Thursday, February 5, 2015

Gut Guardians DOUBLE Podcast Episodes: Diabetes, Fiber Diversity and the Gut Microbiota w/ Dr. Tim Gerstmar, Parts I and II

Diabetes and the Gut Microbiota (Part 1) With Dr Tim Gerstmar ND

The Gut Guardians Podcast welcomes Dr. Tim Gerstmar (@DrTimGerstmarND) onto the show. He shares his insights on how he is treating his patients with diabetes and also gives us his take on the most recent findings that show the relationship between the gut microbiota and diabetes. Dr. Grace and Matt had a lot of fun chatting with Dr. Tim, as he brings his expansive knowledge to the show.  


The conversation continues on the Gut Guardian Podcast with Dr. Tim Gerstmar. He gives both Dr. Grace and Matt a look inside of his “secret” jars. Well, looks like they aren’t going to be much of a secret after listening to this podcast! Inside the jars are Dr. Gerstmar’s special blend of fibers which range from FOS to glucomannan. Get your mason jars ready! Dr. Tim and Dr. Grace go back to the discussion on the mismatch between the modern human and the environments surrounding in and around us. And be sure to listen to the end, where Dr. Tim sums up what all of us should do to lead a happy, healthy life. 


Show Notes

Dr. Tim Gerstmar’s Site Aspire Natural Health

@DrGerstmarND and on Facebook 


Lack of translation between refined RS2 and RS3 animal studies to human trials:

Sorry. Resistant Starch is Unlikely to Miraculously Cause Weight Loss and Body Fat Loss

  • Low (15g) and high dose (30g) RS2 for 4 weeks didn't induce fat loss either but mildly improved insulin resistance in obese men, not women (Maki et al, 2012).
  • Neither did 25 grams refined RS3 supplementation (Novelose330), but high-protein/40% carbs resulted in all body fat parameters pivoting: improved insulin sensitivity, body fat loss and weight loss in human subjects with metabolic syndrome (Lobley et al, 2013).
  • Neither did 40 grams RS2 supplementation for 12 weeks in T2 diabetes (Bodinham et al, 2014). Worsening in body fat mass, BMI, fatty organs such as fatty pancreas, also higher insulin secretion observed.
  • GREEN BANANA FLOUR: However, a whole food supplement which contains a broad spectrum of microbial superfoods, native banana starch flour (NBS) 24 g/day induced 1.2 kg weight loss, improved waist-hip ratios and insulin sensitization in T2 diabetic, obese females after 4 weeks, contained only 8 grams RS2 (Ble-Castillo, 2010). Version B of BIONIC FIBER in the 7 steps. Green banana and plantains have been shown to heal ulcers and infectious colitis.


EB said...

Hi Dr BG, really enjoy the info your putting out here. My digestive issues(from biggest to smallest) are constipation, constant post nasal drip, and occasional bloating and acid reflux. I've tried the low carb/paleo diet, fiber protocols, and various probiotics(primal defense and Prescript Assist). Unfortunately, nothing has dramatically alleviated my symptoms. I'm now considering using a herbal antibiotic to wipe out any bad bugs that may be causing my digestive issues. I know you've mentioned herbal antibiotics before and have had success with them. You've mentioned metagenics candibactin BR being one that is good. I found a clinical study that showed it was just as effective in treating SIBO as rifaximin when used in conjuction with the AR version. Would you recommend using both or could I use just the BR version. The stuff is expensive, so I would prefer to purchase one of them. Thanks in advanced, looking forward to your reply.

Betty said...

**Sorry. Resistant Starch is Unlikely to Miraculously Cause Weight Loss and Body Fat Loss**

What's there to be sorry about? Not everyone needs to lose weight. Some of us are trying to gain weight! LOL

Anonymous said...

Dr. Grace,

Your podcasts are such a treat.
How wonderful to have breakthroughs in understanding Diabetes and all that that can inform so many disease processes.

Your website is an important oracle for health and science. I'm so grateful to have found it.

Thank you!

Dr. B G said...


I think a lot of people are in the same boat -- the gut is quite disabled and damaged from the lack of the gut guardians.

What testing have you done? You may be missing 'something' in all your strategies and waste quite a bit of time, energy and resources unless you narrow down the pathogens you're trying to affect.

steve said...

dr bg,

i'm 7 days into a berberine trial. i started it primarily for frequent stools (formed), but larger qty and gas. testing has consistently shown overgrowths of strep. i'm seeing improvements as of now, but wondering how long to continue the berberine. some studies show 4 weeks for sibo. thoughts?

Anonymous said...

P1 said...

Do you have a yogurt starter you recommend? I want to try making my own yogurt with coconut milk instead of milk.

Pablo said...

