The Gut-Brain Axis: Your Gut Health Questions, Answered, Part 1 

Learn more about the gut-brain axis and the connection between gut health and mental health in this Q & A with Dr. Jane Oelke, ND, PhD. Explore more on-demand webinars here. 

Q: Could a good and bad gut microbiome be genetic/hereditary? 

A: I am not sure if it is genetic other than we often eat like our ethnic group or family eats. Because of the lack of diversity in our diet of certain whole foods, and more processed foods being consumed more young people have gut microbiome imbalance than older adults. 

Q: I need to use a CPAP at night due to structural apnea, but the air often bloats my gut. What damage is being done? 

A: I am not experienced with CPAP use, but I know that untreated sleep apnea does cause many chronic disease factors like high blood pressure, diabetes, and memory issues. There must be an intestinal barrier leak if the air is getting into the gut. I do mouth taping to keep my sleep apnea in control. (Mouth taping: use NexCare Gentle Paper Tape over your mouth at night to make sure you are breathing through your nose and not your mouth.) 

Q: How can someone repair their blood-brain barrier if damaged? 

A: Repairing the blood-brain barrier goes along with reducing intestinal permeability. Once you improve your leaky gut symptoms, the blood brain barrier will also improve. I look at a weak intestinal lining as an open wound where we must make sure it stays clean (less toxin exposure – weed out toxins that damage it further) then feed it with whole unprocessed foods and specific nutritional support. 

Q: Once you have leaky gut, can it ever be reversed? 

A: Yes. It takes time and continued support with daily dietary considerations. Continuing to pay attention to weeding out toxins, and feeding the gut microbiome what it needs to get healthier. We create a new intestinal lining every few days, but it only creates a healthier lining when it has a healthier environment to create improvement. It gradually strengthens the lining as the nutrients are there to be used. 

Q: Can leaky gut cause thyroid issues, particularly T3 and T4 conversion? 

A: The liver is involved in converting T4 to T3. The thyroid is very sensitive to environmental toxicity from heavy metals, plastics, radiation, and especially receipt ink. So, if there is more toxicity in the body affecting liver health it will affect thyroid metabolism. The toxins affect the leaky gut, so that is the connection by making the liver work harder to reduce the toxins absorbed in the digestive tract. 

Q: Is fasting a good method of resetting your gut health? 

A: Fasting does help with resetting your gut microbiome. By fasting 12-14 hours per day, it gives your body time to do autophagy that clears cell debris or metabolic waste from the body that we create from digestion and metabolism. 

Q: How can you get your gut back in shape after taking antibiotics for an acute infection? How long does it take for the gut to be healthy again? 

Antibiotics kill off “good” and “bad” bacteria, so it takes at least 2 to 3 months, depending on your overall gut health to reverse it. If you have antibiotics more often than every 3 years, it could take longer. 

Q: Is there a test that can tell when your gut is balanced with healthy bacteria? 

A: In the webinar, I mentioned the Wheat Zoomer test by Vitality Wellness that looks at many factors of gut health in a very comprehensive manner. In my office, I use a simple urine test called the Indican test to tell if you have a malabsorption issue especially related to protein digestion and intestinal permeability in the gastric tract. 

Q: How do we know our gut is ready for probiotics? 

A: Good question. Finding a good probiotic that doesn’t bloat you is often difficult with any small intestinal bacterial overgrowth (SIBO). I often begin with simple 2 strain probiotics with about 8 billion CFUs, and move up from there. When there is an imbalance with too much “bad” bacteria, adding more even “good” bacteria can overwhelm the system, and we need to back off until the prebiotics from our foods create a healthier environment. 

Q: What blood test would show leaky gut syndrome, or how would you find out if your gut microbiome has been affected? 

A: The Wheat Zoomer test by Vibrant Wellness is a blood test that has an intestinal permeability panel that measures zonulin, actin, lipopolysaccharides, and gliadin levels. 

Q: How can one discern if signs and symptoms when eating are from leaky gut vs. Mast Cell Activation Syndrome? 

