Episode 33: The Most Important Micronutrients For Gut Health

 Have you ever considered how your daily multivitamin contributes to your gut health? Which micronutrients are critical for microbiome balance? And is it possible for a doctor to decipher whether you have gut dysfunction merely by looking at a blood nutrient panel?   

Our guest today is Dr. Arland Hill, the clinical director of Genesis Wellness, a doctor of chiropractic and a board-certified diplomat of the American Clinical Board of Nutrition. He has been practicing since 2003 with a clinical focus on the use of science-based natural therapies for the management of chronic diseases.  

On this episode, he talks to Andrea about why micronutrients are imperative for optimal gut health and breaks down which nutrients are most important when we’re talking about balancing the microbiome. To put it all into perspective, the two also go over Andrea’s micronutrient panel and Dr. Hill gives some real-world tips for how she can better balance her gut.   

To download Dr. Hill’s 30 energizing breakfast recipes and learn more about his work, head to drarlandhill.com.   

On this show, you’ll learn: 

• The impact of micronutrients on the activity of the microbiome (2:24)
• The cycle of the microbiota producing and using their byproducts (3:57)
• Vitamin B5 and Vitamin D (5:45)
• How it’s not just the quantity of these nutrients (7:55)
• Is supplementation a short term fix or can it be used long term? (10:02)
• Testing for deficiencies (11:02)
• When looking at test results, can issues with the gut be seen? (13:01)
• Common deficiency patterns (15:03)
• How combining nutrients plays a factor (19:51)
• The importance of finding the proper practitioner (22:29)
• Andrea’s own test results (24:39)
• The dynamics of a fructose sensitivity (30:00)
• Dr. Hill’s favorite ways to increase antioxidants (33:36)
• How to find out more about the SpectraCell test (34:52) 

Transcript:

Andrea Wien: Happy to New Year and welcome back to the Microbiome Report. I am your host Andrea Wien and today we're talking to Dr. Arland Hill. Dr. Hill is the clinical director of Genesis Wellness. He's a doctor of chiropractic and a board certified diplomat and the American Clinical Board of nutrition. He's been practicing since 2003 with a clinical focus on the use of science-based natural therapies for the management of chronic diseases.

In addition to his clinical roles, Dr. Hill routinely lectures on topics that are core to functional medicine and emphasizes the importance of research based interventions. On this episode, we talk about something we haven't talked at all about yet, how the microbiome directly affects nutrients and which micronutrients impact the activity of the microbiome. So actually what things we're taking in and how those things like vitamin A, glutathione, vitamin C. How these things can really make an impact on the balance of our microbiome and overall gut health.

We also talk about some common deficiency patterns that he sees in practice with gut dysfunction, and he's actually gotten quite good at being able to look at a micronutrient panel and then say with some pretty impressive confidence, whether or not that person is experiencing gut dysfunction. We also do something a little bit different on the show. I personally have had my micronutrient tests done. So Dr. Hill takes a look through that, goes through what he would recommend if I were his client.

So that might be helpful for those of you who struggled to see how this looks in practice, and it shows you that you don't have to make massive changes in your diet or lifestyle. If you're already doing some of the right things, we can make some small tweaks and see a big difference. Enjoy the show. Dr. Hall thank you so much for joining us on the show.

Dr. Arland Hill: Glad to be here with you.

Andrea Wien: So today we're really going to be talking about the impact of nutrients on the activity of the microbiome, which is not something that we give much thought to. We talk about foods that are beneficial, we might even talk about macro nutrients, fat, fiber protein, and the effects of something like a ketogenic diet, high fats and the microbiome or different types of fiber.

But we rarely break it down into these specific micronutrients and how they are really driving so much of what's going on. Let's lay the foundation a bit. How is the microbiome directly impacted by these nutrients?

Dr. Arland Hill: I think I have to start this conversation off with the word commensal and most of us appreciate that that is a symbiotic relationship. That generally there's two parties there and they, they both benefit from that relationship. And that's really at the core of what…When we talk about the micronutrients and how they influence the microbiota, that's really what we're talking about. These microorganisms, what we often term as the probiotics, they are producing multiple nutrients for us among those the B vitamins, vitamin K.

But what we also appreciate from this now is that there's this dual relationship where they're producing those nutrients, but they're also benefiting from the presence of those nutrients as well, much like as you alluded to, we think about with fiber and prebiotics, these types of compounds. What we know is that the availability of certain B vitamins and really it appears that the spectrum of B vitamin support the activity of the microbiota, but there do appear to be certain B vitamins that have been shown to have more of a profound effect.

