The Real Reason You’re Bloated, Tired, & Anxious (It Starts in Your Gut!) | SHE MD

0:00 You need five things.

0:01 Try to eat these five things.

0:03 Super easy things.

0:04 Prebiotics are food for the gut bacteria.

0:06 That's like your fiber.

0:07 First meal of your day, you want to get 30 g of protein.

0:10 The second 30 is 30 g of fiber throughout the day.

0:14 The third is three probiotic foods.

0:17 Eat your vegetables no matter what.

0:18 If if you don't know they're organic,

0:20 this is something I think everyone can do is

0:23 take two tablespoons of baking soda in a big pot,

0:26 like a pot, and just throw your produce in there.

0:28 How do you know if you're deficient from magnesium?

0:30 How do you get it into your diet?

0:32 Is that a supplement?

0:33 If so, what supplement do you like?

0:35 This is something I've actually changed my positioning on.

0:39 Hi everyone, it's Mary Alice Haney and Dr.

0:43 Tais Ayabati.

0:44 We talked to so many women in our CMD community who are just done.

0:49 They're doing the workouts.

0:51 They're eating the right things, but they're still hitting that 3PM wall,

0:55 dealing with brain fog and feeling like their body is working against them.

0:59 As an OBGYn, I see this every single day.

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2:19 On today's episode of CMD, we are so lucky to have Dr.

2:22 Amy Shaw.

2:23 She's a double board certified allergist and immunologist who studied

2:27 at some of the really underachieving places like Cornell, Harvard, Colombia.

2:32 Um, but you had a fork in the road

2:36 when your own personal health hit a real issue.

2:39 So, I'd love for you to talk to us about that.

2:43 Yes.

2:43 So, I think so many of us can relate to that feeling

2:47 of overwhelm and your mind is like racing and you

2:50 can't even hear what someone's saying to you because your mind

2:53 is like on autopilot like thinking about the next thing,

2:57 adrenaline and cortisol and all of those things.

3:00 Being a doctor is really overwhelming.

3:02 And so, I thought to myself, um, I got to change something.

3:06 It wasn't until like a really kind of wakeup call happened

3:10 that I actually started to see my life in a different way.

3:14 And what was a wakeup call?

3:16 So, it was one day I was in clinic

3:18 and I had just become a partner in my practice.

3:22 And later there in the morning, one of my partners came up to me.

3:25 He's like, "Hey, can you stay after a little bit after

3:27 clinic and we just have a few things to go over,

3:30 partner meeting." And I thought to myself,

3:31 "Oh my god, not today." I had two little kids and they were

3:35 at karate and they were going to need a pickup at five o'clock.

3:38 Like I have all these I have to run

3:39 and I have to go get them and the center closes.

3:42 But in the words that came out of my mouth was

3:46 like okay yes sure because I didn't want to let them down.

3:50 So I raced through the day.

3:51 I went through all the patients and my mind, my heart was like pounding.

3:56 And we do this meeting and in the meeting I'm like I can barely see straight

4:01 or like even hear them because I'm like thinking

4:03 to myself like my god I got to go.

4:05 I got to go.

4:06 I got to go.

4:07 And um finally the meeting ends and I'm late.

4:09 Like I'm going to be late.

4:11 I get in my car and I'm like if I just go really fast I could probably make it.

4:14 And as I was turning to go to the center I got in a huge multi-car accident.

4:20 All the glass is on me.

4:22 There's all the airbags are off.

4:24 Luckily, my parents showed up there and I and they,

4:28 you know, they were taking care of the kids.

4:31 But I in that moment, I thought to myself, what am I doing?

4:35 Like, I don't like how I feel.

4:36 I don't like what I'm doing every day.

4:38 I don't like the how I am as a mom, as a as a person, as a partner, as a friend.

4:44 Um, and so that was my wakeup call to really say like I got to do something.

4:49 And I had got to change.

4:50 Yeah.

4:51 I had a couple of days of chaos,

4:53 you know, dealing with everything that you deal with.

4:56 It was not catastrophic in the way it could have been.

4:59 And so I just said to myself like, I need to heal myself from inside out.

5:03 I was just kind of looking for something

5:06 to give me um a new life after this accident.

5:08 I started to eat better and then I started

5:11 to get more sunlight and I started to walk more.

5:13 I started and then I started to like write

5:15 about um the things that I was doing because

5:18 I knew about that gut brain connection and the gut

5:21 hormone connection and then I started writing about

5:23 it like little pieces um that I would write

5:25 in between patients or after work and that's how

5:27 I actually started all of this and I would

5:29 just do that on the side for many many years.

5:30 I would submit like a blog post a week or every two weeks or something.

5:34 And then one time, MindBody Green,

5:36 which was the place I submitted my blogs most often, they said,

5:39 "Hey, we're having a writer's conference like just

5:42 for the like people contributors um of our site.

5:44 It's like a hundred people in wellness." So,

5:47 I go there and I had like chills like goosebumps while I was there.

5:51 I was like, I mean, this is it.

5:54 Like, this is what I'm supposed to be doing.

5:56 this is the this is the path that I'm supposed to be going on.

6:00 And so I started to share on social media and that was like

6:04 kind of it grew really fast and everybody there was so much interest

6:08 in how does nutrition play into our bodies and how does this all

6:13 play into um longevity and women's health and pmenopause and all of that stuff.

6:18 And so um that's really how I kind of got into the space.

6:23 Can you teach us about gut health?

6:25 You know, we there's so much misinformation.

