Monday, December 22, 2014

High Dose Potato Starch Can Make You Fatter, Insulin Resistant, Feed Vipers in Your UPPER GUT If You Are MISSING Bifidobacteria longum and Akkermansia mucinophila, aka SAD Microbial Fingerprint (Part IV) NSFW

Part I: Bifidobacteria longum, Roseburia, F. prausnitzii (and Akkermansia) Made Us Human (NONE OF THESE EAT RAW POTATO STARCH) NSFW
Part II: HADZA GUTS HAVE THE ANCESTRAL CORE MICROBIOTA IN ABUNDANCE; High Dose RAW Starch Can Suppress Bifidobacteria, Roseburia, F. prausnitzii That Make Us Human
Part III: PALEO MAG HOT TONY FEDERICO HAS THE ANCESTRAL CORE MICROBIOTA IN ABUNDANCE; Citizen Science; Cautions with RPS-RUMPS; High Dose RAW Starch Appears to Suppress Christensenella, Akkermansia, and B longum That Make Us LEAN
Part IV: High Dose Potato Starch Can Make You Fatter, Insulin Resistant, Feed Vipers in Your UPPER GUT If You Are MISSING Bifidobacteria longum and Akkermansia mucinophila, aka SAD Microbial Fingerprint  NSFW
Part V: High Dose Potato Starch Can Make You Fatter, Insulin Resistant By Lowering GLP-1 AND ESPECIALLY If You Are Missing  Bifidobacteria longum and Akkermansia mucinophila, aka SAD Microbial Fingerprint NSFW







IF VIPERS IN SMALL INTESTINES:
Raw RS2
Cooked RS3,
Starches
Klebsiella
Bacteroides-Prevotella
Bacteroides
E. coli, Other starch eaters
Y
Y
Y
Y
Y
Y
Y
Y


VIPERS IN THE UPPER GUT (SIBO/SIFO)


Early on, very few of the studies on RS2 showed fat loss, weight loss or significant metabolic improvements in any human trials I saw. No improvements in diabetes, insulin resistance, blood pressures, or blood cholesterol panels (triglycerides, HDL or LDL-cholesterols). This deep lack metabolic benefits for humans deviated from decades of studies using other types fiber and prebiotics (eg inulin, FOS, GOS, psyllium, beta glucan, etc). RS2 produced butyrate, but nearly all fiber and prebiotics produce butyrate. Gram for gram GOS, FOS-inulin and (pure) RS3 produce more butyrate than RS2. Beyond butyrate in the lower gut (colon), what benefits were there for RS2? Very few I found. And there is a cost -- RS2 at high doses compromises gut diversity and specifically the species that make us human and lean, fat-burning machines: Christensenella, Bifidobacteria longum, and AKKERMANSIA

If there was fat loss or insulin improvements observed in animal studies with RPS or HAM-RS2, then the authors had poor study design -- they had substituted starch (digestible carbs) with RS2. In other words, they ran a VLC or LC (low carb) study, and we all know cutting refined rat chow carbohydrates will produce metabolic improvements, and often dramatic ones.

When bifidobacteria and other guardians in the upper gut are removed by antibiotics, stress, high sugar diets and lack of vertical transmission from mom, the environment in the upper gut becomes vulnerable to opportunistic flora such as the organisms from the lower gut. They crawl up uninhibited. If acid, bile or the stomach's protein degraders (pepsin, trypsin, chymotrypsin) and pancreatic enzymes become compromised in secretion, they crawl up faster and more furious. If these vipers consume potato starch  or RS2 or high amylose maize, they will enjoy ultra fermenting this substrate and can create silent and insidious havoc in the intestines, particularly if the gut guardians are gone (Akk, B longum, lactobacilli, etc).

There is a false 'myth', untruth pseudoscience that potato starch granules will 'carry' pathogenic bacteria away perpetuated on the internet.  Few vipers in the uppergut are 'carried away' from what I observe. Potato starch and raw starches ferments furiously and fervently where it lands. Worse, potato starch 'removes' the potent guardians of the uppergut, leaving the uppergut vulnerable to infections, E coli, fungi/candida and other potential commensals-turned-vipers and the vipers themselves.

What protects vipers from migrating to the uppergut? How to get rid of the vipers?

