Which underlying causes can lead to rheumatoid arthritis, and how can we act to prevent them? Dr. Kiran Krishnan explains the crucial role of our microbiome, and how we can even reverse symptoms by keeping it healthy.
We discuss in this interview:
- What is the microbiome and the role of microbes in our body
- Dysfunctional microbiome and chronic illnesses
- Dysbiosis of the colon and its impact on the immune system
- Leaky gut
- Butyrate and building the mucus barrier in the gut
- How antibiotics, diet and general lifestyle can negatively impact this process
- The connection between leakiness and inflammation
- Reversing inflammation without stopping the immune system – like the allopathic approach does
- Increasing the diversity on a plant-based diet using the Paddison Program for RA
- The role of stress and the importance of stress mangement
- Staying in contact with nature
- Psychobiotics
- The placebo effect
- Kiran’s Microbiome Labs Product Store https://microbiomelabs.com/home/products/
Clint – I am super excited about my very special guest today. I have watched him on many, many other interviews across multiple platforms for about the last 12 months, and he is one of the leading world experts in the microbiome on gut-derived inflammation, and systemic inflammation. Today we’re going to talk about all of the underlying causes of rheumatoid arthritis, namely leaky gut, dysbiosis, lipopolysaccharide in the bloodstream, and systemic inflammation. We’re going to cover all that. He is a guru at this, it’s Kiran Krishnan. Thanks for joining us.
Kiran – It is my pleasure. Thank you so much for having me.
Clint – Now, let’s get straight into it. You’re a microbiologist, you’re a gut health pioneer, and you’re wonderful at helping us understand complex topics in a simpler way. Let’s start with the microbiome. What is it or how does it impact us as humans?
Kiran – Yeah. In fact, it may be easier if we try to illustrate how it doesn’t impact because then the answer is zero, right? It impacts everything. Let’s talk about the microbiome for a moment. The microbiome is described as the totality of microbes and their genetic elements as they interact with the host. Of course, our human shell is the host. Now, the totality of microbes refers to bacteria, viruses, fungi, protozoa, and all kinds of organisms. We have a nice variety of organisms that fit into different phylum and different categories within our system. They exist virtually everywhere in the body, in the digestive tract, the skin, in our circulation, and in our brains or virtually everywhere. When you get to specific ecosystems like the gut or the skin, then we often refer to that as the microbiota. For people to help with terms, they may hear both terms and get confused with microbiome, he just said microbiota. What is the microbiome? So the biome is a whole thing, all of the ecosystem. The microbiota is a specific ecosystem of a given region. Then, the other part of the microbiome definition the genetic elements, that’s where this really becomes interesting. It is because as we progress in the understanding of human biology, it becomes apparent that there are microbes within us, right? Scientists started swabbing and taking samples out of stool and growing microbes. Then, you consistently see microbes in the stool. The understanding was that there are probably microbes in the gut helping us digest and break things down. But then you start using high technology like genome sequencing. You start to be able to discern all the different microbes. Then, what we came to discover is these microbes were virtually everywhere in the body and that they were commensal. They were there not as an infection and not as a contaminant, but they were meant to be there. Thus, that understanding was happening. Now, in parallel, another research line was happening that really created a massive amount of confusion. That was the Human Genome Project, right? A lot of people may remember when they had this goal of sequencing the entire human genome. The idea was it was important to sequence the entire human genome because we were going to find a gene for every disease that we deal with. The assumption was disease was driven by genetic issues and dysfunctions. The early estimates were that the human genome likely contained 150 to 200,000 functional genes. It is because we are so complex, that we contain lots of biochemical capabilities, lots of metabolic capabilities. Thus, we must have a lot of genes. They go through the whole genome human genome project. As it turns out, we’ve got about 22,000 functional genes, And that sounds like a lot.
Kiran – If you don’t know about genetics, keep in mind an earthworm has about 32,000 functional genes. We are significantly less sophisticated than an earthworm is. Then, the question became, how the hell do we do all the things we do? If we barely have enough genetics to get by? Then, that’s when the parallel streams started to come about. The studies on the microbes in the human body and then the genomics and the lack of genomics in the human body. That’s when the Human Microbiome Project started. The hypothesis was if we don’t have enough genes, maybe we house microbes that have genes that conduct the vast majority of our functionality. This is where the microbiome begins and it’s this understanding that is really important for people to grasp. It is because then you start to realize that the majority of our code to function as a human comes from microbes, not from us. If we lose those microbes, or if we don’t have some of those microbes, or if they die off because of our choices and behaviors, we also lose their genes. We also lose those codes and capabilities. Then, it compromises our ability to be human. Unless, we encompass and incorporate, take care of our microbiome, we become less and less human as we go along. We become less and less adapted to existing in the world that we live in today.
Kiran – So that’s the microbiome in a nutshell. Then because of that, it affects everything. here’s a very important way to think about the microbiome. It’s an ecosystem, right? This ecosystem, through the course of evolution, has been designed to be a symbiotic type of relationship with its host. We provided a home, a very elegant home, and a biologically elegant home. They do a lot to maintain the home. Now, if we start having an antagonistic relationship with this ecosystem, meaning we expose the ecosystem to things like antibiotics, antimicrobials, processed foods, pesticides, herbicides, plastics, and all these things that we do so well as humans. Then, we start exposing that ecosystem to those negative stimuli, or we start creating an antagonistic relationship. The ecosystem starts to dismantle and change from being symbiotic to being pathogenic because now the ecosystem that supports your functionality actually starts to drive disease. The microbiome and the human, which are kind of one and the same, have a very interesting spectrum of relationships. On one end the microbiome is the most protective and supportive thing in your system. On the other end, where the microbiome becomes the most toxic thing to your system. In the case of people with disease, their microbiomes have leaned all the way to that end. Wherein, it’s the most toxic thing in their system. Thus, most chronic illnesses are driven by a dysfunctional microbiome.
Clint – Wonderful. Now that would be called dysbiosis? A dysfunctional microbiome?
Kiran – Yeah, it’s a very general word for an imbalance of microbes. There are a few different ways you can describe inequality. But to me, the most profound way to describe inequality is an imbalance of microbes that build and maintain the gut lining versus microbes that break down and eat away at the gut lining. The moment you have that imbalance, then you have the issue of chronic low-grade inflammation and leaky gut and all that, which I’m sure we’ll jump into. Thus, dysbiosis really moves you towards disease or allows you to have resilience and health.
