Intro 0:03
Welcome to Maximal Being! A podcast devoted to ditching fad diets and using real science to get you healthy and feeling great. I'm Doc Mok, a GI and functional medicine doctor who harnesses the power of gut health to get you achieving your goals. And I'm Jacky P, a well-informed layman who challenges the experts and asks the questions that you want. Don't forget to hit the subscribe button or leave a comment. And now, onto the show.
Doc Mok 0:32
What's going on Maximal Beings, Doc Mok here with maximalbeing.com. Don't forget to hit the subscribe button. Leave us a comment, it does help us to get the word out. If you have any questions, you can email us at [email protected]. Enjoy the episode.
Jacky Homme 0:48
Hello, hello, hello, Maximal Beings. It is I, Jacky P, your favorite layman. And I'm here with my co-hostess with the mostest, Doc Mok. How are you doing today, my friend?
Doc Mok 1:05
Jacky P, today I'm feeling inspired because this is the time of year where aspiring therapeutic endoscopist, so that's fancy GI doctors that do stuff like me, are applying to do what I do. And I happen to be the program director at my particular fellowship program. And I am reading some of these amazing stories of trial and tribulation that people have been through and reading all the research that people have gone through in their careers. And I tell you, there are some amazing people out there. So I think it's gonna be the best interview season yet. And that alone alone Jacky P is not enough. This is also, as you know, the time in Florida where it's actually nice to be outside. So
Jacky Homme 1:47
Love it.
Doc Mok 1:47
I'm just playing outside, like all day after work. So it's fantastic Jacky P. How are you doing?
Jacky Homme 1:55
I'm doing great. You know, I cannot complain. It's leap year. I don't know why something, what about leap year? You know when we're recording this, I don't know when you're listening to this, but something about the extra day, it's like a bonus day, you know,
Doc Mok 2:08
I read about it?
Jacky Homme 2:10
Yeah
Doc Mok 2:10
Can I jump in like?
Jacky Homme 2:12
Absolutely, please do.
Doc Mok 2:14
The way the reason why it was created is because of the rotation of the earth. And if we did not do it based upon this theoretical calendar schema, eventually, theoretically, Halloween would be during the summer. So that is why we have leap years is due to the rotation of the earth on its axis.
Jacky Homme 2:34
So nice. Well, I'm glad they figured that out. Awesome. Well, of course Doc Mok we're not here alone. We have I think I'm sure you are very excited Doc. Right? Because this
Doc Mok 2:47
I'm so excited
Jacky Homme 2:48
But nothing gets, nothing gets Doc more excited than some good microbiome talk. So we've been
Doc Mok 2:53
Other than poop. Yeah.
Jacky Homme 2:55
Yeah. I mean, you know, how many times have we talked about poop on this podcast? I don't even know. But we have Martha Carlin, CEO and founder of the Bio Collective. Now what is the Bio Collective? It's a microbiome research company that studied thousands of fecal samples. So she knows her poop. And she knows her stuff. But you can replace that S word with the other word, if we're talking puns. But Martha, how are you today? And also, of course, thanks for joining.
Martha Carlin 3:31
Well, thanks for having me. Yes, I am affectionately known by my family as the Poop Queen.
Jacky Homme 3:38
Love it.
Martha Carlin 3:40
And I, you know, I proudly take on that name, there is so much incredible information in that waste that we're flushing down the toilet. And that really kind of sent me down a path that has changed my life.
Jacky Homme 3:56
Wow, incredible. And, and I definitely don't want to do a spoiler alert folks. And you know, you have a pretty good online following. So there might be folks listening that know their story. But for those that might not be familiar with you and your background, you know, take some time give us a little bit of your super hero origin story. You know, I I might go into lecture and say, hey, when you're coming up in high school and college you didn't think, you know what one day they're gonna call me the poop queen. You know, you look and you'll find out. And so talk us you know, how did you become, you know, Martha to Martha the poop queen?
