RHR: Why You Need a ‘Digital Detox’ (and How to Do It Right)

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Do you often have difficulty sustaining attention in tasks?  Do you often have difficulty listening when one is speaking to you directly?  Do you often have difficulty organizing tasks and activities?  In this episode, we cover my best tips to do your own ‘Digital Detox’ (and who might need one).

In this episode, we cover:

2:02 How to tell you need a ‘Digital Detox’
14:20 Chris’s best tips to do your own ‘Digital Detox’
22:34 Does a high fat diet cause endotoxemia?
28:50 Will my FODMAP sensitivities eventually go away?
36:29 Steps for rebuilding your gut

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Full Text Transcript:

Steve Wright:  Hey, everyone.  Welcome to another episode of the Revolution Health Radio Show.  This show is brought to you by ChrisKresser.com.  I’m your host, Steve Wright from SCDlifestyle.com.  With me is integrative medical practitioner, New York Times bestseller, and healthy skeptic Chris Kresser.  Chris, how are you feeling today?

Chris Kresser:  I’m great.  How are you, Steve?

Steve Wright:  I’m very grounded today.

Chris Kresser:  Oh, good!  Glad to hear it.  That’s germane to our topic, so we’ll get into that in a second.

Steve Wright:  Yeah, we almost talked too much before we got going on the show here today.  Before we get into that, though, Chris, what did you have for breakfast?

Chris Kresser:  What did I have for breakfast today?  Let’s see.  I had bacon, eggs, and some bok choy cooked in a little bit of coconut oil.

Steve Wright:  Nice.  Sounds very good.  It might edge out Jordan’s sweet potato fries he made me for breakfast this morning.  He came to stay.

Chris Kresser:  I don’t know.  That sounds pretty good.

Steve Wright:  They were, like, these shavings.  It was like a hash, sweet potato hash, so that was pretty good.

Chris Kresser:  Yeah, that sounds great.

How to tell you need a ‘Digital Detox’

Steve Wright:  We’re going to be doing a Q&A episode today, and we’re going to start, though, with a little bit of an experiment that you’ve been undertaking, Chris, and after what Jordan and I kind of put ourselves through the last couple weeks trying to finish our new product, it’s been on my mind, and one of the reasons why I’m feeling grounded today is we just got done doing a hike here in Boulder.  So, yeah, tell me.  Let’s just talk about your experiment.

Chris Kresser:  Yeah.  This is something I do regularly, once a year at least, preferably more, but the last year has been pretty intense, so it’s been a while since I’ve done it.  Some people call it a digital detox.  That’s as good a name for it as anything, unplugging completely.  But the idea is you take a certain period of time, I recommend a minimum of five days if that’s possible – I took 10 days this time because I felt like I really needed a good solid break – completely away from technology.  There are a lot of reasons for doing this, and I want to talk about a few of them before we get into the details of how to actually do the digital detox, at least how I do it, and I want to start just by asking a few questions.  So, if everyone listening – and you, Steve – let me know if you resonate with any of these descriptions.  Do you often have difficulty sustaining attention in tasks?  Do you often have difficulty listening when one is speaking to you directly?  Do you often have difficulty organizing tasks and activities?  Do you often avoid or dislike or are you often reluctant to engage in tasks that require really sustained mental effort?  And are you often easily distracted by extraneous stimuli, like an email coming in or a text message or something like that?  Does that often distract you from what you’re doing?

Steve Wright:  Yes.

Chris Kresser:  Yes!  Right?  I imagine a lot of people would answer, yes, to most or even all of those, right?  The interesting thing is those are essentially the diagnostic criteria for ADHD.

Steve Wright:  Oh, wow.

Chris Kresser:  Yeah!  I’m not saying this to make any of us feel bad or that I’m trying to diagnose you or everybody that’s listening with ADHD, but the reality is, as Dr. Edward Hallowell put it, a psychiatrist who specializes in treating ADHD, once applicable only to a relative few, the symptoms of ADD now seem to describe just about everybody.  Another way to put it is we’re living in many ways in an entire culture that is ADHD.  We are subjected to constant distractions, emails coming in, multiple windows open in our browser, Facebook, Twitter, LinkedIn, Instagram, Pinterest, YouTube videos, news, stocks, text messages – I mean, I’m only getting started.  There are so many other ways that we can be distracted throughout a day, and all you have to do is think about when the last time is that you went an entire day, for example, without checking email or social media.  Or how about even an hour?  When’s the last time you went an hour when you didn’t do that?  Or when is the last time you took an hour or more, maybe several hours, to just think creatively about something or think long term, really consider what your vision is for yourself, what you’d like to accomplish or any particular thing that you’re thinking about in your life, without interruptions?

