Initiate Healing: Why It Starts With Your Digestion

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

Thank you, Sinclair. It is so wonderful to be here.

Sinclair Kennally, CNHP, CNC

Hey. Okay, so let us dive right in. We have a lot we want to cover today, and I know that you, as a clinician, have robust experience with this in your own practice and now running your school. You can really see this at bird’s-eye level. I want to give the layperson watching today and also the practitioners here in the audience, who are really on the search for new tools and clinical gems, the benefit of your expertise. Why do we not start by going through the digestive process itself, where things can go awry, and how that creates systemic health issues elsewhere? Because it is just a small question.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

It is just a small question. We take several hours to teach this in our class, but I am going to do my best to bottom line them here. 

Sinclair Kennally, CNHP, CNC

I believe in you. You can do this.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

I think one of the most important big-picture concepts to remember is that the gut is the mother of the body. It is what nourishes us. It is what feeds us. It is the absolute starting point for health. It’s also the starting point for dysregulation. So if there is any kind of issue going on, something that might seem completely removed from the gut, specifically skin health or migraines, I have clients all the time who do not necessarily present with digestive symptoms per se. When we heal the gut, it is amazing what else can shift because, as the mother of the body, it is what nourishes and supports us. But if it goes awry, it can be one of the biggest sources of inflammation and toxicity. We really need to start there now. That is the big picture of why this is so absolutely imperative. Even if you do not specialize in the gut, even if you think, Well, I am just here; this is because I am curious, but it is not my jam, it needs to be your jam. That is just what he needs to be, really. 

The digestive process is basically one big, long tube right from the mouth to the anus. Different things happen along at different stages. There are some really integral moments, and it is quite a profound process if you think about it. This is where the outside world—something that we eat—literally becomes us. I mean, is that saying we all know you are what you eat? We kind of throw this out, but it is literally true. We are walking food. Every single cell in your body was once food, and when your body processed that, it mechanically broke it down. It chemically broke it down, and then it actually absorbed it. There is this moment that we are going to talk about where the outside world literally becomes you. Really, the digestive tract is still on the outside of the body. That is an essential concept. We are basically one big, long, complicated donut, and the donut hole is our digestive tract. 

This whole process, as we think about it, goes from north to south, and it is very important. The order is very, very important because dysfunction and dysregulation anything north in the process will affect everything further south. Something as simple as eating really quickly, not paying attention to what you are eating, and not chewing properly can actually have really significant impacts further south. Certain enzymes are not triggered to be released unless you are actually aware of them. You probably had this feeling where you sit down and you eat a meal. You eat it really quickly from a caloric perspective and from a nutrient profile. It might be perfect, but you are still kind of hungry and jonesing for something more at the end. Then your brain has not actually had the opportunity to register it. We really need to think from north to south.

I am going to start. There is the brain component of being aware of the food; there is the mechanical breakdown as well as the chemical breakdown, which, of course, starts in the mouth when we are chewing. There is that saying, To your liquids, drink your solids. I am not going to sit here and say you’ve got to chew things 100 times. But I do. We need to be mindful of this process. The more we can support anything further north and support this clinically with our clients, the better. For those of you who are not clinicians and are thinking about this, just chew your food. You are setting everything else up in your digestion for much, much better success. 

Now we swallow, and the food goes through our esophagus, and then it ends up in the stomach, which is basically this bladder. It’s just this pouch. It is quite a magnificent pouch. I think of it as a very complicated Ziploc bag. Okay. The food comes in, and it should be masticated. We’ve got all those nice salivary enzymes mixed in with it. We have broken it down with our teeth to get to that mechanical breakdown. It comes into the stomach, and the stomach has what we think of as churn and burn. There is a muscular pouch. Those muscles are kind of massaging and moving all of the contents while they are also mixing with hydrochloric acid, which is what drops the pH of the stomach and allows the conversion of things like carcinogens that converts into pepsin, which is the primary enzyme that breaks down protein, critically important. Hydrochloric acid is also important for sterilizing the contents of the stomach. We do not have enough hydrochloric acid. We are basically rolling out the red carpet for any kind of foodborne pathogen, parasite, or bacteria. Instead of killing it, we just digested it and allowed it to take residents further south in the digestive tract. One of these is: let us pause here and talk about some of the areas of dysfunction, or would you like me to keep going and then come back to dysfunction?

Sinclair Kennally, CNHP, CNC

I think we should pause and talk about dysfunction along the way. Otherwise, we will never get them, and we would not bring dysfunctional first. We will have dysfunction first. We love dysfunction. Let us start with dysfunction.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

Well, when it comes to the stomach, the biggest and most common source of dysfunction is low hydrochloric acid, which we call hypochlorhydria. There are lots of reasons for this. You can have an H. Pylori infection, which is a bacteria that basically damages the parietal cells that secrete hydrochloric acid, does happen. There are a lot of other things, though, that are super common: high stress, eating too much starch and carbs, too many carbohydrates, a high sugar diet, high alcohol intake, getting older, and a low protein diet. For our vegans and vegetarians out there, it is very, very common to have low hydrochloric acid because when the body does not sense that protein, it does not sort of trigger that response. A lot of, and we think about what I have just said here, even if you could maybe not drink if you are on a really clean diet. Well, you are probably getting older because that is just what happens with age and stress. A lot of these things are very common. 

