Title : New Science on the Human Gut and Health: A Clinical Conversation with Zach Bush, MD, and Robert Rountree, MD
link : New Science on the Human Gut and Health: A Clinical Conversation with Zach Bush, MD, and Robert Rountree, MD
New Science on the Human Gut and Health: A Clinical Conversation with Zach Bush, MD, and Robert Rountree, MD
New Science on the Human Gut and Health: A Clinical Conversation with Zach Bush, MD, and Robert Rountree, MD
Published Online:4 Jun 2019https://doi.org/10.1089/act.2019.29220.zbu
Dr. Zach Bush obtained his undergraduate degree from the University of Colorado. In 2002, he received his medical degree from the University of Colorado Health Sciences Center. Dr. Bush is triple board certified in Internal Medicine and Endocrinology and Metabolism from the University of Virginia Health System, and in Hospice/Palliative Care. In 2012, Dr. Bush discovered a family of carbon-based redox molecules made by bacteria. His focus is on the use of these molecules in humans to compensate for the disruption of the body's natural defense systems by glyphosate and other dietary and pharmaceutical toxins.
Robert Rountree: Let me start by asking where you are from and what were your earlyinterests or influences.
Zach Bush: My early interests in childhood involved building things. I was always a Lego maniac. I was a Boy Scout. I got into building large construction stuff. By the time I was 14 years old, I was into car mechanics. I started renovating old classic American cars with two of my close friends. I made a small business out of that for a while. By the time I was 16, I was cleaning up construction yards. I eventually worked my way to being a class A general contractor many years later. I spent a lot of time in the building environment. I thought I was going to go into engineering, specifically robotics. In the end though, I decided to take a year off after high school before going into my engineering program. Within a few days of deciding I was going to take the year off, I had an aunt call me up. She was working in the Philippines and they needed help birthing babies. I jumped on that opportunity. For six months, I worked at a tire company to make enough money to go and live in the Philippines. I worked with an international group of midwives. Initially, the idea was to help out logistically. Within two weeks of my arrival, a nurse had a family emergency back in Canada. Then I was put in charge of 14-day infant checkups. As simple and rudimentary as the checkups were, the experience was awe-inspiring and terrifying all at once. Experiencing the world of patient interaction was an event that I could not turn my back on. There were a lot of really miraculous experiences.
This experience got me into the medical industry. It was a long slippery slope from there. I really disliked taking tests and I did not think that I wanted to be a doctor for that reason. I thought maybe I could handle being a nurse. So I started in the direction of pre-med, then discovered the new program for physician assistant licensing. I thought that did not sound like too much more effort than becoming a nurse.
I held that philosophy for about a year. Then I decided that it would only be another year or two of work to be a doctor. Nobody had told me about what a residency, a fellowship, or postdoctoral education looked like. Obviously, I went in very naive. It was 17 years later that I finished three subspecialties in medicine, and had a really broad education.
Dr. Rountree: Where did you end up going to medical school? Can you tell us a bit about your training?
Dr. Bush: I was at the University of Colorado Health Sciences Center in Denver. After four years, I went on to the University of Virginia (UVA) and did my postdoctoral studies. I completed an internship and residency in internal medicine. While I was there at UVA I was practicing hospital-based medicine, and after residency I was selected as a chief resident with a faculty year of teaching. I then went into endocrinology and metabolism and did a three-year fellowship. This was in large part due to a desire for more root-cause understanding of disease, as I still felt poorly equipped to really understand what was going on in a patient when they would present in clinic or in the hospital with advanced disease.
I did not feel like I had any root cause understanding of why they were presenting that way. We called things congestive heart failure and diabetes, but I did not really understand the obvious increase of prevalence of disease in the population, or the vulnerability to pathophysiology my patients were demonstrating at ever younger ages. I certainly did not understand the first thing about how you would go about reversing those processes with a healthy lifestyle.
I thought maybe if I learned the endocrine system, which is supposed to be the master system of the body, then I would get a really good sense of how the human body works and a way to prevent disease.
