(0:00 - 0:30) Many doctors today are still stuck in the big pharma regime of prescribing drugs for everything under the sun, often making the health issues their patients are experiencing even worse. But increasingly, research is showing that in many cases drugs are not the answer. Dr. Sabine Hazan has been doing groundbreaking research for decades on the gut microbiome, and understanding it might well be the cure for most things that ail us. (0:31 - 11:28) Her book, Let's Talk Shit, Disease, Digestion, and Fecal Transplants, is a window into that research and the radical improvements many of her patients experience when their gut microbiome issues are addressed. And it extends to far more than just the things you might think, like obesity, diabetes, and inflammatory bowel disease. Dr. Hazan's research has given some of her patients dramatic improvements in conditions like Alzheimer's, Parkinson's, Crohn's disease, arthritis, and even depression, anxiety, and autism. In this interview, Dr. Hazan shares some of the results of her research, outlining the complexities of a condition for which there is no one-size-fits-all cure, but also giving hope that in time, ways may be found to analyze each patient individually and provide treatments that can lead to longer, healthier, and happier lives. Dr. Hazan, welcome to the show. Thank you. Thank you for having me. And I've invited you because I read your excellent book, and yes, in this particular instance, we can say shit on my show because it's in the title of your book. Yes, let's talk shit. And it's all about the gut microbiome, which people don't understand is incredibly important to our health, not just our health, our mental health, everything. So while I've known about this for years, for our viewers who don't, could you please give as brief as possible an overview of just how important the gut microbiome is? The microbiome is your immunity. So immunity starts in the gut. It starts with microbes that are doing something to help you absorb vitamins, absorb minerals, decompose sugar, etc., break down foods. Those microbes are a huge necessity for digestion, but also for metabolism, for mitochondrial function. So it starts in the gut. If you don't have the microbes that are degrading the sugar, you're not absorbing sugar. If you don't have the microbes that degrade and help absorb calcium, you're not going to absorb calcium. So it starts with microbes. And while, of course, genetics can play a role, of course, diet is, I think, the major contributing factor to how healthy the gut microbiome is. And we have this crisis in our society, Canada and the U.S., with the ingestion of these manufactured foods, diets that are high in sugar, high in processed grains, just awful for you. And how is that affecting the gut microbiome? Well, that's a good question, right? Because that's the question of how come some people have an amazing microbiome and eat all that junk, and some people have a horrible microbiome and eat very clean diet, right? So that's something we're going to be publishing on and kind of showcasing, but I'll just give you a hint. It has to do with resilience, resilience of the microbiome in that individual. And that's something nobody really talks about. So as much as we think, well, I'm going to eat a yogurt and I'm going to get better and I'm going to, yes, of course, changing your diet if you're not on the right path can only improve you. But it's not all that. It is also about what microbes are in you, what microbes you've acquired from your family members, what microbes you've been exposed to, and how you handle those microbes. Think about the person that's exposed to COVID all day long at their job as a physician, not wearing a mask, exposed and not catching COVID. What is in that microbiome? And yet the person has a horrible diet, right? So obviously processed food, all that is not the right path to healing a diseased microbiome, right? But at the same time, is that the culprit or is there something else? And that's the something else I want to understand. I think it's something else, what we're doing to our foods, more importantly. What substances are we doing to manipulate these foods? How are we manipulating these foods? How are we sterilizing these foods? How are we preserving these foods? That preservative has more problems than the food itself. Now years ago, I knew a couple where, as a couple, they were eating largely the same diet. He was what would be probably described a normal healthy weight, and she was literally 400 pounds. Could the gut microbiome be a partial explanation for that? So if you look at studies of mice where they took stools of a skinny mouse into the fat mouse, that mouse became skinny and vice versa, you could say, well, you know, there is something in the microbiome of obesity. Our own study that we did with Arizona University was basically where we fed skinny mice some soy, and then we noticed that their microbiome changed, right? So with the ingestion of soy, the microbiome of the mice changed, and they changed to becoming obese, right? So did we change the natural food that a mouse is supposed to eat by giving it just soy, and did that change the microbiome enough to start creating obesity, right? So there is probably a microbiome signature to obesity. We seem to believe we've seen it, we've identified it, but here's the thing, you know, what microbes are needed and what microbe for what population are needed? That's the big question. This is, and, you know, I know other doctors where you bring up gut microbiome when they're trying to diagnose a patient, and they'll just poo-poo it, pun intended. But are you seeing, because you've been researching this for years now. We're there yet, right? So I can understand. I put myself in the shoes of a doctor, a GI doctor, because I just had that today with a woman who has ulcerative colitis. Her doctor's not there yet, right? Think about when we started using biologic for Crohn's disease and ulcerative colitis. Us on the frontline of research, as GI doctors on the frontline of research, working with new development of drugs, we kind of knew, okay, biologics is the future. This is going to change ulcerative colitis and Crohn's, right? But the doctor who's in the frontline still writing mesalamine or anti-inflammatories for Crohn's or ulcerative colitis is not cued into that research. So that doctor's going to say, oh, biologics, are you kidding me? It doesn't work. It's crazy. So science is only science for the day with what we know of