Steve Wright:  Well, I was having a hard time on the hike today not pulling out my cellphone.  I was tracking myself, and I would have this unconscious urge to just pull it out of my pocket.  It had been, like, 35 minutes.  Oh, no.

Chris Kresser:  Right.  Yeah, and I actually just talked to someone yesterday.  He didn’t do a full digital detox, but he uninstalled Twitter from his phone, and he said that he was literally, like, his hand was twitching to move to his pocket to take out the phone and look at it to see if there were any tweets.  It was like a physical, trained response, and it was just remarkable to him that it really was like dealing with an addiction.  And there are a lot of addictive aspects to this kind of technology and media and distraction because it stimulates reward centers in our brain.  Each time we check an email, there’s a chance that something will be there for us, something that reinforces some aspect of who we think we are and gives us a little bit of a reward; the same for Twitter, Facebook, etc., and any time those reward centers of the brain are engaged, there’s the potential for addiction or addictive behavior.  What you just said, Steve, is, I think, almost universal in terms of the experience that people have when they do the digital detox or they try to step away from this kind of engagement.  It’s just really pervasive and insidious and affects us in ways that we’re often not even conscious of.

Some people might say, well, so what?  What’s the problem with that?  The thing is the ability to control where our attention is directed is really fundamental to optimal performance in just about anything, whether you’re talking about anything, whether you’re talking about writing or whatever kind of work that you do or sports or learning a new hobby or music or athletic performance, and it’s also really crucial to health and happiness.  There are many wisdom traditions and religions that focus on or have techniques that in some way train attention, like meditation, for example, meditation practice and mindfulness practice, because they recognize that the ability to control our attention rather than just have it be bounced around like a pinball in a machine by any type of distraction that happens to be present is really crucial for a sense of presence and groundedness and health and happiness.

There are a lot of people now who are writing about what this exposure to constant distraction has done for us and what it might do for us in the future, and I think it’s a little bit alarming.  We had a podcast a while back on how the Internet is rewiring the brain, and we talked a lot about some of the nitty-gritty research on this topic, so you can refer to that – I’m not going to go into all the studies this time – but one author, Maggie Jackson, who wrote a book called Distraction: The Erosion of Attention and the Coming Dark Age – you can see what she thinks about it just from reading the title! – she wrote:  “The way we live is eroding our capacity for deep, sustained, perceptive attention,” and that, I think, is the biggest problem that we’re facing right now in this age of constant distraction, is an inability to think deeply about anything because we’re thinking horizontally more and more.  We’re thinking about a lot of different things but not very deeply, and we’re constantly kind of skimming the surface of attention, and our attention is being pulled in multiple different directions, so we rarely have the opportunity to just drive vertically, deeply into a particular issue, problem, or a vision that we want to manifest in the world.  At the end of the day, I think, that’s one of the most compelling reasons to do a digital detox or to completely unplug.  Many people now, even when they’re on vacation, are still checking social media, taking picture, uploading them, checking email, doing all this, so it’s rare for folks to get a break at all, even on vacation, and I think there are really potentially serious repercussions for that.

Steve Wright:  Yeah, so what have you noticed, Chris?  Is there anything that you were tracking going into it that you’ve noticed now on the other end of 10 days of no tech?

Chris Kresser:  Well, in the past it’s been more difficult for me and I have noticed a sort of knee-jerk response to want to get online and check my email or whatever.  This time, to be honest, it was pretty easy, and I think in part it was just because I was so ready for it with the book and the book tour and the lead up to the book launch and all of the work that went into that.  I was just really, really ready to just completely disconnect.  The first day, I think, was maybe a little difficult, a little unusual.  I noticed my mind wandering and wanting to check my email or tune in, but very quickly for me I got to the point where I had an active aversion even to the idea of doing that.  I was using the phone or computer for very simple things like if we needed to get directions somewhere.  I’ve been away for a little while, taking a break, and so if we needed to look up directions or check the weather or something like that, but it was limited to single activities that were related to something that we needed to do in the world right then.

