by Ali Miller
Less than 15
You are likely experiencing some level of dysbiosis, which can be based on yeast or pathogenic bacteria overgrowth. Phase 1 dietary protocol with carbohydrate restriction will help starve off bad bacteria or yeast. Enjoy a cultured food four times per week. The addition of these probiotic-rich foods with prebiotic fibers support your gut to produce serotonin, GABA, and other feel-good mood stabilizers! In addition, it is recommended to take at least 15 billion CFU of a 50:50 blend of bifido and lacto bacteria strains, such as Restore Baseline Probiotic, to optimize probiotic function for digestive health and beyond. If the addition of this probiotic supplement or probiotic- and prebiotic-rich foods exacerbates symptoms, it is likely that dysbiosis is severe enough to proceed with a bacterial cleanse.
Greater than 15
This score points to definite dysbiosis, which can be based on yeast or pathogenic bacteria. Follow the Phase 1 dietary protocol with carbohydrate restriction, and withhold probiotics and prebiotics while proceeding with the six-week gut reset protocol detailed in this chapter. During the six-week cleanse you will starve off and weaken the overgrowth, and also attack the bacteria and yeast with the natural antimicrobial, antifungal, and detoxifying compounds. Following the gut reset protocol, you will add probiotic-rich foods with prebiotic fibers in your diet to support the rebuild in your gut to produce serotonin, GABA, and other feel-good mood stabilizers! Due to the severity of dysbiosis, following your gut reset protocol, it is recommended to take at least 50 billion CFU of a 50:50 blend of bifido and lacto bacteria strains, such as Targeted Strength Probiotic paired with S. Boulardii–rich Spectrum Probiotic to combat regrowth of bacteria and yeast while optimizing probiotic function for digestive health and beyond. If post-cleanse, following four weeks of the probiotic support, you are still experiencing symptoms of dysbiosis, you may consider advanced functional testing of stool (see Advanced Functional Labs on page 166 for details).
If you score with a high value and suspect you are a candidate for dysbiosis, I would encourage removing yeast and vinegar-based foods for six weeks as a supplement to your anti-anxiety diet. Also, restrict probiotic foods for the first three weeks, reintroducing them at weeks four to six.
The removal of all long-chain carbs, such as grains and beans, during the anti-anxiety diet supports resetting the microbiome, as bad bacteria can ferment these fibers, perpetuating dysbiosis. Your first phase of the program will work to starve off bacteria to support a successful dysbiosis reset and cleanse, if necessary.
Supplements to Support Your Microbiome Reset
When looking to remove the overgrowth of unwanted pathogenic yeast or bacteria, first remove foods from the diet that might be feeding them. High-carbohydrate foods, especially those with refined sugar and added yeast, are known to feed bad bacteria and yeast overgrowth in the small intestine and should be removed if dysbiosis is suspected.
The strategic use of natural plant compounds, nutrients, and probiotics is a helpful tool to help kill off pathogenic bacteria or yeast and promote optimal digestion and neurotransmitter production. This is preferred over the use of antibiotics, which can have a sterilizing effect, killing off the good bacteria and reducing our powerhouse of production.
A benefit to using natural compounds such as berberine root from Oregon Grape is that they can have antiviral, antibacterial, and antifungal support while also working to promote bile flow, balance blood sugar levels, and fight against cancer. Food as medicine offers a synergy and unintentional beneficial influence versus the deleterious side effects of drugs. Consumption of bitters, such as dandelion and lemon, can promote the production of bile flow, stimulating liver and gallbladder function while further supporting bacterial balance.
Supplements to Remove Yeast or Bacterial Overgrowth
These supplements will support a balanced microbiome and a bacterial, fungal, or yeast cleanse. See Supplement Support for the 6 Foundational Rs on page 159 for specific dosages and details.