Martha Carlin 4:34
Well, it's, I studied actually accounting in college. So my background is in business and accounting. I came out of school and went to work as an auditor, and we were trained in that process to never take anything at face value. Always investigate for yourself. We are also trained on how to look at a business through a process called transaction flow review, where you do a flowchart of everything that's flowing through the business, and you're looking for those break points that could cause risk in the business. So I had a pretty good run as a business person, kind of a business turnaround expert. And in 2002, my 44 year old husband was diagnosed with Parkinson's disease, and seemingly healthy, he's got an old person's disease. And, you know, they sort of handed us some pills and are like, you know, it's progressive, there's nothing you can do. You know, here's a few books, and I'm kind of a problem solver. So I looked at it, and I said, I think this is a systems problem, I'm going to take my transaction flow review, and start mapping things out. And so, of course, the first thing I looked at was food and water, what's going through that pipe. And I started to study the science of, you know, food, nutrition, agriculture, all those things that could be affecting his health that, you know, he had been a marathon runner, so he was drinking, you know, the GU packets and high carb diet. And there's a lot of factors around that he was also drinking soy protein shakes a lot, kind of in the two years leading up to that. So I started looking at all these things and got very concerned about the food supply, through all the processed food out of the house and started trying to cook, you know, cook real food and focus on that. But in 2002, is kind of hard to find organic food. So along that path, I continued studying science. And then in 2014, I read a book called Missing Microbes, by Dr. Martin Blaser, who showed this connection to the overuse of antibiotics in medicine. And also in the food supply. I didn't really know at that time that antibiotics were used to make cows fat and chickens fat faster. And so about six months after that, the first paper came out that showed that they could divide the two primary types of Parkinson's. One is tremor dominant, the other is posture and gait, dominant. And they could actually segregate them by the bacteria in their gut. And I've said Eureka. That's it. That's like the general ledger of the body, your gut. And I quit my job, I started funding some research at the University of Chicago, and ended up founding the Bio Collective with Dr. Jack Gilbert, who was at University of Chicago at that time, and Dr. Suzanne Vernon, who had studied chronic fatigue at the CDC for 20 years. And we said, these diseases have common elements, we call them one thing, but really where the breakdown is, is in the gut microbiome. And if we start to collect samples, and share them across, what we wanted to do was build a giant poop bank that we could share across the planet. And that researchers would look at it in different ways. And we thought they would share their data. But, you know, we're still not in a big sharing kind of a world. But we started to get data ourselves and some people did share with and we can start to see those common elements. So we collected a lot of poop. And then we started to build computational models about what was going on and trying to figure out, okay, how are we going to fix this problem and building a bank of microbes that we can start to put back into the gut to try to fix things?
Jacky Homme 8:48
Wow, that's, that's incredible. And, you know, you said you, after you found this Eureka, you then quit your job. So you're doing all this data analysis while you're doing your day job.
Martha Carlin 9:02
Yes.
Jacky Homme 9:03
Wow. That is, that is really cool. So what was it, you know, roughly, the timeline was this a matter of years, months, somewhere in between?
Martha Carlin 9:13
So it was 13 years from my husband's diagnosis to when I founded the Bio Collective and and made the connection to the gut and Parkinson's. So that took 13 years and I studied a lot of different areas of science before finding the microbiome, which honestly I think ties all of those other areas together.
Jacky Homme 9:40
Yeah, I mean, you're probably seen singing song to Doc Moc's ears, the microbiome, right? It's, it's, it's awesome. So when you you know when you found that aha moment. I mean, can can you walk us through a little bit of just how you like, how did you decide to go from okay, we found like, the bacteria in the gut. And like, what was the step between deciding to get this huge like poop library? Right? Like, what? Like, was this something that you figured? Because I feel like you're very data minded? And you can see like the system? Was it something like, okay, we just got to get data? Or did maybe someone recommend it, you know, like, how does that come into play?
Martha Carlin 10:30
Actually, it was, it was kind of a little bit crazy when I read that first paper, and I got a flip chart. And in my living room, I mean, I was waking up in the middle of the night at two or three o'clock in the morning, with my flip chart, drawing pictures, and how do we connect all of this and you know, what I have still have all of those pieces of flip charts like let the data speak, and all these different pieces of the puzzle that I had been gathering over the years I'm putting on on this flip chart. And that went on for about a month. And then I actually started looking on LinkedIn, for, you know, people that I might be able to connect with. And I that's how I found Jack Gilbert and started the research at the University of Chicago. But I also reached out to Linda Avi, who was one of the founders of 23 and Me, and she was incredibly open. And she said, well, you know if you're ever out in San Francisco, and I just got on a plane and flew to San Francisco and met with Linda and talked about all of her work, and she had some interest in Parkinson's, and she started connecting me to people. She actually connected me to Suzanne, who was my other co-founder, and it just started having this great blow of information for about six months until, you know, I finally said, okay, I'm gonna start a company. And, you know, that's not for the faint of heart.
Jacky Homme 12:01
Yeah. I can imagine.
Doc Mok 12:04
You know
Jacky Homme 12:05
Yeah
Doc Mok 12:06
You know
Jacky Homme 12:07
I can imagine Yes.
