Dr. Justin and Dr. Baris interviewed health coach Steve Wright, co-founder of the SCD Lifestyle which is a community of health experts dedicated to help people heal their guts and take responsibility for their health and body.
In this podcast, discover what SCD or Specific Carbohydrate Diet and how to use it to help restore one’s gut health. Learn the healthier way of dealing with constipation without using Psyllium husk. Understand why the functional medicine approach to treating patients is much more effective and beneficial than the insurance based approach to treatment. Also find out about the common gut infections and key lab testings to accurately detect them.
In this episode we cover:
05:44 SCD versus GAPS Diet
14:07 Psyllium Husk and Constipation
31:20 Functional Medicine Model vs. Insurance Model
35:50 Key and Foundational Lab Testings
45:16 Other Clinical Markers for Infections
Baris Harvey: Welcome to another awesome episode of Beyond Wellness Radio. In today’s episode we are interviewing Steve Wright of scdlifestyle.com. Steve is a health practitioner. He is also known as a poop specialist in our space.
Dr. Justin Marchegiani: Laughs
Baris Harvey: He struggled with severe IBS and digestive problems and now helps other people fix their guts. So, how is it going today, Steve?
Steve Wright: Great man. Thanks for having me on.
Baris Harvey: Yes, it is awesome to have you. How is it going today, Dr. Justin?
Dr. Justin Marchegiani: It is going great Baris. I am really excited for today’s podcast.
Baris Harvey: Yes definitely. So Steve, I gave a little quick introduction but for the people out there who do not know about you. Could you give us a little background about your story? I know one thing that I like, we actually just did an interview with Garrett and he had a different, like an engineering background and you also did some electrical engineering in the past. Can you tell me about your background and how you got led into this health space?
Steve Wright: Yes, definitely. And that is actually what I tend to call myself, as a digestive engineer or a health engineer. I have in the past few years worked with people one-on-one but I have recently stopped doing that. So I guess I am no longer officially any sort of practitioner. It is sort of everybody’s story of how you ended up in the space. I had an issue and no one in the modern medicine system was giving me any relief at all. Not even a small amount. And so my background from college was electrical engineering and I think what engineering in college does teach you is, it teaches you to be okay with really complex problems and problems that has unknown parts of them. And so once I really realized that food was a big thing in my digestive issues. I had a really, really bad IBS with gas and bloating that was like so bad it would make me want to cry. But then when I farted I would feel so good but it would smell so bad.
Dr. Justin Marchegiani: Laughs
Baris Harvey: Laughs
Steve Wright: It was like those kinds of farts that nobody wants to claim, like you are afraid that something died in you.
Dr. Justin Marchegiani: Laughs
Steve Wright: (Laughs) So, it was a very diabolical problem everything I had to eat. I had all kinds of other symptoms that was just my big pain. I had cystic acne. I was 30 pounds overweight, used to be 60 pounds overweight and all these different issues. And one of my good friend Jordan, my business partner now, he was celiac and he was getting help from gluten-free and a practitioner put him on a Specific Carbohydrate Diet and he stated getting better. And so in a moment of fury and just tears and “upset-ness” I called him one day and he convinced me to give it a shot. And in 3 days into changing my diet my gas and bloating was gone. And so at that point it was when I felt empowered. And suddenly I had started to take a little bit of responsibility for my own health and not outsource it to cure everything. And so between kind of being angry and really sick that kind of led me to like sort of own my training and as far as problem solving goes and take responsibility. And so it has been a 5-6 year process now of, “Okay well, that feels better but how much more energy could I have? Can I have clearer skin? You know, could I go from a very strict diet that works very well to a diverse diet that is like 80-20? You know, can I do a sprint triathlon? Can I go backpacking for multiple days up in the Rocky Mountains? And just kind of every layer to sort of getting my health back to levels I never thought existed. And then each time I find something that works I try to turn around and educate the public about it or create some sort of program to allow people to do it cheaper, better and faster.
Baris Harvey: Definitely, that sounds good. That is a good overall view of what happened. And I like the fact that you had to go on a strict diet because of how much healing you needed in the past but also where now you probably can be a little bit more lenient and not so strict on your diet. Do you still have to be pretty precise? Do you notice like a definite change when you eat like maybe the wrong foods? Or is your body a little bit more shall I say resilient to that now?
Steve Wright: I definitely have a much more resilient health perspective at this point or health level at this point. I mean I can eat gluten for like a meal or two. Anything more than that my skin will like instantly begin to breakout and I will feel some fogginess in my brain sometimes as well. So I still have sensitivity to some types of foods. And in general, I eat all whole foods, typically. If I do go out, I am going out to the best restaurants eating very much it is like Paleo with some Weston A. Price sort of mixed in. So I will eat legumes like once a week properly prepared. Obviously, I would eat high quality dairies from time to time. But in general, 85-90% of my template diet is meats, fruits, vegetables and healthy fats. You know, that type of thing.
Dr. Justin Marchegiani: That is awesome. That is awesome. So Steve, this is Justin here. A couple of questions for you on the SCD diet. I have used that diet with my patients quite frequently especially the ones that have colitis or Crohn’s disease, etc. And I also use the GAPS diet or the into phase diet for GAPS. And I am just curious, when you are working with patients, how would you apply the SCD versus GAPS and when would you choose one over the other?
