Anti-Inflammatory Diet

All health care starts with diet. My recommendations for a healthy diet are here:
Anti-Inflammatory Diet and Lifestyle.
There are over 190 articles on diet, inflammation and disease on this blog
(find topics using search [upper left] or index [lower right]), and
more articles by Prof. Ayers on Suite101 .

Tuesday, August 3, 2010

Why Discuss Mother’s Milk on an Inflammation Blog?

Milk Is Perfectly Adapted for Infant Nutrition/Development
I think that I should explain, if it is not obvious, why I keep bringing up breastfeeding/infant nutrition on this blog about diet, inflammation and disease.  The starting point is that infants need nutrition, protection from disease and continued normal development or they won’t be able to reproduce.  That means that milk is the focal point of a lot of natural selection and absence of the natural functions of milk, e.g. use of formula, would be expected to lead to inflammation and disease, which it does.  Analysis of milk and how formula makes infants susceptible to disease and alters normal development, provides an extreme example of the interactions of diet, gut flora and the immune system.
Since this is World Breastfeeding Week and my wife is an Internationally Board Certified Lactation Consultant, I think that writing a few articles on milk is good for my health.
Milk Provides Complete Nutrition, Controls Gut Flora, Promotes Gut Development -- Formula Doesn’t
I find it amazing that supplements are encouraged for exclusively breastfeeding infants.  It doesn’t make sense to suspect that breast milk is inadequate and why is formula fortified with ingredients at ten to a hundred times the levels in breast milk?  The answer is in the infant gut flora and perhaps in poor maternal nutrition/gut flora.
Mother’s Milk Promotes Normal Infant Gut Flora -- Bifidobacteria
The normal infant gut flora is very simple, Bifidobacteria.  Adults have gut flora composed of hundreds of different species of bacteria and infants have just Bifidobacteria.  The name of the infant bacterium should be familiar if you read labels on yogurt.  Bifidobacteria are common probiotics.  That also explains why the diapers of exclusively breast fed babies smell like yogurt.  
Formula Promotes Adult Gut Flora
One bottle of formula kills the Bifidobacteria and replaces it with adult gut bacteria.  The diapers are forever changed, because the adult gut flora is very persistent.  The presence of the adult gut flora also explains why formula has the high levels of supplements.  The adult gut flora consumes the supplements and leaves only tiny amounts for the infant.  All of the breast milk nutrients go to the baby if only Bifidobacteria is present, but after the adult gut flora are established much higher levels are needed and the infant may still be deficient.  Adult, formula-supported gut flora also digest antibodies and other protective factors in mother’s milk.
Supplement Mothers to Improve Infant Nutrition
Modern mothers are also eating modern diets that produce deficiencies.  Chronic diet-based inflammation leads to a compromised ability to produce vitamin D in sunlight.  Nursing mothers with poor diets may not be transferring enough vitamin D to their nursing babies.  Since formula and the adult gut flora that it stimulates, causes gut inflammation, I suspect that formula fed infants are also compromised in their ability to produce their own vitamin D in sunlight.  It makes more sense to supplement mothers than babies.
Formula Is not Breast Milk, It’s Not Even Close
Formula is cheap to produce, but expensive to buy.  Formula is promoted as the next best substitute for milk from a baby’s own mother, but that isn’t true either.  The next best alternative is mother’s milk from a certified human milk bank.  It is available at a reasonable cost.  Hospitals should know better and provide the only appropriate alternative.  Early formula use dramatically increases healthcare costs.
Formula Lacks the Oligosaccharides Needed to Support only Bifidobacter
Fructose oligosaccharides (FOS) and other short chains of sugars are being promoted to support the growth of beneficial gut flora.  These oligosaccharides do promote the growth of adult gut flora, but not just infant Bifidobacteria.  Formula plus FOS and/or other prebiotic oligosaccharides other than those present in human milk support the growth of bacteria that rob nutrients from and degrade the protective components of breast milk.  If the diaper smells like adult gut flora, then the baby was not fed mother’s milk.
Development of Gut and Brain
The newborn gut and brain are only partially developed.  Mother’s milk is needed to supply growth factors to close and differentiate the gut epithelium, and long chain omega-3 fatty acids for brain growth.  Formula may eventually be supplemented with the needed fatty acids, but the growth factors/hormones present in mother’s milk will not be provided in formula.  Recent studies have shown that hundreds of different genes are activated in gut cells from infants fed either breast milk or formula.  Formula leaves the gut leaky and fails to stimulate the development of the immune system that is dependent on interaction with normal infant gut flora.  These dysfunctions partially explain the increased (10X to 100X) gut and respiratory infections resulting from formula use.  The reduced brain development with formula explains the five point reduction in IQ of formula fed infants.
It’s worldwide breastfeeding week.  Support healthy, non-inflammatory gut flora (infant Bifidobacteria) around the globe!


jamie said...

Thank you so much for the info you provide on this blog. As an exclusively breastfeeding mother, to my now 3rd child, I know how important breastfeeding is. My first child was supplemented with formula, as I did not have a clue (youth...) and had NO support. Thankfully, he only had maybe a handful of formula bottles, and was exclusively breastfed until he was 13 mos after that. However, comparing him to my other 2 children...My daughter breastfed until 28 mos and never had a bottle of anything. My youngest is almost 7 mos and has never had formula and just started solids (paleo-ish) Both are already healthier than my oldest was at this point. My oldest has leaky gut (as do I, an exclusively formula fed infant and then fed a horrible SAD). We both have issues that I am learning to heal. All that to say, thank you. To you for this blog and to your wife for her very important work as an IBCLC. I share your blog posts about infant nutrition with many friends who are scientifically minded and it really is important to them to see the science behind it!

sr said...

Dr Ayers, do you have any thoughts on keratosis pilaris?

Hannah said...

Just discovered this wonderful site, trying to read through all the material! Thank you!
The importance of mother's milk seems like it should be intuitive and obvious, how did we get to a point where we could possibly think that a processed formula is a reasonable substitute? Frightening. The idea that mother's milk is growing more than baby, it's growing a network of bacteria really supports the concept that we should think of the human body as a complex system of micro-organisms rather than one single organism.

I'm wondering are pre-biotics like pectin and inulin destroyed at all by cooking?

@sr- I used to suffer from keratosis pilaris and daily dry skin brushing and very gentle circular massage with washcloth in the shower has completely eradicated it. It will take a couple months but I believe this is the solution. I began doing this shortly before cleaning up my diet and eating high sat fat, low carb so it's difficult to determine if my diet played a role.

Ruth Almon said...

Hi Dr. Ayer,

I discovered your blog recently, and have gone through many of the posts. Lots of interesting material here.

One issue that intriged me is that you seem to be against cutting out foods that one is sensitive to (if I understood correctly from various comments).

Would you consider doing a post on dealing with food that one is sensitive to. I'd like to understand how exactly you would suggest someone reintroduce a food that causes a reaction, and the rational behind it.


Bonnie D. said...

Hello doctor Ayers.

I was just wondering why do you recommend small amount raw vegetables ?

Bonnie D.

Anonymous said...

@sr and Hannah:

I had mild keratosis pilaris on my arms and had tried various cream remedies over the years to no avail. I have never used body brushing. As I transitioned to a paleo style diet with low Omega 6 and no grains and the last two years, however, my kp gradually faded away. I suspect it is the anti-inflammatory properties of the diet that fight this skin problem.

Anonymous said...

Interesting to see this article in The Economist:

Hard to Stomach: A Western Diet Promotes Unhealthy Gut Bacteria in Children

Jason said...

What your thought about whey protein supplements with artificial sweetener like acesulfame potassium?

againstthegrain said...


Thanks for that link. I liked the reader comment from Duccio Cavalieri.

Tanya said...

Couldn't find a post to attach this to, so since this is the most recent one, here it is. I found this while reading Dr Eades blogpost about Protexid, the supplement (melatonin is the key) mixture that he was going to try to market for GERD.

TedHutchinson said...

May I also suggest you consider the possibility (hopefully even before becoming pregnant) of improving 25(OH)D status to around 60ng/ml to ensure breast milk is vitamin d replete.
Circulating 25-Hydroxyvitamin D Levels in Fully Breastfed Infants on Oral Vitamin D Supplementation
This may take as much as 6400iu/daily/D3
Grassrootshealth offer postal testing but so does LEF, The Vitamin D Council and others.

May I also suggest attention is paid to increasing omega 3 intake and lowering intake of industrially made seed oils such as corn, soybean, safflower, sunflower and cottonseed oil.
Stephan shows the recent changes in breast milk omega 3 ~ omega 6 ratio here.
Bear in mind the half life of omega 6 is around 2yrs so reducing high levels is a long term project, however some of the benefits of raising omega 3 status are measurable very quickly.

Krissie said...

Thank you as always for bringing out info that is so important.

For clarification, does the gut flora stay bifido until the child starts eating solids? (Does a bottle of formula do more damage if it is introduced before solids?) or does it not matter when?

Dr. Art Ayers said...

Hi Ted,
As always, thanks for the solid info.

Dr. Art Ayers said...

Solid food also provides a transition of gut flora in an exclusively breastfed baby to adult gut flora. That is why it is recommended not to give infants either solid food or formula for at least six months.

Thanks for the question.

Dr. Art Ayers said...

I never recommend artificial sweeteners, because they are not safe. At the same time, for a brief time, such as using them to make whey shakes palatable for a two week shift in diets, I think it is no big deal.

Thanks for the question.

Dr. Art Ayers said...

Bonnie D.,
I am recommending some raw veggies for both the polysaccharides in the plant material as soluble fiber to feed gut flora, and as a source of bacteria to supplement the gut flora.

Most people with modern diets and excessive hygiene gradually deplete their gut flora and end up with a compromised immune system that leads to autoimmune disease and allergies. What is lacking is a source of diverse bacteria, e.g. raw, modestly dirty veggies. Kids and animals that have been playing in the soil would be other sources of needed bacteria.

Thanks for the question.

Dr. Art Ayers said...

Anon and againstthegrain,
The New York Times article comparing the gut flora from kids in Africa and Italy is very entertaining, but just as expected. Modern urban diets lead to depleted gut flora, whereas subsistence on rural plant materials results in greater complexity in gut flora.

Just as I noted in a previous article about Japanese gut flora adapted to digesting algal polysaccharides, in the African example there were gut bacteria similar to those found in termites to digest other plant polysaccharides. Exclusively breast fed babies from all locations have the same highly simplified gut flora to develop the infant gut. Greater complexity of gut flora was associated with resistance to infant diarrhea. Modern living creates greater gut flora simplicity and greater susceptibility to disease. Formula use does the same thing.

Thanks for your input and comments.

Chris said...

Hello Dr Ayers,

I was never breastfed and out of nowhere developed a high ANA with RNP auto-antibodies in my 30's. Raynaud's is my only symptom.

I know you have suggested raising vitamin D to a very high level.

Do you believe there is considerable benefit going above 50-60 ng/l for me?

Also how much fish oil do you recommend per day.

Suzann said...

I appreciate that you want to spread awareness about breastfeeding. However, what is your solution for women who cannot breastfeed?

My daughter was born 3 months premature and my breast milk did not come in. Despite pumping, supplements, teas, medication, I was left with about 5 oz a day after pumping. Also, she was, of course, not able to breastfeed due to her medical condition and this also affected my supply.

While I really wanted to do what I thought was best (breastfeed), it was not possible for me. At the time I looked for other options, but the milk we found from other mothers through some lab was just too expensive. I think some help should be given to those mothers and breastfeeding advocates should recognize that this will not work for everyone for various reasons.

Anonymous said...


You're case is different, but most mothers who find they "can't" breastfeed, are just a product of not being given the proper conditions and right advice. This article explains the situation beautifully.

Anna said...


Great article at that link you provided, with very good suggestions for what we all can do to make the US a more breastfeeding-friendly place.

I visited my SIL in Norway not long after one of her sons was born and wow, what a family-friendly place - not only do employed mothers have maternity leave, but fathers can take a month to be with the baby, too. Breastfeeding is the norm in Norway. I don't see the US going quite that far, but a shift in that direction would have immense benefits on American children's well-being and health stats.

John said...

Dr Ayers,

Where do chemicals/pesticides/organic-types fit into your recommendations to eat small amounts of raw vegetables?

Dr. Art Ayers said...

I recommend eating lots of veggies, but at least some of them raw to provide a source of gut bacteria.

I don't think that environmental contaminants are as big a deal as diet-based chronic inflammation and simplified gut flora. I think that in the absence of inflammation, the toxic stuff in our environment, as well as most genetic predispositions to disease would not result in disease.

Thanks for the question.

Asim said...

Dr. Ayers,

I am a new reader to your blog and enjoy it. I have one question and another request for some advice:


Fruits are high in fructose, yet I have read that they are anti-inflammatory. WHat exactly is the deal, considering that most people, including yourself, argue that fructrose is inflammatory? The following blog considers them bad, but speaks nothing of the research regarding fruits lowering inflammation:


As a Muslim, I fast during Ramadan. We take a pre-dawn meal and break our fast at sunset. COnsidering the meal intake, what would be your advice regarding the types of food to take during this time to reduce hunger and crankiness throughout the day, as well as provide the greatest amoutns of nutrients?

Dr. Art Ayers said...

Fruits contain fructose, starch and phytochemicals.

Fructose is metabolized in the liver as alcohol and has the same negative consequences. It is very inflammatory and therefore fruit consumption, especially juices, should be minimized.

Starch is the quickest source of blood sugar and the biggest contributor to insulin stimulation. Starchy foods, such as bananas, grains, breads, rice, potatoes, pasta, etc. are quickly converted by enzymes into glucose. Dietary starch results in a rapid rise and fall of blood sugar, leading to hunger.

Fruit phytochemicals are often categorized as antioxidants, but must function more specifically on different parts of the gut, gut flora and organs. An example is aspirin, which is a natural plant product that acts on dozens of different enzymes through out the body.

During Ramadan, when muslim hosts have been fasting, I just follow the low carb diet that I recommend on this blog. The high fat content and very low starch/sugar give me plenty of energy during the day, without hunger, and provide for a satisfying break of the fast and sunset. I would recommend adjusting to the diet prior to the intermittent fasting.

I hope that this is helpful. Let me know.

v said...

hi! sorry for this off topic post. i am anemic and i have h.pylori. 2 years ago i was put on triple antibiotics for it and told to take iron supplements. they did a blood test for the h.pylori after the antibiotics and it was '4'. it had been 1 before the medicine. were the iron supplements responsible for the higher number, or is that number meaningless since i've read i need to be tested with a breath test after antibiotic treatment?

also, 2 years later, my ferritin is 5, my h.pylori is around 1 and my c-reactive protein in 0.18 (hope you are familiar with the units and reference ranges). the c-reactive protein test shows i have low body-wide inflammation. should i therefore not worry about the h.pylori? my main problem with this bacteria is that my gi doctor thought my ferritin was so low because of the h.pylori. so if i get rid of it, my ferritin will go up. any thoughts? thx!!!!

Dr. Art Ayers said...

I think that most people get plenty of iron in their diets, but iron absorption is the problem. Women need more than men.

Hp would be a problem only if ulcers develop. I think that ulcers develop as a result of disruption of gut flora by dietary problems. Hp with a diet should not be a problem. The diet that I recommend should be fine to resolve the iron problem with or without Hp, as long as you work on getting your gut flora to recover after the intense antibiotic treatment.

The antibiotics wiped out your gut flora and may have disturbed some of your gut absorption. Start with probiotics, yogurt with live bacteria, and add soluble fiber.

The diet and reestablishing your gut flora should fix the anemia as well as osteoporosis. You should also check your blood vit.D level and increase your exercise.

Let me know what happens.

Asim said...

Thanks Dr. Ayers!

v said...

hi again dr. ayers. i have been following a diet like the one you recommend since august of last year. i went from 143 to 129. i'm holding pretty steady at this weight. the thing is when i got my bloodwork done this past april, my ferritin was still a 5 and my hemoglobin actually went down. it may be a lab error, or part of it may be that i had the blood drawn soon after my period was over. so i'm awaiting new blood work results that will be arriving in the next couple of days. i mad sure i had blood drawn right before my period started. i'm having stuff tested like thyroid hormones, ferritin b12, folic acid, potassium, magnesium, etc. i eat healthy food, so if the non-iron nutrient values are low- that means i definitely have an absorption problem, no? if the nutrient values are good, but the ferritin is low, it may have something to do with bleeding too much during my period (although my blood flow has been reduced on this diet) or maybe something to do with my thyroid be out of kilter- how's that for scientific precision!!! anyway, i'm looking forward to getting the results and trying to put the puzzle pieces together. thanks for your answer.

