cover of episode Dr. Will Cole On Trauma & Gut Health Connection, Healing Leaky Gut & Inflammation, US VS European Diet, Keto, And Setting Boundaries W/ Technology

Dr. Will Cole On Trauma & Gut Health Connection, Healing Leaky Gut & Inflammation, US VS European Diet, Keto, And Setting Boundaries W/ Technology

2023/3/20
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Functional medicine is described as evidence-based alternative medicine that focuses on interpreting labs using a thinner reference range and looking at optimal health rather than average health. It involves a comprehensive approach to health history and individual differences in treatment.

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The following podcast is a Dear Media production. Hi guys, it's Mari and you're listening to The Pursuit of Wellness.

Today we have Dr. Will Cole on the show. He is a leading functional medicine expert who has consulted thousands of people around the world via his telehealth clinic. He was named one of the top 50 functional and integrative doctors in the nation. Dr.

Dr. Cole specializes in clinically investigating the underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormone imbalances, digestive disorders, and brain problems. I am going to have a million questions for you today, Dr. Cole. Welcome to the show. Thank you so much. I'm excited to be on. So firstly, kind of a basic question, but what is functional medicine?

That's a great question. I think it's a good place to start. Functional medicine is, in short, evidence-based alternative medicine. It's more than that, though. The Cleveland Clinic has a functional medicine center and many mainstream clinics.

hospitals and medical centers, institutions have functional medicine centers. So if I had to boil it down, like these are the takeaways. Number one, we interpret labs using a thinner reference range. So everybody that's listening to this right now will know, hey, when I go to my PCP, my GP, I get my number on the lab and then I'm being compared to this reference range, this sort of X to Y interval of numbers of what they are saying I should be.

We get that reference range from a statistical bell curve average of people who go to that lab. That number may vary, and it typically does from lab to lab.

People that are typically going to labs are people sadly that are not feeling so well. They're going through some health issues. So there's a lot of people, especially women that know intuitively something's off here. Like my fatigue, my hair loss, my weight loss resistance, my inflammatory symptoms. There's something off here. And they go to the doctor, they run the basic labs and

And the doctor will oftentimes say, there's nothing wrong. All the labs are pretty good. Maybe you're just depressed. Here's an antidepressant or you're just getting older or you're just a new mom. You're just stressed. What they're unintentionally saying is you're a lot like the other people that are going through health issues.

And that's just because something's common doesn't make it normal. And comparing yourself to people with health problems is no way for you to find out how you can feel your best. So in functional medicine, we're looking at optimal, not average. Like where does vibrant wellness reside? And if you're not there, let's figure out the context and get you there. And then we run more comprehensive labs who are looking at underlying what we call upstream or root components.

causes of why people are going through their health issues. So for example, it's based off of health history, but things like underlying gut problems or chronic infections or trauma and stress and shame, that's what I'm talking about in my latest book, these sort of mental, emotional, spiritual things and how they impact our physical health and can be literally stored in our cells, dysregulating our nervous system. But things like nutrient deficiencies and hormonal imbalances, what are the physiological and the psychological effects

upstream root pieces to the puzzle of why you feel the way that you do. And then we realized we're all different. It's bioindividuality is a major facet of what I do is that you could have a hundred people at the same diagnosis code that say a hundred people with thyroid issues and what's driving it for one person isn't driving it for the next person. There's a lot of

myriad of different variables to consider. So we don't want to be overly reductive and give everybody the same medication with that same diagnosis code because they may not be the most relevant step for them. So that's what functional medicine is. We use food as medicine. We use natural medicines as medicine. We use medications when needed. It's really both and approach, not an either or approach. I love that. Do you feel like

There's been an increase in people who are looking to use functional medicine now, because even just based on the comments and DMs that I get every day, people are asking, where can I get these lab tests from? My regular doctor isn't giving these to me. Have you seen a spike in interest? Truly, yes. I mean, it's phenomenal that I've

I started one of the first functional medicine telehealth clinics over 13 years ago. The things that I've seen change culturally over the past 13 years is bananas. 13 years ago, the blowback I would get by saying certain things, it was just so out of the box to say,

inflammation is what researchers are looking at is what's driving things like anxiety and depression and fatigue. That was very controversial at the time. And maybe it's controversial still, but it's in the scientific literature. It's not just my opinion, but it just takes a long time for it to hit mainstream and pop culture. And like for people to realize, oh, this is actually going on in the research world. And yeah, it's,

People want agency over their health. People want answers for their health. And I think the age of this medical gaslighting and this Dr. God complex is over, and it's at least on its way out. And people, especially women, I have to give credit to women because they're the ones that have really moved the needle, I think, in this conversation in wanting answers. And it's not enough to say because a guy in a white coat says so.

that's not always going to cut it. They want second opinions, they want answers, they want reasons why, they don't want to just say, "Well, just because, take this pill, see you later." Like Maya Angelou says,

When you know better, you do better. And I think that's what's happening now. It's like people know better and they want to do better. 100%. I think also podcasts like this and getting, you know, the word out about certain issues and, you know, talking about this topic is so crucial. And you really do need to kind of be your own health guru when it comes to figuring out what's going on in our own bodies. Where did you initially get into wellness? What is your story?