Steve Wright: Great question. So essentially, what we use at SCD lifestyle and what I would use with people is basically the best of both worlds. So in my opinion, the Specific Carbohydrate Diet as it was written by Dr. Sidney Hass or as it was written by Elaine Gottschall in her very popular book “Breaking the Vicious Cycle” is incomplete. And the work of Dr. Natasha Campbell McBride has done with the GAPS diet again, all of these people are amazing and they helped saved my life. So this is not a sort of walking on them. We need to continue to further the ability to help people. And so both diets by themselves and silos have disadvantages. And they do not seem to produce consistent results for the majority of people who tried them. They seem to maybe only serve 60% or 70% or something like that.
Baris Harvey: Steve, real quick, I think some listeners might not know kind of the overall, what is, before you kind of go into what you do with clients, could you go to a quick brief overview of what the SCD lifestyle or the SCD diet kind of consist of? And also what the general basis of a GAPS diet is?
Steve Wright: Sure. Sure, yes. And that is a great point. We should probably define what we are talking about.
Baris Harvey: Yes definitely.
Steve Wright: Great, great point Baris. Yes, so the Specific Carbohydrate Diet started in the literature in the 1920’s. Essentially the diet as it was written through those various evolutions I just mentioned, is a diet that is processed food free, additive free, grain free and polysaccharide or disaccharide free even though that is a little bit of a debate right now if you get into the minutiae. But essentially, what is allowed on Specific Carbohydrate Diet are properly prepared legumes, some fermented dairies such as cheese or homemade yogurts. Meat, fruits, vegetables, nuts all of those types of things. And there are specific, for instance, Elaine Gottschall chose to not include seaweed and multiple other specific parts of fruits that have polysaccharides. And the basis for that is just that when your gut is really messed up, you cannot breakdown those carbohydrates chains and actually absorbs them and end up feeding bacteria or feeding the gut dysbiosis that might have already be going on. So, Dr. Natasha Campbell McBride saw the golden SCD and took that and made it as the underlying foundation of GAPS. And what she did was she essentially innovated on top of it to really help her autistic son. And so she removed dairy from it because a lot of people have dairy allergies and totally understand that. She also added in juicing. She added in like some specific probiotic recommendations. She did come up with like a lengthy Intro Diet whereas SCD has sort of an initial phase diet like 3 or 5 days whereas the GAPS intro phase can be much longer. And so both of them have a lot of merit and they help a lot of people. And I think Dr. Natasha Campbell McBride totally hit on something that we also abide by at SCD lifestyle which is that dairy is very reactive. And we personally tell everyone no dairy for 30 days. You know, always be testing it. And then if you do happen to be okay with dairy, I think it is a really powerful food group that you should not completely exclude. And so that is one of my sort of beefs with the GAPS diet. As far as like how do we use either one? It is a great question. So, essentially, it comes down to I think creating your own custom diet. And both diets could get you there. Might be for GAPS really is that the juicing can be overtaxing if you are already learning how to cook and how to shop again, how to clean up. And so if you want to add on top of that another layer of juicing, those are more skills and more money where the bang for the buck only seems to be there for a certain set of people who have really bad detoxification issues. And for other people who have like SIBO, that is small intestinal bacterial overgrowth or other really bad gut dysbiosis the apple juicing can really affect them. And if you have someone who switches diets in the first week or two and all they do is feel worse they are not going to stick with it. And so once again I am not against juicing. I just think it is something that you add later as you begin to jump into this lifestyle. So basically my overall thing is start with meat, fruits, and vegetables. Cook everything. And we have like phasing charts over at scdlifestyle.com but I am kind of staying away from actually like the cruciferous family in the beginning because those can be hard to breakdown because it has a little bit more complex molecules and fibers in those. And really just starting from a cooking standpoint. The GAPS intro can be like no fruits and vegetables. And I think that works for some people but in general from a satiety standpoint and from the ability to stick to a diet, I think there needs to be some sort of compromise there. And so that is kind of what we are trying to do at SCD Lifestyle. It was like we saw these people failing in multiple ways and we are like, “Okay, let us just take the best practices and sort of begin to coach people through that.”
Dr. Justin Marchegiani: Awesome. Those are some great points, Steve. So looking at the SCD and looking at GAPS, one thing I noticed on the GAPS side is the big emphasis in bone broths. I do not quite see that on the SCD side. So I just wanted to kind of figure out how you apply, how you use bone broths. And just one layer on top of that is I kind of want you to go into FODMAPS. Because I know even in the GAPS intro they still talk about adding in broccoli and cauliflower and even onions at some points. And I see in the intro diet they even mention apple cider and things like that in one and two and then avocado I think in phase two or three. So I want to get your take just to rehash that on when you apply broths and do you ever take FODMAPS 100% out of the equation? And you probably even want to go into what FODMAPS are, too.