•Berberine supplement (page 160) such as Berberine Boost
•Aromatic, antimicrobial, and antifungal herbs (page 161) such as CandiActivator
•Bacteriophage/probiotic combination formula (page 161), such as GI Cleanup
•Phase 2 liver detox supportive formula (page 161), such as Ultimate Detox
Supplements to Support Your Rebuild of Healthy Gut Bacteria
After a bacterial cleanse, it is important to rebuild your army of beneficial bacteria. Prebiotics from the Phytofiber in combination with different targeted strains of probiotic will work to prevent relapse and support a healthy gut microbiome!
•Restore Baseline Probiotic, page 162
•Broad-Spectrum Probiotic/Rebuild Baseline Probiotic, page 162
•Prebiotic fiber blend/PhytoFiber, page 162
Lifestyle Support for Your Cleanse
If you do go into a cleanse, you may experience a Herxheimer reaction, where your symptoms get worse before they get better. As you are plowing the garden bed, those weeds may kick up pollen or bad seeds, and the bacteria or yeast fight back. I like to recommend locking down and moving forward with the cleanse during these symptoms, as this is a sign of the excess activity that needs to get removed. You can support symptom management and reduction with anti-inflammatory and detox-promoting foods and activities. Focus on high-antioxidant, low-carb foods such as green tea, rooibos, turmeric, leafy greens, avocado, cacao, and seeds such as hemp, chia, pumpkin, and sunflower. These foods will support healthy cells in a time of cleanse and reduce inflammation.
Supporting the excretion pathways of the liver should be another primary focus. Sulfur-rich cruciferous vegetables such as broccoli, cauliflower, cabbage, kale, Brussels sprouts, and bok choy have indole-3-carbinoles that increase detox activity in excretion pathways, aiding in gathering the dust from die-off and reducing symptoms.
If anxiety gets severe during a cleanse, consider using GABA or other inhibitory compounds to aid in managing anxiety reactivity. If anxiety prevails after 5 days, bring in a 5–15 billion CFU, 50:50 Lactobaccilus and Bifidobacterium probiotic blend (even if anxiety occurs earlier than week 4, depending on circumstance).
Beyond diet, moving your body will support lymphatic tissue function, which in turn supports detox and removal of bacteria, yeast, and their debris, as well as reduces the inflammation in the body. Additionally, massage and Epsom salt baths are two of my favorite recommendations to soothe and support removal.
Common symptoms of pathogen die-off include:
•Loose stools or diarrhea
•Nausea
•Flu-like symptoms
•Body aches, muscle aches, and joint pain
•Fatigue
•Brain fog and headaches
•Increased insomnia or anxiety
Dietary and Lifestyle Support Action List
•Keep probiotic supplements and foods out for first three weeks! (See note above for exceptions per severe anxiety reactivity.)
•At week 4, start to bring in small amounts of probiotic foods.
•Aim for >80g of protein in biological form, per day. Use 2 tablespoons of coconut oil daily (see sidebar on page 32).
•Consume ½ to 1 cup of cooked cruciferous vegetables daily.
•Drink turmeric lemonade (find a recipe at www.alimillerRD.com; omit the honey).
•Aim for 6 to 8 ounces of (chicken, beef, turkey, or pork) bone broth daily.
•Reduce vinegar intake, keeping to a maximum of 1 tablespoon/day for weeks 1 to 6 of active cleanse.
•Keep carbs at <60g/day, with no refined sugar or yeast foods, following Phase 1 of the anti-anxiety diet.
•Practice gentle movement therapy! Walk, incorporating hills, and try yoga, Pilates, or bar resistance.
•Stretch using a foam roller.
•Shower using hydrotherapy HOT to COLD, plus body brushing.
•Indulge in a sauna or Epsom salt bath.
•Consider a massage at least once a month, or twice d
uring the cleanse.
•Incorporate oil pulling three to four times a week (page 32), with 1 tablespoon of coconut oil.
•Use coconut oil topically.