Ironically this study took me the other direction, into the pharmaceutical industry. I had found my way into cancer research and was developing a novel pathway for chemotherapy using vitamin A compounds—retinoid derivatives. This ended up being my break into the world of nutrition and realizing that food is important. It took me almost three years to figure out that these compounds were coming from a carrot. I was thinking so drug-like that I just assumed they were synthetic man-made compounds. After almost 15 years in academia, this was a new thought for me. Eventually, in 2010, I left academia.
Nine years later I feel like I am still slowly extracting myself from the belief that these conditions can leap up out of nowhere. I am still trying to realize that there is a long process of loss of health. That if you regain health, then all your other symptoms that we might call diseases should disappear. So that is the journey I am on now.
Dr. Rountree: You did not just study endocrinology and metabolism. I believe you also got board certified in two other specialties?
Dr. Bush: Correct. First, I did internal medicine, then endocrinology and metabolism, and then hospice and palliative care. By the time I left academia, I was pretty disillusioned. I had pharmaceutical funding denied for my vitamin A compounds because they were competing with high-dollar drugs on the market. This showed me a bit of the ugly underbelly of the reality of funding for research in the academic environment. It is very much tied up in the pharmaceutical industry, and anything that we do to try to separate ourselves from that is nominal at best. So between that disillusionment and the fact that I still felt like I lacked the resources and knowledge on how to fundamentally make my patients healthier, I looked to hospice as I really felt that I had helped patients the most in the easing of the death and dying process.
I started a small clinic in a poor rural community in Virginia, with no marketing or operating capital and no patients to call my own; word of mouth in the community was my only hope. I was on call 7 days a week, 365 days a year. I was working on my own and not making any money, so I needed to do something else. I became an associate director for a hospice organization on the side and spent four years doing that as my part-time job that paid my mortgage.
Those four years were definitely some of my best learning years. Once you spend time helping people through the death transition, you find out that it is not an endpoint, it is really a rebirth and an expansion. At that point, when you lose fear of death, you take a different look at life and how you should live it. This experience was a massive paradigm shift on perspective.
When I first went into medicine, I thought I was going to be a surgeon. I was good with working with my hands, and that is what I was confident in. However, over time I realized that I was bored. The operating room functions like a really slow construction site. I realized that I was going to be really bored if I remained in surgery. It would take 12 hours to do a hip joint fix, for example. That just did not hold my attention long enough. I realized that I actually loved thinking three-dimensionally about complex problems and finding simple solutions to them. With the entrepreneurial world and the biotech world, I found my way back into engineering—with both biomedical and mechanical/chemical engineering facets. I have my own biotech companies and a sustainable energy company that is developing biodiesel conversion technology. I love the synergies of science in my now multifaceted career.
Dr. Rountree: During this time, were you still following that track of interest in nutrition? How were you able to make it accessible?
Dr. Bush: My clinic was called Revolution Health Center. It was a primary care clinic built around the philosophy of nutrition to reverse chronic disease. I felt like if I could teach a curriculum in nutrition that is simple enough that it could be accessed by any patient of any socioeconomic and education level, then I would be able to really crack the code on our national health care crisis. And so that is what I still do with that clinic—pushing the paradigm of scalable lifestyle education and intervention.
We are about ready to create a national training center in Florida. We have found that it works very well when people are eating healthy and learning how to move and hydrate. It is amazing what happens to their bodies. We are ready to scale that up.
When you look at food as the solution instead of dietary supplements as the solution, health care can get really inexpensive. The paradigm jump is helping people overcome the belief that this is going to be super difficult and inconvenient. In the end, I discovered that my fifth-generation poverty rural families had an easier time making this transition than many of the CEOs flying in from San Francisco and New York to my clinic. These rural communities remember growing up on the same plot of land that they now live on. The difference is that there was a three-acre garden in the back when they were growing up, and now there is no garden. I ask them to consider planting again. I let them know that if they do that, they will be able to reduce drug costs, and improve independence financially and medically. That is a huge draw. Saving $200 a month on drugs can take somebody from completely crippling financial stress to freedom at the level of financial subsistence that a shocking amount of our population operates under.