Doc Mok 12:09
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Jacky Homme 14:43
I have to say, you know and you definitely don't need my kudos, right but like I gotta I gotta give you kudos for just like that, that pursuit, right. Something affected you and and you know because most people you know you get a diagnosis and you trust it to the medical personnel and medical industry to do their thing. And you said, no, I'm gonna do what I can. And now you have this company. And you have. I mean, I, there's, I've got a lot of questions about the poop database, and we'll get to that. But I just want to like give you kudos that because it's it's not something that, every folks do every day. And I think the the research of the things that I read, there are people now benefiting from you taking up that initiative so so many years ago. So I've got a quick ,I've got a few questions, a lot of questions. And Doc Mok, please, butt in when you like. But what would you say is something that because you, you mentioned foods and how there's antibiotics in almost everything, right? So the the lay folks out there who aren't really pre- to this? What would you say would be some things that we should be looking out for? Like, what should be some things that? Of course, it's tough, because it depends on where you are, and locality. But what are like, what should I, you know, Jacky P, where everyone should be looking for and said, hey, you know what, I can't control everything. But maybe I should cut this out or eat more of this when it comes to like your your food integrity.
Martha Carlin 16:24
Right? Well, one of the key things in food integrity that I started looking at all the way back 20 years ago was the chemicals that are used on the food, and organophosphate herbicides, glyphosate being the number one that I was looking at and all the way back then I was like, There's got to be a way that we can connect the dots to what's going on here. And the microbiome is absolutely that way because glyphosate is damaging will destroy about 50% of the gut bacteria, it's mostly the good gut bacteria, it also affects the gut lining, it affects those bacteria that are making vitamins and all of that. So I try to get people to be mindful of when they can either knowing their farm or like shop at the farmers market and ask your farmer, what have you used on this food, because likely a local farmer is going to be using less chemicals than the the large scale, commercial agriculture, there's a section in the Central Valley of California is called Parkinson's alley, and that's where about 50% of our produce is grown. And that's that chemical exposure go. So be really mindful of the chemicals that are used on the food that you're eating. And now there are about 60 different crops that use glyphosate at the end of the harvest, to dry the crop. So things like lentils and chickpeas and a lot of things where people think, oh, that's, that's a healthy food, you have to be really mindful of, like I call I called up Bob, Bob's Red Mill and said, do your farmers use glyphosate to dry the oats at the end of harvest? So you know, that
Doc Mok 18:12
What did he say?
Martha Carlin 18:14
They said that they do ask all their farmers and their farmers attest that they do not do that. But they did tell me they don't test the, they don't test for the.
Doc Mok 18:28
We've talked about glyphosate before Jacky P. You know, I lived in Cleveland, Ohio for about five, six years in practice. And there is so much glyphosate used in the state of Ohio that it is airborne. And so people like myself have had our urine samples tested and my glyphosate levels were super high. And Mark Hyman has a similar story because he's he was based out of Cleveland at one point. And just moving geographic locations can dramatically decrease your glyphosate levels. And another thing that people may not be thinking about is if you have a yard and somebody else is taking care of it, if you're lucky enough to be able to do that. You can tell those people not to use glyphosate products and there are plenty of other products that they can utilize that are safer for the environment, for your kids, for your pets, and for you. So I think looking at that is also a very direct thing that that people can control in addition to food.
Martha Carlin 19:29
Well, there was also an interesting, we used to live near a park that had a lot of children's play equipment and stuff and we walked very early in the morning we'd walk at about seven o'clock and the park crews the the lawn crews for the park would come in and they would be spraying around the children's gym equipment. And you know, you're thinking like people are bringing their kids there later in the day and they don't know and they're touching it and getting on themselves. So
Doc Mok 20:01
I absolutely have seen cases of esophageal cancer in in gardeners and people that are chronically using glyphosate products. And there are great funds of data that link it to various types of GI cancers for similar reasons that you've talked about.
Jacky Homme 20:17
And, you know, and I don't I'm definitely doing a little bit of a turn here, but not a turn. I just realized, we talked so much about microbiome on this podcast that we haven't really explained it. You know, there might be someone hopefuly multiple people listen to this episode, and is the first conversation or first time listening to Maximal Being so maybe we should take some time to discuss the microbiome, and its just role on our health. I mean, of course, like its impact on neuro degenerative diseases, but I mean, almost everything else. So I mean, I'll I'll you know, dealer's choice, you know, if if Martha you wanting to crack it, Doc Mok, you want to nerd out for a while, but let's take some time just break down to microbiome. And so for the first time, we're just gonna catch up.