Steve Wright: Yes, yes that is a lot of stuff to unpack there but great questions, Justin. So let us start with the bone broth. Yes, bone broth can be like this amazing human food and I do think it should be very much a part of a healthy person’s or a person who can digest it very much a part of their life. You know, hopefully having it on a weekly basis if not a more often basis. Now you know some people love it every day. And I think it is a great food for that. So I love the fact that the GAPS diet really elevates bone broths and talked about it a lot because it does seem to be like a needle mover for a lot of people. And so I think we have to always keep our eyes on the different needle movers because you know something like maybe supplement x is really good for your health but it is maybe not going to like really cause massive change in a month or something like that whereas bone broth could have a potential to do that. So my thoughts are we typically add it in a little bit later after the first 30 days or so and always looking out for fat malabsorption. Because there are a lot of IBD people for instance or people who are still misdiagnosed or undiagnosed who have just a really wrecked gut and bone broth for them is like death soup. Like drinking it just makes them want to cry. So I think it is worthwhile to let people know that if you cannot tolerate a lot of fatty foods or anything like that, where you have like some really bad gut dysbiosis, sometimes it is better to wait four to eight weeks before you begin to slowly introduce bone broths. And then the same thing could be said for probiotic foods. You know GAPS is really, really big on probiotic foods and I love that as well. But again there are the really, really sick people who need to have a gradual introduction into all of these things. Like for instance, my business partner Jordan, he had to start with the one strain of sauerkraut per day for like months. It took him like two or three months to get up to like two or three spoonful or forkfuls of it. And so that is where I think that first three days is really key for just keeping it really simple and trying to keep the diversity a little high with fruits and vegetables. But also as you mentioned you know watching out for FODMAPS. So FODMAPS you know, is a fascinating diet out of Australia. And I think it is a really cool new take on foods and how they impact us and how the gut flora is impacted from them. In general, I think a 30,000 foot view, my experience with FODMAPS is that the more intolerant you are to FODMAPS foods the more damaged and the more destroyed your gut is. And so removing them if you are intolerant to them in the beginning can be sort of like a life changer. Like your quality of life can immediately go way up. However, I do not think there are classes of foods that you want to keep out forever. Like you mentioned, onions and broccoli and cauliflower, these are very powerful great foods.
Dr. Justin Marchegiani: Yes. Right.
Steve Wright: That we should use later on in a very healthy diet. But I think sometimes for those people, they will just have to heal their gut a little bit longer before they can reintroduce those.
Dr. Justin Marchegiani: Excellent points.
Baris Harvey: Yes. That makes a lot of sense. So it is basically a certain level of making sure that you are healthy enough or you take like a more therapeutic approach where maybe you have to kind of babysit, be kind of delicate on what foods you introduced until that gut is kind of cleaned up and now you can actually take some of the nutrients out of these other foods that might be harder to digest.
Steve Wright: Yes, I mean let’s face it. The diet that you should be following is like for me is the Steve diet, it’s the Baris diet, it’s the Justin diet. And your gut flora, my gut flora, our epigenetics, all these things are different. And they are also different depending on where you are in your health in your life. So in the beginning, you might have to get a very restrictive diet. But do not label food just good or bad. Just label them good for me right now or not good for me right now and based on whether you can digest them or not digest them.
Baris Harvey: Uh-hmm. Definitely that sounds good. So you are just talking about how some people have a problem digesting fats. And it is funny because we also talked about how people can have problems with breaking down the carbohydrates and often times when people are backed up and have constipation. I know a lot of people they really like to bulk up with like psyllium husk or just pack a bunch of fiber in order to get things moving along. But I like how you have a little bit of a different perspective. Could you for the listeners out there who might have some constipation issues and they are just trying to stack up on psyllium husk, can you give some other advice on how they can maybe helped with their constipation issues?
Steve Wright: Yes, so I guess my counter perspective is that fiber from whole foods is really the kind of fiber you want. And supplementing with psyllium husk is basically you would try to do the same thing if this analogy makes sense to you this is what you would be doing with psyllium husk. So let us say, since we are talking about poop, you take a big dump and you clog your toilet. And you go to flush and yet nothing happens. Would you pour out more toilet paper and start shoving it in the toilet to make that…
Baris Harvey: Yes, it would make everything worse.
Steve Wright: Right, right. So that is sort of the same thing with psyllium husk. It is sort of like a plugged toilet in a way. Would you dump a bunch more of poop basically into your system hoping that it is just going to unclog it? With some people it works in the short run. Myself, when how much you will actually experience it is that it is either going to make a bunch of bloating and really hurt or it might work for a week or so. And then also you will notice you need more, and more and more. And through this process you might actually be damaging your colon just because you are creating so much feces. So my take on that is it is not an amount of poop problem that constipated people have, it is the inability to get rid of it. So there is an evacuation problem going on and not a lack of poop to get rid of.
Baris Harvey: Uh-hmm.
Steve Wright: There are lots of ways that we could do this without using psyllium husk and some of the herbal laxatives and enemas and things like that. And that is through substances that either help with peristalsis which are the waves that actually move the food through your stomach and then obviously get rid of your stool. And then there are also substances like vitamin C and magnesium which are nutrients that your body could absorb and could help you in that regard. But when you overdose on them or begin to sort of micro-overdose on them they will actually draw some water into your digestive tract and sort of begin to help move things along or soften the stool and kind of get it along. So, I really prefer the sort of short term interventions with vitamin C and magnesium and typically magnesium glycinate or citrate. And then long term thinking about what is going on in here? Why is peristalsis not happening? Do you need more probiotics or more fiber from whole foods and begin to try to get to the root cause of why you are constipated in the first place.