today. Don't ask the doctor on the frontline of GI who is following the boards of medicine, who is following the guidelines, don't ask him to go into the future 10, 20 years from now, because that's not his job. His job is to follow that box of research that is within the guidelines to protect himself from a lawsuit from a patient, right? What I'm bringing you into is 10 years, 20 years down the road, right? So I'm bringing you to the beginning of clinical research, clinical trials that are being innovated and that are going to become the future of pharma. So, of course, to the GI doctor that's within the box, he's going to say, oh, he's going to poo-poo it. I expect him to poo-poo it. You know, only when it becomes standard of care, other doctors have validated the research, other doctors have reproduced the data. Only then does it become within the guidelines. So think about research. A doctor comes up with an idea. Drug XYZ is working for this condition of Crohn's disease, for example, okay? Meanwhile, drug ABC is still in the guidelines. The College of Medicine, GI, has said these are the guidelines for this condition, drug ABC. Now, in the meantime, someone else comes up with XYZ and brings it through clinical trials. So first, before it goes to clinical trials, they have to do an N of 1. Then they do an N of 30 to basically show it's safe. Then they have to raise money to do an N of 1,000 to show that its placebo-controlled trial is working. And then it becomes the data gets published. And from there, the GI association starts using the product. And then it becomes the guidelines. So from the process of I'm thinking about a drug and I'm innovating to it's coming to the market and becomes a guideline, 20 years will have passed. That's the reality of research. That's the reality everybody follows. And the only way to speed up research is to increase the funds towards good research that can get us moving a little bit faster. Now, you are one of the top researchers in the world in this area. So I have to ask, based on everything you've just told us, obviously, it's extremely complex. It's not going to be some point in time where you can say, well, it doesn't matter who you are. If you eat this, this, and this, you'll be fine. Because as you've already pointed out, it doesn't work that way. So where are we at in the research? And what are the challenges that you're facing to, I guess, come up the spectrum where each person can be identified as what's your potential gut microbiome problems and how do we address them? Where the very beginning, I hate to say it. There's a lot of hoopla out there. We all know our gut instinct tells us there's something in our gut. It's all about nutrition. All disease begins in the gut. We all know this, right? But how do we make that a reality? And here's the problem. Problem number one is we're all different. Problem number two is within our differences, some people have some microbes that are elevated and are good for them. (11:28 - 13:21) Some people have some microbes that are missing and are good for them, right? So how do you set up a standardization? How do you standardize this field? Secondly, how do you compare two individuals, right? You have one guy has a lot of, you know, bacteroides and another guy has a lot of allosterpies, fine goldie. Which one is it? Is it the allosterpies that's the good? Is it the bacteroides that's the good? Is it the bifidobacteria that's the good? Is it the lactobacillus? Which one is it, right? You take that and you add to that complexity people taking nutraceuticals, probiotics, prebiotics, bovine, vitamins, medications, drugs, marijuana, alcohol, processed food. You add all that and you go, okay, now I have two people that are completely different and they're completely different diets, completely different drugs, completely. How am I going to compare those two Parkinson's patients, for example, to set me up into what is Parkinson's? What is the signature microbiome of Parkinson's, right? So for that, we need a lot of numbers. We need numbers of, you know, Parkinson's in Russia, Parkinson's in China, Parkinson's in Japan, Parkinson's in wherever, right? In America. And they kind of get out of there, the foods that they're taking, the supplements, the diet, the meds, the surgeries they've had to eliminate. And then you start seeing this clearer picture. So that's a lot of work and that's a lot of funding. So that needs to be funded. (13:22 - 15:46) So when you look at that, you go, okay, that's a big job, right? How can we possibly advance this science when, and here's the other bigger problem. You look at all these labs that are doing microbiome analysis, right? And none of them are validated. None of them can say with certainty, this is reproducible data, right? So you have all that complexity. So let's see if I'm comparing a lab at, I don't know, a lab that's doing genetic sequencing of the microbiome and telling you the same story, take probiotic, prebiotic, whatever. And you believe that, and you do that. A small percentage of people will respond to that because they actually, that was the standardized diet for them. However, the rest of the population will not. If you use those labs that are telling you, this is the diet you should be eating, et cetera, and you repeat your stool test a couple of times, you're going to realize your stool test is different. One will have a lot of LSTPs one day, the same exact stool sample will have a lot of LSTPs one day, and then the next day it'll have a lot of bacteroides, right? Or within the same sample. So how can you compare if the lab itself is not validated, right? And to achieve validation in the microbiome space is very difficult because it's like flying around the moon, but, and trying to find the moon, but you have no idea where the moon is. So you're kind of like, now, if I know exact location of the moon, they get back and forth. No problem. Cause I know the location. Those labs knowing, do they know the location of the moon to find these microbes? Did those labs do the proper diligence to make sure those microbes are normalized? And mice, is that a microbiome testing that's looking at a small piece of the microbe or is it looking at the whole entire picture of the microbe? So there's so many factors to basically the microbiome that we're really at the beginning. What we are seeing at ProgenaBiome is really the beginning of research. (15:46 - 16:09) It's processing research, you know, a woman full of psoriatic plaque, you know, psoriasis all over her