It is incredibly rare for someone who has not paid attention to this to actually have really robust hydrochloric acid. Even in the absence of something like an overt H. Pylori infection—we really need to pay attention to this because the dysfunction goes so much beyond just the stomach. We are not just thinking about, Okay, we cannot breakdown our protein properly, which is already in and of itself a really big deal. We also need hydrochloric acid in order to absorb really key vitamins and minerals, especially those all-important B vitamins. One of the other reasons I am not trying to come down on our vegetarian vegans out there, but it is actually one of the reasons why that type of diet is very challenging, is because not only is it deficient in those nutrients, but the chemical processes required for the absorption of those vitamins are triggered in the absence of consuming animal protein. That is so important.

Sinclair Kennally, CNHP, CNC

It is important to break down and highlight that because so many people do not even know or skip over the importance of that. Maybe we could highlight just very briefly why B vitamins are so crucial to overall health and well-being. Why does that matter so much?

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

I mean, for all the things for energy production, one of the clinical dealbreakers in practice is if you see anemia, so an A, B, or B vitamin deficiency is going to translate as anemia. That is actually going to impact the body’s ability to actually shuttle oxygen through the cells. Our energy regulation growth—I mean, it is absolutely essential. You will see that it is interesting. I sometimes work with athletes because I myself run, and so my coach and I have worked with athletes, and we see a massive difference in their performance when we incorporate more animal protein into their diet. I attribute it largely to the B vitamins as well as the iron. That is a big piece of it.

Sinclair Kennally, CNHP, CNC

Yes. It is so interesting. I am 100 percent careful not to derail our beautiful linear progression here, but as an almost lifelong vegetarian myself, it was very difficult for me to come to the realization that clinically, it was just undeniable that people who are willing to eat animal protein, as long as it is clean animal protein, heal faster from chronic illness. It is just as undeniable. You might have it short, and people get really confused because of the primacy effect. You can have a short-term reduction in symptoms immediately by becoming vegetarian or vegan. Also, going off a super-inflammatory diet is usually a sad experience.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

100%

Sinclair Kennally, CNHP, CNC

But long-term, you waste away, and it can be an onramp to chronic.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

It is that balance between needing to cleanse and needing to build, right? A vegan diet or a plant-based diet can be very cleansing in the short term, but it is not building. You need the building component, and back to the digestive piece of this: when your body senses animal protein, like when you eat that piece of steak, chicken, or fish, that stimulates the release of intrinsic factor in your stomach, which is another critically important component to being able to access those B vitamins. Actually consuming the food and the nutrients in the food is always the best way to get those nutrients. So you need the hydrochloric acid and the protein in the diet in order to access those B vitamins as well as the minerals. It is really, really important to be able to access them through the diet. 

We already know that our diet, even the cleanest and healthiest diets, tends to be quite deficient in minerals. If you compound that by making it more challenging for the body to absorb the minerals that are in the food, you are just worsening an already not-fabulous situation. You only have to think further south in terms of the digestive process. I think this is the piece that often gets missed: when you have hypochlorhydria and you have insufficient hydrochloric acid, what that does is it affects everything that happens next. Because the pH of the kind, that is, the contents of the stomach, they leave the stomach and enter the duodenum, which is the first part of the small intestine. It is the pH of the kind that, first of all, allows the pyloric sphincter. It is that little valve that sits at the bottom of the stomach and does not let the contents move into the duodenum until it is in the appropriate state of digestion. Until the pH ends, it is located somewhere between 1.5 and 3. If you stick your finger in that, you are going to burn your finger, and that’s designed that way. 

That is the chemical. That is the burn part of churn and burn, right? It is that chemical breakdown. Your finger does not have the protective mucosal layers that your stomach does. Your stomach is designed to be this incredibly acidic environment, and it is that acidity that triggers the pyloric sphincter to open up and allow the contents to enter the top of the small intestine into that duodenum. It is also that acidity that stimulates a bunch of hormonal releases that are so critical for the next stage. It stimulates the sodium bicarbonate released to neutralize the contents of the stomach to a pH of seven. What it’s doing is balancing that because the small intestine and everything further south in the digestive tract do not have that same thick layer of mucus. It has a mucosa there, but it is much, much smaller than what we see in the stomach. It neutralizes that, if that neutralizing does not happen properly. If we do not have a sufficiently acidic kind moving into the stomach or into the duodenum, excuse me. It also stimulates the pancreas to secrete those all-important pancreatic enzymes. 