Dr. Justin Marchegiani: Excellent points. Great points, Steve. Now I work with a lot of patients and I find gut infections are strongly at play. Lots of different parasites issues, whether bacterial issues, H. pylori, chronic, fungal overgrowth, SIBO. And a lot of these infections they produced toxins, right? So we know endotoxins or lipopolysaccharides. These are produced from a lot of the gram negative bacteria and these can disrupt a lot of those peristaltic waves or kind of like if you would get the last bit of your toothpaste out of your toothpaste you kind of roll it up. That is kind of how your intestine works. So can you talk about how kind of in your role working with patients being a clinician, how these infections really kind of muck things up, if you will?
Steve Wright: So just to clarify, I do not have a medical license or anything. So I was just a health coach.
Dr. Justin Marchegiani: Uh-hmm.
Steve Wright: Yes GI infections are extremely prevalent. And people are not getting this message or are not hearing this message. If you sort of poll the community and I am not sure what percentage you saw, Justin but like Dr. Tom O’Bryan sees 70 to 80% of every person who walks into his clinic whether they are complaining about GI issues or not have a gut infection. I have heard Dr. Lauren Noel talked about around 80% as well.
Dr. Justin Marchegiani: I agree.
Steve Wright: Okay cool. Yes.
Dr. Justin Marchegiani: Totally agree.
Steve Wright: And that is what we pretty much saw, too. It is 80-90% for the people that we are working with. So it is a really high percentage. And so, yes exactly those infections do a lot of damage. Number one, they could shut down the peristalsis waves. Number two, all those toxins are definitely causing inflammation and probably leading to leaky gut. And it is really the root cause especially constipation. Like constipation to me is like a huge massive red flag that there is probably some sort of infection that you want to go and get tested for.
Dr. Justin Marchegiani: Yes. That is great. And I also have a site called fixyourthyroid.com and I talk a lot about thyroid issues. And I see on your blog here today, you did a blog on, “Is your thyroid destroying your gut function?” Could you touch base on the thyroid gut connection, Steve?
Steve Wright: Yes sure. I am sure you have mentioned this before but every cell in your body needs thyroid hormones. They need at least T3 to function. And so the thyroid is extremely important. And if you look in the research, there is a high prevalence of thyroid disorders and inflammatory bowel disease, celiac disease and thyroid disorders are very high. And so it is kind of fascinating to think that there is a gut issue that is diagnosed and then typically or at least you have a much more increased risk of ending up with some sort of thyroid autoimmune disease as well. And I think a lot of what is going on here is you have a couple of things. Number one, is that if there is not enough thyroid hormone ending up in your gut cells the peristalsis waves, this is shown in research, the peristalsis waves will be either slowed down or the strength of them, their ability to sort of squeeze out like what you are talking about the toothpaste, will be diminished as well. And that is just because the cells are not getting enough of the hormone signals to do the job that they are supposed to do. Now if you are hyperthyroid instead of hypothyroid then you could be causing like diarrhea or something like that. And you know that the really cool research that is coming out that I am really pumped about now that I would be writing more about in the coming weeks, is that they are now showing that maybe up to 20%. And this is really new stuff. But all we really know is that the gut flora plays a big role in the conversion from T4 to T3. I know this is not perfect science but I think it is easiest to remember T4 is sort of the inactive form or thyroid hormone, more of storage part of the thyroid hormone.
Dr. Justin Marchegiani: Right.
Steve Wright: And T3 is the one that everybody wants majority of the time. And so the gut flora helps with not only the conversion of the T4 to T3 but they also store some of the T3. So if you have a disrupted gut flora you might have, you know, poor conversion. And then that is going to feed the signal back to begin to make more thyroid hormone and it can continue this bad feedback loops and really begin to cause a bunch of issues. And conversely, maybe you are eating an SCD diet or a GAPS diet. You have gotten rid of your gut infection but you are still having to rely on magnesium or vitamin C to have bowel movements when it could be just that you needed some sort of thyroid support or some work up there to actually begin to restore full function to the gut. Does that make sense? I do not know if I was talking all around that article.
Dr. Justin Marchegiani: Yes absolutely.
Baris Harvey: Yes, I know that sounds awesome. I mean like a simple way to think about it and it is so awesome how complex yet amazing our bodies are. When you see something like hypothyroidism and then slowing down the intestines. And we know like our thyroid is like our master metabolism kind of gland. And then we see like, “Oh, if you have hyperthyroid you might have diarrhea.” And it is kind of like your body telling you like things are hypermobile, it is speeding up. There is something going wrong. Or if the inverse is happening through your body and it is kind of obviously telling you something. And often times it is just so common that we kind of ignore those signals.
Steve Wright: I mean, I think that is just part of like every system in the body. Like functional medicine, like everything is just connected to everything. And so it could be that the gut is messing up in the HPA axis where the thyroid adjusts itself or it could be the other way. And so I think what you said there is perfect. Really a lot of this is about becoming aware of our bodies again. And I know one of the ways in which I got sick was essentially and it is no fault of anybody’s but sounds like humans we get like a manual that says this is how you should relate to your body. And this is what a perfect poop is. And this is what a perfect thyroid is, right? We do not get that. And typically the process of getting that is through getting back into our bodies and realizing what we are putting in, what we are consuming and then talking to other people who have like a very robust, resilient health: how did they feel? Like what did they do? And if you can’t do what they do then you are like, “Oh, interesting. I wonder why that is?”
