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Speaker 0 asks: first, what impacts the loss of bifidobacterium? and second, what can we do to replenish it and keep it strong and populated? Speaker 1 responds that the microbiome is still in its infancy, and urges not to assume you can test your stools in the market because the FDA doesn’t have a test approved for testing stool. Regarding buying Bifidobacterium, he says that the problem with replenishing is you may suppress your own ability to make Bifidobacteria, and what Bifidobacteria needs is good nutrition, good vitamins, and good yogurt. He cites the case of a woman who lived to 117 years old in India, noting that remnants of bifidobacteria were found in her stools, and that she ate yogurt three times a day. When asked how much she ate, he replies that there aren’t studies on that, but yogurt is happening. Speaker 1 continues: in a world where we constantly dodge viruses, parasites, and bacteria that secrete toxins, survival involves doing one’s best. There are things that kill the microbiome, notably antibiotics. Therefore, when you take antibiotics, that’s the time to supplement with a good probiotic and good vitamins. He notes a problem: 16 out of 17 probiotics on the market do not have Bifidobacteria. He explains why he began focusing on Bifidobacteria: in the trillion-dollar probiotic industry, if you turn a bottle around and read the ingredients, the bacteria listed are Bifidobacteria. That observation during the pandemic sparked his interest in Bifidobacteria. He says the whole path is to save the Biff, referencing the idea that during stressful moments—political division, hate, anger—seeing the power of a microbe becomes important.

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Speaker 0 describes being on the front line in Miami and using vitamin C as a go-to, questioning whether it is taken orally and in what amount. Speaker 1 confirms oral administration and notes taking a lot of vitamin C due to exposure and concern. Speaker 0 explains that a scientist contacted them after testing their sample, asking if they noticed their Bifidobacteria levels had risen fourfold. The speaker reveals they had been taking high dosages of vitamin C, which prompted a shift in approach. While dealing with treating COVID-19 patients and assessing stools in high-risk and severe cases, they decided to consult naturopaths and collect stool samples before and after treatment to evaluate the impact. Speaker 1 recounts that they began making phone calls, offering to pay for stool samples before and after on patients treated with vitamin C. They collected about twenty to twenty-five samples and observed that vitamin C increased Bifidobacteria. This finding led to publishing research showing that vitamin C increases Bifidobacteria in vitro, and they extended this to show an increase in patients as well. Key points: - Vitamin C was used as a primary approach by a frontline clinician in Miami, with emphasis on oral administration. - A scientist noted a fourfold increase in Bifidobacteria, prompting a change in strategy toward investigating vitamin C’s effects. - They initiated a program to collect stool samples before and after vitamin C treatment in COVID-19 patients, collaborating with naturopathic practitioners and funding the stool analyses themselves. - About 20–25 samples were analyzed, revealing that vitamin C increased Bifidobacteria. - They published a paper demonstrating the increase of Bifidobacteria with vitamin C both in vitro and in patient samples.

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The speaker, a gastroenterologist, discusses research on the microbiome's role in COVID-19 and challenges faced publishing findings that went against the public health narrative. Early research documented the virus in stools for up to 45 days and showed hydroxychloroquine and azithromycin killed COVID-19 in stools, but also harmed the microbiome, necessitating vitamin C, D, and zinc. The FDA initially granted an exemption for clinical trials using this combination, then revoked it. Media-fueled fear around hydroxychloroquine hindered recruitment. Research revealed that severe COVID-19 patients lacked bifidobacteria, a key microbe for immunity, which is abundant in newborns but declines with age. Vitamin C and ivermectin were found to increase bifidobacteria. A hypothesis that ivermectin increased bifidobacteria was retracted after being widely read. Research on mRNA vaccines showed they killed bifidobacteria, presented at a gastroenterology conference, linking bifidobacteria loss to Crohn's disease, Lyme disease, and invasive cancer. The speaker concludes that research interference during the pandemic hindered scientific progress and that clinical trial guidelines were not followed.

