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RHR: Gut Health 3.0- The Power of Polyphenols and Postbiotics

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In this episode of Revolution Health Radio, Chris Kresser unveils the world of Gut Health 3.0, a comprehensive approach that goes far beyond traditional probiotic supplementation. Drawing on the latest scientific research, Chris explores how polyphenols, bacteriophages, and postbiotics work together to optimize gut health, offering listeners a roadmap to improved digestion, mental clarity, metabolic function, and overall wellness. Through compelling case studies and in-depth scientific insights, this episode demonstrates how understanding and supporting our gut microbiome can be the key to transforming multiple aspects of our health.

In this episode, we discuss:

  • Gut Health 1.0: Probiotics and Bacillus coagulans
  • Gut Health 2.0: Prebiotics and bacteriophages
  • Gut Health 3.0: Polyphenols
  • Gut Health 3.0: Postbiotics and butyrate
  • The benefit of taking a synergistic approach to gut health
  • A review of clinical case studies
  • The future of gut health

Show notes:

Chris Kresser:  Hey everybody, Chris Kresser here, welcome to another episode of Revolution Health Radio. Today we’re going to dive deep into the fascinating world of gut health and explore what I call “Gut Health 3.0.” Over the past two decades, our understanding of gut health has evolved pretty dramatically. We’ve moved from a simplistic view focused mainly on digestion to recognizing the gut as a complex ecosystem that plays a crucial role in almost every aspect of health. In this episode, I’ll walk you through the evolution of our understanding of gut health, from Gut Health 1.0 to 2.0 and now to 3.0. We’ll explore how each stage has expanded our knowledge and approach to supporting optimal gut function. Gut Health 1.0 was all about probiotic- introducing beneficial bacteria into the gut. Gut Health 2.0 added prebiotics to the mix, recognizing the importance of feeding those beneficial bacteria. Now, with Gut Health 3.0 we’re zooming out further to look at the entire gut ecosystem and how we can holistically support it.

This isn’t just academic stuff. Understanding these concepts can have profound implications for your health. The gut is connected to everything: your immune system, your brain function, your metabolism and even your mood. By optimizing your gut health, you’re laying the foundation for overall wellness and resilience against chronic disease.

In today’s episode, we’re going to focus on two key components of Gut Health 3.0: polyphenols and postbiotics. These are cutting edge areas of research that are revealing exciting new ways to support gut health. We’ll dive into the science behind these compounds, explore their unique benefits and discuss practical ways to incorporate them into your diet and supplement regimen. By the end of the show, you’ll clearly understand the most up to date approach to gut health and how you can apply these principles to improve your well-being and extend your health span. So let’s dive in and explore the world of Gut Health 3.0.

Gut Health 1.0: Probiotics and Bacillus Coagulans

Before we dive in, let’s quickly recap what we’ve learned from the earlier stages. This will help set the context for why the newest developments are so exciting. As I mentioned in the introduction, Gut Health 1.0 was all about probiotics. We recognized that introducing beneficial bacteria into the gut can have positive health effects. But as our understanding evolved, we realized that not all probiotics are created equal. Probiotics are a mature field of study in therapeutics today. There are many effective, evidence-based strains, from lactic acid bacteria like Lactobacillus and Bifidobacterium to anaerobic bacteria like Akkermansia. However, over the last few years of my clinical practice, I’ve tended to recommend spore-forming probiotics, particularly Bacillus coagulans.

Bacillus coagulans has some unique characteristics that make it a superior probiotic in many ways. As a spore-forming bacteria, it has the ability to form a protective endospore. This gives it several advantages. Number one, it can withstand extreme conditions, including high temperatures, acidity and bile salts. This means it’s much more likely to survive the harsh environment of the stomach and reach the intestines intact. Number two, unlike many probiotics that require refrigeration, Bacillus coagulans is shelf stable. That means it’s stable at room temperature. This makes it more convenient and reliable as a supplement, because you don’t have to worry about refrigerating it. Number three, once it’s in the intestines, Bacillus coagulans spores germinate into active bacteria, allowing for a more targeted probiotic effect where it’s most needed.