Hello Dr. BG,

I have to thank you for this blog, I've found so many answers to my questions here... But I have some more:

- is it safe to consume Larch AG on a daily basis? I don't know of any ancestral populations that eat it.

- What do you recommend: berberine, clay or charcoal? Can you copy some links to iherb?

I'm trying to erase the bad effects of high dosage PS and many many rounds of Amocillin...


Ilaine said...

Dr. Grace, what about shiritaki noodles? They are derived from konjak.

Ilaine said...

Dr. Grace, what about shirataki noodles? They are made from konjak.

Anonymous said...

Hi Dr Grace
I've been taking your Bionic Fibre for a few weeks, but I'm on antibiotics for a UTI, should I stop the fibre until antibiotics are finished?

Dr. B G said...


Thanks for your awesome thoughts!

'Amped bionic fiber' helps lean mass -- I had the same prob gaining muscle but it switched completely on it for me.

I rarely use berberine alone. Each person is unique and their gut issues. Hopefully you'll work with someone who will tailor the therapy? Retesting the urine and stools can help guide the next step.

Yogurt is superfood incl coconut milk ones! Awesome. You are 10 steps ahead of me. I have not had a chance to make on my own -- I've there are several great brands on Amazon. My gal pal Hannah has some great kefir cultures but not sure if they translate into thicker yogurt

Would love to hear which strains you enjoy later.

You're right I don't think any ancestral society does but some of the more extreme ones may use tree bark. AG is found in whole grains so actually many long-lived societies do get significant AG.

Konjak (konjac) is awesome -- the taste is squishy if it is pleasant for you. Personally i like the mung bean cellophane noodles better, but both absorb the flavor of sauces or soups well.

Studies for probiotics and fiber/prebiotics seem to show improved restoration and protection of our native gut flora during antibiotic courses. Good luck!

P1 said...

Do you have any opinion about the value of these bacteria:
for use in a yogurt starter?
I'm going to add some B Longum just from the capsules.

Juan said...

Hello, Dr BG

I'm very thankful for the information you have been posting, and have found it really interesting. However, I have a couple of questions.

First, you constantly recommend testing for gut issues, but I live in Colombia, and here it's impossible to find anything better than basic stool tests (and common gastroeneterologists), and those have not been very useful. I have bad gut issues and autoinmune disease, but sadly there's no way to do tests on the level of metametrix here, or any distributors. Actually, I think there's no decent functional practitioner either, sadly, at least none that I have found (years looking for it). Aside from flying to USA (very difficult, money issues), what would yo recommend me to do?

Second, you say that bacteria like Bifidobacterium longum are essential for gut health, and recommend them to be supplemnted as probiotics to "seed them". However, it seems not even something as strong as VLS#3 can really change the gut flora Of course, I'm not saying your recommendations aren't good anyway, but how do you reconcile that with the concept of "seeding". It would seem probiotics aren't really good for introducing lacking species permanently. That's kind of a bummer XD.

Thank you very much for your time!

Dr. B G said...

I think they're great -- B longum may not grow because it may have special requirements, I think I read. I'll be interested in your results! Maybe you can do some yogurt without B longum and see if the taste, consistency, texture are altered?

Great points! IBS-D is a dysbiotic gut 'fingerprint' as I'm sure you're aware. Things will not shift so immediately or without addressing the 'root problems' like pathogens, parasites and-or yeast overgrowths.

With that said, there are nice studies with VSL showing significant shifts of the gut microbiota like the one below

J Neurogastroenterol Motil. 2015 Jan 1;21(1):111-20. doi: 10.5056/jnm14048.
Change of Fecal Flora and Effectiveness of the Short-term VSL#3 Probiotic Treatment in Patients With Functional Constipation.

Kim SE1, Choi SC2, Park KS3, Park MI4, Shin JE5, Lee TH6, Jung KW7, Koo HS8, Myung SJ7; Constipation Research group of Korean Society of Neurogastroenterology and Motility.

We investigated gut flora characteristics in patients with functional constipation (FC) and influences of short-term treatment with VSL#3 probiotic on flora and symptom improvement.

Thirty patients fulfilling Rome III criteria for FC and 30 controls were enrolled. Fecal samples were obtained before and after VSL#3 intake (one sachet twice daily for 2 weeks) and flora were examined by quantitative real-time polymerase chain reaction (qRT-PCR). Symptom changes were also investigated.