The first day or the second day when I would go to check the weather or something, I might notice a desire to also open my email and just check in.  I didn’t do that, but after the second day, it was almost the opposite.  It was like I didn’t even want to open my email because I knew the effect that that would have on my mental space, and after the second or third day I really just started to settle in.  I was writing in my journal.  I was doing some of these visioning exercises that I sometimes do when I’m at a point in my life where I feel like I’m thinking about what the next steps are.  I’ve just been reading a lot, both nonfiction and fiction, meditating a lot, a lot of physical activity and a lot of time just doing nothing, and it’s been really extremely therapeutic.  Yesterday was my first day back, and I was kind of dreading it.  I was dreading opening my email and seeing the hundreds of messages there and dreading getting back online because there’s a way that I just got really attached to that mental space that I was in.

Steve Wright:  Nice.  Well, thank you for sharing that, and I hope to be able to do that later this year.  I can definitely tell even, you know, Jordan and I made a conscious effort to unplug this week for a few hikes and it was just like, oh, wow!  This is interesting.

Chris Kresser:  Right!

Steve Wright:  I haven’t been in this space in a while.  This is nice.

Chris’s best tips to do your own ‘Digital Detox’

Chris Kresser:  Exactly.  Yeah, and I mean, you don’t have to do 10 days to benefit from it or even five days.  One of the commitments I’m going to be making and that I used to do that I’ve fallen out of the habit of with the book was to just have one day each week where I don’t even go near the computer or phone or anything.  When I’m at home I don’t really need to get directions or anything like that, so I think one day of having no interaction with screens at all is really therapeutic.  Again, I did that in the past, and I found it be really, really helpful, just one day, and I think most people can probably work that in their schedule, and even just having periods during the week, maybe a half day during the week or a couple of hours during the week or maybe evenings past a certain time you cut it off.  There are a lot of ways to work in smaller breaks where you’re not dialed in.  And of course, we did those two podcasts on increasing your productivity, and I talked about things like batching email and social media where you’re not checking them consistently throughout the day, you’re just dedicating certain periods of time during the day to check.  You turn off the reminder on your phone where it beeps any time a new email or social media notification comes in.  There are lots of different strategies for doing this throughout the week, and I definitely recommend that as well as a longer period of digital detox each year if possible.

A couple details on just how to do it:  It’s pretty straightforward, and it obviously depends on your circumstances, but for me, I set up an autoresponder on my email that just said, I’m unplugged and not checking or responding to email during this period, and if you need help with this, you can contact this person.  If you need help with that, you can contact that person.  In my case, because there’s a lot still going on, I had someone within my company who was checking in with my email every two or three days and just scanning to make sure there wasn’t anything urgent, and he had my phone number and permission to call or text if there was a dire emergency, like the sky was falling and I absolutely needed to deal with something, but that didn’t happen, fortunately.  I didn’t expect it to, and it didn’t.

Then, as I said, my rules were no checking email, no social media, no browsing the Internet, just kind of getting on the web and looking something up.  We all know how that works.  One thing leads to the next and it’s 45 minutes later and you don’t even have any idea what you’ve been doing.  No reading news headlines.  I figured the world would go on without me!  No kind of undirected activity online.  Some people prefer to just completely unplug and not use screens at all, like no checking weather, no directions, no looking at restaurants or anything like that because they just find it’s like a slippery slope.  As soon as they get on they’re not able to stop it there.  So, that’s up to you.  For me, I think going to that extreme isn’t really necessary because now the computer and phone are so easy to use to get directions, check weather and that stuff.  It’s way faster and more efficient than doing it any other way, and as long as you just do it for a minute or two, I don’t think it really interferes with the purpose of the detox, the unplugging.

Then I think it’s also a good idea to have some ideas for how you’re going to spend all that time that you used to spend checking email and social media and all that stuff.  For me, as I said, I was journaling and writing and meditating, taking lots of long walks and lots of physical activity.  It’s a great time to start learning a new hobby or start doing some new creative activity, brainstorming, hanging out with friends, spending more time with your partner or your kids, and just like you and Jordan were doing, go on a hike, have some things to do that will really engage your senses in a way that you don’t typically do.