The research on Bacillus coagulans is really promising. For example, one randomized controlled trial of 100 men and women between the ages of 50-85 with age associated memory impairment found that 12 weeks of Bacillus coagulans supplementation improved overall and episodic memory. Another study involving 60 healthy adult women found that Bacillus coagulans significantly improved focus and attention and reduced attentional deficits. Perhaps most impressively, a study out of the University of Utah involving 75 healthy young men found that Bacillus coagulans improved attention and psychomotor speed and reduced impulsivity. This was interesting because they found that it works in younger people as well as older adults, and it suggests that Bacillus coagulans may help improve athletic performance, in addition to boosting cognitive function. And third, it indicates that Bacillus coagulans could be beneficial for treating ADHD and other attention disorders.

I’ve highlighted a few studies involving the gut brain access and how Bacillus coagulans supports cognitive function, mood and behavior. But as I’m sure you know by now, probiotics are linked with improvements in everything from skin and hair health, natural beauty benefits to hormone balance and regulation to mitigating the stress response, to improving metabolic function, and of course improving gut health, whether you’re talking about irritable bowel syndrome or inflammatory bowel disease or GERD or bloating, constipation, diarrhea, etc. In fact, there are many studies showing that Bacillus coagulans is one of the most effective interventions for IBS and reducing IBS symptoms. I could go on, but I’ve talked at length about probiotics in the past, and I want to focus more this episode on Gut Health 3.0. But suffice to say that these spore forming probiotics, including Bacillus coagulans, are one of the best things you can do to improve your overall health.

Gut Health 2.0: Prebiotics and Bacteriophages

Let’s move on to Gut Health 2.0, which introduced the concept of prebiotics. We realized it wasn’t enough to introduce beneficial bacteria, we also needed to feed them. But again, not all prebiotics are created equal. While fibers and non-starch polysaccharides can be beneficial, they can also cause digestive discomfort in quite a few people, especially those with conditions like IBS and SIBO, which are unfortunately very common. Another significant disadvantage of fiber-based prebiotics is the amount that’s required for effectiveness. You often need to take several grams per day to see benefits, and so this often means choking down unpalatable powders that have to be mixed with water, or maybe swallowing five or six plus capsules a day. Not only is this inconvenient, it can be a barrier to consistent use for a lot of people. This is why I’ve been especially interested in a newer type of prebiotic called a bacteriophage.

Bacteriophages, or phages for short, are viruses that specifically infect and replicate within bacteria. Now I know the idea of ingesting viruses might sound alarming to some people, but bear with me here. These are incredibly safe and have some unique benefits. Bacteriophages meet the definition of prebiotics because they selectively promote the growth of beneficial bacteria. They do this a little bit differently than fiber-based prebiotics, which feed beneficial bacteria. Bacteriophages instead target and eliminate specific harmful bacteria, which then allows beneficial bacteria to thrive. And this approach is a key advantage that bacteriophages have over traditional fiber-based prebiotics.

Some of the benefits include better precision. Unlike broad-spectrum antibiotics or even some probiotics, phages are highly specific. They only affect their target bacteria, leaving beneficial bacteria untouched. They’re adaptive. They can evolve with bacteria, potentially overcoming antibiotic resistance. They tend to have minimal side effects. Because they’re so targeted, phages don’t disrupt the gut microbiome as antibiotics can, and they don’t tend to cause bloating like fiber-based probiotics do. And they’re effective at a very low dose. Phages can be effective at doses between 10 and 20 milligrams, versus 2000 to 5000 milligrams, which is the dose of a lot of the fiber-based prebiotics.