Those are really important in helping to complete the breakdown process—that chemical breakdown of the food that we are eating. This is not something that is just done in the stomach or just when we are chewing. It is an ongoing process that continues. We absolutely need those pancreatic enzymes to complete that process. It is also what triggers CCK, or cholecystokinin, to stimulate the gallbladder to root and to inject that little flush of bile into the duodenum, which is critical for breaking down fats. We think of bile as an emulsifier, kind of like dishwasher detergent. I always think of that old sunlight, probably dating myself with that old sunlight dish soap detergent commercial where it was like super grimy water. Then we thought, Oh, here is this one last wine glass that we need. They squirted the sunlight in, and all the little fat globules split up and broke apart. That is basically what bile is doing in your duodenum. It is helping to break up those larger fat globules into much smaller globules.

Sinclair Kennally, CNHP, CNC

None of that because they are liquid gold detergents and because it’s so expensive for the body to make at once to recycle it. 

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

Yes, it is so critical. It is critical. It is a critical detoxification pathway. I think the gallbladder is one of the most important and unsung organs of digestion.

Sinclair Kennally, CNHP, CNC

Unsung hero. Yes. See, now you are speaking gut language right now as well.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

Think of what it is doing. It is not only helping you, of course, break down the fats, but it is also escorting all of those toxins out of the system. It is stimulating the peristalsis. That is the muscular contraction, helping to move food along. It is funny that when people come to me who are presenting with constipation, most of the time they are thinking, Oh, I am not hydrated enough or have any more fiber.  It is like, possibly, and more times than not, we discover that they have very sludgy, thick bile, and it is that bile flow. When we support the bile flow, then regardless of fiber consumption or hydration status—I mean, they are both important—we see this beautiful resolution of their symptoms. I am a big believer in the gallbladder.

Sinclair Kennally, CNHP, CNC

Love it. Do you want to pause here about dysfunction because, of course, 750,000 gallbladders are removed a year in the U.S.?

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

Oh, God. Yes

Sinclair Kennally, CNHP, CNC

What do you want to say and highlight for those who are missing that gallbladder in the digestive process?

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

150%. I am really glad you paused here. This is such a critical piece of the puzzle now. The gallbladder is absolutely essential. What happens when they remove the gallbladder? The gallbladder is basically like the little pouch you think of. It is about the size and shape of a deflated balloon, but a little bit larger. It is sitting right there underneath the rib cage. It is a storage. It is basically a little storage bladder, again, for bile. When you eat a meal, particularly one containing sufficient fat, the gallbladder squirts some of this bile directly into the duodenum to do all the wonderful things we have been talking about. When you remove the gallbladder, what happens is that they basically attach the common bile duct surgically directly into the duodenum. What you have now is a steady, slow drip of bile into the duodenum, which means not enough when you need it and too much when you do not. 

The good news is that there are some very simple but lifelong clinical strategies that you can use to rectify this situation. You cannot get your gallbladder back, but you can essentially replace its function or mimic it by supporting the digestive process whenever you consume bile salts with your meals. That is going to replicate, basically, the bile that you should be getting. sufficient quantities when you eat. But, as I said, it is not enough when you need it. This is the first piece of the puzzle. The second piece of the puzzle, as I said, is that bile is very caustic. I mean, not to get graphic, but any of us who have been sick long enough to sort of throw some of that up, we all know how gnarly that stuff is. As I explained, with the acidity of the duodenum or the acidity of the contents going into the duodenum, the duodenum is not designed. It does not have this kind of protective layer. 

When you have a bolus of food in there and there is stuff for the bile to deal with, it is fine. But a steady, slow drip when you do not need it is incredibly caustic and is going to do a lot of damage. It is very irritating and inflammatory to this very, very delicate small intestinal layer, which we are going to talk about more in a second. It is one of my favorite parts of the digestive process, but it is very damaging. You need to mitigate that damage. What I recommend to clients is that they do some kind of gut healing support every day. It is just part of what they do from here on forward to mitigate that damage, which does not necessarily need to be in full doses. But something I will recommend is that you can do different things, like marshmallow root, glutamine, or slippery almonds; there are different strategies. 

The one thing I would say is, do not just find your favorite product and never change it up. I think it is a really good idea to kind of cycle through some of these different strategies and some of these different herbs and nutrients that can really help to build and support that layer, that mucosal layer, and the lining of the intestine. But those are two pieces, and I say that means lifelong because the gallbladder is gone. It is not something that you sort of correct and then do; this is something you need to be thinking about. But I have had many clients in this situation, and they have gone from being extremely symptomatic to just functioning completely normally. They do not need to be micromanaging the amount of fat that they are consuming in their diets; they have totally regular and consistent bowels and a happy gut. It is not the sort of life sentence of misery, but it is like you need to be paying attention to this.

Sinclair Kennally, CNHP, CNC

Yes, I totally agree. Beautifully said. Okay, so what else do you want to share about the small intestine’s processes and dysfunction? I am like, she is rubbing her hands together.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

This is my most favorite moment. I mean, the small intestine is so fantastic; at the beginning of this, I mean, really, we are still on the outside of the body. This is such a mind-bending thing to think about, isn’t it? This is literally still the outside of the body. But this is this moment, particularly the Jejunum and Ileum. This is second only to components of the small intestine. This is where the vast majority, or 95%, of your nutrients are absorbed. First of all, the lining of the small intestine is one cell thick. so that it is not very thick. And so incredibly delicate. We have the microvilli. These look like finger-like projections. When you stretch that out, the surface area is incredible. 