Clint – Wonderful. Just as we were speaking about before we hit record here. The spectrum of content that you have to talk about on this topic is so vast. My challenge is to try and keep this as relevant as possible and not become my own passion and education session. So to to keep it to my audience’s interest the most. Let’s go to specifically the gut because I know that you’ve spoken on many platforms about the oral microbiome and how that impacts SIBO and other things. We might even get there, But let’s go to the colon. The microbes that we have in our colon. Then, talk about dysbiosis of the colon, because what the studies have shown is that folks with rheumatoid arthritis have dysbiosis in their large bowel. Also, the degree of dysbiosis correlates to the severity of their rheumatoid arthritis. The more dysbiosis, the more joint pain. So what could be happening there and what sort of things? What would a dysbiotic colon look like?
Kiran – Yeah. A dysbiotic colon would typically be one that has low diversity. It means that the number of viable organisms tends to be lower than it should be, and that’s one factor. The second factor is low levels of what we call keystone species. These are really important species that not only maintain diversity and balance within the microbiome. Then, they also produce byproducts that are incredibly important for the host and for the host immune system. We’ll dig into the immune system and the microbiome because this becomes super relevant for a condition like rheumatoid arthritis. So loss of diversity and loss of keystone species. Those are the two profound, most profound factors in a dysbiotic colon. Then, we can talk about how that happens and why. But what it results in is, number one, a lack of compounds that are needed for the immune system to function properly. A lack of compounds that are needed to manage inflammation in the body. Also, an inability to break down undigested food and convert it into really important metabolites that the immune system uses. Those are what our bodies need for repair and mechanisms as well. Finally, it also leads to leakiness in the gut, which means the lining of the intestine is permeable. When that lining becomes permeable, you start to leak in a number of toxins and things that can generate massive amounts of inflammation right within the body. Now, in the case of leakiness in the gut.
Kiran – The moment you start getting leakiness in the gut. The inflammation first starts in the lining of the gut. If people think about the lining of their intestines as a couple of important structures. The lumen is basically the tube where the food goes through or it’s in a hollow tube, essentially. Then the lining of the tube, the inner surface of the tube is made up of a mucosal layer. There’s mucus in there and there’s a sizeable component to that mucus layer. There are two components of the mucus layer. There’s mucin one where all the microbes are swimming around in that top mucus layer. There’s mucin two where the microbes aren’t present, they don’t migrate into that layer. That’s really a safety zone for the lining cells that make up the intestinal barrier. Then, you come down and have the intestinal barrier cells. Now, keep in mind that the intestinal barrier is really interesting because it’s the last barrier that separates something from truly being inside of the body. With that, you can consume something. We have this misconception that if we put it in our mouth and swallow it, it’s in the body, but it’s actually not in the body yet. It is because your digestive tract is a tube that’s open on both ends so things can move right through and not actually enter the body, which is circulation.
Kiran – In order for something to enter circulation, it has to go through those mucosal layers, pass through the intestinal cells, and then enter into circulation. The intestinal cells are the final barrier before something actually enters your blood. Given that they are that important of a barrier because they’re protecting you from all these unwanted things that may enter your system. Given how important they are, it’s really quite curious that they are just one cell thick as a barrier. One human cell thick and that’s not a very thick barrier. But the reason they are that way is because the intestines, both the small and the large, have to be selectively permeable. Thus, they have to let certain things through. In the small intestine, for example, they have to let through nutrients. That’s where you absorb a lot of your nutrients, proteins, carbohydrates, vitamins, and so on. The same thing in the large intestines, you do absorb nutrients not from breaking down the food, but from the microbes fermenting the food in the gut. The single-cell layer is a barrier nonetheless. However, it is a dynamic barrier in that it’s supposed to know when to open up. It also allows things through and remains sealed when it’s supposed to not allow things through like toxins. Now, the control of when it’s open or closed is also done by keystone species and other microbes in the large bowel. If you’re low on keystone species, your barrier is going to be mostly open. Things are going to be leaking through all the time. The mucosal layer that acts as the primary hurdle for things getting through that mucosal layer also is controlled by microbes. If you’re missing those microbes, you also have a very thin mucosal layer. You have an open barrier, things start to leak through all the time. In the case of rheumatoid arthritis, when you have dysbiosis, you tend to have a diminished mucosal lining. Also, you tend to have an open barrier. You have lots of things leaking through all the time and those things are driving inflammation in the body. At the same time, your communication between the microbiome and the immune system is dismantled. It is because of your dysbiotic and we’ll talk about what kind of communication they have. Then, the third thing is because you’re dysbiotic, you’re not producing all of these important anti-inflammatory and repair compounds. Thus, you can’t repair all the damage that’s happening. You have to remember that there’s a triple whammy going on in people with rheumatoid arthritis. It isn’t that you just have bad luck and all of a sudden you’re like, the gene turned on and now my joints are being attacked. Nope, that was a very slow and steady ecological dismantling process that has occurred. Now, it leads to this outcome and the best part about all of this is you can reverse that process and repair it.
Clint – Wonderful, right? I’m just wondering which aspect of this should we go deeper in first? The mucosal lining seems like this is where you mentioned mucin one and mucin two. We’ve got the outer and the inner. All the microbes live and that’s their home or that’s their happy mucus home. But then the lower layer of the mucus, they don’t live and that’s the protective layer. How can we establish a stronger mucosal barrier then? If all this stuff’s getting into the bloodstream through that mucosal barrier, would it be a gross approximation, a solution B, just try and have a better mucosal layer?
Kiran – That becomes a very essential thing, right? If you can’t continuously produce your mucus barrier, you will end up with a diminished mucus barrier, which dramatically opens you up for leakiness in the gut. The way the mucus barrier works is it’s a layer that is built from the bottom up. What’s actually secreted is that mucin two-like layer, that thicker barrier-like structure, and then it’s constantly being pushed up. Then, it gets to a certain point where there are microbes that eat the top layer of the mucin two and turn it into mucin one. Then, as the mucin one gets pushed up, it’s the top layer sloughed off through defecation. Think of the mucus as a continuous elevator that’s continuously growing from the bottom and pushing up. It’s exactly the same as your skin, right? Skin, remember, is a barrier that’s being grown from the inside out. Then, the topmost layer swaps off, and then new layers keep pushing up. You have to keep building the mucus layer. It’s not like we’re born with one mucus layer and that’s it, right? The mucus layer is supposed to be able to turn over completely within 72 hours, right? That’s how active it is. How is that done? Well, so this is where the rubber hits the road, right? We have these amazing cells in our intestines called goblet cells. These amazing cells are designed to produce mucin. They’re the ones that are continuously producing this mucus secreting it up and creating the entire mucus barrier. Goblet cells require something called Butyrate. Butyrate is a short-chain fatty acid that’s made by these keystone species that digest fibers and digest prebiotics. They break down prebiotics and fibers and convert them to butyrate and other short-chain fatty acids. This Butyrate feeds the goblet cells and provides them the energy they need to produce the mucus. Now, you have the mucus factory and you have the fuel for the factory. But what’s the on switch for the factory? What turns on the goblet cells to tell it to produce mucus? That’s another interesting thing. As it turns out, a lot of the on-switch is from microbes. There’s a bacteria called Akkermansia Muciniphila. One of the things it does is it’s one of those microbes that’s that’s responsible for eating the top layer of the mucin to convert it to mucin one. When it does that, it turns on a gene called the MMUT gene. The MMUT gene is the gene that tells the goblet cells to start producing mucus. Thus, you need Akkermansia to turn on our gene to tell our goblet cells to produce mucus. But our goblet cells need short-chain fatty acids from Faecalibacterium prausnitzii in order to fuel the production of the mucus. Now, you start to see this beautiful symbiotic relationship. Thus, you can develop a condition like rheumatoid arthritis.