The research on bacteriophages is really exciting. For example, the PHAGE study found that supplemental bacteriophage intake significantly reduced the E. coli population in the gut, while increasing beneficial bacteria like Bifidobacterium and Lactobacillus. The participants also saw significant improvements in inflammatory markers. As for safety, bacteriophages have an excellent safety profile. They’ve been used therapeutically in some countries for nearly a century with no significant adverse effects reported. They’re naturally present in many foods and are a normal part of our gut microbiome. The FDA has classified several phages as GRAS, or “Generally Recognized As Safe.” One bacteriophage product I’ve been particularly impressed with is called PreforPro. It’s a patented blend of bacteriophages that’s been clinically studied and it works at a very low dose, just 15 milligrams per day, compared to much higher doses for traditional prebiotics. Studies have shown that PreforPro can enhance the benefits of probiotics, improve digestive health, and support a healthy inflammatory response.

While probiotics like Bacillus coagulans and prebiotics like PreforPro are important parts of the gut health regimen, they’re just the beginning. As we move into gut health 3.0, we’re discovering even more powerful ways to support gut health, and that’s where polyphenols and postbiotics come in. These compounds work together with probiotics and prebiotics, but they also have unique benefits on their own. They represent a more holistic approach to gut health, one that considers the entire ecosystem of the gut and its far reaching effects on the rest of the body.

Gut Health 3.0: Polyphenols

Let’s start with polyphenols. These plant compounds have been receiving considerable attention in the scientific community lately, and there’s good reason for that. Polyphenols are a diverse group of molecules found in many plant-based foods. They’re known for their antioxidant properties, but their benefits go far beyond that, especially when it comes to gut health. What makes polyphenols so special is their ability to interact with our gut microbiome in ways that traditional probiotics and prebiotics can’t. They modulate the composition of our gut bacteria, promote the growth of beneficial species, and even act as a food source for these bacteria.

Let’s examine four specific polyphenols, the ones that I think are the most effective- cranberries, pomegranates, grapes, and blueberries. Cranberry polyphenols increase the abundance of Akkermansia, a beneficial bacterium vital to maintaining gut health. Known for its unique ability to thrive in the mucus layer of the intestinal lining, Akkermansia supports the integrity of the gut barrier, which is essential for protecting against harmful pathogens and toxins. Akkermansia stimulates mucus production and interacts with immune cells, which contributes to a healthy inflammatory response and improved gut resilience. Several studies have linked Akkermansia to a balanced microbiome and better metabolic health, highlighting its potential to support digestion, nutrient absorption, and immune function. Cranberry polyphenols also promote the growth of Bifidobacterium and Lactobacillus species while reducing levels of potentially harmful bacteria. A study found that cranberry extract protected mice from diet induced obesity and insulin resistance. The researchers observed an increase in Akkermansia population in the gut microbiota, suggesting this could be one mechanism behind cranberries metabolic benefits.

Pomegranate polyphenols have also demonstrated impressive effects on gut health. Like cranberries, they can increase Akkermansia muciniphila. They also enhance the growth of Lactobacillus and Bifidobacterium species. What’s particularly interesting about pomegranate polyphenols is their conversion into unique metabolites called urolithins. These compounds have potent anti-inflammatory and antioxidant effects throughout the body. A review by Yin, et al. highlighted the potential of pomegranate in managing various health conditions through its effects on the gut microbiome. Urolithins, especially urolithin A, have been shown to improve gut health by promoting the integrity of the intestinal barrier and decreasing inflammatory markers, potentially reducing the risk of chronic gut disorders like inflammatory bowel disease and IBS. Urolithins also support metabolic health by enhancing mitochondrial function, which boosts energy expenditure and insulin sensitivity- key factors in combating obesity and type 2 diabetes. Urolithins are also linked to cardiovascular benefits, as they help mitigate oxidative stress in endothelial cells and lower blood pressure.