For example, nutrients like B12, B5 seem to really be standouts there. And then things like glutamine and vitamin A, just the sheer presence and the availability of these nutrients in adequate quantities can shift the profile of the microbiota from one of being a more inflammatory profile to being one of more of an anti-inflammatory health degenerating profile, if you will.

Andrea Wien: So it's really almost like a cycle of the microbiota are producing some of these things, and then they're also using them to fuel more growth.

Dr. Arland Hill: They do. That's exactly what's happening. It's interesting when you look at for example pantothenic or pantothenic acid, which is B5. I think this is the most interesting of all of these because of the relationship that it has with vitamin D. And I guess, I think it's so interesting because there's such a contrasting acknowledgement between B5 and vitamin D in terms of health benefits.

Most people don't give a lot of credibility to B5 and all the roles that it serves other than it just being present in a multivitamin or B complex. Whereas we seem to put a lot of attention on vitamin D, but what we know is that the availability of B5 and again, this is a nutrient that is produced by the microbiota. The availability of B5 improves the availability of vitamin D.

So it actually allows us to internally be more productive in making vitamin D and then that vitamin D influences the microbial profile. And it seems to be able to do this over a long timeframe, meaning that if you don't have vitamin D for an extended period of time, what we actually see is that it can negatively order the profile of the microbiota, and it can start to have some permanent effects in a way that it does that.

But when that vitamin D is available, it stimulates the microbiota to begin to produce B5 at a higher level. And you restart this whole cycle again, where B5 is improving the production of vitamin D. Vitamin D allows the bacteria, the probiotics to be more productive. And as a result of that, we get B5 and not just B5, but all the other benefits that come along with those microorganisms as well.

Andrea Wien: Interesting. So aside from B5 and vitamin D, are there other nutrients that are more or less impactful when we're talking about microbiome activity?

Dr. Arland Hill: One of the ones that I've recently become more aware of and started noticing it in some of the nutrient testing we do, some of the things I was seeing there was starting to force me to ask some questions. It forced me to dig into the literature, and we've known that vitamin K2 comes from the microbiota. That's been well acknowledged for a long period of time, but what hasn't been so well acknowledged is the other side of that story, which is that the vitamin K, what we often talk about is these iminoquinones, the vitamin K2 is an influential on increasing the activity of the microbiota.

And when I say increasing the activity of the microbiota, I think it's important to really highlight what is it that I'm talking about there? What is actually taking place when we discuss that, and what I'm alluding to there is if you think about the role of the microbiota, they do a lot of things in the body.

They not only produce nutrients, they act as regulators of the immune system. They're going to be able to support the detoxification process. They're interacting directly with the nervous system and providing constant input into the nervous system, they in and of themselves have the ability to influence the landscape of that environment, because they produce their own antimicrobial types of proteins that for lack of better terminology on this, it's almost like they have their own antibiotic production systems that negatively affect organisms that are less ideally suited in that environment.

I'm trying to shy away from…I'm just speaking in terms in generalities of good and bad, because it's not quite that type of situation in the gut, but it does help in terms of having a general understanding of what's going on in there. And when you think about the availability of these nutrients including vitamin K, the availability of these nutrients makes the microbiota not just more productive at producing other nutrients or in turn producing that nutrient, it makes the microbiota more productive at all of its rolls.

Andrea Wien: So it's not just the quantity that's in there. I guess you could maybe draw the comparison of someone like a couch potato versus a top performer at work. Just the fact that they're there doesn't mean necessarily that they're performing at their highest level without some of these nutrients.

Dr. Arland Hill: You nailed it. That is absolutely one of the things that I think is so important about doing nutrient testing in a clinical setting, as opposed to just solely looking at a stool test. It is important to certainly have that information from a stool test and to be able to glean what the balance of the microbiota are. But it's also important to be able to ask the question are these microbiota facilitating and carrying out their roles every day?

And one of the easiest things to do to assess that is simply to look at the nutrient status and understand that relationship of these nutrients with the microbiota, when we see general trends, where there's for example, a descending pattern of the majority of the B vitamins, I always tell other clinicians, look you if you see that you have to rule out imbalances in the microbial environment of the gut until you prove otherwise. Until you know definitively that that is being caused by something else, that is your first thing to start to look at.