Although I am, there is new research that shows we used to say, Oh, the size of a tennis court, but it is now apparently the size of half a badminton court, still really big. It has a ton of surface area for your body to actually absorb nutrients, and these little microvilli in that one cell-thick lining have all these little tight junctions sort of lined up, kind of like little bricks in a wall. When we say tight junctions, that is exactly what they are. They are cells that are really tightly stacked next to each other. What happens is that they open up very selectively. This is a process that is regulated by the immune system by certain proteins, similar to cytokines and immunoglobulins, and decides when the bodyguard, or the body’s bouncer, instead of standing there at the tight junctions, is like, You? You are in; You? I do not know who you are. You are out. You? You are a toxin. You are out. You? Oh, you are well. You are in, right? 

It is like they are constantly evaluating everything that comes by and determining what gets absorbed. Because when that passes through that tight junction, especially the proteins and carbohydrates broken down, that is going directly into the bloodstream. That is like the moment where this food becomes critical moment and we need to have all hands on deck, right? We do not. One of the ways I like to describe this is that we can have what is called leaky gut, which is when those tight junctions become dysregulated and start to open up. Just to be technical, because I know you like technical, fat does not get digested through the tight junctions in terms of the space between them. It actually goes through the lack of tails in the middle of them. Sometimes it is inside the actual cell itself. Sometimes it is in between. But the point is that when you damage the integrity of that border, that very, very delicate border, what happens now is that all sorts of things that shouldn’t get into the bloodstream can get directly into the bloodstream. 

A good analogy would be, Let us say you live in a big, beautiful house with lots of doors and windows.  I was on a super-busy street. If you would like, I think of the house in Manhattan, although I do not even know if there are houses in Manhattan. But I think about the house on a really busy street in Manhattan, and there is like a butler at the front door, sort of letting people in very selectively, right? That is the way we want it. We want a very selective entrance. What happens with leaky gut, or intestinal permeability, is that all the doors and windows are suddenly opened, and it is a free-for-all. Of course, that butler is at your front door, and maybe it’s others if you are trying to say, Oh, do not come in, do not come in. But what happens is that all sorts of things come in that you do not necessarily want in there, and that can be maldigested food. It is just not yet ready. It could be a perfectly beautiful piece of broccoli from your lunch, but it is not actually in the right form for your body to recognize it as a nutrient. It could be a pathogen or a toxin. It could be. I mean, we think about the end; where is the end goal for things that do not get absorbed into your body? That is the toilet bowl, right? 

So think of it that way. There is lots of stuff in there that we do not necessarily want absorbed directly into our bloodstream. The challenge with any kind of compromised gut barrier is that it allows all of that to come in, like a freeway, which means that we are dramatically increasing our inflammatory processes and up-regulating our immune system. This is the birthplace of systemic inflammation. This is why I say the gut is the mother of the body. But if it’s not functioning properly, you have a leaky gut. Now you are in a lot of trouble because this is a key source of what we call endotoxicity. That toxicity from within—I realize I am talking a lot. I want to make sure you have the opportunity to ask any questions.

Sinclair Kennally, CNHP, CNC

I think this is really important for people to remember because we often talk about leaky gut in passing way and in isolation. What we are really talking about is that your digestion rules have been thrown out the window, and I also really want to take a second to highlight that you mentioned the villi, and of course, we want to discuss the tails and how those are really where those fats get observed. That is such an important distinction. I also want to know if you could just speak to pairs, patches, and tails and how the lymphatics are really keyed into the gut and why that matters so much.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

Yes, I know. I mean, 80% of the immune system lives in and around the digestive tract. What is happening is that the immune system is constantly sort of sampling what is going on in there. It’s like, Oh, is this friend or foe? Is this something that we can actually use as a nutrient, or is this something that we need to mount an immune response against? That is what is happening all day, every day. When we have a compromised gut barrier, and this can happen. We have that one cell-thick layer, and then you have two layers of mucus, mucin one and mucin two. That mucin is it; mucin always gets the one; mucin two is so mucin one is the one. I was like, Which ones? One and two? 

Anyway, the one closest to the actual gut lining, it should be sterile. Nothing should be like that; there should not be anything in there. Microbes. We think of our microbiome, that lives in that layer that is closer to the gut. That is where all sorts of this activity occurs, and when you have something that has compromised that, you have some things that have gotten into that mucin layer, too. That is when the immune system is on red alert. Red alert. It is an integral part of our first line of self-defense, ultimately with the immune system. We talk a lot about the integrity of barriers in functional health. This is just one of those barriers. I think you are absolutely right. We sort of flippantly talk about, Oh, leaky gut. It is profound what happens. The stress on that immune system when it is sampling and when it is just the sampling activity is dramatically upregulated. Then, as if there were some sort of breach of that barrier, the immune response that needs to be mounted is quite significant. 