Kiran – If you don’t have Akkermansia telling your gene to turn on. Then, even if the gene turns on and the goblet cells are ready to go. If you don’t have the butyrate producing microbes to produce butyrate for you. So if you’re missing these two microbes, you have the goblet cells, you have the gene, and you can’t do anything with it. This is because the microbes are largely in control. Now, you can see that if you went through a process of antibiotics, poor diet choices, living in a place where we get pesticides and all that. These two microbes start to diminish, then our ability to regenerate the mucus becomes compromised. Our barrier shrinks and our gut becomes leaky. Now, you’re set up for rheumatoid arthritis. It’s a process and it’s a process of dismantling our ecosystem slowly, step by step. It’s a factor of the modern world, right? It’s not something that’s inherent to humans as a species. You don’t have rheumatoid arthritis in the Papua New Guinea tribes that are hunter gatherer tribes and foraging tribes. You don’t have it in the hands of Tanzania tribes. Actually, largely in rural people, you see a lot more things like rheumatoid arthritis and other autoimmune conditions in people in urban areas versus people in rural areas, for example. It’s an unfortunate occurrence of our lifestyle.
Clint – We’ll get back on track in just a moment. Just FYI, I did five years of antibiotics as a teenager for acne treatment, and then I do entertainment. I was asked to entertain the Western troops throughout the Middle East in 2006. I went over there and the anti-malaria protocol was three months of more antibiotics. I took them and when I got back from the deployment, I developed rheumatoid arthritis. The studies show a strong link between not just a recency of antibiotics and the development of rheumatoid. It is a cumulative relationship as well associated with the development likelihood of rheumatoid. I had five years plus another three months, which was recent and away we went. Just to sort of give you an example firsthand of someone else who falls into this category.
Kiran – Here’s the thing though the five years of antibiotics are really detrimental to your gut microbiome. It’s a perfect way to set up a disease process like rheumatoid arthritis. The good news, however, is even after that you can actually recover your microbiome because it’s an ecosystem. The thing about microbes, especially bacteria, is you can never get rid of them 100%. This is why all the cleaning products that claim to sterilize things always say kills 99.9% of microbes. They say that because they cannot say you kill 100% of microbes, they could always be one cell just hanging on, waiting for the right environment to multiply. Then, it becomes our job to foster the growth of those few remaining examples of your keystone species and so on. Then, one of my biggest goals is to ensure that we’re providing people with adequate hope. Even if they’ve had years of damage to their gut. Then, they have resulting chronic illness because of that, you can absolutely fix it and reverse it. We’ll talk about how you do that.
Clint – Yeah. Awesome, right? Well, I think we’re about a third or nearly half the way through the problem setting up the issue here. Let’s continue looking at the rest of the problem further. Then, we’ll enjoy talking about what we can do to try and resolve that. Then, you mentioned Akkermansia, one of the keystone or most important species in our microbiome. Then, we talked about short-chain fatty acids that fuel the goblet cells that then are able to produce mucus. You mentioned also that there is another difficult-to-pronounce bacteria that helps to kill bacteria.
Kiran – Prausnitzii
Clint – Yeah. I can’t say that.
Kiran – That one is off the tongue. Yeah, that one is inversely correlated with all kinds of inflammatory bowel conditions like Crohn’s, colitis, microcolitis, colorectal cancer, and so on. So any time there’s inflammation and significant damage to the lining of the gut, that means you have diminished fecal bacteria. Prausnitzii.
Clint – Okay, great. Now, we are taking this another step further. Then, when we have this diminished mucosal lining and low keystone species and low other species that are difficult to pronounce. We’re then getting stuff entering our circulation or entering the bloodstream to bring this back to the rheumatoid studies. We know that rheumatoid arthritis, synovial fluid, has identified bacterial components that are meant to be in the gut, that are actually in our synovial tissues. We can talk about that. Also, really elevated levels of this stuff called LPS endotoxin. I’d love you to talk about what’s getting into our bloodstream and what does it do when it gets there. How does it stir us up?