So I was in hindsight, I now realize that I was a very strange kid because I thought I was normal. And I guess I'm so used to being weird that I like, oh, that's why they were laughing at me. Right. I was a kid. I would go and buy like bell peppers and like raw vegetables and like dice them up at like 14 years old and like pack my lunch and

in my brown paper bag. And that's what I ate as a teenager because I was always reading things, reading books, where it was really what it was, reading health and nutrition books. And my first job, 16 years old,

I got a job at the finish line, like the sneakers shoe store at the local mall. And I used my paycheck to go to the health food store and buy like the random superfood that I read about or the random supplement blend that I read about. So that's what I like to do as a child. And then that evolved to me, obviously wanting to be formally trained in this and not just be this random quote unquote biohacker, but before biohacking was even a thing.

I went to an integrative medicine school in Southern California. And yeah, that's the rest is history. Because I graduated, obviously, knowing that I wanted to practice this way. And the whole telehealth thing, there wasn't even language for that. I just moved back to Pennsylvania, where I'm from.

from LA and there were lots of people in different states and countries that needed access to this field of healthcare where we called it a virtual functional medicine clinic back then 'cause there was no such thing as telehealth. So I'd be writing an article or talking about something like on YouTube or something like that or social media. And we started talking to people like we're talking right now via Zoom or some sort of interface like that to get, we ship labs to them and we really provide the support that many people need.

What would you say is the most common issue someone will come to you for? And sure, it's people somewhere on this inflammation spectrum. There's three main areas on the inflammation spectrum. There's silent inflammation on one end, meaning they are, if you ran labs, you'd find something, but they feel all right. I don't typically see them that much. I see most people in stage two and three. Inflammation reactivity, meaning they have symptoms.

They know there's something not right. And the labs are coming off, coming out a little bit weird, but there's no clear answers in conventional medicine. They're told that, like I mentioned earlier, that it was just kind of falling through the cracks in many ways. And they're kind of left to fend for themselves and kind of be, as you said, their health advocate and sort of immerse themselves in learning and becoming erudite and

just gaining agency over their health. And then inflammation react at the full blunt, the state tree would be like an autoimmune, the actual autoimmune disease or the diagnosable health problem, even if it's not an autoimmune problem. So researchers estimate it's about four to 10 years prior to that diagnosis when things were brewing on that inflammation spectrum. So that's a lot of time and a lot of symptoms and a lot of hard days of flare ups and feeling poorly. So that's

They're dealing with some sort of inflammatory problem, but that's very broad. I would say if you're talking about specifics, it's manifesting in things like anxiety and depression, brain fog and fatigue. When you're talking about neuroinflammatory problems, neuroinflammatory, like print issues, we see a lot of Hashimoto's autoimmune thyroiditis. We see a lot of Addison's like autoimmune adrenal issues, and then digestive problems are massive problems.

percentage of my patient, people that have IBS, chronic constipation, people that have small intestinal bacterial overgrowth or SIBO, which is what causes IBS in most cases, and people that have these sort of wild, complex chronic infections and food reactions. So we see a lot of histamine intolerance and mast cell activation syndrome, and that's oftentimes caused by these environmental toxins and biotoxins like mold,

mycotoxins and chronic Lyme disease, co-infections to Lyme, and then these underlying gut issues.

it can, what motivates somebody to come to us is going to look different. Like maybe it's the digestive issues for one person and maybe it's anxiety for the next person. But those people typically aren't just dealing with that one thing. They may think it's just that one thing, but it's just like larger context of like the body's interconnected here. And when you get to talking to somebody and really getting comprehensive with their health history, there's so much going on here, but because the body's interconnected,

It's it makes it I don't want to say healing is easy, but when you deal with these root issues, a lot of this stuff will calm down and start to move in a positive direction. Just even doing my own tests at home, whether it's the Dutch test or the stool test, I'm seeing a lot of correlation between my gut health issues, inflammation issues, hormonal. It's all kind of tied together.

Huge. Let's start with gut health, because I think everyone has so many questions about gut health. And I think a lot of people's issues kind of stem from gut health in general. Why do you think so many people in today's society are having gut health issues to begin with? Well, in short, it's a mismatch, right? It's what researchers refer to as an evolutionary mismatch or an epigenetic genetic mismatch. So 99% of our genetics

haven't changed in 10,000 years, but yet look at our world, right? It's the foods we're eating and the foods we're not eating, chronic stressors, environmental toxins, collective and personal trauma. All of these things are kind of coming to a head in many ways. And there's sort of this, I think, collective reckoning that's happening in the form of our physical health. And even if you think about this, is that we...

are, if they've learned nothing else in this conversation, we're a part of nature, right? And we are just a microcosm of nature. Humanity in its ultimate hubris likes to think we're separate than nature, but ultimately we're just part of it. And you think of what's happening from a climate change standpoint and what's happening environmentally from a, let's just say global warming or sort of a global inflammation is how I think of it, where it's causing a lot of dysregulation on a planetary level.