belly, six months later, gone, skin clear, processing, N of one, amazing. Alzheimer's, guy remembers his daughter's date of birth six months after implant. Great, amazing, N of one. (16:10 - 18:49) Now the problem is you need to find, to reproduce that N of one to N of 30. So we can continue to treat these patients one by one, N of one, N of eight, N of 28, or we can say, all right, it's time to look at the microbiome of the planet, to fine tune these microbes to say this microbe is linked with this disease and maybe more microbes are linked with the same disease, right? And create a dictionary. The dictionary, if you remember, was not created in one day. The whole population of the world started creating words and they sent it. Remember you saw the madman, that movie with Mel Gibson, you know, where he basically, you know, hired a guy in prison to help him write the dictionary, right? This is what we're at. We need everybody to help us. We need every doctor and every scientist to step in and say, you know what? I'm seeing this microbe is with this disease. I'm seeing this microbe and start treating. So my mission in a way is to unite the world, to understand the microbiome, to bring doctors to the same platform, to say, yes, you're absolutely right. You're poopooing this technology because you don't have all the facts. You don't have all the information, but guess what? Come on boat, come on the train with me. Let's drive together to understand it together. And then I saw doctors step in. You know, we saw it with COVID, the doctors that stepped in to see the microbiome, not to see the microbiome, but to treat patients with COVID. You, what happened to those doctors? They all follow the protocol, hydroxychloroquine, vitamin C, D and zinc, which was my original protocol that I put on clinicaltrials.gov April 2nd, right? 2020. Then we wrote ivermectin, doxycycline, zinc in July. We posted it on clinicaltrials.gov. Ivermectin became the new sensation, right? What's, what's been to those doctors? They come back to the source to say, wait a minute. Hazan was the one that was talking about ivermectin and hydroxychloroquine. What else does she know? And now they're embarking on the microbiome. You know, Mary Bowden is like all interested in the microbiome now. Kate Lindley, Lynn, you know, so many doctors are interested now in the microbiome because of this movement that was this healthcare revolution that happened during COVID really. (18:50 - 20:16) Right. Now you've mentioned Parkinson's and Alzheimer's, but based upon the research you have done, how many of the common diseases, ailments that we were seeing in our society today do you think could be traced at least in part to the microbiome? Well, well, I'm not going to put myself in a rabbit hole, but if I had to put myself in a rabbit hole, I would say by gut feeling only that probably all disease have a microbiome etiology. And probably because I'm trying to stay humble, but I think all of it, I think cancer is going to become a microbe for cancer. I think, you know, you know, we certainly have seen HPV, cervical cancer, H. pylori, gastric cancer, EBV, Burkitt's lymphoma. There's always been, you know, there were microbes linked to the cancer. I think in the future, it's going to be just tumors or this microbe. Breast cancer is this microbe. And again, it's not just causation, right? It's not about the microbe causing the tumor. It's really about the microbe elevation linked with the tumor and the loss of microbes that didn't prevent that elevation of that bad microbe. (20:16 - 21:41) Okay. I want to be specific on that because it's all about the balance. Some people have that microbe high and they don't have breast cancer, right? But they also have a high level of good bacteria that's keeping this microbe a check, right? So in the microbiome space, it's about check and balance. It's about one microbe is suppressed by another. You know, I have a microbe in my gut that was transferred from my great great grandmother to my grandmother to my mom to me. And it doesn't cause the disease. I'm not going to say what it is, but it doesn't cause the disease that it supposedly should cause, right? But here's the thing. Why? Because over the years, immunity built and suppressed that microbe. And that microbe is no longer active. Now, if I remove the guard, if you want to put it, then that microbe is going to go crazy thinking about it. What we discovered with COVID is that people that had severe COVID had zero bifidobacteria. People that were exposed to COVID, but never got COVID had a lot of bifidobacteria. Is bifidobacteria the bug that was neutralizing COVID and not catch it? Data's coming from progenitobiome to show that. Okay. Now, there's been a lot of talk in recent years about the overprescription of antibiotics. (21:42 - 23:40) And of course, that can really mess up the microbiome. Are you concerned about that? And should people be concerned about that? Maybe being reluctant to pursue antibiotics as the first solution when they're sick and maybe go with that as a last step. So there's a great chapter in this book on how antibiotics were created. I encourage everyone to read it because when you start understanding what is an antibiotic, you'll realize that antibiotics are just microbes fighting other microbes. So there are some good antibiotics that can help your microbiome. And there are some antibiotics whose function is to just neutralize, kill that microbe that's overgrown. Think about the urinary tract infection patient, needs an antibiotic that's sensitive. What is that sensitivity? It's just microbes that are suppressing that bacteria and stopping the process of your urinary tract infection from becoming sepsis. So a person that has a pneumonia, for example, is getting antibiotics because you don't want that person's lungs to crash and you want to prevent the spread of that microbe in the lung. You know, in the future, it's probably going to be a different way of approaching, you know, microbes to begin with. But right now, this is what we have. So yes, you have to kind of look at the balance. So would I give an antibiotic for a viral infection? We've done it for people that are really severe, that are dying. We saw it with COVID. We gave antibiotics for COVID. And that was a need. However, you've got these people that have just a small flu or cold. We wouldn't necessarily give antibiotics for that because that could kill your microbiome. (23:40 - 25:50) There was a time in GI when people would basically do, you