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Speaker explains the intent to guide toward nutrients that increase bifidobacteria: "vitamin C increases bifidobacteria, vitamin D increases bifidobacteria, bovine immunoglobulins, ... increases bifidobacteria." Probiotics based on bifidobacteria were shown in newborns and "decrease with old in old people." He warns, "majority of probiotics out there say they have bifidobacteria but don't even have bifidobacteria," and that even when present, "it's not making it all the way to the large intestine" because "it gets broken down by the stomach acids" or "small bowel, which now causes SIBO." If a patient has some bifidobacteria, he uses vitamins to increase it; if not, "I will give a probiotic," but "the probiotic you have to make sure the probiotic is quality. You have to make sure it goes to the colon." Overuse can cause gas, bloating, and SIBO. Baseline testing is essential: "You have to test it ... know where you are at baseline," not using unvalidated labs. They rely on a validated assay and fecal transplant data; if a patient had "4% Bifidobacteria" and the probiotic raises it to "5%", but if it drops to "zero," "we have a problem," akin to antibiotics.

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remember, I was the girl that basically was doing clinical trials for pharma, and I was doing fecal transplant. The first thing that came to me during COVID was I bet you it's in the stools. COVID can persist in the stools. Some people were asymptomatic and had COVID in their stools, but yet never had symptoms. What was the difference between those people? The difference was their bifidobacteria. Forty three severe patients with COVID had zero Bifidobacteria. Bifidobacteria was really the beginning for me. It was like, I wonder if that's the microbe I need to focus to neutralize COVID, to suppress COVID. If I have a lot of good bifidobacteria, maybe I'll be fine during COVID. Anecdotal studies like of kimchi and sauerkraut because obviously you can talk to people that ate sauerkraut and still got COVID.

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Speaker discusses anecdotal findings on bifidobacteria from vitamin C and ivermectin, and the publish‑or‑perish obstacle in research. "I took a lot of vitamin c at the beginning of the pandemic. Grams a day." "I do not recommend it to anybody." He did it as a guinea pig, and notes that vitamin C "increases bifidobacteria." He then tested about 20 patients to see what happened. "Ivermectin increases bifidobacteria," but publication was blocked by research interference, making long-term effects unclear—"could there be kidney problems? Could there be liver problems?" He laments that you cannot advance research if you don't publish, because publication validates work. When he published "the lost microbes of COVID," labs, Japan, China, and Italy, reproduced the data, confirming replication. "If that paper is real, it gets reproduced into three, four, five papers." He emphasizes colonization as the essence of the work and notes cross‑population questions about who it helps.

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" I'm a big believer of vitamin c. " "This doesn't mean it's going to work for everyone and we're not making any claims. " "There is definitely something about vitamin C through the years that have said to people, wait, vitamin C is pretty safe. " "But then we looked at the in vitro studies and that's how they grow the bitter bacteria. " "In vitro studies of vitamin C effect on the microbiome, you actually see increased Bifidobacteria with in vitro. " "So we just proved on a human clinical model what the in vitro model did. " "I'm on this big push of increasing the betrobacteria. " "That's my science... my vision. " "Are antibiotics good? Are they good long term? " "Now we're in the world of biologics. What are biologics doing to the microbiome? " "Maybe all disease starts with lots of bifidobacteria. " "As I'm improving the benefit of bacteria, I see improvement in the disease clinically as a physician."