Dr. Rountree: You make a really powerful point about telling people to get in touch with their food. The food comes from the soil, from the ground. When people eat canned, frozen, or other packaged foods, the first thing that is lost is the sense that somebody grew this stuff somewhere. Can you discuss this?
Dr. Bush: That is exactly right. We are so recently divorced from that relationship. If you look back to only 1945, we were growing 40% of our American food chain in backyard victory gardens. That is an incomprehensible amount of productivity coming out of our backyards. We now grow less than one-tenth of 1% in our backyards.
So in two generations, we completely gave up any sense of food independence and participation in food production. We did it out of the pursuit of wealth and convenience. In the process, we created large chemical companies that would then be outsourced to for our food production. The companies would sell us the message that we need these mega-chemical farms so that America can feed the world. But the reality is, the whole world was still feeding us. We still import most of our food that we consume, especially throughout the wintertime.
One example of this is what just happened in the last year. We just sold 85%–90% of the ownership of the seeds of our country to Bayer, a German company. What was Monsanto is now Bayer. This means that Bayer pharmaceutical company owns 85%–90% of our crops. This is incomprehensible. If this was any sort of political campaign, it would be shot down. Yet, that is exactly what Trump's administration allowed to go through. At the same time, they are trying to build walls and tell everybody that we are an isolationist superpower, when in fact we are selling the very backbone of our freedom and sustainability to a foreign entity.
Dr. Rountree: When did you start thinking about the global implications of what you were doing?
Dr. Bush: Before I started the clinic in Virginia. I was born a big thinker, I think. At UVA I was running large think tanks with pharmaceutical and insurance companies, and hospital groups, looking at the future of health care. In 2002, we saw the writing on the wall that we had a completely unstable situation. By 2012, the doors had blown off our chronic disease epidemics. But by even 2002, we were in what was called the death spiral of health insurance. Every year we were seeing a 6%–8% increase in health care costs. For every 1% increase, 1% of people would drop out. So 6%–8% of the population were dropping out of their health insurance policies every year. Of course, the people who would drop out were those who did not need it. They were the young healthy people. They could not understand the increasing cost for resources they were not even utilizing, and so they would drop out.
However, what this meant was that when the more healthy people dropped out, there was a further concentration of sick people who were insured. This, of course, drives up costs faster. This is the death spiral of insurance that was already in effect by 2002. So you can imagine where we are heading now that it is 18 years later.
The American Affordable Care Act got passed, but not because Obama was a great step up from the Clintons with regard to his understanding of where we were heading. In fact, all the whole thing did was kick the can down the road by just trying to get more people insured to help dilute some of that sick population who were making up the majority of the insured.
There is a landlocked relationship between hospitals and pharmaceutical companies, and other special interests within the situation. They all are in bed together financially. The insurance companies are footing the bill for everything and they do not see a way out. So they have had to partner with those industries, as well.
So now you see these juggernauts of relationships between the Anthem Blue Cross Blue Shields of the country and these large hospital groups who are constantly scratching each other's backs to create some solubility in what is a completely insoluble situation.
Dr. Rountree: Do you accept insurance at your clinic, Revolution Health? Is it a cash practice? Or what other model are you using?
Dr. Bush: I accepted insurance for the first five years. Later, I went through a transition, moving my clinic to Charlottesville so that I could get a larger workforce built around it. By that time, we sorted out what we wanted the curriculum to look like. However, around the same time, the former president of Anthem Blue Cross Blue Shield had heard about my clinic in Scottsville, and she had flown her team out from San Francisco to see what it was about. She said it was sounding like something that she was envisioning years back.
We spent quite a bit of time to sort out what steps would be needed to scale this thing nationally. This has meant that over the past four years, I have been working on making those incremental steps toward a national scalable program that would fit along and outside any other clinic. So at the moment, we are just a cash practice, but we are quickly moving to a self-insured model.