know, procedures. And if you had endocarditis, they would recommend antibiotics. We've stepped away from that because we recognize that antibiotics have a problem themselves. So I think, you know, you got to look at the risks versus benefits. And here's the thing. If you're giving antibiotics, you probably want to optimize the gut, you know, sauerkraut, you know, all sorts of things to kind of improve the patient at the same time. So... Now, and just to clarify for the viewers, when you were talking about giving antibiotics for a viral infection, you know, of course, antibiotics don't fight a viral infection. You're giving those to prevent a potential secondary bacterial infection that could potentially kill the patient. Exactly. But also, you know, for a virus like COVID, the thought of antibiotics was to break down the membrane of the virus. Remember, we're in a world now, and I don't think people realize or recognize this, we're in a world of designer bugs. What are designer bugs, you ask? They are microbes that you could take a virus and take a piece of a bacteria and you link them together. And now you have a novel microbe. Well, that novel microbe, unfortunately, will need an antibiotic because you just put in a piece of a bacteria in the virus. So, you need to not only get rid of the virus, but you need to get rid of that piece of the bacteria that's late with the virus. So, you're going to need an antibiotic for that. Okay. Now, let's talk about... So, designer microbes is what's happening right now. And people don't realize this is a dangerous science because we don't know what we're playing with. This is like recreating... You know, you've got these scientists in the lab that want to recreate a dinosaur, but they don't think of the consequences of recreating a dinosaur. And then you've got these venture capitalists that are basically saying, oh, you know what? That would be so cool, reproducing a dinosaur. (25:50 - 30:03) But they're not thinking, what would happen if you have created a dinosaur in today's world with all these buildings and cables? The dinosaur is going to destroy everything. So, we don't think of the consequences. We just think, oh, well, wouldn't it be cool to do this? And that's the world we live in right now. Right. So, let's talk about fecal microbiota transfer. FMT, you've got a very humorous story in your book about Aunt Marge. Let's start with that. Yes. So, fecal transplant is essentially, you know, stools from a healthy donor that basically gets put into an unhealthy with C. diff. In America, so it's basically you take stools and you process them, make them as clean as possible, test them for multiple microbes, right? Because you don't want to give a vancomycin resistant E. coli to a patient that's immunosuppressed because you might kill him. So, you've got to test every single, you know, microbiome. You've got to test the microbiome, but you also got to test the microbes that could potentially kill the immunosuppressed patient. So, you can't just do it in your kitchen table. And once you do, once you do fecal transplant, it's only approved for C. diff because C. diff is what started us all on all this. C. diff is the microbe that basically we kept giving it antibodies. I was the girl that was doing clinical trials after clinical trials to try to kill the bug. And when I realized it wasn't about killing, it was about suppressing it with more microbes, more diversity, a new garden, that's when things changed for me. You know, so C. diff was started in the 50s by Dr. Einsmann and then Dr. Tom Barotti started doing a lot more cases of fecal transplant, but not just for C. diff. Dr. Adams started doing it for fecal transplant for autism, et cetera, but that's all in clinical research. So, I had a case with the FDA on metastatic mesothelioma and fecal transplant. I had autism and fecal transplant. I'm going to have Parkinson's soon and fecal transplant. So, this is the future, but we're just not there yet. And why are we not there? Because we haven't figured out the exact formula of microbes. In the future, it's not going to be about taking stools and processing it. That's kind of barbaric. And we're going to look back at this and say, how barbaric. In the future, it's going to be consortium of microbes. Take microbe A, B, C, join them together, put them in the colon, and you achieve, you know, improvement of disease. But we're not there. Right. Now, I was referring to that story about Aunt Marge, which I found quite humorous, where a relative is calling up Aunt Marge, because they're a blood relative, and saying, I need your stool. Right. Of course, the reactions that you would get. And I'm sure you've had many patients now have had to do this, who've had to go and talk to a relative and say, I need a stool from you, because we're going to do a transplant. What kind of stories are you getting back from people when they have these conversations? You know, like, I think most people are flattered to hear that they have a golden microbiome, you know. So, let me tell you, half the time, when I analyze these stools, and I joke, I say, it's like the golden ticket of Willy Wonka, when you eat a bar of chocolate. Some people have a golden microbiome, and I actually call them and say, hey, you may want to be a stool donor at some point. You know, the family members, I think it's pretty out there now, fecal transplant. So, everybody's kind of in tune with that. You know, the stories I've had have been incredible and funny, to say the least, because there's some kids don't want to give their stools to their parents, you know, or, you know, it's like, no, I'm not a lab rat, I'm not giving it, you know. So, it's interesting, the reactions, it's interesting, the stories, and definitely makes for a fun field in a way. (30:04 - 32:38) Now, you've also researched the potential for gut microbiome treatments for autism, and that's become a huge thing. I happen to know the statistics on this. Back in the 1950s, it was one in every 2,222 children were diagnosed with autism. Recently, we were told one in 36, but a news report came up just this week saying, no, it's actually one in 31. So, now this is getting, and if you think about that, I mean, that's the size of an average classroom, which means that one kid in every classroom now is autistic, or on that spectrum. So, how could gut microbiome be used to treat that? And what have you seen? We're seeing it, it's happening. So, you know, my N of 1, which used a family member, a sister, we tested the sister, she seemed to be the best donor for her brother, and he started speaking, went to graduation with a girl. You know, that case is constantly progressing and improving. We're seeing it more now with a fine-tuned product, right? So, in other words, like, how do you manipulate the microbiome so that you don't have to necessarily give stools, right? That's my role, because, you know, after fighting for four years to get this one protocol into the FDA, I gave up, and I basically, I'm still fighting to get to do familial fecal transplant, because to me, I feel that's a necessity. You know, the FDA wants a product, you know, pharma wants a product, but here's the problem with the product, not everybody is going to respond to the product. 