[Answer: GUT GUARDIANS (Akkermansia, Bifidobacteria longum, Lactobacillus plantarum, etc), probiotics, soil probiotics, bifido/lacto, weeding with botanicals, inulin/FOS, GOS, psyllium, etc]

Akk -- that is today's topic. Journal club: de Vos et al.  It's one of our best guardians of the upper gut (ileum, small intestines).

Various disease states are connected to microbial fingerprints.  At the top is a short list of the vipers that eat raw potato starch and raw starches; they all eat digestible starches too and this is why so many with j*cked up guts do well initially on strict Paleo, SCD, Gottschalks, GAPS and VLC diets. For a short term, limiting starches helps until seeding (weeding) with the right probiotics and weeding of identified vipers occurs. Long term however the root problem is not fixed and may even get worse (low FODMAPS and low fiber diets may lower akkermansia).

The microbial fingerprint for most post-SAD people (and formerly SAD fat/ill/sick):
(1) missing one of ultimate gut guardians: Bifidobacteria longum (recall: the raw potato starch users have nearly none)
(2) missing also another gut guardian: Akkermansia mucinophila (recall: for the family of 4 in their intrepid experiment, raw potato starch lowered everyone's A. mucinophila except for the one taking psyllium husks)
(3) presence of vipers: alcohol producing yeasts and E coli, Staph, starch eating Prevotella, etc.


Unique T2 Diabetes Fingerprint:
MISSING MANY (B. longum, and Akkermansia)
EXCESSIVE UPPERGUT PATHOGENS (Bacteroides,
Yeasts/Candida, E coli, Starch Eaters, etc)


If symptoms occur, they often involve joint pain, muscle aches, headaches, rash, challenges with losing body fat, increased blood sugars, or worsening of the respective condition. On stool testing these commensals-turned-opportunistic overgrowths may be evident for those who have the below conditions


Overgrowths (Klebsiella, Prevotella, E coli, and/or Bacteroides) Detected In:
  • obesity (I had this)
  • GERD/reflux, heartburn (I had this on high dose potato starch, out of the blue)
  • NASH (non-alcoholic steatohepatitis)/fatty liver (Tim Steele had this recently)
  • T2 diabetes
  • skin disorders, acne
  • IBS-C, IBS-D
  • autoimmune disorders
  • IBD, Crohn’s, ulcerative colitis
  • celiac
  • psoriasis
  • RA
  • MS
  • AS
  • Hashimoto’s
  • Grave’s
  • autism, ADHD, spectrum
  • reactive arthritis
  • esophageal adenoma
  • colorectal/bowel cancer
  • breast cancer
  • and other gut signatures marked by these



HIGH DOSAGE RAW STARCHES INCREASES BODY FAT IN T2 DIABETES SUBJECTS


Bodinham et al 2014. Authors were shocked to find that 40g HAM-RS2 (raw starch, resistant starch type II) failed to improve blood sugars, hyperinsulinemia, or glycemic control. High dosage raw starches actually worsened many parameters including insulin resistance. Several other human studies reflect these results (previous post: sorry, resistant starch type 2 won't induce fat or weight loss).  It appears RS2 can induce changes in metabolism that don't show up in rodent studies.

Humans aren't rodents. Our gut flora are vastly different (Moeller et al PNAS 2014). We're big-brained, long-living furnaces of fatty-acid utilizing carnivores/omnivores. If one eats hamster food, will they develop a lame #HAMSTERGUT?

Raw high-amylose maize RS2 high dosage 40 grams daily for 12 weeks appeared to make subjects with controlled T2 Diabetes fatter.............and higher inflammatory IL6, 30% more fat in the pancreas ('fatty organs'), higher triglycerides (which corresponds  higher insulin and IR, insulin resistance), and higher LDL (dense, atherogenic LDL-particles).

Notable indicators of a healthy microbiome -- butyrate and propionate in the stools -- were all statistically lower. 

So what was raw potato starch feeding, just the bottom feeders? Starving the gut guardians and making extinct Akkermansia and Bifidobacteria longum in the uppergut?


Results Tab 1:
--increased fasting TG (p=.039)
--increased LDL cholesterol
--increased HOMA% (aka nsulin resistance) wtf??!
--~30% increased pancreas fat  wtf?
(v control, Body fat depots determined by MRS scanning (n=14).)
--increased fat mass
--increased BMI
--increased weight
--reduced GLP1
--increased IL6 (but lower TNFa)
--lower butyrate (p less than 0.001) 
--lower propionate (p = 0.021)



MECHANISMS FOR HIGH DOSE RS2 HALTING FAT LOSS?