This is why we sort of have the birthplace of a lot of autoimmune diseases, because when you mount an immune response loud enough, it can actually damage tissues around it. The immune system is doing what it is supposed to do. It is coming in and cleaning things up. But sometimes things get sort of caught in the fray and tagged as the enemy when they are actually themselves. Now we have an autoimmune response. It really is, any kind of immune challenge, anyone who has immune compromised, we have to think about the gut because we are eating normally multiple times a day, every day. If you are somebody who notices that you feel significantly better when you just do not eat, that might not be just digestive. I have some clients who have just been like, Oh, gosh, if I do not eat, then my knee does not hurt. It is something, and it is..

Sinclair Kennally, CNHP, CNC

Your energy is more even. You’re not getting brain fog, all of the above.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

You are not inundating your immune system. You are not overwhelming it with these highly inflammatory compounds, things like LPS or lipopolysaccharides, that are just coming in and causing havoc throughout our system. The source is the same. In my clinical experience, the destination in terms of where that inflammation is felt is very bioindividual, where that sort of whatever the constitutional weakness for that individual is, for one person, it might be migraines. It could be joint pain for one person, but not for another. It might be a skin issue. It might mean it really sort of manifests in different ways. But when we address these key pieces, we see resolution for all sorts of things. I mean, I have gotten to the point where, if I specialize in autoimmunity and I have had some people come in and I share their diagnosis. I have never heard of that before.

I had to go and do some research. I remember my first myasthenia gravis was very serious, and talking to a couple of other functional doctors, they were like, Oh, do not touch that. There is nothing we can do. I was very clear with my client. I said, Here’s the deal. I have never worked with this particular autoimmunity before, but here is what I know about the body: I explained to her much of what we are talking about today. I said, Let us start with the gut and let us just see how far we get. I followed the process that we are talking about today. She went into full remission. She used to have to take these medications because she was allergic to them all, so she would have to go to the hospital for three days. They would load her up with Benadryl and give her the treatment. She’d react horribly. But it was the thing that kind of kept her symptoms at bay for a few months, and then the symptoms would start creeping in and getting worse and worse and worse. But you could not have another treatment yet, and she went into full remission just with this. I mean, it did not do anything fancy. She did this. We addressed the gap. We identified and removed inflammatory foods.

Sinclair Kennally, CNHP, CNC

It is a story of hope. I really want to give you a chance, and I want to make sure we get into your lab preferences.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

Yes.

Sinclair Kennally, CNHP, CNC

Would you like to look at it? I do not want to rush you, but I really want to give you a chance to finish up, like the process, because I know people are going to look

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

The homestretch. We’re in the homestretch. Once we get past the small intestine, what happens is that the remains go into the large intestine. As I said, 95% of the nutrients have already been absorbed at this point. What is happening in the large intestine is much richer from a microbial diversity perspective. It is a much richer environment. This is where our gut bacteria have a chance to get in there and have a little party. So we absorb and reabsorb a lot of the water that comes from the remains that have kind of gotten to this point. Also, this is where our gut bacteria produce vitamins like vitamin K from our food. This is where we have the production of short-chain fatty acids, which are really potent anti-inflammatory agents in and of themselves and really help to maintain the health of the lining of the gut, and really, this is where we are at this point. Then we loop it out. What is left, to be technical.

Sinclair Kennally, CNHP, CNC

Looking for technical word. It is true accounts.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

I mean, the kind of imbalances we see here are largely caused by imbalances in that microbiome. We will be seeing things. We have an incredibly diverse microbiome that we know just a tiny little bit about. I mean, I feel like this is the new frontier, and this is the new research that is coming out about it on almost a daily basis. It is fascinating. But really, what we know is that it is incredibly diverse, and you have some beneficial species that are really important and some keystone species that are important because they maintain the health of the mucosal lining and produce these short-chain fatty acids. Then we have opportunistic species, some of which are highly inflammatory. 

We mentioned the LPS, the lipopolysaccharide they produce, which creates that indotoxicity situation. Some are histamine producers, right? I produce methane and hydrogen. We can get some clues into all sorts of different types of dysfunction. If you do not have sufficient benefits, then we create an opportunity where we can have things like yeast overgrowth and fungal overgrowth of all sorts of different kinds. This is one of the many places where parasites can take up residence, have a little party, and do some damage. This is one of the key things that we are looking for when we are thinking about testing. We are looking at the balance in the diversity of the microbiome and seeing if there are imbalances because there are too many opportunities that are feeding on maldigested protein, maybe because there is hypochlorhydria up north in the digestive process, or because we have dysbiosis, which is just essentially an imbalance in that bacterial balance. It can happen just because you are not digesting your protein enough because of a lack of hydrochloric acid. That some of those opportunists are just having a little field day party, eating down on the maldigested proteins. There are a lot of different subtleties and nuances here. But that is actually one of the places that testing can be incredibly helpful to us: understanding what is really growing in excess, what species are really low, and how can we kind of support that to regain balance? It is not about regulating or even using. It is the balance that is so important.