Andrea Wien: So it's not as easy as this came back on test, and we'll talk a little bit more about testing and how it's a little bit more specialized than just your general test. But can we just supplement these things? Let's say my B5 came back low. Can I just supplement with that?

Dr. Arland Hill: You can, in fact in the early stages of care that probably is the best way to jumpstart the system so to say. I'll use your example of B5, realistically consuming enough dietary B5 on a day-to-day basis, that's not likely to happen. Someone's just not going to eat enough of the B5 containing foods to really replenish a deficiency state. And this is also a nutrient that there's a high demand for. So the probability and the demand for this nutrient is to correct that just through food is not very high.

Andrea Wien: But when we're looking at supplementation, is that more of a short-term thing? And then we're looking to really fix the gut as we're giving the gut more nutrients to balance out and become what it needs to be. Are we hoping to eventually be able to move away from supplementation? Or what does that kind of relationship look like?

Dr. Arland Hill: We are, the mindset that we're going to use supplementation on an ongoing basis to…Again we'll just use this B5 example to continually support B5. There shouldn't be a need to continue to do that on and on and on and on. If there is, then that inherently says that the microbiota are not getting the support that they need. I'll use the concept that when you look at your total B5 requirements over the course of a day, a large percentage of that, half or more should come from the microbiota, not necessarily from the diet and certainly not from supplementation. Again the supplementation is meant to be nothing more than a patchwork short term. We're speaking in terms of B5 but this is not only related to B5. This is related to all the nutrients that the microbiotic produce.

Andrea Wien: So when we're looking at how to test for this, I've never gone to my regular doctor for my yearly physical, and had all of these glutathione. And sometimes the B vitamins may or may not be on there in my blood work, but how are we testing for these things?

Dr. Arland Hill: Most individuals, when they have a blood test are accustomed with standard tests, blood counts, chemistry panels, these types of things. And there may have even been times when someone's had a B12 or folic acid looked at. But the point to remember on these is that these tests are what are known as serum assessments. Which means that they're looking for information that occurs outside of the cell.

When we're looking at the functionality of the body, how dynamic and adaptable is the body, we really need to be looking inside of the cell. That's where biochemistry takes place at, that's where the happenings of the body occur is within the cells. When we look at a lymphocyte test, this is a taken our immune system cell, is one of the groups of the white blood cells and taking those cells, bringing them to the laboratory environment and challenging those cells ability to proliferate, to grow in the absence of certain nutrients.

And when we do that, that tells us at a more functional level, whether or not that cell has adequate reserves of that nutrient to be able to function. The nice thing about this is as compared to looking at a serum assessment, which is a snapshot of what the body is doing at at a moment in time, this functional assessment is different than that.

It is a window over the last six months. It allows both the patient and the clinician to have a better understanding of not just what's going on today, but what's the story been for the last six months for that individual.

Andrea Wien: So I like analogies. So I'm kind of as you're going through this, thinking about this would be almost like looking at the engine of an individual car, which would be ourselves versus watching the highway, which would be the bloodstream.

Dr. Arland Hill: That's exactly it.

Andrea Wien: We're looking at these test results. Can we see whether someone has gut dysfunction? Can you look just at the micronutrient testing and make an assumption of I think this person has some gut issues going on?

Dr. Arland Hill: If you would've asked me that question 10, certainly 15 years ago, the answer would have been no. But because of the information that has come out over this timeframe, and interestingly enough some of this information I'm using 10 to 15 years, but there was literally data coming out in the 50s and the 60s that was starting to point to these relationships between the nutrients and the microbiota especially around the B vitamins, but of recent we have seen this increase in information that shows us that when certain nutrients are deficient.

For example vitamin A being an example, we know that when vitamin A is deficient that the ability of the cells in the GI tract to turn over into replicate themselves as impaired, simply because vitamin A is essential for turning over cellular tissue everywhere in the body. But the reason that it's so important in the gastrointestinal track is because the turnover rate in that end environment is faster than anywhere else.

Therefore, if you don't have adequate amounts of vitamin A, those cells are already going to be stunted. They don't have the basic precursor they need to replicate. And given their fast pace of replication, it would be a short period of time before that environment begins to crumble so to say, because it's just simply not able to heal and repair itself. And that's just a single nutrient. And that nutrient also directly ties into the immune activity of the gastrointestinal environment.