Martha Carlin 21:10
Sure, I actually, I was just working on a slide presentation today, where the first two slides are, what is the microbiome. And it's, it's roughly about what, so it's the trillions of microbes that live in and on our body. And I tell people, they function as our internal pharmacy to maintain our health, it weighs about four pounds, there's about roughly about two times as many microbial cells as human cells. And it's making vitamins, hormones and neurotransmitters. So those microbes are essentially the key workers in the factory have our body that is breaking down our food, providing nutrients to us, and making those hormones and new neurotransmitters. So controlling our mood. I mean, they're really involved. They're also involved in training the immune system, so 70% of our immune system is in the gut. And that early training occurs when babies are breastfed preferentially. So that's kind of an overview.
Doc Mok 22:23
Yeah, it's a classical example of a symbiotic relationship. So you hear it in Hollywood and romcoms. But Jacky P like the best example in nature I can think of is, you know, you see an alligator in Florida sitting in a pond and there's a bird sitting on its back. And that alligator is not eating that bird because the bird is symbiotic to it and serving a purpose for that alligator in its cleaning its back of various parasites and insects and things like that, that can harm that alligator. And the alligator is serving as protection, because who's going to climb over an alligator to get to a bird, so it was a symbiotic relationship. And, and it's existed since the dawn of time. We, you know, part of our cellular structure, the mitochondria is synonymous from, like a genetic perspective, if you analyze the genes of our mitochondria, it is the same as Rhizobacteria. And so we've kind of coexisted with this microbiome, although it's not just bacteria, yeast, and fungi and all these things, right. For since we've existed as the human race.
Jacky Homme 23:38
Oh, great. Wow. I don't know. I don't know how many. It's been a while I just like I just love watching Doc Mok go into a zone, his eyes kind of glaze over and his brain takes over, he just kind of talks.
Doc Mok 23:48
Yeah.
Jacky Homme 23:49
But yeah
Doc Mok 23:50
Can I say a one more thing?
Jacky Homme 23:51
Oh, please do.
Doc Mok 23:53
So you mentioned this, Martha that, you know, it's in and on us, I think most people think of the microbiome, they think of the gut microbiome. And that's like all I talk about, but we have microbiomes like, everywhere, right? We have them on our eyes, on our skin, in our lungs, in our reproductive organs, you know, so it's everywhere in the environment, in and on us not just the gut microbiome, and the composition is variable.
Martha Carlin 24:18
And there's really some research going on in the skin microbiome and the importance of that, because we're now in this kind of hyper clean environment where we've lost a lot of those microbes that were performing functions on our skin also.
Doc Mok 24:35
Yeah, we did a an episode with a scientist who looked at vesicles in the skin microbiome and the link between that and acne vulgaris. So listen back to that episode, if you haven't done so already listeners out there.
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Jacky Homme 26:39
Okay, so the folks are caught up, we know about the microbiome and let's talk about let's talk about the poop. I want to talk about the poop. You know, it just is fascinating to me. So I remember seeing somewhere on your website, we talked about, like, learning about just our collective health. And I came up with this word, and I don't know if it's the correct word like way, but like we have our microbiomes, but would it be considered a macrobiome? If we're like looking at the overall health of a population? Based on? You know, this data from your fecal library?
Martha Carlin 27:18
Well, I liked new term that's, I've not heard that, but it is you are looking a layer up at that macro level, and you could go to even planetary macro levels and and sort of layer that down. So yeah, like that.
Jacky Homme 27:39
Awesome. So what what would you say has been a few, I guess, maybe aha moments, or just interesting findings, when you looked at, you know, at a macro level of, you know, the the fecal library, like is there been anything that you've learned, like, based on like population, I'm not too sure how you store it or track it. But
Martha Carlin 28:01
Well, of course, Parkinson's is one of my reasons for doing this in the first place. So we we did have a larger set of people with Parkinson's in our data set. So the process of collecting this stool samples, we developed these, a kit that we would send to somebody's home, it had this nice little hammock that sat on the toilet, you could collect it in an ick-free way, you just picked up the little hammock and drop it in a bag and put it in with your ice brick and mail it to us. And then in our laboratory, we would do a homogenization process and an aliquoting of into little tubes so that they would be available for use of other scientists. Well, the young people in our lab who were processing the samples after a period of time, one of them came to me and she said, you know, I can tell that someone has Parkinson's, by just by looking at their sample, without knowing that they have Parkinson's, when I see the sample, I know it's a Parkinson's sample. And I said, what do you mean? And she said, well, I can't process it the way I process the other samples. So the other ones would go into a syringe, you know, a large scale syringe and you can squirt it out. But the Parkinson's samples were like concrete
Jacky Homme 29:33
Oh, wow.
