this stuff. stay consistent with the things that are needle-movers and do it from a sense of self-respect and nourishment and wanting to give your body things that love you back. That is how I operate my life for the most part.
I don’t stress. When I practice these tools that I talk about in the book, there is this base of grace around my day. It’s relatively but not absolutely. It’s relatively like, “I have these things that I have to do. I didn’t get it done.” It’s a relative, it’s on my mind. I don’t even call it a stressor or something to do with but it’s not going to rock my world. When you practice these practices like mindfulness, breath work, somatic practices, and eating foods that love you back, there is resilience and there’s a perspective on what truly matters too.
I’m not a guru but it’s a matter of I have seen the benefits of these practices that I see work in my patient’s lives and I talk about in the book. A practical thing for me is being in nature as much as possible, which I know you know about too. Do whatever you can and whatever you have access to. Find green space if you’re in an urban area. I live in the country in the woods and the most healing thing ever for me. I couldn’t imagine if I was living in such a frenetic busyness all the time and after I had a busy day at work, it’s healing for me to come home. I know not everybody has that but it is something, for me, practical that’s grounding for me.
What’s the latest thing that you’ve either added into your practice or removed that was a challenge for you?
Breathwork, I’ve been more consistent with it over the past two years of researching the book. I’ve implemented it in patients’ lives but I’ve not done it in myself so consistently, and it does not come naturally to me. When I’m saying, “Be consistent with it, that’s the only way you can see change,” I’m talking to myself too. That’s the biggest change.
What it was in my research of this book of seeing, “This has so much compelling research around it,” and then seeing enough patients over the years see it be such a game changer in their life that I’m like, “I want to see what this can do for me too.” It is a great tool to release a lot of stored stress. Our body is a cellular library and our experiences throughout the day, our thoughts, whether to other people or to ourselves, our emotions, and past traumas are living in themselves. They’re the books that fill up that library.
There are so much spiritual components of this too. When you think of prana and the ancient Eastern, that’s breath, and that’s the energy life force. You think of in the Bible, in the Old Testament, Ruach Hakodesh was the breath. The Holy Spirit is the Holy Breath. Ruach is translated as breath. There are a lot of ancient origins of that.
Somehow, the gut and the vagus nerve didn’t have randomized control trials but somehow our ancestors knew that the gut was the seed of the soul and the breath was connected to life and that now we know the vagus nerve is connected to all of these things. Science is catching up with antiquity that we can get back to our birthright of a regulated nervous system, a regulated neuro immuno endocrine system, to have not only a balanced nervous system but balanced hormones and calmed inflammation levels.
I was surprised, in your book, Gut Feelings, there are many beautiful recipes. That was a big move. It’s beautiful.
The pictures are beautiful. It’s thoughtful. This book has also a different level of support where it’s like, “I’m going to talk about these things and this food and then we can do this together.” This brings me to the grocery store. If someone go, “I’m not going to go to the store hungry.” We all know that secret. I never buy more peanut butter or chocolate than when I go to the market when I’m hungry. It’s just the way it is. Someone is going fed. Nothing in boxes and bags. Do you have any other secrets for somebody if they are on this quest to heal or maximize their gut health?
One of the major things that I talk about in Gut Feelings is it’s born out of something that I use clinically for many patients and it’s something called a GAPS Protocol. GAPS is an acronym and it stands for Gut And Psychology Syndrome or Gut And Physiology Syndrome. we use it for different gut-brain access issues and gut inflammatory and different autoimmune problems. It’s effective therapeutically over months and not days. It is a way to show up for yourself and nourish that gut brain, that neuro immuno-endocrine axis, and your gut health as a whole.
I put soups and stew recipes in the book. It’s one of the easiest ways to calm a dysregulated gut health, an irritated inflammatory sensitive gut, a bloated gut, or IBS-ridden gut. It’s an effective tool and it’s nothing new. Going back to science and catching up with antiquity, this is known and used for thousands of years in Ayurvedic medicine and traditional Chinese medicine, and many other cultures around the world. It’s almost in a way predigesting the food. Instead of lots of raw foods, lots of harder-to-digest foods, we are cooking them down. I even have some patients puree the vegetables and cook it down. The meat is soft and easy-to-digest protein.
You could do vegetarian and you could do vegan options too. I have many recipes of those in the book too to ground and nourish an upset gut. It’s economical too and affordable because you can put lots of things that maybe are going bad, produce-wise, put it in the soup. You can batch-make it and have it throughout the week. That’s something to think about. People who are more interested in wellness, they’re maybe having lots and lots of salads, big bowls of salads, which can be hard to digest.