That's exactly what's happening on our microcosm level is that where there's a lot of dysregulation and climate change, if you will, going on in the human immune system, it's

because it's in the form of chronic inflammation. It's sort of a physiological global warming. And a lot of that has to do with our gut microbiome, which is intimately connected to the soil microbiome in our world, in the actual soil of our planet. So it's a big conversation because you really can't talk about gut health without talking about massive, massive topics that are very complex.

But to put it short, it's an evolutionary mismatch. And our microbiome, which is co-evolved with us, which in many ways we can say it's co-evolved with us, but we are here because of it. We would be all dead without our gut microbiome. So in many ways, we're sort of a...

sophisticated hosts for the microbiome. I think of the 90s cartoon, The Teenage Mutant Ninja Turtles, where I think his name was Krang, the villain with the brain inside of the huge robot. We are Krang, if I'm even getting his name right. Because if that brain leaves us, we are the robot that will just fall dead. Because we need it to metabolize food. We need it to make neurotransmitters. We need it to regulate our immune system, regulate inflammation levels.

I mean, it's massive. So our gut and brain are formed from our same fetal tissue when babies are growing in our mother's womb.

And they're inextricably linked for the rest of our life through what's known in the research as the gut-brain axis, or the connection between the gut and the brain. And 95% of serotonin is made in the gut. 50% of dopamine, our sort of pleasure, happy neurotransmitters are made in the gut and stored in the gut. And 75% of the immune system is made in the gut. So it's why we're seeing so many gut health problems. It's these confluence of factors that are big.

And the variables are different for different people. But these are the things that I can quantify with labs and look at someone's health history and look at the pieces. What are the most relevant pieces to your puzzle to start healing your body? Because you really can't heal. In most cases, you really can't heal mental health issues or hormonal problems or autoimmune problems without taking into consideration your gut.

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What a perfect episode to tell you about my own gut health routine. As you guys know, I had a big fitness journey back in 2017. I lost over 90 pounds. And what I realized from that journey is that health isn't just about fitness and weight loss. It's about internal health. And all

And all of our internal health starts in the gut. Gut health impacts so much from our mood, energy, skin, overall health, et cetera. It really impacts absolutely everything. And that's why I came up with the Bloom Nutrition Greens formula. In 2019, my husband and I came up with Bloom Nutrition. We initially launched with pre-workouts.

but I really wanted an all-in-one supplement that had all my fruits and veggies and probiotics that tasted really good that I could take every single day.

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Thank you.

So with all of these environmental triggers and things that maybe we can't control around us, what can we control when it comes to gut health? Well, I mean, I think we wield a lot of influence to varying degrees. And you're right, we cannot control everything. And I think that's sort of the deeper context here is I want there to be sort of a grace and a hopefulness and a lightness to these conversations because that's heavy stuff. But ultimately, the human species doesn't

we have some grit. I know maybe we don't show it very often these days, but we have some resilience and we wouldn't have made it this far if we couldn't handle some tough times. And if you just know a little bit about human history, you know, that's true. So it's,

You don't have to live in a bubble. You don't have to become orthorexic, which is sort of disordered eating around healthy food. You don't have to be a zealot, obsessive, militant person. You can live a normal, quote unquote, normal life. You can live in a middle ground environment.

easy, like easeful life by making some simple choices. That there is bio-individuality in this conversation. It's like the bucket analogy that I tell my patients. Like some people have big buckets, some people have small buckets. That's sort of our genetic

tolerance for stressors. A lot of my patients tend to be the smaller bucket people where they sort of hit their tipping point a lot easier, right? They're in many ways like the canaries in the coal mine for their friends and family because they cannot get away with the things that their friends and family get away with. I think I'm a small bucket for sure. I'm a small bucket.

Well, when you mentioned Dutch test and stool test, I'm like, this girl had to figure some shit out. Oh yeah. We're on the journey. We're on the journey. So yeah, that's, you're my people. I get it. It's like, and you want to figure out what's going on in your body. And that's a great thing. That's an empowering thing. So the foods we eat, it's a good place to start. I mean, talk about gut health. Every food we eat

is either gonna feed inflammation or fight it. And some in negligible ways, like some in ways you're not gonna notice, so don't stress about it. But like, it's like the bigger areas we wanna look at, like what are the most significant needle movers, both positive and negative, to really mess up your microbiome, which in turn is gonna mess up your mood and your mind and your brain health, and also mess up your hormones because of that, and inflammation levels. So, you know, starting with that, what I would call the inflammatory core four,

If they haven't done this, I would look at someone's relationship with these four things. Plus, if I could add plus one, the first four would be industrial seed oils. Like look at things like canola oil, soybean oil, you know this. I mean, it's not that that is inherently bad. Maybe that's controversial for me to say in the health space. It's, in my opinion, more to do with the out of balance ratio of these polyunsaturated fatty acids. Like we need healthy products.