Sinclair Kennally, CNHP, CNC

Yes, absolutely. Why do we transition to talking about your favorite labs to start with, especially for budget-conscious people who are not sure where to start? They just know they have chronic gut issues. 

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

100%. There are two main types of testing. When it comes to stool testing, we have what was used as the gold standard for many years, which is culture-based tool testing, in which essentially you take a sample of the stool and it goes in some kind of substrate, basically a chemical reagent that is there to feed the organisms that are living in that stool to keep them viable until they get to the lab. Then they would take a little bit of the stool and look at it under a microscope. In some cases, this can be really beneficial. For example, it’s one of the best ways to identify yeast or anything fungal. But in a lot of cases, particularly with bacteria, they all like different reagents. you do not get, and you need to have the organism still viable when it gets to the lab. There are a lot of challenges with that.

Then another type of stool testing that has become a lot more popular recently is PCR testing. This is, in simple terms, basically looking for genetic evidence of things that are right. It is very sensitive and also very quantifiable, which is very helpful because we can detect things at very minute amounts and get a sense of the amount of them. When we did the old culture-based testing, we did have some sense of quantity, but it was really quite limited. It was sort of like low, medium, high, etc. Now we can really get a lot more granular in terms of the amount of certain species, both in terms of what is ideal as well as what is out of range either above or below the lab.

Sinclair Kennally, CNHP, CNC

Super important distinction.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

There are some labs that are strictly PCR-based, some that are strictly culture-based, and some that have integrated the two. A strictly PCR lab that we love is a GI MAP by Diagnostics Solution that is strictly culture-based and is based on the doctor’s comprehensive stool and parasitology data. Then we have some Doctor’s Data, which is called the GI 360, which is a combination of culture-based as well as some PCR technology. The GI Effects by Genova is also one that is a combination of PCR and culture-based, which is the one that we love and get the best results with clinically. It also happens to be the most affordable of the bunch, the GI MAP from Diagnostic Solutions. It depends a little bit on where you get it, but it’s going to run you anywhere from as low as $300 to, as I said, maybe as high as $500. But really, in the land of stool testing being so affordable, what I would say is its weak point is the fungal area, and all stool testing is a little finicky when it comes to parasites. I do not know that we have perfected the art of detecting parasites.

Sinclair Kennally, CNHP, CNC

Thank you for saying that. The technology is not there yet. Another commercial test for the public? Absolutely not. That is super depressing. Do not make huge decisions about what is there and what is not there, but be present.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

I want to say that, as it is so important to realize, there is no such thing as a perfect test. It’s just that we have to hammer that in over and over again. It is more data. It is not perfect data. We are also using it in the context of the bigger symptom picture and symptom presentation. It gives us clues about where to focus, how to structure, and how we support the body’s ability to heal. But we are not chasing numbers. I think that is so easy. Once you and I love, Hey, I love objective data from labs. It would not practice without it. It is not about chasing numbers. We can get into that, like, Oh, I see a little bit of this, a little bit of that, or I want this perfectly clear, especially those type A’s like True Confessions. I am so calling myself out on this, but that is not what is important. When we are highly symptomatic and trying to understand how to support the body, this testing is invaluable because you have even a simple presentation, as I mentioned earlier, something like constipation. There are endless things that can cause constipation, right? It can be about the gall bladder, stagnant bile, sluggish thick bile, or insufficient bile. It can be hydration. It could be about food sensitivities, a fungal overgrowth, a bacterial overgrowth, or insufficient hydrochloric acid. It could be some nuanced combination of all of these, which is normally what it is, right?

Sinclair Kennally, CNHP, CNC

Yes.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

You could say, Well, wouldn’t you just sort of support it all? There are aspects you would definitely support. You are going to always support the microbiome overall. You’re a big believer in supporting fat digestion and hydrochloric acid. These kinds of digestive functions. But if we are talking about this, yes, I am not going to throw someone on an antifungal protocol just because I think they might have fungus. That is a big deal. It is a lot of work from a dietary perspective. It is a lot of work from the supplement perspective. It’s just that it is a big investment. So when we start thinking about things like eradication, we really need those test results to inform what we do. Because, let us say that low stomach acid is a piece of the puzzle, but it is due to age-related pylori. Of course, we want to support stomach acid production, but if we do not recognize there is an H. Pylori component, and that is what is causing the low stomach acid, then we are never going to get anywhere. We need to identify the root cause so that we can then support healing very specifically.

Sinclair Kennally, CNHP, CNC

That is beautifully said. Could you give an example of what it means to support healing very specifically based on tests?

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

Sure. 100%. There are some aspects that we have gone through in terms of dysfunction that are very specific markers that will tell us how things are working, and there are other aspects that we need to use other forms of clinical assessment for, but starting with the stomach, so H. Pylori. One of the reasons I love the GI MAP is that it is extremely sensitive to picking up H. Pylori. I have had a number of clients where we suspect H. Pylori; they have suspected it for years and have gone to multiple practitioners. No one has ever done this test. Someone said, No, you do not have it. No, you do not have it. We do this, they have it, we support them, and they get resolution of their symptoms. Just determining H. Pylori would give us a clue as to the status of hydrochloric acid. 