Kiran – In fact, when you have a dysbiotic gut it leads to a leaky gut. In terms of setting up the pathogenesis of diseases like rheumatoid arthritis, you actually have a double whammy. When the gut microbiome is dismantled, there are multiple things working towards disease. Let me explain the first part as to what’s leaking in, right? What can actually leak are things like bacterial components. You can get like the bacterial flagellum or the actual whole bacteria to some degree, depending on how leaky the gut is. Viruses, environmental toxins, and all of these things leaking into circulation. Now, most of what leaks in about 85% has to go to the liver first. It goes through the portal circulation to a certain degree as much as it can. Now, it also escapes into circulation, general circulation as well, and makes its way throughout all kinds of tissue. Whenever it ends up in tissue, your tissue has to deal with it by signaling the immune system to come to that area and neutralize or deal with whatever that toxigenic substance. Now, the reason why LPS becomes a problem, number one, it’s because of the the abundance of LPS in the gut. Lps is an endotoxin, meaning it’s a toxin that’s generated inside the body. Versus an exotoxin is one that comes in from the outside. Thus, an exotoxin would be like an environmental toxin or mold toxin that you might have in a home or workplace somewhere in the room. You can get away from exotoxins, you can reshape your lifestyle to reduce the exposure to exotoxins. But there’s nothing you can do to get away from Endotoxins because they’re produced by large numbers of bacteria in your gut lining. Now, you might ask the question, why the hell do we have all these microbes that are producing endotoxins? Well, they’re not actually toxins when they’re in the bacteria. In fact, the bacteria, many of which are your commensal bacteria, utilize these compounds, this LPS compound for things like adhesion or communication with other bacteria and so on. The microbes aren’t actually producing it to create a toxigenic effect. It just so happens over time, over the course of evolution, and your immune system has used LPs as a way of identifying the presence of bacteria. It learns what LPS looks like. This is because LPS represents bacteria. Inside your body, any time you have high amounts of LPS, your immune system thinks you’re going septic because it thinks you are getting a huge influx of bacteria. Keep in mind that these are pattern-recognition proteins, and that’s what we call them in immunology. It means that your immune system develops a capability of recognizing certain patterns and proteins in certain microbes. That’s how your immune system tries to tell the difference between one microbe and the other microbe. LPS being as ubiquitous as it is among bacteria in your gut, your immune system has an innate knowledge of it. In fact, to a point where your immune system makes a protein called LBP LPS binding protein that secretes inside your body to run around looking for LPS all the time. Now, why does your immune system do that? It is because, again, your gut barrier or your lining is only one cell thick. It doesn’t take much for that gut barrier to get damaged. Then, trillions of microbes escape into circulation, putting you into septicemia, bacteremia, or even things like your gums, for example. Our gums are a direct conduit into our circulation. We have 22% of the microbes in our body are in our mouth and we have lots of gram-negative toxigenic pathogenic organisms in our mouth. If we get trauma in our gums, those bacteria are flowing in by the billions into your circulation. We have all these areas in the body that are susceptible to microbes flooding in. Over time your immune systems develop this defense mechanism to look for LPS as a sign of bacteremia. Thus, it takes it very seriously, right? Then, it means when it sees LPS, it elicits a massive immune response wherever it sees it. It is because it thinks there are trillions of bacteria that are going to be there. So now, LPS leaks in because it’s in the lumen of the gut.
Kiran – Normally, if your gut is not leaky, what happens is it stays in the lumen and then it gets pushed out. This is because the mucus keeps pushing things up and then you defecate it out. Also, if you have a healthy immune system, you’re also producing a lot of secretory IGA, and that secretory IGA will bind and neutralize the LPS in the Lumen. Under normal conditions, if you have a healthy gut, you can produce all the LPS that you want in the gut, but it stays in the gut and you poop it out or you neutralize it. But in a leaky gut, a lot of that leaks through. Now, LPS is in circulation and the thing about LPS is it’s a small molecule and it looks a lot like the lipid bilayer of your own cells. It is because it’s a carbohydrate head and it has these fatty acid tails that are very similar to your own cell membrane. It’s incredibly pervasive and it can get everywhere with no restrictions. It crosses a blood-brain barrier very easily. It ends up in deep recesses in your brain like the hypothalamus and causes diabetes and insulin resistance. It’s the number one driver of the inflammation that leads to the formation of Alzheimer’s and dementia. It gets into the deep recesses of the brain and it very easily gets into your joints as well. It gets into your heart and creates myocarditis and inflammation in the heart.
Kiran – Let’s say LPS gets into your joint, here’s what happens. Then, immune cells in that area detect the presence of LPS. They freak out and they go, Oh my God, we have bacteremia. Let’s recruit the immune system to come over here and fight this. Now, the immune system that shows up is the innate immune system. Those are the first actors in any sort of immune battle. The analogy I give is to imagine you have a giant house, your body is a huge house and there are hundreds of rooms in the house. Then, there’s all these open windows all over the house. One of the worst things you can have in the house is bugs coming into the window. Then, you’ve got a couple of players that are the anti-bug people in the house. One set of players is really fast and really nimble, and the moment there’s a detection of bugs coming into a window. Let’s say on the third floor in room 50, they can get there faster than anyone else, right? The problem is they have a blowtorch as their tool to get rid of the bugs that are coming through the window. Thus, they get there first and they start blowtorching the area near the window to prevent not only the bugs that entered from doing anything. It can also prevent more bugs from coming in. Now, the bug expert is supposed to follow them depending on which bug that is, tap them on the shoulder, and go, I know exactly what bug that is. I have something that’ll only get that bug and nothing else. So you step aside, turn the blowtorch off and I’ll take care of it from here. Right now, you can imagine if the blowtorch stays on for too long, you’re likely going to burn the walls and burn the house down. That’s what’s happening in most people’s immune systems when your gut is dysbiotic. It is because when your gut is dysbiotic you shift to the adaptive immune response. The specialists that don’t blowtorch everything are also compromised and slowed down. It not only does the Dysbiotic gut allow you to have leakiness where LPs can leak through, and make their way to the joint. Now, the innate blowtorches are coming in and starting to blowtorch that area. Then, that Dysbiotic gut is also slowing down the response of the specialists who don’t blowtorch the area, right? Now, you get a longer innate blowtorching like response in the joint. Here’s what happens then because it’s a blowtorch, not only is it killing and neutralizing the LPs, but it’s also damaging your own tissue. In that area of battle, you’ve got all this cellular debris, you’ve got bacterial components, and you’ve got LPS. However, you also have components of your own cells that are there. Then, the secondary immune system comes along to go, what is going on here or what’s the target? This is your adaptive immune system and that system comes along. Then, it starts looking at all the different proteins in the area to try to figure out what the culprit is and then elicit a specialized immune response against the culprit. Now, what happens? Now, there’s lots of cellular debris, often those cells accidentally pick up your own protein and think that that’s the culprit. This is what we call the bystander effect. Your own tissue is an innocent bystander in this battle going on between a microbe and your immune system. Your own tissue accidentally gets represented as the target molecule to go after. Now, you’ve got your T cell or B cell that thinks your own cell component is the culprit and it starts mounting an immune response against that. We have a protection mechanism against that happening because that’s happening all the time in your body accidentally. However, we have a protective mechanism and there’s another component of the immune system called a TREG system that comes in and monitors this whole thing. It has a specialized capability of recognizing our own tissue. If it sees the immune system accidentally going after your own tissue, it shuts it down and goes, that’s not the target and stops that response. Here’s a triple whammy the TREG system is largely dependent on butyrate and other components of the microbiome to function. If your microbiome is dismantled, not only is your gut leaky and so more endotoxins are going in, you’ve got the innate blowtorches working longer than they should. When the specialized guys come along, they accidentally present and go after your own tissue. The regulators of that are also dismantled. Your chances of developing an autoimmune condition like rheumatoid arthritis increase dramatically. This is the same thing that happened in COVID-19 with people who ended up with long hauler syndrome. The inflammation and the damage that occurred in these individuals because of the presence of the virus ended up presenting their own tissue to the immune cells. Now, the immune cells for the next x number of months are attacking your own tissue even long after the virus is gone. As it turns out, the people who are most susceptible to COVID-19 long haulers are the people who have low diversity and low keystone species like Mickleham and Akkermansia in their gut microbiome. Those are also the people that had the highest propensity to die from COVID-19 and then also the highest risk for developing long-term long hauler syndrome. Their immune systems are dismantled. When you have RA, it basically means that your dysbiotic gut allows leakiness. It’s also driving the blowtorch response too long and it’s also dismantling the regulatory component of your immune system. If your immune cells do accidentally go after your own tissue in that bystander effect, it doesn’t get stopped. Thus, triple whammy and that’s how that’s how it happens.