6:27 There's so much misinformation and people don't know how important gut

6:32 health is and how so many conditions are associated with our guts.

6:37 We really want to know.

6:38 So, let's start with the gut and we can kind of go from there.

6:43 Yes.

6:44 So like we have been neglecting this entire universe um of organisms that live

6:49 in our gut that not only determine

6:51 our hormones but it determines our brain health, it determines our metabolism,

6:56 um it determines um our longevity like so many things.

7:00 When I was in immunology fellowship at Colombia,

7:03 I remember us talking all the time about how

7:06 the immune system and the gut and the hormones

7:10 and the brain would all talk together

7:13 and the microbiome like that's how our body makes decisions.

7:16 And when you think about it from that way,

7:18 it becomes so much easier to know what to do.

7:22 So the things that I talk about is like hey how do we

7:26 nurture this entire microbiome so that it can help us it can communicate better.

7:31 It can make these decisions better.

7:33 What are the basic things that you can do to heal your gut?

7:37 So I think one thing I think is obvious is like I

7:41 think we use antibiotics very um too easily um in our world.

7:46 we're taking antibiotics for acne or they're taking it for maybe an infection

7:51 that's not an infection like just in case like you have a cold.

7:55 And so that's number one.

7:56 The other thing that's killing our gut bacteria is our gut bacteria need food

8:00 and they're starving to death and mostly it's because of the food that we eat.

8:06 That's like a huge contributor because our gut bacteria need fiber to survive.

8:11 They need like other things like polyphenols and they

8:13 need all these other omega-3s are great too.

8:16 But fiber is their main food and because

8:19 what happens is when you eat something with fiber, let's just take blueberries.

8:24 Berries have great fiber.

8:25 So that you eat the berries,

8:27 your body absorbs the vitamins from the the berries and then

8:30 the um the bacteria get to eat the fiber that's left.

8:34 That's their food.

8:35 And so when you're eating fast food and they

8:39 don't have any fiber or they have very little.

8:42 So what happens is it the calories gets get absorbed

8:45 and then there's nothing left and these gut bacteria are starving.

8:49 And and I'm not like saying that this is like a portion of the population.

8:54 95% of Americans are not eating even the baseline adequate levels of fiber.

9:00 I don't think I am honestly.

9:01 So tell us the what are the foods that have the most fiber?

9:05 So, if you're listening right now and you're like,

9:07 I know I'm not getting enough fiber.

9:09 You know, if you need five things, try to eat these five things.

9:12 Super easy things.

9:13 I love berries.

9:14 I think everybody could have fiber.

9:16 Berries are high source of fiber.

9:18 So, blueberry, blackberry, they're all the same.

9:20 Yes, they have great there's great source of fiber.

9:22 Avocado.

9:23 Avocado is a great source of fiber.

9:25 Um, fruits like apples and kiwi,

9:27 kiwi fruit actually is like an amazing source of fiber if you

9:31 eat the skin especially because the skin adds to the fiber content.

9:35 It's like um 50% more fiber by eating the skin.

9:37 You can eat it like an apple.

9:39 Um so fruit with it's peeled that has fiber on it.

9:42 Um and then of course there's the typical things you think

9:46 of with fiber like you know oats um is a great source of fiber.

9:51 Leafy greens is the most amazing source of fiber because they're

9:55 like they're uh very low in calories but really high in fiber.

9:59 That's all I eat.

10:00 Yeah.

10:00 and every so kale is the same as lettuce is the same as No, I mean,

10:05 of course, um something like a kale is better

10:08 than iceberg lettuce because there's more fiber in it.

10:10 But I would say that for most of us, including ourselves,

10:14 like if we just concentrated on getting more seeds and nuts

10:17 and leafy greens and berries and avocados and a fruit,

10:21 um we would be getting to that level.

10:24 And what nuts are the best?

10:25 Um, so all nuts are great, but if you had to pick like the one

10:30 that's maybe is probably walnuts because it has a high it has a higher uh level

10:35 of omega-3s and that's really great for our brain.

10:37 So one of the pneumonics that I give to people especially for women is 3033.

10:43 Yeah.

10:43 So talk about that because I love this this whole idea.

10:47 Yeah.

10:47 So first meal of your day you want to get 30 grams of protein.

10:51 That's the first 30.

10:53 The second 30 is 30 grams of fiber throughout the day.

10:56 The third is three probiotic foods.

10:59 So 30 grams of protein in your first meal, 30 grams of fiber throughout the day,

11:04 and three probiotic foods every single day.

11:06 And what probiotic foods do is they

11:09 actually give your gut bacteria other bacteria.

11:11 So it adds to the bacterial count um in our gut

11:16 because we are on average killing our gut bacteria over over time.

11:22 Give us an example.

11:23 30 33.

11:24 Yes.

11:24 Okay.

11:25 So, in the morning, you might have an egg scramble with veggies, um,

11:29 and a side of cottage cheese, um, and maybe some berries on the cottage cheese.

11:34 That's 30 grams of protein right there.

11:36 What else?

11:37 Greek yogurt has like 15 grams of protein, a half cup,

11:40 and then you make a parfait, you can add, um, things to it.

11:43 Yeah.

11:43 Very.

11:44 Or you can have a tofu scramble or a smoothie, you know, with protein powder.

11:49 20 grams of protein right there.

11:51 You can have um bacon.

11:54 No, there's a lot of things that you

11:57 can actually have that have 30 grams of protein.