Claire said...

Hi there, I have asked you questions previously relating to relapsing polychondritis and my diet. I have read your posts on antibiotics and am curious for your opinion on Antibiotic Protocol for connective tissue disease as made popular by Thomas Mcpherson- Brown and Henry Scammell (and more recently Mercola). The website is dedicated to educating about his. As I understand the therapy is 100mg of Minocycline (Minocin) twice a day (I think that is quite a low dose?) for a long period. It looks pretty good in supporting the theory that infectious disease may cause some auto immune conditions, esp connective tissue ones.

What do you think?



Tim said...

Not getting the growth factors from baby formula must be a major contributor for milk allergies in children, right?

But I guess even breastfed babies can get milk allergies? At what age is it safe to introduce cow's milk to a breastfed baby?

If a baby gets formula, what foods could one give the child (when it's one year or older) to promote closing of the gut epithelium?

v said...

Dr. Ayers,

What are the signs that you have healthy gut bacteria?

I'm guessing a good c-reactive protein number showing a very low-level or no level of inflammation, good bowel movements, the absence of heartburn, etc..

any other signs? sorry if you have already discussed this.

Dr. Art Ayers said...

The signs of a healthy gut flora are consistent with bacteria that can convert soluble plant fiber into the bacteria that form the hydrated solids of stools and provide stimulus for the development of the GALT, Th17 and Tregs:
normal bowel movements (no constipation),
no food intolerances,
lack of symptoms of chronic inflammation -- allergies, autoimmune diseases, acne, depression,
absence of gut symptoms -- bloat, gas, etc.

Thanks for the questions.

Anonymous said...

Hi Dr. Ayers,

from Peter’s Blog ( I‘ve known that two of the exponents of the Optimal Diet community recently have died of cancer.

Adam Jany, President of OSBO (Optimal Association), 64 y.o., after 17 years of “optimal diet”, has died of gastric cancer.

Karol Braniek, the second prominent figure of the Polish OD community has died for gastro-intestinal issues last year at the age of 68. Presumably from duodenum cancer.

I’ve read somewhere (but the article was in Polish, translated in English by Google...)
that these are not the only cases of gastric cancer in the Polish Optimal Association.

The impression we get is that there's rather high occurrence of gastrointestinal cancer.

Higher chances of dying from gastric cancer in your sixties, obviously, is not too encouraging for Optimal Diet followers.

However Poland has a high incidence of gastric cancer so the problem may NOT be diet related...

Do you see any relationship with VERY HIGH fat diets?

The news of these deaths has striked me so much because I though high fat (saturated) diet to be somehow protective. Maybe I’m wrong...

Anna said...


I read Peter's Hyperlipid blog, too. I don't follow the OD in particular, but I do eat a high fat, LC, mostly-primal diet that has some similarities to the OD (I don't avoid leafy plants and I don't calculate my protein intake). Frankly, the news of the recent OD follower's deaths due to cancer don't concern me very much.

I'm not an expert on Poland or Polish food by any stretch, but I did spend some time in Poland in Spring 2010, hosted by friends and colleagues of my husband (research scientists). I know this isn't very scientific, but I find it hard to attribute the OD diet to the gastric cancer after observing the general Polish diet (and trying to experience traditional Polish cuisine whenever possible).

Anonymous said...

my question to Dr. Ayers about the possible relationship between gastric cancer incidence and HIGH fat diets bases on the common association between animal fat intake and this type of cancer.


("In conclusion, although GC is a disease of genes,
mainly triggered by H pylori-related mucosal inflammation,
overwhelming evidence suggest that diet and lifestyle
factors are important causes leading to cancer...
At present, even if foods and food components acting as risk or protective factors for GC still remain to be fully
defined, a diet rich in FRUIT, VEGETABLES and CEREALS and poor
in meat, fat and salt has a good prophylactic potential for
cancer and many other chronic diseases of lifestyle i.e.
coronary heart disease, hypertension, obesity and diabetes.").

Uhm... how much fruit, vegetables and cereals do you eat when on Jan Kwasniewski's "Optimal Diet"?

And how much meat, fat and salt?

Bonnie D. said...

Thank you for your answer. I have one more question though.

Would eating dirt (from a home garden) be as efficient as eating raw vegetables ? I presume the bacteria is only on the outer skin of the vegetables so eating whole isn't really necessary and can be replaced by dirt ?

Thank you in advance,

Bonnie D.

sr said...

I'm not too familiar with the Optimal Diet, but were they making bacon or other cured meats staples? The nitrosamines, rather than fats, could have caused cancer. And with n=2 there might not be a need to look for a cause anyway.

Anonymous said...

Your suggestions are fascinating as always.

After reading your suggestions, I've made a few salads with unwashed, organic veggies (just wiped the dust off).

I understand this is to introduce new bacteria to the gut. So how many times would you suggest one eat a particular vegetable or fruit, tomatoes, let's say, before one can assume that the bacteria that like to hang out on the tomatoes are now part of the gut flora?

Is this something one should do every once in a while over the years? Or simply give up washing veggies forever?

I assume it's important to eat a wide variety of unwashed veggies?

Thanks, R

Dr. Art Ayers said...

Gastric Cancer and the Optimal Diet,
Gastric cancer stands out as primarily caused by H. pylori. Antibiotic treatment lowers the incidence of stomach infections by H. pylori and lowers stomach cancer.

Cancers develop over a long period of time and therefore dying of stomach cancer reflects a distant history of H. pylori infection and other dietary problems. Many people switch to healthy diets in response to digestive problems. The new diet may solve many of the problems, but leave the lasting damage. Cancer is a disease of inflammation.

My impression is that the Optimal Diet doesn't explicitly cultivate gut flora and tend to the immune system. Thus, it avoids many sources of inflammation, but doesn't support the immune suppression of inflammation, autoimmunity and cancer.

So, I would be surprised if someone died young from cancer after living their whole life on the Optimal Diet, but I would expect that cancer deaths would not be uncommon for those who switched to OD as adults.

I don't think that a high fat diet is related to cancer. I think that the saturated fat is safe, but the polyunsaturated fats are a problem. High carbs also contribute. I don't think that environmental carcinogens are major contributors to cancer and I also doubt that there are major genetic contributions to predispositions to cancer. There are obvious exceptions, but even in those cases the diet is still the primary determinant.

So, I don't worry about OD contributing to cancer. The typical modern diet is far, far worse.

Thanks for all of the discussion.

Steve_P said...

Great blog. I don't know if you've seen the report of an individual who treated his asthma by supplementing with probiotics, but it seems to be consistent with some of your theories:

varg said...

Dr Art Ayers,

Thanks for your comments regarding the OD. I'm a swedish ODer trying to follow a modern kind of OD, that is with PUFA avoidence, not so much sausages and bacon etc. After finding your blog, I'm thinking about adding maybe a banana a day and some onions for the cultivation of healthy gut flora. Have never really had a problem with digestion, but I do notice that stools take along time to develop with this diet, up to 3 days. Maybe faster stools could be beneficial?