A: The symptoms can overlap. When someone is very sensitive to many foods and skin care products, I often correlate them to intestinal permeability. In my online Metabolic Assessment Form, I often find clients with leaky gut due to their oversensitive reactions to many foods. In Mast Cell Activation syndrome, a leaky gut can create a salicylate intolerance causing digestive symptoms often related to malabsorption and SIBO. 

Q: I take a 5-billion-unit capsule of acidophilus daily. I bought it at my trusted health food store. Is that enough? 

A: That’s hard to say exactly. How do you feel taking it? Are your bowel movements good? Regular? Do you have better digestion with it? Less food sensitivities? 5 billion is on the low side of CFUs, but I like to start slowly to figure out if the probiotic is working for clients. 

Q: When is the best time to take prebiotics and probiotics? 

A: I personally like to take probiotics away from foods, either first thing in the morning or at bedtime. There are bacteria in the foods we eat, so I like to give beneficial bacteria time for themselves to work away from foods. Prebiotics can be taken with other whole foods to support their absorption. For example, sauerkraut can be added to a vegetable dish. 

Q: What is the best probiotic for a 17-year-old with IBS and OCD, and who is on an SSRI for it? 

A: I can’t specifically recommend one probiotic. You would do best by starting with a low dose 5 to 8 billion and see if there is bloating with it. I would improve their diet to avoid gluten, sugar, and processed foods first, and then add aloe vera and bone broth daily. 

Q: Is there a specific prebiotic/probiotic available you would recommend, outside of whole foods? 

A: I recommend a variety of choices. My current favorite pre and probiotic is from Klaire Labs. They have a Vital-10 with 10 strains and 10 billion CFUs. They also have a higher TherBiotic Complete that has 40 billion CFUs. Both have chicory root as the prebiotic. 

Q: How do you choose a good probiotic and know which one will make it to your gut and not be broken down in the stomach? 

A: It is true that the probiotic needs to be broken down well, and some companies have special capsules to help them digest later in the stomach digestion process. I do believe that a good balance of hydrochloric acid is needed to keep ‘bad” bacteria from foods from getting into the digestive system. Too much or too little stomach acid will affect how we absorb food and have an effect on the level of bacteria getting into the gut. H-pylori bacterial imbalance is a sign that excess bacteria is affecting the gut. 

Q: What are the best foods to increase probiotics versus taking them in capsule form? 

Fermented foods like sauerkraut and kimchi work like probiotic supplements. Also kefir has live active cultures, more than yogurt usually. 

Q: Are there certain brands of probiotics you prefer, suggest, or recommend? 

A: There are many options available. I currently recommend Klaire Labs products that combine probiotics with prebiotics, with chicory root as the prebiotic. They also have prebiotic powders to add to smoothies. Other companies include Garden of Life Dr. Formulated Probiotic formulas. 

Q: Do any of the supplements you mentioned (DGL, turmeric, oil of oregano) have interactions with prescription meds? 

A: It depends on the prescription meds you are taking as to how the herbs will affect them. Turmeric is an anti-inflammatory and may interfere with steroids. Oil of oregano can work similar to antibiotics if taken too often. DGL licorice is different than regular licorice herb that can raise blood pressure and cause electrolyte imbalances. I would be cautious with mixing any of these herbs with blood thinners since they can increase the action of the medications. 

Q: Are gummy vitamins absorbed better than tablets? 

A: No, gummy vitamins are not better than tablets, due to the sugar base. I actually prefer capsules over tablets for absorption. Tablets have more fillers than capsules. Gummy vitamins are becoming popular but not as well absorbed or useful because of the added sugars and fillers. I won’t recommend gummy vitamins in a sugar base. 

Q: What is the best time to take vitamins? 

A: I recommend taking vitamins with meals. B complex vitamins are better earlier in the day. 

Q: If I take turmeric, does it matter if it is in a shake, gel cap, or should it be in tea? 

A: Turmeric can be taken in many forms. I like capsules best. It depends on what oil is added to the softgel capsule, if that is a viable option. In tea, we don’t get all the value of the herb. Adding turmeric to a shake can work too, depending on how much is added due to the bitter taste. 