One of the primary proteins that we produce a compound on is Secretory IgA, almost every step in the production of that compound is vitamin A dependent. Again, if we don't have that nutrient available, the immune function locally at the GI track, which of course has systemic whole body presence influence is going to be impaired.

Andrea Wien: And now we met because you were doing a talk on all of this and micronutrient testing. And you talked about some common deficiency patterns that we see with gut dysfunction. Can you speak to those?

Dr. Arland Hill: I can. The first one that you absolutely have to look at are the B vitamins. My general rule of thumb on this is that if I have five or more B vitamin deficiencies, and when I define a B vitamin deficiency, it doesn't matter what degree of severity that is. If that person's cellular function has moved into a deficiency status on five or more of those B vitamins, then I look at that as being a state of dysbiosis.

That tells me there's some type of imbalance in the GI tract of the microbiota, and again until proven otherwise, and that could be defined as there are pathogenic or opportunistic organisms in there that need to be eliminated or reduced, or it could simply mean that they're just insufficient quantities of the beneficial, the commensal species that we expect and want to see here. It can be either story that we're talking about.

Andrea Wien: So the B vitamins, we talked about vitamin A. Are there other patterns that we see often with gut dysfunction?

Dr. Arland Hill: Let me give you a few more here. Vitamin K I alluded to. Vitamin K is certainly becoming more and more influential in many times it's interesting when I look at the B-vitamin pattern, that a lot of times the next thing that I'll reflexively look to is the vitamin K. And if I see that vitamin K is deficient as well, it's the clincher. That tells me exactly what I'm looking at.

Another nutrient that is extremely important in this conversation is going to be glutamine. Glutamine is an interesting. Most professionals, most clinicians especially those working in the nutritional functional medicine arena will acknowledge the impact of glutamine on the gastrointestinal tract. They know that the cells in that environment are heavily dependent upon glutamine.

However, when we look at the full benefit of glutamine, one thing that's often missed on this is the dosing on this. How much glutamine it actually takes to fully generate a positive effect of the microbiota. Most clinicians dose this too low based on what the literature says. And that's important because glutamine literally has been shown within 14 days to be able to shift the profile of the microbiota from that of a more of an inflammatory type of profile that can be that generating unhealthy in nature to one of an anti inflammatory profile that is pushing the body composition of metabolism towards more of a lean overall top of profile.

So it's overall improving metabolic activity. And just to give scale on this, in terms of numbers we have a more tangible appreciation of these numbers. A lot of times we talk in numbers of three grams and four grams in terms of intervene clinically. But we know that if we want the studies that talk about 14 days, those studies are looking at 30 grams.

So that's a massive discrepancy there between you're talking about a tenfold increase over what the average clinician is out there giving to get this effect from glutamine. Glutamine is a very big one and a lot of times we can see from an intervention standpoint, we can see more impact from glutamine in a short period of time, probably than any other nutrient that we're going to put into the conversation.

I just want to highlight the point that vitamin D is a nutrient that the longer that nutrient stays deficient, the more negative impact, the more likelihood of a permanent negative impact you're going to see on the microbiota.

Andrea Wien: And again, when we're looking at vitamin D I think the conventional ranges. So if you just do get your vitamin D checked at the doctor and you're "in normal range" that's not really what we like to see for functional medicine and for optimal range.

Dr. Arland Hill: You're correct about that. When we do the micronutrient testing, one of my favorite things to look at other than just directly assessing vitamin D which we do is also to look at calcium. I want to see what the dynamics of vitamin D are. How is it influencing the uptake of calcium and how is it influencing the activity of magnesium? So those are other nutrients that we look at in addition to vitamin D as opposed to what is it that that vitamin D marker says by itself.

Andrea Wien: And that's another thing that I don't think a lot of people think of. And again, to use one of my other analogies, if calcium is kind of the two by fours of the house, then the vitamin D and some other co-factors and co-nutrients are like the hammers and the nails. So we can't even utilize that calcium without some of these other co-factors, which people don't realize.

They think if I'm supplementing with X, insert whatever nutrient you want with X that it's going to be okay, but we can talk a little bit more too I think about why you might take this test, get some deficiencies back, supplement with those things, take the test again in six months and new deficiencies pop up.