Clint – Sensational. All right. Well, I think we’ve done enough justice to the problem then. I think just before we go on to the solution and my attempts to understand these complex matters the best I can. Reading the science on this, it seems that the white blood cells or the leukocytes that are oxidized are using free radicals to break down these bugs if you like, the intruders. In the process of doing so are oxidizing the surrounding tissue. Is that explanation just a different variation of what you’ve just given as well or are there some differences there?
Kiran – No, that’s the blowtorch because it’s nonspecific and that’s the key. These leukocytes do is they come to an area, they know there’s a problem in the area. However, they don’t know what exactly the problem is. They bombard the area with things like pro-oxidants and the complement system. These are all these immune tools that just carpet bomb an area. It’s going to destroy the organism that’s causing the problem, but it will also damage your own tissue.
Clint – Okay, Fantastic. Thanks.
Kiran – Incidentally, we should point out so people understand that when you feel sick. The feeling of sickness, the fever, the aches and pains, and all that’s the innate immune system. That’s a blowtorch component of the immune response. It is why normally when people get just a regular illness, a cold or flu, they feel like that for a couple of days and then they start to feel better. The feeling better means that the immune system response has shifted to the specialist, not the blowtorch. This is because what you feel when you feel sick is the blowtorching right? It’s your own immune system that makes you feel sick. If that goes on for too long, then the net result is damaging your tissue. Then, the potential for your immune system to start accidentally attacking your own tissue.
Clint – Okay, let’s now get into part two, which is the solution here. Just to kick us off with some optimism now, because you’ve so eloquently described the problem. You said earlier something that really excited me, which is that it is possible to resolve this. Your level of confidence that we can get massive improvements to these symptoms is very high, isn’t it?
Kiran – Yes, absolutely. With good reason, because we have good empirical data. Of course, we’ve been in the US in our various clinics. We’ve been working with RA patients for a long time, but also we’ve done a pretty substantial study on this. It hasn’t been published yet, but I do have the manuscript from it. We did a 90 or 100-patient study for 90 days, revamping the gut, and we’ll talk about the process. We did not only on RH factor or rheumatoid factor measurements, inflammatory cell measurements, measuring movement of the joints, and so on. But we also did, MRI scans of the joints to actually be able to visualize the level of inflammation and damage that’s occurring. We were able to see really measured improvements in all of those things without compromising the rest of the immune system. It is because of the allopathic approach is the immune system’s gone nuts or it’s attacking your own joint and let’s shut down the immune system. That brings about lots of other issues and the idea was just twofold. It’s actually really quite simple. If people listen to the part where the problem comes from, it starts to become obvious that there are really two things you need to do.
Kiran – Number one, stop the leakiness in the gut, right? This is because that continues to fuel the problem. Number two, stop the dysregulation of the immune system by increasing the regulatory T cells. It is because even though you even if you’ve had rheumatoid arthritis developed five years ago. It means you don’t have the T cells that regulate the immune response stopping that response. Now, you have a B cell that’s continuously producing antibodies and all that against your own tissue. It doesn’t mean that can’t be stopped and reversed at any given point. You can upregulate the TREG cells, which are the regulatory component, and have them circulate around your body for some time. Then, start identifying the presence of these immune cells that are doing the wrong thing. We’ve seen it and it’s about; (a) stopping the source, which is the gut lining and the leakiness and (b) upregulating the TREG. You do those two things and you can make dramatic improvements towards alleviation in the condition.
Clint – The reduction of gut leakiness is something that we as a community and I’ve pioneered a lot of work on this for many years. I feel that in that sense we’ve got a pretty good understanding of the science we’ve seen through our community’s incredible turnarounds of people with their symptoms by eating a large plant-based diet, exercising a lot, getting lots of sunshine, monitoring their vitamin D, reducing stress, restricted eating only between 7 a.m. to 7 p.m. and so on. You’re going to educate us on why these things can help in a moment. However, upregulating the TREG cells is a completely new concept to me, and I’m fascinated to learn about how your laboratory did that, perhaps in a moment and that’s lots to cover. Should we start with fixing the leaky gut first? What can we what’s our best approach?
Kiran – Everything that you said is really important, right? I think the key to fixing a leaky gut is a compounding number of behaviors, which is really important. Everything you said like increasing the diversity of your diet, that’s absolutely critical. Especially on the plant-based side of things because know the vast majority of microbes in the colon are dependent on plant-based materials. That’s where they get all their nutrients, their substrates to produce all these important compounds like butyrate and so on. You do have to increase the diversity there. Intermittent fasting is absolutely important. The reason is when you’re in a fasted state, it actually increases the diversity of the microbiome. There are some microbes that can only grow when you’re in a fasted state. Then number two, that’s what kicks on all these housekeeping genes. Start cleaning up cellular debris, repairing damaged cells, getting the lining back where it should, and so on. So that kind of intermittent fasting is really important. As you said, stress management stress is the biggest driver of leakiness in the gut It’s even more potent than antibiotics than leakiness in the gut, which is mind-boggling when you think about it. There was a 2015 publication in the Frontiers of Immunology. This was a meta-analysis paper, meaning that it was a study of lots of studies on the topic. Basically what they showed was that stress-induced intestinal permeability was the number one cause of death and disability, worldwide stress-induced leaky gut. Just like wrap your head around that. Think about how many hundreds of millions of people a year are dying from very preventable things. To me, I cannot overstress the importance of managing stress. There are a couple of things I’ll mention about that. Then, the other part of it is getting outside, right? We’ve kind of divorced our association with nature. The farther we get away, from interacting with nature on a regular basis, the more dysbiotic our gut gets. So as much as people can, they should be prescriptive about time outside in natural environments. If you’re on the coast, go to the beach. If you’re anywhere near forests and things like that, go for hikes but be prescriptive about it. Give yourself something like 30 minutes, three times a week at least. A wonderful thing to do on the outside, which mimics how we evolved is eat on the outside, right? If you’re going for a hike. For example, if you want to elevate the benefits of that hike, take an apple with you take fruit with you, or take a sandwich, or whatever it may be. Then as you’ve walked through, what I always tell people is to be deliberate about touching things and picking up things and all that, right? Like, I love seeing that with my kids. Kids are so curious and we’re born very curious. Then, we sample the environment, right? We walk through, they’re picking up rocks and sticks and touching trees and doing all of that. That’s very innate to our behavior. We need to do that when we’re in the outside environment. Then, sit down at some point and then grab a sandwich or something in your hands and eat it. Now, don’t go sterilizing your hands before you do that. Allow the environment to be within you and that is really powerful for modulating your gut microbiome.