12:01 And when I say 30 grams of protein in the morning,

12:04 the reason I say that is that not only does it set yourself up for a better day

12:09 because whatever you choose in the morning kind

12:11 of uh helps you make better decisions throughout the day,

12:14 but it helps with cravings.

12:15 So, protein will help with cravings.

12:18 Protein helps your gut um and protein metabolically obviously helps you balance

12:23 your blood sugar um and helps with um lean muscle mass building,

12:27 especially as you get older.

12:28 At least start with that and then try to eat healthy the rest of the day.

12:32 Which protein powders do you recommend?

12:33 So you if you're doing a plant-based protein powder,

12:35 you definitely want to get it um third party tested,

12:38 like a one that's third party tested for um heavy metals.

12:41 You basically have to go to brands

12:44 that you trust and that have third party testing.

12:46 I like whey and I like micr filtered whey because it's better

12:50 on the people lactose intolerant people

12:53 and the reason why it's the closest to source.

12:56 So remember protein powders can be ultrarocessed food too, right?

13:00 And so you really don't want to um always better to eat the food.

13:04 It's always better if you can have your egg scramble or you

13:07 can have your parfait or you can have your um tofu scramble.

13:12 I would much rather you eat it,

13:14 but we all know life happens and you can do a smoothie.

13:18 Are there certain brands you recommend?

13:20 I don't have one that I think is the end all be all if um for plant proteins.

13:26 I do like the things that have third party testing like a like

13:31 um Vani Hardy has like the Troubani and they have third party testing.

13:35 Transparent labs is a good one because they

13:38 are really ex say exactly what's on the label.

13:42 also perfect amino um because of their the amino

13:46 acid profile is really per like a full a full amino acid so you really absorb

13:51 it better without all of that extra stuff.

13:54 Um and so those are some of my go-tos but I prefer food first.

14:00 People have a lovehate relationship with cottage cheese but cottage

14:04 cheese has great amounts of protein and so does Greek yogurt.

14:09 So Greek yogurt is different from regular

14:11 yogurt because not only is it probiotic,

14:14 it is strained and so you get 15 grams of protein

14:17 in one serving instead of like seven or eight in a typical yogurt.

14:21 Which brand of Greek yogurt do you like?

14:24 So I um I do the fier the one

14:28 that is very typical because I think it's easy to find.

14:31 Most people can find it.

14:33 It's like the one that's it's either 2% or 4%.

14:36 And for probiotic cottage cheese, um, I like Nancy's or Good Culture because

14:43 those are both brands that have probiotics in them.

14:46 And so, not only are you getting your protein,

14:49 but you're getting that one serving of probiotic foods for your day.

14:51 Got it.

14:52 And so, you can knock that out right there.

14:54 We got the first 30 and the next 30 is the 30 gram of fiber.

14:59 So, that is your fruits and your vegetables,

15:01 your seeds and your nuts and the avocados um that we talked about.

15:05 You can um supplement with a little bit of inulin fiber if you want.

15:10 Um I again think most days I'm just trying to eat if you eat

15:15 a bunch of if you eat something with fiber at every meal you will get there.

15:19 You will.

15:20 Okay.

15:20 So it's the berries in the morning and avocado

15:23 for lunch on your salad and greens or whatever veggies.

15:27 Yeah.

15:27 So maybe I am eating enough fiber.

15:29 I that's all I eat.

15:31 Well that's good for vegetables.

15:33 Okay.

15:33 So then you're and the third thing is three probiotic foods.

15:37 So again like I told you if you had

15:39 the Greek yogurt and the cottage cheese in the morning

15:41 you're done with one at least one serving

15:44 and three means like you want different sources right?

15:46 So like our gut bacteria like black temple but they

15:50 also like um you know uh other types of bacteria.

15:54 So if you eat um say kimchi, sauerkraut,

15:58 even raw apple cider vinegar in your dressing um even um

16:04 those are miso um tempeh um kefir which is a fermented yogurt.

16:09 I have kefir in the morning.

16:12 Yeah, there you go.

16:14 Um but that's only one.

16:15 And then you know that nowadays I'm so thankful that we can go to our grocery

16:20 store and there's an entire refrigerated area of like

16:24 probiotic vegetables and probiotic um drinks and probiotics.

16:26 So kombucha is one of them.

16:28 But just watch the sugar content.

16:30 I really love this like a fermented coconut water

16:32 that's like uh go gut this is like the brand.

16:35 It's just like a jar and you just have to have

16:38 one serving is one spoon and it tastes like coconut water.

16:42 That's a little cuz I could do that twice and then have two of them.

16:45 Yeah.

16:46 Or you could put apple cider vinegar three times.

16:48 Totally.

16:48 We'll go one, two, three.

16:50 Or you could have like a glass of water

16:52 with apple cider vinegar and there's one, you know.

16:55 So that's why my daughter has a spoon of apple cider vinegar every morning.

16:59 Well, as you know, apple cider vinegar has many, many different uses.

17:03 Um, apple cider vinegar is a great um blood sugar management tool.

17:07 And then the other benefit is that it's

17:10 probiotic and works Works like a probiotic.

17:12 Totally going to do that.

17:13 The raw one.

17:14 The raw with the mother.

17:15 The raw with the mother.

17:16 Yeah.

17:16 And then you can add it to your dressing.

17:18 What do you mean the raw with the mother?

17:20 So, you know, apple cider vinegar can be filtered, right?

17:22 Right.

17:23 Or it can be raw.

17:24 But what's the with the mother?