Baris Harvey: Yeah definitely. So I want to slightly transition. I was actually on a call. Somebody called and they are talking about a client going to their doctor after you know they tested these gut panels. And it is funny because we talked about the infections and parasites and usually people think like unless you are swimming in some dirty water in Thailand, we do not get parasites or infections or things like that in America. But they also had leaky gut and they went to their doctors and their doctors said well it is not real, right? It is not a real thing. I am not going to treat anything like that. Could you answer this question? For us, we kind of know this but is leaky gut real? And how have you seen that in your practice?
Steve Wright: Yes, this is such a profoundly simple question. What is real is what is real to us individually. So in that doctor’s point of view, leaky gut is not real to him. I do not know what his basis of medicine is or how he functions in this world. I am not here to judge him. But let us say for instance, you just went to PubMed which is, and for people to know, that is a big search engine for all the research that is going on in the medical community. If you type in intestinal permeability which is the medical term for leaky gut; leaky is kind of like the slang term. You will find well over 10,000 research papers that reference it. So I do not know, maybe things become real for that doctor at 100,000 references or 12,000, I am not sure. But what is true is that since the 1980’s, papers have been published since we realized how the gut actually begins to function is through cells that become more permeable depending on the conditions that are present in the body and outside of the body. And so this is a known fact now that there is such a thing as a permeable gut and that is actually how the gut cells function. The problem is that this is just beginning to be taught in medical schools and as most people know your average family practitioner and even most gastroenterologists and people like these, they got into school a long time ago. And to be honest they are not interested in learning new ideas. They are just interested in going through a yearly conference or two and brushing up on the paradigm that they bought and paid for and work really hard to get. So I think at this point, the patients out there have to decide whether or not they believe it is real. If they believe it is real then it is time to fire your doctor and find someone who believes the same thing you believe. I mean if you believe that you should pay your taxes and your accountant says do not pay your taxes you will probably fire that accountant and go to one that believe what you believe.
Dr. Justin Marchegiani: Right.
Steve Wright: So the same thing applies to medicine. Doctors are there to serve you. And that is not how it always had been portrayed but that is really how the world works. When you buy a consultant they are there to help you. So if your consultant is not acting in a way you wish they would it is time to fire them.
Baris Harvey: Awesome.
Dr. Justin Marchegiani: Awesome points, yes. And Steve just so you know, 10, 842 for intestinal permeability on PubMed right now as we speak.
Steve Wright: That is so awesome. It is creeping up.
Dr. Justin Marchegiani: I know.
Steve Wright: It is going to get to 11,000 real soon.
Dr. Justin Marchegiani: (Laughs) I know. Right. So, you kind of touching back on the doctor’s paradigm and being a physician myself and working with lots of patients you come to the resolution that what you are learning in school and what you are learning in textbooks is about 20 to 30 years old. So to be on top of things and to really help your patients, you have to be studying what is clinically working now. Talking to other doctors, going to cutting edge conferences where you are learning the application of what is happening now. What are the best tests? What are the best things we can use supplementally? Diet wise, lifestyle wise to fix these things. And also we have to step outside the insurance model because a 5-minute doctor’s visit is not going to be enough to get the information to teach our patients. So you can talk about kind of the functional medicine model versus the insurance model?
Steve Wright: Yes. Sure. So, I love analogies, right? So I think this is how the insurance model works. It is much like the public school system. So if people can think about the public schools system. They probably thought about that more than the insurance model. But the teacher and the doctor are the same role. So in the public school model, the teacher is told exactly what they must teach. They have exams that their students are measured on. If they do not get their students through that certain grade then they could be fired. They get specific kinds of pencils. They get specific textbooks regardless of what they want to teach. They are told how they have to teach and what exactly the takeaways are. Well, that is the exact same thing that is happening in the medicine world. So I really do not fault the doctors. I do think that obviously, like you Justin, like you decided that you are going to do something different. And you have decided to take more responsibility, more investment into your profession. And there are teachers; they are stand up teachers who do the exact same thing. They buy their own markers. They buy their own stuff. But that takes a really special person. And so if you want to subsist inside either system you have to realize the standard of care that is practiced there. And so in the insurance model, the insurance companies dictate exactly how these doctors have to function. And if they do not follow what the insurance companies said with step one it can go so far as the medical review board could remove their license.
Dr. Justin Marchegiani: Wow!
Steve Wright: So their license is what they paid hundreds of thousands of dollars and eight to ten years of their life to get. So they are stuck in a really, really rock and a hard place position here. And so that is where you almost have to step outside of the system and go over to this non-insurance based model where a lot of the functional medicine practitioners practice. And I think there is another distinction there that we should make which is that, I think the insurance model is really built around symptoms care. It is about solving the immediate pain but no time is spent on why are you in pain or how did you get here. Whereas in the functional medicine model, which is typically outside of this insurance model so that physicians like yourself can actually spend 30 minutes, an hour, more time than that. You actually have time in your day to probably research the tough cases and figure out the newest and best models or reach out to world class practitioners who are doing something different that no one has heard of yet to help these people. And that model is really about why is this happening in your body. Because you might have acne and depression and a little bit of constipation and you knee might hurt a little bit. But in the insurance based model you are probably going to have a physician for each one of those things. You are going to have a dermatologist. You are going to have a neurologist. You are going to have a gastroenterologist and you probably will have some sort of an orthopedic surgeon or something on your team. And none of these people talk to each other. And then in the functional medicine model, you can go and see someone and they will be like, “Oh, actually all that stuff is related back to… Oh, looks like your gut and your hormones are off.”