Kiran – Let me mention stress real quick before we go on to other things. Mindfulness work is important and it can really help. Also, what a lot of people really need are psychobiotics. These are probiotic bacteria that actually change brain wave function and modulate how your body responds to stress. As it turns out, the deciding factor in the body that decides whether or not you’re going to go way overboard with the stress response and continuously activate your HPA axis, which continuously turns on the stress response is the presence of psychobiotics in the gut. If you’re missing certain psychobiotics in the gut, you will continuously reactivate your HPA axis and stay in a basal anxious state throughout the day. From a single stressor, it becomes really hard to shift from sympathetic back to parasympathetic. Microbes modulate that whole process in your gut. These are microbes called psychobiotics. We’ve discovered a psychobiotic with with through the work of the University College Cork in Ireland, which is the number one microbiome research institute in the world. It’s the work of integrative psychiatrist, Ted Dynan and a number of his colleagues. However, these psychobiotics are absolutely critical because they dramatically reduce cortisol from experiencing a stressor. They dramatically reduce the perception of the stressor. They shift your brainwaves into going into low-frequency waves. When you experience a stressor, it dramatically reduces all the inflammatory responses that stress creates. Then, they help your body turn off the sympathetic and go back to the parasympathetic. They do all of this for you. Thus, it really helps people manage stress because managing stress is something we all say. But it’s really hard in practice, right? When your body or your neurological system is geared one way and you’re constantly in that sympathetic state, it’s very hard to bring it back. You can do all the mindfulness work, the meditation, all that good stuff, and that stuff is good. However, use a psychobiotic because that can really bring it back for you.
Clint – Can I jump in? Just to emphasize this point, there was a study done on patients who were about to start biologic therapy for rheumatoid arthritis. Then, they measured their vagus nerve activity, which is related to the parasympathetic nervous system or fight or flight state. Then, they put them on the biological drug for an appropriate amount of time. Then, they measured their response to the biological drug and correlated that with their parasympathetic nervous activity. Thus, they found that to an accuracy of 90% predictive ability those with the lowest vagus nerve activity or those in the most stressed state did not respond to the biological drug. Meaning that the overarching, most powerful influence on whether the drug worked or not was how stressed they were.
Kiran – Yeah, that’s absolutely correct.
Clint – Mind-blowing.
Kiran – This is because stress creates a leaky gut and that’s the biggest source of leaky gut in the modern world, and it’s profound. Leaky gut because it does it in two steps. One is stress increases the virulence factor and the growth of opportunistic microbes in your gut and throughout your body. There are lots of opportunistic microbes that have been designed by nature to monitor the host stress response and hormones. Only when it sees your stress hormones does it express their virulence and growth factors? It is because over time they’ve come to learn that when the stress hormones are high, that means the host immune system is compromised, right? When they rear their ugly heads and start growing. Then, lots of bouts of stress throughout the day are no different than taking a bunch of antibiotics throughout the day. It hits your gut over and over again, and it allows the growth of pathogenic organisms. Then, there’s a second way in which it makes your gut leaky, and that’s cortisol. So cortisol, as you go through a cortisol curve because you’re experiencing a stressor. A portion of the cortisol dumps into the gut. Right now, the reason it dumps into the gut in a healthy individual is that you have microbes that metabolize cortisol. They send the byproducts of metabolized cortisol to your kidneys, where you open up sodium and potassium pumps to increase the fluid going into your circulation. It’s doing that to increase blood pressure so you get more perfusion of blood to your brain and your heart that’s in the fight or flight state. Thus, cortisol is trying to get you physically ready to fight or flee. Then, one of the principal goals of fight or flight is to get more perfusion of blood to your brain and to your heart. Thus, you’re ready to fight or flee. Now, if that happens continuously, it leads to hypertension. This is how chronic stress creates hypertension and it’s through that mechanism. The cortisol is designed to dump into the gut. However, cortisol also makes your gut profoundly leaky in a very short amount of time. Both your small and your large intestine and inflammation shoots through the roof when cortisol makes your gut leaky. Then, the inflammation results in an elevation of IL-6, a compound called interleukin six. IL-6 can go back to the hypothalamus and re-trigger the HPA axis, putting you back into a new stress response, even though there is no more external stressor. Think about it, one external stressor will reactivate your HPA axis over and over again. Then, it continues to drive dysbiosis making your gut more and more leaky, both through cortisol and through the growth of opportunistic microbes. It becomes kind of nonsensical in a way to people who don’t know this. If we say, one of the most important things for you to improve your rheumatoid arthritis, and your joints is to manage your stress. Then you go, what does that have to do with my joints? But this is the pathology here and it’s when it’s working through the gut. So that’s why I say for people, a psychobiotic that helps modulate all of that can be so powerful. It’s through a direct mechanism for the driver of the condition.
Clint – The psychobiotic drug, is that something we can buy as a supplement or is it something that we can stimulate through eating certain foods?
Kiran – Unfortunately, psychobiotics are highly specialized. If you are a stressed individual, you probably don’t have much or any of the right psychobiotic already in your gut. Thus, you do need to supplement it. This is what we’re seeing in our studies. This is one of these organisms that we lose good numbers of over time with behavior. Then, you start to see these escalations of conditions associated with that loss and in particular, anxiety and depression. The latest estimate in the US is that as much as 605 to 70% of US adults have confirmed anxiety or depression. I mean, that’s a massive number, right? It’s absolutely crazy and it’s so prevalent because of this highly prevalent, diminished level of psychobiotics. In Australia, you can get it through a product called Gutsi that has the Bifido Longum 1714 the most well-studied psychobiotic. I think the Gutsi product is called Gutsi mood or Gutsi calm, or something like that. It provides you with a psychobiotic. Now on top of that. Then, here’s the other beauty of it. Psychobiotics also increase TREG or the t-regulatory cells I talked about. We’ve got a number of studies showing that psychobiotic increase IL-10, which is an anti-inflammatory cytokine and increases t-regulatory cells. Right, that’s absolutely another benefit of it. Now, spore-based probiotics also increase t-regulatory cells, right? Taking in the spores as probiotics will get those TREGs up. Then, being in the environment and getting exposure to environmental microbes also increases your t-regulatory cells. Just those three things along with all the things you’re doing to stop the leakiness in the gut, you’ll start modulating the gut and the barrier, and then you’ll start modulating the the immune response as well.