Claire said...

~~~~Sorry for repeating this! Just anxious as I have to see my consultant tomorrow and wanted another opinion of this, thanks~~~~

Hi there, I have asked you questions previously relating to relapsing polychondritis and my diet. I have read your posts on antibiotics and am curious for your opinion on Antibiotic Protocol for connective tissue disease as made popular by Thomas Mcpherson- Brown and Henry Scammell (and more recently Mercola). The website is dedicated to educating about his. As I understand the therapy is 100mg of Minocycline (Minocin) twice a day (I think that is quite a low dose?) for a long period. It looks pretty good in supporting the theory that infectious disease may cause some auto immune conditions, esp connective tissue ones.

What do you think?



Dr. Art Ayers said...

Sorry that I haven't been more responsive lately.

I suspect that all connective tissue diseases are inflammation/autoimmune-based. That implicates the GALT and the gut flora that activate development of Th17 and Tregs. Some of my readers have also brought the remission of diseases such as rosacea by cancer chemotherapy to my attention. I view rosacea as a potential case of cryptic bacteria similar to the hypotheses of bacterial involvement in connective tissue diseases.

I think that bacteria will always migrate from a leaky gut (e.g. NSAIDs) to sites of inflammation. Bacterial endotoxin/LPS will modulate inflammation by TLRs throughout the body and intestines. So bacteria will be involved in any inflammatory disease. Th17 cells will be involved in attacking bacteria and signalling inflammation in response to bacteria, but they will also be a major target of antibiotics, since the antibiotics will wipe out the gut bacteria needed to produce Th17 in the GALT. Unfortunately, the antibiotics will also wipe out Tregs that are the actual cure for autoimmune disorders.

The bottom line is that antibiotics probably act via the gut and wipe out part of the immune system that produces symptoms in connective tissue disease. I doubt that bacteria in tissue, i.e. cryptic bacteria, are a big part of the problem. Thus, my prejudice is that antibiotic treatments will relieve symptoms, but will contribute to more problems via a still more compromised immune system.

Thanks for the questions.

Anonymous said...

What about the unwashed vegetables? How long and how often?

Claire said...

Dr A thank you so much, appreciate your time and response, interesting as always and much food for thought.

How does one 'up' the pro inflammatory Tregs? I am guessing it all relates back to gut health.....


Anonymous said...

Hi Dr. Ayers,
I was thinking to the possible sources of pectin and I was wondering if it'd be good to centrifuge peeled apples, discard the juice (to limit fructose intake)and eat the soluble fiber.


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I found your website and wanted to ask, please, for that added the link to my blog for disclosure in order to be partners.
Already added your on my list of partners, ok?
My blog is about technology, science and health:
Thanks Doctor!

Stipetic said...

What is your take on scalding breast milk for storage? How does this affect gut flora?

Dr. Art Ayers said...

I can see no reason to treat breastmilk prior to storage. All that would do is decrease maternal lymphocytes and denature protective enzymes. Any contaminating bacteria, fungi or viruses will decrease over time as the defensive components of the milk kill the microorganisms. Heat treatment is counterproductive.

Raw cow's milk is used to treat pruning equipment in orchards to prevent spread of disease. Traditional walking on hot coals is terminated by walking into milk.

Pasteurization of breast milk is only used in milk banks and makes no sense for individual use.

Scalding should only reduce the effectiveness of breastmilk to maintain a monoculture of bacteria in the gut.

Thanks for the question.

Stipetic said...

That might explain the colic we saw in our solely breastfed baby. The recommendation to scald milk (stopping when the temperature reaches 82-83 degrees) is apparently to inactivate the lipase enzyme to stop the milk from going rancid. Thanks for the info. I wish I found your website a few months ago and could have advised my wife about this. Now, if only I can convince her of dropping the formula to supplement the breast milk!

Dr. Art Ayers said...

My wife, a lactation consultant, reminded me a little earlier today, that scalding is sometimes recommended for babies who apparently reject stored breastmilk because of flavor. The culprit in that case might be the lipase acting on milk lipids to release free fatty acids, that taste soapy.

Colic is caused by other problems, e.g. cow sialic acids transferred into breastmilk. Problems with gut flora should not occur if the baby is exclusively breastfed, because their should only be one bacterium, Bifidobacteria sp., that protects the baby gut from other bacteria.

Thanks for the comment.

Stipetic said...

Good info. Thanks.

JohnN said...

Dr. Ayers,
On eating unwashed produce and/or garden dirt: be aware of the nasty roundworm - Bayliscaris procyonis. Where raccoons are known to frequent there is high probability that B. procyonis eggs are also present in the soil. For human the resultant infection by swallowing the eggs is deadly.
Interested readers may refer to Rosemary Drisdelle's excellent book, Parasites - Tales of Humanity's Most Unwelcome Guests, for more detail.

To cultivate a healthy population of gut microbiota an alternative approach may be as simple as first starving the existing overgrown bacteria population by periodic fasting concurrent with high fat and low fiber diet before reintroducing probiotics and fibers from produce. The appendix can provide samples to reseed the intestinal garden.

Dr. Art Ayers said...

That is wise counsel. I have hesitated to recommend that people eat soil, simply because of the potential for pathogens and parasites.

As you indicate, the appendix normally provides a source of replacement bacteria to restart the gut flora after diarrhea. Unfortunately, people who have been treated with antibiotics seem to have also compromised their appendix starter culture. In rats, a pretreatment with antibiotics alters the gut flora even after subsequent fecal transplants.

I think that a wise approach to safely establish gut flora is still lacking, since probiotics only provide a tiny fraction of the 100+ bacterial species needed and established biofilms, which may be corrupted, provide a lasting source of synthetic bacterial species.

Thanks for your input.

Anonymous said...

Dr. Ayers,

Many of your readers seem to be adults concerned with preventing or halting various age-related illnesses. BUT what if we have a child who has already suffered through a complete failure of her immune system AND must remain immune suppressed?

I found your fascinating blog when searching for possible developmental side effects of Rapamycin-my daughter’s current anti-rejection drug.
Rapa was recently in the news due to its ability to prolong the life of lab animals reared in a sterile environment. However, its effects on a child don’t sound positive to me

Medical History
-Breast fed for 2 years and 5 months
- full term birth by C-section, due to breach position
-at 4 yrs and 2 months diagnosed with acute liver failure
-viral cause suspected but not confirmed
- 2 weeks later diagnosed with non familial hemophagocytic lymphohistiocytosis (HLH), confined to liver, Dexamethasone started that evening
-one day later received partial liver from me, her mother
-Tacrolimus, prednisone and some other stuff like anti-thymoglobulin as well as ganciclovir and Cytogam.
-Suffered a great deal of muscle atrophy and severe insomnia –apparently this was not expected. We are convinced that this was due to one month of Dexamethasone
-After 2 months she was regaining her strength but was hospitalized two more times and eventually diagnosed with PTLD (post transplant lymphoproliferative disorder) which of course coincided with her becoming sero-positive for EBV.

-PTLD lesions found through out bowel-2 enlarged lymph nodes actually causing intussusceptions and nodules both in liver and spleen
- foscarnet given for almost 2 weeks and was successful in getting her viral count to nil.
-6 cycles of cyclophosphamide/prednisone and rituximab.

It has been 6 months since the chemo ended to treat PTLD and she began Rapamycin as anti-rejection drug due to its” anti-tumour properties” I am quoting her oncologist
- neutrophil counts are low but seem to climb to normal during infection

Numerous liver and bowel biopsies post liver TX during first 3 months and during diagnosis of PTLD
Extensive tooth decay noted one month into chemo despite good oral hygiene
1 month ago strep A throat infection-amoxicillin

Now 15 months post liver tx
Current skin infection initially treated as yeast but 4 days ago identified by culture as Strep A skin infection-currently on 4th day of 7 day amoxicillin.

Current drugs: Rapamycin and above
Supplements ½ tsp Nutra sea fish oil, Vit D drops 1000 iu, Tums for calcium, mulit-vitamins and just restarted Proferrin every other day for low iron reserves.

I know that there are significant side-effects to anti-rejection drugs and indeed my daughter has already dealt with one of the most serious –cancer.
Can anything be done to reduce the negative side effect of Rapa?

Can diabetes type 1 be prevented in this situation?

Are drugs like CP-690,550, that from my understanding, have a more precise immune suppressing mechanism the only hope?

How can I reduce the risk of opportunistic infections?

She eats small portions of grains but at times snacks on salty crackers. She has always craved things like olives (not pickled) and eats them for breakfast. Rarely drinks milk. Eats some cheese and yogurt. We use only organic butter and olive oil and I am close to sourcing a grass-only fed beef. How much yogurt does she need to eat to get the good bacteria? She will drink a protein shake with berries/ banana that I can add some to.
I can use unsweetened yogurt but should I stop giving her sweetened ones for occasional snacks?

Besides adding a Vit C and perhaps increasing her Vit D drops (with permission of Drs) do you have any recommendations?

My apologies for the length of post. have found very little info specific to this situation. Her caregivers are wonderful but I want to give her the best.

Thank you

Anonymous said...

Any comments on this Dr. Ayers ?

We tested whether a high-fat diet (HFD) impairs the survival of probiotics in mice. In Expt. 1, after feeding either a HFD (62.7% energy) or a normal-fat diet (NFD; 11.1% energy) for 2 d, C57BL/6 mice were i.g. administered Lactobacillus plantarum No. 14. Fecal recovery of viable L. plantarum was significantly decreased 99% by the HFD compared with the NFD. Total bile acid concentrations in the small intestine and cecum were significantly higher (1.5- and 2.2-fold of NFD, respectively) in mice fed HFD than in those fed NFD. Cholic acid and deoxycholic acid significantly reduced the viability of L. plantarum No. 14 in culture experiments. In Expt. 2, after feeding HFD for 2 d, simultaneous administration of inulin (10 mg) with L. plantarum No. 14 significantly increased (100-fold of that without inulin) the fecal recovery of viable L. plantarum. Inulin administration did not alter intestinal bile acid concentrations. In Expt. 3, after feeding HFD for 2 d, mice were i.g. administered either inulin (10 mg) or vehicle and, after 6 h, cecal contents were subjected to culture experiments. Growth of L. plantarum No. 14 was significantly higher in the cecal contents of inulin-administered mice than vehicle-administered mice. Inulin supplementation to cecal contents of vehicle-administered mice significantly enhanced the growth of L. plantarum No. 14. We propose that HFD impairs the survival of probiotics in the gut due to increased bile acid stress and that simultaneous administration of inulin prolongs the survival of probiotics in mice fed HFD.

Anonymous said...

Title too:

J Nutr. 2010 Sep 8. [Epub ahead of print]
Inulin Prolongs Survival of Intragastrically Administered Lactobacillus plantarum No. 14 in the Gut of Mice Fed A High-Fat Diet.
Takemura N, Hagio M, Ishizuka S, Ito H, Morita T, Sonoyama K.

Graduate School of Life Science, Hokkaido University, Sapporo 060-8589, Japan.

Dave said...

Hey Dr. Ayers,
Quick question, which hopefully just warrants a quick answer. My only symptom is that I get these loud stomach noises/rumbling/gurgles, I think the medical term is borborygmi. They are not associated with hunger, often occurring just after I have eaten.

I have used Accutane and some antibiotics in the past. They are probably caused by gas/liquids getting squashed in the gut.
I don't suffer from excess gas, so maybe it is an issue of gut function and not fermentation.

Any thoughts as to what might be causing them?

Anonymous said...

Interesting study re bees foraging with their gut:

John said...

What is your opinion of Saccharomyces boulardii (brand name Florastor) which is a yeast based probiotic. Ny daughter has been on multiple courses of antibiotics for ear infections, and our pediatrition recommended this as it is supposedly not killed by antibiotic therapy, but I wondered if it was benificial since it is not a bacteria?

Dr. Art Ayers said...

I don't think that any type of probiotic can fully compensate for antibiotic treatments. Antibiotics are very severe treatments with many residual effects and should not be used on children, except in emergencies. Ear infections are not emergencies. It has been estimated that use of antibiotics for ear infections is responsible for most subsequent visits of children to pediatricians. In other words, pediatricians, perhaps unwittingly, use antibiotics to increase their patient morbidity and expand their practices.

I have three grown daughters. Each has had ear infections and all have been treated with simple treatments for inflammation/swelling. My personal estimation is that even the most severe complication of an ear infection (rupture of the ear drum, which usually resolves without complications), is not as damaging to long term health as the consequences of the casual use of antibiotics.

My point is that the impact of typical conditions that result in pediatric use of antibiotics is minimal, even if untreated, and the consequences of typical use of antibiotics are much more severe and long term.

I think that antibiotics should not be considered unless provision is made for a subsequent replacement of damaged gut flora with a fecal transplant. Use of probiotics is mostly cosmetic, and does not repair the loss of hundreds of species of gut bacteria killed by the antibiotics. Many of these species are permanently lost, but are needed for normal immune system function.

Fortunately, the human body and its gut flora are very resilient and can eventually restructure and heal after major trauma, such as surgery or use of antibiotics. In most cases, however, insufficient attention is spent on regaining function and the result is chronic constipation, food intolerances, allergies and autoimmune diseases.

I make these strong statements for clarity, because most people, including physicians use antibiotics casually, as they do major abdominal surgery, e.g. Caesarian sections. There is a great deal that can be done with diet to reduce the impact of antibiotics. Please read my other articles.

Thank you for your questions.

Medjoub said...

This is very interesting/horrifying. I've read most of your articles, but that was the most concise and clear statement on the subject I've yet read. You mention that some species of bacteria are permanently lost, but that the human body is resilient. Speculatively, to what *extent* do think can bacteria be recovered if antibiotics are not used further? In other words, can we who have used some antibiotics actually ever return to *fully* functional immunity, or are the dietary measures just partial until doctors wise up?

Your insight on this and other subjects is very profound and I believe I speak for most of your readers in saying it can also be illuminating and shocking. Many of us would like to restore full health and are struggling to do so on a daily basis. We appreciate all the time and shared wisdom you give without apparent reward. Thank you.

Anna said...

John's question brings to mind an issue I am currently struggling with. My nearly 12 yo (uncircumcised) son seems to be prone to UTIs, unusual for boys. He recently had the 3rd UTI (the first two were 2-4 years ago. As it was a holiday weekend he was seen at Urgent Care and prescribed Keflex/cephalexin for 10 days (urine culture later indicated the expected e. coli).

Of course, I'm not happy about giving him antibiotics, but with his history of UTIs I'm left scratching my head wondering how else to treat the infection safely and why he is getting them in the first place (the first one definitely involved dehydration, not sure about the second, and this last one might be due to dehydration, but I also suspect a lot of his pocket money is being spent on sugary junk at the local 7-Eleven). I am somewhat reluctant to even broach the subject with our current Family Medicine primary care doctor, as I know he only can recommend the standard protocol - treating with antibiotics and I already butt heads with him about other stuff (and so far, he is still the best I've found in our manage care plan options).

After the second UTI a few years back, the pediatrician who used to see my son ordered a VCG imaging test, which indicated reflux of the contrast fluid into one kidney (I wonder about the validity of the test, though, as a LOT of fluid is introduced into the bladder and could that result in such an supranormal amount of pressure upon urination that might never occur with normal urination?). There was so much fluid in him he peed repeatedly for hours after the test.

Of course, the standard protocol for kidney reflux in kids is make sure the urine stays sterile by taking low dose antibiotics for a year and to later repeat the test, and hoping the child grows out of the reflux.

After discussing the recommended treatment with my husband we called the pediatrician back and said while we certainly didn't want to jeopardize our son's kidney, we had concerns about the prophylactic antibiotic protocol and instead suggested routine urine tests to be sure his urine remained sterile. We haven't repeated the VCG, though.

Do you have any thoughts on this situation and what I should do/not do about it? I don't know of another way to treat a full-blown UTI without antibiotics of some sort (as the culture later indicated e. coli, perhaps Macrodantin/nitrofurantoin would be a better option if another UTI develops. I don't want to give my child unnecessary antibiotics, but at the same time I don't want to risk a scarred kidney.

Anna said...

In case it isn't clear, he IS taking the Kelfex for the current UTI (almost done with it) and the VCG test was done a few years ago.

At this point I know I need to do what I can to restore his gut bacteria.

What I wonder about is what else can I do if he gets another UTI and why it might be (besides anatomical factors beyond my control ) that make him susceptible to UTIs?

TedHutchinson said...

Antimicrobial Peptides, Innate Immunity, and the Normally Sterile Urinary Tract

Michael Zasloff

Because my bladder does not communicate with my brain I have to self-catheterise every 4hrs so was prone to UTI. Only since keeping my 25(OH)D around 60ng/ml have I seen a reduction in UTI.
Grassrootshealth offer postal testing

Anna said...

Thanks for the comment, Ted. That's worth looking into. I have the family's mail-in test kits here already so this is good reminder to just get them done. The past few years typically my son maintains a Vit D level at least 50 ng/mL, but he grew a lot recently and he didn't take Vit D supplements as regularly this past summer. Also we had a prolonged gray coastal marine layer pattern blocking the sun for most days in July, though he had two weeks of Junior Lifeguards at the beach in August and lots of sun exposure then. School started a few weeks ago so he's indoors a lot again. It's very possible his Vit D level has dropped quite a bit since the last test.

He'll be 12 yoa in a couple weeks and it's a challenging time for both of us. His growing independence sometimes clashes with my efforts to influence his health, which is normal of course, but requires a lot of effort at patience to achieve a good balance.

When he brought the UTI symptoms to my attention, he volunteered that his recent exploration with sugary convenience store junk food might be a potential factor. He must remember me mentioning in my 20s and early 30s when I was eating high carb I was also very prone to frequent UTIs; when I adopted a LC diet for good I never had another UTI.

Tanya said...


I am self-medicating with high doses of vitamin C (like 3000 mg per hour is my goal but it has been every couple hrs...) and d-mannose for my's my second in ? months (I can't recall the last one) Don't know why it is bothering, but it is. Also read that high dose/titrate to tolerance of Vit C increases efficacy of the net, it's out there. Interesting to note, I think I took a total of 7 doses, 21000 mg yesterday and never got diarhhea...which is consistent with body fighting an infection.