Dr. Rountree: With the expansion, are you planning to call the center Revolution Health around the country?
Dr. Bush: No, it actually got rebranded already. The clinic and its supporting brand will stand behind other independent clinics that will join the network. My clinic is now the M Clinic. The M has got a lot of symbolism for us in its representation of balance. It is the center of every written alphabet, and it is also the sound of creation in the ancient Sanskrit—as in the now ubiquitous Ommmm. It has got a lot of interesting historic meanings, including its representation of both the masculine and feminine and the like. The national network brand is Powered by M (powered by balance). This means that everybody will keep their current brand identity and clinical expertise or niche. For example, the network will be identified by Integrative Clinic of Houston, Powered by M. We will be able to come alongside any independently owned clinic around the country that is practicing a holistic or whole health approach to chronic disease reversal. We will come with a unified prevention and wellness strategy that all the patients can participate in. If participating, they will be able to come into this novel insurance environment that will be inclusive to integrative medicine reimbursements and incentives for wellness, and include catastrophic insurance as well. Once we pool a likeminded and like-lifestyled population, we can see radical changes in premium costs, and improved community and outcomes for longevity and quality of life. That is the dream.
Dr. Rountree: Can you tell me how the human microbiome figures into this picture? I understand that the microbiome has become one of your major interests.
Dr. Bush: Yes, that was by mistake. All the things that we were supposed to be doing always seem to show up by mistake. We never know what we are supposed to be doing when we start off in life or in our career. I started this nutrition clinic in 2010, and within a couple of years had realized that nutrition was not working like it was supposed to.
A full third of our patients were actually getting higher inflammation scores, not lower, eating some of the most powerful “superfoods” on the planet. At first, I just blamed them and said they were noncompliant, in line with the usual accusatory doctor mumbo. That group ended up being my test case group that would eventually take me to the microbiome. About a third of my patients had such severe intestinal permeability or leaky gut that when I would feed them something like kale, the insoluble fiber would cross that gut membrane and hit their immune system. The immune system does not know how to deal with insoluble kale fibers well. So I was inducing an inflammatory reaction by introducing large macromolecules.
While delving into this situation, we ended up starting to study soil. This was when we discovered the potential relationship of Roundup® or glyphosate to the destruction of the microbiome. In 2012, we found a family of molecules made by the microbiome that are responsible for communication between species. These carbon molecules would become the foundation for the biotech company that we launched in 2013.1
Since then, we have been making dietary supplements that are from fossil soils and the microbiome elements of these soil ores. There are no bacteria or fungi in the product line, instead, the active ingredients are composed of carbon molecules that function as a communication network between the microbiome and the human body. And so we have been in this area of expertise in my laboratory for the past six years.
I speak internationally on the subject of the intersection between the microbiome and human health and cellular function. One of the most profound discoveries we have made is in the ability of these compounds to reverse the impact of the toxic chemical environment of our modern soils on our farms all the way to the “organic soil” of our gut and internal organ systems. We used to think the microbiome was limited, of course, to the colon or the skin. Now we realize that other areas of the body also have living bacteria—the breasts, lungs, urinary tract, and beyond.2,3
The most ubiquitous chemical that we have added to our food and water system right now is glyphosate, the active ingredient in Roundup. It is used worldwide. Glyphosate is a water-soluble toxin that gets into the groundwater from the runoff from the farms.4 It gets into the large river systems, which evaporate as they head out to the ocean. So, we get glyphosate in the air we breathe, and ultimately in the rain that falls. In the United States, ∼75% of air or rain samples in the agricultural environment are going to be positive for Roundup. We are just surrounded by it.
It actually takes me a three-and-a-half hour lecture to point out the things that Roundup does to our food and bodies. It acts as an antibiotic, possibly causing antibiotic resistance.5 It acts as a mineral chelator.6 It is unbelievable, the number of layers of damage that it does. It is, in my mind, certainly the most damaging chemical we have on the planet right now.