50% at best will respond, if you look at the data from Dr. Adams. What happens to the other 50%? Maybe they need something like a familial fecal transplant, maybe they need to modulate the microbiome differently, maybe it's a neurological problem, maybe it's a brain-gut-access problem. So, you know, we need to be better at dividing where is autism, where is autism a microbiome issue, or is it a neurological issue? So, saying that, yeah, absolutely, there is a crisis right now with 1 in 31 kids with autism, 100%. We need to be better at diagnosing, preventing, and treating, because here's the reality that I see. In about 30 years from now, or maybe 50, it's going to be one-on-one. (32:39 - 40:42) So, what happens when you have one kid out of one is autistic, and we're talking about on the spectrum here, okay? We're talking about, you know, non-verbal, unable to care for himself, banging his head on the wall, that's what we're talking about, right? Aggressive, that's what we're talking about. Moms having to stay up all night to watch their kids because they're not sleeping, and therefore mom is worried that the kid's going to jump all over. These moms are warriors to be with these kids, like holding them down, etc. So, we need to be better at understanding what happened, what happened that got us to here, right? And yes, you were talking about the foods, the process, the environment, all of that is a possibility, because that's changed. But also, what are we doing to these kids? What are we doing to these moms, you know? That needs to be looked at, because when it's one-on-one kid, care if you're a billionaire or, you know, or celebrity, your kid is going to be that kid. You're, or you're not going to be able to find help, because what happens when the population, half of the population becomes autistic, who's taking care of these kids? Who's taking care, who are your doctors? Now you've gotten a shortage of doctors, you got a shortage of farmers, of truckers, etc. You know, these kids kind of, are we going to start creating homes and places for all these kids? Fix the problem, prevent the problem, diagnose better. That's what we need. Now, we've talked about disease, we've talked about the complexities of the research, but something we haven't touched on yet, which I've also known about for years, is the effect of the gut microbiome on the mind, on the mood, mental clarity, the ability to focus, the ability to sleep properly, how you feel about yourself, about life, and that has an impact as well. What has your research found in that area? So, we actually showed, we published last year a paper where we showed the anxiety microbiome. It was patients that basically came to my clinic, and we did a GAT questionnaire, which is an anxiety questionnaire on these patients. And as we did the GAT questionnaire, we basically analyzed their microbiome. And what we noticed is there was a signature microbiome in patients with high severity of anxiety versus people that were non-anxious. So, when we started looking at that, we said, well, maybe anxiety is a microbiome dysbiosis. Maybe anxiety is the microbes going up the nerve to the brain, creating that anxiety behavior, right? The other thing that we kind of said, well, the other thing that could happen is the brain could be so anxious thinking about something that it's triggering those microbes to grow, right? So, anxiety, mental health, that was noticed with microbiome dysbiosis. The other thing that we recently just published, and we were at the anxiety meeting presenting that data, was bipolar disorder. Bipolar disorder has a signature microbiome. That means loss of certain microbes, overgrowth of other microbes. And when you restore that, you hope to improve the bipolar disorder. That's what we do. So, when we see a patient that we do fecal transplant for C. diff, and the patient happened to be suicidal, for example. So, when we talk about mental health, so we had a case where the patient was essentially suicidal, psoriasis, C. diff, and chronic UTI. We did fecal transplant using an amazing donor, and the suicidal ideations were gone. Psoriasis was gone, chronic UTI was gone, and C. diff was gone. So, while we were attempting to cure C. diff, all these other three side effects happened with that super donor that we gave this guy, right? So, right there showing you the correlation that maybe we can fix suicidal ideation. So, imagine the hope there. Imagine going to prisons and realizing that these prisoners are in there because they have mental health problems, because they have a gut dysbiosis. Imagine if you could correct that microbiome dysbiosis, and they could start being less angry, less bitter, happier. You know, happy people don't kill people. Just a fact, you know? People that exercise, that are happy, that have endorphins do not want to kill people. So, maybe changing that microbiome, changing the nutrition, could improve society, could balance us back. So, the hope of all that is uncomfortable. You were talking, well, we've discussed, first of all, that there is no easily identifiable commonalities between the people who are suffering from an unhealthy gut microbiome, but you also mentioned you've got these golden donors. I wouldn't say there are no differences. I would just say that we can pinpoint to right now with certainty. Again, the golden donors are what we see, you know, nothing is set in stone or written of what a golden donor looks like. It's really the Dr. Sabine Hazan gut instinct right now. Okay. So, that was going to be my question, is whether or not you were seeing any commonalities amongst these people. So, the answer clearly is no. Well, I wouldn't say no. There are commonalities that we're seeing, nothing that we can discuss that makes them a golden donor, but there's obviously something