17:26 The mother is the fermented part.

17:28 Oh, I know like you see that sediment

17:31 or something like it's like little like yes.

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21:58 So, let's talk about two things.

22:01 Probiotics and prebiotics.

22:02 What do you think about those?

22:04 Yeah.

22:04 And do we need them if we're following your 3033 rule?

22:08 Okay, that's a great question.

22:09 So, that's a great question.

22:11 Um, so because I want to do the three spoons and be done.

22:15 Yeah.

22:16 Prebiotics are food for the gut bacteria.

22:18 That's like your fiber.

22:20 Okay.

22:21 So, prebiotic foods, especially healthy prebiotics,

22:23 like asparagus and leaks and um there's certain foods that have

22:27 the highest uh number of fibers that the uh bacteria can eat.

22:32 And what are those?

22:34 And that's like asparagus, hikima, um, artichoke.

22:37 I have artich choke three times a week.

22:40 There you go.

22:41 You need both prebiotic and probiotic.

22:43 Yes.

22:44 Right.

22:44 So prebiotics are basically anything that your gut bacteria.

22:48 So any of those fiber foods I talked about,

22:50 but you don't necessarily need just those particular like foods.

22:54 It's just high fiber foods that are going to um support your gut.

22:58 Uh those are that's more important because you really

23:01 want to grow the gut bacterial community that you already

23:05 have rather than adding a bunch of probiotics to it

23:09 because you don't know if they're going to even stay.

23:12 Our body's very good at killing probiotics.

23:14 And so when we're taking a pill, it's very easy for the body to just destroy it.

23:20 Even in the stomach, right,

23:22 before it gets to your gut the probiotic industry, it's so difficult.

23:27 So there's certain brands like for example like Metagenics is a good

23:31 brand because they check for you know the viability of it getting

23:35 to the colon where it needs to go and has coding on it

23:39 and it's you know it's especially formulated because they know this but if

23:43 you go to Amazon and you just buy probiotic you're basically throwing

23:46 money down the drain and so most experts say with the fiber

23:50 the prebiotics and eating a better diet and like that will make

23:54 your uh microbiome really healthy And then all of a sudden you're like,

23:59 "Oh, now the probiotics are working now.

24:01 Oh, I'm able to eat dairy and gluten and I never could.

24:05 Oh, like I was bloated all the time and I didn't realize it.

24:08 Now I'm, you know, better." We have now good data that it

24:11 can even change your personality and your mood symptoms like anxiety,

24:15 depression, um, and even athletic prowess.

24:18 I just have a question for the uh,

24:20 for patients who suffer from SIBO, which is so common right now.

24:24 We see it in patients with thyroid.

24:26 I see it all the time with endometriosis.

24:28 I see it with PCOS patients.

24:29 Especially with endometriosis, one thing I've noticed over the years

24:33 is that unless you fix their underlying condition,

24:36 which is the inflammation from endometriosis,

24:38 they can't get rid of this uh SIBO.

24:41 So, let's say you suppress their endometriosis and they have SIBO.

24:44 Can you tell us about a low the low FODMAP diet?

24:49 there are fermentable sugars in fruits and certain

24:53 foods that are really irritating um to the gut.

24:56 So any kind of elimination diet is

24:59 what I recommend anytime people have gut issues

25:02 in general is because if you eliminate the uh foods that are causing the issues,

25:08 let the inflammation come down,

25:10 then reintroduce it because as you know a FODMAP diet,

25:13 if people don't know, it's a restrictive diet.

25:16 It it excludes a lot of the foods that you would eat uh

25:20 uh you know out at restaurants or at Can you give us examples?

25:24 Yeah, there like a lot of fruits are on there.

25:27 There's like a lot of grain.

25:29 I mean dairy, alcohol, caffeine, alcohol, caffeine, like everything.

25:32 It's a very temporary and to get rid of some of that inflammation

25:37 that you're talking about and then you can add that back in.

25:41 And I think my biggest um thought also

25:44 by the way with the endometriosis and the SIBO together,

25:48 the reason why they all come together so

25:51 much is that inflammation is what ties them, right?

25:55 And so when you lower the inflammation through treating

25:58 the endometrius and treating um and eating a better diet,

26:02 for example, you're starting to lower the inflammation level for both.

26:05 Your gut health is so intimately l linked to your hormone

26:09 health that every single person coming in with a hormonal issue,

26:13 we should be addressing their gut.

26:15 100%.

26:16 100%.

26:16 I'm glad you said this.

26:18 Yeah, we talked about PCOS yesterday and you know how these patients

26:22 have all these gut issues or they get diagnosed with IBS,

26:26 they get colonoscopies, endo patients.

26:28 Yes.

26:28 Every other one comes in, I've had a colonoscopy, I've had this.

26:33 It's none of that.

26:34 It's the inflammation in your pelvis that's causing a leaky gut.

26:38 Yes.

26:38 But you have to fix the underlying condition.

26:41 Look for hormone changes.

26:42 And I always say it becomes a vicious

26:45 cycle because for example for PCOS patients,

26:48 insulin resistance makes you have this leaky gut.

26:52 It changes your hormones.

26:53 Yes.

26:54 uh it affects your gut motility and in return

26:57 when you have a leaky gut your inflammation goes

27:00 up your androgen secretions go up you become more

27:03 insulin resistance like one thing is causing the other.