Grape polyphenols are another powerhouse when it comes to gut health. They’ve been shown to decrease the Firmicutes to Bacteroides ratio, which is associated with improved metabolic health. Grape polyphenols also increase Akkermansia and enhance the growth of butyrate producing bacteria. A systemic review by Nash, et al. found that grape and red wine polyphenols can significantly modulate the gut microbiota composition, potentially explaining some of the health benefits associated with moderate red wine consumption.

Lastly, let’s talk about blueberry polyphenols. These have been shown to increase the abundance of Bifidobacterium and enhance the growth of Lactobacillus acidophilus. They also reduce levels of potentially harmful bacteria like Bacteroides and Clostridium species. One review highlighted how blueberry polyphenols can positively impact gut microbiota and health. Blueberries contain high levels of anthocyanins, (which give them their blue color) that can significantly improve health through multiple mechanisms. While these compounds have relatively low bioavailability, meaning only a small percentage is directly absorbed in the bloodstream, they interact extensively with gut bacteria to produce beneficial metabolites and improve the gut microbiome composition. Research shows blueberry polyphenols can reduce inflammation by inhibiting inflammatory signaling pathways and decreasing pro-inflammatory molecules. In the brain, blueberry compounds have been shown to enhance cognitive function and memory by stimulating nerve growth factor production, improving blood flow, and protecting neurons from oxidative damage. Blueberry polyphenols also demonstrate anti-cancer properties, particularly against colon cancer, by promoting programmed cell death of cancer cells and reducing tumor growth. Studies indicate blueberry polyphenols achieve many of these effects through direct action and beneficially modifying the gut microbiome, increasing healthy bacteria like Bifidobacterium and Lactobacillus while reducing potentially harmful bacteria. This creates a positive feedback loop where the improved gut environment leads to better absorption and processing of the beneficial compounds.

What’s particularly exciting about these polyphenols is they don’t just affect the composition of our gut bacteria, they also influence microbial metabolism. All four of these polyphenol sources have been shown to increase the production of short-chain fatty acids, or SCFAs, in the gut. SCFAs, particularly butyrate, play a crucial role in gut health, and we’ll discuss this more when we get to the section on postbiotics in a couple minutes. It’s worth noting that while you can certainly get polyphenols from your diet by eating these fruits, the amounts used in many of the studies demonstrating polyphenols benefits are difficult to achieve through diet alone. That’s where supplementation can be a useful strategy to leverage the gut health benefits of polyphenols in a more potent way.

The key takeaway here is that polyphenols represent a relatively new frontier in gut health. They offer benefits beyond traditional probiotics and prebiotics, interacting with our gut microbiome in complex and beneficial ways. There are already hundreds of studies documenting the benefits of polyphenols, but this is an accelerating area of research. I quite literally see two to three new studies published on polyphenols and various aspects of health each week. So we already know a lot, but we’re learning even more as we go, and I think more and more attention is going to be directed to the incredible gut health and overall health benefits of polyphenols in the next five to 10 years.

Gut Health 3.0: Postbiotics and Butyrate

Now let’s talk about another crucial component of Gut Health 3.0, which is postbiotics. Postbiotics are beneficial compounds produced by probiotic bacteria during the fermentation process. You can think of them as the metabolic byproducts of the good bacteria in your gut. And among these postbiotics, butyrate, the short chain fatty acid, stands out as especially important.

Butyrate is produced when certain bacteria in your gut ferment dietary fiber. It’s the primary energy source for the cells lining your colon, which gives you an idea of how crucial it is for gut health. Butyrate supports our gut through several key mechanisms. First, it’s a potent anti-inflammatory agent. It inhibits NF-κB, a key regulator of the inflammatory response. This anti-inflammatory effect isn’t just limited to the gut. It can have systemic benefits throughout the body. Butyrate also plays a critical role in maintaining the gut barrier. It enhances mucin production and increases the expression of tight junction proteins, which help maintain the integrity of the gut lining. This is crucial for preventing leaky gut, which of course is implicated in a wide range of health issues. But butyrate’s benefits extend far beyond gut health. Research has shown that it can improve insulin sensitivity and glucose metabolism, potentially helping with weight management and metabolic health. It’s also been linked to improved cognitive function and brain health, and may even play a role in preventing neurodegenerative disease.

