About 10 years ago, I contracted a GI infection, accompanied by chronic diarrhea that took over a year to fully resolve. In the first few months, I lost 14 pounds, putting me at 108# at my lowest (I’m 5’9″). What finally helped me resolve the issue was a DNA-based stool test that I collected at home. After approximately 18 months of treatment, coupled with diet and lifestyle changes, I was able to resolve salmonella as well as several chronic infections, and gain enough weight to be in a healthy BMI range for the first time in my life. (WAIT! Before I lose you, balancing the GI tract helps normalize weight, so most patients see weight loss.)
Because so much of our body’s immune response originates in the gut, optimizing its function is one of the most impactful things you can do to enhance immunity. At Leaves of Life, we know firsthand that many of you may have the time, interest and need to focus on this type of regimen, but may prefer a DIY approach, so that’s what this blog post is all about.
It’s rare that a new patient doesn’t need to address their GI tract as one of the first and most important foundational pieces of their care, so even if you opt not to test, I feel confident that addressing the most common imbalances we see on stool testing reports would significantly boost your immune response.
Why DNA Stool Testing?
Parasites, bacteria and other invading microbes don’t LIVE in the stool – most burrow into the gut lining, snagging nutrients from food passing by, and expelling their metabolic waste in exchange (akkk!–their poop!). However, they still shed cells, and DNA stool testing picks up the presence of non-human cells and identifies their microbial origin. This type of testing is much more sensitive than conventional stool testing.
Some microbes can cause or contribute to disease, but at the very least, “unfriendly” microbes:
- Contribute to chronic, ongoing toxicity
- Deplete nutrient levels
- Weaken immunity by crowding out “friendly,” beneficial flora
- Cause chronic, systemic inflammation
- Create or worsen leaky gut, which can lead to food and environmental sensitivities
- Can be an underlying cause of insomnia and mood disorders (anxiety, depression, irritability)
- Make it difficult to attain or maintain an ideal weight
- Can trigger acute or chronic skin conditions
- And more!
As you can see, eradication of unwanted microbes can be pretty critical to overall health. Below, we’ll discuss what to use and how to dose it, but first things first…
The gut lining is fragile, at just one cell thick, and is protected by a mucosal barrier. We’ve learned over years of practice that healing the gut lining and associated mucosal barrier needs to come first. This keeps die-off-generated debris and toxins from crossing over into the bloodstream during the eradication phase.
More than 90% of our stool tests come back with indications of a leaky gut lining, and most patients feel noticeably better with just this first step. We typically have patients begin GI lining support about 2 weeks before an eradication regimen begins.
There are three stool test markers we use to evaluate the integrity of the GI lining:
- High or low secretory IgA (immune response at the mucosal barrier)
- Low levels of normal flora (the protective sentries along the GI lining)
- Elevated calprotectin (indicating inflammation)
Here are some of our favorite products and dosing:
GI Revive by Designs for Health (contains a small amount of prune powder)
If having less than 2 BMs per day, take 1 tbsp at bedtime, mixed to taste with water or nut milk
If BMs at 2-3/day and formed, ease in at 1 tsp, then 2 tsp, then 1 tbsp per night over 2-5 days
GI Restore by DesBio (can be used with any type of bowel pattern – contains bonus colostrum)
1 scoop at bedtime, mixed to taste with water or nut milk
Glutashield by Orthomolecular (the chocolate is delicious – we often recommend for kids and adults with sensitive palates – it can use some additional mucosal barrier support such as aloe juice 1/4 cup or slippery elm powder – 1tsp)
1 scoop at bedtime (with optional aloe or slippery elm), mixed to taste with water or nut milk
Typically, we keep patients on GI lining support until their protocol is complete, and for some patients, it’s necessary for them to take it for a longer period of time before beginning eradication. Heartburn or ulcers, if present, should be resolved before moving ahead with eradication.
The most common cause of weak digestion is Helicobacter Pylori infection (H Pylori for short). If present, this microbe requires a 3-4 month treatment regimen, which I’ll cover in more detail in a separate blog post (coming soon). H Pylori lowers stomach acid, and can create imbalance in the following stool test markers:
- H Pylori present, sometimes strains that product toxins that can lead to ulcers or stomach cancer if left untreated
- Pancreatic elastase <500 (pancreatic digestive enzyme)
- Presence of steatocrit (undigested fat in the stool)
- Overgrowth of pathogenic or opportunistic bacteria (these displace normal, “friendly flora” that participate in digestion and absorption)
When digestion is weak, proteins don’t break down into amino acids needed for tissue repair (think leaky gut and achy joints) and neurotransmitter production (one reason mood disorders can stem from GI dysfunction), and minerals and fat-soluble vitamins are poorly absorbed.
