How To Rebuild Your Microbiome After Antibiotics (And Why It Matters For MS)

Introduction to Dr. Bhanote 0:00

Welcome to another wonderful interview for the M.S. and Autoimmune Summit. Now our next guest is Doctor Monisha Bhanote. She is a bestselling author of The Anatomy of Wellbeing and a distinguished authority in gut health, cellular health and longevity with quintuple medical board certifications. She leads an integrative medicine, functional culinary medicine side, a pathology, and an anatomic clinical pathology. She's the founder of well, Kola, and she merges ancient wisdom with mind body science and advanced clinical testing for optimal health.

Doctor Binet's global influence extends through Doctor Burnout Decom immersive longevity retreat experiences, and featured in prominent publications emphasizing sustainable, science backed lifestyle changes to enhance vitality and health span. Welcome, Doctor Bhanote Okay, you know, I'm so glad to have you today. Let's talk a little bit about why gut health is so important for people with M.S. and other systemic autoimmune diseases. Absolutely. Thank you so much for having me join today, Terry. So I like to think of the gut brain immune kind of access

Why Gut Health Matters in Autoimmune Disease 1:09

if we take it that way, look at the gut, the brain and then the immune system. It's quite complicated and sophisticated. And I like to refer to it almost as a way, like a do you remember the days where we used to do phone calls and it was a three way conversation on the phone call would be like, okay, somebody is calling in, pick up the phone, and then somebody else gets to call in. And now we're having a three way communication. So I like to think of it that way, because the gut and the brain are always communicating through the longest nerve, the vagus nerve.

But there's also a enteric or a almost a third nervous system in your GI tract, which is a host to a lot of immune cells. In fact, about 70% of your immune system lives in your gut. So when we have that and we're thinking about neuro immune and auto immune conditions, keeping that gut brain immune access healthy is absolutely critical. Even if we're thinking more peripheral in the brain and the spinal cord. This communication is constantly happening through a number of trillions of microbiota, whether that's like different bacteria and those bacteria, then have their own communication pathway through using chemical compounds, how they communicate with neurotransmitters.

So there's always something kind of going on, almost like this little army of organisms doing stuff in our body. And individuals who have M.S. are experiencing flare ups and all that. That can actually get even worse if their gut is not healthy. So that's why it's extremely critical for many factors addressing this, though maybe we should be, refresh for our listeners, what is the gut and where is that what what parts of our body are part of the gun? Yeah, absolutely. So the gut I like to think of the gut actually starting in the mouth.

Right. So we have from the mouth going down a to through the esophagus, into the stomach, into the remaining part. So let me kind of describe in the point of when you're eating something right, that food has to travel. The food can be nutritious and feed your gut microbiome. You think it's feeding you. It's actually feeding your gut microbiome. And so the food we eat, our eating, we put it in our mouth, and our salivary glands secrete enzymes that start breaking down the food. Salivary enzymes start breaking it down.

Then through the natural process of peristalsis, it moves from the mouth into the esophagus, straight into the stomach.

What the Gut Includes and How Digestion Works 3:43

Now the stomach has its own enzymes that start breaking down food. So it's got acids and all this kind of stuff. But then one of the most significant parts is when it goes from the stomach into the duodenum. The duodenum itself is made of three parts, the, proximal and distal part of the duodenum. But this is really important because this is where a lot of absorption of nutrients is happening. So, the absorption of nutrients, the the vitamins and minerals and all these different things coming from our food gets absorbed there.

Now, when we are at that place, you can think of the, the duodenum, kind of like almost like an SCC shaped structure. And in between that C, h, C shaped structure lives the pancreas. It's kind of like this, almost like a ball and glob like, here's the duodenum and here's the pancreas. The pancreas has like a nice, like long tail. But you got the head of the pancreas in here. The pancreas also secretes enzymes okay. So the pancreas secretes enzymes into the duodenum to help further break down food.