Discover Gut Health 3.0! Learn how probiotics, polyphenols, and postbiotics can transform your health. From IBS to mental wellness, uncover the secrets of your microbiome. #GutHealth #Wellness #ChrisKresser #RevolutionHealthRadio

A 2016 paper in the journal Neurochemistry International described butyrate as “the bread and butter of the microbiotic gut-brain axis.” The researchers noted butyrate’s ability to cross the blood-brain barrier and its potential to influence brain function through multiple mechanisms, including epigenetic modulation and neurotransmitter synthesis. Another study by Chen, et al. in 2018 found that butyrate significantly reduced inflammation and maintained epithelial barrier integrity in a mouse model of inflammatory bowel disease. This highlights butyrate’s potential in managing chronic gut conditions.

Given all these benefits, you might wonder why we don’t just supplement with butyrate directly. Well, here’s the catch- most oral forms of butyrate have limited bioavailability. They’re often broken down before reaching the colon, which is where butyrate is needed. This is where tributyrin comes in. Tributyrin is a triglyceride that contains three butyrate molecules bound to a glycerol backbone. It’s much more stable in the gastrointestinal tract, allowing for better absorption and a more targeted delivery of butyrate to the colon. One of the leading sources of tributyrin is an ingredient called CoreBiome. It’s designed to maximize butyrate absorption and utilization in the body, and studies using CoreBiome have shown significant increases in fecal butyrate levels, indicating effective delivery to the colon. One study in 2019 compared the effects of butyrate and beta-hydroxybutyrate, finding that butyrate had more pronounced effects on histone acetylation and gene expression. This underscores the unique benefits of butyrate and the importance of effective delivery methods like tributyrin.

So how can we increase our butyrate levels? Well, diet does play an important role. Eating plenty of fermentable fibers that can help feed the bacteria in our gut that produce butyrate is a good thing to do on a daily basis. However, supplementing with a high-quality tributyrin source like CoreBiome can be a more direct and reliable way to boost butyrate levels, especially for those who fall short of the recommended fiber intakes, or who have trouble digesting fiber, like folks with SIBO or IBS.

The key takeaway is that postbiotics, particularly butyrate, represent a crucial and often overlooked aspect of gut health. Just like polyphenols, butyrate are the subject of intensive scientific research. I subscribe to a research alert for butyrate, and I get papers almost every day linking butyrate to not only improvements in gut health, but improvements in many other aspects of health and well-being. I would say it’s one of the approaches to gut and overall health that I’m most excited about and that I think we’re going to see the most attention on in the next few years.

Taking A Synergistic Approach to Gut Health

Now that we’ve explored the key components of Gut Health 3.0, let’s talk about how to combine them in an optimal gut health approach. The key here is synergy. While each of these elements- probiotics, prebiotics, polyphenols and postbiotics- have benefits on their own, they work even better when they’re combined. It’s like assembling a team where each player has a specific role, but together they create something greater than the sum of their parts.

Let’s break down again how each element contributes to overall gut health. Probiotics, particularly spore-formers like Bacillus coagulans, introduce beneficial bacteria in the gut, may help crowd out harmful bacteria, and support the immune system. Prebiotics, especially next generation ones like bacteriophages, selectively reduce harmful bacteria and increase beneficial bacteria. Polyphenols act as both food for beneficial bacteria and as signaling molecules. They can modulate the composition of the gut microbiome and have anti-inflammatory effects throughout the body. And then postbiotics like butyrate directly benefit the gut lining and have far reaching effects on metabolism, inflammation, and brain function. When you combine these elements, you’re not just adding their individual effects, you’re creating a gut environment that’s optimized for health and resilience. For example, the polyphenols from cranberries, pomegranates, grapes and blueberries can enhance the growth of beneficial bacteria that might be contained in your probiotic supplement. These bacteria, in turn, ferment fibers to produce more butyrate. The bacteriophages help keep potentially harmful bacteria in check, allowing this beneficial ecosystem to flourish.