Omega-3, 6, and 9, right? They're all important. But the human diet, again, evolutionary mismatch is so pro-Omega-6 and Omega-3s is so low, so that ratio is off. So the problem in my mind isn't to demonize

PUFAs, these canola oil, vegetable oil, soybean oil, safflower oil, grapeseed oil, say that they're inherently bad all the time, but okay, the ratio is just off. And they could be pro-inflammatory because you're kind of eating out of alignment with how your biochemistry and your microbiome has evolved. But for the sake of simplicity, looking at those foods and the overconsumption of them, looking at things like gluten-containing grains, which most people have heard of, right? It's like an expletive in the health world for the past 15 years, but

it's what we've done to it right it's the hybridization it's in many ways in some grains the genetic modification of it it's the spraying of glyphosate on these grain so it's not a simplistic answer of just demonizing wheat but it's saying it's a lot of variables to consider of why there's an evolutionary epigenetic genetic mismatch of the triggering inflammation in many people some people tolerate better versions of wheat like sourdough bread is for men some of the gluten to make it more digestible it's

being easier on your gut, basically. And ancient grains, again, less changed, more in alignment, sort of decreasing the chasm between epigenetics and genetics. And then dairy, same thing. What we've done to the dairy world is just insane. The crossbreeding of cows, in addition to the crossbreeding of cows, it's

the grass that the cows are eating, the grains that the cows are eating. And most cows are not grass fed and that's how they've evolved to be. And that's why you're seeing all the grass fed things out there. And the A2 milk is the subtype of the dairy protein that is more ancestral. So we're eating more in alignment with what dairy our ancestors would have eaten. And it's less inflammatory because of it. And the last would be sugar, which is like

a no-brainer, but I would say look at the grams of added sugar because humans are eating way too much compared to even just our great grandparents. It's insane. Like dumpsters full every year. And the fifth one would be alcohol if I had to add in a plus one, but it's going to mess your microbiome up too. A couple of questions about some of those points. So in terms of the oils, better oil choices, coconut, olive oil, avocado oil, any other suggestions?

All those are good. What I would look for are what's the smoking point of these oils, right? It's like the more refined an oil is, the less polyphenols, antioxidants are probably going to be in there, but tends to raise the smoking point. So you could fry, saute, bake things in those higher smoking points.

And then the lower smoking points, like the extra virgin olive oil that like is really sort of polyphenol rich, antioxidant rich. You're going to want to use those for more room temperature things like salad dressings. Yeah. So I would say all those things you just said, coconut oil, olive oil, ghee, avocado, extra virgin olive oil, and tallow and lard, even grass fed organic varieties of those all can be great sources for oils for sure. Yeah.

In terms of gluten, maybe this is, I don't know if this is a controversial question, but have you noticed a difference in the gluten in America versus Europe? Absolutely. So I have a lot of years of looking at this with patients, like thousands of people. And because we have many patients

not in the United States. And they tend to have a little bit more wiggle room as far as the food that they can eat. They don't have to be as diligent with looking at the sourcing of it. And sadly, that's becoming less and less a thing because of, I think, the globalization of food supply and where the quality of food

how things are even made there. But that has been true historically for the past 13, 15 years. And I would say for the Americans that I know that are on holiday in Europe or they're somewhere else and they know intuitively and just logically, they're not having the flare-ups, they're testing it out because they heard about this and they try it out and they know, "Oh, I could never get away with this at home, but I can get away with this here."

Part of me thinks it's multifactorial, that it's probably the stress, like the lack of stress on vacation, that they don't, they're more stressed at home. And I think that's a major component for people too. Like what's the space in which you eat that food? Because I think that plays a role in it. But certainly on a practical level, the food, the glyphosate use and sort of the wheat supply as a whole in the United States is far different than most of the world.

So everything for me comes out of my face. So when I eat processed sugar, canola oil, things that have gluten, it comes out as acne. And when I do go to Europe or even back to the U.K.,

I don't struggle with acne even when I'm eating gluten. So that's been something I've noticed, but I also agree with you. I think it is to do with the fact that we're maybe in a less anxious state. And also I'm walking a lot more on vacation. So I don't know if that's helping me with the digestion of everything, but I do think it's an interesting thing to look at. In terms of stool tests, let's hop into stool tests. I've done this twice now. I did one about a year ago and one about two weeks ago.

The test is a little traumatizing to administer, I will say. My assistant was like, what are you doing? But I think it's really, really, it's been really helpful for me. The first test showed that I had issues with leaky gut.

And I've been working on the variety in my diet and also reintroducing some healthy carbs because one of the major issues I was having was apparently due to the fact that I was ketogenic for a long time. So I'm curious what your thoughts are on that. And do you think stool tests are the most accurate way to see what's going on with the gut?

We have a long way to go. I think you're getting the best with the stool test that we have access to now. We run stool tests for all of our patients, but we're using the best data we have access to. And I like different snapshots. I like different labs for different data points. We don't necessarily have one lab with all the data points that I use, but to look at the metabolites the bacteria are producing, as well as the different colony forming units themselves and more like the

the classic sort of comprehensive functional medicine stool test, some of the bigger pointers that I look at is any opportunistic or pathogenic bacteria, leaky gut syndrome or intestinal permeability, digestion and absorption, because we aren't just what we eat, we are what we absorb. And we see a lot of maldigestive, malabsorption issues and inflammation in the gut, the different immune markers that are showing evidence of sort of gut-centric components to inflammation. So