As you we know antibiotics can cause obesity (Blaser et al 2014). Certain probiotics can cause weight loss (Bifidobacteria longum, Akkermansia mucinophila) and others may induce weight gain (certain Lactobacilli strains). What about prebiotics, fiber and resistant starch?

I think RS2 halts fat loss and for many with susceptible guts, increases subtle fat gain as several studies are showing now.

What I would love to know about these test subjects is their abundance of the insulin sensitizing gut flora and how much % they dropped:
--Christensenella
--Akkermansia
--Bifidobacteria longum

What I'd also love to see is how much fat was gained in the liver and how high the liver tests (AST, ALT) increased. I bet it was a cr*pload since the pancreas increased in fat mass% by about 30%.

After potential losses of B longum and Akkermansia, what vipers/commensals were consequently overgrowing as a result of high dose raw starches, in the uppergut (SIBO/SIFO)?
--alcohol producing E coli?
--alcohol producing Clostridium or Dorea?
--alcohol producing yeasts/candida?
--Bacteroides?
--Klebsiella?
--Prevotella?

Every gut is unique but the obese, fatty liver/NASH and diabetes one has several overlapping clusters of microbial factors. Namely, the below. These fingerprints are so characteristic they can be predicted now in 80% of cases. A hallmark feature is low diversity. Scientists call this LGC, low gene count. Many gut symbionts are absent. The ones left are opportunistic vipers. Without the gut guardians in the uppergut, only a few vipers can lead to devastating metabolic and disease burdens .
Unique Obesity/ NASH/fatty liver/T2 Diabetes Fingerprint:
  • MISSING MANY (B. longum, and Akkermansia mucinophila)
  • EXCESSIVE UPPERGUT PATHOGENS (Bacteroides,Yeasts/Candida, E coli, Starch Eaters, etc)


GAME-CHANGER  =  AKKERMANSIA MUCINOPHILA


When scientists boost Akkermansia in humans with prebiotics (psyllium, inulin-FOS, etc), all the metabolic biomarkers dramatically reverse or improve (fatty liver, elevated liver function tests, circulating LPS, endotoxemia, hyperinsulinemia, elevated blood glucoses, inflammation, etc). Akkermansia is found depleted in every modern illness that it is tested: appendicitis, obesity, T2 diabetes, insulin resistance, high intestinal permeability, fatty liver/NASH, IBD, etc. (However, in severely disrupted guts, Akkermansia will overgrow where the gut barriers are compromised like in severe IBD and colorectal cancer.)

Through the entire animal, bird, fish and reptile kingdoms, Akkermansia is found ubiquitiously.  It's is everywhere, even in deepsea fish that live 5000 meters deep in the ocean. Everyone has it except SAD guts and those on high dosage potato starch

For healthy guts, it lines the entire GI tract. By scientists' estimates, our entire microbiome is 3-5% Akkermansia.   In stools Akk has an abundance of 1-3% in healthy guts (ubiome avg in healthy subjects = 1.2%). Akk is the game-changer for human disease for many.
"Studies have demonstrated an inverse
correlation between the presence of the closely
adherent mucin-degrading bacterium Akkermansia muciniphila  and obesity in humans [15]. Further
studies have confirmed that A. muciniphila is
reduced in obese and type 2 diabetic mice, and
demonstrated that prebiotic feeding enhances the
abundance of this organism with an associated
improvement in the metabolic profile [16].
Significantly, administration of A. muciniphila to
mice reversed the high-fat-diet-induced conditions
including inflammation, fat mass gain and insulin
resistance via improved control of inflammation
and gut barrier function potentially mediated
by increased intestinal levels of endocannabinoids
[16] Studies such as these are important in
establishing the causal relationship between
elements of the microbiota and disease states
, and
will greatly inform future diagnostic and treatment
protocols for metabolic diseases." (Joyce, Gahan 2014)


MOAR CHARLIE HUNNAM BY REQUESTS
Human or Hamster Guts?
What's his gut guardians (Akk, B longum) and GLP1?