Anonymous said...

I was plagued by UTIs until I got my vitamin D level up to 80 ng/ml. Now I get none at all.

Iosol iodine worked brilliantly for getting rid of those UTIs. 12 drops for the first dose then 6 drops every 6 hours for the next few days. The relief from the first dose came quickly, in less than an hour.

Tanya said...

Thanks for the iodine tip. I have some iodine pills...would that be the same? Will research that. And the Vit D posts rang a bell for me. I couldn't figure out why I got a UTI...but I have recently cut back my Vit D because have been taking 15K units a day for a few months now...but haven't gotten around to getting another lab test. Perhaps it was not as high as I thought it was...

Anonymous said...

Tanya, it is my understanding the the free, unbound ioDINE in Iosol is what kills bacteria. Most other supplements have the iodine bound up in ioDIDE, like potassium iodide or sodium iodide, and are not as effective.

I too had a recurrence of UTIs when I cut back my Vitamin D dosage, that was when it hit me that it was the Vitamin D that was keeping UTIs at bay.

Tanya said...

I got some liquid iodine today...not the same brand but what i can find here. Upped my D again. Started GSE when UTI started as is is antifungal, antibacterial, etc. Had already been taking olive leaf extract for antifungal...we'll see how it goes. Thanks again.

Anna said...

Dr. Ayers, I hope you don't mind, but this does pertain to the importance of breastfeeding in yet another way.

Just want to alert any readers who are in the greater LA/So California region in late October about a seminar being presented at the annual symposium of the International Association for Facial Growth Guidance. Dr. Brian Palmer, an expert in proper oral posture development (breastfeeding being a crucial element for good facial growth and development) is presenting a seminar that while aimed at dentists, orthodontists, and other oral health professionals, is open to the public, so that parents and parents-to-be can also learn about proper facial growth guidance for their children.

Anonymous said...

Dr. Ayers,

Your blog is one of my favorites and it has been quite a while since you last posted. Do you have a timeframe on when you might post again?


Tanya said...

Thanks again for the iodine tip. There is a lot of good reading out there about it as well and how bromine replaced it in bread and that is causing thyroid issues etc. Another piece in the bread puzzle...

Bill Mullan said...

Dr. Ayers,

I have had a mild case of folliculitis for 3 years on my lower cheek/jaw area. It has been controlled in the past by topical antibiotics and oral (never for more than 3 weeks at a time, Doxycycline twice, Amoxicillin before that). Done the oral antibiotics 3 times, one the first year, another the second, and the final this year.

I decided no more antibiotics, as the organism that came up in the culture is Enterobacter Aerogenes, a gram negative strain that was probably the result of me taking Tetracycline back in 2003 for acne.

I did a 30 day raw milk diet, although I did not rest well and I cheated with a probiotic and a magnesium supplement. I also screwed around with various topicals at the same. It cleared a good bit of it during the last week when I finally just stopped washing and let my skin heal itself, but some spots still pop up every other day or so.

I am now following the anti-inflammatory diet, but with raw milk, sweet potatoes (I honestly see no difference with low starch, as long it is from tubers, I have been off grains for a year now).

I am also taking Theralac and Ohhira probiotic daily with good results, but like I said some spots pop up every now and then. I am not sure if this is the lingering infection or my skin adjusting to the new water only regime, as I notice some minor flaking sometimes. Granted, I have really only been "not washing" for 2 weeks.

I am wondering if you have experience or knowledge of Enterobacter Aerogenes or gram negative strains of bacteria.

I am certain the way to combat this is by re-establishing proper gut flora. I suffer no other maladies except for a slightly low body temperature (97.6, but now up to 97.9 or 98.1 thanks to a drop of iosol a day and a tsp of Maca, all started this monday). I read that chronic infections can be a cause of low body temp. My thyriod numbers are all normal and I have no antibodies when tested for Hashi's and Candida.

I guess I am just wondering if I am on the right track, and if there is something more I can be doing to re-establish the gut flora. Hoping to have this well behind me soon.

Your comments would be very appreciated.

Dr. Art Ayers said...

I personally think that folliculitis is a rather simple immune system dysfunction compounded by some other compromise, such as mechanical damage, e.g. shaving, lengthy soaking in water, e.g. hot tub contaminated with bacteria, etc. The immune system dysfunction is associated with a disruption of gut flora that is a combination of diet and antibiotics use.

In your case, your gut flora never fully recovered from the antibiotic use and simply limps along by temporary augmentation with probiotics. You haven't reestablished the hundreds of bacterial species for a healthy gut flora, and your folliculitis is a symptom of that chronic problem.

There are numerous posts of readers on this site who have systematically introduced new bacteria and supplied food for the new bacteria with diverse veggies. You need to increase the diversity of your gut flora to get proper function of your immune system. The bacteria are not the problem and it doesn't matter what bacteria were found in the follicles.

Bill said...

Dr. Ayers,

Thank you, I will be adding more veggies, you recommend unwashed right? Do most supermarkets wash their lettuce, produce, etc? What is the best method to introduce diverse veggies? A few a week and rotate, gradually adding more to the plate?

Do you have knowledge of recovery from anyone who has damaged their gut flora with antibiotics?

I guess as the severity clears, as it has, I just hope for recovery in the near future.

It's unfortunate that the FDA has no interest fecal transplant (for obvious profit based reasons), because clearly such a procedure would take care of this sort of immune system dysfunction.

I hope this is not a bother, I very much appreciate the free advice you give on your blog and responses.

Morhangeois said...

Dr. Ayers, I believe that you and your readers will find this short video from the TED site very interesting: Heribert Watzke: "The brain in your gut"

Adam said...

Dr Ayers,

I am about to try these Biestmilch products. And right away thought, I am very curious, what is your idea about bovine colostrum, and if you know these products.

I am not sure if link sharing is allowed, and i am not here to advertise either. Only looking for clues.


Dr. Art Ayers said...

Thanks for the link to a very interesting article. It highlights the complex role of the gut. I found it entertaining and illuminating that the size and complexity of the nervous system in the gut approximates that of a cat.

Dr. Art Ayers said...

Biestmilch is cow colostrum, or the milk first produced by a cow to complete the development of the calf gut and initiate the development of the calf gut flora. This is very potent and is obviously the product of intense evolutionary selection pressure.

Colostrum is very species-specific and the composition varies. Colostrum contains a complex mixture of growth factors that modify the function of the gut, immune system and gut flora. Most of these components are poorly understood. The impact on newborn animals is different from adults. Some of the impact on adults may be beneficial and some may be harmful. I would certainly not consider colostrum safe, just because it is a natural product.

The needs of adults and newborns are very different. Colostrum suppresses part of the immune system to permit newborns to ingest milk. Calves without colostrum become runts. Similarly, human babies that due not receive colostrum are heavily compromised and their aberrant gut flora leads to gut inflammation. Suppression of inflammation and disruption of adult gut flora may not be beneficial to adults. I would, therefore, question the routine ingestion of colostrum.

Colostrum may be effective in the treatment of compromised individuals, e.g. Alzheimer's patients or HIV infected, or those exposed to extreme stress.

Thanks for your question.

Danny Roddy said...

I apologize for this question being off topic, but I wanted to ask you what affects a zero-carb diet would have on gut flora?

I love your blog Dr. Ayers.

Adam said...

Thank you the insight, Dr. Ayers!

Your blog is awesome!

Till's Triathlon Blog said...

Hello Doc,

I have read your comment about Adam wanting to try Biestmich with great interest.

I suffered severely from glandular fever about 10 years back - it took me 4 years to be able to run 15 minutes at a go again without having a truly bad headache all day.

However, ever since I have tried many 'modern medicine' to get my immune system back on track but failed poorly.

Now doctors have told me that they can't help me anymore and I should learn to deal with it.

I then started using Biestmilch and thought I had some success but apparently when working out or being under stress I seem to be getting sick right away again.

Symptoms start on the tongue and from there go straight into the head, congestion and then the body breaks down for about 1-2 weeks before I recover. This happens about 4-5 times a year at least and sport is very hard for me to keep up.

I was wondering what your insight would be on that - as I suppose we are certainly talking about some form of inflammation here.

After 10 years I am not giving up hope but it is hard to deal with again and again and again!

I would very much appreciate some feedback on this!

Best regards,


Dr. Art Ayers said...

The important parts of your story seem to be Epstein- Barr infection (Mono, glandular fever), trigeminal nerve involvement with the tongue, and autoimmunity/inflammation.

Major initiators of autoimmunity are celiac and EBV infections. Both lead to closely related autoimmune diseases that share the same autoantigens, e.g. tissue transglutaminase in Hashimoto's thyroiditis, peroxireductase in gum disease, between celiac/intestines or EBV-infected tissues or lymphocytes and the antibody-targeted tissues. I bring up the parallels with celiac, because I have discussed that more on my blog.

My prejudice is that your condition results from the original EBV infection that has built up an autoimmune response that flares under physical stress. The tongue/congestion/brain route is a parallel with the rosacea responses that involve another set of the trigeminal nerves. Inflammation in this system is also involved in migraine headaches. Direct infection of the trigeminal ganglion, as I recall, also leads to very profound psychological ramifications, such as the impression that parasites are moving through your tissues.

I just mention all of these associated phenomena, to illustrate that involvement of these nerves immunologically can have major organic consequences.

The EBV infects lymphocytes and would be expected to terrorize lymphoid tissues, such as the gut associated lymphoid tissue that makes up more than half of the immune system. Your symptoms result from attack on tissues and inflammation by lymphocytes that are normally suppressed by another class of lymphocytes, Tregs, that are controlled by interactions with bacteria in the gut.

It seems to me that the health of your gut and gut flora should dominate your symptom development in response to exercise. I would expect that constipation, antibiotic use and food intolerances are in your past. I discuss fixing the gut and gut flora throughout my blog.

Let me know if this makes sense.

Dr. Art Ayers said...

I think that a no carb diet, which would eliminate fruits and veggies, as I interpret it, would also eliminate a diverse gut flora and should preclude the normal development of the immune system of the gut. Plant polysaccharides (soluble fiber) are only digested by gut bacteria and those same bacteria supply most of the short chain fatty acids from the colon. A meat only diet would necessarily produce intolerance to veggies.

Thinking outside of the box, however, the fat-based energy diet would result in gut bacteria adapted to anaerobic metabolism of fat and produce hydrogen and short chain fatty acids. Perhaps these bacteria will impact the gut and immune system in the same way as the veggie-adapted bacteria. Some groups of people have adapted to meat diets, so their gut flora and immune systems may be very interesting to examine.

Thanks for the question.

Anonymous said...

Dr. Ayers. Do you have any thoughts on the role that yeast plays in the gut good and bad? I have heard of the benefits of yeast touted for kombucha and old style beers that are not filtered.

On the other hand there is an allergist in my area that is heavily prescribing nystatin for oral use. Does this mean that yeast and or fungi is bad for the gi tract?

steve said...

my wife is currently pregnant with our 3rd child. she tested positive for group b strep before delivering our first 2 and as a result, needed an infusion of pcn before delivery. i'm assuming that her vaginal flora is likely a result of her own GI flora (and mine as well), so would think that your steps to maximize gut flora for both of us might prevent this for our upcoming child. any thoughts on group b strep?

Dr. Art Ayers said...

I think that you are correct in supposing that the group B strep problem in birthing women is a dietary/gut flora issue. The diet guidelines that I recommend just avoid the problems of chronic diet-based inflammation that is the basis for most modern diseases. It sounds deceptively simple, but I think that it is. The current medical guidelines that encourage high carb diets rich in vegetable oils and low in saturated fats (and omega-3 oils) cause inflammation and also shift gut flora to permit the establishment of potential pathogens, e.g. B strep.

There is nothing extreme or unusual in the diet that I recommend and it has produced health in many different cultures for many generation. The same cannot be said for the US food pyramid in its recent incarnation.

I think that the clues for a predisposition to gut flora issues would be (prior to pregnancy) food intolerances, constipation, yeast infections, antibiotic use, or inflammatory symptoms such as depression, acne, allergies, autoimmune diseases, infertility, etc.

Let me know how it goes.

Viktor said...

Dr Ayers and other readers

Interesting article

For physicians and researchers alike, fecal transplants present an opportunity to gain insight into disease

Kind regards,

MasK said...

Hi Dr Ayers,
I wanted to ask you abut my CDSA (comprehensive stool test analysis). They found very high levels of alpha haemolytic streptococci and gamma haemolytic streptococci, with very high level of pseudonomas aeruginosa, and no growth or low level of acidophilus and bifidobacteria.
I'm following your recommendations, taking probiotics, fermented foods, kefir, prebiotics,etc.

Are these species (streptococci, p. aeruginose) dangerous ones? They classified them as non pathogen for the strep and possible pathogen for P.aeruginosa.
How could I have be infected by these?
Thank you.

Dr. Art Ayers said...

That is a nice general article on the utility of fecal transplants. They will probably develop as a powerful therapy for a variety of troublesome diseases. Without antibiotics, fecal transplants may be a safe, cheap way of initially approaching diseases, e.g. Clostridium d., which are now difficult, expensive or dangerous to treat.

Thanks for the heads up.

Dr. Art Ayers said...

Those are rather typical bacteria, but they do indicate an unhealthy gut flora. Simply changing your diet as I outline should go a long way toward improving your gut flora.

Anonymous said...

Hi Dr. Ayers.

Have you read this study by Reinhold Vieth?

This is Vieth's hypothesis to explain a "prostate/pancreas cancer paradox".

But it's just ONE researcher's hypothesis of a POSSIBLE paradox.

You have somewhere stated:
"The basic anti-inflammatory diet starts with a return to optimal vitamin D with the use of an initial blood test, followed by high level supplements to reach a suitable level and then maintenance with D3 supplements of usually 2,000-5,000 IU per day.".

But how can we trust on a researcher's hypotesis, when
the side effects could be so scared like an increased risk for prostate or pancreas

Thank you.

Dr. Art Ayers said...

Vieth is trying to reconcile patterns of cancer with the response of serum vit.D levels based on known enzymes in major organs. It is a simple model that just includes UV skin production (solar exposure) and supplementation vs. resultant serum levels of various vit.D metabolites and cancer rates. The actual studies typically ignore the diversity of the test population with respect to critical factors, such as inflammatory state. For example, people with low serum vit.D respond very differently to supplementation and solar exposure. Those with diet-based inflammation require high levels of D3 supplementation in order to produce their own vit.D in response to solar exposure. This is similar to the response to fish oil supplements, complicated by different levels of dietary omega-6 vegetable oils, or heparin anti-coagulant response in the presence of different levels of existing chronic inflammation.

Many studies ignore pre-existing inflammation and give scattershot results that are interpreted in the best light possible. Unfortunately, the medical authorities who control public practice just pick the observations that they prefer. Medicine is not scientific. It is primarily a business.

Personally, I just try to explain biological phenomena from as many different scientific perspectives as I can. I call that making sense of the observations. I am not trying to optimize drug applications. I use as few drugs as possible, because my impression is that addressing the cause of diseases with simple changes in diet usually avoids the significant side effects of most drugs. Vit.D3, or fish oil, can be used as drugs to treat existing diseases, but the underlying basis for the disease must also be addressed, i.e. what was the source of the damaging inflammation? Such a simple approach usually exposes dietary inflammation and provides an equally simple solution that avoids expensive and damaging drugs.

My impression is that a healthy, anti-inflammatory diet will minimize the need for vit.D3 supplementation and permit regulation of serum vit.D with minimal solar exposure. Low serum vit.D is a symptom of chronic inflammation and leads to numerous diseases. From my perspective, the problem is finding the source of inflammation. Aging is not a source, but a consequence of poorly managed chronic inflammation.

Anonymous said...

Thanks Dr. Ayers.
I agree with you.

I was "pressed", some years ago, to take Vit.D3 supplements by the growing number of studies that were estabishing a direct connection between higher 25(OH)D3 level and cancer prevention.


So, scared by cancer risk, I begun to take 1000 i.u, then 2000 i.u. daily and now 5000 i.u. daily.
My D3's level before supplementation was 44 ng/ml (110 nmol/lt.). So not so bad.

Now I've decided to eat REAL FOOD and stop supplementation.

After all, if we changed the colour of our skin when we came out of Africa, that means it was an adaptation to less sunlight or/and to less Vit.D3 in food.

Thanks again.

Asim said...

Dr. Ayers,

What is your view on cod liver oil? I am particularly interested in respect to the arguments of VItamin A and D relationship.

Dr. Cannel seems to be against the supplementation eith cod liver oil because of the potential for vitamin A intoxication. From my understanding, he seems to hold the view that vitamin A antagonizes the effects of vitamin D, while the Weston Price Foundation has different views and argues that the relationship is 'symbiotic'.

What do you think?

I normally just take vitamin D, but I may just start supplementing with cod liver oil, that obviously hasn't had the vitamin d purified.

Viktor said...

Dr Ayers,

I came across an interesting study - confirming that a variety of fruit and vegetable is more beneficial in reducing inflammation than quantity.

Background: Puerto Rican adults have prevalent metabolic abnormalities, but few studies have explored fruit and vegetable (FV) intake and coronary heart disease (CHD) risk in this population.

Objective: We tested the hypothesis that greater FV intake and variety are associated with a lower 10-y risk of CHD and C-reactive protein (CRP) concentrations.

Design: In a cross-sectional study of {approx}1200 Puerto Rican adults aged 45–75 y, we assessed FV intake with a food-frequency questionnaire. The 10-y risk of CHD was assessed with the Framingham risk score in participants free of cardiovascular disease. CRP was measured in fasting serum.