There is so much talk about mercury in our fillings, and vaccines, and all these other things that get a lot of press, but after five years of running a basic science laboratory evaluating this chemical, there is zero question in my mind, that it is the single biggest problem we have threatening human health today.
Dr. Rountree: I often get asked how to detoxify from glyphosate. For example, let us say you have a patient who has glyphosate in his or her urine. Do you have a specific strategy to lower the body burden?
Dr. Bush: That is exactly what we have been doing through this biotech company. By adding these carbon molecules from the bacteria and fungi back to the human system, it immediately induces a huge change in the human genomic activity. There is a protein called ZO-1 that is the main constituent of the tight junction in the gut.7 This is a regulatory protein that looks a little like Velcro. It holds one intestinal cell to the next. It also holds the entire blood vessel tree, the blood–brain barrier, and the kidney tubules together, for example. This single protein structure is critical to these barriers throughout the body, and helps to keep the body safe. So, the gut lining is the primary exposure point to the environment.
When Roundup is consumed, the tight junctions are destroyed. There is a leak. So now there is unregulated entry into the body of organisms and chemicals and everything else. So, to reverse that, we use the carbon molecules made by the ancient microbiome and preserved in that fossil soil.8 In the past, 60 million years ago, we had a microbiome that was far more diverse than anything we have on the planet right now. We had soil depths that were far in excess of anything we have. We see way more variety and functionality in fossil soil extracts than we would from a modern soil extract.
Dr. Rountree: These chemicals that you are talking about, are they similar to humic acid or fulvic acid? Or shilajit?
Dr. Bush: Shilajit from the Himalayas is a very chalky white mineral, with a very high mineral content.9 It is extremely oxidative. Humic acid is a smaller molecule version of shilajit with a lot more mineral diversity in it. It is typically more of a brown to black solution, or solute of solids within a liquid. Humic acid is an oxidative salt, and it can grab mineral salts. It is pretty toxic to kidney tubules and things like that. Fulvic acid is a very small carbon molecule that crosses cell barriers very quickly. It is also oxidative. All of these are mineral carriers.
What our process does is to try to release the oxidative minerals from the carbon substrate through a water extraction process. When the water reacts with these small carbon molecules, we can begin to adjust the resulting hydrogen interaction. At that point, you get something called a redox event, where you have an equal number of reductants or negative charge to an equal number of oxidants, positive charge.
That is the process that we put our soil compounds through. It results in a carbon structure that is reduced in oxidative minerals, and then down to a hydrogen source so that you can get the hydrogen release.
Dr. Rountree: So the original source is what? Would it be shilajit or something like that?
Dr. Bush: Oh, no. It looks like a brown coal. It is a soft ore, a fossil layer of soil. It looks like what you would expect topsoil to be after it turned into a rock. It is a brownish rock referred to often as lignite.
Dr. Rountree: Are you saying that these carbon molecules are something that bacteria or microorganisms in general use to communicate?
Dr. Bush: They are metabolites, breakdown products from the bacteria and fungi produced as they digest nutrients, which, in turn, function to create a “wireless” communication system between cells. The way in which I discovered them was related to my past experience with mitochondrial signaling during my vitamin A research. My research got me used to thinking about redox signaling in my study of mitochondrial metabolism, which was the second half of my endocrinology fellowship. I had been studying intensely the way in which mitochondria communicate to the human cell in the setting of cancer. Keep in mind that the mitochondria are part of our microbiome.10 They are tiny little bugs that live inside of our cells. They look like tiny bacteria, except that their DNA strands actually are more similar to that of a virus. So they are a weird cross between a viral and a complex bacterial, double-walled organism.
Mitochondria proliferate. They can replicate and reproduce within our cells. They can die within our cells independent of the survival of our cells. The typical human cell has ∼200 mitochondria per cell, which is different than you see in a biology textbook that traditionally only shows you two. Longevity of the cell is now recognized to have a lot to do with the health and number of the mitochondria within it.