Here’s some practical tips for incorporating these principles in your daily life. Eat a diverse diet with plenty of fermentable fibers. These are typically found in plant foods and will provide a variety of polyphenols and fibers to feed your gut bacteria. Consider supplementing with a high-quality, spore-based probiotic like Bacillus coagulans. And then add a bacteriophage-type of prebiotic like PreforPro to your regimen. This is generally better tolerated than fiber-based prebiotics and has some unique properties, as we’ve discussed. Then think about including a polyphenol blend that contains extracts from cranberries, pomegranates, grapes, and blueberries. Green tea extract polyphenols are useful as well. And finally, supplementing with a source of tributyrin postbiotic like CoreBiome can help directly boost your butyrate levels.

The goal here isn’t to simply add more and more supplements to your routine. It’s about creating a comprehensive, synergistic approach to gut health that addresses all aspects of the gut ecosystem. As a Functional Medicine clinician, this has always been my focus. How do we holistically address the root cause of health problems, rather than playing whack-a-mole with symptoms? And we know beyond a shadow of a doubt that the gut is often the root cause of many different health problems that we didn’t know were related to gut health before. Autoimmune disease is a classic example of this. Alessio Fasano, who is a pioneer in the study of gluten intolerance and autoimmune disease, actually believes that you cannot develop an autoimmune condition without having a leaky gut. In other words, a leaky gut is a precondition to developing autoimmunity, and there’s actually quite a lot of research that supports that idea now. So that’s just one example. We know that people with metabolic issues, whether it’s overweight and obesity, impaired blood sugar, or insulin sensitivity very often have gut health issues. We know about the gut-brain axis and the connection between the gut and conditions like dementia, Alzheimer’s, Parkinson’s disease, and depression. I’ve talked about the inflammatory cytokine model of depression, which holds that depression is largely driven by inflammation in the gut, which then causes changes in the brain. We know about the estrobolome, which is the connection between estrogen and the microbiome, and that the microbiome impacts both female and male hormone levels. We know about the gut-skin connection, where conditions like eczema, acne, psoriasis, dry skin, premature wrinkling, etc, are directly connected to gut health. I mean, I could go on and on. There really is no condition at this point that I can think of that’s common and that’s a chronic health-related condition that hasn’t been directly or indirectly linked with changes to our gut health. It’s not a stretch to say that pretty much every chronic disease that we know about today has been either directly or indirectly linked to changes in gut health.

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In my clinical experience, patients who adopt a comprehensive approach like this, incorporating probiotics, prebiotics, postbiotics and polyphenols, often see improvements, not just in their digestive symptoms, but in their overall health and well-being. They report better energy, clearer thinking, improved mood, and greater resilience, in addition to improvements in whatever health conditions that they’re dealing with. Of course, it’s important to remember that gut health doesn’t exist in isolation. It’s part of a larger picture that includes diet, sleep, stress management, physical activity, and other factors. But by optimizing your gut health with this Gut Health 3.0 approach, you’re laying a solid foundation for overall health and vitality.