Dr. Arland Hill: This is an interesting point you bring up and it's what we talk about as nutrient interactions. And it is certainly an under appreciated concept because we tend to generically think about nutrients as a little is good, more's better, if you put it in, it's either going to have a positive outcome or no effect whatsoever. You generally think it's going to fall into one of those two categories. But what we don't appreciate about it is that we can also disrupt our physiology or biochemistry with these nutrients as well.

And that truly underscores the importance of taking this test. One of my favorite reasons for doing this test is so I can tell patients what not to take, where they should focus their efforts at, and to make the whole process of improving their nutritional status much more simplistic for them. I'll give the audience here, an example on this. And that's between B12 and folate. These are two well-established nutrients.

A lot of folks will let's say they're having issues with fatigue. They'll pick up some B12, they'll start supplementing B12, not realizing the negative impact that that can have on folate status. And that the higher that B12 level goes the greater the likelihood of suppressing the folate status, and many of the symptoms that are associated with the deficiency in B12 also are associated with deficiencies in folate.

So while you end up correcting one deficiency. You're actually inducing another at the same time. From an intervention standpoint, you would have to know what both of those nutrients look like. Hence the rationale for doing the testing. And that way you can intervene with a strategy that doesn't run the risk of creating a deficiency in ancillary nutrients.

Andrea Wien: This episode is brought to you by our resident researcher Dr. Mahmoud Ghannoum's new book, Total Gut Balance: Fix your Mycobiome Fast for Complete Digestive Wellness. This book is a combination of Dr. G's last 40 years of research. Now condensed into an easy to follow diet and lifestyle plan that will give you a proven formula for how to fix your mycobiome and heal your gut for good.

In the book he talks about putting this diet through a clinical research trial and dives deep into the science on why your body's fungal communities can impact how you lose weight, your energy, and your ability to achieve optimal health. The book is now available for purchase. So head to totalgutbook.com or wherever you buy your books to get started, fixing your gut health today. Now back to the show.

Now are most doctor's going to be able to understand all of this, understand the synergy between these things, or is it really important to find someone who knows how to read a micronutrient test and really understands the symbiosis?

Dr. Arland Hill: It is really important to work with someone who understands this. I will state this as an example of this is in no means, meant to be a prod in any way or poke in any way at anyone. But I've literally talked to professionals of recent that when I mention of the word cobalamin or riboflavin, which are B12 and B2, I had to explain what the terminology means. And for someone that's making nutritional recommendations AND that's doing nutritional assessment, those would be common terms.

So I guess the point you have to take away from this is that you want to work with someone who is skilled in this. Has an understanding of the information they're looking at and how it relates overall the biochemistry and symptomatologies someone may be presenting with, because there's not just a science to look at this information. There's also an art to looking at this information and being able to piece these nutrients together.

Andrea Wien: Do you have any advice for people who might be looking for a practitioner?

Dr. Arland Hill: I do, SpectraCell who we use for the micronutrient assessment. SpectraCell has resources on their website for patients to find clinicians local to them that can offer this test, and that can do a good job in interpreting the information for them.

Andrea Wien: Perfect. And we will link to that in the show notes as well. So now we're going to switch gears a little bit. We're going to talk about my test results. So this is something that we haven't done too much on the show, but regular listeners will know that I have celiac disease. I was diagnosed 20 years ago. So this whole conversation about the gut and the microbiome is very close to home for me.

And I had SpectraCell testing done actually on two different occasions, but the most recent time I was pregnant and sent you over my test results. So I would love to just go through and pick apart some of these correlations or synergies that we might be able to see. So let me get that opened up on my end. You have it on yours and-

Dr. Arland Hill: I do.

Andrea Wien: I mean let's pretend I'm a patient. What is this looking like for you?

Dr. Arland Hill: All right. So the history of celiac disease, the things that I'm going to be worried about here, I'm going to be looking for, again these nutrients that are related to overall gut health. The one that stands out to me for you is going to be vitamin B12. There's a couple of things that are important to acknowledge on this. One is that with celiac, we know that what are known as the villa, the micro villa, the absorptive layer of the GI tract, that area becomes denuded. It becomes less efficient if you will, at being able to uptake the nutrients. And it almost has a scoring effect.

When you look at one of the nutrients that is extremely prompted efficiency with this type of disease, it is vitamin B12. That is often one of the ones that is directly point to as a result of that. So that in and of itself raises a red flag. You obviously are an individual that takes care of themselves. That is staying on top of their health and their data, their laboratory information, to be able to make decisions with.