But that's not the only thing that's happening on the other side of this c shaped kind of duodenum is coming from the liver is bile. So the gallbladder, which houses with our liver, well, technically the gallbladder holds bile for you that the liver produces. And when you eat something particularly fatty, that gallbladder will secrete bile to help break down that food again. Right. So it's all going into the duodenum. So now that there's a lot happening in this like structure right here, and then from the duodenum, the food then gets further taken down.

The small intestine, which is a huge long piece of small bowel. And then from there it goes into the large intestine. Also, people think of it as a colon. And the colon has its own kind of a kind of upside down U structure, where then like water is reabsorbed and then whatever is left over from the food, which is usually the indigestible fiber part, gets taken out in stool. And that's a very simplistic way of thinking of digestion. But in that whole process, there's a lot going on, because when we have a microbiome that lives in our gut, those bacteria are kind of taking these little, like nutrients from the food.

They're, you know, turning things into metabolites. They're helping make vitamins, they're helping make neurotransmitters, all these different things that are happening. And if we don't have the best microbiome because maybe we didn't know that, you know, I talked to people all the time and they're like, they didn't realize food had such a big impact on their health conditions. And so, you know, probably just like me and you grew up eating like whatever was put in front of us, whatever we had in school thinking that that was what food was, right?

Until you actually have a health condition, you have to deal with it and you go, maybe this isn't this isn't right. So that microbiome needs to stay healthy. And there's certain bacteria that we now know, like you know, that can be very, very protective, especially when it comes to neuro immune health. One of them that there's a lot of conversations going around is Akram NCA and Akram. NCA is so important because what it does is it strengthens that gut lining and it helps that immune system. And in fact, taking one dose of antibiotics can wipe out your Akram NCA okay.

So imagine that's just one dose of antibiotics. You're not thinking anything of it. It's cold and flu season. The doctor gives it to you. You're like okay I'm going to take it and it can wipe it out right. And this is so protective for you. And I could tell you that it wipes out because I have my own pre and post like GI stool tests where I can see that I had gazillions of Akram NCA and after one round of antibiotics not even detectable levels which it's a big deal. It's it's a huge deal. And without me making sure that I'm like testing pretty regularly on myself, like once a year is regular for me.

But I wouldn't know that, you know. But but we do know that Akram NCA particularly is really, really protective. The other one that I notice a lot when we're thinking of neuro kinds of things is it's quite a long word. It's a so bacterium we can call it with a P. So there's another specific bacteria in there also that we know helps reduce, inflammation in the body. And when these organisms are reduced, other bad guys start taking over. And then you have this imbalance of this growth that isn't doing like it isn't making your neurotransmitters.

It isn't making your vitamins, it isn't doing what it's supposed to do. And this is where we can think, all right, here's where some symptomology comes up. Here's what are some flares come up. Things that like when we don't start feeling good. Okay. So I think, the listeners now should have a good understanding. Gut health is important. Microbiome, is important.

Microbiome Support During and After Antibiotics 8:51

What are some of the things that we can do to help restore our microbiome? Because, you know, you know, I just recently myself had a bladder infection needed to take another round of antibiotics. And so, yes, there are times when that needs to happen. And many of our listeners, listeners will have episodes of urinary tract infections. We'll have to take their antibiotics. What should I do now? So let's say I just finished my antibiotics. What are the next steps. Yeah. All right. So now we want to first of all, even when you're taking antibiotics I want you to protect your gut microbiome.

Right. So don't wait until afterwards. Let let's start with it. The doctor gives you a script and you're going and taking antibiotics. Start right then and there. So that might look like okay I'm going to eat more fermented foods okay. So when you're on antibiotics even before you're on antibiotics I usually recommend people to have three. Like with each meal. If you're eating three meals to make sure you have something fermented with each meal. And then when you're taking antibiotics, even up it even more so, fermented food might look like, you know, some kind of kefir, some kind of yogurt.