Steve Wright:  Perfect.  Well, I’m definitely getting in tune with that idea of at least picking an afternoon or a morning.  I typically work in the mornings.  That’s when I have my ability to focus the best.  So, I’m definitely into unplugging for an afternoon or two every week, starting to have some new rules around that.  That sounds pretty delicious for me.

Chris Kresser:  Yeah.  Maybe we’ll do a kind of digital detox challenge at some point.  Of course, you won’t be able to check in and get any help that way!  Maybe just knowing that other people are doing it at the same time could be helpful.  I don’t know.

Steve Wright:  Yeah, it could work.

Chris Kresser:  So, let’s answer a couple of questions.  I will say, one thing we didn’t mention at the beginning of the show is there are probably going to be some changes to the show in the future, just kind of reflecting on what has worked, what hasn’t worked, and what future directions to go in, so I would be curious to hear from you listeners what it is that you really like about the show, what you’d like to see more of, what you’d like to see less of, because I’m in a period of thinking about this now and would love to get some feedback.  Maybe we can create a little form that you can fill out and we’ll put the link in the show notes on the website and you can go there and do it that way, or you can submit something on Facebook or fill out the existing podcast question form, whatever is easiest for you, and that way we’ll have your feedback as well.

Steve Wright:  Yeah, so before we jump into the questions, Chris, as we switch over our documents to the questions, I just want to let the listeners know that in case you haven’t heard yet, Chris redid ChrisKresser.com and basically created this wonderful cocoon of how to get healthy.  Over 80,889 people as of today have already signed up for a membership at ChrisKresser.com.  And when you sign up there, what Chris did is he really consolidated a lot of stuff that you might not have known that he has already created.  There are MP3 recordings with experts on all kinds of things from thyroid to gut health.  Chris has done a lot of eBooks on gut health and on thyroid and other topics as well, so whatever your choice of medium to consume information from Chris, he’s created this membership site where you get access to all of this material for free.  In with this membership, you’ll also get a 30-part email series on the most essential topics that he’s basically isolated out for anyone who’s serious about feeling great, eating well, and living that high performance lifestyle that we were just talking about.  This is a call to action right now to go over to ChrisKresser.com and get your free membership.  Check out whatever your subject is that Chris writes about that you’re following us for.  Make sure you’ve read all the stuff that he’s put there because he’s spent a lot of time and effort on that.

Chris Kresser:  All right.

Steve Wright:  All right, Chris.  Let’s do some Q&A, man.

Chris Kresser:  OK.

Does a high fat diet cause endotoxemia?

Steve Wright:  These questions were pulled from Chris’ Facebook feed, so if you’re not following Chris on Facebook, go to Facebook.com/ChrisKresserLAc and hit ‘Like,’ and then you’ll be able to have some input on these last-minute shows that we do where we’re asking for questions.  These will all be just coming from people on Facebook, and the first one we have here is:  “Chris, does a high fat diet cause endotoxemia?”

Chris Kresser:  This is a really interesting question.  First of all, for those of you that don’t know, endotoxemia is a condition where there is an increase in endotoxins like lipopolysaccharide, and that can provoke low-grade inflammation, chronic inflammation, which in turn promotes metabolic disease like diabetes.  There is a lot of research in mice and some in humans that suggests that a very high fat diet can contribute to endotoxemia and increase circulating levels of the endotoxin known as lipopolysaccharide, or LPS.  LPS is the primary structural component of the outer membrane of certain bacteria, gram-negative bacteria, and LPS only originates in the gut, so this is all gut mediated.