The Power of Fermented Foods
As noted, the human gut is said to contain nearly 5 pounds of live active culture. Eating lacto-fermented foods provides the body with beneficial bacteria that aid in fighting off bad bacteria in the intestine. The healthy, friendly bacteria in our gut not only aid in digestion, it is also responsible for synthesizing various nutrients, such as vitamin K2, vitamin B12, and biotin. If you tolerate probiotic-rich foods and don’t have dysbiosis, incorporate these foods for significant anti-anxiety effects. If you do not tolerate them, keep them out of the diet until you are halfway into your cleanse.
Perhaps the highest influential shift in your microbiome will occur when adding in fermented vegetables that increase Lactobacillus and Bifidobacterium, which, with colonization in the gut, increase GABA production and expression. GABA is the major chill pill of the brain, having inhibitory influence on anxiety activity. Beyond balancing mood and mellowing out the mind, GABA can have anti-inflammatory effects on the gut itself. This reduces the response of inflammatory chemicals as well as stress chemical compounds, such as epinephrine, which in excess can drive panic, worry, irritability, and distress.
PREVENT TRANSLOCATION OF BACTERIA AND YEAST
As you work to cleanse your gut and weaken the bad bacteria strains, often they will translocate to other areas of the microbiome that are less targeted. This is exemplified when women get yeast infections following antibiotic use. With a Candida (yeast) and bacteria cleanse, bacteria may shift to other areas outside of the gut, causing changes to skin with rashes, itching, hives, phlegm or thrush on the mouth or tongue, excess wax in the ears, or styes and mucus shifts in the eyes. To prevent this unpleasant experience and support true removal of the bad bacteria and yeast, consider using coconut oil for oil pulling and topical use. Oil pulling is the process of essentially swishing coconut oil in your mouth for about 5 to 10 minutes and then spitting it out. This aids in circulation of blood and delivers antimicrobial and antifungal compounds to your periodontal tissue and mouth. Also, consider gargling with a mouthwash containing wild harvested herbs with antimicrobial effects.
Benefits of Consuming Probiotic and Lacto-Fermented Foods
•Enhances digestibility and absorption of nutrients
•Activates immune system, supporting the body’s defense system
•Improves bowel regularity
•Enhances production of serotonin and GABA for brain balance
•Improves metabolism
•Reduces risk for cancer by reducing free radicals and increasing natural killer cell activity
Probiotic Challenge
Try this to see if you are a good candidate for a candida and bacterial cleanse. Oftentimes with candida or bacterial overgrowth, probiotic foods and supplements will not be tolerated well due to competitive inhibition. This challenge is an easy and cost-effective way to evaluate the need to dig deeper with a cleanse!
Restore Baseline Probiotic offers a 50:50 blend of lacto and bifido probiotic strains to support the bowel without fermentable fiber that can throw off gut bacteria. This makes it a great probiotic to use in a test of tolerance.
Here’s how to do it:
Supplies: Sewing tape, a notebook, and a bottle of Restore Baseline Probiotic.
Step 1: Take your waist circumference measurement at your belly button for three days in a row from rising to bedtime and record as a baseline.
Step 2: Start the probiotic at 1 capsule at bed for three days. Continue to measure waist circumference at rising and at bedtime.
Step 3: Increase by 1 capsule every three days for ten days until you reach four per night (not counting initial reads without the probiotic).
Step 4: Try to continue at 4 per night for 3 days. Note changes in waist circumference as well as any changes in GI, such as cramping, bowel movements, belching, or gas during the challenge.
If you experience increased bloat or increased GI symptoms, this indicates dysbiosis and requires a cleanse; in this case discontinue probiotics.
If you experience a flatter abdomen or no change and reduced GI symptoms, this is a pass and sign of symbiosis. Continue taking 1 probiotic at bedtime; if well-tolerated, take the full dosage of 4 per night. If you notice when you reduce back to only 1 capsule as your baseline that your symptoms decline from where they were at 4, you may consider a targeted strength probiotic that provides 60 billion CFU versus 15 billion.