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Speaker 0: What results kind are you seeing with this study, with the fecal transplants in autistic children? We published that case supervised by the FDA: it was giving one sibling to another and the kid started verbalizing and he's not aggressive. He came to my office banging his head, breaking his teeth, and now he's responding and he's responding to treatment. He's communicating better. He's listening. He's doing classes. He's developing. Obviously, this kid was old when we got him, it's much better, we get better results and I think Doctor James Adams will tell you we get better results the younger they are. So that's one kid. We are on to more precise manipulations, kind of, with two twins that we did. We won a research award at the American College of Gastro about two weeks ago. And basically what we showed was two identical twins that had the same exact microbes at baseline. We manipulated the microbiome and then those microbes disappeared. But what we showed, which has been my path and my mission, save the Biff, is those kids, two identical twins, nine months later, their Bifidobacteria increased with whatever we did. And now they're verbalizing, they're fully reading, fully verbal. This is a beginning. The judge that judged my presentation said this is a proof of concept, right? That when you actually attain an engraftment of Bifidobacteria, these kids are improving. This is obviously my hypothesis, has been my hypothesis. To get to that, to do that, unfortunately, we do not have a stool assay right now that is valid, verified and reproducible in the consumer product, right? So this is the problem because parents are going to say, well, I gave my kids these probiotics and my kid's not improving. So what is Doctor Hazen saying? Well, the problem is if you don't see the increase in the bifidobacteria, your kid's not going to improve. And unfortunately, the tests that are out there are not valid, verified, or reproducible or anything that I could say, oh yeah, use this consumer product. We are developing a consumer product in full transparency, but we are far from that because of the fact that there are trillions of microbes in the gut. And as a responsible physician, I feel that I cannot give a report to a patient that says you have eubacteria or you have Alistope sphingoldi, but I have no idea what Alistope Spine Goldie does, if it's a good bug or a bad bug, because here's what's gonna happen. You're gonna get this lab test from me, you're gonna go to like a thousand doctors and they're gonna say, I have no idea what this test means. Which was the problem, by the way, at the beginning when all these tests were starting. Remember, UBiome, the company that sold all these tests? All these patients would get all these testing and then they would go to the GI doctor and the GI doctors would say, what is this? What the hell?

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The speaker observed that patients with severe COVID were missing bifidobacteria compared to those highly exposed but uninfected. Bifidobacteria is a key microbe for immunity and is present in newborns but absent in older people. The speaker's research indicated vitamin C increases bifidobacteria, which may explain its use for treating colds. Ivermectin also increased bifidobacteria within 24 hours, possibly because it's a fermented product of a similar bacteria. The speaker hypothesized that ivermectin's observed benefits in COVID patients might be due to increased bifidobacteria. This hypothesis was the most read during the pandemic but was later retracted. The speaker believes the retraction of a hypothesis is not in the spirit of science.

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The speaker, a gastroenterologist, discusses their research on the microbiome and COVID-19. They found that the virus lingers in stools, hydroxychloroquine kills the virus but harms the microbiome, and bifidobacteria is crucial for immunity. Their studies on vitamin C, ivermectin, and mRNA vaccines' effects on bifidobacteria faced challenges in publication due to going against the mainstream narrative. They highlight the importance of unbiased research and collaboration in finding solutions. The speaker also raises concerns about pharmaceutical companies prioritizing profits over patient safety during the pandemic.

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A woman with a dairy-free yogurt concept claimed to have bifidobacteria; I tested her microbiome. She didn't have any and had a history of cancer on top of that. And then I tested the yogurt, and the yogurt didn't have any bifidobacteria. Now here's a woman that bought into that whole yogurt, decided to make her own, trusted a factory from wherever to make it for her, and the factory scammed her and never made never put some bifidobacteria in there. So, you know, she had to change formula. Amazing story. “I mean, so we realized after you said 98% of the probiotics don't make it all the way to the large intestine.” “We'll not inoculate your large intestine with beneficial and you don't really you don't know what you're doing, so it could be actually more harmful than helpful.” “So that's why we decided to make the yogurt.” “It's kind of right now at the way and I try not to, you know, guide people because, really, everything I do is research.” “We are going to come out with something that's going to allow everyone to test. That's a cheap solution.” “That's great to for know.” “The end of the month.” “A cheap test that's gonna allow you to test your yogurt once and for all.” “If something is healthy then great keep doing that.” “If something is causing you gas, bloating, constipation, then stop it because that tells you right away that something's wrong with what you're doing.”