Results: Variety, but not quantity, of FV intake was inversely associated with FRS after adjustment for the following: sex; waist circumference; perceived stress; alcohol use; intakes of energy, trans, and saturated fatty acids; and use of supplements, cardiovascular medications, and diabetes medications (P = 0.02). However, the association was attenuated after adjustment for income (P = 0.11). Variety, but not quantity, was associated with a lower serum CRP concentration after adjustment for age, sex, smoking status, alcohol use, servings of FV, white blood cell count, diastolic blood pressure, diabetes, nonsteroidal antiinflammatory medication use, intakes of energy and vitamin B-6, waist circumference, perceived stress, and income. The adjusted odds of a high CRP concentration for those in the highest compared with the lowest tertile of FV variety was 0.68 (95% CI: 0.49, 0.94).

Conclusion: FV variety, but not quantity, appears to be important in reducing inflammation. Although the results are suggestive, larger studies are needed to confirm a possible association with CHD risk score.
Am J Clin Nutr (November 10, 2010). Greater variety in fruit and vegetable intake is associated with lower inflammation in Puerto Rican adults.

I hope that you find it interesting.

Kind regards,

Dr. Art Ayers said...

Hi Viktor,
I always look forward to your interesting posts.

I see why this article on fruits and veggies caught your eye. Diversity was more important than quantity. If the phytochemicals were just active as anti-oxidants, then the quantity would be paramount. Diversity suggests that the phytochemicals and perhaps the associated plant polysaccharides were enhancing the diversity of the resident gut bacteria and thereby altering the gut associated lymphatic tissue. A healthy immune system reduces chronic inflammation and CRP.

I think that most people forget that most of the phytochemicals never get out of the intestines or past the liver.

Thanks for your input.

JHmaryland said...

Hi Dr. Ayers,
This is my first post, but I have been reading up on the information you provide. I think it's great what you are doing and I was hoping you could spend a few minutes reading my post and possibly give me your opinion on an issue that I have.

In 2004 I took an antibiotic called Ketek for an upper respiratory infection. It didn't really help, so after about two months I went back and was given Ketek again. After the second pill from a dose of five I had a major reaction to the drug. Blurry vision for a few days, kidneys ached and I had zero energy. This lasted about one month and was intense. I lost weight and my body temp flipped. Over the next year my temp switched back to normal and I regained some energy, but never completely recovered. Then I developed a lower back problem which persists today. Two years ago I was diagnosed with Hashimoto's disease and have spent the past year on syntrhoid and have stabilized my TSH at 3.2. Prior to taking the synthroid my TSH was in the 5-7 range. I have no goiter or other symptoms of a thryoid issue other than the presence of the antibodies for Hashimotos. My eyebrows are all but gone and now it seems like the hair on my head is tingling and is starting to fall out even on the meds. Family history is no hair loss. Ever since I took the ketek I have gotten easily sick. I had my immunoglobulins tested 3 years ago and they were at the low normal level, but have been trending up the past few years. Recently, they plummeted and are below the low normal level. IGG in particular (i.e. 570). Prior to the Ketek, I never got sick or even went to the Dr. Now I cant stay healthy. My doctors don't know and are not interested.

I tried the anti-inflamatory diet you write about for 30-days and felt a little better and lost a little belly weight. Since I have just cut back on the carbs, wheat in particular. I am planning on going back on the diet for a longer period. I am male and exercise 4 days a week and have always done so.

Thanks for reading my rant, I look forward to any suggestions you may have?

Dr. Art Ayers said...

This sounds like a classic presentation for celiac (gluten intolerance), which typically leads to Hashimoto's thyroiditis and lower back inflammation. The hair loss is the result of another autoimmune response, also initiated by celiac.

My anti-inflammatory diet with special note of the avoidance of grain, should help. You probably also suffer from some absorption/deficiencies, because of the celiac.

I would assume that the Ketek disrupted your gut flora and intensified pre-existing autoimmune conditions.

I hope that this is helpful.

JHmaryland said...

Dr. Ayers,
Thank you for the response. I will initiate the diet right away and keep to it, hopefully this helps. I am tired of getting sick, usually upper respiratory.

I have also been taking probiotics the past few months. I forgot to mention that ever since the Ketek everyday I had white patches in my tonsils. After the first month of probiotics they went away and have not returned. Any thoughts how I could find out if I have specific absorption issues? Thanks again.

liv said...

Dear Dr. Ayers,

I am not sure where to post this question, so here I go, hope it is okay.
I have been diagnosed with microalbuminuria 4-5 years ago, this is my only symptom. I am taking ACE inhibitors, the proteinuria went away, of course. What is your opinion, can the antiinflammatory diet you recommend help with this condition? I'd like to stop taking the medicine, but I know leaking even small amounts of protein will harm my kidneys in the long term.
What do you think?

Bill said...

Dr. Ayers

Do the probiotic bacteria in raw milk colonize in the digestive tracts of humans?

If one is persistant with raw milk drinking, raw milk kefir, and raw fermented veggies, will these species take up space in the gut?

JB said...

Hey there Art!

I will be doing a comprehensive stool analysis soon and may post the results to get some info from you.

I am currently following your diet guidlines. I am eating lots of saturated fats (raw butter, coconut oils and milk, fu fat kefir, ful fat greek yogurt, fatty beef, organ meat, etc), generous amounts of protein, and a modest amount of carbohydrates in the form of veggies, some fruits, brown rice, quinoa, and yams. I am probably eating more starch then you recommend but I am trying to gain weight as it is so there is only so much meat and fat one can eat!

What are your feelings on protein powders?? I use a brand that the only ingredients are whey and egg protein, and stevia.

Also, how would you set up a protocol for doing a at home fecal transplant. I am having my mom tested and will be using here if everything is good.

Would you recommend something along the lines of THomas Brody??

He basically oes a short course of anti biotics to reduce the load of the constipating bacterial agent (suspected clostridium species), then a PEG lavage, then 5-10 days of HPI.

Would you just do it sans anti-biotics?

JB said...

forgot to mention getting in loads of omega 3's from wild sockeye salmon and omega 3 oil

JB said...

Since the USA doesn't openly do fecal transplants yet, it seems like the only available means is do it yourself via at home enemas. This will obviously, with some skill/abdominal massage/body positioning, and a previously cleaned out colon, allow the transplant to make its way into most of the colon.

However, if you are following Borody's protocol and using antibiotics prior to the transplants, what will re-populate the small intestine? Just following the anti inflammatory diet, eating veggies, pectin, inulin, FOS, etc? How populated are the small intestines with bacteria anywho? I was under the impression that the majority of the bacteria resie in the colon and very few are in the small intestine (and none in the stomach) normally.

Anonymous said...

Hey there. Great blog.

I am yet another person who suffers from constipation. However, my form is a little different then everyone elses. I will go every day, but most days I will pass very little stool even if it is soft. I will have maybe 2 or 3 "good days" each week where I will pass a large amount of stool.

What is also of note is that even on the good days, I just don't sit down and have one big motion. I will have multiple motions and will visit the bathroom a good 5-10 times in a matter of 15-20 minutes. My stool is generally on the narrow or flat side, and I never really produce the "logs" I did years ago. I have also ha a colonoscopy and celiac tests and ruled out any colon cancer, ruled out celiacs, etc. I will get minor bloat on some days near the end of the day if I have had a long string of insufficient bowel movements, but besides that I wouldn't say I have any other IBS symptoms besides the motility/defecation issues and minor bloating.

I guess you could say that my muscles that control my bowels movements just feel weak, and the urge I get isnt super strong. Can this be a case of insufficient bacteria and dysbiosis as well. I have read some things about how certain bacteria (particularly clostridium specie) can cause motility problems.

As far as getting fresh veggies, that is pretty challenging for me. I have no yard basically for growing, and dont know of any farmers markets nearby. Do you think maybe throwing a coating of dirt on the veggies I do it and shaking it off would be worth a try, or is that potentially dangerous?

Also, you say it could take months and even years to re-establish bacteria, but do you think trying a series of FT's from my partner could help dramatically speed up that process?

-- Rick

Dr. Art Ayers said...

The anti-inflammatory diet that I recommend is a good general purpose diet appropriate as a foundation for the treatment of most health problems, since most diseases are based on chronic inflammation.

I would say that kidney problems that result in protein leaking into the urine have a foundation in the basement membrane that is the barrier between blood and urine. That barrier is made up substantially of heparan sulfate and my lab experiments show that the genes involved in the synthesis of heparan sulfate are turned off by inflammation. That suggests that protein in the urine is a response to kidney inflammation, which may be reduced by lowering diet-based components of inflammation. Hence, the diet I recommend is a kidney friendly diet.

It seems to me that in many, if not most cases diet and lifestyle adjustments can have a better, i.e. safer and more effective, impact on health than drugs. Most people cannot be motivated to change even what they eat, and use dangerous drugs instead.

Thanks for the question.

Dr. Art Ayers said...

Hi Bill,
Most probiotics reside only temporarily in the gut, but since biofilm formation enhances gene flow between species, genes from the probiotic bacteria are readily transmitted to other gut bacteria. So even if the probiotics do not last, their impact may.

Species of bacteria are created dynamically in the gut, so the definition of species, which excludes gene transfer between species, is not appropriate in many cases with bacteria.

Probiotics also support the growth of other members of the gut flora and can help to diversify the gut. They can also initiate responses from the gut, to change the gut environment.

The benefits of raw milk can derive from the living bacteria present, but can also result from avoiding the modification of the milk protein and fat complexes during homogenization and pasteurization.

Thanks for the quests.

Dr. Art Ayers said...

It seems odd to me to consider carbs as needed to gain weight, but carbs do encourage fat storage. I think that protein powders are effective in disrupting gut flora and may therefore be helpful in gaining or losing weight. I don't think that protein powders are healthful for a normal diet.

I think that the point with fecal transfers is repetition. Of course, there is no point to changing the gut flora, if the diet does not support it. Also there is not much benefit in doing a transplant of a family member in close contact with you, since they should have already transferred the needed bacteria. Family members usually share related gut bacteria. If those bacteria were diverse and provided a healthy gut flora, then any disruption, e.g. due to antibiotic use, should be readily reversed in that environment. Conversely, if the family gut flora is unhealthy, then a FT will not be supported unless the environment changes.

If you are considering a FT, then it is wise to improve the gut flora of all those with whom you come in contact, prior to the FT. Make sure that your support group is healthy. This is a good reason to avoid hospitals and healthcare workers, if you have dysfunctional gut flora.

Why are you considering FT?

JB said...

I had been underweight for a good 1.5 years or so due to anorexia atheltica. I never starved myself, but was in a minor-moderate caloric debt daily and over time the same thing that happens in people who restrict food happened to me. Fatigue and really slow bowels were the first manifestation of this. We thought it was a digestive issue at first but after many many tests and finally gaining weight, it has been the only thing that has helped.

As a result of the malnutrition I pretty much decimated my bacterial population. On a stool sample I had done I had the lowest you could score for the good bacteria, and various unwanted bacteria. I have been eating a healthy weight gain menu consisting of basically the stuff you listed under your anti-inflammatory diet, with higher amounts of carbs from things like gluten free oats, yams, and higher amounts of fruit. THe only unhealthy things in my diet would be the higher amount of carbs (which I dont necessarily think is unhealthy in some people) an the protein powder (I always mix it with real food if this makes a difference, such as shakes with whey, fruit, yogurt, oils, etc).

My bowels responded right away to gaining weight but really havent made much progress after the first 2 months of the past 6. I believe I just dont have enough to form healthy sized stools. I know it takes time to re-establish the bacterial colonies, but I just wanted to try and speed the process up. I eat a very healthy and supportive diet, take glutamine, probiotics, fresh veggies, kefir, fermented veggies, etc.

My mother also eats extremely healthy. The only vice she has is maybe a few mini-coke cans a week, and some milano cookies here and there. She has not taken anti-biotics recently, and in her entire life has taken maybe one course. She also had a stool sample done and has all the good guys at the top of the labs range, and no over abundance of unwanted bacteria, as well as no parasites.

Would you advise against the FT?

JB said...

I have just read how Borody has used FT's to succesfully restore a large number of people with IBS-C dominant symptoms back to normal/fully operational bowel health.

One lady had only been going every week or two for 30+ years an after here FT she began going 1-2 times a day and continued to do so even after 3 or 4 years!

liv said...

Thanks, Dr. Ayers! :D

Cassandra said...

Hi Dr. Ayers. I wondered if you saw this recent study regarding how three common probiotic strains affect the expression of hundreds of genes in the gut lining:

Missing your posts, love your blog.

Anonymous said...

Hey Dr. Ayers, I have been reading through most of your blog and I find it very fascinating and informative. Recently I had a stool test done which revealed I have a gut dysbiosis. I am not producing any beneficial lactobacillus bacteria at all but have a +4 for other beneficial bacteria, and a potential pathogen, from the Bacillus Species. The test showed my yeast levels were under control, but I am wondering if candida could still be a culprit. I suffer from dandruff, jock itch and a stubborn toenail fungus.

Anyways I have scoured the internet for solutions to my problem and everywhere I go I find different and conflicting information. I have tried following a very limited diet for 4 months, limiting myself to low-carb veggies, meat and fat, with no fruit, nuts or dairy consumption. My macro nutrient ratio followed the same outline as the Optimal Diet. But I don't know if what I am doing is helping.

Last week I began consuming probiotics and added back a little starch into my diet, after reading its benefits from The Perfect Health Diet book, but I have yet to feel any improvement.

I am currently eating a variety of cooked and raw veggies, with the occasional sweet potato, lots of meat from grass-fed animals, lots of sardines and salmon, olive oil, and lots of coconut oil. What do you recommend I do? Is there a possibility I have candida, and if so, should I restrict my diet from...basically everything.

I am also supplementing 5000IU of Vitamin D, began last week, and taking fish oil.


P.S- I posted this in another post, but I realized it was old. Sorry.

Ben said...

JB & anonymous. Where did you get your stool tests done ? Metametrix ?



Anonymous said...

Hey Ben,

I got them done through a naturopath. He used Geneva Diagnostics. It cost me about 100 dollars if I recall correctly.

Ben said...

Anonymous: Thank you for your reply.

Do you maybe remember the name of the test ? I searched the UK site of Genova and found "Comprehensive Digestive Stool Analysis 2.0 + Parasitology (CDSA2.0+P)" although it costs like 300$ here.


Anonymous said...

Any advice on my post about my particular type of constipation/dysmotility??

--- Rick

Dr. Art Ayers said...

I don't rely very much on most of the early types of colon screens for particular bacteria, since 95% of the useful bacteria have not yet been identified and the remaining potential pathogens are often as not of no consequence. Most of the screens simply don't give a good sense of what is happening in the gut metabolically and immunologically, simply because those processes are not fully understood.

There are at least small numbers of bacteria throughout the gut and many of those species are in thin, constantly rejuvenating biofilms that compensate for the shedding of the lining of the gut. The appendix is at the confluence of the large and small intestines and serves to supply both with stocks of bacteria. Bacteria are also present in small numbers, frequently without their pyrogenic outer walls, throughout the body and may even be transferred from mother to baby in breast milk. Sterility is over hyped. Living tissues and fluids control bacterial growth rather than eliminate all bacteria.

Diet is the major determinant of the composition of the gut flora. The biggest limitation of changing gut flora with diet changes is access to the hundreds of different bacteria that each have unique metabolic and signaling functions in the gut. People work very hard to avoid eating the bacteria that they need for a functional gut.

We compensate for defective immune systems with excess hygiene. The result is further compromised immune systems that rely on gut flora for proper development.

The answer is a diverse diet with complex plant polysaccharides, but low starch, and access to sources of bacterial diversity, e.g. animals and small children that come in contact with soil, raw veggies moderately clean fresh from the garden, other healthy people.

Thanks for your questions and comments.

Dr. Art Ayers said...

Thanks for the reference on the interaction between the gut and typical probiotics. It was a massive study and showed broad responses of hundred of genes of the gut cells that were unique for each of the bacteria. Metabolism, immune system and development/inflammation of the gut is altered by bacterial products. This study provides some of the molecular detail to explain the practical benefits of probiotics and the importance of gut flora on health.

Dr. Art Ayers said...

I don't see anything unusual about your constipation. You have a severely simplified gut flora. You can try feeding occasional diverse foods, but without the bacteria you won't see much of a change.

You need to make some particular plant soluble fiber available routinely and think of the bacteria that grow on them as pets that must be fed to avoid rapid starvation. Eat some apple (pectin) and leeks (inulin) every day and if you are around healthy people who can digest those foods (an produce normal stools), then you should over a period of months pick up the bacteria to handle them.

In the mean time, much of the benefit can be obtained by mixture of probiotics. How do you respond to yogurt (full fat, Greek style honey-flavored is fantastic) with live cultures of bacteria?

If you have not already responded by picking up healthy bacteria from your partner and you are eating plenty of diverse veggies, then I would suspect that your partner also has a compromised gut flora.

Let me know what happens.

Dr. Art Ayers said...

You can see some comments with an example protocol for fecal transplants in my articles on the subject (look in the index at the right).

I don't think that the antibiotic treatment is proven to be as necessary as repetition of the process. Animal studies show that the gut flora from antibiotic treatment prior to the transplant is a hybrid of transplant alone and antibiotics alone. So antibiotics continue to cause problems.

Thanks for your questions and comments.

Anonymous said...

I respond fine to pretty much any food I eat. I dont have allergic reactions or outright bloating to any particular food, it is just the dysmotility issue. I will only get bloated if I have had several days in a row of sub par BM's.