I prefer the plant based ones. But, you know, as long as you're getting some some kind of probiotic in there, you can do things like sauerkraut, kimchi, miso soup is really an easy way to do it. Right. So cup of miso soup goes goes a long way. So making sure you're always eating something, fermented with each of your meals and it and it doesn't really take that much, you know, just like two tablespoons. Get some sauerkraut and put it on your plate. Oh, and let's clarify the difference between fermented foods and pickles, because you go to the store, you see pickles down the grocery aisle, but that's not quite fermented.

So you want to explain the difference for our listeners. Yeah. Yeah. So so there is a little bit in there, but that's not the type of fermentation that we're talking about. We're talking about a specific process where there is literally live cultures of bacteria inside of this food. And it's very common to see, like if you take a like yogurt container and you flip it over and you'll see, like live cultures of these different like lactobacillus and these kind of different bacteria, same thing you'll see with a couple beers, I don't think I, I don't recall seeing an on labels of like sauerkraut, but you'll notice it that something's fermented because when you kind of go open the jar, it has like almost like a distinct, like smell, or it has like a little bit bubbling happening in the liquid.

Right? So like even in kombucha, sauerkraut, kimchi, like when it's been fermented and you open the jar, it's got this like bubbling happening. And that's the live organisms. And those live organisms are part of replenishing your gut. You know. So something we want to definitely do regularly and even more so when we are on antibiotics. The other thing to think about to help your gut is fiber. And the reason, fiber is so important is because fiber from foods can be turned into something called short chain fatty acids.

Okay. And the short chain fatty acids, one of them being butyrate, is almost like a fertilizer for your immune system. So this can help calm down inflammation and can even potentially start repairing myelin for like Ms. patients. Right. So we want to make sure we're having high fiber foods. And this is also once again in general not like just when you're on antibiotics. So can we clarify fiber like celery or fiber like berries. And what's the difference between okay. So the fibers I'm talking about is things like maybe sweet potatoes, oats, lentils these digestible of flax seeds fruits and veggies have fiber.

Right. So lots, lots of fruits and veggies are three things that do not have fiber are dairy. Right. So you might be having dairy to get your fermented, but you're not going to get your fiber from that, right.

Fiber, Polyphenols, and Gut-Friendly Foods 13:03

Sugar also does not have fiber. So if you're on a kind of more sugary processed food diet, like, you know, bagels, crackers, pastries, you're not going to get fiber there. And unfortunately, meats do not have fiber. So you got to make sure you're balancing and getting your fruits and veggies. And I've seen the stuff you cook. So you always have like a plate of veggies. You know, about fiber. Absolutely. And so fiber is critical. You know, I was talking to somebody yesterday. One of my patients, she has not touched the beans or lentils like, her entire life.

So can you imagine you're missing out on all these nutrients that you've never even experienced before. So whole grains is another way to do it if you choose to eat grains. But really, I'm a big fan of, just fruits, vegetables, sweet potatoes, lentils. And then the other thing is to think about for the gut microbiome is polyphenol rich foods like phenols are a special compounds inside your foods. We love to get them from different colors of foods. So berries are going to be really important, and we should be eating berries daily, especially for neurologic health, you know, different color berries.

Green tea is another one. Green tea is extremely high in polyphenol. Specifically, it has ego. Galactose, catechins and olives is another one that's really polyphenol rich. And then the one I'm giving you permission to eat is dark chocolate. Yes. You're allowed to eat dark chocolate. Yay! Yeah. So I really like the dark chocolate as well. For the listeners, one of the, polyphenols in olive oil, hydroxy Tiraspol. There's more and more research showing that to be very protective for people with multiple sclerosis and neuro immune conditions.

The caveat I want the listeners know, is when you hit it to 180 degrees, denature, destroy that hydroxy tirer sol, which is why, if you follow me, I encourage people to blend their delicious olive oil with fresh green herbs and then put lots of this pesto, the olive oil and herbs over everything you're eating. So if you follow me, you see that I. I'm putting tablespoons of my olive oil pesto over my vegetables. Over my meats. Yeah. It's a great way to make everything taste super delicious, to get olive oil, to get your hydroxy tirer sol.