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"The public is tired. They're tired of the old science. They're tired you know, antibiotics were great." "I trained in the world of antibiotics where we were giving antibiotics for everything." "then came the biologics, and then it became biologics for everything." "And now we're in the pill poop level, and it's gonna be pill poop for everything, you know." "So science is only good as science is during the moment in time where the research is not advanced." "What me and doctor Barodi do is we're the innovators." "We're the ones that are basically on the frontline challenging the status quo and saying, why not look for this?" "Why isn't Crohn's mycobacterial paratuberculosis? And why shouldn't I look for it?"

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The probiotic industry understands the loss of bifidobacterium in cancer and aging populations, but cannot claim probiotics improve longevity due to FDA regulations requiring clinical trials. Doctors also face scrutiny for promoting products without sufficient data. The speaker conducts clinical trials, involving the FDA when bringing products to market, such as ivermectin, doxycycline, and zinc for COVID. Data showed no deaths during treatment, suggesting its effectiveness. Despite a product's market approval with a 20% success rate, the speaker emphasizes the need to address the remaining 80% of patients. Innovation and discussion among doctors are crucial, but social media is now essential for educating doctors and the public due to the high cost of publishing data.

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Speaker 0: I had been on the front line in Miami, and my go-to is always vitamin C. Speaker 1: Do you take it orally or is that— Speaker 0: just Orly. Orly. Speaker 1: Orly. Is there a certain amount that you can take orally? Speaker 0: Well, I was taking a lot because I was exposed and I was worried. But then what I realized was I tested my sample, my scientist calls me and he goes, Did you notice your C? Did you notice your Bifidobacteria went up four times the level? What have you been doing? I go, Oh, I’ve been taking high dosages of vitamin C. And then he said to me, Well, you got to look into vitamin C. So right away, I switched my gears. As I’m dealing with treating COVID patients, as I’m dealing at looking at the stools before in high risk and severe, I switched my gears and I said, Okay, we need to call a bunch of naturopaths and send us patients before and after. So I started making phone calls again and said, I’ll pay for stool samples before and after on patients with vitamin C. And then we had like twenty, twenty five samples, and we noticed that the vitamin C increased Bifidobacteria. We published on that because actually vitamin C increases Bifidobacteria in vitro. So we published the paper to show that it increased in patients.

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"Vitamin C improves gut Bifidobacteria in humans." "This was an incidental finding of my berythrombacteria increasing with vitamin C." "the only thing I've done different is I've been taking these enormous amounts of vitamin c." "Essentially, what we noticed was an increase in the bifidobacteria." "within twenty four hours of the infusion of the pills." "We created the Microbiome Research Foundation essentially to raise the funds to continue doing the research." "So when the vitamin C came on, it was really calling my colleagues and saying, have a protocol that is looking at the microbiome." "Our job was not to treat the kids." "We gave an informed consent." "we didn't need an IRB approved giving vitamin c to these kids." "We got these kids poop." "Our job was to look at what is vitamin c doing before and after." "before and after for nutraceuticals, pre and post vaccination, pre and post drugs, pre and post foods." "We tested 20 kids."

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The speaker discusses personal experiences with their microbiome and the role of vitamin C in recovering gut bacteria after a disruption. They note that when they killed their microbiome, they had zero, and then saw a reappearance of bacteria with vitamin C. They raise questions about whether remnants or precursor forms of bifidobacteria were missed by testing, and whether there are unknown factors from the microbiome that weren’t captured. They describe this as a future area of study: determining how much vitamin C to administer, for how long, and whether to use it short-term or long-term. The speaker shares their own recovery process after wiping out their microbiome, mentioning that it took a long time and involved tracking bifidobacteria until it stabilized. Once stability was achieved, they felt back to normal and stopped using supplements, returning to their pre-pandemic routine. They describe this as “refloralization,” a term they coined to describe bringing back the flora and microbes to resemble what they were before, acknowledging that no one has their exact pre-pandemic microbiome signature. They express hope that future efforts—ideally in collaboration with a government agency—will make stool assays available to the public so long-haulers can understand their gut health, including the status of bifidobacteria and how dietary factors might affect it. The speaker emphasizes that addressing long-hauler symptoms requires attention to bifidobacteria in the gut and understanding which foods promote or diminish it, including which meats are beneficial or not. They acknowledge that giving practical hints is complex because many factors influence bifidobacteria. They illustrate this with an analogy: a personal conflict the night before could reduce bifidobacteria, underscoring how daily events can impact gut health. The speaker also notes personal changes in temperament, describing themselves as previously a fireball who would engage in conflicts, but who has become calmer as stress responses shift, particularly in light of stressful news or retracted papers. They conclude with a sense of resilience, joking about not being overly affected by setbacks and maintaining confidence in their ongoing adaptation.