27:05 So if you're like someone who's even at home and you're like how

27:09 do I improve my hormones you start with your gut health and like

27:12 vice versa like how do you improve your gut health like make sure

27:16 your hor you don't have some crazy hormone issue that you're not addressing.

27:19 So I think it's like they go together and I want

27:22 to add one thing because uh one of the because for patients who

27:26 don't know what SIBO is um some of the common symptoms small

27:29 intestinal bacterial overgrowth some of this common

27:32 symptom is besides bloating is fatigue,

27:35 brain fog, weight gain, feeling nauseous,

27:38 they just don't feel well and you know it's so non-specific because like oh

27:43 I'm allergic to this food but really

27:46 it's your gut microbiome that's being affected.

27:48 So, if you're tired, if you're gaining weight,

27:51 if you're bloated, if bloating is an issue for you,

27:54 then make sure you're don't have SIBO and and there's a test for SIBO.

27:59 Yeah.

27:59 But you don't necessarily have to have the test cuz

28:02 sometimes some doctors will say if you have all these symptoms,

28:05 they treat you anyways.

28:07 But SIBO is not the only gut issue.

28:10 Sometimes you have to figure out.

28:12 But SIBO is very common.

28:14 It's the most irritable bowel syndrome is the overarching

28:17 kind of uh you'd say it's extremely common.

28:20 The problem is is that our society,

28:23 the way we eat and the way we live is really not supporting that gut microbiome.

28:29 So IBS is literally like your gut microbiome is irritated.

28:33 They need food, they need sunlight, they need sleep.

28:36 So what happens is as you're healing yourself

28:40 from SIBO by normal things that you would do, right?

28:44 But you will not be able to tolerate the amount of fiber, prebiotics,

28:49 probiotics that you would if you didn't have it because

28:53 your body's not able to process that fiber in the right way.

28:57 And so you can have it, but you can't have it in this huge amount.

29:01 That's why the FODMA diet is is almost no fiber.

29:05 Yeah.

29:05 because you're trying to heal.

29:07 It's like um it's like trying to train when you're injured, you know,

29:11 like you're trying to grow your muscles when you have a big broken arm.

29:16 And also remember that you can't go from five grams of fiber to 30 in one day.

29:21 You will your body will talk to you.

29:23 It will say you will have gas and you will have for example,

29:27 I'll give you the best example, a bowl of raw broccoli.

29:30 Have you guys ever eaten a bowl of raw broccoli?

29:33 No, it doesn't.

29:34 Because that doesn't sound good.

29:35 That does.

29:36 And your your gut is going to be like bloating.

29:39 Yeah.

29:40 And most people can say raw vegetables,

29:42 especially cruciferous vegetables, broccoli, cauliflower, Brussels sprouts.

29:46 If you're not used to eating fiber, your gut's going to be like, whoa.

29:50 Um that happened to me once.

29:52 I went to a raw food restaurant and I literally almost did not make it off.

29:56 I mean, it was my body went no.

29:59 And I thought, you know, you think, oh,

30:00 I'm doing all these healthy things for myself.

30:02 But you're right.

30:03 I love that analogy.

30:04 It's like work trying to work out with a broken arm.

30:06 So I have a question.

30:07 You know PCOS and endometriosis.

30:10 I see a lot of gut dispiosis with both of them because of the hormones,

30:16 because of the inflammation, because of all of that.

30:19 When you have a patient,

30:20 let's say with endometriosis who has SIBO, which is very common.

30:24 In my practice, I would say like

30:26 85% of my endometriosis patients suffer from SIBO.

30:29 Besides treating them with antibiotics like Zyaxin, I have two questions.

30:35 A, when you take Zyaxin to treat SIBO, does it affect your other gut microbiome?

30:40 Yes, number one.

30:41 And number two, is there a way to treat the SIBO

30:45 in these groups of patients without u giving them zyaxin?

30:49 So as you know with endometriosis or PCOS

30:53 there's people on the spectrum where it's very mild

30:57 or moderate where dietary changes actually will do the trick

31:02 meaning their diet has been so bad for so

31:06 long that if you just switch them to a higher

31:10 nutrient quality diet with less of those processed

31:12 foods less of that junk all of a sudden

31:16 their dispiosis by itself starts to get better.

31:18 But there are people who've already done that who've tried and they're

31:22 on the very other end of the spectrum where nothing is dietary can work.

31:26 A lot of that starts because that hormonal um millu of endometriosis

31:31 mixes with that poor diet and lifestyle and that's what caused the problem.

31:36 So when you fix the lifestyle and the diet

31:39 if sometimes it just fixes itself, right?

31:42 And so it's it's something that you can definitely and depending on the person,

31:46 you might want to try that first or you

31:48 might want to try that with the um treatment.

31:50 But yes, the problem with SIBO is like you're then giving antibiotics.

31:54 So once you're healed from that, then you're starting from like a kind

31:59 of a scratch from and you know when we prescribe when I prescribe antibiotics,

32:04 I always tell you know my patients maybe take probiotics with it.

32:08 Can you when you're taking antibiotics, let's say for a bladder infection,

32:12 can you change your diet without having to do probiotics?

32:15 The reason I say someone like me, when I take probiotics,

32:19 I get so nauseous to a point that I have to take a Zopran.

32:23 So, it's not sustainable for me, at least the ones I've tried.

32:27 And so, is there a way to change

32:30 your diet while you're on antibiotics to, you know,

32:34 reverse the effects of the antibiotics?

32:35 Absolutely.

32:36 When you're taking a probiotic and you're taking an antibiotic,

32:39 it's not necessarily helping.