It’s very interesting, though, when you look deeper into this research, and some newer studies have actually looked at the contribution of the gut flora here, and what they found was that when levels of bifidobacteria are low, which is a beneficial species of bacteria in the gut, a really high fat diet does contribute to endotoxemia in animals and in humans, but when bifidobacteria levels are normal or increased, then it doesn’t have that effect.  The LPS normalizes and you don’t get that effect of chronic inflammation.  That’s really crucial to understand because it suggests that a high fat, low fiber diet, because fiber, soluble fiber in particular, and prebiotic fibers are what feed the beneficial bacteria in the gut, the bifidobacteria.  If you follow a diet that is really high in fat and really low in those prebiotic fibers, then it is possible that that could cause some problems and some chronic low-grade inflammation, but if the high fat intake is in the context of a diet that is rich in fruits and vegetables and starchy tubers and things that promote the growth of beneficial species of bacteria, like bifidobacteria, then there’s no evidence that the high fat intake will have this effect.

When you think about it from an evolutionary perspective, that makes sense because we don’t really know of cultures that have extreme high fat intakes without eating some significant amount of either fermented products or plants.  Most traditional cultures that have been studied, hunter-gatherer cultures that have been studied, eat a lot of plants and prebiotic-bearing plants.  There are over 36,000 species of plants in the world that contain the carbohydrate fructan, which is a prebiotic, and many of those are tubers, which played a very important role in the early hominid diets in human evolution.  As I’ve argued before, there’s a lot of research showing that tubers along with meat in part made us human because when we came down from the trees and started to eat different foods than ripe fruit, these meats and tubers were foods that made that possible and allowed us to obtain a significant number of calories and nutrients so that our brains could continue to get bigger and we could get smarter and turn into the humans that we are today.

That’s one of the reasons why I typically don’t recommend really long-term very low carb, ketogenic, GAPS intro types of diets unless there’s a really specific reason to do them, and even then, it’s best, I think, to accomplish whatever the therapeutic goal is and then to start adding back in fermentable fibers into your diet as quickly as possible so that you can get the benefits of those fibers, like improving your gut flora, and avoid some of the potential harms of a diet that is not feeding those bacteria.  There’s been a lot of discussion about this lately, right?  It seems like every time I open up my news feed or social media I’m seeing studies about the impact of gut flora on various aspects of health, so this shouldn’t be a huge surprise really.

Steve Wright:  Yeah, it’s finally gaining some steam in the media as well as the science community.  There are a lot of people studying it, so it’s really cool to see.  I like to think now about how fruits and vegetables are feeding the gut bugs and the butter that accompanies those fruits and vegetables, that’s feeding me.

Chris Kresser:  Right, although butter has some butyrate, which is pretty good and important, too.  Yeah, it’s feeding you but it has some nutrients that are produced by the gut bacteria, so butter is kind of a win-win there, right?

Will my FODMAP sensitivities eventually go away?

Steve Wright:  True.  Awesome, well, I think we should keep rolling with this kind of carb topic, and this next question really segues into that, Chris.  “Do FODMAP sensitivities ever go away?  If someone has SIBO, small intestinal bacterial overgrowth, and has a FODMAP sensitivity, what kind of carbs can they eat?  And do you have to take antibiotics to get rid of SIBO, or can it be fixed through diet?”

Chris Kresser:  That’s a good question.  I think we’ve talked about it a few times on the show in various places, but I would say in general, FODMAP sensitivities can be eliminated completely, but in many cases, they’re significantly reduced rather than completely eliminated.  What I will often see happen is that people are able to add back in many different FODMAPs that they couldn’t tolerate before, but there might be a few FODMAPs that they just still don’t do very well with.  Onions and garlic tend to be the worst offenders.  Or they might be able to tolerate a small amount, a moderate amount of all of the FODMAPs, but if they go overboard, if they have a dish that just has tons of onion and garlic, for example, or they ate a really large amount of fruit that has more fructose than glucose, then they might have a little bit of discomfort.  I would say that’s kind of a typical response, although some people do seem to completely lose all sensitivity.  I think as fecal transplants become more available and alternative delivery systems become available, like – well, they’re kind of affectionately known in the medical world as ‘crapsules’ –

Steve Wright:  Nice.

Chris Kresser:  Because that really is probably the future of fecal transplants.  It’s not practical to do them the way they’re done now on a widespread basis.  It’s always going to be more expensive that way and less accessible to people, and so I imagine that people are going to figure out an oral delivery system that works, and then when that happens, they’ll much more accessible to people.  And when that does happen, we might assume that it would be possible to completely eradicate FODMAP sensitivity because I think that FODMAP sensitivity is really caused by alterations in the gut microbiota, and we can do a lot with changing our diet and using probiotics and even prebiotics, but in some cases that may not be enough to just have the really profound impact on the gut microbiota that a fecal transplant or taking capsules with isolated bacteria strains from a healthy human donor would have.  So, that’s the first part.