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The main issue with vitamin C is that it cannot be patented, which means there's no financial incentive for companies to invest in it. Without a patent, there’s no profit, and without profit, there’s little motivation to pursue its potential benefits. Ideally, saving lives should be the primary incentive, but unfortunately, that’s not how the healthcare system operates.

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Dysbiosis can be caused by antibiotics, alcohol, and certain products, including nutraceuticals. Preservatives and capsule materials can kill the microbiome. The lab showed vitamin C improves bifidobacteria, but certain capsules can negate this benefit if they kill bifidobacteria. Contaminants can also harm the microbiome. More human studies are needed to understand the effects of natural products like manuka honey, apple cider vinegar, and cumin on the microbiome, as animal studies don't always translate to humans. It's important to know what kills and what heals the microbiome, especially when trying to regrow microbes in patients, to avoid counteracting the treatment.

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Speaker 0 explains that in the probiotic market, one out of 17 probiotics on the market has real bacteria in there, meaning 16 out of 17 say Bifidobacteria on the label but don’t actually have it. He adds that three out of 26 yogurts or drinks that say bifidobacteria on the market have bifidobacteria; the rest do not. He then asks about verification and testing. Speaker 1 asks if there is any way to know by looking at the label, and whether testing exists. Speaker 0 says you can call the lab Progena Biome to test, and there are other labs that do spot checks. He notes another problem: whether the microbe is alive or dead. Bifidobacteria in the gut are anaerobic, so exposing capsules to air may kill them, and stomach acid could also kill them before they reach the gut. He reframes the question: what does dead bacteria do to a live microbiome? He compares it to sleeping with corpses and suggests eventual effects on the microbiome and potential diseases, reflecting his viewpoint. Speaker 0 then raises another issue: by taking probiotics, are you suppressing your own gut production, similar to taking pancreatic enzymes which helps digestion but may shut down the pancreas’s own secretion? He questions whether taking oral enzymes could cause damage by reducing the body's own production. He explains that their approach is research-focused: they test patients with a stool test in the research world, then determine what the probiotic is doing, and implement a protocol with the right probiotic, the right prebiotic, the right bovine, and the right vitamins to see if the patient improves. If it works, great; if not, they reassess why the probiotic didn’t work—whether the probiotic was killed in the gut or interacted with certain bowel areas and became inactivated or transformed. Speaker 0 notes that he doesn’t talk about which probiotics upfront because they are still testing. He mentions several probiotics he is testing and acknowledges that not everybody responds similarly. They must understand why a probiotic works in some patients but not in others. Overall, the discussion centers on probiotic quality, viability, and personalized testing to determine effectiveness, along with concerns about dead bacteria, potential suppression of natural gut processes, and the need for ongoing research to explain variable patient responses.

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During the pandemic, the speaker took 1,000-3,000mg of Vitamin C but currently takes none due to a balanced microbiome. Testing confirms good bifidobacteria levels, especially during summer with outdoor microbe exposure. Vitamin D from the sun also boosts bifidobacteria. Vitamin C intake may need to increase depending on location. As people age, skin produces less Vitamin D, making Vitamin D and K2 the most important vitamins for older individuals.