Our cells are full of these bugs, or mitochondria, and these little microorganisms are feeding us. When we eat, the nutrients from the food have to go through the belly, where they are first exposed to bacteria or fungi, and then the breakdown products or metabolites of microbial activity are absorbed in our body. The nutrients get repackaged in complex structures by the liver and then sent back out into the periphery, eventually ending up next to a cell. Some of the nutrients will get absorbed into a cell, and consumed by the mitochondria.11 They are consumed through the citric acid/Krebs cycle, and the respiratory chain. During this process, they are delivering electrons to the respiratory chain, a chain of enzymes in the wall of the mitochondria, converting adenosine diphosphate to adenosine triphosphate.
So, the way in which we discovered the potential for the bacterial communication was by watching the mitochondria talk, and they do that through electrically charged compounds coming out the back end of the mitochondria.
Dr. Rountree: So what is the physiology behind the response when people consume these carbon molecules that you have found?
Dr. Bush: We have studied these compounds in vitro and in humans.12 We have conducted a double-blind placebo-controlled trial to show the effects on the gut lining integrity and the resulting inflammation status. We have also discovered a very fast impact on protein synthesis when the human cell is exposed to this redox potential from the microbiome. We liken the process to a cell phone. Your cell phone does not break when you walk away from a cell phone tower, but it stops functioning, and so it cannot update or communicate with other cell phones. If you bring that cell phone within seven miles of the closest cell phone tower, suddenly it does everything it needs to. You can talk to anybody in the world. Then when you walk away again, you are suddenly dysfunctional as a unit of the family because nobody can reach you, and you are having a fishing trip.
This kind of situation happens in cells all the time. As long as there is unfettered communication between the cells, the whole system really never breaks. It can be repaired seemingly infinitely. However, if a cell is suddenly so damaged that it cannot repair itself, the neighboring cells simply let it know that it is time for cell suicide, or apoptosis. A stem cell is called in and it is replaced. This suggests that in a community with unfettered communication, there is never any disease. I get excited about thinking about this communication, because it is what we see in the clinic at the same time as we see it under the microscope.
If the wireless communication network is turned back on by adding these carbon molecules from the microbiome, normal health and healing start to take place. It turns out that we have an intrinsic gift within our bodies, within our biology for health and healing, and it just happens. It happens naturally. You do not need to be taught it. It does not take somebody with a science degree to do it. It does not take a doctor with a stethoscope. There is health and healing until you do not have enough communication, and then the whole system starts to shut down.
That is the joy of watching this product in hundreds of thousands of people over the past six years. It has never done anything to a patient. It does not fix disease. It does not fix pain. It does not fix inflammation. The body naturally fixes all those things when it has unfettered communication.
Six years into this journey I am slowly letting go more and more of my belief of what a disease should look like. We have only understood disease in a state of isolation as humans. Every Petri dish we have ever studied cancer in was sterile. With this product, without adding bacteria to mess up the culture, we can add back the communication of the bacteria and see what cancer cells do. We can add back the communication network and see what intestinal cells, liver cells, kidney cells, or any cell you can imagine, do when they have information from a diverse ecosystem. They suddenly behave differently because they have that vast communication in place.
In the intestinal cells, as soon as they have access to communication, they immediately respond by more connection. They start making more tight junctions. They make more gap junctions. The immune system behind that intestinal barrier responds by a more robust production of the antioxidant reservoir, like glutathione. We start seeing an increased production of glutathione, the main antioxidant in the body, by cells in the gastrointestinal system and the liver within minutes of exposure to the communication network. This makes so much sense. Our body is supposed to make glutathione all the time, creating a deep reservoir for injury management.
Dr. Rountree: Are there specific biomarkers that you track in people when you are using these lignite-derived carbon molecules in your practice? How do you know that you are using the correct dose or using it for the correct duration?
Dr. Bush: It took us a few years to sort this out. We now know that for 80% of people walking around in a pretty normal state, 5 mL or a teaspoon of this stuff with each meal is enough to get the communication network ramped up. This allows us to deal with whatever threat the food may be carrying in it.