Martha Carlin 29:34
Sections that were like concrete, and they actually had to use a caulk gun. So I started looking through the literature, because I also knew, like chronic constipation can precede a diagnosis of Parkinson's but 10 to 15 years. So I'm looking through all the literature to see if there's anything about fecal water content or dehydration or you know what's going on with the water and nothing published at all. So that was like a huge kind of aha for me is like, you can tell from the stool. And that sent me really looking at the Bristol stool score. So if your viewers know what that is, I'm sure, you know, you want to be in that three to four range. But in the European Human Microbiome Project, they did a large scale project like the US did. They actually showed that the Bristol stool score was in the top 10 things of they measured something like a thousand different things, in the top 10 things of prediction, predicting your health was your Bristol stool score and your stool that you are consistently going on a daily basis.
Jacky Homme 30:51
So Martha, I'm gonna put a flag on you here because some folks may not know what that score means. So we gotta you're you're getting expert. You know, you're showing off that big old brain of yours. All right, so walk the walk the folks walk me through what that Bristol score is. So
Martha Carlin 31:10
Yeah, the Bristol stools and actually after being in the poop business for as long as we did, Berman, that the Bristol stool score does not have enough numbers. Because it's goes from number one to number seven. And I'm hoping I'm getting this right. But so you go from a very liquid stool to a very solid, pellets, concrete. And in the middle is kind of like, you know, smooth peanut butter, or you know, something that you're easily passing. So you go from blowing it out, too, very hard to get out to, in the middle is where you want to be, which is nice and easy, comes out smooth. And they use that as a measure of of kind of looking at general stool health, and I'm sure that Doc Mok can probably elaborate on.
Doc Mok 32:10
Yes. And we use it in clinical practice. We use it in gastroenterology research. And so score of one is the little pellets and score of seven is just just a puddle of water essentially, it does correlate with multiple different diseases that it kind of lends objectivity to something that's very subjective. And an example of that is how people describe diarrhea, which can be more liquidity, more frequent, inability to control, it can be continence issues. It's all over the map. So so lending a little more objectivity to something that seems so simple as the number two right? is really useful for scientific literature. We may be jumping ahead a little bit, Martha, but you talked about the viscosity of the stool. And I was doing a little bit of research in preparation for today. And it's hard to make the jump from Parkinson's and gut health, right? Like where is the connection there? We've talked about the vagus nerve. That seems like that's the highway. But you're talking about how constipation can kind of predate Parkinson's. And what I found in my research, and correct me if you found anything to the contrary, is that years prior to a diagnosis, if you were to look at the enteric nervous system, so the guts nervous system, and biopsy in people with Parkinson's they have inflammation that occurs and as a result of the inflammation, they generate Lewy bodies. So α-Synuclein right. And α-Synuclein is the same thing that we find in the brains of people with Parkinsonism. And so the thought is that this chronic inflammation due to disruptions in the gut microbiome causes these proteins, these Lewy bodies to form which kind of shuttle up the highway, the vagus nerve up to the brain, and therefore it can cause Parkinsonism, which I just thought it was absolutely fascinating. Do you agree with that? Or?
Martha Carlin 34:15
Yes, it is.
Doc Mok 34:16
Wanna add to that?
Martha Carlin 34:17
So as it turns out, also α-Synuclein, which is that protein that's aggregating and beta amyloid in Alzheimer's, both of those are anti microbial peptides. So that's something that's more recently discovered as well, but and there are over 500 papers using a mouse model to induce they get a mouse and they give the mouse Parkinson like symptoms, and it's called the LPS-induced Parkinson's model. Well, LPS stands for lipopolysaccharides and that is the cell wall of gram negative bacteria and as it it turns out not only Parkinson's, there's a number of animal models using gram negative bacteria cell wall endotoxin to induce the symptom profiles. And so you get inflammation in the gut, you get a leaky gut barrier is crossing over and those the endotoxins are causing inflammation throughout. And then you're also getting this aggregation that's trying to solve the problem, I think. But they there have been some interesting papers in the last couple of years showing that traveling up the vagus nerve to the brain. And there's, there's also Brock's hypothesis, I think, now they think it can either come through the nose so you can breathe it in, or come through the mouth, or both. And there's a slightly different presentation of what they're finding in the microbes, whether it came through the nose or the mouth first.
Doc Mok 36:02
Wow, fascinating.
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