A Review of Clinical Case Studies

Let’s bring all this to life with a few case studies from my clinical practice. I like to do this because it can take what can seem to be sort of intellectual, academic discussion and make it a little bit more real. The first patient we’ll call Sarah. She was a 42-year-old woman with IBS, and she came to me with a long history of this. She’d had it since she was a teenager. She experienced frequent bouts of diarrhea, abdominal pain, and bloating, and they hugely impacted her quality of life. She had a pretty constrained social life. She couldn’t travel very much because she always had to stay near a bathroom. It affected even what she chose to do for her career. And for as long as she could remember, it was just something that dominated her life. So I put her on a protocol, including a spore based probiotic, bacteriophages, polyphenols, and then we later added CoreBiome. It wasn’t available when I had first started treating Sarah. We were using butyrate enemas, actually, to give you an idea of how far we had to go to get butyrate into the colon, because most butyrate supplements just didn’t work. That’s what I used to do with patients who were willing to do it. They would apply sodium butyrate via enema, a rectal enema, and that would also get it into the colon. Thankfully, we have an easier way now with CoreBiome tributyrin. Within two weeks, Sarah reported a really significant reduction in her diarrhea episodes, and by the end of her first month, her abdominal pain and bloating had decreased by about 80 percent. So just think about that for a second. This is a woman who had been, for over 20 years, dealing with these symptoms and had gone to multiple different doctors, gastroenterologists, alternative practitioners, etc. And after about three months on this protocol, Sarah said her IBS symptoms were 95 percent better. She was able to eat a wider variety of foods, she could travel again, her social life started to blossom, and it just had a dramatic impact on her overall quality of life.

The second patient we’ll call Mark. He was a 55-year-old man with metabolic syndrome. He didn’t come to me complaining of gut health issues, and this is the interesting thing about gut health and the microbiome and probiotics. As I’ve said multiple times through the show, we know that gut health is not just about the gut and symptoms in the gut. In fact, some people who have a disrupted microbiome, or leaky gut, or other gut health issues, may not experience a lot of GI symptoms. Or if they do, they’re in the background, and they actually have other symptoms that are more prominent. And that was definitely the case for Mark. He had obesity, high blood pressure, high fasting glucose and post-meal blood sugar, and also a really dysregulated lipid profile. He had high cholesterol and LDL-p, high triglycerides, low HDL, etc. He had been diagnosed with metabolic syndrome and he was at really high risk for progressing to full fledged type II diabetes and heart disease. He was still in the very high pre-diabetic range when he came to see me. So I put him on a similar protocol to the one I gave Sarah. By this time CoreBiome was available, so Mark got to skip the butyrate enemas, lucky for him. And then, of course, we made dietary changes. He was not on a fantastic diet when he first came to see me. It was a lower carb, paleo-type of diet, but we made sure to include plant diversity so he could get that benefit of polyphenol production. After about six months on the protocol, Mark’s results were impressive. He had lost 30 pounds, his blood pressure normalized, his fasting blood sugar dropped from the pre-diabetic range to normal or high normal, which is pretty incredible, and his lipid profile improved significantly. He was basically in the normal range for most markers. He was pretty ecstatic about this, but what he was even happier about in terms of his subjective day-to-day experience was that he felt so much more energy and so much sharper mentally. He wasn’t expecting that from this treatment and that was a game changer for him. He found sticking to his diet and exercise plan easier as a result of that. He had some huge breakthroughs at work. He actually ended up quitting his job and starting a business, which he’d been wanting to do for a long time but just hadn’t really had the energy or wherewithal to do. And, yeah, it was life changing for him, and really fun to watch as a clinician. These are the cases that we live for as practitioners.

The last study I want to talk about is a little bit different as well. I’ll call her Emily. She was 28 when she came to see me, and she had a long history of anxiety and depression. She had tried several different medications, SSRIs and anti-anxiety meds and had some success, but also lots of side effects, and just didn’t really feel like they were moving the needle how she wanted. And so that’s why she came to me. She wanted to try a Functional Medicine approach. And again, this is a situation where gut health wasn’t her primary concern. She did have some bloating, constipation, and occasional gut health symptoms, but those were not what brought her to my practice. It was mostly the anxiety and the depression. But as you know, if you’ve been listening to my podcast for any length of time or following my work, I’ve been writing and speaking about the gut-brain axis for 15 plus years now. So when somebody comes to me complaining of brain-related issues, whether that’s depression or anxiety like Emily, or cognitive issues, I am always looking at the gut because I know the research and I have the clinical experience that tells me that the gut-brain axis is often the critical player in these situations. So we started her on a very similar gut health protocol, along with lifestyle modifications like regular exercise and meditation. Exercise in particular can be really critical for depression, mild to moderate depression especially, but even for severe depression. We paid special attention to her diet. I was encouraging her to eat more fermented foods and a variety of plant foods that would be fermentable fiber to increase butyrate production and increase her polyphenol intake. And after about two months, Emily started to notice really significant shifts in her mood.