if they're improving a disease, right? Right. So, if we use a stool of a person that we believe is a golden donor, you know, and they improve the person, then we're on the right track, right? Okay. But it's nothing that, you know, the American College of Gastroenterologists is going to say, oh, yeah, Dr. Hazan has found the golden donors. No. I mean, it needs to be, you know, all research needs to be valid, verified, and reproducible. That's it. So, it needs to be a consensus amongst the doctors to say, you know what? She's right. She figured out what a golden donor is. So, as it stands right now, then, how are you identifying these donors? My ways. I have my ways. So, that's a trade secret. Okay. We won't go there. All right. Yes. In your book... This sign in my door that says no need to hack our computers. Everything is in Dr. Hazan's brain. Okay. He's in her brain for now. All right. Now, in your book, you discuss the possibility of setting up stool banks just as we have blood banks because, you know, when it gets to the point where we can identify these donors, that's a great idea because then you've got this supply that you can be donating to people who are having issues. How would you see those stool banks working and what would be the challenges in setting them up? Well, there are stool banks right now. University of Minnesota has a stool bank. Has a stool bank. Mayo Clinic has a stool bank. So, you know, they're doing a good job with that. Some pharmaceutical companies have a stool bank. My vision is really stool bank of what I believe is the golden donor, but we're not there yet to kind of describe the golden donor. (40:42 - 41:50) But essentially, I think as we become more and more confident that this is what a golden donor looks like for this disease, then possibly, yeah, stool banks around the world. That's vision into the future. Okay. Now, this is going to seem almost tangential, but I don't think it is. You told a really interesting story in your book about your pregnancies, food you were craving, and then your children ended up having those cravings as well. Right. Yeah. So, that was fascinating and I think that's probably a good thing that there's women GI doctors that got pregnant in fellowship and spearheading the microbiome. So, I guess, you know, God wanted a woman to be spearheading that for that direct intuition. I mean, you know, it was an observation. My first child, I was craving vegetables and she only eats, she loves vegetables and only eats vegetables. And my second child, I was eating, you know, I was craving McDonald's, you know, crap food, nachos, and that's what she likes to eat. (41:51 - 43:51) You know, did I crave the microbes my kids were starting to be? You know, is that, am I craving to feed the kids, you know, in utero? Are we, you know, that was an interesting finding. I tend to believe from that finding, I started looking at family portrait, the family microbiome, looking at moms, grandmas, grandchild, to see the similarities in the microbiome and discovered really this family portrait where, you know, when you look at, you know, my oldest kid and my microbiome are identical and we're really identical in our personalities. And then my little one and my husband, you know, are identical in the microbiomes, but also identical in their personalities. You know, I joke because they have this crying gene where they watch a movie and they start tearing, you know, and I'm starting to think that's a microbiome issue. But that was an interesting finding, right? I mean, all that is, all we're doing in the microbiome space really is looking at our own experiences and correlating them with science really and observing. It's all observational at this stage. So that's, that actually raises a really interesting question because we touched on it briefly early in the interview about how genetics plays a role. And you've just outlined this story, which makes it fairly clear. There's a very much a genetic component in passing on that microbiome. So we've got these people who, and as you made an allusion to this earlier, people who eat a perfectly healthy diet. So when we say genetics, it's a passage of genes. When we're talking about passage of microbes, that's not necessarily, it's passage of genetics of microbes. Right. Yes. Yes. Thank you for clarifying that. Yes. So, but based upon your research then, because we've talked about, or you talked about people who, you know, there's the people who eat the kraut diet and yet they're perfectly healthy and have a good microbiome. (43:51 - 45:46) There's people who eat a really healthy diet and they're sick and their microbiome is sick. How much of that do you think is that genetic passage of the microbiome from future, from past generations? That's a good question. I don't know, but you know, it's something to be explored. It's something to definitely look into. You know, are we passing our resilience in our genetics? Right. So think about the mom, you know, and I was saying that today on somewhere else, you know, think about my microbiome is essentially light and comfortable with Mediterranean food. Right. So I love tzatziki, you know, is that tzatziki something that was, you know, part of my genetics, part of my ancestors, right? Is that something they were eating? I'm one third Greek from what I'm told by 23andMe, if you believe it. You know, am I craving the foods of my ancestors and is that making me feel content? Right. Now I go to Venezuela and I'm eating arepas and I can't tolerate them. My gut is completely upside down, maybe because I'm not exposed to that. Right. So, you know, when you look at passage of microbes, passage of diet, you know, within a family, when you talk to people, for example, that were Japanese and they moved to Mexico and then essentially they moved to Mexico and they can't tolerate the foods, the tortillas and the corn and all that. Is it because of the fact that they've changed their diets radically from Japan to Mexico? Right. And vice versa, the Mexican that goes to Japan doesn't tolerate it. (45:47 - 48:21) How often have I seen in my GI practice as a gastroenterologist, people that change their diet radically and basically say to me, well, Dr. Eason, you know, I thought I was doing the right thing by eating multigrain bread. And then all of a sudden they have full blown celiac sprout. You know, their small bowel is full of ulcers. They stop the multigrain and they're fine. They're back to normal. Right. So was that something that just was not tolerated? Do we pass on