FOOD AS MEDICINE
Reset and Cleanse Your Microbiome
These recipes have ingredients with antimicrobial, antifungal, and antiviral activity and provide antioxidants and detox support.
Coconut No-Oatmeal, page 107
Curry Roasted Cauliflower, page 117
Bacteria-Battling Chimichurri, page 139
Lime in the Coconut Fat Bomb, page 144
FOOD AS MEDICINE
Support Symbiosis and Healthy Gut Flora
These recipes contain probiotic-rich ingredients and prebiotic fibers to aid in fertilizing a balanced gut biome. Beyond direct favorable effects of promoting production of GABA and serotonin, these foods will defend against bad bacteria to aid in maintaining continued sustainable neurotransmitter production. Prebiotics and probiotic-rich foods fight against pathogens and dysbiosis with strength in numbers and keep your targeted lactobaccilus and bifido strains in your probiotic supplement alive and viable.
Quick Coconut Yogurt, page 104
Creamy Green Chile Chicken Soup, page 126
Coconut Chia Seed Pudding, page 145
CHAPTER 4
Repair GI Lining
The gut refers to both the small and large intestines. With this anti-anxiety Foundational R, you will target these organs and their role in inflammation, bacterial imbalance, and malabsorption of nutrients, which drive nutritional deficiency.
This chapter takes you into the structural influence of the primary barrier regulating what enters your bloodstream and how your body responds to the compound that enters. If needed, you will learn how to repair your gut lining for whole-body health. If the gut is in an optimal state of health, the lining will be intact, able to prevent large particles or irritants from entering the bloodstream while providing space for good bacteria to thrive and enhancing nutrient absorption. But when the gut is in a leaky state with damage to the delicate internal lining (in medical terms, intestinal enteropathy) you are at risk for increased food and chemical sensitivity because the damaged barrier allows large compounds into the bloodstream, creating an overactive inflammatory response on an immunological level. Also, if the gut lining is not sound, the gut bacteria have less space to proliferate and grow, which means you will have less defense mechanisms against bad bacteria and less space to absorb nutrients.
Gut Anatomy 101
The intestines’ primary function is the absorption of nutrients and water. The small intestines, which are 20 feet or so of a narrow, winding mass, directly connect to the stomach, the colon, and large intestines, all the way to the anus. Beyond absorption, the intestines play a great role in housing gut bacteria, which in turn support neurotransmitter production, and the large intestine especially plays a great role in detoxification and electrolyte stability.
The tissue of the submucosa (the external part of organ) is resilient, whereas the internal layers of the mucosal lining (the internal part of the intestines) are quite delicate. The thin mucosal lining has a significant role in your immune health. It houses the GALT, which has the largest storage of immune cells, such as T cells (made in the thymus), and B cells (made in bone marrow). These specialized white blood cells play a role in tagging and attacking foreign invaders, such as harmful viral and bacterial influencers, while providing an adaptive immune response to things inside and outside the cells. One role of B cells is determining what is friend or foe. If the B cell tags a f
ood or chemical as harmful (reactive), the immune system has inflammatory reactions. The thickness and integrity of the gut lining where the GALT resides is strongly correlated to how reactive the immune cells will be to foods and chemicals. If the gut lining is damaged, there will be more antigen reactivity, as seen with food sensitivity and inflammatory conditions.
The most internal lining of the intestines, called the epithelial lining, has finger-like projections called villi and microvilli, which are delicate projections that enhance surface area for optimal absorption of nutrients as they work to scoot food particles along what is called the brush border. This border includes an area where nutrients are exposed to bacteria and digestive enzymes, further enhancing breakdown of food particles for absorption while regulating pH and defending against invaders.
What Is Leaky Gut?
Leaky gut, or intestinal permeability, is the condition in which larger-than-desired particles, including metabolic byproducts of food and gut microbes, enter the bloodstream. This overburdening of compounds in the bloodstream triggers a chain of events where the body drives an immune response and attacks otherwise neutral molecules, thinking that they are “invaders.”