So as you can see, the amount of time it takes for people to experience changes can vary. She had results pretty quickly with her gut health symptoms, and started to notice improvements in her mood almost right away. But it took about two months for her to really drop in and feel much less anxious and much more emotionally stable. And her mood was starting to brighten considerably by then as well. And part of this, too, is just how this corresponds with the medications. As she started to feel better, she was starting to withdraw from the medications. And that drug withdrawal can also cause some side effects. So it can be a little murky in the first bit of time, but after two or three months, really by the end of the third month, she said she was feeling better than she had in years. She’d also noticed improvements in physical symptoms that she hadn’t initially thought that this treatment would improve. She had much more consistent energy and her sleep improved dramatically. That’s something that people don’t necessarily connect with gut health, but it is very often related. So her case really underscores the connection between gut health and mental health- the gut-brain axis. And I’ve seen this time and time again in my practice. It’s almost always the first place I look, the gut, when people have either mood issues or cognitive function issues.

Recap of Gut Health 3.0 Principles

As we wrap this up, let’s recap some of the key points we’ve covered. Gut Health 3.0 is a much more comprehensive way of looking at gut health. It’s not just about probiotics. Beneficial bacteria are important, but they’re just one piece of a much larger puzzle. Within probiotics, we know that some of the next-generation probiotics, like Bacillus coagulans, and prebiotics like bacteriophages, can offer advantages over the more traditional options. Polyphenols from sources like cranberries, pomegranates, grapes, and blueberries play a crucial role in modulating our gut microbiome and offering wide ranging health benefits. And postbiotics, especially butyrate, directly benefit our gut and overall health. And forms like tributyrin or CoreBiome offer a much more effective, and convenient compared to butyrate enemas, way to supplement with butyrate. The most effective approach to gut health and health in general tends to be a combination of elements. So, combining probiotic with prebiotic, postbiotic, and polyphenol is going to be better than taking just one or two of those.

The Future of Gut Health

Looking to the future, I think we’re really still just scratching the surface of what’s possible in gut health. There’s a lot of new, exciting research that has shown connections between the various elements of gut health that we’ve talked about today and so many different medical conditions that people suffer with. And I’m sure you’ve already noted that you started to see probiotics being marketed for specific conditions like metabolic health or vaginal health or women’s health, or cognitive and brain function. And this isn’t just marketing, it’s real. We have the studies to back it up, and it’s absolutely the case that improving our gut health can lead to meaningful changes in all of these other aspects of health. As a clinician, and just personally, I still think that the best approach for most people is to focus on a combination of probiotics, prebiotics, polyphenols, and postbiotics, and to choose some of the strains and types that I’ve talked about today that have been shown to impact several different aspects of health. Now, certainly, if you have a specific condition you really want to narrow in on that, there are certain strains of probiotics, for example, that have been shown to be particularly beneficial for that condition. But for the vast majority of people, this type of combination approach will check all of the boxes and be a more economical and practical way of getting the benefits of these four different gut health compounds, rather than getting hyper-focused on particular strains. That’s just my opinion and has been my experience as a clinician. Your mileage may vary, of course.

But I hope you enjoyed this show and learned a lot. It’s been a while since we’ve done a specific episode on gut health, and there have been some really meaningful changes to my approach and just to what we understand about gut health in general. So I hope you get a lot out of this, and it helps you improve your health and well-being. Keep sending your questions in to ChrisKresser.com/podcastquestion and we’ll see you next time.

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