In our clinical trials, we have used up to two or three times that much. In my clinic, I have used up to 5 or 10 times that much.
There are many assays that we can use to measure our success rate. But I always remind my patients before doing thousands of dollars of laboratory tests that the body is a perfect biological laboratory. They will know instantly when something is working.
The compound we use has been proven to be safe in every single usage in vitro. We can put it on kidney tubule cells, the most sensitive cells in the body, at a concentration of 100%, and have no cell death. In fact, they live longer. So for humans we suggest starting slowly to find the minimum dose that works best. For some of our patients, like our very sensitive autistic population, just three drops under the tongue is enough to have a huge benefit, a new foundation to work from with their microbiome, and its interaction with our brain.
Dr. Rountree: Who else would be a candidate for using these molecules?
Dr. Bush: Anyone. The reality is we are all being exposed to Roundup all the time. Roundup is only the beginning of our antibiotic problem. The typical glass of California wine has 64 herbicides and pesticides. These will kill the microbiome. The alcohol itself will also kill the microbiome and damage the tight junction system, causing leaky gut and leaky brain—in concert with the 64 chemicals, it becomes a nuclear bomb event for the immune system and beyond. Hello hangover. It does not stop there. Our meat contains antibiotics—five times more antibiotics are delivered to our livestock than to humans each year in the United States. Our fruits and vegetables also are carriers of the herbicides and pesticides, and in turn our water systems. This means that you are constantly threatening the microbiome and the integrity of the gut and vascular barriers. If you are a wine drinker or a food eater, you are going to be consuming these molecules.
In addition to food, in the United States for the past 20 years, we have been prescribed 833 prescriptions of antibiotics for every 1000 men, women, and children. There was a New England Journal of Medicine article in 2013 that showed that this volume of prescriptions has been remarkably stable over the years.13 So we are eating them, we are drinking them, and our doctors are prescribing them.
It is a disaster for the microbiome on planet Earth right now. For that reason, there is nobody who has a replete microbiome with the exception of maybe the last hunter-gatherer tribes in Africa. But they are disappearing quickly.
Dr. Rountree: Do you perform microbiome testing in your patients, or do you not consider that relevant?
Dr. Bush: We only do it in the research environment. It is not really relevant right now for an individual. You can show changes that are relevant to science at a population level, but we do not know how to apply individual results to an individual. For example, we cannot tell them that they are missing a specific type of bacteria.
We have to be humbled by how little we know about the microbiome. We mostly think about bacteria. But the microbiome is primarily fungi and viruses, and bacteria are the tip of the iceberg.14 We have ∼40,000 species of bacteria that could be interacting in some way with the body. There are probably >5 million species of fungi. There are 1031 viruses on the Earth. There are 10 million times more viruses than there are stars in the entire universe.
This means that the amount of microbiome that is in daily contact with the body is staggering in size. We just cannot truly understand the sheer biodiversity and density of microbiome.
So to say that we could test that in a patient is wholly inadequate. Typically, if you get a genetic microarray of the stool microbiome analyzed, there may be 180 bacterial species tested at best. Most companies test <120, with many testing only 40 species. They are not even looking at the 5 million species of fungi or anything else.
Testing is useful in clinical studies where we can show population effects of an intervention, for example, a shift, like more Bacteroidetes, or less Firmicutes. Looking at the shift of a genus becomes important data that we can start to hang a hat on. But within the individual, seeing a small shift in the Bacteroidetes to Firmicutes ratio is not useful enough to make any clinical determination of benefit.
So we still do not understand the microbiome as a whole, and for that reason, our group has been really preaching against the probiotic movement for six years. We finally got huge support this past September from publications from Cell.15,16 The authors demonstrated that with probiotic use in mice and humans, there is an enormous collapse of the microbiome diversity. Interestingly, the probiotics were given at the end of a two-week course of antibiotics. This was the only time that I thought that it might be a good idea to take a probiotic. And it turned out to be a disaster. The mice never recovered their microbiome once they were put on a probiotic. In contrast, if they had no probiotic and were just put back into their normal environment, they made 100% recovery within 30 days. In the humans put on probiotics, their microbiome had not recovered within six months. They were back to normal by 30 days if they were not given antibiotics. So we now know that probiotics hurt the ability to rediversify the bowel after antibiotics.