Now, there is no good way of testing hydrochloric acid production specifically. There is this really uncomfortable and hard-to-get test called the Heidelberg Test, where you swallow a little capsule with a string. It is just awful and miserable, and it is not accurate. The way that we work with hydrochloric acid is that we follow a very carefully supervised, slow titration process. But knowing if H. Pylori is a component or not, it is absolutely essential to guiding that healing protocol. For example, we talked about the bile flow as being really integral for fat digestion. There are some markers on each one of these tests. For example, on the GI MAP, that is still an adequate marker, which is basically fecal fat. If that is high, what is it? That is a really good indication that the body is not actually breaking down. This is a good point at which to say, again, that we are not just chasing numbers. If your client has a condition or if you yourself have all the indications of impaired bile flow—things like nausea, motion sickness, feeling really disgusting when you eat fats, constipation—having these symptoms when you do the GI MAP and the hydrochloric looks great does not necessarily mean that you do not want to support the gallbladder. I think it goes both ways. You cannot just forget that you do not want to just chase the numbers, but you also cannot forget client symptoms and your individual symptom presentation. When you are thinking about structuring this. 

There are always markers for enzyme production, so we can get a sense of whether there is a need to support enzymes through supplementation or not. Then, in the microbiome, we can get a sense of different types of bacteria, which can give us clues as to what impact that microbiome is having on one’s health. I mentioned there are some species, some examples like streptococcus and staphylococcus species, that can overgrow in the gut. They feed on poorly digested proteins. We see that. Then we are really wanting to support hydrochloric acid, which we kind of wouldn’t. But we know that we need to double down on nuts. We see elevations and species like Klebsiella, Citrobacter, and some of these more inflammatory-producing bacteria. Then we are going to really think about inflammation. 

We are also going to be thinking about bringing in some eradication agents because we are not necessarily going to just try to rebalance and hope that they leave. We were seeing high producers of histamine, of which Klebsiella and one more dinella are another high producer. This is the LPS we wanted. We are actually bringing in herbs that will help eradicate those along with the other healing components. There are really, I think, five things you always want to consider with any healing protocol for the gut. You want to be thinking about digestive functions. That is what we are talking about with the hydrochloric acid enzymes and the biliary flow. That is the actual function of the digestive process. You want to be thinking about that gut lining we talked about. There are test markers that will give you some indication of the integrity of that, things like an elevated Zonulin. There is a lab called Vibrant that has a whole leaky gut panel. Here is the deal: I am a believer that we just want to support the integrity of the gut lining because so many things can damage it. It repairs quickly and easily. It’s just one of those things where it is like, Well, if you do not see Zonulin elevated in a lab, it does not mean that there is a leaky gut. It just means you are not elevated Zonulin through your own mechanisms, right?

Sinclair Kennally, CNHP, CNC

Yes. We know we are getting microexposures, at the very least, to life every day. Of course, that is going to immediately disrupt the gut within 15 minutes of exposure. Why are we spending money on something? We could just make use of that if resources are precious and you need to spend money on solutions.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

Let us focus on the solution and just bring in some gut healing. We want to make sure that in that microbiome, the beneficial species of commensal species are nice and robust, and if there are any pathogens that are highly inflammatory, they are really interrupting the processes of digestion like an H. Pylori, some like Klebsiella, and some of these more inflammatory opportunistic bacteria. We do need to eradicate them along with all of these other pieces. Then, finally, is identifying and removing those foods that are in and of themselves inflammatory. There are some that are the usual suspects: gluten, dairy, soy, industrial seed oils, sugars, and highly processed foods for everybody. Those are out. But each of us has food sensitivities that are hidden, meaning that they are not the usual suspects, and they might not be overt, meaning that you are not like someone with an allergy, like a peanut allergy, where you consume the peanut and break out in hives. 10 minutes later, food sensitivities can take up to three days to manifest symptoms.

Sinclair Kennally, CNHP, CNC

Yes. Thank you for underscoring that. Yes, people forget this. Yes.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

Almost impossible. I do not want to say that it is completely impossible. I would not want to try to figure that out through an elimination diet alone because you would have to go down to nothing and slowly introduce things one at a time every three days. I mean, it’s virtually impossible to do a true elimination diet to identify all the food sensitivities. Some sensitivities can be moderate, versus others can cause a really overt inflammatory response. So I am a big believer that there is a food sensitivity test called the MRT, or Mediator Release Test. What it’s looking at is not very different from a lot of food sensitivity tests that look at mechanisms like IgG. IgM mostly, some IgA. Those are evidence of the immune system mounting an activity, but they are not necessarily directly connected to inflammation. That is a super important distinction because what causes symptoms is inflammation. IgG, for example, is a normal and natural process of the body’s housekeeping, and you can have elevated levels of IgG without a corresponding elevation in inflammation.