What are some good foods to eat daily with my goals in mind? I will eat kefir and or yogurt daily, raspberries and apples for pectin and inulin, and I have managed to find a local fresh source of veggies (several different kins of mushrooms, various greens, small amounts of dirt still on em so plenty of bacteria hopefully!). I try to get in modest amounts of nut, and a little ground flax as well everyday along with probiotics.

One of my problems is I am not as social as I should be. I tend to stay in more often then not. Maybe I need to get out and play in the dirt with some of my relatives young ones and dogs :)

One thing that may have been preventing the bacteria from ever building up was the fact I was on mirilax every night for the past 6 months. I know PEG is what is in most bowel preps, and it is fairly toxic to bacteria in your gut, so do you think taking that every night could prevent establishment of bacteria? I have noticed several other people make the same comments that after they were on mirilax for a while things started to go wrong in their GI system (causing dysbiosis over the long term).


Anonymous said...

And would farmers markets be a better choice for fresh bacteria harboring produce??


Anonymous said...

Thanks Dr. Ayers for the prompt response. When you say a low-starch diet, do you mean no sweet potatoes too. As an athlete I find it hard to sustain an adequate athletic level, without at least a little bit of starch.

Dr. Art Ayers said...

My impression is that starch can be eaten, but it reduces performance until the body recovers from the high blood sugar impact, which disrupts fat metabolism and places the body in a lethargic state for storage of the glucose as body fat.

Thanks for the questions.

Dr. Art Ayers said...

It sounds to me that your gut flora still has a long way to go. You still lack the bacteria to digest all foods and so they pass through undigested and don't contribute to the bulk and hydration that the would if converted into growing bacteria. You need to eat more to produce more stool volume as the gut bacteria digest the soluble fiber that passes through the small intestines. That means low starch veggies and fruits.

I don't think that you can improve your gut flora while using laxatives. The PEG disrupts the healthful biofilms that provide the bacteria that you are trying to cultivate. It also makes it difficult to assess the build up of gut flora, because you are assessing artificial stools of partially digested food, rather than actual stools of packed bacteria. The routine use of PEG or any laxative causes more severe constipation, because it disrupts gut flora. Laxatives are inherently unhealthy and should be considered as antibiotics in their negative impact on the health of gut flora and gut function.

The goal should not be just to pass stools, but rather to build up gut flora that are needed for health and are reflected in hydrated stools that pass without laxatives.

Make sure that any fermented foods that you eat still contain live bacteria.

Let me know how it works out.

Anonymous said...

I had a feeling the PEG was doing more harm then good. I am already noticing improvements in my stool and overall feeling throughout my GI system after only 1 or 2 weeks of not using it. Just from these improvements alone I am optimistic things will be much better in the future as long as I keep eating the way I do and avoid the PEG.

Is there anything inherently wrong with higher fiber starch foods like oatmeal, sweet potatoes, and quinoa? IS it that they do not cause harm, but they don't help build up the bacteria (have a neutral effect). I know they have lots of soluble fiber as well, and plenty of the healthiest civilizations throughout history ate lots of starch (non processed obviously).

I would say my diet consists of equal parts protein, fat, and carbs (so 1/3rd each) with fat being from saturated sources, wild fish, fish oil, olive oil, and some nuts. My proteins are from dairy, meat, fish, and nuts. Out of my carbs I would say one third is from veggies, another is from fruit, and another is from starch (so it is by no means super high starch). My fiber comes to around 30-35 grams.


Dr. Art Ayers said...

I think you are right. Past the point where you are, further starch reduction becomes more individual with impact. I think that lower starch is easier to maintain over the long haul, because the starch tends to increase body fat and appetite. It is easier to go longer between meals on a higher fat diet. Frequent, smaller meals are used to discourage fat accumulation on higher starch diets while still satisfying the higher insulin, more rapid lowering of blood sugar.

It is also important to avoid routine fructose. That is why I am not a big proponent of fruits. Sucrose and particularly high fructose corn syrup are problems for inflammation and liver damage. Soft drinks are particularly dangerous for health.

Let me know how you progress.

Anonymous said...

Well my daily routine for fruits is a medium apple and either a serving of blue berries or raspberries. Now and then I will have a medium banana.

Do you not recommend fruits daily, and if so how can you get a good source of pectin besides apples? I know I can get inulin in some of the fermented dairy products I use.

Will keep you updated.

-- Rick

Anonymous said...

A question re constipation & fiber which may be of general interest. I’ve been on a strict LC experiment/diet (66F/18P/16C) , 16 hour eating window, 1 day/week fast for 4 months and gradually decreasing carbs for 4 months before that. As a sub-experiment I have been reducing fiber so that now it is 10-15g/day; this takes some effort. At the start of the strict diet, the fibre intake was about 25-30g/day and I had (too) large stools, in mass and in diameter and BMs were daily. Now the the stools are much smaller in mass (perhaps less than ½) , soft/uniform/small/diameter. Previously the stool shape mirrored the “convolutions” of the large intestine suggesting unhealthy stretching. But now I need glycerine suppositories to have daily BM’s. Possibly nerves in the anal canal are no longer sensitive to the small stools. My diet is about 2700Cal and is not deficient in vitamins or minerals but for my age/mass/activity is about 500Cal above standard recommendations. I weigh 150lbs and am not gaining/losing weight but appear to be losing small amount of resistant sub belly-button fat. The inventory of feces has reduced noticeably and gradually over a 4 week period, the small hard protuberance of the stomach has gone. I still have a gum infection which has improved greatly and which was the original reason for diet experimentation. Actually I went in the high carb/frequent meal direction (dr’s recommendation) at first and my gums worsened very markedly. No other clinical complaints before diet experiments or now. I took some pro-biotics for 4 weeks. My feeling is that things are right with my IG tract with the exception of loss of sensitivity. I have been eating high fiber vegetable in large quantities for decades, guess habitual daily fiber about 30-40g. The ideas re fiber come form Monastyrsky BTW. I view these happenings as part of an ongoing experiment subject to adaptation etc. I would appreciate your comments, specifically re merit of small stools/low fiber.

Dr. Art Ayers said...

It sounds to mean like your gut flora have never adapted to your diet and cannot digest the soluble fiber in your diet. Perhaps the high fiber diet and rapid transit rate have eliminated most of your gut flora diversity and you have to build it back up again.

Many cases of dysfunctional gut flora are improved by minimizing the contact time of the bacteria in the colon by increasing the rate of transit. This is just avoiding the problem of a diet that has produced an unhealthy combination of gut bacteria.

I don't think that there is any problem with the nerves in your colon. They are responding normally to abnormal stools made of undigested fiber, rather than bacteria that have grown by digesting the fiber. You lack the bacteria to digest the complex polysaccharides in the soluble fiber.

I outline on this blog a healthy diet to avoid inflammation and I give suggestion on improving gut flora.

María said...

Dr. le escribí hace un tiempo explicándole mi experiencia después de que me diagnosticaran celiaquía hace 5 años. Ahora estoy pasándolo muy mal con la columna, tengo los discos intervertebrales muy deshidratados y una hernia discal en las cervicales. Me gustaría mucho que me indicase un remedio para la artrosis y para los problemas de columna. ¿Conoce algún remedio que pueda prevenir el deterioro? Muchas gracias y un saludo muy afectuoso

Dr. Art Ayers said...

I think that the best approach for your celiac and related back problems is to follow the anti-inflammatory diet that I recommend and also build up your gut bacteria.
1. Eliminate grains to avoid gluten and extra starch.
2. Make sure your serum vitamin D levels are OK. Test blood levels, supplement with D3 and recheck.
3. Low carb, high saturated fats, no vegetable oils (use butter, coconut oil, olive oil), lots of different fresh vegetables

That is a start. This approach is appropriate for all of your problems.

Tell me how it works out.

María said...

Muchas gracias Dr.
Qué puedo hacer para paliar la artrosis y la descalcificación?

Dr. Art Ayers said...

Arthritis is an autoimmune and inflammatory disease that can be approached by the diet I recommend. You can see if your symptoms are reduced by taking fish oil. Vit. D3 supplements should also help reduce inflammation in the arthritis, as well as osteoporosis. Exercise is helpful for all of your conditions.

You can also try topical application of castor oil, menthol (e.g. Vicks Vaporub), and capsaicin to reduce the arthritis symptoms. You might also look into low dose Naltrexone to help resolve all of your health problems.

Thanks for the questions and exercise in my Spanish.

María said...

Gracias de nuevo. Hago la dieta antiinflamatoria desde que me diagnosticaron la celiaquía y practico la natación y el ejercicio físico con frecuencia, pero aún no siento alivio. Seguiré con ilusión y optimismo. Muchas gracias

Anonymous said...


This is a random and probably stupid question, but does the act of anal sex have any effect on the colon flora?

I am seriously asking this. Say that a natural lubricant was used such as pure aloe vera gel or emu oil, it couldn't possibly damage the gut flora right?

Sorry for the question... I was just wondering since so many have reported success agaisnt C Diff and some UC with fecal transplant via enema... that wouldn't sex via the anus also have some sort of effect?

I have my doubts simply because then wouldnt we see a massive amount of IBS, autoimmunity (besides HIV) and gut flora issues in gay communities?

Sorry if I have grossed you out here or crossed a line.

Adam said...

Dear Dr. Ayers,

I am asking to help one of my friends. He just got diagnosed Crohn. Assuming the diagnosis right, if Crohn case were discussed here, where can i find your thoughts and suggestions about it?

I have already suggested him, the very basics I understood from your helping comments, articles. But I am afraid it is not enough or the best. :DSurely your words are more helpful.

2nd and less important:
what is your opinion on flex seeds? Crashed, or milled...

this tread is again unbelievebly helpful.


Asim said...

Hey Dr. Ayers,

I just noticed that many companies are starting to adopt probiotics in their formula.

After reading your blog, if I understand your argument correctly, it still seems to me that they miss the fundamental premise that the variety of gut flora for an infant is not the issue, but the fact that their digestive system is not yet adapted to handle the diversity of the gut flora.

Am I correct on this take?

Dr. Art Ayers said...

You are exactly correct. Infants are not born with an intact digestive tract. It is leaky and undeveloped. Use of formula for infants and especially premature newborns, causes stress and a very high risk of complications, such as necrotizing enterocolitis. The biomedical literature shows that all of these complications can be eliminated by using mother's milk or banked breast milk.

There is deliberate confusion between the specialized prebiotic oligosaccharides, call bifidus factor, in breast milk and other oligosaccharides/polysaccharides from plants, soluble fiber, that can support the growth of unrelated gut bacteria. These other "prebiotics" and probiotics are bad for babies, because they produce gut inflammation and inactivate the nutritional and protective components of breast milk. Babies fed formula in the "hygiene" of developing countries die at alarming rates.

From my gut-centric, inflammation-phobic perspective, formula use is equated with tobacco smoking. There are some situations in which smoking may be therapeutic, but it has been a half century since smoking was considered healthy.

Hospitals need to promote healthy behavior by using only banked breast milk and human milk components, especially in neonatal intensive care.

All new mothers should be aware that exclusively breastfed babies do not produce the smelly brown constipated bowel movements that result from occasional bottles of formula. Adult-like bowel movements in a baby are a sign of gut inflammation. Normal, healthy babies have yellowish, "curds and whey" bowel movements that smell fermented and are resistant to constipation.

It is always better to use as much breast milk as possible, even if formula is required for rare medical conditions, but even a single bottle of formula dramatically degrades the gut flora of babies and increases health risks.

It is not commercially feasible to add bifidus factor-probiotic to formula, so formula companies will be trying to convince mothers that all gut bacteria are the same and soluble fiber is good enough for babies, even though it is destructive to healthy baby gut flora. They never claim that their products pass the sniff test.

Thanks for the comments/questions.

Anonymous said...

Natural solutions are revolutionary these days, but lucky are the babies who benefit from this:

The Human Incubator, an article from the New York Times

Dr. Art Ayers said...

Kangaroo care is as good as an incubator for premature infants and also provides enhanced bonding and self-image for the mother. The only problem is that it does not empower the NICU staff and requires more interaction with the parents. Hence, some hospitals still do not use this effective method for reducing the length of time in the hospital. Note that the probability of hospital-initiated infections, e.g. C. difficil, increases with each day in the hospital.

Thanks for the link and comments.

Bill said...

Dr. Ayers,

I know you specialize in the gut flora... but I have a question about the skin flora.

Antibiotics such as the tetracyclines tend to prevert the skin flora after usage, destorying much of the normal Actinobacteria that thrive in the acidic conditions... is it possible to recover this flora?

I am the guy with the folliculitis, like I said I have had it for 3 years and it has most consistently come up as gram negative Enterobacter Aerogenes.

I have had the most success I have ever had so for with raw milk kefir, raw milk, fermented veggies, raw dirty veggies from a local organic farm and different probiotics... as well as a complete drop in all hygiene. I only wash with water on my body and hair and now never let water touch my face.

My facial skin has gone from dry to nice and mostly moist, sometimes oily.. but I still seem to always have 1 or 2 of the lingering folliculitis spots... mechanical damage perhaps? It is getting better.

I just hope the Enterobacter hasn't changed the environment of my skin for good and that I can recover the commensal species via leaving the skin alone and recovering it's acid mantle.

Also- I have read a ton of research about sweats antimicrobial protein Dermcidin, and I am contemplating going to a sauna a few times a week.

On the gut flora front, everything seems to be okay... I did a home fecal transplant (5 total) via enema and I have no bowel issues to report of, my body temp which was low, is now back up at 98 regularly, I digest raw veggies and starch in the form of potatoes and very well again and my bowel movements are normal, regular, and formed.

Perhaps I am still missing some key gut species? Or is this a lack of commensal skin species?

Regardless, I will never go back to topical therapy for the skin, especially that of the antimicrobial sort. I am hoping by this time next year after leaving my skin to do it's job, this folliculitis will be behind me.

The diagnosis by the way is Gram Negative Folliculitis, and is becoming a more common complication from antibiotic therapy for acne.

Would love to know your thoughts. I want you to know that your blog as helped me in my journey more than anything over years. I can't thank you enough.

Bill said...

By the way, regarding the home fecal transplant...

the donor only taken 2 antibiotic his whole life for just 5 days, never had any issues typical of those with gut flora issues and I had him eaten/take a ton of prebiotics and probiotics starting 2 weeks before hand.

Followed Tom Borody's protocol, but could only do it for 5 days rather than 10.

Dr. Art Ayers said...

Hi Bill,
Nice to get your update and success with a simple fecal transplant.

My prejudice about acne and folliculitis is that it has little or nothing to do with the bacteria that are cultured, since those are just the bacteria that happen to be around a developmentally defective follicle that is providing an unusual nutrient source. The bacteria are a symptom and not the cause.

I think that in many cases white blood cells will accumulate in response to inflammation prior to the presence of bacteria, i.e. any pus could be sterile.

The question is, why are the follicles sensitive to physical trauma and respond with inflammation? I have to admit that in response to your questions about folliculitis and related adult acne, I have experimented, i.e. used your case as an excuse, to indulge in a binge of Christmas desserts to stimulate a very high insulin peak. The idea was to see if I could stimulate acne somewhere by high insulin, since my normally low carb diet makes me very insulin responsive.

I was very hungry the next morning and I soon had inflamed follicles on my back, stomach and the tops of my thighs, where the hair is rubbed off by my trousers. I tried vitamin E oil, castor oil, Vicks and benzyl peroxide in different regions. Only the benzyl peroxide slowly eliminated the inflammation as I returned to my low carb diet. I have no idea why benzyl peroxide would do anything under these circumstances. There was no pus evident. It was an interesting, but annoying experiment.

Thanks for the comments.

Bill said...

Dr. Ayers,

Yes, I learned long ago that sugar, wheat, etc really inflamed the folliculitis.

Your reaction is curious, do you think it was more a histamine reaction to the sugar/grains you ingested?

My folliculitis is very localized to both sides of my lower cheeks, middle jaw area. Those areas were badly damaged by a horrible shave while on Accutane, which caused a massive irritation and even boils. I have no other acne or skin issue to speak of anywhere else on my body.

I improperly treated the irritation with irritating topicals and picked at them. After that I spent another two years putting benzoyl peroxide on them, which controlled it to a degree but clearly also caused some irritation.

It struck me in October that I have never let the skin heal on it's own. I am convinced I need to let topicals go and just let my skin do it's thing and sort itself out.

Started that officially in November, had some set backs with overwashing still with water and wet rags, but now find much more success with not even letting the skin get wet and allowing myself to sweat, get dirty, and use a simple gentle baby brush to brush of any shedding skin.

My hope is that in a few months from now, folliculitis will be long gone. I don't expect to be 100% clear ever, but I would love to reduce it to a pimple every month or so.

It is amazing how much the skin care industry has conned us into thinking we need their products to make our skins look like... our skins want to look nice, we just have to let them.

I will keep you updated on my progress and I appreciate your experiment and feedback!

Dr. Art Ayers said...

WilliamS wrote (deleted by spam filter):
Bill, I wonder if iodine—taken orally and/or applied topically--might be helpful for you. The skin concentrates it, most of us seem to be quite deficient even if we're getting the RDA, and there are many reports of skin problems improving after orthosupplementation. Dr. David Derry, among others, has written about this. More resources are here if you are interested in investigating this:

Dr. Art Ayers said...

Random question about anal sex and gut flora.

I was hoping that one of my readers would do something with this one. I thought that I would have nothing to say on the subject, but alas...

My first observation is that exposure of pregnant women to semen, regardless of whether it is vaginal or oral, decreases miscarriages. Apparently the omega-3 fatty acid content of semen is enough to lower inflammation and enhance gestation. I don't know if there is any provision for long chain fatty acid uptake in the colon.