The second part, is it necessary to take antibiotics to get rid of SIBO?  I don’t think so.  Definitely not, because I treat a lot of patients for SIBO in my practice and I don’t use antibiotics, and in fact, I have a lot of patients who come to me having taken multiple courses of rifaximin or neomycin, which are the narrow-spectrum non-absorbable forms of antibiotics that are used to treat SIBO, and while they generally have initial success from taking antibiotics, what often happens is the SIBO will come back, and it tends to happen more quickly the more times they take the antibiotics.  The natural protocol that I tend to use in my clinic takes longer generally to produce the result, but the results tend to be longer lasting.  Now, having said that, everybody’s different, and some people do very well with the antibiotics and seem to need the antibiotics even after taking a natural protocol, but more times than not, I find the natural protocol is more effective.

Steve Wright:  Yeah, I can’t echo what you were saying earlier about the FODMAPs enough.  It’s very common for us to be working with people, and people on our site have all kinds of FODMAP sensitivities, and I think I definitely want the message out there that they go away.  They can go away.  What I’ve seen is when some of the people who haven’t resolved every single FODMAP is they’re kind of new in the entire integrative approach of fixing all of their health-related issues and it seems to take 12 to 18 months or longer for you to really get the complete resilient health back that might be what you need to be able to handle all types of FODMAPs.  Obviously everybody who’s sick, including myself, wants to get better tomorrow, and so sometimes, I think, some people say, well, I can’t do the FODMAPs or I can’t do eggs or something, and they sort of adopt that as just who they are when the reality is it just wasn’t really time yet for the immune system to have been corrected, for their hormones to be corrected, or whatever the root issue with them is, and so I think people should continue to try those, keep testing them.

Chris Kresser:  Yeah, exactly.  And we’ve talked about this before, but it’s a little bit of a tricky thing sometimes to treat these issues because with FODMAPs you’re avoiding prebiotics.  All prebiotics are FODMAPs, so when you’re on a low FODMAP diet, you’re avoiding prebiotics, but the thing is, prebiotics are what have the most profound effect on the gut flora over time.  So, if you always avoid prebiotics and you don’t make any effort to work them back into your diet even at low levels, then you might feel better for as long as you avoid those foods, but you may never regain your ability to eat those foods because the changes in the gut microbiota are what led to that inability in the first place.  It’s a little bit, I think, of a situation where you need to avoid those at first for symptom relief and while you’re addressing the SIBO with a natural protocol, doing other things to heal your gut, and then you gradually add back in some of those fibers as you can tolerate them so that increasingly over time you have less sensitivity, and that’s the really tricky part.

Steve Wright:  Yeah, and I think what you said there was key, Chris.  It’s been my observation that essentially anybody with severe FODMAP sensitivities or even full FODMAP exclusions of certain classes, they typically have some sort of GI infection.  So, just sitting on the FODMAP diet or the GAPS diet or the SCD diet for years is not going to be doing yourself any favors.  You need to be working with a qualified functional medicine doctor or integrative practitioner who can kind of help guide you through that.

Chris Kresser:  Exactly.  Yeah.  So, we have one more question that’s related to this topic.  Let’s just do that one since it’s easily grouped in here.

Steps for rebuilding your gut

Steve Wright:  Awesome.  Yeah, so let’s say you’re hopping into this.  You’re trying to figure out what kind of diet you should eat.  You start with getting some more fruits and veggies.  You realize you have a FODMAP sensitivity or you realize you have SIBO.  You get that treated, Chris.  Now all of a sudden the story changes to, what do I do to rebuild my gut?  And specifically this question is, how can you restore your gut flora when you’re unable to tolerate probiotics or fermented foods?

Chris Kresser:  Yeah, and he or she adds that it’s not likely due to histamine intolerance, because histamine intolerance might be one reason that someone couldn’t tolerate probiotics or fermented foods.