Clint – Okay. A couple of questions. Most of our audience is actually in the US and the US, and quite a lot in India as well. If thereafter a psychobiotic, do you have another recommendation? I know you’ve also been a pioneer in the development of multiple supplements. Feel free to suggest ones that your company produces as well, that people, particularly in the US where the bulk of our audience are.
Kiran – Yeah, in the US it’s Zen biome, and it’s also a Bifido Longum 1714 product and that’s the most well-studied psychobiotic in the world. I think we have about 8 or 9 published studies on it. I think four more in the pipeline that are being published and it’s super well-documented. In fact, it was developed by and we work with the researcher who coined the term Psychobiotic. His name is Professor Ted Dinan, and he wrote a book called Psychobiotic Revolution. It’s absolutely the best and it’s an essential product for most people in the Western world. It is because we’re so geared towards chronic sympathetic activation and stress response.
Clint – Okay, beautiful. I just missed the third way to upregulate the TREG cells.
Kiran – Sporebiotics, probiotics, and the environmental microbes.
Clint – You’re right. You introduce spore probiotics quite quickly. This is something that even I have very little understanding about. I know that it’s an area that you have sort of driven. Not many people outside of the work that you’re doing are talking about spore probiotics, at least I’m aware of. Can you explain how they differ from regular probiotics and then how they can benefit us?
Kiran – Yeah, absolutely. To make the story on Spore shorter. Basically, when I looked at the idea of probiotics, my inclination was always to mimic things that naturally happen in nature. We have too much in the world of medicine and biology and health, where we’re trying to outsmart nature and we’re trying to intervene in an unusual way. Then more often than not, that causes more trouble than benefit and that’s the pharmaceutical approach largely for things. There are benefits to many of those, but often they come with the price, side effects, and so on. When I was looking at probiotics, I asked myself, what is nature’s probiotic? Like, how did our ancestors interact with bacteria where maybe some of them became probiotics? Most bacteria you interact with in the environment and so on are going to go through the system, die in the stomach, get killed off, and then you’re going to defecate them. However, there are some microbes that end up with the capability of surviving through the digestive tract and then start functioning in the intestines in a live manner. Thus, that’s where the spores come in, because they are ubiquitous organisms in the environment. They have the capability of forming this spore-harden-like shell around them. When they’re in the environment, they’re basically in a dormant state because they’re waiting to get back in the gut. That’s their commensal home. They’re sitting around in the environment in this dormant state. Then, let’s say you pick them up from the environment, and you swallow them. Then, they survive through the harsh gastric system because of this spore coating. But the moment they get into the small intestine, they can bust out of the spore coating and start to go to work for you. When we started looking at what the spores did, what we realized is as early as 1952. There was a large pharmaceutical company called Sanofi Aventis, which is still a pharmaceutical company out there that launched a probiotic product for the treatment of dysentery in the gut. Right. It’s for the treatment of gut infection. They launched a bacillus endospore to treat this gut infection. The reason they can do that is because these bacillus spores have a capability called quorum sensing. Quorum sensing is for microbes to read other microbial signatures. They have an innate knowledge when they come across a microbe that doesn’t belong in the human gut or that is infectious or overgrown. They find that microbe, they sit next to it, and they use a number of tools to bring down the growth of that microbe. Then, they became a very effective treatment for dysentery, better than some antibiotics, because antibiotics kill everything.
Kiran – These probiotics like special forces know exactly what the enemy looks like. Thus, they go in there and surgically remove that enemy, and that’s the basis for what they do. Now, our ancestors inadvertently consume these spores on a regular basis. The spores provided that kind of natural protection to them because as you imagine, our ancestors were exposed to tons of microbes all the time. Even things from rotting flesh, for example. If you think about animals or if you look at what a lion is eating or many animals, mammals are eating on the ground. Then, semi-rotting flesh or flesh that’s been sitting there or plants haven’t been cleaned. They don’t get sick, right? How is it that they don’t get sick? If we ate that same thing, we’d have all kinds of food poisoning and so on. It’s because they have from the environment all of these microbes in their system that protect them against infectious bacteria growing. Now, humans had that too, right? Our ancestors have that and you can see that in the hunter-gatherer tribes. Now, if we went and lived in Papua New Guinea like they do the first meal we ate, we would be sick as a dog. Also, the same thing as in India. If you went to India and ate like the villagers, you’d be sick as a dog. It is because we don’t have the resilience of microbes that actually protect us against those. We have this false notion that you are resilient because you live in Southeast Asia or India or you live in Mexico. You are resilient to the microbes there. It’s not because of your immune system. It’s because of microbes in that environment that actually protect you against those microbes. This is where spores come in and they do this amazing thing. We hypothesize that spores not only could find and bring down the growth of dysfunctional bacteria, but we hypothesized that they could probably do the opposite. Wherein, they increase the growth of beneficial bacteria as well. We prove that through a number of clinical studies. So what spores do is they increase the growth of beneficial keystone bacteria like Akkermansia, Faecalibacterium, Prausnitzii, and so on. They bring down dysfunctional pathogenic organisms. They rebalance your microbiome and from that they seal up leaky gut, right? We published the first study on a probiotic that stops Endotoxemia. We published that in 2017 in the World Journal of Gastrointestinal Pathophysiology. Since then, we’ve been the only probiotic that’s shown to be able to stop LPS migration from the Lumen into circulation, right? The spores become a very important step here as well.
Clint – Okay, so naturally, what is that probiotic?
Kiran – Yeah. The one we pioneered is MegaSporeBiotic. MegaSporeBiotics is the number one-selling clinical probiotic in the healthcare practitioner space in the US. It’s also available in New Zealand and Australia, and it’s also available in the UK. MegaSporeBiotic was the first all-spore probiotic and we launched it in 2013. At the time, there wasn’t a single other one out there as you mentioned. It’s a less known category of probiotics, but now it’s the number one selling probiotic in the health care practitioner space. It’s surpassed all the other ones and it’s the most well-studied. We’ve published, I think, 14 studies on Megaspores. It’s one of the most well studied in fact, the rheumatoid arthritis study that I talked about earlier is a study on megaspore and rheumatoid arthritis.
