Why You Need to Clean Your Gut, Now

By Kristy Ojala

In her book The Immune System Recovery Plan, Dr. Susan Blum, one of the most sought-after experts in the field of functional medicine, shares the four-step program she used to treat her own serious autoimmune condition and help countless patients reverse their symptoms, heal their immune systems, and prevent future illness. I found her quizzes and tips very helpful and I wanted to find out more about how we can live better-and be nicer to our poor, poor guts.

First of all, thank you for your book. If I hadn't picked it up at work, I wouldn't have been able to start taking charge of some major health issues I was not aware of. Your quizzes are very helpful. Why are so many of us in the dark about our diet and the importance of a "healthy gut"?

Dr. Susan Blum:
Because we are in the midst of an obesity epidemic, and also a self-image crisis, everyone is very focused on being thin and counting calories. This is just the wrong way to look at food. One of my favorite sayings is that "all calories are not created equal". A 100 calorie apple and a 100 calorie snack bag of pretzels causes a completely different series of reactions in the body. The apple results in less inflammation and the pretzels are the opposite. We need to shift our thinking away from calories to the idea that food has function, and we need to choose our food based on the information it brings into the body. This is a new field called Functional Nutrition and when practiced by a doctor is called Nutritional Medicine. Eating this way has the power to prevent and treat disease, and this is the approach I use in my medical practice. Many registered dieticians are still behind the times, and so many people don't understand this yet. But the word is definitely getting out.

The importance of a healthy gut has become news in the last decade. While those of us in functional medicine have known this for longer, recent studies have shown the medical community conclusive evidence that the health of the gut has the power to drive inflammation throughout the body-certainly for autoimmune diseases, but also for other inflammatory conditions like osteoarthritis and fibromyalgia. These conditions are on the rise, in epidemic numbers. One of the reasons is that we have been very cavalier about doing things that harm our intestinal flora: taking lots of antibiotics, and antacids for example. Not to mention all the medication like Advil and other NSAIDS, alcohol and stress. As a nation, our guts are a mess, and we are just now seeing conclusive evidence of the fall out.

But at the end of the day, one of the main reasons that people are in the dark about the role of food and gut health is that most physicians aren't trained to understand this connection, or taught skills to teach nutrition or treat the gut in this way. Medical schools still don't teach nutrition, and conventionally trained rheumatologists don't know anything about the gut connection to arthritis, for example. If people don't hear it from their doctor, where will they learn about this and believe it is true? While the Internet is very helpful, when your doctor doesn't believe or know about this, a lot of people don't get on board either.

Autoimmune disease is on the rise. What is the biggest challenge to overcome when you're diagnosed with an autoimmune disease?

The biggest challenge to overcome when you are first diagnosed is the attitude of the conventional medical community. You are usually told there is nothing you can do, that there is no hope of cure, and the best you are offered is medication to try to control the symptoms. People become passive and give up and feel hopeless and depressed. This is not the road to healing! People need hope, they need to know that there IS something they can do to find the cause of their illness, and cure the cause, and then they will feel better and improve without medication. They need to feel empowered.

Is the popularity of a gluten-free diet helpful or harmful?

I would say the popularity of a gluten-free diet is both helpful and harmful. It is helpful because in most areas (except in rural areas, perhaps) there are so many gluten-free products available in the supermarket or health food stores that you can adopt a gluten-free diet relatively easily. And there isn't much stigma associated with eating this way.

I suppose one way it can be harmful is that some people dismiss it as a fad just to sell expensive food. But I think there are so many people who obviously feel better on a gluten-free diet that this is irrelevant.

There is so much evidence in the research that gluten causes inflammation and autoimmunity in the body, that it is hard to dismiss this as a fad. So, I would support the positive side and say it's good that it's popular.

Many of us have had amalgam fillings all of our lives. Dr. Oz recently did a show on the dangers of mercury in our mouths, and my own (integrative) M.D. strongly recommended I remove all of my amalgam fillings ASAP. My dentist scoffed during my first appointment, but I am proceeding all the same. Why is there so much controversy over the safety of mercury fillings?

I think that most people agree that mercury from fillings can leach into the body and cause problems. There is also mercury "vapor" that can be released and inhaled. The controversy seems be that after having the same fillings in your mouth for many years, most dentists believe there isn't much mercury vapor being released any more and that removing the fillings are therefore unnecessary. The problem is, this attitude isn't really based in fact because it is hard to know which fillings are a health hazard and which ones aren't. There have been studies that have looked at silver fillings and autoimmune thyroid disease, with a drop in mercury levels and an improvement in antibodies when the fillings were removed.

I am a believer that they should be removed, especially in people with thyroid disease because the mouth sits right next to the neck, where the thyroid is located.

What is self-care, and why is it essential to our overall health?

Self-care means that you are fully engaged in activities that are good for you, and making time for yourself to do these activities. Examples of self-care are eating healthy, meditating or practicing other relaxation techniques, and exercise. These kinds of activities are essential to your overall health because stress, eating poorly, and too little exercise contribute to 80 percent of all our chronic disease in this country. In order to treat and reverse illness, lifestyle change is crucial, and this isn't something that a doctor can just give you a pill for.

And this is the other part of the definition of self-care: You are a partner with your health care provider. You need to do your part. It turns out that people who are fully engaged in helping themselves in this way heal faster and do better then people who take a passive role and expect to be "fixed" by someone else.

How much are all the plastic products we're using every day affecting our health? I realize that in the course of a day-despite my best efforts-I drink from plastic, eat from plastic, throw away receipts made of plastic, use a phone made from plastic, work on a plastic computer with a plastic mouse and write with a plastic pen, and carry a ton of plastic in my purse. Then I get home and try to remove plastic from my household and my pets' food. It's exhausting.

I like to use the concept of total toxic load to think about environmental exposures. These things are cumulative. Your liver is in charge of removing toxins from your body, and it needs lots of nutrients, like greens, antioxidants, protein, and cruciferous veggies to do its job effectively. Plastics have toxins that leak out into the food, and for some people it might not be as big of a deal if they don't have a lot of other environmental exposures like pesticides, heavy metals, or air pollution, to name a few. The liver has to deal with all of it. If you have a high exposure to many things, adding plastics to the list can just be too much. Some symptoms of having an overload of toxins are fatigue, brain fog, weight gain, feeling puffy and swollen.

The best strategy is to go to a website like ewg.org and try to reduce the toxins in your world. Couple that with eating lots of veggies to support your liver detox processes, and you can increase your protection from all those things you can't see.

Can you please explain what the rotational diet is, and why it is being recommended more frequently by medical professionals such as yourself?

Rotation diets are used to treat food sensitivities. Here is the definition of a food sensitivity: You feel worse when you eat it and better when you don't. There is more and more understanding now that eating the same foods day after day can increase the possibility that your body will become sensitized to that food. By doing a rotation diet, you can reduce the immune reaction to a particular food by not eating it every day.

I found it interesting that you said "going more than four hours without eating activates your stress system." When is it best to eat our main meals, and how often should we be eating? Do you recommend small meals over three main meals?

Cortisol, the stress hormone helps regulate your blood sugar. So when you haven't eaten for more than 4 hours, your blood sugar can drop, triggering a release of cortisol to bring it back up. If you are trying to restore balance to your stress system, for example when treating adrenal fatigue, you don't want to add this stressor. Therefore, I recommend eating breakfast, lunch, snack, dinner, with some form of protein (veggie included) at each meal. I think every 4 hours is a good rhythm, so if you eat an early breakfast you might also need a snack mid-morning.

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