And yet you still have a vitamin B12 deficiency. In scenarios where I see a deficiency like this, that doesn't correct, or seems to be on an ongoing nature, we dig a little deeper with this because generally you're starting to find at this point that there are some microbial imbalances that are taking place. And the point I would make here is that it's important, the initial information you get from a micronutrient assessment is extremely important.

However, the information that you gleaned from the second report many times is actually more insightful than even the initial report because now it starts to speak to even more specifically about what's going on with you. And this vitamin B12 deficiency is a specific example of that in your situation where we would look deeper. When now we would start to see that since this deficiency was not corrected with the initial intervention, and it's ongoing, now we start to see what impact is the GI tract having.

Are there market organisms there that are inhibiting the uptake of B12. Are the organisms, the microbiota as a whole low, and do we need to work to build those nutrients back up? And I would actually say that it's this latter point work into build these nutrients back up, that we can also use information from the micronutrient test to substantiate that. And here's what I mean by that. Your spectrum score, we know celiac by nature is an inflammatory state. Well, we look at this marker called a spectrox and this is a trade marker.

But essentially what this marker is looking at is the ability of the immune system cells to handle an inflammatory insult. And the lower this marker goes the more difficult it is for those cells to be able to offset that inflammatory attack. The reason that that's important in relationship to that vitamin B12 in the microbiota is that the way we can mitigate this inflammation, and sometimes you'll hear this referred to as oxidation, the way that we can mitigate this is through the inclusion or incorporation of greater quantities of our plant-based compounds, such as flavanoids, polythenols, terpenes, alkaloids, these types of compounds especially the polythenols that show antioxidative activity.

These antioxidants of a plant in nature, whether they're consumed through the diet, whether they're consumed short-term through supplementation. These are going to bolster the activity of the microbiota. They are literally a turbocharger for the microbiota to get them to be more productive. They want to see color, and they want to see a diversity of color every day. And the more of that color that they see and the more frequently that they see it, the greater the output of the nutrients from them are going to be.

And then nice dual benefit that you get from this is that the organisms that we might refer to as opportunistic or pathogenic that are negatively affecting the activity of the microbiota, these polyphenols and other plant compounds inhibit their activity and allow the microbiota to become more productive day in and day out.

So inherently over time by improving the antioxidant level here, that we can see definably where that's at. We're also going to have an ability to improve the B12 level through the activity in the gastrointestinal tract. And short term to glean the benefit of B12 right away into amplifying turn the physiology back on as fast as possible, we would implement some, some supplementation here. At a realistic level, make sure that we're not negatively affecting the folate, but we do want to get that B12 level corrected as soon as possible to turn the physiology back on as fast as we can.

Andrea Wien: Absolutely. You're just looking at two markers. I mean, I'm looking at this test and there's dozens if not 100 different markers that we're looking at. So just like you said, working with a practitioner who can really piece this all together. I know we had mentioned also and I noticed when I looked at my test, you had talked in your talk that I saw you speak at about this fructose sensitivity.

And then I went back and looked at mine and I think that this is something we don't talk enough about on this show, but just in general, I don't think many people really understand the dynamics of a fructose sensitivity. And we talk a lot about the impact of sugar, let's say just on the microbiome in general, but can you spend a little bit of time on that piece?

Dr. Arland Hill: I can. It's an interesting point. I always like to start this conversation off by when someone is told to eat fruits and vegetables or eat vegetables and fruits, most people hear fruits on that and most people tend to lean towards fruits just because they're sweet and they're easier to consume. However, the problem with that is the fructose in those fruits and I'm going to share some other sources of fructose as well, but the fructose in that fruit, you can only assimilate so much of that on a given day.

And that amount varies person to person hence the reason we like to look at this information to be able to find out where that point is for someone. But when you're not metabolizing fructose, and you're not pushing it into your energy production cycles, what you're instead doing with it is pushing it the direction of triglyceride production. And triglycerides are going to be those you've essentially got this sugar backbone with three fats attached to it.

And they ultimately circulate through the blood. They can become stored, they can increase, they cannot promote fat deposition, or if they continue to circulate at high enough levels for a profound period of time, what they end up doing is decreasing the sensitivity of our insulin receptors and start to move us to the direction of diabetes, insulin resistance.