Clint – Right, which was going to be my next question is to talk about the approach that you took with the patients. Wherein, you said there were 90 to 100 patients and you got great results. Did you do any dietary manipulation or stress reduction and exposure to green spaces or any of that, or was it purely a just an intervention with the MegaSpore?
Kiran – It was only the intervention of the MegaSpore now. The reason you do that in a clinical trial is to try to understand and narrow down what the effect is. However, in practice, the idea is that you use the MegaSpore. Then, you also do the other things, which then compounds the results quite a bit. The purpose of the other things is not to just increase the efficacy and the results that you get. It also re-establishes a new ecosystem in your body that now makes you resilient to further development of rheumatoid or any other condition. One of the dangers here that we face is that once you have one autoimmune disease. It means you already have the pieces in place to potentially develop another one and another one. Right. For example, a lot of women with Hashimoto’s thyroiditis, which is an autoimmune condition, started off as lupus. Lupus tends to be one of the first kinds of general autoimmune conditions that a lot of people get. Then, they might end up with psoriasis after that, or thyroiditis or RA in something more specific. It is because your system is geared towards this inflammatory damage, the bystander effect, and the lack of regulatory T cells. So that process can happen over and over again in different tissues. All the lifestyle and other changes become so important that you restructure your system so you’re no longer vulnerable in that way.
Speaker2 – Okay, Fantastic. Well, time has flown. I’ve just looked at the clock and realized that we should summarise what we’ve learned today as best we can and wrap this up. I’m going to let normally I do that, I’m going to let you do that. Could you list the lifestyle? Just bullet points, lifestyle, things that we should do. Your highest recommended supplements that we should take and anything else. Just a checklist of all the things. If you had a patient with rheumatoid arthritis sitting next to you, go do this and that would be amazing.
Kiran – Yep. I would say the first thing I say to the patient is to know that you will and can get better. That hope component is so important because remember, we have this beautiful effect in the body called the placebo effect. Now, the placebo effect is always talked down upon. However, the reason it’s talked down upon is because it’s so powerful. In studies when we do clinical trials, we have to do all this work to try to control against it. The placebo effect is your body aligning the intention to heal itself, and it can absolutely do that. If you have that as part of your frame and your psyche, then everything else you do will actually be enhanced. So that’s step number one, reframing your condition. Don’t look at your condition as your identity. A lot of people who have long-term chronic conditions, that becomes their identity, and that’s not you. It’s a temporary version and you can get through it, and you absolutely will get through it. Set the intention first and reframe the mind. The second part is a diet. You absolutely have to diversify your diet. I tell people that try to include a new plant or fruit-based food into their diet each week. Then, maintain the previous one if you can. I go to ethnic grocery stores and all that because you’ll find roots, tubers, and, vegetables that you don’t find in your regular grocery store. I just add one of them into one of my meals in the week. You don’t have to make a whole thing out of it. Just add one of them, right? Then the next week, try to keep that in there and add something else. By the end of the year, you will have added 30-40 new foods to your diet, and that’s going to dramatically increase the diversity of your gut. So diversify your diet, start some sort of intermittent fasting, and find out what works well for you, Whether it’s daytime fasting or evening fasting, you can play around with it to figure it out. Of course, number four is stress management. There are tools, there are meditation apps and things like that. Do those things, but know that a psychobiotic is probably going to be really important, which is the Zenbiome product that most people end up having access to. Then, you need the probiotic to seal up the leaky gut and that’s the MegaSpore. You need a prebiotic to really feed the Akkermansia and all of the Faecalibacterium and all those beneficial microbes. I always recommend oligosaccharide-based prebiotics. I talk about MegaPre, we formulated an oligosaccharide-based prebiotic that increases butyrate production by 150% in three weeks. Also, remember how important Butyrate is for the rebuilding of the gut microbiome. Then we say exercise and sleep, and those are non-negotiables, right? Because when you sleep, you repair the system. If you don’t get adequate sleep, you’re not going to repair the system. In fact, your gut is going to be leaky. Exercise is really important to trigger myokines and other repair mechanisms, and adaptive changes in the body. Then, finally, reach out to somebody else who has the same problem, guide them, and help them as well. This is because it’s a community structure and that’s really, really important. If you’re doing that, maybe do it outside so you can get outside. You can get some green time, as you would call it, and meet with them outside. Maybe you find somebody who also is dealing with a similar issue and maybe it’s not RA. Maybe it’s a different autoimmune disease, but the process is the same for all of them, right? It is because they’re driven by the same thing. So go and get a chance to meet up. Hey, let’s go for a walk once a week or twice a week together. Let’s talk about what we’re doing or let’s talk about what we’re trying, or know what progress we’re making. Then, keep each other accountable and that is a very powerful tool. That accountability to somebody else is a very powerful tool and do that for each other.
Clint – Thank you. We have a community support forum where we have over 500 members who interact, post updates, and share. We have coaches in there, including medical doctors, and we support them. Thus, we have that set up. If people are now reinvigorated to go down that path and reach out, we can connect you to that platform here. This was absolutely awesome. Thank you and I really appreciate it. Yes, if you come to Sydney, I would love to try and coordinate a live presentation training with you if you would be so kind. How can people contact you or at least follow you online and watch other presentations that you’re giving?
Kiran – I’ve really been working hard to put a lot more information out there on education, so reach out to me on Instagram and my handle is kiranbiome. On Facebook, a lot of what I do on Instagram goes on Facebook too. Just search Kiran Krishnan as a last name you’ll find me there as well. I interact with people as much as I can on there. I get people asking me all kinds of questions, and I try to provide as much information and support as I can. Then, you can see a qualified practitioner to help you through your journey as well. The platform, the group, and the assistance that you’re talking about, the coaching, and all that. It’s hard to do this kind of stuff on your own because there’s so much it’s overwhelming. You need accountability and you need people to lean on. The community structure is really important as well, and reach out to me and any of you. If you actually go on YouTube and you just type in my name, you’ll find hundreds upon hundreds of videos that people have very kindly uploaded from interviews and all that I’ve done so many different ways.
Clint – It is how I found out about Kiran initially on YouTube. He has so much knowledge on this topic. We’ve only just skimmed the surface and some of the topics that we’ve spoken about here. He spent an hour talking about just this one aspect. I hope you’ve enjoyed this interview. I’m going to put links to each of the references that we discussed on the show notes over at rheumatoidsolutions.com will include links to the Psychobiotic, the Zenbiome, and the Gutsii Psychobiotic. The only one I need to grab for you once we end is the Oligosaccharide.
Kiran – It’s called MegaPre.
Clint – Mega pre. I’ll put links to those on the website. Thank you, Kiran. This has been amazing and so grateful.
Kiran – Thank you so much.