So bacterial diversity is associated in a lot of studies to be akin to more robust, longer, healthier lives. So if you're looking at a lab, which is what you're explaining right now, of less bacterial diversity, like these beneficial probiotics, so to speak, the beneficial aspects of the microbiome, which depending on the study that you look at, it's upwards of 100 trillion bacteria. And

you're just looking at the most common ones, the most well-researched to be beneficial to the human brain, human hormones, human immune system on these tests. So you can't, it's a lot more complex than we can even quantify on a lab right now, but you're kind of getting a good scope of what the balance is. And a lack of good bacteria tends to be, I mean, because probiotics in many ways act as antibiotics because they regulate things, right? They are regulators of these opportunistic,

and pathogenic bacteria, which are kind of like weeds that overgrow in this gut garden. And if you have the lack of the good crops that these, these sort of weeds, these pathogenic bacteria can overgrow and the conversation around the ketogenic diet and

bacterial diversity, you always have to weigh what is the benefit somebody's getting out of something, right? And for the average person, I would advocate a more of a cyclical, flexible, ketogenic diet if they're going to do it at all. You know, if some people don't even have to do it, they could just moderate their carbs and sort of eat that way forever and be fine.

But there is a lot of exciting science in the ketogenic diet, which I've talked about for years and written about. And my first book was about that. But a cyclical approach, I find, is a great way to really prevent that lack of bacterial diversity because the bacteria eat what we eat.

And we need plant fibers to, the gut bacteria need plant fibers to ferment and use as food to make short chain fatty acids like butyrate and other short chain fatty acids that are needed for the human immune system. And to manufacture these beneficial compounds, we need plant fiber largely. So you can get a very whole food, plant forward, ketogenic,

diet for sure and stay in ketosis, but it's just going to be limited. You're not going to get as much plant variety there. So moderating your carbs can make it more easy for you beyond just

Not everybody wants to do ketosis long-term, right? But look, some people, I just had a patient yesterday tell me this. Like when we were moderating their carbs, she was saying, I don't feel as good. Like I felt better in ketosis, she told me. So we have to figure out how do we work? Like she's getting more benefits in ketosis than detriments. So for her, she's staying in ketosis longer time and we're leveraging tools like exogenous ketones and other things too. So she can increase her carbs, right?

and still get some ketone levels in our body. That's a rare case. Normally people can cycle with no problem. I was someone who loved keto. I felt really good on it. I had great energy. My mood was great. And I think that was part of the reason I did it for such a long time. And I agree. I think it's a great tool, maybe not for a long period of time, but it's great in the temporary, if that makes sense. I agree with you.

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Dinner time is super important in my household. We're both big foodies, health-oriented, but also so busy. And that's where we found HelloFresh. HelloFresh has 40 weekly recipes to choose from for all meal occasions, lifestyles, and preferences. So for example, I am married to a bodybuilder and I myself lift weights. So we are super protein focused. And I'm

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Go to hellofresh.com slash pow60, that's P-O-W-60, and use code POW60 for 60% off plus free shipping. I highly recommend you guys try this out, especially if you're focused on your health right now. So in terms of mental health,

Why do our guts affect our mental health? And then conversely, can our mental health affect our guts?

Yeah. So this is probably my favorite part of my job is thinking about these things, reading the research and talking to my patients about it and correlating it to labs for them because it's so bidirectional. And to me, I love the fact that as a society, we are talking more about mental health and destigmatizing it and getting people access to this stuff and not making it sort of this shameful thing. I love it. But I think in many ways,

it's an incomplete conversation around the topic because you really can't talk about mental health without realizing that mental health is not separate from physical health. Mental health is physical health. And instead of us relegating mental health as sort of the separate thing where you just have this sort of abstract chemical imbalance that really has flimsy science at best anyways, like what's actually causing this, this massive epidemic of mental health issues in the world. Well,

The researchers have been looking at this for the past decade plus. This is nothing new. I just feel like functional medicine has been the voice, sort of the microphone for the research world, the gut research world, basically. And what is very clear is that there's a massive gut component to many people's mental health issues. And

Different bacterial colonies, beneficial bacteria, different types of lactobacillus and bifidobacterium are associated with low levels, are associated with things like anxiety and depression. There's other studies that show different dysbiosis, different bacterial imbalances in the gut are actually a causative rule in different neuroinflammatory autoimmune problems. It's

researched in different autism studies as well, fatigue, brain fog, chronic fatigue syndrome as well, and many other autoimmune problems. So we have to realize that this is implicated. There's a massive gut component to this. And as I mentioned earlier, 95% of serotonin is made in the gut, 50% of dopamine and inflammation is an immune system issue. 75% of that is made in the gut.

And what the researchers referred to it is the cytokine model of cognitive function. Cytokines are pro-inflammatory cells. Like how does inflammation impact how our brain works? How does inflammation impact mental health? But it's bidirectional, right? And I think that we need to realize that it's, and that's why my newest book, I call it Gut Feelings, because I want to talk about the gut and the feelings, because they both are interplaying and cross-talking with each other all the time.

And physiological things, like I just said, the gut problems, the inflammation issues, like stealth infections, like mold toxins, chronic Lyme, will drive anxiety and depression, brain fog and fatigue. We just have to figure out what variables are at play for people. Nutrient deficiencies would be on that list too.