Dr. Justin Marchegiani: Laughs
Baris Harvey: Uh-hmm.
Steve Wright: And so if we fix both of those all that stuff will go away. And so I think that is also a big distinction between those two models. One model is silo and specialty focused and the other model is like wait, everything is related. It is all of the system. And so if I treat something over here it is going to affect something else over here.
Dr. Justin Marchegiani: Absolutely. And I am constantly learning and I found the SCD Lifestyle phasing chart through you guys, through your site and I have been using that for my patients for the last year. And that is where they worked wonders. I appreciate that. You know, that contribution you made.
Steve Wright: Oh, thank you so much. Yes. Really and this is probably both of you guys just kind of thought, I just want to create this stuff, you know. I am in this for myself as well as for everybody else. But I really want to create tools and blog posts that I wish I would have had 7 years ago. Because it is inexcusable that more people do not know about these stuff. So that is kind of like a rule that I have about what products and what things you put on the market. What blog posts we publish. If this would not serve me 7 years ago we are not going to do it.
Dr. Justin Marchegiani: Love it, I love it. And right now, there are a lot of people out there that are trying to get answers, right? They are trying the diet stuff and they are also curious about functional medicine lab testing. So I know there are a lot of ways that you can spend a lot of money on lab testing and maybe not accomplish a whole bunch. So there are certain tests out there that may not get you the underlying cause of what’s driving things. So, what would you think are the key foundational lab testings that you would recommend? And again there are exceptions to every rule. Like a lot of times people think that food allergy testing is a waste but for some people it may be beneficial. What tests do you think are key and foundational to addressing maybe chronic gut and/or fatigue issues?
Steve Wright: Yes, yes that is great. And you are right. Everything that we talked about in the world there is an outlier. So from my point of view, again kind of like if you take sort of my engineering mindset, how do we get the most bang for our buck? And what are the biggest needle movers regarding diet? And we can apply this for test, too. And so when it comes to test, I think the first thing is getting a good handle on a salivary adrenal panel, like adrenal stress index is what they are called, for your hormones. Because we talked about thyroid earlier in this podcast but with a lot of people who are just learning or do not know about it yet, is that as long as you do not have an autoimmune condition with the thyroid a lot of it could be handled just through fixing your adrenal glands. And then a lot of sort of other sex hormone issues can be taken cared of if you really get those guys working properly and the feedback loop is working properly. So I think number one, you know working with a physician who can screen you for autoimmune markers. That is really a needle mover test. And some people do that through like Cyrex Labs. Other people can do that through blood testing. I think those are really big needle mover test because if you find that that is huge in this whole grand scheme of things and what you are going to eat and what you should go after. I think the salivary index BioHealth is the trusted lab that I like. I tried a lot of labs out there and I have run panels. Do you agree?
Dr. Justin Marchegiani: I agree. Like a 100% agree.
Baris Harvey: Uh-hmm.
Steve Wright: Okay great. I have run panels and I am not going to name any other labs but almost every other big labs you have ever heard of I run side by side panels and BioHealth always seems to line up with symptomology for people and so that is what I trust for the salivary or hormone stuff. And then the next big thing is the GI infections test or two. So here is a fascinating nugget that is not only fascinating but extremely frustrating. We did over 400 case studies where we have people doing a BioHealth 41H which is a stool test for infections versus other labs stool test. So we just essentially said this is the model of what we do. If you want to work with us because of what we have seen you have to do these two tests. And that means basically double the money. And we found somewhere around 70% of the time roughly, you know give or take 10% they were off. And there was one test that caught some bugs, that made sense and the BioHealth did not or the BioHealth caught them and the other test did not. And so that is a really frustrating but it is a very interesting point which is that you want a practitioner who not only uses sort of the same base testing but also sees a lot of these tests because tests are not perfect. There is nothing about any medical testing out there that is perfect. Even cholesterol testing is very imperfect. And so you need a practitioner that understands the subtleties and the limitations of testing. So when it comes down to needle mover test, I would definitely go with a BioHealth salivary panel at least the 41H from BioHealth and then combine that with maybe another one out there Genova or Doctor’s Data or something like that or another trusted lab. And then however your doctor prefers to screen for autoimmunity.
Baris Harvey: Awesome. I know you mentioned the false negatives with kind of the GI testing. I know you might not treat in a specific way if you do not find anything. But are you still going to kind of go about it the same if somebody is having a lot of symptoms of infection and you are not finding anything. Or you still might do some kind of protocol that is still geared that way just in case it was a false negative?