microbes that help absorb certain foods and break down certain foods? No, no. I mean, those are good questions to ask. And that's the future. So I encourage everyone to sponsor or donate to the Microbiome Research Foundation, because that's how we advance. That's how we follow moms with kids. We look at the microbiome of the moms, the microbiome of the kids. We see the differences, we analyze all that, and then we get more answers, you know. So last question, because one thing has become very, very clear in this interview is it is incredibly complex. There is no one size fits all solution. And as you've said, you're probably 20 to 30 years away in the research from really being able to nail this down. But because everyone is different, people can experiment. If they're having health issues, they can start trying to adjust their diets. What would you suggest people should be doing when they try to make these changes? Well, the first thing is probably decreasing stress. I think we don't acknowledge the amount of stress that we are facing every day. We're constantly out, and stress decreased by putting yourself in a better environment. I just had a little girl today who was having diarrhea, bloating. Gorgeous girl, 23 years old, zero bifidobacteria, horrible gut. And she was a welder. That's not the field I would have picked for this girl, you know, because she's breathing in all those metals and all that. So the first thing I did is say, you know, you may want to reconsider career, right? Because obviously something is happening to your microbiome, and your profession is not necessarily good for your microbiome. Now, perhaps for the person that has been family history of welders, right, they've become resilient. (48:21 - 54:57) You hear the case, you've probably heard cases of people that smoke tobacco, and they live to 100, and they used to live on a farm of, you know, tobacco plants, right? And you go, well, how is smoking causing lung cancer? This woman lived to 100 years old, and she had a factory of tobacco plant. Did she become resilient? Did she adapt to the plants in the environment, and therefore never going to get lung cancer? And then you hear of a person who never smoked, and gets lung cancer, and is dead within two months, right? And you go, I don't understand. They never smoked. They weren't next to secondary smokers. How did they get lung cancer, right? So obviously there's a passage. Obviously it's complicating. So one of the things that I tell people is decrease stress, because stress tends to have an effect on our microbiome, whether we like it or not. You know, when you're looking at the media, when you're looking at who's going to run for president, get rid of that. It's not going to change your life. Who's going to be president if you have six months to live, okay? It's just a reality. I mean, great. Yes, get involved politically. Do, be, enact, you know. But if you're sick, and you're heading towards disaster, focus on your health, and focus on your body. It's like, you know, put an oxygen mask first before taking care of someone else, right? On a plane, right? If a plane's crashing, put your oxygen first before putting it on your child. Take care of your gut first, then worry about taking care of the world and the politics, okay? So decrease stress, number one. Number two, try to expose, to not expose yourself to some of the toxins, right? So if you're in an environment where they're spraying toxins or they're spraying pesticides, may not be a good thing in your microbiome if you're trying to improve them. Number three, decrease alcohol. If you're drinking two to three glasses of alcohol, you're essentially sterilizing your gut. What is alcohol? It's a sterilizer. So you're killing your microbiome. Why would you want to do that, right? Number four, drugs. Look at your repertoire of drugs and ask yourself, do I really need this drug? Do I really need this enzyme? Do I really need this? My experience is people overdo it. They listen to these influencers that are basically guiding them the path to sell a product, right? So the new, you know, vitamin on the blog, the new herb on the blog, the new this, the new that, the new probiotic on the gut. And people are so desperate that they try it. But here's the problem. The people that are healthy should not be trying those because the people that are healthy are healthy for a reason. Don't mess what you already have, right? Don't change. It's like, you know, your microbiome, and I'm going to give this analogy. Your microbiome is this pure groups of microbes that are doing exactly what they're supposed to do, okay? And then the more you change them, you'll never go back to what you were at the beginning, right? It's like coloring my hair. I don't remember what color my hair was because I've colored it so many times, right? So there's a point in your life where you say, I'm going to stop the nonsense because I was healthy and I'm going to try to go back to that by doing the foods, the natural foods, the natural drinks, the natural everything. And, you know, expose yourself to good microbes, go on that hike, go breathe the oxygen outside, go outside. One of the biggest mistakes we made during the pandemic was put a mask on everybody and assume that that was healthy. Well, how many microbes are in that mask that I'm breathing constantly of bad microbes that I'm now contaminating? And by the way, my patient has COVID, is breathing on my mask. I take off the mask. I put the mask back. I just touched the virus, right? On the mask. So that whole concept was just ridiculous. I mean, you go outside to breathe microbes, good microbes, so you could be exposed, diversify your microbiome. You don't stay in a bubble, in a box, because here's what happens. You can live in that box and you can live a long time in that box, right? But if you leave the box into the environment, you're affected, right? So think of the person that's living in a sterile environment. And I know a lot of people that are listening to your report right now can really know someone that got sick from going from sterile environment to the Amazon jungle, to India, to Africa, to Zimbabwe, right? So you went from sterile, sterility, to over-diversified microbes. Your body is not able to tolerate that. So it has to be a gradual progression, you know? And here's the thing, when you go from that diverse environment, like India, and you come to America, and all of a sudden you're sterilizing all your microbes, because we do so much here, alcohol, sterilizer, and