But the feeling side will also impact your physical health. And I think of all my people that have autoimmunity and looking at the research around chronic stress and shame and trauma and even intergenerational trauma, how those mental, emotional, spiritual things can literally be stored in ourselves, dysregulating our nervous system, raising inflammation levels. So

What came first, the chicken or the egg? Like it's a bit of both for most people. And that's where health history and context will determine for the individual what pieces are the most relevant for me. But for most people, it's going to be a bit of both the mental, emotional stuff and the physical stuff that's impacting their mental health. So if someone came to you and let's say they had a mood disorder or they were struggling with mental health and they wanted to

start a diet or a lifestyle that would help them with that or help them manage that, how would you begin to approach it? Well, it's the unsexy stuff first, where it's like a health history stuff. Nobody wants to hear that. But it's like it's normally me spending an hour plus with them, really asking them like in-depth questions and like clinically just investigating things. And one of the things that we talk to patients about is what's called an adverse childhood experience.

question at score, basically. The higher aced you are,

it's associated in the research with more likely to have different inflammatory problems later on in life, different mental health issues, different autoimmune issues, different metabolic issues like type two diabetes, insulin resistance, things like that. So it's not just that it's we'll also look talking about gut health in detail, endocrine, hormonal health in detail, how they were born. I mean, babies that are born vaginally versus C-section have different microbiomes at the beginning of their life because the first

microbiome donation we get is from our mother. And then were we breastfed or not? Like these are things that are, we didn't have even decision on, but we have to know cumulatively what's our story. And we all have messy,

not perfect stories. That's not to stress anybody out. It's just saying, what are the pieces to my story? And no matter how bad that story may look like to you, the human body is resilient. Like you are resilient, whoever's listening to this. And it's not to be overwhelmed or shamed or feel like, what the heck, I'm screwed. Like I'm up against the worst. I see people up against the seemingly insurmountable, overcome these health issues and heal. So

It starts with that stuff. Labs are there if you want it and are needed for some people. But look, that's why I write books too, because I realized not everybody's going to come to my telehealth center. Now everybody's going to set up a consultation or put their poop in a fry dish and send it out to a lab like you did. The brave ones will.

Like, yeah, I mean, I'm there if they need that. That's what I do 10 hours a day. I look at labs for people. But I realized like there are I'm meeting people at different parts of their journey. So when I'm on my podcast talking, I'm thinking, OK, that's thousands of people that may not get a poop test, but they're going to go and learn things from listening to us talk today. Right. And the book is a great resource because really what I did is just

boil down, like what are the top gut action items and feeling action items that I've seen in protocols be the best, most effective needle movers for these people that I love. So that's what it is. Start with food. I talk about in the book, a GAPS protocol, which stands for gut and psychology syndrome or gut and physiology syndrome, which is a lot of soups and stews, which is really restorative and nourishing and grounding to the gut brain axis. So that's a

great resource to do over the protocol in the book. And I have many patients do it. And then, you know, the feeling action items are so many that I talk about, but I mean, things like breath work, meditation, EMDR, somatic experiences, self-compassion practices are so much, but there's, it's about learning what resonates with you and what's the most relevant for you and then staying consistent with it.

I think the approach of, you know, when you have a consultation, not just talking about the medical history, but talking about the trauma history and emotional history is so, so crucial. Even in my personal experience, I'm really health conscious. I eat super well. I exercise every day, but I'm a chronically stressed individual and I'm seeing that in these lab results. I'm getting back and seeing it in my blood work and it's insane how

To kind of, you know, I felt like my healthy lifestyle would make up for the stress that I experience on a daily basis and the lack of meditation that I, you know, the lack of routine maybe in my self-care. So to hear it from you is also a big reality check for someone like me who's health obsessed, but maybe not taking care of the spiritual side.

Yeah, you're not alone, by the way. I think giving yourself grace on that, because I think a lot, it's less prescriptive, right? I think for what I know about my patients is that it's easier, right? I didn't say easy, but it's easier for me to say, okay, these foods we know are going to be the ones that are most likely to mess up your microbiome, mind, mood, complex. So decrease those, increase the ones that love you back, foods that love you back. And then just, that's very cut and dried,

prescriptive, and they know what to expect. It's a lot bigger and more complex. Sometimes you don't get the immediate gratification all the time with the feeling side of it. Someone does one

breath work they may feel good in the moment but they just they're busy and they're it's distracted and it's hard to calm down sometimes a nervous system that's used to being more in that sympathetic fight-or-flight stressed state right it's very uncomfortable for many people that have very deep neural pathways built over the course of their life of having to be that way that hyper vigilant state so these acts of stillness is what i how i called it in the book

Look, these supporters of the parasympathetic, the resting, the digesting, the hormone balanced aspect of our autonomic nervous system is uncomfortable for many people that just like yourself and myself as well. And a lot of people that are listening to it because our culture is very sympathetic-based.