CONCLUSION AND ACTIONS

  • Consider the whole spectrum of fiber to feed the flora and amplifying the gut guardian species associated with leanness and longevity: B longum, Akkermansia, and Christensenella by seeding (probiotics), weeding (probiotics, botanicals) and feeding (inulin, acacia, FOS, yacon, onions, leeks, sunchokes, GOS, psyllium, hemicellulose, cellulose, lignins, gums, beta glucan, arabinoxylan, xylans, etc).
  • Consider adding in foods and prebiotics that weed out E coli and  that raise diversity and B longum and Akkermansia  (both Version A and B of bionic fiber) in the 7 Steps.  
  • Version B is a fat blaster and can help reverse fatty liver/obesity/diabetes (Akkermansia).

28 comments:

  1. If it's a lie (myth) that RS2 removes vipers from uppergut, why is the addition of HAMS into oral rehydration therapy an effective way to remove cholera from upper gut?

    I thought there were a bunch of studies showing certain pathogens cling to RS2 and help remove it from the uppergut.

    James N.

    ReplyDelete
  2. Thanks James! YEs they are the ultra fast fermenters
    -- animal strains and starch-eating strains of bifidobacteria (not B longum which lacks the adhesion 'machinery' enzymes)
    -- clostridium
    -- Bacteroides
    -- B-Prevotella
    -- Rumininococcus bromii (keystone species)

    Vibrio too -- but how many of us have vibrio cholera? Other than vibrio, I've not seen other pathogens. E coli can increase substantially with raw starch (post) (but probably only if probiotics/bifido/soil insufficient).

    In the human gut, we can have 200-300 different pathogenic, opportunistic bacteria. Many of these directly degrade both cooked and raw starches equally well. This is the problem with modern conditions and gut permeability, and the depletions of gut guardians which ultimately protect the gut terrain and immunity.

    The strains that make us human never 'cling' to starch granules or directly degrade raw granules (all are gut guardians too):
    --Roseburia
    --Bifidobacteria longum, B infantis, B bifidum, B pseudocatenulatum
    --Akkermansia
    --Lactobacilli
    --Faecalibacterium prausnitzii
    --etc

    ReplyDelete
  3. Hi Dr. BG,

    Is this product okay to use as 1 - 2 TBS (for your version B) .....http://www.amazon.com/Jarrow-Formulas-Inulin-FructoOligoSaccharides-Powder/dp/B001BAA15C/ref=sr_1_3?ie=UTF8&qid=1419316056&sr=8-3&keywords=inulin+powder

    thanks,

    scott

    ReplyDelete
    Replies
    1. S Hall

      I like Jarrow but prefer the organic inulin better. Whole foods are great too -- onion soups, sunchokes, nibble on some dandelion root/salad, etc.

      Delete
  4. Sorry Grace, I have read your article 3 times but I can't work out whether you are saying to kick out RS3 as well as RS2 or not, temporarily or permanently or at all?? I also think it would help if you clarified whether this applies as much to a healthy person with a healthy digestion. I.e. No RS2 or RS3 (if that's what you are saying because if you are that's pretty much cleared out the cooked and cooled rice and potatoes etc.) Where does one get their carbs?
    Cheers, Adrian

    ReplyDelete
    Replies
    1. Adrian

      What gut testing have you done? What probiotics have you tried?

      See the new post -- yes RS3 intolerance because of starches can be a problem until the uppergut is seeded well by soil, bifido, Akkermansia, etc.

      http://drbganimalpharm.blogspot.com/2014/12/high-dose-potato-starch-can-make-you.html

      Delete
  5. Hello DrBG,

    Coming back to your Bionic Fiber versions, what is your view on Aloe vera. Have read positive and negative things about it. But it is quite popular here in India, so just wanted to know what you think of it.

    Thanks,
    PJ

    ReplyDelete
    Replies
    1. PJ ~There are great reports on aloe. I love also pickled fenugreek from my favorite Indian restaurant. It's all made and fermented by little old grandmas! It's so delicious and my gut seems to do happy cartwheels after that and milky Chai tea ;)

      Ashwin Patel and others talk about several Indian gut healing botanicals (neem) and digestive support here, ck it out

      Part 1: Don't Take Raw Resistant Starch Alone and Other Precautions; RS2 Needs to Be Taken With Other Fiber To Spread Fermentation Completely Across the Entire Colon
      http://drbganimalpharm.blogspot.com/2014/09/dont-take-resistant-starch-alone-and.html

      Delete
  6. I should also clarify that you don't mention aloe vera in Bionic Fiber. It does have high mucilage content so was thinking if that could substitute for Psyllium.