32:41 And there has been a couple of cases where it has hurt the process.

32:45 We need more research to know.

32:47 I see.

32:48 So, changing your diet is more important.

32:50 I have one child that's always on antibiotics and I'm

32:53 so I'm constantly like just you have to take a probiotic.

32:56 So, what do I do for this child?

32:57 Is it, you know, and by the way,

32:59 we have in my refrigerator, we have probably 10 different probiotics.

33:03 And some days, again, you know me, some days I'm like,

33:06 I'll take that one, that one, that one, that one.

33:08 Have no idea if they're working because it's so confusing.

33:12 So, just to totally simplify this, okay, so the problem with antibiotics,

33:16 as you know, they don't just kill the bad bacteria,

33:20 they're killing all the bacteria.

33:22 So, number one is, do you need to use systemic antibiotics?

33:25 That's my question.

33:26 So, first thing is if you can do local,

33:29 that's better because then it kills the bacteria

33:32 with on the site cuz when you take it by mouth,

33:35 then you are it's killing everything along the way.

33:38 The more you can be localized and um not have

33:42 to kind of atomic bomb your entire like system, the better.

33:45 And then the second thing is supportive care.

33:48 And what does supportive care mean?

33:50 That means sleeping well.

33:51 That means eating real foods, not ultrarocessed foods,

33:54 less sugar, less um, you know, junk, right?

33:57 So, I'm not saying probiotics will not help in that situation,

34:01 but you want to be doing all the things.

34:03 So, supportive care, good nutrition, good sleep, good exercise, sunlight.

34:06 Gut bacteria love when you exercise.

34:08 They love when you get sun in the day, dark at night.

34:12 They love when you eat really clean foods that they can recognize.

34:17 With probiotics, you really do have to kind

34:19 of do the research to know which ones.

34:22 Like for example, um there's a probiotic

34:24 called from Pendulum for that has acromancia.

34:26 Yeah, I was going to ask you about acromancia.

34:29 And acromancia is really really now um known to be

34:32 a way to support your own GLP one, you know.

34:36 So, if you're someone who is on a weight

34:39 loss journey um or you're trying to heal your metabolic,

34:41 you might want to pick that one because that's a really nice one for that.

34:45 But there's um for I would say it's not like you're just gonna take

34:50 probiotics and you can and eat a h you know McDonald's every like it's

34:54 kind of in it's almost like the other extreme like I would say that if

34:59 you were going to exercise every day and you're going to get good sleep,

35:04 manage your nervous system and eat really good diet and hydrate.

35:06 That's going to be the best thing that you you can do for your gut.

35:11 And then of course eating probiotic foods and um is is another thing.

35:15 But like the problem with the probiotic industry is that a lot

35:19 of people believe that they can just take a probiotic and that's it.

35:23 And that's it.

35:24 And I think gut health is so much more than just eating a probiotic.

35:27 It's like that whole you don't need a fridge full of them.

35:30 I have five literally.

35:32 Now a normal person that doesn't have SIBO or anything else,

35:36 what do you recommend?

35:37 Yeah.

35:38 normal person who doesn't have SIBO, um you would do the 3033.

35:42 You would um you could be a little more aggressive.

35:46 Maybe, you know, maybe you're having very little fiber.

35:48 Wherever you are stand, like say you do My Fitness Pal and you find out

35:52 how much fiber you're having in a day and you're like,

35:55 uh uh oh, I'm only having 20 grams.

35:57 Like, you could go up to 30 and you'd be fine.

36:00 Can you talk about organic versus non-organic when it comes to gut health?

36:05 Oh my gosh.

36:06 So, this is something I've actually changed my positioning on.

36:09 Of course, like everyone else, I was always like,

36:12 you have to have organic, like organic, organic, organic.

36:15 And then I started to learn

36:17 that organic in general doesn't really mean anything.

36:21 Organic, you can still use pesticides.

36:24 And what a lot of organic, a lot of farmers say is that they can't afford

36:29 the organic certification because it's like this big business, right?

36:33 And so what I've learned and I'll and everybody can make their own decision,

36:38 but this is what I'm doing for my family is like when

36:40 I can afford it and when I can find it, I'll do organic.

36:44 However, that is not going to stop me from eating vegetables,

36:47 eating fruit whenever I want it.

36:49 So if I'm out, I'm traveling, I'm, you know, whatever,

36:53 I will have fruits and vegetables even if it's not organic.

36:56 And like the more you can go to farmers markets, local is the best.

37:01 And a lot of farmers will be very clear about, you know, what they use.

37:05 I love what you're saying.

37:07 Eat your vegetables no matter what.

37:08 If if you don't know they're organic, they're still good for you.

37:11 So, say you're at a restaurant and you're ordering a salad.

37:13 How do you You don't know if it's all they use all organic vegetables.

37:17 But I'd rather you eat a salad, right, than not have it at all fries.

37:21 Yes.

37:21 Exactly.

37:21 The best of the best of the best is to go

37:24 to a farmers market and try to eat locally produced.

37:27 But at the end of the day, I hate to say it, you still don't know.

37:32 You still don't.

37:33 So, I've started to do this, that the best

37:35 way to wash your fruits and vegetables,

37:37 this is something I think everyone can do,

37:39 is take two tablespoons of baking soda in a big pot,

37:42 like a pot or whatever, and just throw your produce in there.

37:46 And with water, with water, like for how long?

37:49 Uh, 15 minutes.

37:51 And then just drain the water and you're done.