Yeah, yeah. Absolutely. No, that's a great idea. And I do something very similar. So you can pretty much make anything taste good with, herb, a couple cloves of garlic and a little bit of olive oil. Right. So if you want to make like a gremolata sauce, it's like parsley, a couple cloves of garlic and a, a little bit of olive oil. Blend that up, drizzle that on all your veggies or whatever you're eating. Chimichurri sauce. Do the same thing cilantro, garlic, olive oil, chimichurri, gremolata and then a pesto like you said.

So that's basil. And you know, so it's super easy to take these herbs. And the one thing that people don't realize is herbs are not meant to be a garnish. You know, I think about like when somebody puts like a parsley sprig or mint leaves and then I always see it put on the side of the plate like nobody actually eats it. It's actually one of the most valuable things, because herbs are really detoxifying for the body. And in the life and environment that we are living, we are exposed to so many toxins, many of which can be neurotoxic for us, that we want to make sure that we are incorporating as many herbs as possible.

I mean, I'm somebody who actually buy a bunch of cilantro and chop it up and have like half a bunch just in a salad where it's like most people are like like, oh, it went bad because you're not really using it, right? So so those are all really. And then I'm going to ask you another question. So I see people, you know, my spouse will chop up the leaves, put, you know, in with our, tacos and then just ready to throw away the stems. So so no, no, no, I take the stems, I blend them with some water, a little bit of the lemon, and I drink that as my green beverage.

During the meal. What are your thoughts on that? Yeah. Oh, yeah. No, absolutely. Like when I make a green juice, I'm a big fan of, like, I like a good cilantro, cucumber, lemon and celery. Like super, super simple. Just green juice. Blend that up so you keep the whole whole whole strand like we end up throwing away a lot of the good parts because we're so used to things being pretty when we're eating, like there's a lot of nutrients in this stuff. Yeah. So listeners, don't throw away your stems or your parsley, your stems of the cilantro.

Just put them. Oh, chop them up. Put them in your salad. Put them in your smoothie. Put them in my pesto. Another place I like to put them is I will, put them into ice cube trees. So then when I'm ready to, like, say, blend like a soup or something, like, say, I'm making a. Last week I made a thing of cauliflower soup and I made. So they took an entire head of cauliflower, a couple of stocks of celery, some carrot, put it all in there, and then I dropped the ice cubes in that had a mixture of different stems.

Culinary Medicine, Herbs, and Reducing Food Waste 18:18

It's almost like making a like veggie broth kind of thing, but it had those herbs already in there through those ice cubes in there. And now I haven't wasted them. I've gotten more nutrients in my soup. Perfect. You know, and I think we could talk a little bit about some of your tips when, when we get into the next question I have is culinary medicine, how to, use lean into culinary medicine and also reduce food waste. Because groceries are expensive, food is expensive. I want people to learn how to reduce their food waste so we can get as much health as possible.

Yeah, so culinary medicine is technically a relatively new field, but what that field is looking at is the connection between food and disease. Like how does food really impact how disease is developing in the body? And then additionally, how can we prepare foods to really make them optimal, like you were talking about how you use the olive oil, so you're making sure you're getting the most nutrients from it. So really kind of understanding that is is the essence of what culinary medicine is. And one aspect of culinary medicine for me that I find is really important, as I'm a big fan of phytonutrients.

And phytonutrients are critical for reducing neuroinflammation. They're critical for our overall health and addressing like oxidative stress. And I know individuals with neuro immune conditions and Ms. have a lot of oxidative stress in their body. So more phytonutrients and we have three critical ones. One I already mentioned, which was the polyphenols. One of the polyphenols I did not mention in there was curcumin. So the compound that's important inside of inside of turmeric can reduce the activation of the microglia, which is it's a specific type of brain cell.

Another polyphenol that I did not mention would be resveratrol okay. So control is found in those berries right. So red grapes blueberries. And this one can help with mitochondrial resilience. Because what happens is when we have neuro immune conditions our mitochondria are just not producing the type of energy we we need it to. And this is why we feel fatigued. So those are some just a few more additional polyphenols subcategory of phytonutrients. Another one I would think is critical for neuro immune health is quercetin.