    ReplyDelete
    Replies
    1. I love all the mucilagey foods and fiber -- okra, slimy Okinawan purple tubers, lotus root, waxy red potatoes, etc. Aloe is really awesome. Of course anything can sub for psyllium -- it is one of the most studied but it is a 'seed' and those with cross reactivity, allergies or other intolerance (like high Prevotella overgrowhts) will not do well. Would love to hear what works for you later!

      Delete
  7. @Adrian

    Eat your potatoes, rice and beans (cooked / cooled / reheated). Absolutelyt nothing wrong with that at all.

    If I understand what Grace is saying, it is when one high-doses some raw starch powder in the hope of fixing something such as SIBO, yeast overgrowth, etc.

    If your digestion is fine and you don't know yourself any gut issue, why would you even consider taking one of those powders ? To me, it would make no sense. What makes sense really is to eat whole foods, traditionally prepared, including as much starchy veggies as you like.

    ReplyDelete
  8. I really liked your blog post. What are the best brands and name of a specific robotic supplements with good and not bad probiotics?

    ReplyDelete
    Replies
    1. Please see Step #3
      http://drbganimalpharm.blogspot.com/2013/11/how-to-cure-sibo-small-intestinal-bowel.html

      Some good bifido below on another comment (B longum straight up)

      Delete
  9. Tim Steele has shown in several posts that if we eat potato starch, our bifidobacteria population should potential grow at an exponentially significant rate. This is backed up by many human and animal studies, his own N=1, and the Folz family experiment.

    If we instead want to grow Akkermansia, Christensenella
    and Bifido Longum,what exact fibers do you recommend and are there any studies and N=1's that show this is possible?

    I'm planning some gut testing soon. What would be a good target percentage for Akkermansia, Christensenella,and Bifido longum?

    Any recommendations for a gut test that would capture all three?

    I like the thought of simply increasing random bifido strains but would much rather target these other important microbes.

    ReplyDelete
    Replies
    1. Tim S. is growing low populations of Akkermansia and selecting only starch-eating bifido strains with potato starch. This is not ancestral.

      The Folz family had slightly higher blood sugars which are meaningless as small #'s but I suspect they reduction in gut flora that are anti-inflammatory and gut protective have affected metabolism. Only Child 1 on psyllium had lower blood sugars. So high starch-eating bifido but metabolic degradation? Low AKk and low Christensenella?

      Ubiome or Genova -- great tests.

      New post:
      High Dose Potato Starch Can Make You Fatter, Insulin Resistant By Lowering GLP-1 AND ESPECIALLY If You Are Missing Bifidobacteria longum and Akkermansia mucinophila, aka SAD Microbial Fingerprint (Part V) NSFW

      http://drbganimalpharm.blogspot.com/2014/12/high-dose-potato-starch-can-make-you.html

      Delete
  10. From Perfect Health Diet:
    These foods are made of PHD-compliant ingredients – rice flour, potato starch, and tapioca starch in the case of baked goods – but they have a few defects:

    Low nutrient density. As a purified macronutrient, gluten-free flour is unaccompanied by micronutrients.
    Low water content. Whole food starches, like white rice and white potatoes, typically have less than 500 calories per pound due to a high water content. But flours and foods made from them, like noodles and pizza dough and bread, lack water and provide 1300-1500 calories per pound.

    The lack of water is potentially a problem because water is crucial to digestion, especially digestion of proteins. In the stomach, food needs to be dissolved in an acidic water bath in order for protein-digesting enzymes like pepsin to work properly. Dry foods are just not digested well.

    Flour-based foods may be problematic for more reasons than their lack of water. Last year, Ian Spreadbury proposed (http://www.dovepress.com/comparison-with-ancestral-diets-suggests-dense-acellular-carbohydrates-peer-reviewed-article-DMSO) that “acellular carbohydrates” – carbohydrates that are not surrounded by cell walls and embedded within a cytoplasm – may be unhealthy because the carbs can feed bacteria in the upper digestive tract which can then infect important organs like the pancreas, gallbladder, liver, and small intestine. Cellular carbohydrates would be digested lower in the intestine, helping to maintain an antiseptic and healthy upper small intestine.