Steve Wright: Yes, yes definitely. I definitely talked to people about that in the past. And I know a lot of high, really respected coach or medicine practitioners do the same thing. And the issue with that is that you do not know. You have to then use a sort of like a broad protocol. You cannot target a specific type of bug for instance if it was H. pylori versus SIBO those are two different programs. Every one of those infections has a specific protocol that works really well for it. If you get a false negative but you still think that there is an infection there I think it is still worthwhile at that point to use some sort of broad spectrum based protocol and then follow-up with testing again. So just because you have one false negative, here’s a crazy story for you guys. So I have low stomach acids since I started this whole journey. It was one of the first things that I have figured out and nobody was talking about. And I am like, “Oh, my gosh! If I take Betaine HCl like I would start to have these amazing poops. I don’t burp anymore. And I do not have indigestion anymore. It was just an amazing thing. And so ever since and that was like 7 years ago, I am like Googling and trying to figure out like what causes low stomach acids to be low or to be suppressed. And you know there are a lot of different things but the main one out there is typically is H. pylori. And so for years, I am like, “I have H. pylori I know I have it.” But I have like two and a half years’ worth of tests that are negative, negative, negative. No H. pylori. And so we have never treated it because there was never anything there. And we are talking about all kinds of different labs, all kinds of different ways of testing. But as I got healthier and healthier, I did another stool test and then eventually I did get a positive for H. pylori. And treated it and now I do not need any sort of stomach acid boosting support unless I am under a really bad stressful situation. So the moral of the story here is number one, tests in and of themselves just done once are almost worthless. You need to continue to do testing overtime. And there are conditions such as crypt hyperplasia which may have been happening in my case or there is maybe this idea in my head, this theory that as you begin to solve a root problem, as I began to increase my immune system through fixing hormone dysregulation all of a sudden that infection became active enough to actually finding it on the test. And so I really think it is a fallacy to think that you can test once and figure this all out.
Justin Marchegiani: Yes. That is a great point. And I recommend lab testing just for preventative medicine maintenance just once a year. At least a gut test even if you are healthy. I know when I met my fiancée for instance, she had 15 years of IBS issues going to the ER, being scoped many times. And when I first treated her she had a blastocystis hominis infection. We removed that infection half of the pain gone. Then we tested again H. pylori, then it is cryptosporidium, then it was a worm infection, then it was Giardia. It was 7 or 8 infections layered in the crypt. So if all of our listeners can just open the palm of their hand, think of the fingers as like the villi and then where the finger gaps meet the palm of the hand, that is like where the crypts are. And these infections get burrowed up in there. So based on your experience Steve, what do you think are the most common and most virulent strong infections that you see out there are?
Steve Wright: Well, I just want to echo exactly the advice that you just gave, Justin. I do the exact same thing. I actually just ordered a $2500 worth of preventative testing.
Dr. Justin Marchegiani: Nice.
Steve Wright: I do it every year. And that is part of my budget. That is part of how I look at health care and taking responsibility for my health these days. I have a catastrophic health insurance policy. But then I also have that deductible covered in savings. But every year, I budget two to three thousand dollars’ worth of preventative testing just to make sure I am on the right track. Because if I can catch this stuff I will never even use that deductible unless it’s some sort of an acute problem that happens through sports or accident or something like that.
Dr. Justin Marchegiani: Love it.
Steve Wright: So I could not echo that enough.
Dr. Justin Marchegiani: Love it.
Steve Wright: So back to common infections. So I would say like out of the 600 or so case examples I can poll from blastocystis hominis as a huge one. See what else, H. pylori was another really, really common one. Entamoeba coli is another really common. I would say those three are probably the most common that I saw on a regular basis along with SIBO. Excuse me, I should definitely throw small intestinal bacterial overgrowth in there because that is super common.
Dr. Justin Marchegiani: Yes, yes. And then when you are looking at patients because I have the same thing where sometimes the lab work does not come out positive, you know, like what are you going to do? What are the clinical markers and signs that you may look to say, “Well, there are still something wrong.” Maybe they have cut out FODMAPS and they have an improvement. What are the other clinical markers would you look at outside of just lab testing?
Steve Wright: Yes, I would look at number one, any gas or bloating at all is an indication to me that there is likely low stomach acid plus some sort of overgrowth. Those are really big red flags for either or both conditions because they sort of feed each other. I would guess like, okay so if you are using supplements that physically alter the way in which the intestines work that would be things like digestive enzymes, Betaine HCl, ox bile, vitamin C, magnesium if you want. So like the first three are more about like stopping diarrhea or helping constipation. And magnesium, vitamin C, laxatives things that improve constipation. If you are not having perfect poops on a really healthy diet like a whole foods diet or like any of the diets we have talked so far you are still having loose stools or constipated tools that is all we really need right there. The other thing is if there are any autoimmune markers at all I am automatically thinking GI infection and yes I would say any autoimmunity, any sort of GI distress at all. And then lastly like, if things just seem complex, like you have been sick for a really long time, then typically I am assuming you have multiple areas of your body that have been down regulated overtime and part of that is just going to be the gut. So maybe it was not always the gut. Maybe it started with some thyroid and adrenal stress and then you have lost your immunity and then you just picked up a gut infection. So now you are presenting as chronic fatigue or multiple chemical sensitivity or fibromyalgia. And you know, for instance, fibromyalgia. Essentially 70% of people with fibromyalgia have SIBO. So any of these sort of complex syndromes and undiagnosed problems like IBS immediately I am thinking this person has a high, high chance of having a gut infection of some type.