37:54 Washing vegetables and fruits, but rubbing them is a great way to get pests.

37:58 So, wash with a rub, you know,

38:00 and then if you add the soak to it, you're up to 95% of pesticides.

38:05 Even lettuce.

38:06 Even lettuce.

38:07 Okay, that's great.

38:08 95% of pesticides.

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40:49 Okay.

40:50 Magnesium.

40:50 You talk about magnesium and how most of us are deficient.

40:54 How do you know if you're deficient from magnesium?

40:56 How do you get it into your diet?

40:58 Is that a supplement?

40:59 If so, what supplement do you like?

41:01 I love magnesium.

41:02 I love magnesium.

41:03 Actually, the way it changed my life was one

41:06 of my best friends is an OB/GYN and I was having um bad PMS symptoms and we were

41:11 in yoga and she was like, "Yeah, you know,

41:14 a lot of people take magnesium before their periods, you know,

41:17 it helps." And I so I had started it like years ago right

41:21 before my period and then I saw the data on um higher magnesium diets.

41:26 There was a huge difference in their brain health and especially in women.

41:29 That doesn't even need to be a supplement.

41:32 it can just be through your foods.

41:34 So, seeds and nuts again are a huge very good magnesium richch foods.

41:38 Um, you can get magnesium in uh higher amounts in your diet

41:44 and then you can actually improve your brain health over time.

41:48 So, tell us some foods that have high magnesium.

41:51 Leafy greens, seeds and nuts, um, dark chocolate.

41:55 The lucky thing about magnesium is that a lot

42:00 of the foods that I talked about with fiber,

42:04 like I'm saying the same foods for magnesium,

42:07 when you're eating a diet with the 30 33,

42:09 we're starting to eat more fruits and vegetables

42:12 and um you're automatically getting more magnesium.

42:14 Uh nuts and seeds and um what kinds of nuts and seeds?

42:19 Um so pumpkin seeds are an amazing source of magnesium.

42:24 Um, but really like uh magnesium is found in most seeds and nuts.

42:31 And how much did you eat a day?

42:33 So 550 milligrams is the recommendation for a day.

42:37 So that's both food and supplementation together.

42:39 But if you think I'm not getting enough magnesium,

42:42 what's the best supplement that you magnesium glycinate?

42:46 So magnesium glycinate is a a magnesium bound to glycine.

42:50 This is something that will help reduce cortisol,

42:54 uh that can help with relaxation before sleep.

42:57 It's um great for women in perry menopause.

43:00 And what brand do you like?

43:03 Um oh, that's a great question.

43:05 There's so many um good brands of magnesium glycinate.

43:08 Um what is the one that I have?

43:11 I think I have Nature's Bounty magnesium glycinate.

43:14 Thorn has a good one.

43:16 Okay.

43:17 But you can So that's a very common one.

43:20 That's a good supplement to do.

43:22 Try to eat foods and maybe take the supplement as well.

43:25 You know, I I recommend magnesium all the time to my patients

43:28 and I say at you want to take if you want to supplement it,

43:31 you want to do it before bedtime.

43:32 And there are two forms of uh magnesium.

43:36 Magnesium 3N8 is the form that crosses the bloodb brain barrier.

43:40 So for people who are anxious and stressed out,

43:43 you want to take that at night and it calms your mind.

43:47 It helps with anxiety.

43:49 Uh if you want to pick one magnesium that affects

43:53 that relaxes you your muscles and just relaxes your body,

43:57 I would say magnesium glycinate.

43:59 What I do, I take a combination of glycinate and thrienate at night.

44:05 It really in one in one pill.

44:08 No, two separately separately.

44:10 I take 200 and 200.

44:12 U you cannot overdose on magnesium.

44:15 Some patients can have loose stools with magnesium.

44:17 Well, that'd be great for me.

44:19 So, take it at night.

44:21 You can take magnesium citrate if you want the like if you

44:25 take some magnesium citrate at night along with your glycinate or the 30onate,

44:29 you will fix that problem because I often when I travel,

44:32 especially I'm traveling right now, I always take the citrate at night.

44:35 That's a good one.

44:36 But I always say for permenopausal women,

44:38 menopausal women, people who are stressed out,

44:40 they're not sleeping, always start with magnesium,

44:44 for anxiety at 3 and8 for general magnesium.

44:47 I love 3 and8 and glycinate together at night.

44:51 So when do you when do you start taking them?

44:54 Can you give your is it too early?

44:56 Give it to your kids.

44:57 So yeah, doing a combination or doing if you were just doing one,

45:01 you probably do the glycine.

45:03 It's easier to find.

45:04 less expensive, but definitely the 308 308

45:07 is great for crossing that blood brain barrier.

45:10 And then the citrate is great for women who have constipation issues.

45:15 Um, magnesium is just a golden amazing thing.

45:18 I love what you said too, you said the laziest way to build your brain

45:22 health that costs you nothing, go for a walk.

45:25 It actually grows the area of your brain called the hippocampus.

45:28 Yes.

45:28 And it's not just for exercise, it's actually for your brain.

45:32 Studies show that those people who are walking

45:35 regularly only like 40 minutes three times a week,

45:39 it's growing a region of your brain called the hippocampus.

45:43 When you're moving around,

45:44 your brain knows to make new connections, new brains brain cells.

45:48 Like, I mean, how amazing is that?

45:49 Cuz as we age, our brain shrinks.

45:51 Everyone can do that.

45:51 Everyone can do that.