But, coming back to the main subject, semen should reduce inflammation in the colon, but have relatively little impact on the gut flora. My impression is that the bowel contents don't mix very much as they start to dehydrate in the colon and changing the bacterial growth rates or metabolism at the very end, is not going to make much difference. The same could be said for most enemas, they will have little impact on health via changes in gut flora.

Thanks for your questions?

Tanya said... the bad spots on your face. Perhaps to aid healing you should try raw milk and or honey dressings. I've read quite a bit about honey or sugar dressings healing skin lesions etc. and reducing teh scarring. It may be extrapolated to your theory about allowing your skin to heal. Just a random thought...

Anonymous said...

Dr. Ayers,

Thank you for addressing my question even though it seems a bit strange.

I ask because I am a gay man and I have done a ton of work recently to restore my gut flora, and I have come a long way and made substantial improvements.

But the other day I came across this paper:

It basically blames the act of douching for unhealthy gut flora and even the act of anal sex itself, and the progression on HIV to AIDS. Now, it also doesn't take into account the massive drugs that some gay men do to enhance the exerpierance, and doesn't really weigh on the antibiotics that they will take for immune issues with HIV.

Now, I never douche. Never have and dont think it is necessary. I use a natural, aloe vera lubricant with vitamin E and sodium bezonate. Aren't all preservatives somewhat antimicrobial?

Sorry that I have to "go there", but it scares me to think that a common sexual practice could be destorying me and my parnter's healthy flora.

Dr. Art Ayers said...

As I suggested, I don't think that gut flora will be altered by an alternate approach. I think that safest idea is to get your gut flora in good shape, so that your immune system is fully functional, i.e. it is the same advice that I give everyone.

Bob said...

Dr. Ayers

What is your take on alcohol and the gut flora. I am not a huge drinker, perhaps a glass of wine or two once or twice a week, sometimes a shot of vodka at a bar on special occasions. Wouldn't say I ever have much more than that and drink about 4-5 times a month max. How do you think this effects my gut flora?

Is there anything I can do to potentially lessen alcohol's harmful effects on the gut flora?

Thank you, you have a wonderful blog.


Julia said...

Hi Dr. Ayers,

I love your blog but became alarmed when I read your concerns with drinking colostrum. My daughter has food allergies and chronically swollen toes and stomach. I've been making her yogurt with raw colostrum with the idea it would help her immune system and help heal her leaky gut. Should I use raw full fat milk instead when I make the yogurt? She's having nutrient malabsorbtion issues.

Also, do you think glutamine would be helpful to heal her intestines?


Dr. Art Ayers said...

Your alcohol consumption seems moderate. Alcohol will have most of its impact on the few bacteria that inhabit the upper part of the GI tract, so it would suppress H. pylori to a small extent. I wouldn't give it much thought, if the rest of your diet is healthy and you have no signs of problems with your gut flora. I would consider a soft drink each day with HFCS as harder on your liver than a couple of alcoholic drinks a week.

Thanks for your questions.

Dr. Art Ayers said...

I don't think that your daughter's consumption of colostrum would have a whole lot of impact for good or evil. It is not magic, especially after it has been converted to yogurt.

Please check out my article on an recommended anti-inflammatory diet. Note that grains are a big risk factor for her symptoms. That is what would benefit your daughter. She also needs to repair her gut flora to cure her allergies and the damage from prior use of antibiotics. There are lots of posts by readers on how they repaired their gut flora by incorporating veggies in a high fat diet. All it takes is persistence. The alternative is for the allergies to gradually turn into autoimmune diseases.

Let me know how you and your daughter progress with your new diets.

julia said...

Hi Dr. Art Ayers,

Thank you. I respect your knowledge and willingness to help. I believe we already eat a low inflammation diet. No grains, breads, or starchy veggies. I have been cooking her vegetables really well because otherwise she'll poop them out whole without digesting them. She eats coconut oil, butter, cod liver oil and plenty of meat. Also cream, cinnamon and yogurt. I have homemade saurkraut that she doesn't like but I can mix it with food so she dosn't experience the sourness.

Is this enough? I was using the yogurt as her probiotic "medicine." What about any bad bacteria that's causing leaking gut? Will this starve them?



Dr. Art Ayers said...

It seems to me, based on your daughter's inability to digest veggies, that she has lost most of the necessary 150 different species of bacteria that inhabit the normal healthy gut. She will benefit from probiotics, but she still needs to build up the other hundred different bacterial species in order to digest, via the gut flora, the full array of plant polysaccharides, i.e. soluble fiber (e.g. pectin, inulin).

I assume that she has had several prior courses of antibiotics that have wiped out her gut bacteria. Those gut bacteria prime the immune system, which develops in response to contact with gut bacteria. In the absence of appropriate gut bacteria, following antibiotic treatment, the immune system attacks common proteins, such as allergens. Another common result is autoimmunity.

Your daughter lacks the gut bacteria needed to digest soluble fiber and as a result cannot digest veggies. These bacteria are found on the surface of the veggies as they are harvested. The needed bacteria are lost by washing and killed by heat in cooking. Close contact with other people or animals that work/dig in the garden can provide the needed exposure. It is important to persist in eating one type of vegetable long enough to establish a community in the gut able to metabolize all of the components in that vegetable. This may take months.

You have not mentioned your daughter's serum vitamin D level. It think that it would be a good idea to have it checked, supplement with enough vitamin D3 to reach 60-70 and then recheck to make sure that it actually reached that level. Less than half of those treated for vitamin D deficiency actually reach a healthy level.

I think that problematic bacteria in the gut are eliminated as a healthy bacterial community is formed. Most people with significant health problems have severely damaged their gut flora and try to compensate using a few probiotics. The result is typically dependence on drugs to compensate for the missing gut bacteria.

Thanks for your questions. Please update as you get more info.

Anonymous said...

Hey Dr ayers.

Have you heard of the GAPS diet. It is similar to your anti-inflammatory recommendations. However, you just say limit starches to 30 grams or less at a meal, while the GAPS diet says completely avoid all kinds of starch and grains (and many other foods) for a long time.

DO you have to completely avoid starches and such to help kill off the bad bacteria and re-establish a healthier gut?

Wouldnt avoidance of starches and grains and such lead to intolerances to eating them in the future, or is the concept that fixing your gut would allow you to re-intorduce them in the future with little ill effect?

I am considering going on a diet like this due to constipation symptoms. I have very weak and incomplete bowel movements in the mornings. I will have several small unsatisfying movements over a short period in the AM. I am afraid of losing lots of weight on this kind of diet though. Do you just recommend replacing all carbs taken out with proper fats?

Dr. Art Ayers said...

You are just describing constipation, the lack of the numerous bacteria species needed to digest plant polysaccharides, soluble fiber.

Starch is readily hydrolyzed by your own enzymes to produce free glucose that is absorbed into your gut. Bacteria are not needed. The grain fiber is just unhealthy and should be removed before eating. Whole grains produce mineral deficiencies, even though they do provide some additional vitamins. The added risk of the glutens means that most people are healthier without exposure to grains.

With the diet that I recommend, it is easy to maintain your weight by replacing the problematic high-starch grains with beneficial saturated fats. Also, get your serum vitamin D checked.

Read the rest of my 100+ articles and posts on diet and inflammation to learn how establish the hundred + species of bacteria needed for a healthy gut.

Let me know of your progress.

Anonymous said...

Will do.

After a extended period on the inflammation diet, and after you have established a healthy gut flora and have no digestive issues, would it be fine to re-introduce/gradually increase some starches like yams/sweet potatoes/potatoes again and be able to handle them properly due to a healthier bacteria population?

Anonymous said...

@ Anonymous December 22, 2010 4:54 PM,

Another possibility for your pattern of bowel movements is a rectocele condition, which is a form of posterior pelvic prolapse, where it can be difficult to completely evacuate the stool. Constipation makes the problem worse in a number of ways, but also advances the prolapse condition due to straining.

Julia said...

Hi Dr. Art Ayers,

Thanks so much for giving me a lot of things to think about. I do not know my daughter's D3 status. I've been giving her cod liver oil since she was 1 but I really don't know what her level is.

I looked at the archives to seek information about parasites but I didn't find it. Forgive me if my question is redundant. Would eating veggies from my garden (there are a few) without rinsing just wiping off the dirt introduce unhealty parasites? Or are the unhealthy parasites located on decaying leaves? Also, if I'm understanding you correctly, you're suggestion is to provide raw, fresh, unchlorinated (unwahsed) veggies on a continuous basis to help establish good gut bacteria from this day forward really. I don't want to get discouraged when I see whole chunks of veggies in her stool if I know that in time her body will be capable of breaking down the cellulose.

I appreciate your insights.


Dr. Art Ayers said...

Your questions reveal some of the problems with our current understanding of the role of gut flora in health. It is now obvious that health is dependent on complex gut flora, but medicine has not studied gut flora, it has focused on pathogens that cause problems when people have defective gut flora. There is no simple and safe approach for fixing defective gut flora. The market for gut flora-establishing bacterial cultures has not been established. The beginning of that is the crude probiotic market. I can only tell you what I and some of my readers have found to be successful. Obviously, the people who most need to improve their gut flora are going to be the most susceptible to pathogens and parasites from veggies, but avoiding bacteria compounds the problems.

Thanks for your comments/questions.

Cassandra said...

Another fecal transplant article:,60148.asp

Anonymous said...

Dr. Art Ayers,

Thanks for the wonderful blog, i've spent time with heartscanblog and a stephens blog before discovering your blog last week. It's very interesting and i've read a lot of your posts. Some questions and obersvations have come to mind and i request your comments on them.

1. Castor oil suppresses inflammation according to your blog and alopecia is mainly hair fall due to inflammation of hair follicles. So perhaps for hair regrowth or prevention of further hairfall castor oil would be essential? (besides using Red Pepper/Black pepper) also i read Ray Peat on copper for hair and Dr. David William talk about Vitamin D and fish oil as anti inflammatory. it would make a neat hair regrowth protocol by combining all this information i suspect.

2. after reading about dairy over the last year and my own experience with it i stopped consuming raw milk or packaged milk, specially because it would give me weird body odour. Though from your articles i understand i probably lack the particular gut flora for its digestion and therefore have started taking cream 3 days back and hope to include yogurt next week besides picking up some raw washed but unpeeled veggies in the mix. Is this good, because i notice slight BO after including cream in the diet.

3. Talking about inflammation i've noticed looking at the back of my hand the veins recess and disappear when i follow the proper diet but they pop up as soon as i diverge. So i've looked around and found plenty of people with hair loss and swollen veins, even in healthy looking people. I wonder if glancing at the veins for swelling is a good way to judge the internal swelling in people besides checking out their hairline, waistline and neck sag(for thyroid)?

oh and i love your long replies, every reply of yours on this blog is an article in itself so you don't have 150-200 articles but probably well over a 1000 articles! :-)


Anonymous said...

HEy Dr art. I realize you do not like high starch grains, but how do you feel about other sources of starch such as potatoes, sweet potatoes/yams, lentils and beans, etc. And what about gluten free grains such as certified gluten free oats, and other gluten free starches? Do they pose any problems?

Anonymous said...

And to add to the above, if you are eating low omega 6, lots of omega 3 and saturated fats, good proteins, and plenty of diverse veggies along with inulin/pectin, etc. is there any harm in including a modest amount of starches as well (150-200 grams a day, along with 150 grams of protein, and 100+ grams of fat), or will the starches de-rail any attempts at establishing good gut bacteria?

Anonymous said...

Hi Dr Ayers,
when I drink supermarket milk (homogenized and pasteurized) I have a strange reaction.
I usually begin to sneeze in one or two minutes and feel full of mucus in my nose.

I'm wondering why this happens (as the reaction appears in one minute maybe it's not related to my gut flora, or could it be?).

I've found in internet a lot of similar cases with milk but no explanation for this.

My daughter has the same reaction with dark chocolate (nolt milk chocolate). She begins to sneeze in seconds.



MasK said...

The last post convinced me to ask you about such problem I experience. When I eat, even cold foods, my nose starts running very soon. My sister has this same problem, as sometimes my mother. I don't understand well why it happens, but we all three have lot of antibodies to foods showing an increased intestinal permeability. I was wondering if intestinal inflammation can lead to an overproduction of mucus, and could this start as soon as we eat?
I know doctors are diagnosing that as gustatory rhinorrhea, but I didn't experience this before having digestive issues.
Thank you.

Unknown said...

Dr Ayer,
I just discovered your blog and am THRILLED to have found you. I am hoping, praying, that you can steer me in some direction toward curing the digestion issues that have taken over my life.
I am 37 years old and have had these issues for 14 years one getting progressively worse. My main symptom is chronic bloating, gas and repetitive burping. So bad sometimes I feel like I can't catch my breath. I get lots of heartburn. It feels like there's is so much pressure from the gas that with all the burping it pushes acid upward causing heartburn. I feel like I just cannot digest food.
I have had multiple endoscopies showing mild inflammation, no surprise there! I have done an esophageal manometer which showed everything normal and a ph capsule study which showed only minimal heartburn with all of the digestive upheaval I live with. I simply do not know what to do.
I have done rounds of nystatin,diflucan and bottled probiotics. Been told various diets to do which failed...I just want to heal myself. The only remaining ideas of drs are a slow emptying stomach and to try an antibiotic for small bowel bacterial overgrowth.
The few things I have read on your blog thus far seem right in line with a path I need to walk on. Please dr ayer, if any of this sounds like something you can help me with, suggestions, specific issues, please let me know.
I am too young to keep living like this and am at the end with no one left to help.

Thank you so much for reading this far and thank you for making such valuable information available for all of us.

Kim kowalski

Dr. Art Ayers said...

I think that your whole problem is that MDs don't understand digestion and the role of gut flora. It seems that you have an extreme form of dysbiosis, disruption of intestinal bacteria.

Most MDs think that there are just a few bacteria in the gut and that they can be eliminated with antibiotics without side effects (aside from yeast infections.) The reality is that there are more than a hundred species of bacteria that must interact for you to digest meals without accumulation of irritating products that cause your symptoms.

You could fix your situation in a couple of days with a fecal transplant (see Wikipedia) or by gradually increasing different parts of your diet. One obvious approach would be to shift to the anti-inflammatory diet that I recommend on this site using the Six Week Cure of Drs Eades. I describe this approach in a series of articles on this site. I explain it in enough detail for you to cure yourself by just buying a couple of large containers of whey powder. You should notice a huge improvement in a week. You might also benefit from a total bowel irrigation (PEG) prior to the Six Week Cure.

You apparently have an extreme case of food intolerance, i.e. deficiency of key bacterial species in your gut flora. The goal is not to avoid foods that cause problems, but to gradually increase those foods from a small portion of your diet that does not cause symptoms. You need sources of new bacteria, since you have probably started the whole problem with antibiotics. See numerous other articles and posts on how to recruit new bacteria. The people with whom you are in most contact, also probably have defective gut flora, because they are not serving as adequate sources.

Let me know how you do.

Anonymous said...

Dr Ayers i was hoping for a reply as i had more follow up questions. Never the less thanks for your blog.


Unknown said...

Dr ayers,
Thank you so very much for your Reply I am truly grateful that you took the time to write back.
I have gone ahead and ordered the 6 week cure so that I can begin the dietary changes necessary to repopulate my gut. I had a couple of quick questions that I hope you wouldn't mind me asking before I begin.
I am currently 6 months pregnant-can I still follow this diet as obviously am not trying to lose any weight now! You mentioned that doing the whey shakes would make a change in about a week, can I do this without the weight loss? Any other things I should keep in mind going about this while pregnant?
Also, you mentioned that those around me probably have diminished gut flora. My 7 year old son had multiple,multiple rounds of antibiotics as a toddler due to ear infections. He also had tons of ibuprophan for fevers since he hot febrile seizures. Now, 3 years later he has viral induced asthma, gluten intolerance and cannot seem to process phenolic foods without a strong reaction. Would this diet help him too? Can a child follow this as well and would there be any exceptions/additions for him?

Again, dr ayers, I want to thank you for your help. I had seemed to only be running into closed doors when it came to answers for my digestive issues. I am now filled with hope!

Kim kowalski

Dr. Art Ayers said...

I would not suggest a large shift in diet during pregnancy. I don't even consider most vegetables safe during pregnancy, especially not during the first trimester. Morning sickness is a mechanism to avoid vegetables that contain many plant components that are not safe for growing fetuses.

I think that you would be better off enjoying grassfed meats, fish, eggs and dairy (if you were eating these before the pregnancy.) The basic information in my recommended anti-inflammatory diet should be very supportive of pregnancy and should be good for kids. I think that a diet low in sugars/high fructose corn syrup, vegetable oils and grains, is great for kids. What's left is all of the natural, unprocessed, tasty foods. Don't be afraid of the saturated fats and avoid large amounts of starchy foods, e.g. bread, pasta, rice, potatoes. Normally, I would recommend lots of fresh veggies, but not for a pregnant woman. Leeks and apples should be good for soluble fiber for your gut flora.

I think that most major changes in gut flora should be done in preparation for pregnancy. Remember that conception and pregnancy require that fetus suppress the mother's natural immune response, inflammation. Avoiding dietary inflammation supports fertility and pregnancy.

So, don't fret over the dietary details. Enjoy your meals and trust your body.

Let me know how it goes.

Medjoub said...

Dr. Ayers -

You've mentioned in several places your opposition to high-starch diets. Do you distinguish between the starch in, say, white rice and white potatoes?