Here are some of our favorite digestive aids with dosing:
OrthoDigestZyme by Orthomolecular (blend of enzymes and hydrochloric acid for broad spectrum support) or Proactazyme by Nature’s Sunshine (blend of pancreatic enzymes that work in various pH ranges, no stomach acid for those intolerant at treatment onset)
1-3 per meal, at the beginning of the meal, dose is based on level of digestive weakness and size and complexity/richness of meal – I recommend increasing until you notice improved digestion
Metagest by Metagenics (contains betaine HCl and pepsin that stimulate bile flow and pancreatic enzyme output
Start with 1 per meal, mid-meal and slowly increase to 2-3 per meal, as tolerated. If stomach acid deficiency has been longstanding, the stomach may no longer be producing a sufficient mucosal barrier as protection, and this takes time to build back, so starting slow allows for this to take place. Most often, heartburn when beginning simply means more mucosal barrier support is needed before starting or increasing.
Because stomach acid triggers the next steps in digestion (bile flow and pancreatic enzyme output), hydrochloric acid (betaine HCl) is the workhorse of digestion. If I can only choose one product for digestion, I choose HCl (Metagest) because it will stimulate the patient’s own digestive functions. Additionally, stomach acid sterilizes the food we eat so microbes can’t survive digestion and set up camp in our intestinal tract. For this reason, I think of stomach acid as the bouncer at the door of a party. It won’t do much good to eradicate if you don’t take away the welcome mat that will allow for new exposures to settle in. Hydrochloric acid is also critical for protein digestion and absorption of minerals and fat-soluble vitamins.
Pathogenic and Opportunistic Bacteria
There are nuances when addressing microbial overgrowth, dependent on what all is present and in what amount, but in general, after 2-3 weeks of intestinal lining support, we typically shift into broad-spectrum antimicrobials (alongside probiotics–see below).
Our favorite antimicrobials:
Candibactin BR by Metagenics (berberine based blend of dry herbs with broad-spectrum action)
GI Microb-X by Designs for Health (berberine-based blend with broad-spectrum action)
Candibactin AR by Metagenics (a blend of aromatic oil-based herbs that can penetrate biofilms)
Oil of Oregano by Designs for Health
Intestin-Ol by Orthomolecular (similar to Candibactin AR)
I typically choose one of these products and one of the parasite remedies below, and dose 1-2 per meal, though some patients may need to start low and build up to the full dose. As microbes die, they release toxins and bacterial debris into the intestines, so die-off symptoms may occur, though they’re most likely to occur at the beginning when bacterial numbers are highest. As patients make headway and the numbers drop, they can typically tolerate the full dose.
Whether or not parasites are present on the report, I typically like to treat for them. The stool test only looks for the specific parasites that are listed, and there isn’t any way to test for every known parasite, and if they’re present and not addressed, it can be very difficult to eradicate the other dysbiotic microbes, and it doesn’t hurt to treat if they’re not there.
Our favorite anti-parasitics:
Wormwood Complex by MediHerb or Artemisia Combination by Nature’s Sunshine
Work up to 2 tablets per meal and take for 1-3 bottles, depending on what parasite is present
Whether or not testing shows low levels of normal flora, they are impacted by anti-microbial treatments and should be supplemented during eradication of “unfriendly” microbes. Probiotics stand as protective sentries along the gut lining, and help with nutrient absorption from the diet. They also produce vitamin K and some of the B vitamins. No wonder they’re often referred to as “friendly!”
Because they also support respiratory health, we’re currently favoring these two probiotics:
Ultra Flora Immune Booster by Metagenics and Ultra Flora Balance by Metagfenics
1-2 per day on empty stomach
I prefer dosing at bedtime when peristalsis slows and GI lining support can be paired with the probiotic as comprehensive support.
Refined carbohydrates and high-glycemic foods are the favored nutritional source for many harmful microbes, so continuing to consume them will prevent successful eradication, and fiber is the preferred food for the friendly flora (think vegetables, fruit and whole grains). You can see why most Americans are in need of a GI detox plan.
Click here to read Caitlin’s recent article on eating for optimal immunity. It covers all the basics in supporting a GI detox plan.
- Heal and seal the GI lining (GI Revive, Intestinal Restore or Glutashield)
- Digestive Support (Metagest and/or OrthoDigestZyme)
- Broad-spectrum antimicrobials (Candibactin AR/BR, Intestin-Ol, Oregano oil, Wormwood Complex or MicroDefense)
- Probiotics (Ultra Flora Immune Booster or Ultra Flora Balance)
- Avoid sugar and refined carbs and include plenty of fresh veggies and low-sugar fruits.
I hope you find this article helpful. I’m available for consultations, with or without GI stool testing, if DIYing isn’t your thing or you need additional help.
Remember: The Road to Health is Paved with Good Intestines!