Q: Do you have any recommendations for brands of supplements? 

A: I used a variety of supplement brands – Klaire Labs, Biotics, Metagenics, Pure Encapsulation, and some over the counter Now Brand products mostly. I really pay attention to the added ingredients, and fillers. If they add synthetic vitamin versions, or many preservatives like polyethylene glycol or titanium dioxide, I won’t buy it. 

Q: After removing inflammatory foods, what are the most cost-efficient gut health healing supplements to recommend to patients? 

A: Vitamin D3 is relatively inexpensive and is needed by many people to improve the immune system and gut health. Find out the level of vitamin D3 in your blood to make sure you have a good level of at least 40. I also recommend a good bone broth, about 3 to 4 ounces per day, for gut healing. 

Q: What form of magnesium is most bioavailable? What kind of magnesium is best to take? 

A: There are at least 7 different types of magnesium. Magnesium oxide is the cheapest version, but not the most useful. I like magnesium glycinate for a better metabolism and healing ability, magnesium citrate for energy and circulation, magnesium asporotate for muscle pain. Some companies combine them, and I often use these combinations. Magnesium is generally needed to improve sleep, energy, and muscle pain or weakness. 

Q: Is psyllium fiber good to take daily? Konsyl? 

A: Yes, psyllium husk fiber is a good prebiotic. Konsyl is a good pure brand. Just make sure you get enough water with it. Take at least 8 ounces of water per teaspoon of fiber. If you are constipated start slowly to not get bound up. If you do, then take cascara sagrada to get peristalsis action going in the gut. 

Q: I’ve always heard that OTC supplements are unregulated. How do you determine which ones are safe? 

A: There are different levels of quality OTC supplements. To choose better OTC supplements, I look to see if there are using natural or synthetic versions of vitamins. For example, I look at the Vitamin E version. Is it d- alpha tocopherol or dl-alpha tocopherol? The dl-alpha tocopherol is the synthetic version and is not as effective. I also look at the added ingredients. When there are many preservatives and additives like polyethylene glycol or titanium dioxide, or food dyes I won’t recommend it. Many supplements have fillers like cellulose or rice flour, which I don’t like either. 

Q: I recently had a patient who had toxic neuropathy from herbal supplements. I’m a firm believer in supplementation, and this kind of shook me. How much is too much? 

A: Too much of any supplement is hard on your liver. Some combination he took affected his circulation. Look at the added ingredients in supplements to make sure there are not too many fillers and artificial preservatives. 

Q: Is there a certain amount of vitamin D that you’d recommend since we don’t frequently check that lab? 

A: I believe in checking Vitamin D levels when doing bloodwork annually. I live in Michigan where we don’t get a lot of sun most of the year. I recommend 5000 IU minimum, more if the blood test levels are low. Less if the blood test levels are over 60. 

Q: What are the top 2 supplements you would recommend for gut health for a teenager/young adult? 

A: For a teenager or young adult who is still growing, they need to make sure they get the minerals and B complex vitamins in their supplements, since they are not often part of the diet. A good option for everyone is Life Extension Whole Food Vitamin. 

For gut health, turmeric antioxidant plus an essential fatty acid supplement can help, and vitamin D3 if needed, if not outside in the sun often. 

Q: What kinds of supplements or vitamins are beneficial? 

A: From the previous answers, I do believe a good whole food supplement without synthetic ingredients is often needed to support our overall health. Look for supplements that support our stress levels, including balancing GABA, for controlling stress and sleep. We need enough magnesium and B Complex vitamins to help generally, along with antioxidants from fruits and vegetables. 

Q: What is the best form of vitamin D? There is information about it being sourced from chemicals. 

A: I have heard some news questioning vitamin D supplementation. The most often source is from cholecalciferol. Vitamin D is a fat soluble vitamin and should be in a softgel capsule for best absorption. But watch out for the type of oils used. I don’t like seed oils like sunflower or safflower oil. I prefer olive oil as the base in my Vitamin D3 supplements.