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- "Who knew bifidobacteria liked vitamin c and liked vitamin d and that it grew?" - "We saw an in vitro study, but nobody's ever done a clinical study where you give people vitamin C until our lab where we basically took 20 patients and we gave them vitamin C before and after and noticed vitamin C increases bifidobacteria." - "Now it's like that light bulb, right?" - "That comes out that says, wait a minute, a patient has COVID, he has lots of bifidobacteria because he has COVID or a virus, right? Any virus." - "And is this why vitamin C is helping with viruses?" - "Because it increases the bifidobacteria that those people are lacking to begin with, right?" - "So are these microbes depleted in nutrients and what nutrient feeds each microbe?" - "This is the future. So it's gonna change nutrition a lot."

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Speaker 1 discusses probiotics and the current state of microbiome science: taking random probiotics may be questionable because the technology of the microbiome is not FDA-approved yet. The reason is that there are many bacteria in the microbiome and we don’t know what they are, what they do, whether they’re good or bad. For example, blotia and Rosaburia are poorly understood; 90% of GI colleagues don’t know blotia is a microbe, and 90% don’t know there’s such a thing as Rosaburia. Historically trained on Klebsiella pneumoniae, E. coli, Salmonella, C. difficile, Clostridium perfringens, but not on nonpathogenic microbes. The question remains: is blotia a good bug or a bad bug, and who has too high or too low levels? This represents the abyss of the microbiome and is still research, not consumer product or standard medical practice. Speaker 1 explains that doctors cannot be told to use a new stool test or to start using microbiome data broadly until researchers reproduce findings and doctors see the data for themselves. The idea is that oncologists may notice correlations, such as loss of bifidobacteria in invasive cancer, and observe improvements in cancer alongside bifidobacteria, which could influence acceptance of the gut-brain or microbiome link. However, such observations need replication to move from incidental findings to established conclusions. An example given is Colleen Kelly at Brown University, who published two cases of alopecia areata with C. difficile where hair grew back after fecal transplant. The question is whether fecal transplant for alopecia areata is valid; however, an academic center trying to reproduce the data could not. The speaker suggests uncertainty about whether a specific microbe caused hair regrowth or if exposure during treatment led to it. Until data are reproduced, no one can claim alopecia areata is improved by fecal transplant or microbiota transplant. Concluding guidance: if you’re healthy, keep doing what you’re doing and do nothing else; if you’re not healthy and have multiple diseases and you’ve tried a probiotic, if it works, continue, but if it doesn’t work, then it’s probably not a great probiotic. The overarching theme is careful interpretation, replication, and recognition that microbiome science is still evolving and not yet ready for universal clinical application.

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Speaker 0: Bifidobacteria was absent in kids with autism, that Bifidobacteria was absent in Alzheimer's. Bifidobacteria was absent in long haulers, vaccine injured, Lyme patients, Crohn's patients, invasive cancer. When you look at who has Bifidobacteria, the newborns have a lot of Bifidobacteria, old people have zero Bifidobacteria. Nursing home dying, zero Bifidobacteria. The process of aging is really this loss of Bifidobacteria. Expanded: if you look at and you believe the Bible, you know, people lived a lot longer. In biblical times than we are right now. We're barely making it to seventy, eighty and not really healthy seventy, eighty. You know, the mind starts going. So, is the mind starting to go because of the loss of Bifidobacteria? And, when you start looking at, well, what improves Bifidobacteria, right? So, our lab discovered vitamin C improves Bifidobacteria. Okay. Our lab discovered bovine immunoglobulins, the blood of the cow spun around that clear stuff, provided that the cow is not on a lot of antibiotics, is not given a lot of hormones, is not given like thousands of vaccines. So when you start looking at all that, you start seeing the importance of Bifidobacteria and you start seeing, like even me, you know, with Progena Biome, looking at the stool samples before the pandemic, during the pandemic and after the pandemic, there is a lot of disappearance of Bifidobacteria. Is that why we're having an increase in Alzheimer's, increase in cancer? Have we demolished this bifidobacteria? So, to me, that's a very important microbe that I believe is our longevity, if we can retain it. And it's not easy to retain in a world that's toxic in a way and in a world where we are, you know, put you know, given media full of stress, where we are divided, where we are, you know, constantly nervous of the next pandemic or the next virus, you know, it's it's almost like this bottle that you're shaking and it's full of gas and you just need to put it on the counter and let it just calm down, right? So, I think that's, it's a very important microbe.