driven. It's very like pro sympathetic fight or flight stress. So parasympathetic is seen as sort of a waste of time, not as important, sort of like why I have better things to do. But it's the most important I tell you that the patients that I see do both the gut and the feeling stuff

they untangle the dysregulation so much faster. You're so right. It kind of feels like a fight in today's society to find moments of stillness because there's the phone, there's so much noise all over the place. And I feel like this is almost encouraged to stay busy constantly. Taking that minute to sit down and be still feels...

like a struggle, but once you get in the habit of it, because I've been on and off with it, once you get in the habit, it becomes easier and easier, I feel like. Totally. Yeah, you're right. It's glorified. It's deified even. Burnout is sort of this sort of deified badge of honor, but it's not. I mean, we are not machines. We are not robots. We are not our phones. We need to be more being in the human being. We need to bring that being up. And

Healthy boundaries with technology is a major part of the book. I mean, the research is clear. It is contributing to that sympathetic fight or flight stress state because of the blue light, because of the FOMO inducing content we're constantly scrolling and it's sort of designed that way to be addictive and compulsive. But again, it adds to the distraction. I think that we are so, so

sold so much distractions that it's any acts of stillness that goes inward is uncomfortable. And I see people can get very outwardly kind of defensive and say, well, meditation is not for me. You know, it's not, it's not for me, but then it's,

The people that typically say there are the people that need it the most. I mean, it's like, that's why you need to do it because it's not good. And it's the reason why they call it a practice because nobody's actually good at it. And we all need, we all have different monkey minds, like the Buddhists call it, of just sort of supporting that parasympathetic. But the entry point of how you do the meditation is really, yes, that is bio-individual. Not everybody needs to sit in the lotus position and do their traditional practices. And so,

that what's your entry point to the acts of stillness that's like make your life a meditation like maybe it's forest bathing for you like in the research out of japan and south korea of shinrin yoku of just using nature as a meditation maybe a walking meditation is more appropriate for you or maybe a somatic movement experience is appropriate like dancing or drumming or yoga or

or tapping these so many tools that can be meditative too. But even if you think about the traditional breathing, mindfulness, or the present moment awareness, I have to say, even those, they don't come to naturally to most people. And that's why we do it. Cause it's like going to the gym once and saying like the gym didn't work for me. And so no, it's, we have weak mindfulness muscles and we need to work it out and gain some resilience. What is forest bathing? I need to know.

So forest bathing sounds like a weird thing that you and I do weird things in wellness. Like we make up weird, weird words and we're going to Venice beach and going, getting our bathtubs to going into the forest and bathing in the forest.

It's not what that is, but it's translated from the Japanese of Shinrin-yoku, which means translates to English at literally as forest bathing. So it's taking nature in with all of your senses, sort of using nature as a medicine and as a meditation. It's sort of a sensorial process.

experience that physicians in Japan actually prescribe for their patients for things like anxiety and depression and fatigue.

because it's the technicalities of it, it's multi-sense. If you think about from visualizing nature, breathing it in, listening to the sounds, it's very meditative. But on one level from a breathing in standpoint, the essential oil compounds that are in plants, in water, in nature, it's been shown to modulate the human immune system in a positive way, supporting the parasympathetic and lowering inflammation levels.

So that's just one level, let alone the sights and sounds, the stillness, like all of that has been very well researched in Japan and South Korea to be beneficial for mental health issues, immune issues, cardiovascular issues, because it's supportive of the parasympathetic. So that's one of the tools that I talked about. I talk about in gut feelings. It's one of the feeling action items that I talk about in the book.

I'm going to need that book. I cannot wait to read it. It sounds incredible. Quickfire community Q&A for you. Okay.

What is the most common misconception in your practice? It's that functional medicine is just for the elite. Functional medicine is just for the wealthy, celebrity, and it's unattainable to the average person. That is just absolutely not true. I mean, 99% of my patients for the past 13 years have been normal, middle-class, working-class people. And yeah, I have some people that the world would know who they are as my patients, but they are a

1% of my patients, 99 out of 100 are school teachers. School teachers are my top patient base. Nurses are the second highest patient base. Engineers, interestingly enough. And then I found over the course of my career that the commonality between functional medicine, nurses, school teachers, and engineers is a love of spreadsheets and getting to the root cause of why they're

Their poop is why their gut health is off and they want to see that gut health improve and their inflammation levels improve. Those are not celebrities. So I have like thousands of thousands of thousands of people experience every year

that everyday normal people can get healthy. Their why is just bigger than their excuses. And many people count themselves out with the sort of victim mentality that it's, oh, it's not for me. It's just for these wealthy people in Hollywood. It is definitely not the case. If someone wants to book with you, can they just go on your website?

Yeah, drwillcold.com. We have group telehealth models to make it even more democratized, more accessible, more affordable. I still see people with concierge as well. So yeah, it's all that I do, but I have an amazing team as well. If people want to get in sooner, have options for them. What is one of your current health goals right now? I'll tell you what it is. I'm a work in progress, just like anybody. And maybe it's good that I'm

saying this, because I think sometimes with this FOMO inducing content we have on social media, it's easy to compare ourselves to the highlight reels of somebody else. It's the feeling stuff. It does not come naturally to me. So when I say it's a practice, like what you said is exactly where I'm at. It's like, I have to show up and I would rather do a workout in the gym than go and do a meditation. It's just not as easy. It's like, if I have 20 minutes, I'd rather do one

versus the other. So it's me prioritizing and saying, no, I need to carve time in here. And we make time for things that are important to us. So it's me shifting my, making this an important thing to me instead of me putting it in the back burner and say, I don't have time for it. That's an excuse that people say oftentimes, but we often, we, in most cases, we'll make time for things that are important to us. So that's my

New Year's resolution is to be more consistent with my meditation practice. I love it. And perfectly aligned with the book as well. Yeah. Feelings on acupuncture.