Dr. Rountree: What about fermented foods? Kombucha or kimchi, for example? Do you think those are beneficial?
Dr. Bush: I would say that these are 100% beneficial if they are done with a wild fermentation. The ancient approach involves saltwater or brine exposed to the air. This results in thousands of species of bacteria and fungi, and viruses all intermingling into the fluid. They all work together to metabolize the cabbage or the miso, or whatever is being fermented. The intelligence of that complexity of the microbiome and the natural balance that comes from an unperturbed ecosystem is what you get from a wild fermentation. In contrast, with a probiotic, you are giving two or three species at billions of copies. You just planted a monocrop right in that person's intestine, and that is what is now being shown with that Cell article.
Dr. Rountree: Is there any blood biomarker that you consider useful for following patients on your protocol? Glutathione for example?
Dr. Bush: Glutathione is very short lived. Glyphosate is one of my favorite measurements because it is stable in urine. Urine glyphosate would be a go-to. However, again, I do not end up measuring these clinically because my patients come in after a week letting me know that things are so good. They cannot believe what is happening. So I do not need a test. When you have patients who are improving, I find it a waste of money and resources to send them for testing to prove they are getting better.
The only times that I really do these tests is if there is a diagnostic dilemma, or somebody is not responding appropriately. Then I will go after it. Glyphosate is a good starting point. Sometimes I will find patients with sky-high glyphosate levels in the urine. In these cases, I usually find that there is something causing that. For example, the person is consuming water from a well downstream of a huge chemical farm. In these cases, it might take two years before we really see them get under a threshold of toxicity for achieving clinical resolution.
The other things I measure include immune markers. For example, interleukin (IL)-6 or IL-9. IL-6 is a simple and inexpensive marker to run. I choose this over C-reactive protein (CRP), which only gives you a blink at the vaster environment. It does not show the gut environment. In a patient population today, what you really need to look for is gut inflammation.
Gut inflammation occurs where 60%–80% of your immune system is residing, which is within your gut lining. That lymphoid tissue is where you are going to produce the vast majority of your ILs, because that is where 60%–70% of your T cells and B cells live. By just measuring CRP, you might only be measuring downstream effects of what is going on. You do not know how much work is being done in the gut. With this level of detail, you would want a doctor involved.
Another example would be to look at κ and λ light chain production, which is looking at overall antibodies. You could also do a total immunoglobulin A (IgA) or total immunoglobulin G (IgG) to look at how busy the immune system is at the gut level. How many antibodies are you producing overall?
If three months into a patient intervention, I am not seeing the progress that I would expect, then I might do these tests to see whether there is a reason that I am somehow not being effective. Perhaps I am not being aggressive enough with my nutrition. Then I ask whether I need to fast this patient. I ask what might be going on in his or her gut. This is when I go after the ILs and the total IgG or IgA levels.
Dr. Rountree: Thank you so much for taking the time to tell us about your work. Where is a good place to go if people want to read more about all of this?
Dr. Bush: My education site is (ZachBushMD.com). At the worst, I have a bunch of opinions on this site, and at best, some good data. If you want to hear my opinions on just about anything, this is where I go to say them. Sometimes I think I am going crazy with what is going on in the world, so I just have to vent a little bit. Among the venting, there are also some of my better-thought-out pieces on everything from pregnancy to what is happening with GMO, why that is important, and across the board. It is a deeper dive into my brain. In social media: @zachbushmd and #zachbushmd. If someone wants specific information on the soil products, the website is (Restore4Life.com). These websites also include some of our own published articles.
Thus Article New Science on the Human Gut and Health: A Clinical Conversation with Zach Bush, MD, and Robert Rountree, MD
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