45:52 I wish I wish walking around my office would do this.

45:55 I know.

45:56 You need to You know what you need to do?

45:58 Tell me.

45:59 This is what I do.

46:00 When you have a break, even if it's 10 minutes,

46:03 maybe it's you may not get a full lunch.

46:05 I don't get 10 minutes, but maybe you have like two minutes.

46:07 Okay, I do.

46:08 You have a phone call.

46:09 You have to be on a call with some doctor or some hospital.

46:13 You go outside and you take that call.

46:16 You walk around.

46:17 You walk around.

46:18 It'll change it even for two, five, 10 minutes.

46:21 And say you're like, "Hey, I have a uh, you know, no show, a couple minutes.

46:26 I'm going to go outside.

46:28 Just make a habit to just walk out whenever you have a minute.

46:33 Just walk out.

46:34 Be like, "I'll be right back." Go like

46:35 as if you're going to the bathroom getting sunshine.

46:37 Yeah.

46:38 So, you have been amazing.

46:39 This is awesome.

46:40 I want you to tell us for all every

46:43 woman listening and maybe we got some men too.

46:45 Love you guys.

46:46 Um, top five things that you tell every woman to do.

46:50 Okay, top five things.

46:51 Number one, um, let's start with nutrition because that's the easiest.

46:55 Let's do the 3033.

46:56 That's number one.

46:58 That's easy.

46:58 Yeah.

46:59 Number two would be the magnesium.

47:01 Um number three, I like omega-3s also in your food or a supplementation.

47:07 And then I like vitamin D because as you know most

47:12 people even if you're getting enough sun but in general I

47:16 like vitamin D and I think you should supplement um uh

47:19 to get the levels in a place um that makes sense.

47:23 And then I wouldn't I'd be remiss if I didn't say exercise is my top

47:28 like fifth thing because exercise there's nothing

47:30 nothing better than exercise for your brain.

47:34 Any kind of exercise.

47:36 Oh well move your body.

47:37 Move just move your body.

47:39 My favorites are walking because of these studies

47:41 about uh brain health and also nature you know.

47:44 So I love walking.

47:46 Um and then for women 35 plus especially

47:49 weight training two to three times a week.

47:52 Before we let you go, five foods.

47:54 Yes.

47:54 Your top five foods to eat.

47:57 What would they be?

47:59 Um, okay.

48:00 My favorites are blueberries because they have high levels of um anthocyanins

48:05 and the fiber and they actually boost brain health even with one serving.

48:10 By the way, I eat them every day.

48:12 Number two, I would say eggs.

48:14 I love the combination of protein and um choline that you can get from the yolk.

48:20 And so, um, and they've been taken off of the bad food list from even,

48:25 um, the American Heart Association.

48:27 Now, it's included in a healthy heart diet.

48:29 Um, I love nuts because of all

48:32 those micronutrients that we talked about, and the fiber,

48:35 walnuts for brain health, almonds, and then Brazil nuts for thyroid health,

48:39 um, selenium levels, and then pumpkin.

48:42 Pumpkin, uh, so seeds and nuts.

48:45 Yeah.

48:45 And then my fourth favorite foods, leafy greens.

48:49 They're like literally the most nutrient-dense foods you can eat in your life

48:53 and what can really improve your gut health um in ways.

48:56 And then the fifth would be probiotic foods

48:59 because we need more probiotic foods in our life.

49:02 And you have two books where where people can go

49:05 to really sort of learn about everything that you're doing.

49:07 And I love the titles.

49:09 I'm so effing tired and I'm so effing hungry.

49:11 So one of them is about sleep and then one of them is about food.

49:16 so people can buy your books and um learn more and learn more.

49:19 I have a new one coming out in early 2026 which I'll talk about soon,

49:23 but around the same exact topics that we all just talked about.

49:27 Okay, great.

49:28 And how can people find you?

49:30 So, I'm at amymdwellness.com or I'm on social media.

49:34 I'm really on Instagram all the time at Dr.

49:36 Amy Shaw.

49:36 I just have to say I'm going to I love I

49:39 love a podcast when I I'm taking notes as I'm listening.

49:42 I'm like, "Okay." And you're going to go home and we're

49:44 going to do all that apple cider vinegar with No, but you need to tell me, too.

49:48 You should be like, cuz it only takes 3 days to change your gut.

49:51 So, by like next week, if you do it every day,

49:54 you should be like, "What's better?" Wow.

49:56 I'm going to do it on social media.

49:58 I'm going to do it and then I'm going to let you know.

50:00 Thank you so much.

50:01 I'm so happy you came and this is so informative and it's, you know,

50:05 and thank you for making such a difference and thank

50:08 you for bringing so much knowledge to gut health.

50:11 And I think it's the most important organ that's completely dismissed.

50:15 Completely dismissed.

50:16 Completely.

50:17 I I'm so thankful cuz we had such an amazing conversation.

50:20 You guys are making such a difference.

50:22 So, thank you.

50:23 Well, it takes it's take it takes a village of women.

50:29 So, thank you for coming.

50:32 Thanks so much.

50:34 Thanks so much for joining us today on GMD.

50:37 If you want to own your own health,

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50:49 For takeaways from today's episode, visit our website shemdpodcast.com.

50:53 We'll see you next time on Shemd.

50:58 This podcast is for educational and entertainment purposes only.

51:01 It is not intended as a substitute for a physician's medical advice.

51:05 You should regularly consult your medical provider

51:08 in matters relating to your own health.

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