What happens with those tests that look at the mechanism is that you have someone who has removed all these foods. Some of them probably do trigger inflammation, but others do not. They are not necessarily avoiding foods. There’s also a whole class of food sensitivities that do not involve antibodies at all. It is a mechanism that is driven by the cell inside the cell itself. You miss all of those entirely. It is like false negatives and false positives. I am not a big believer in those food sensitivity tests, but I love the MRT because it gives us information about what foods are triggering inflammation, regardless of whether antibodies are involved or not. It does not give us any information about food allergies. It is a very important distinction because it is a totally different mechanism. The inflammation does not happen in the blood; it happens in that tissue, but it can be powerful. What you are doing here is getting the information from the gut test that informs how we support the gut to come back into balance, to restore function, and to heal. At the same time, we use the information from the food sensitivity test to remove those foods that are causing inflammation right now. This is a right-now thing, but here are the foods you’re never going to eat again. This is a 3- to 6-month-long process while we do the healing. Then there is a reintroduction process because the goal here is not to make life hard and have a very restricted diet. The goal here is to eat as many diverse foods as possible while allowing the gut to heal. If you do not remove those inflammatory foods, it’s a little bit like if you had a big old cut on your arm and you were doing all the healing bombs and all the things, but every day, multiple times a day, you are running that open wound along a brick wall. It’s a sort of gross analogy, but it’s basically what’s happening. It’s just irritating while you are trying to heal. We do not want to remove all irritants while we are allowing the body to heal. You think—I mean, my arms are totally healthy. If I ran it along a brick wall, it might get a little scratchy, but it is not to hurt me. It is a similar thing, but how are the digestive processes working? It is nice and robust. There are no imbalances. You should be able to tolerate most foods. 

Sinclair Kennally, CNHP, CNC

Oh, that’s right. That is what we are supposed to do—just be resilient. That really is the default. It is totally the deal. That is, you covered a lot of great insights about what people can test for. Are there any other thoughts that you want to share with our newbies who are just taking control over their health for the first time? Our advanced students, as we lovingly call them, our junkies. They know more than their general practitioners. Just looking for that step that they have overlooked.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

Here is what I will say: If you have not yet gone and done a deep dive into your gut health using the tools that we are talking about here today and you have any kind of health issue, you need to do this as a piece of your puzzle. If you are a newbie, we can share some resources with you in terms of how to get started. What are the tests? What are some of the key markers to be looking for? If you are somebody who has been doing this for a while and you are feeling stuck, which, in my experience, a lot of people who have been doing this for a while are still doing, it’s because they are stuck. Then really go back here, and I really encourage you not to write this off if either you or I have already done gut healing. Oh, I have already manipulated my diet like that. These strategies that I am talking about here are very nuanced. You want to work with somebody who really understands the balance of these pieces. Even if you do not have those digestive symptoms, if you have some lingering health problem that will not go away, this is the starting point. It might not be the end point. I am not going to promise absolute miracles with this, but it is absolutely essential because of what we talked about at the beginning. It is the mother of the body, and it’s either really supporting and nourishing every single body system or it is one of the biggest sources of stress on your immune system. It is one of the biggest sources of systemic inflammation, and it is sort of the birthplace of a lot of chronic diseases.

Sinclair Kennally, CNHP, CNC

It is beautifully said. Thank you. I appreciate it. Anything you want to share with the practitioners in the audience who are listening and want to know how to deepen their work?

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

Yes, absolutely. Well, I run a great school.

Sinclair Kennally, CNHP, CNC

Yes. Yes.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

Our school is called Restorative Wellness Solutions, and we do a deep dive into everything that I am talking about here. We start with the gut, unsurprisingly. It’s a 12-week intensive program called Mastering the Art and Science of Gastrointestinal Healing, and it is exclusively for practitioners. This is where we are able to really go deep because we assume already that you have your foundational training and are working with clients. This gives you the skills to work with tests like the GI MAP and the MRT in a very clinically nuanced way, understanding how to interpret the information you get from these tests and how to take that information, marry it with your clients symptom presentation, and then craft very precise and effective healing protocols for your clients. Because the whole purpose of this is to get our people feeling better as fast as possible. Many people have been struggling for way too long, and it is time to stop that. It is time to get them well in a hurry. There are very specific strategies for that. That is what we teach.

Sinclair Kennally, CNHP, CNC

Which she is not sharing with you folks because she is so modest, is that some of the biggest names in functional medicine today studied with Margaret, and that is part of how they became thought leaders because they started doing stuff that works? That is something just to note, and I think that is absolutely worthy of note. Thank you so much for sharing so many clinical gems. I am just saying that it was like a fun magic school bus service that they get today. It has been fantastic, and thanks so much for giving people hope, because I absolutely agree with you. The whole point is resilience, and health is the default. And if the gut lining replenishes itself every three days, what is that? What are the conditions right now that need to be shifted so that it replenishes itself and actually heals? Thank you so much.

Margaret Floyd Barry, RWS, NTP, CGP, FNTP

Thank you!