    ReplyDelete
    Replies
    1. Thanks -- "because the carbs can feed bacteria in the upper digestive tract which can then infect important organs like the pancreas". I think our upper gut guardians prevent upper gut fermentation, SIBO/sifo (small intestinal bacterial/fungal overgrowths). The gut guardians do not derive energy from RS2 but from fiber from whole foods that rich in RS3 and non-starchy fiber (greens, stems/leaves, celery, roots like rutabagas, daikon, konjac, parnips, carrots, etc)

      Delete
  11. When you 1st tapped the brakes on potato starch I remember a distinction being drawn between that and banana flour because banana flour was the "whole food"

    Now you are strongly less enthusiastic about all RS2 but only mention potato starch. Is banana flour less problematic/less bad or are you just hammering potato starch since it's way more popular?

    I'm not crazy, only talking about 1 or 2 tbsp per day

    ReplyDelete
    Replies
    1. What is your gut testing? Are you reaching leanness and other metabolic goals?
      http://drbganimalpharm.blogspot.com/2014/12/high-dose-potato-starch-can-make-you.html

      Delete
  12. Ditto - a small raw potato, a small green banana, and a small chinese yam all have 15-30g RS2. These are all off-limits?

    ReplyDelete
    Replies
    1. Thx -- Raw potatoes compromise protein digestion in the stomach and small intestines because many raw starchy tubers contain trypsin inhibitors, which lead to pancreatic adenomas, hypertrophy, cysts and pancreatic masses. Are you trying to eat it daily? They don't even feed that to pigs and other livestock.

      What is your gut testing, B longum, Akkermansia, Christensenella, Roseburia, etc?

      Delete
  13. Hi Grace,

    Just my N=1.

    I dabbled with an earlier version of your 'bionic fiber' mix, for a few weeks earlier in the year - specifically the version that included psyllium and raw potato starch.

    I developed quite bad GERD (both heartburn after meals and silent reflux at night). I'd never suffered from reflux before, in hindsight I suspect the potato starch might have aggravated an existing overgrowth in the upper gut which I was unaware of, and the psyllium contributed further as it caused me to get very backed up.

    Supplementation of Betaine HCL for a month or two resolved the majority of reflux symptoms, and after a couple of further months of 'weeding' I've now started to introduce your updated bionic fiber version B (inulin/acacia/greens) without issue.

    Keep up the good work!

    ReplyDelete
    Replies
    1. Joe L~ Yes me too and several others who emailed me. The new post might offer some highlights for you ;) I had Prevotella overgrowths and hopefully they are improved now. Version B lowers Prevotella; if Prevotella is a problem, then psyllium needs to be avoided until the upper gut is re-seeded because grains, psyllium and starches-raw/cooked may aggravate overgrowths. Psyllium is double edged -- it grows B longum like mad. I do very well with it but there is a balance until Prevotella is low enough and bifido/Akk can do their work I think.

      Glad to hear the reflux is resolved. What benefits are you noticing with Version B?

      How is the seeding of the upper gut going?

      These B longum probiotics is working really well for people
      GI Balance (life extension)
      bio clinic B longum
      http://www.smithspharmacy.com/shop/product_view.asp?id=2558698&StoreID=A2CA0A52C8E242409B8D577B01E035A1&private_product=1

      Delete
  14. Dr. BG, I second to the earlier question RE Aloe Vera: I make a lemon smoothie with added fiber, probiotics, and fresh aloe gel scooped out of the leaf, and it made a huge difference in my digestion... Can you pls comment on Aloe Vera?

    ReplyDelete
    Replies
    1. Kira ~Aloe is fantastic. It's great topically for skin and 'topically' for gut epithelium, very mucusy and coats wounds and micro-ulcerations. Thank you for sharing a great blend! Lemon pith has fantastic antioxidants and the pectin-oligosaccharides generated will super heal up the gut because it grows B longum, etc.

      Delete
  15. Dr. B G,
    Regarding your comment on, DECEMBER 24, 2014 1:45 PM, you mention of Ashwin Patel. Do you mind linking the blog or podcast of this guy. I am using Neem at this moment, and would very much like to hear what other Indian herbs are out there one can try.
    Oregano oil and Grapeseed extract are another on the list, but not Indian I believe.

    ReplyDelete
  16. Is there a pure probiotic source for Akkermansia and Christensenella?

    ReplyDelete