There are a couple ways to answer this.  I think I’ve mentioned this before, but back when I was still really sick and starting my recovery process, I could not tolerate probiotics either, but that’s not necessarily a reason not to take them.  And what I mean by that is that you may just need to start with extremely low doses and build up very slowly over time, because if your gut microbiota is really screwed up, then you take a full dose of a probiotic – I mean, one of the things that probiotics do, one of the ways that they work is they upregulate the immune system, they compete for adhesion sites in the gut with less beneficial forms of bacteria.  Some probiotics are actually antimicrobial themselves, so they can potentially cause a lot of different, for lack of a better term, detox reactions, things that could make you uncomfortable.  A lot of folks buy a probiotic, they take a capsule or the dose that’s recommended on the bottle, and they have a terrible reaction, and they just figure, oh, I can’t take probiotics.  But that kind of reaction is often a sign that you really need them more than anybody else, and the solution is not necessarily to stop, it’s to either reduce the dose dramatically or to switch to different types of probiotics.  If you’re taking, like, lactic acid forms of probiotics, like acidophilus, bifidobacteria, etc., then you might want to switch to a soil-based type of probiotic because they tend to be a lot better tolerated with people with SIBO.

I’ve spoken before about how SIBO often involves an overgrowth of lactic acid-forming bacteria, and that type of bacteria is typically found in commercial probiotics and fermented foods, so if you have SIBO and you take those kinds of probiotics or eat those foods, you very well could feel worse.  However, there are other types of probiotics that are made from soil-based organisms that typically won’t have that effect.  Prescript-Assist is one, which I sell on my website because of that.  It’s probably the best tolerated probiotic that I’m aware of.  It works for the greatest number of people and seems to cause the fewest side effects, and it’s very effective for constipation, which is not always the case.  A lot of probiotics tend to make constipation worse, in large part, I think, because of the phenomenon I was just talking about, how if you have SIBO and you take certain kinds of probiotics, it makes it worse.

So, switching to soil-based organisms and then taking a very, very small dose.  For example, if you get Prescript-Assist and you get the capsules, you would actually open the capsule and just pour out, like, a quarter of a capsule on top of some food.  It’s heat stable.  Soil-based organisms don’t need to be refrigerated.  You don’t have to worry about that as much, so you can just put it on a little bit of food and eat it that way.  And then you just increase very, very gradually as your symptoms dictate.  You might be on a quarter of a capsule for two weeks before you can go up to half a capsule, etc.  For me, when I was doing it, I had to be extremely methodical, and it took months until I could tolerate a substantial amount of probiotics and fermented foods.  I remember I started with kefir.  I started with, like, a half a teaspoon a day, which is such a small amount it seems almost not worth doing, but if I did any more than that, I would have a reaction.  And then after about 9 or 10 months of doing that, I could tolerate a full glass of kefir without any problems when my gut was a lot better.  That’s one answer.

The second answer relates to what we were just talking about in terms of prebiotics and fermentable fibers.  All of the research now suggests that it’s really prebiotics and fermentable fiber that has the most profound impact on the quantity and composition of the gut flora over time.  Probiotics have a number of beneficial effects, like regulating the immune system, promoting T regulatory cell development, improving our immunity, helping fight infection, lots of different effects, but the easiest way to summarize them is just to think of probiotics as immune regulators, whereas they don’t really impact the quantity and composition of the gut flora over time so much.  On the other hand, prebiotics or fermentable fibers can significantly increase the quantity of beneficial species of bacteria, particularly bifidobacteria, which is one of the most important species in the colon.  So, prebiotics are arguably more important for restoring beneficial gut flora over time than probiotics, and whether you get them from food or whether you do things like eating resistant starch, which has been a big topic of discussion recently and this is why, so potato starch or potatoes that have been cooked and cooled or green banana flour, some people are using or green plantain flour, dehydrated green plantains, etc., those are all perfectly valid and important strategies for improving the gut flora and, as I said, arguably more important than probiotics themselves, but I do think you should try to do both and just go as slowly as possible and try different probiotics if you’re still reacting to some.

Steve Wright:  Yeah, it’s kind of fascinating to think that you might have to look at the FODMAP list as foods to focus on eating, but it might be a good thing, except for the sugars anyway.