I’m not against salads at all if it’s working for you. I have many patients that even steam salads at the beginning. Not having so many raw things. Over time, you can build up your raw stuff fine but you have to meet your gut where it’s at. Having more cooked soups and stews, steamed salads, and cooked vegetables. Over time, You can shift that pie chart to more raw and less cooked if you want to. Some people stay indefinitely with more cooked vegetables and do better there.
It’s true. When I either have been traveling or get off the rails a little bit, the broths and soups glide me back into this better lane of not only feeling better but giving myself a break. They give your system this break that is nurturing. Supplements, prebiotics, and probiotics, all of this is like, “90 million. 18 billion.” It gets confusing. Are there supplements themselves that show up? Is it something that creates an anti-inflammatory response in the body? Are there supplements that you like across the board? I know not everything is for everyone.
Food is first. You can’t supplement your way out of a poor diet so start with food. Food can provide your body with prebiotics and fiber to be food for the microbiome to then support bacterial diversity and produce these short-chain fatty acids that we want for our immune system and our brain. Certainly, things are food technically but you’re not chewing them.
If you’re talking about the microbiome mood axis specifically, psyllium husk or inulin fiber, some prebiotic fiber, is a great low-cost accessible way to increase the fiber you’re consuming. Start off low and slow if you’re new to this. More isn’t always better. Most people aren’t getting enough fiber from the foods they’re having. Especially if you have an unhealthy gut, you have to find the right fiber that works for you.
Some fiber can make bloating worse. We deal a lot with SIBO cases, Small Intestinal Bacterial Overgrowth. A lot of these fermentable fibers can be problematic. Psyllium husk, I see work well for a lot of people. You add a tablespoon or so in water, it congeals in this viscous liquid, and you can drink it. It doesn’t taste like much, it’s fine. It adds bulk to the stool. If someone is prone to constipation, it can help constipation but more can add too much bulk and make it worse.
Start off low and slow. Psyllium husk probiotics can be beneficial. Different strains of lactobacillus and bifidobacterium. I love spore-based biotics. Those spore-based probiotics can be great. Postbiotics, we put in many patient protocols, butyrate, because we’ll see oftentimes low levels of butyrate, which is needed for digestive health, gut health, and brain health. Now you can get that from fiber. The more you’re producing short-chain fatty acid, the more you’re producing bacterial diversity. You can get that from eating more diverse sources of fiber from plant foods as well as if you’re supplementing with something like Psyllium husk, you can over time produce butyrate.
Therapeutic levels of butyrate can be a tool within the toolbox while you’re working on healing your gut. I see it as a seasonal temporal time for a gut healing protocol. There’s a compound called UrolithinA, which the research around that is compelling. It’s another postbiotic that some of us can make when we have copious amounts of pomegranate seeds. Have at it.
Some of us don’t have the right bacteria in our gut to produce urolithin A. I’ve been supplementing and experimenting with different postbiotics like urolithin A to help my immune system and mitochondrial health, and something called mitophagy, which is mitochondrial renewal or mitochondrial autophagy. Those are some things that come to mind as far as gut health. Food is first.
I love that. I eat perfect. Let’s say I go to bed early, I’m managing my stress, I meditate, or I have a breathing practice. I’m super busy, I don’t need to exercise. Exercise, taking a walk, and a little time under tension, how does moving your body impact your gut?
It’s huge and massive. Most people aren’t moving enough. One of the most common things that people don’t realize is that being sedentary, and most of us have more of a sedentary job, can be one of the easiest things to get things moving. Getting your body moving by walking will help with GI motility. Staying hydrated is part of that. Beyond GI motility, if you’re talking about constipation or bloating, movement can be helpful. It’s also great for your metabolic health too.
Walking even fifteen minutes after a meal can tremendously decrease glucose spikes and balance blood sugar. We do it at lunch together as a team. Most of the team goes with me. I try not to shame the ones that want to stay back. We go on a communal speed walking for about 30 minutes around the block here, which is great. Community is important so get a walking buddy, it’d be great. It’s like therapy too, we’re downloading the day of what’s going on.
Secretly, no one is trying to pretend that they’re racing but you all are racing and who’s going to be first, I’m sure? In our house, it would turn someone pulling someone’s sweatshirt back and something like that. Trends, a lot of times you’ll see things peak up and people love trends like a hot new thing or a magic bullet. Is there anything that you’re seeing that you like or don’t like as far as trends talking about gut health that people should be aware of?