I think it's great. I talk about it in the book. I talk about it with my patients because science is catching up with antiquity, right? Traditional Chinese medicine has known for thousands of years that there were these things called meridians. We couldn't see them. And now we're finding out, hey, wow, there's some nervous system connection in utero to these things. And we have a lot of

exciting data and obviously more should be done, but a lot of data to show that acupuncture can be a great tool to support the parasympathetic, to really get the body in a more of a balanced state. And that's why mainstream institutions, hospitals have, many of them have acupuncture as an adjunctive complementary tool.

option for people. So I think it's a great tool. It's a great tool for people that have many different inflammatory problems. And I would consider it an effective tool within the toolbox. And I'll say this real fast. Years ago, my son's 16 now and my daughter's 13. We had an acupuncturist in LA and she, weeks after conception, she told my wife both times, she felt her pulse and she said,

I don't know if you know this or not, but you're pregnant. And if you are, it's a boy. And the second time she said, you're pregnant. I'm pretty sure. And if you are, it's a girl. Before a pregnancy test could even tell. No way. Oh, my gosh. That's crazy. So the reason I asked was kind of selfishly. I went to an acupuncturist for the first time the other day, and she was able to tell me things about myself that she would have had no idea.

I mean, that's insane. Yeah. I mean, it's through pulse reading, tongue reading, which I'm sure she did, looking at your eyes, asking you lots of questions. It's a deep, rich science and art. And I'm such a fan of it. She told me I'm an overthinker, which, you know, she wasn't wrong. Okay, now it's time for the question we ask every guest. I started this podcast because I believe everyone's pursuit of wellness looks different. What does wellness mean to you?

Wellness means to me, and this is appropriate because I have this hoodie on right here. This is wellness on it. I didn't realize that.

What it means to me is a massive component that I'm always educating my patients on is imbuing a grace and a lightness into your life. So these amazing wellness tools of all the food things we talked about today or the self-care things we talked today or the gut feeling things that we talked about today, it is a shell of itself.

if you don't imbue it with grace and lightness. Because all of that, when it's a shell of itself, it can be turned into a weapon. It can be used as such a weapon against your own self, right? You use it to punish yourself, you use it to shame yourself, you do it to obsess about it, and it can become sort of this shame-based orthorexic thing

Because it's a shell of itself. But if you shift your paradigm to say, how can I really imbue this with using self-care as a form of self-respect and realizing, no, I can eat whatever the heck I want, but I love feeling great more than I want something that's going to dim my light. And avoiding things that don't love me back isn't restrictive. It isn't toxic diet culture. It's self-respect. And that's what wellness means to me. It's flipping its head on dietetics.

diet culture versus anti-diet culture, because both are just sort of both are messed up in my opinion. But really having a logical, loving, self-respecting, healthy boundaries for yourself when it comes to food and your body. So that's what wellness is for me. It's not just one word, but that's how I feel like the paradigm shift we need in wellness, I guess, is the best way I can put it. Fantastic answer. Where can people find you online?

Everything's at drwillcool.com. That's D-R-W-I-L-L-C-O-L-E.com. The links to gut feelings there. We're giving away tons of pre-order stuff right now until the book comes out and after. There's a three-week mastermind online with myself, Dr. Nicole Lepera, the holistic psychologist who actually wrote the foreword of the book.

as well as Dr. Daniel Amen and Dr. Caroline Leaf. We're doing sort of this deep dive of the science around the things we talked about today, and they get tons of free stuff when you pre-order. But all of that's at drwillkohl.com. And I made a quiz. I made a quiz because people like quizzes. The quiz is not in the book, but I put the quiz on the website because it's adapted from questions that I ask patients for them to sort of measure their microbiome mind

connection. And what I call in the book, shame, inflammation, sort of this sort of mental, emotional, spiritual impact on the physical body is impacting the inflammation levels. So the quiz is there. And then my podcast, the art of being well, which you're going to be on. I'm so excited. Thank you for coming on, but it's called the art of being well, it's also with your media. And there's an episode out every week. So exciting. Could we do a giveaway with the book?

Yeah, let's do it. Let's do it. Everyone, I guess go leave a comment on Dr. Will's latest post and my latest post, your favorite part of this episode, and we will pick someone to receive the book. Amazing. Love it. Thank you so much. That was incredible.

Thank you for listening to today's episode. Go comment on my last Instagram at Mari Llewellyn with the guest you want to see next. I'll be picking one person from the comments to send our bloom greens to. Make sure you hit follow so you never miss my weekly episodes. If you enjoyed the conversation, be sure to share and leave a review. See you next week.

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