Some researchers, like Stephan at Wholehealthsource, seem to think that moderate starch is fine for non-diabetics. Do you agree or is it an issue of potential dysbiosis? I'm interested in why so many native groups (and probably paleolithic man) seem to thrive on starches and saturated fats without the digestive problems of the western world.

Unknown said...

Dr ayers,

Thank you for your response. I find your comment interesting about not eating vegetables during pregnancy especially the first trimester as I have never been able to stomach them at all during any of my pregnancies. I had never heard that some of them are detrimental to growing babies...makes sense.

I will follow your dietary advice for the rest of this pregnancy and begin the six week cure afterwards. I was wondering if incorporating ore foods that would recruit new bacteria in my gut now would be beneficial or do I wait until I can overhaul my diet? also, in reding of ways torepopulate your gut flora I found the following: probiotics powder supplements, yogurt, kefir, miso and fermented foods such as raw sauerkraut. Are these sufficient? Are there strains of bacteria in yogurt/supplements that are more desirable or ones that should be avoided?

Thank. You very much and all the best for you in 2011!

Sarabeth said...

Hi Dr. Ayer,

I found your site while researching gut health, which is my full-time preoccupation. I am currently healing my son (and my whole family!) using the GAPS protocol, which is very similar to the diet you suggest, as far as I can tell, except that GAPS focuses a lot more on fermented veggies rather than unfermented raw vegetables (and GAPS is entirely grain free/starch free/sugar free).

I'm curious if you've had any experience with behavioral/neurological issues and diet. My son was not diagnosed, but has been suffering from autistic/anxious/anorexic symptoms since about 22 months (right when he started eating more solids). It's been a massive struggle, but for the past three months he is finally eating the foods I give him, and I am confident that as his gut heals, so will the crippling (and super challenging!!) behavioral issues.

(Incidentally, my son was born at home/no interventions in labor, exclusively breastfed for 1 year followed by two more years of breastfeeding supplemented by a whole foods vegetarian diet (which I would give anything to go back and do over!!), and was never vaccinated or given antibiotics. I hope that there are latent populations of beneficial flora in his gut, ready to re-emerge, but I'm worried that he is a member of a generation that is showing signs of severe debilitation in overall health... What if the good flora just never went in to begin with?? He was such a sleepy baby, and barely drank any milk/colostrum those first few days...)

I am doing a lot of research, and writing, especially for parents, and especially for parents trying to implement a healing diet for a child who is an exceptionally picky eater. Thanks for all the research you present in your blog! If I may, I'd love to share this article (an introduction to the whys and hows of treating the mental health manifestations of dysbiosis), and other resources on my website, with any interested readers:


Asim said...


According to Dr. Cannell, autism may be connected to low vitamin D levels, including the mother, whether through breastfeeding or in pregnancy. There is also evidence that the vitamin plays a key role in the regulating the immune system through the gut flora.

You may want to check your child's vitamin d levels and increase the levels your child consumes.

ALso, as per Dr. AYers, you were exclusively breastfeeding your child, meaning the baby was not exposed to diverse gut flora, which is HOW IT SHOULD BE. It is when the child became exposed to more diverse foods that his gut flora would have changed to accomodate the new foods. The idea that the good gut flora would have never went in is unjustified.

This adapatation would obviously lead to some digestive problems until sufficient flora is established, but I wouldn't think that such changes would affect neurological issues, especially at the onset.

Dr. Art Ayers said...

I agree with Asim.
I think that the sterility of newborns is overstated and access to the Bifidus spp. that form the normal newborn's monoculture gut flora is underestimated.

I think that gut-based problems originate in babies, because of problems with the diet/health of those around the babies.
In the vast majority of the cases, "inheritance" of family food and flora is more important than genes. Modern diseases result from the exaggeration of isolated islands of family flora as a result of hyperhygiene. Healthy people can spread their healthy gut flora, but antibiotic-compromised people with autoimmunity can also spread their disabilities.
It may also be that aging, inflamed individuals would benefit from and compromise other members of an extended family. A pivotal element in family health would be the extent to which the family is open to the outside influence of the compost heap and farm animals.
Are pets beneficial to mental health because they provide extra candidates for gut flora? Is the hygiene in hospitals detrimental?
I need to address in depth the few differences between your diet/disease relationships and mine. Most of the differences stem from the earlier assumption that there are just a few gut bacteria and most digestion is by intestinal enzymes. Several research articles this year demonstrated that gut flora control the development of the immune system. This makes an explanation of the physiology behind your observations a lot easier.

Thanks for your comments.

Sarabeth said...

Hi Dr. Ayers (and Asim),

Thanks for your responses! I'm very excited to discuss this, so i hope you don't mind further posts.

You wrote: "In the vast majority of the cases, 'inheritance' of family food and flora is more important than genes. Modern diseases result from the exaggeration of isolated islands of family flora as a result of hyperhygiene..."

This is definitely an assumption that agrees with GAPS. Dr. Natasha Campbell-McBride continually states that it's the flora and habits that get passed down (mostly mother-to-child, but otherwise as well) and that are highly relevant in clinical treatment consideration--and that genetics are almost useless to consider in terms of treating gut dysbiosis right here, right now.

I'm curious about your theory that "Healthy people can spread their healthy gut flora, but antibiotic-compromised people with autoimmunity can also spread their disabilities." I'm constantly wondering about this, as my son is having fairly pronounced "die-off"/detox effects and I'm wondering how much this might affect his younger brother (definite signs of gut dysbiosis digestively, but not with such neurological manifestations). How do you know that family members share flora to any significant degree? (By the way, our entire family is doing the GAPS protocol, which makes for a very small sample size, but at least it's bigger than just one patient!)

You wrote, "Most of the differences [between your theories and GAPS] stem from the earlier assumption that there are just a few gut bacteria and most digestion is by intestinal enzymes. Several research articles this year demonstrated that gut flora control the development of the immune system. This makes an explanation of the physiology behind your observations a lot easier."

Sorry if I'm not totally educated in this, but I'm wondering: what do you mean about GAPS assuming that digestion is due entirely to enzymes?

Actually, GAPS (as I understand it) assumes that current knowledge of gut flora (even the identification of beneficial strains) is currently in its infancy. And Dr. Campbell-McBride constantly reiterates the point that the immune system begins in the gut...


Sarabeth said...

Oops, sorry, I guess this got cut's the rest:

As Asim noted, Vitamin D is almost certainly deficient in my son--along with probably dozens or hundreds of other nutrients. We struggled to get him to simply EAT for so many months/years, that right now (since he's finally eating three square, super-well-balanced meals per day) I'm imagining that his system is going to take a long time to get back to "normal" (which he never was, so the potential there is very exciting!!)

But the idea is that once his gut isn't so leaky, and also once he's absorbing the nutrients that go in, his deficiencies will right themselves.

I'm interested in your theories on newborns' sterile guts. Are you saying that the gut is colonized by only the bifido bacteria at first, and then a baby gradually acquires a whole gamut of flora as the s/he nurses, gradually building to the point when solid food is introduced? Or that bifido predominate throughout the time spent exclusively breastfeeding? What about the flora present in the vagina during birth? I assumed that this played a large role in beginning the baby's colonization.

I am absolutely certain that my son's diet played a huge part in the _worsening_ of his gut dysbiosis, since he almost immediately selected for the starchiest possible foods within our very carefully-crunchy-granola-no-sugar household. After four years of living on whole grains, hummus, and fruit (and eggs), his diet was--in retrospect--providing a very hospitable environment for unpleasant pathogens in his gut. By the time he was 6.5 (last spring, when we found out about the gut flora hypothesis, and GAPS), despite all my struggles to broaden his diet to include other, healthier foods, his tastes seemed essentially driven by his dysbiosis.

But he also had issues beginning when he was three weeks old. He had reflux, and screamed for hours on end, and woke up constantly all night (I now imagine that, among other issues, my milk didn't have enough/the right kinds of fats), and began "turning off" in an autistic way (not wanting hugs, etc.) early on. Which makes me think that Dr. Campbell-McBride is correct in assuming that problems result very early if the baby's gut is not populated with "Good" flora, and that this dysbiosis can be a problem even while exclusively breastfeeding (even if it's less so than it will later become once solids are introduced).

A topic that I thought was unrelated, but now feels relevant, is PANDAS. Do you know much about this? I wrote a book review of "Saving Sammy: Curing the Boy who Caught OCD." I'd be very interested in your thoughts:

Thanks so much!

Unknown said...

dr ayers,

i would like to shift my 7 year olds diet to one that will rebalance his gut flora, just as i need to do for myself. he has had numerous rounds of antibiotics, constant ear infections, tons of NSAIDS, asthma, taken oral steroids for his asthma and gets sick at the drop of a pin. this all seemed to come about when his ear infections began at age 3.5 and he was put on round after round of antibiotics.

i am wondering the best way to do this? would modifying the eades diet so that it could shift his flora and not be for weight loss be a place to start? is there any benefit for including the shakes in this process? how impactful are they on 'wiping' out the bad flora vs starting with a 3 meal a day AID plan such as in weeks 5/6?

i would like to do something like this for him as i just know it would be beneficial.

any suggestions would be greatly appreicated!
thank you,

Dr. Art Ayers said...

I have to admit that my biggest problem in establishing diversity in my own gut flora is getting past my cultural hygiene hangups. Modern people are simply too clean.

The most recent research observation on gut flora that are responsible for the development of the immune system is that typical soil bacteria, Clostridium spp., trigger Tregs in the colon. This is the basis for the observations that eating fruits and veggies, with their complex polysaccharides, e.g. soluble fiber, such as pectin and inulin, heal autoimmune diseases, caused in part by deficient Tregs.

The bottom line is that your son is suffering from cleanliness. Enhanced hygiene also feeds the medical industry by providing chronically ill patients from cradle to grave. Anti-microbial soaps systematically isolate people from the bacteria in their environment and compromise the immune system.

Diet is important, because it provides both nutrients for the body and for gut flora. Equally important is that the diet also provides a source for the bacteria themselves. Food will just go in one end and out the other, unless appropriate sources of the required bacteria are also provided. Kids need to play in the mud and come in intimate contact with pets and bacteria from the garden.

[One outstanding problem is how to provide beneficial bacteria while avoiding the small number of actual pathogens and parasites. This is probably the basis for the use of herbs and spices in regional cuisines.]

Thus, the problems with your son's diet should not focus on killing off existing problem gut bacteria, but rather providing a new source of diverse beneficial bacteria.

Thanks for your questions.

joe77 said...

Dr. Ayers, I'm very interested in gut health, because I had abdominal surgery a couple of years ago, and they took out the ileocecal valve and the appendix. Since then, I've had intermittant diarrhea, which is especially likely if I eat a large meal. I probably have small intestine bacterial overgrowth (SIBO) due to colonic bacteria invading the ileum, and my Doctor gave me a 10-day course of Amoxicillin to see if that would help by killing the bacteria in the ileum. Well, it didn't help, but it didn't seem to hurt either. Now I'm not sure if I should try some probiotics to reintroduce some gut bacteria. Do you think that would be advisable given the possibility of redeveloping SIBO?

BTW, I'm eating only about 30 g of carbs/day to cope with pre-diabetes, mostly leafy veggies, squash, green beans, asparagas, cauliflower, etc. I eat lots of saturated fat and not much omega-6 fat. Basically an animal-based diet with a little non-starchy vegetables, but no fruit, grains, or sugar. What would you suggest trying?

Anonymous said...

Disheartening article in the UK Guardian newspaper:

Anonymous said...

Hi Dr Ayers,

I just discovered your blog today and am very excited. This is because the information you present echos what I believe, which is: diet affects gut flora, and gut flora affects health. I normally wouldn't have an interest in this topic, but I have a son that cannot eat. He is 3 years old now and is completely TPN dependent. If you are not familiar, it means he's fed nutrition through his veins. His drs say he has "chronic intestinal pseudo-obstruction" or "gut dysmotility". My careful observations and internet search lead my to believe he has "dysbiosis" which is dominance of bad gut flora and HEAVY biofilm. I see biofilm come out of his draining NG tube all the time, but drs don't know what it is. I know I'm not crazy and the fact that you believe gut biofilm exists confirms my sanity. This is all due to antibiotics, acid blockers and elemental formulas that were given when my son was in the NICU. The drs would not allow me to give my pumped breast milk which would have corrected the problem. The enormous amounts of biofilm have been very challenging. It presents as mucous-like foam. It is not simple to get rid of even though I have tried enzymes, apple cider vinegar, probiotics etc. They all cause severe die-off effects. I have mostly resorted to fasting my son as that is the most tolerable and the biofilm doesn't dislodge too fast. It seems that the biofilm serves as a food source for other microbes too. This is presented as different colors of output from the ng tube (orange, reddish orange, reddish brown, yellow-green, green, greenish gray and gray) and odors (very foul fecal to just an "different" odor). It is taking months to let the biofilm die off but I am confident that this is the best appproach as the good bacteria will not colonize well unless the thick biofilm is gone. I will read more of your articles so I can find more "goodies". Keep up the awsome work and you are promoting good intestinal health, which is overall health.

Thi Tran

Asim said...

Hey Dr. Ayers,

A new article from a different perspective and how it benefits the women that do it:

"They found that breastfeeding had the potential to influence positively bone mineral density, metabolic syndrome risk factors, cardiovascular disease and secondary tumors -- conditions negatively affected by childhood cancer."

Ken D Berry MD said...

Your post if music to this Physician's ears! It has always disturbed me how young mother's are given the "choice" between breastfeeding and formula as if there is no difference; like choosing between Coke and Pepsi. Young mothers need to be vigorously educated about the pro's of breastfeeding and the con's of formula! Excellent.

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Breastfeeding plays an important role in a child's development, it naturally boost the immune system of the child which prevent him/her from any easily acquired diseases.When the child drinks the first drop of breast milk which is called the colostrum a yellowish, sticky breast milk that is produced at the end of pregnancy,this should be feed in the infant within the first hour after birth, and the recommended span of breastfeeding is up to 6 months to 2 years and beyond with proper complimentary foods.
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Krista Gordon said...

Hi Dr. Ayers,
My son was hospitalized when he was 4 months old due to aborted SIDS. He was in the hospital for 10 days, suffering brain injury from the lack of oxygen. While he was in the hospital, I pumped to maintain my milk supply but it was already getting low. It was difficult but I knew that he needed it. When he was discharged, he was on thickened formula to help him swallow. I was working almost full time and continued to pump exclusively; my son was not latching. I finally went to a lactation consultant since I was getting maybe 4 oz/day. Eventually, I took domeperidone to increase milk supply and that worked but although my son started to latch, I didn't have enough milk in the afternoon for him. Also, he has teeth now and would bite and grip. I couldn't tell him no because I didn't want to discourage his latch that took so long to accomplish! Anyway, after all this work and stress, pumping exclusively for 3 months and working full-time, I just cannot continue. My husband is away at work now and it'll be like I'm a single mom at home with 2 kids under 3! I still feel guilty that I can't give him more: since before he was born, my goal was to breastfeed for at least one year. Our family eats Paleo and I am just racking the internet looking for first food solutions for him. I looked into a milk bank before and am not confident there's one nearby and have no clue to the cost.

I quit pumping this week. He's 7.5 months old now and I would like to start introducing foods to him so that he is not taking so much formula. Do you have any suggestions for first foods?

Thanks so much!

Dr. Art Ayers said...

Krista Gordon,
It sounds like you have tried very hard to breast feed, but have had some bad luck. I asked my wife, who is a lactation consultant, for some advice. She pointed to La Leche League as an obvious online resource:

The page to which I pointed is on starting solid foods. LLL also provides suggestions for increasing milk supply, latching, etc. Your local LLL chapfer may also provide contacts for other mothers who have had similar experiences.

When starting solids, it is important to keep in mind that food allergies Re very rare and in most cases reactions to food are merely lack of the appropriate bacteria in a baby's gut to digest new plant polysaccharides. Avoiding foods just prevents the baby's gut flora from developing. The baby needs both new foods and new bacteria. A sterile environment is very hard on the normal development of gut flora. That is why babies raised around dirty siblings and pets are healthier. It is not because their immune system has been extensively challenged, but rather because they have swallowed diverse bacteria and have developed a gut flora that supports normal development of the immune system residing in the lining of the gut.

Let me know what happens.

Anonymous said...

Krysta Gordon

you might find this post interesting:

La Leche League of Idaho Falls said...

Thank you for sharing this, Dr Ayers. Your wife posted a link to this article on our Idaho LLL Leaders site and I very much enjoyed it. We have posted a link to your site from our Idaho Falls LLL blog. Thanks again!

Unknown said...

My son has just been diagnosed with congential heart disease (not severe). He is 8 months and is not gaining weight so I was immediately told to put him on formula or supplement with formula. I explained that his appetite was the problem and not my supply. Nevertheless... Why would this be the case? I even found that "The "work" of breast-feeding is actually less than the work of bottle-feeding. Sucking, swallowing and breathing are easier for a baby to coordinate, and the amount of oxygen available to your baby is greater while breast-feeding than when bottle-feeding. In general, when compared to bottle-fed babies, breast-fed babies with congenital heart defects have more consistent weight gain."
SEcondly, once they are on solids, I guess they would start to get adult gut bacteria?? So then perhaps adding formula doesn't matter??

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