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The speaker, a gastroenterologist, discusses research on the microbiome's role in COVID-19 and challenges encountered publishing findings that contradicted the public health narrative. Early research identified the full viral sequence in stool samples, where it lingered for up to 45 days, and noted hydroxychloroquine and azithromycin killed the virus in stools but harmed the microbiome, leading to the addition of vitamins C, D, and zinc to treatment protocols. An initial FDA exemption for clinical trials using this combination was revoked, and media-fueled fear around hydroxychloroquine hindered recruitment. Research revealed that patients with severe COVID-19 lacked bifidobacteria, a key microbe for immunity, which is abundant in newborns but decreases with age. Vitamin C and ivermectin were found to increase bifidobacteria levels. A hypothesis that ivermectin increased bifidobacteria was retracted after being widely read. Research on mRNA vaccines showed they killed bifidobacteria, a finding presented at a gastroenterology conference and linked to conditions like Crohn's disease, Lyme disease, and invasive cancer. The speaker concludes that interference with research during the pandemic hindered scientific progress and that established clinical trial guidelines were not followed.

The Peter Attia Drive Podcast

283 ‒ Gut health & the microbiome: improving and maintaining the microbiome, probiotics, & more

Guests: Colleen Cutcliffe

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The microbiome is a mutable ecosystem of microbes, including bacteria, viruses, fungi, and yeasts, residing in and on the human body. Colleen Cutcliffe, with a background in biochemistry and molecular biology, discusses her journey from academia to founding Pendulum, a company focused on microbiome-based products. She emphasizes the potential of microbiome interventions, particularly through fecal microbiome transplants, to improve health outcomes. Cutcliffe explains that the gut microbiome is established at birth, primarily influenced by the mode of delivery and early exposure to maternal microbes. The diversity of the microbiome peaks in early adulthood and declines with age. While the idea that microbes outnumber human cells is debated, the functional importance of these microbes is clear, as they contribute significantly to bodily processes. The conversation shifts to the differences between prokaryotic bacterial cells and eukaryotic human cells, highlighting that bacteria can replicate independently and evolve rapidly, which is a factor in antibiotic resistance. The relationship between humans and their microbiota is generally symbiotic, although some bacteria can become pathogenic under certain conditions, such as *Clostridium difficile*, which can proliferate when antibiotics disrupt the balance of the microbiome. Cutcliffe discusses the Human Microbiome Project, which revealed significant variability in microbiomes across individuals, influenced by factors like genetics, diet, and environment. The complexity of the microbiome makes it challenging to draw definitive conclusions about specific strains and their functions. The conversation also touches on the role of different microbes, including the potential benefits of *Akkermansia muciniphila*, which is associated with metabolic health and glucose regulation. Cutcliffe describes how *Akkermansia* can stimulate GLP-1 secretion, a hormone that helps regulate blood sugar levels and appetite. Pendulum's product, Glucose Control, was developed based on clinical trials showing its efficacy in lowering A1C and blood glucose spikes in individuals with type 2 diabetes. The formulation includes multiple strains to enhance metabolic function. Cutcliffe notes the importance of rigorous scientific validation in the supplement industry, which is often plagued by unsubstantiated claims. The discussion highlights the challenges of studying the microbiome, including the need for longitudinal data and the difficulty of controlling for dietary factors. Cutcliffe emphasizes the importance of understanding individual microbiome responses to interventions, as well as the potential for future research to uncover more about the gut-brain connection and the impact of diet on microbiome health. Overall, the conversation underscores the evolving understanding of the microbiome's role in health and disease, the potential for targeted microbiome therapies, and the importance of scientific rigor in developing effective products.