Good trends, I do see more and more people talking about postbiotics. I know that there’s a lack of bacterial diversity going on in the human microbiome collectively and that’s intimately connected to the soil microbiome and what’s going on with our planet. We are a microcosm of what’s going on on a planetary level and an environmental level. Supplementing with postbiotics makes sense to me when I look at labs for a living and I see a lack of bacterial diversity as being a supportive tool.
Start with food but fill in the gaps with supplement support with prebiotics, probiotics, and postbiotics all have their place there. This isn’t a new trend per se but I get asked this question a lot. Maybe it’s trending on social media. It’s colonics. “Do you recommend colonics? Do you recommend enemas?” Not necessarily.
For the average person, there’s probably a specific subset of people who are dealing with specific health issues that need these things for a time. I don’t see it to be needed for the vast majority of people that are struggling with gut health problems. It’s not that that’s a trend per se but it’s a frequently asked question when you talk about poop for a living. People ask you about colonics and enemas.
Or the coffee enemas and things like that.
I’ve had some patients that tell me, “This is a tool within my toolbox. I’ve done coffee enema.” They’ve learned about it and they’ve researched about it and they like it. I’m not saying it’s not a place for it but I don’t see it being, like, “This is the number one thing people should be doing for their gut health.” I don’t think people need to run and get a coffee and put it in an enema bag.
I was reading something, which brings me to anything new and exciting. Do you see something in research that’s making you excited? I was reading something from a woman, Dr. Hazan, about fecal implants. I had a friend use it for a son who was autistic and who had a pretty intense sissing. For people who don’t know what that is, it’s almost like your hands start moving.
I want to explain it as a physical frustration. He had a lot of success through the fecal implants. Now, they’re saying possibly for microbiome and gut health. There are some trends there that are pretty interesting. I was curious if there’s something you see on the horizon or that you’ve come in contact with that you think, “This might turn into something,” or is pretty interesting.
I’ve been following the research and writing about fecal transplants for a lot of years now and have seen over the years work well for many people. It’s not a magic cure-all for everybody. There are a lot of variables to consider. You want to make sure you’re doing it appropriately, ideally with a doctor, and vetting every aspect of these things. These are massive modulators of your immune system. I’ve seen some cases, albeit rare, get worse from fecal transplants. It doesn’t come without a set of potential side effects because it could cause flare-ups.
There are trillions of bacteria and we understand a very small percentage of them and you’re going and putting in all of these variables in an immune system that’s already tempestuous. This is for desperate people. These are for people that have exhausted all options. Most of them are a lot better off than they would be but they’re not where they need to be and they’re looking for the next level. It has its place.
I’m happy and excited that some researchers are looking at this and how it can be helpful for different neurological issues, different autoimmune issues, and specific autoimmune digestive problems. Classically, it’s only been officially used in the conventional world in many spaces for acute C. difficile gastrointestinal infections. Now, it’s been looked at with Crohn’s, ulcerative colitis, MS, autism, and spectrum issues. I am hopeful and I have seen it be an effective needle-mover for some people.
For anyone reading, right now at least, it is pretty expensive. I want to bring that up.
Some people look at YouTube videos and they put poop in a blender and get an enema bag and do it themselves. This is real. This happens. New telehealth patients are like, “I tried it once.” The things that people try, DIY poop transplants, I don’t recommend that.
Whose poop are you transplanting?
My clinic manager was talking about it because she was talking about such and such case and she was like, “Who would we get for this?” “My grandma is going to be turning 100 this year. We need to get Phili’s poop.” My grandma lived 100 years and she’s on no medications and doing fine. We need to find these centenarians. There’s something to that.
Is she on no meds at all?
She’s on a thyroid replacement hormone.
Amazing. They usually want to get you on the meds pretty quick, like, “Your cholesterol is high. This is happening. Let’s slap you on.” They put her foot down and said no?
I’m assuming she probably was pushed at some point. She’s a stubborn old lady and it probably worked to her benefit.
Dr. Cole, you’ve done so much research. I want to say this, your book does a beautiful job not only of bringing awareness to that connection of one’s feelings and past life experience and lifestyle stress management and all these things connected to gut health and giving an achievable and simple description of gut health. If somebody was like, “I want to geek out on some heady books.” What books do you like that most people probably couldn’t get through that would give you a deeper dive into gut health?
Honestly, where I would go is to PubMed. I would look at the journals themselves. If people are interested in the research, look at the journals that are out there, the gastrointestinal journals out there, the microbiologists’ journals out there, the American Journal of Clinical Nutrition. There’s so much exciting research out there and you can search by search word and you can look for things that you are interested in.