So it's important to be able to know where your utilization of fructose is at to make sure that you're not over consuming a healthy food if you will. You want to find out where your point is. Now fruit is a good source for the fructose, it's a common source. Most people acknowledge that. Another easy one to pick out is going to be your high fructose corn syrup and beverages that are not advisable to consume anyway.

But other areas where this can slip in and may not be realized that are going to be with things like honey, gavi, maple syrup, some of these sweeteners that are often talked about as safe sweeteners, or that may get incorporated into healthy recipes so to say sometimes. These can be contributors to fructose as well. And then the last one to point out here is going to be alcohol.

I tend to notice that individuals that have routine consumption of alcohol and maybe a glass or two of wine every night, those individuals do tend to be at higher risk for lower fructose sensitivity. And there is some long-term risk associated with that. So we do want to take action on it.

Andrea Wien: And is that something that can change over time or once I'm fructose sensitive, that's how it is for life?

Dr. Arland Hill: Fortunately on this one, it can change pretty quickly. When we look at these deficiencies, we label them as either borderline or functional. And the intervention for this is that if someone has a functional deficiency, we want them to avoid all sources of fructose for four months. And if they have a borderline deficiency, we want them to avoid all sources of fructose for two months.

Andrea Wien: All right, that makes a lot of sense. So up my antioxidant profile, maybe supplementing with B12 and then cut out some sweeteners it sounds like.

Dr. Arland Hill: That's pretty much what we can do here. And even with this information, what we're able to do. I look at your information and I can tell you in relation to the B12, because of the way that we can scale these deficiency levels for you and knowing where your full life status is 1000 micrograms of B12 in a methyl or an identical form along with about 400 micrograms of folate should easily take care of the B12 deficiency, but also maintain the balance between the B12 and the folate.

Andrea Wien: And that's helpful. And then what are your favorite ways to increase those antioxidants?

Dr. Arland Hill: Color, color, color, and more color. The more you can saturate the diet with colorful elements from vegetables, from these herbs and spices. The herbs and spices are oftentimes overlooked, but these have some of the greatest antioxidative potential out there. Those are excellent and then certainly the fruits do come into, into the conversation as well. But as we alluded to, you have to be judicious with how much you consume those based on what your ability to metabolize that is.

And then from a supplemental standpoint, this a lot of times I think is important to discuss because it gives individuals a starting point. For example, things like curcumin, resveratrol, [huesatin 00:34:17], green tea, the berry extract. These categories and this is by no means an exhaustive list, there are literally thousands of these compounds. But the more of the plant medicinal or help driving compounds that we can consume, that's what's going to pick up this antioxidant status and bolster the activity of the microbiota to produce not just nutrients, but to carry out all the other role they have as well.

Andrea Wien: That's great. That's so helpful. So if someone wants to get this test done or just follow up with you and see more about what you do in your practice, how can they do that?

Dr. Arland Hill: To find out more about this test and for someone that is interested in knowing more about it, go to spectracell.com. There's a wealth of information on that site, you'll have a great immersion into just what this test can do for you. And then if someone's interested in knowing a little bit more about me, what I do and how we run our practice, you can find me at drarlandhill.com.

Andrea Wien: All right, great. And we will link to all of that in the show notes as well at biohmblog.com/podcasts. So we will also link to everything that we mentioned in this show there. And you can check that out. Dr. Hill thank you so much for taking the time. I know it's early on your end, so appreciate the early morning call and we'll hope to talk to you soon.

Dr. Arland Hill: Thank you Dr. Wien, it's been a pleasure.

Andrea Wien: As always. Thank you so much for listening to the Microbiome Report. If you enjoyed today's show, please connect with Dr. Hill. He's at drarlandhill.com. That's Arland, A-R-L-A-N-D and Hill, H-I-L-L. If you go to that website, you'll also find his 30 energizing breakfast recipes for free to download on the homepage. You can connect with him on social media at Harvest Hills ranch, which is a really cool project that Dr. Hill is very proud of.

Harvest Hills is a combination of his education, his experience, his family history and farming, and his passion about nutrition. Within this last year, he's actually begun producing and delivering food into the Houston market that's nutrient dense and also sustainable, and grown in a regenerative manner.

So it really embodies the importance of nutrition throughout the entire life cycle from soil, all the way to date. It's a very, very cool project. And you can check out what he's doing on Instagram again at Harvest Hills ranch. Again, thanks so much for listening. I'm Andrea Wien and we'll catch you next time.

 

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