Dr. Justin Marchegiani: Uh-hmm.
Baris Harvey: Yes definitely. That makes a lot of sense. And real briefly, I know we are coming close to the end of our episode but if you can go over because I know SIBO is really a big issue that is starting to pop up a lot more now. For those of our listeners who are not too familiar with it. I know Dr. Justin you recently did a video on SIBO.
Dr. Justin Marchegiani: Uh-hmm.
Baris Harvey: Could you go a little bit more into SIBO and just talk about how you might get this overgrowth and kind of like what is a little bit behind the mechanisms and maybe some ideas on how you get rid of it as well?
Steve Wright: Yes sure. So small intestinal bacterial overgrowth is essentially you are having too much bacteria in the small intestine. It could be beneficial strains bacteria, could be just neutral bacteria or even bad bacteria that have overgrown. Essentially what has happened is most of your bacterial growth should be in the large intestines not in the small and somehow you now have a colony in the small intestine that is essentially producing a lot of gas. They are just being bacteria. Bacteria very, very simple. I mean they eat and they give up a by-product. But the symptoms that it causes are very intense and can be very debilitating depending on the level of the overgrowth and the length of time. So the ways in which you get it are almost too numerous for us to even go into on the show. It is a wonder that your average sick person in America has not gotten it. A lot of people do have it. But essentially, once you combine stress with one bout of gastroenteritis or just like food poisoning or something like that your chances of having SIBO go through the roof. And some of the new research is starting to talk about the fact that just one round of gastroenteritis something like that, every time you have one of those, your chances of SIBO go through the roof. But there are lots of other things you can have. Valve malfunctions in your intestines; low stomach acid really feeds into it. Essentially, how are you going to beat it is that those bacteria need a food source. So it is just like if you dropped a spoonful of peanut butter on a side walk, the ants and the animals are going to come running. And so that is essentially what is happening with the small intestines. There is a food source and biology is just taking over. Like there is going to be something that is going to step up and fill that role in the community. And so reducing the food source through diets like the Specific Carbohydrate Diet, through the GAPS Diet is one way to begin to lower the community. But a lot of people would need either an antibiotic protocol with typically Rifaximin, maybe some other add‑ons or maybe an herbal protocol to really get rid of it. And from my personal opinion, and as I guess one of the leaders behind the Specific Carbohydrate Diet at this point in time, I do not believe that you can starve out SIBO. I have been working on it with myself, and working with people for over 6 years now and this idea that you can starve out SIBO thing or candida thing infection I think it is just a giant myth.
Dr. Justin Marchegiani: I totally agree with that. I see that all the time with my patients. We have to use a combination of herbal medicines whether higher dose or the oregano or berberine and Goldenseal or higher dose Artemisia, I 100% agree with that.
Steve Wright: Awesome. And I want to say that if people who are listening to us are like, “Man, I did that, too and it came back.” The first thing I am thinking is your immune system is suppressed and it is probably your hormones. So I think a lot of the recurrent candida people or the recurrent SIBO people out there if your functional medicine practitioner has not been focusing on your hormones and your immune system I think that is why a lot of the reinfections are or the colony just overgrows again.
Baris Harvey: Uh-hmm. Definitely. I like the analogy made earlier with the you know, you dropped something on the floor and all the bugs and the ants are going to eat it. It is kind of like if your body is unable to breakdown what you have then something else will and then so yes and it is hard to say, “Oh, we’ll starve it out.” While they are still there you still have to find a way to get rid of them. So definitely, I have looked and have researched and I have seen the same thing.
Steve Wright: Yes, I would totally encourage people to check out Dr. Allison Siebecker over at siboinfo.com. She has proven that these bacteria can live on fats. They can live on proteins. They can live on the mucus that we generate. So this idea of starving them out is not a reality based on the new science.
Dr. Justin Marchegiani: Uh-hmm. Well, his name is Steve Wright. You can find him at scdlifestyle.com. As a physician myself, I highly recommend everyone to go and download Steve’s free quick start guide. I use it with my patients. I recommend it to all my patients. So everyone go out there and get that right away. Steve, are there any other ways our listeners and viewers can find out more about what you do?
Steve Wright: Yes, I mean if you are looking at starting the SCD or GAPS or something like that or having a lot of that stuff I think the quick start guide is great. If you are someone who is beyond that at this point and you have already tried these types of diets and you are looking for the next level of information, we recently created a new site called solvingleakygut.com and on it you can go there and you can take a free quiz. Sort of taking your risk factors into account to see what your chances of having a leaky gut are. And at the end of the quiz you will answer a question about what is your number one complaint right now. Is it digestive related? Is it hormones? Is it energy? Skin? That type of thing. And when you take the quiz you will get the results for free but you also will get a 60-minute interview on whatever your top health complaint is. I would say that what we trying to do is kind of create two different sites. One site for the people who are sort of just getting started with this more of the beginner stuff for free. And then solving leaky gut is more for the advanced people who are on the train of autoimmunity and have had gut issues for a long time.
Dr. Justin Marchegiani: Thanks so much, Steve. We appreciate it.
Steve Wright: Thank you so much for having me on the podcast. It has been a great discussion.
Dr. Justin Marchegiani: You are welcome. We will have you back very soon.