Chris Kresser:  Yeah, and sometimes for people with FODMAP issues, that’s where I think something like potato starch can be helpful because it can be more difficult to finely control the amount of FODMAP or resistant starch you’re getting from foods.  It’s easier to do that with a supplement like a powder, whether it’s a prebiotic powder or a potato starch where you can really finely measure out the dose each day that you’re getting.  Then over time you want to just include as much fermentable fiber in the foods that you eat as possible, but initially it might be easier to do with the supplements than the food.

Steve Wright:  Awesome, Chris.  As you mentioned earlier in the show, you’ve been doing a lot of searching and a lot of visioning, kind of seeing where Revolution Health Radio is going to go, and the listeners, you guys have the ability to have a lot of input here, so please make your desires known, whether it’s on his Facebook feed, through the podcast submission link, or even in this actual podcast on his blog, so put it in the comments.  Tell us what you want, tell us what you want to hear throughout the rest of 2014 and beyond, and we’ll make it happen, hopefully.

Chris Kresser:  Yeah, we’ll certainly consider it!  This show is for you.  It’s for all of you listeners, so I want to make it as relevant to what you need as possible.  Yeah, so it’d be really valuable to hear your feedback.  I appreciate that.

Steve Wright:  Yeah, we’re not going to start doing 3-hour shows after talking about digital detox, but maybe everything else is in bounds.

Chris Kresser:  Yeah, I’d like to hear your thoughts, whatever they are.

Steve Wright:  Awesome.  Well, thanks again for another informative podcast, Chris, and thanks, everyone, for listening.  As I mentioned earlier in the show, you can go to Facebook.com/ChrisKresserLAc or Twitter.com/ChrisKresser.  Chris posts a lot of research throughout the week, a lot of articles that maybe you didn’t get delivered to your inbox, so definitely check him out in those areas.  Thank you for listening, and we’ll talk to you on the next show.

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  1. Fruitbat says

    Great podcast, these Q&A ones are often so helpful.

    Is it a good idea to use prebiotics while you are actively tackling the bad gut flora with natural anti-microbials? I already take Prescript-Assist and am thinking of adding in a strong bfido bacteria only mixed probitotic because my stool test shows that the bfido bacteria is really low in my gut. But is it worth doing that now while I am trying to see off the bad guys? Would taking a prebiotic now just feed them too making it harder to eradicate them?

    Many thanks!

    • Ginger says

      I second this question! When I use prescript assist up to 2 capsules a day, I feel zero change. But when I have been using just 1-2 TBSP of resistant starch a day with a capsule, I tend to get a much larger reaction (itching, slight rash, drainage, or an achy gland). Only slight discomfort, but I’d like to have a hint if this could be an immune/detox reaction, or possibly feeding the negative bacteria more than the positive? Thanks!

  2. Matt says

    Nice show.
    You forgot to mention that polyphenols also make a big impact on the diversity of the gut microbiota.

  3. Wenchypoo says

    A digital detox is important, and so is limiting the time spent on electronic gadgets (like computers) anyway–they are addicting, and they rewire the brain. Not to mention the sleep-depriving qualities of blue light emitted from them.

  4. Katherine says

    I have a question related to fodmaps – I had SIBO, and put my SIBO in remission prior to getting pregnant, however, I got pregnant before I had the chance to start introducing fodmaps. Now that I’m pregnant, what to do? I’d like to have as diverse diet as possible and diverse flora for baby, but with bloating being my main symptom, it’s really hard to tell now whether or not I’m reacting to foods (since I’m big and bloated by default, thanks to Baby). Potato starch? Just add fodmaps back and hope for the best?

  5. Webraven says

    Great reply on the gut questions, thank you! What remains a bit unclear to me is what is meant by “tolerance” in this context. Do you take resistant starch+ probiotics only to the point that you don’t have an exacerbation of symptoms at all! or are we talking about subjective tolerance, i.e. Allowing the symptoms to increase, but only to a (to the individual) tolerable level?
    Thanks!!

  6. says

    Hi Chris!

    So if all prebiotics are FODMAPS does that include the prebiotics in Prescript Assist as well? (My bottles say prebiotic and probiotic) And if so, is that still the one you’d recommend for patients with SIBO?

    Thanks!
    Sylvie

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