The fold differences in Bifidobacterium and Bacteroides species were significantly lower in feces from FC, compared to in controls (P = 0.030 and P = 0.021). After taking VSL#3, the fold differences in Lactobacillus, Bifidobacterium and Bacteroides species increased in controls (P = 0.022, P = 0.018, and P = 0.076), but not in FC. Mean Bristol scores and complete spontaneous bowel movements (CSBMs)/week increased significantly in FC after ingesting VSL#3 (both P < 0.001). Relief of subjective CSBM frequency, stool consistency and abdominal bloating were reported in 70%, 60%, and 47% of patients. After VSL#3 cessation, 44.4% of patients with symptom improvement experienced constipation recurrence mostly within one month.

Bifidobacterium and Bacteroides species might be quantitatively altered in FC. A short-term VSL#3 treatment can improve clinical symptoms of FC. Further studies are needed to investigate VSL#3's additional effects beyond altering gut flora to allevate constipation.

Dr. B G said...

This is a better demo, Juan -- changes in the UPPERGUT is what reflects health and I think if the FC study posted specific species, more change is likely to be noted, eg the anti-inflammatory species (see my other posts -- Akkermansia, F. prausnitzii, Bifido longum, etc). All of which potato starch LOWERS, gut damage occurs gradually and silently.

Fecal transplants 'work' better than VSL because it delivers more to the uppergut to seed it better.

YOu don't believe in seeding? That's pretty funny

Gut Microbes. 2014 Jul 1;5(4):494-503. doi: 10.4161/gmic.32147. Epub 2014 Aug 4.

Amelioration of DSS-induced murine colitis by VSL#3 supplementation is primarily associated with changes in ileal microbiota composition.
Mar JS1, Nagalingam NA1, Song Y2, Onizawa M3, Lee JW4, Lynch SV3.
Author information

Inflammatory bowel diseases encompass gastrointestinal illnesses typified by chronic inflammation, loss of epithelial integrity and gastrointestinal microbiota dysbiosis. In an effort to counteract these characteristic perturbations, we used stem cells and/or a probiotic therapy in a murine model of Dextran Sodium Sulfate induced colitis to examine both their efficacy in ameliorating disease and impact on niche-specific microbial communities of the lower GI tract. Colitis was induced in C57BL/6 mice by administering 3% DSS in drinking water for 10 days prior to administering one of three treatment plans: daily probiotic (VSL#3) supplementation for 3 days, a single tail vein injection of 1x10 (6) murine mesenchymal stem cells, or both. Ileal, cecal and colonic sections were collected for microbiota and histological analyses. Microbiota profiling revealed distinct bacterial community compositions in the ileum, cecum and colon of control untreated animals, all of which were predicted in silico to be enriched for a number of discrete KEGG pathways, indicating compositional and functional niche specificity in healthy animals. DSS-treatment perturbed community composition in all three niches with ileal communities exhibiting the greatest change relative to control animals. Each treatment group exhibited treatment-specific alterations in microbiota composition in the lower GI tract, though disease scores were only improved in VSL#3-treated animals. The ileal microbiota were most profoundly altered in composition in this group of animals and characterized by significant Enterobacteriaceae enrichment compared with colitic mice (P<0.05).

16S rRNA; DSS; Ileum; Microbiome; Microbiota; Probiotic; Stem Cells; Ulcerative Colitis; VSL#3

Maria said...

Hello Dr BG. I have commented before but I think my comments are not going through so I will try again.

First of all, thanks so much for sharing all your investigation and conclusion. I've been reading lots about the microbiome since last year and I've made some good connections and found massive lost links thanks to your blog.
I've had constipation since I was a child (I didn't breastfeed for long, used to have lots of issues with allergies) despite always being a healthy eater. Thing is, since 2013 I started having stubborn constipation along with being bloated and distended regularly and the ocassional tiredness. All this popped up after a week long course of antibiotics for a bad flu and then two more courses of antibiotics for two wisdom teeth extractions (you can flora was wiped out). I live in South America so I am a bit restricted when it comes to supplements, and doctors just give me the same old "fiber, water, excercise" talk, all of which I'm already doing. I have been making milk kefir made from grains for a while and that seems to help with the bloating, but it makes me a bit tired if I overdo it, kind of as if I was hungover without a headache. I've been applying your advice to eat a wide variety of fiber (I've tried low carb before and it did not work at all for me) and that also seems to be helping but sometimes I get super bloated. The most frustrating thing is it's hard for me to get, uh, the urge to go. I rely mostly on coffee these days.
Anyway, I've been thinking of doing a parasite cleanse with botanicals to see if that helps get rid of any bad stuff that may be around and then continue with the probiotics and the fiber from whole food, and lots of patience. Is there anything you would recommend?

Thank you in advance. Best wishes!

Dr. B G said...


Thanks for your patience -- there are many ways to excellent gut health. Testing should be available to you because several tests are available internationally.

Protozoa? Yeasts?
Not enough gut guardians due to depletion with antibiotics?

Good luck addressing these! Hope you see improvements soon