Quercetin can help suppress some of the inflammatory cytokines that are occurring and circulating in the body. One of my favorite sources I know that this might sound like how can you eat that? During our most recent last four years of health, outbreaks that we had, I was eating like half a red onion every day, and it is so high in quercetin and I and I swear that's what it's like. One of the things that really protected my body. Apples. If you don't want to eat half a red onion, eat apples to the red onion.

We're having that raw. Or are you cooking it so I was doing it pretty raw in the sense of a quick pickle. So I would just like chop it up raw like slices and then squeeze some lemon juice on it. So it's like a very like not quite a fermentation, not quite a pickle, but like a quick. Yeah. Just to cut out some of the taste because sometimes right, onions can be really strong. So I know some folks will, chop red onions, drizzle honey on them. I'm a, in the quercetin and the Allison from the onions.

Get into the honey, and they find that to be a very helpful remedy to reduce the intensity of respiratory infections. Okay. I have not tried honey over onions, but we do the honey onion together in the spoon. Oh, okay. Okay. I have not tried that, but I have done, you know, during, like, cold and flu season, taking a jar of garlic and putting your local honey on it, letting it marinate and eat, like, garlic clove covered in honey every day. Pretty amusing. Yeah, I've done that, but I haven't done the onion, so that would be an interesting.

I might try that one. I might try that one. I mean, I think we're getting very similar compounds that way. And, you know, that was a traditional approach that my grandmothers would have been using during the winter time when colds, flus, and pneumonias were, much more prevalent. Yeah. And, and and I did mention, like, green tea and, and sometimes green tea is like an acquired taste. Not everybody likes it. So that, you know, I would recommend if you if you haven't found one you like, like keep searching because there are different ones and specifically because that igo galectin catechin, which is a flavonoid that I mentioned, this can help inhibit those T cells.

Remember that T-cell that gets activated in Ms. and can unfortunately make it progress.

Phytonutrients for Neuroimmune Health 23:09

So green tea can be quite protective. And then the last category big category of phytonutrients is carotenoids. Carotenoids for example lutein and sath. And then those are both found in dark leafy greens. And then another one that's in that same carrot. Carrot carotenoid family is found in some algaes. And the reason that these carotenoids are important is because if you think of the brain, the brain is mostly fat, okay, about 60% of the brain is fat. And when the body experiences, you know, it's a it's technically a, Chemical reaction that's happening.

It's called lipid oxidation. But just to make it simple for you, think of it like rusting. Like, kind of like when you leave, like an apple out or an avocado out and it changes colors. Right. So that's oxidation that happens in our brain too. Except it's it's a lipid type of oxidation because our brain is mostly made of fat. And this is where a lot of these are phytonutrients can be extremely valuable for protecting that oxidative stress in the brain. I mean, like I measure oxidative stress in my patients when I'm seeing them.

And it's like I have some people who, well, you know, like teenagers and they do have like stuff going on and their levels are something that I shouldn't see until an 80 year old, you know, we just have so much more exposure these days because we're not really tapping into the value of food as medicine. Absolutely. Well, doctor note how can our listeners, learn more about you?

How to Learn More and Work With Dr. Bhanote 24:58

Okay. Tell us, can they come see you as a, as a physician? Can they work with you? Yeah. So I do have, a telehealth practice. So if you are in the states of Florida, California, New York, new Jersey, or Pennsylvania, you can become my patient. If you're not in one of those states, you can still become my patient. Except you have to fly and see me at least establish care, which nobody minds. Flying to Florida. You can easily learn more about me and, my work at my website, drbhanote.com, and on social media, Instagram, Facebook, YouTube.

I am doctor Bhanote, so they're super easy to find. And, one more. What are the states that, you're licensed in? California, new York, new Jersey, Pennsylvania and Florida? Okay. Well, Doctor Bhanote, this has been wonderful. Thank you so much for having me, Terry.