you're basically back in a spleen. When you go back to India, you're not going to the microbes of India as much because of the sterility. And think about when you go to China, India, Japan, over-packed buses, over-packed trains, people, one on top of the other, markets, exposure to multiple microbes, the herbs that are outside in the market, you're getting microbes, those dry fruits you're eating in the markets, you're getting microbes. So all that can affect a super sterile person. So don't make the mistake of going from super sterile to super diverse, because you might get affected by that. So that's another hint. You know, I like things like sauerkraut. I like things like yogurt, a good homemade yogurt. (54:57 - 55:10) I like things like preserved lemons. It's in my book, you know, for those of you. There's a few recipes. I love fennel. Fennel is a great food. I love foods that are underground and on trees. (55:10 - 58:52) I like foods with skin. You know, that's basically the things that I would say to be healthy. And then positive attitude. See the light, don't see darkness. Don't focus on the fear. Focus on faith to give you, to remove you from fear. You know, there's a role for prayers. There's a role for meditation. There's a role for yoga. All that is in tune yourself with, with yourself really, because at the end of the day, you come alone and you leave alone. So you have to really get to know who you are. You have to feel your body so that you can heal. And, and you have to feel that healing and you have to accept that healing and, and you have to be open minded to it. If you poo-poo things, poo-poo this, poo-poo that, you're never going to heal. And if you jump ship from one doctor to another, to another, you're never going to heal. You got to find that person that you have a relationship with that understands you, that understands who you are as a patient, understands you don't like to eat meat because you're vegan, because you don't like the cruelty of animals. Therefore, you need to have that doctor that works with you on that, with that diet, not saying vegan is the way I'm just saying, if you have certain beliefs, I would never tell a vegan person who basically, you know, doesn't like killing animals to start eating meat because that whole stress for them of eating meat would kill them, right? So vice versa, a person that eats carnivore and doesn't want to eat vegetarian or vegan, you got to work with that. Ultimately, at the end of the day, it's all about freedom of choice. We make choices. We make choices on what we put in our mouths. We make choices. Do we want to lose weight the natural way? Or do we want to take an injection of ozempic to lose the weight? Knowing that there are risks with ozempic down the road that we don't know we haven't intercepted yet. So, you know, the best advice I can give people is do your homework, be your own scientist. If you're going to experiment on yourself, do it, at least testing yourself. You know, call our lab, happy to test the microbiome before and after anything they try. You know, people come to me and say, well, CoQ10 or, you know, what does that do on the microbiome? I don't know, but we need to look at it. So if you want to be the N of one, let's look at it, right? We certainly showed data with vitamin C improving the bifidobacteria. We certainly showed bovine immunoglobulin improving the bifidobacteria, decreasing bacteroides, increasing firmicutes, decreasing proteobacteria. That was a signature that we noticed, you know, that came from the N of one, N of two. We showed ivermectin increases the bifidobacteria within 24 hours. It started with the N of one. It actually started with me taking ivermectin to see what it does to the microbiome. And then it went up to the N of 20. So do your research, be your own advocate and practice freedom of choice. And that's what I stood for during the pandemic. They don't have all the answers. I'm just analyzing poop, analyzing poop of all sorts of animals and humans randomly. And I stumble on things, right? Break through things here and there. And to me, it's like Christmas, right? It's discovery after discovery. (58:53 - 1:01:29) But here's the thing. I did that. I used my own money for this lab to understand it for me first, right? At the end of the day, I'm not the girl that trusts heavily, you know, a businessman or someone that's selling me something. I need to see it for myself. So, you know, because it's my life. I want whatever choices I make on my body. The day I took ivermectin was a choice that I was okay to do. I said, well, it looks pretty safe. We used to give it to babies with scabies. Let me take it. Let me test, right? So ultimately, as long as you make an informed consent, as long as you, you know, see what you're doing and don't influence others because something worked on you. That's the other thing. People need to stop listening to others. Because the problem is when people come to me and say, well, but this protocol worked for me, I go, congratulations, you're the N of one. Now let's reproduce it, right? Let's see what it did to the microbiome so that I can say, yes, you did something great. That worked, right? But unfortunately, too many people heal for however way they healed, right? And a lot of the healing could be placebo, right? Because we've certainly seen people on placebo-controlled trials improve, right? So there is a placebo effect to healing. Maybe it's spirituality. Maybe it's positive thinking. Whatever it is, that does not necessarily mean that it can translate to everybody healing. And the key is to get everybody healing, or at least the majority of people healing. Dr. Hazen, thank you so much for your time for this interview, for your book, for the research that you've been doing for so long and are continuing to do. I know I'm probably biased because, as I said, I have been a nutrition and natural health, not my entire life, but I, and I'm genuinely not stroking your ego here. I think that the research that you and others are doing in this area is one of the most important areas of research we're doing today, because yes, it could potentially be, once you've unlocked the keys to this, the cure for just about everything that ails us. And I'm looking forward to the day when that happens. So thank you again, folks. The book is Let's Talk Shit, Disease, Digestion, and Fecal Transplants by Dr. Sabine Hazan. You'll find links beneath the interview to the book on both amazon.ca and amazon.com. Dr. Hazan, thank you again. Thank you so much.