If you’re interested in microbiome, search microbiome. If you’re interested in fecal microbiota, transplants, or FMTs, search for that. That’s what I love about the time that we live in where you have this decentralization of health information where it’s not like, “I read the clickbait headlines on the news of the ones that they want to cover,” which is interesting too. I do the same thing.
Can we go and look at all the things that don’t make the headlines or maybe do make the headlines but we can look at the context behind it? All of that’s very interesting. It’s not a book per se. I would encourage anybody that’s interested in health and wellness get into the journals and read the research. If you’re looking for something heady, if you’re looking for something erudite, that stuff is interesting. You can go to the source.
Finally, a lot of people don’t feel good, they’re tired, they’re not fired up about life, and they just think, “I’m gassy.” A lot of us have accepted that it’s just a part of life. Can you remind us that even if you’re feeling pretty bad and you think it’s dire, sometimes the distance between there and feeling a whole lot better and peeling and being healthier is maybe a shorter path than people realize?
It truly is. I see people from mild symptoms who are looking to optimize to extreme symptoms. I’ve seen every variable you can think of for the past thirteen years, thousands of patients a year that we manage as a clinic. I’ve seen about every socioeconomic. Every excuse under the sun, I have seen it and heard it. I’ll tell you a few truths that I’ve seen over the years. One is the body is amazingly resilient. Number two, you don’t have to have it all figured out to start moving the needle in the positive direction. Don’t get caught up in that paralysis of analysis that we talked about.
Number three, people think, “I’m too busy,” or, “I don’t have enough money to be healthy.” I’ll tell you that is a lie that’s keeping you back from living the life you were created for. I see busy people on fixed incomes all the time get healthy but their why was bigger than their excuses. That’s tough love but it’s the truth. That’s the scapegoat that our culture tells us and then we love it because it resonates with our own scapegoating of saying, “It’s not for me. It’s for the one-percenters. It’s for the blonde famous people but not for me.”
The reality is that’s not what I see on an hourly basis. I see people that have limited resources and limited time reclaim their health from serious things all the time. Single working moms that have lost their hair and lost their vision from something like MS and Alopecia reclaim their sight, their mobility, and get their hair back. That’s the type of stuff that I’m used to seeing. I would encourage people to speak life into their situation and realize they have everything they need to start moving the needle in the right direction.
Dr. Cole, I appreciate you and your time. Before I go, I want to ask you how you feel about apple cider vinegar and bitters. I’m curious.
Both have their place. Apple cider vinegar mixed with water, not straight up, which can burn the esophagus and be too strong, can be good at supporting. It’s prebiotic. If you’re getting the ACV with the mother, meaning the actual symbiotic culture that’s part of the fermentation process. It’s prebiotic and it’s acidic and it’s going to help with something called hypochlorhydria or decreased hydrochloric acid. Most people have low stomach acid so start off low and slow.
Too much is not what you want but work it to tolerance. It can be a game changer in shifting the pH of the gut as well as providing some prebiotics to the gastrointestinal system. Bitters, the same thing. Getting a dandelion or these extracts from bitter greens are help re-shifting the HCL production, the pH of the gut, which is low. You don’t necessarily need both but you could use both the ACV and the digestive bitters. Both are potential tools to do very similar things.
People can see you and hear you on a podcast. Can you share with us all the places so we can get more of you? The book is Gut Feelings.
Thank you. Everything is at DrWillCole.com. We have new telehealth options for people if people are interested in that. We have the links to my podcast. The Art of Being Well is there. We have a new episode every week and all the links to the books. There are tons of free resources there for people. There are thousands of articles I’ve written over the years with all the links to the research. I talked about those journals. If they want to go and get further reading, they can go and read the studies themselves if they want to geek out on that stuff.
Have you been having fun doing the podcast? How’s that?
I have been. I’m enjoying it more now. I love talking to people but it was tough for me to go from patient to podcast. Now, I batch record them, which is much better for my self-care and my mental state of staying in the zone with patients, and then I’ll do a block of podcasts. That way, it’s a little bit less jolting to go from my doctor hat to my podcast hat.
I love having you here and it’s great to see you. Congratulations on everything.
Thank you for having me. I appreciate it.
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About Dr. Will Cole
Dr. Will Cole is a leading functional medicine expert who consults people around the world via webcam, having started one of the first functional medicine telehealth centers in the world. Named one of the top 50 functional and integrative doctors in the nation, Cole specializes in clinically investigating underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is also the host of the popular The Art of Being Well podcast and bestselling author of Ketotarian, Gut Feelings, The Inflammation Spectrum, and the New York Times bestseller Intuitive Fasting.