Episode 18: Healing Your Gut and Your Relationship with Gluten with Dr. Tom O’Bryan

Evelyne: You too. So today we’ll be talking about gluten, going gluten-free autoimmune disease, different antibodies, molecular mimicry. I’m really excited for this conversation. Dr. Tom O’Bryan is an internationally recognized and sought after speaker specializing in wheat, its impacts on health and the development of autoimmune diseases as they occur inside and outside of the gut. He’s the author of You Can Fix Your Brain and The Autoimmune Fix. Over 500,000 people worldwide have watched his docuseries, Betrayal: The Autoimmune Disease Solution They’re Not Telling You, an investigation into the global effects of issues underlying the autoimmune system and chronic diseases.

Dr. Tom holds teaching faculty positions with the Institute for Functional Medicine and the National University of Health Sciences. He has trained and certified tens of thousands of practitioners around the world in advanced understanding of the impact of wheat sensitivity and the development of individual autoimmune diseases. Tom, first of all, how did you develop an interest in gluten and autoimmune conditions?

Tom O’Bryan: Okay. I was an intern in 1979 and my wife, my ex, and I could not get pregnant. I called the seven most famous holistic doctors I’d ever heard of at the time, and I asked them what they do for infertility. They told me what they do and I wrote it all down. I put a program together. We were pregnant in six weeks.

Evelyne: Wow.

Tom O’Bryan: My neighbors in married housing, we lived on campus, they had been through artificial insemination and nothing had worked, and they asked if I’d work with them and I said, well, I don’t really know what I’m doing, but I don’t think it’ll harm you. Okay. They were pregnant in three months. So we’re now four months pregnant and we’re hot to trot to tell the world. And a friend would tell her sister in Wisconsin, and I was in school in Chicago and this woman would drive down from Wisconsin to see me in my dormitory room because she had had three miscarriages and no one could help her. And so that’s how it all began. I actually came into the world of healthcare with this understanding that there’s not much in medicine that’s all or every, but this was every, every couple that was dealing with hormone related issues, whatever they were, every single couple had as a component contributing to their problem.

They were eating foods they did not know were a problem for them, because they felt fine when they ate pizza or whatever the food should be. And the most common food that people were sensitive to was wheat. We got the most dramatic results back then without any testing by going gluten-free. I said, just give me three weeks. Let’s just see what happens. Go gluten-free, dairy-free and added sugar-free. And that’s how I started my practice. We opened on Valentine’s Day in 1980, and by then I had been to the first talk that Jeff Bland had given in Chicago in 1978 and had been following him for a couple of years. And so I was thinking a functional medicine perspective from the day I came out in practice. But a primary component is the most common source, in my opinion, the most common source of the triggers causing inflammation in the body.

And CDC tells us 14 of the 15 top causes of death are chronic inflammatory diseases. The only one that’s not is unintentional injuries. Everything else is a chronic inflammatory disease. And the most common source of gasoline on the fire is what’s on the end of your fork in general. And so when people say, well, I feel fine when I eat, it doesn’t really matter how you feel, because in the world of celiac disease, the ratio is eight to one. For every one person that gets gut symptoms with a problem with wheat, there are eight that do not get gut symptoms. They get brain symptoms or skin symptoms or joint symptoms. They don’t get gut symptoms, so they eat wheat and they feel fine. That’s why you have to do proper testing just to see, is my immune system fighting wheat? Because you can’t base it on symptoms. If you do that, you’ll miss seven out of eight.

Evelyne: Very interesting. And thank you for sharing that personal story. I think you’ve shared it with me before and it’s just heartwarming and thank you for sharing it here on the podcast. I’d love to talk about the connection between gluten and autoimmune diseases, but I feel like we need to back up for a second and distinguish for the practitioners listening just so we’re all on the same page between gluten sensitivity, weight sensitivity, celiac disease, non-celiac weight sensitivity. Can you go over all of those and then I’d love to also get into testing, but I’ll ask you that after.

Tom O’Bryan: Do you have eight hours? Yeah. We’ll start with a big picture overview. I’ve got an online course on all of this, and it’s an eight to 10 hour course because there’s so much to learn, but I’ll give you the pearls and hopefully they’re like carrots and you say, I want to learn more. Well, here’s the first thing. There are 62 peptides of wheat, poorly digested wheat, and no human can digest it properly. There are 62 that have been identified as immunogenic. They stimulate your immune system to respond. Now, the most common one is a 33 amino acid peptide called alpha gliadin. And anyone that does a test for wheat, every lab looks at alpha gliadin, and that’s all they look at. But wait a minute, there’s 62 peptides that could trigger a response to wheat. Why are we only testing one?

Because that’s the test that was developed in 1986, and you’re using testing from 1986. If you’re trying to determine if there’s a problem with wheat or not, that’s the test you’re using. And if you’re trying to determine if they’re celiac or not, you’re using transglutaminase. Transglutaminase 2 was designed in 1997, 25 years ago. It’s a good test. But when you read the science, now, I just show you the study after study after study. When you read the science on that, the sensitivity and specificity of transglutaminase 2 to identify celiac disease is somewhere between 97 to 98%. It’s right on the money all the time. If, and this is the big, if you have total villus atrophy celiac disease, if you have partial villus atrophy or increased intraepithelial lymphocytes, which comes before partial villus atrophy, then the sensitivity of transglutaminase 2 is 27 to 32%.

It’s wrong. Seven out of 10 times it’s wrong. It comes back negative, seven out of 10 times when there still is a problem. Because transglutaminase 2 is right on the money when there’s total villus atrophy. Just read the science on this, and if you don’t know that and you’re ordering the test for celiac disease and it comes back, no wheat is not a problem for you. Well, but doc, I think I kind of feel better if I don’t eat wheat. Okay, then don’t eat so much. You’re okay. Wrong. Excuse me. And it was 2016, January of 2016 when the first paper came out from Mayo Clinic from Joe Murray at Mayo. I’ve been teaching on gluten sensitivity since 2008. I did 26, 8 hour days around the country sponsored by Metagenics. They were very kind and I just blew people away, 300 and some studies all day long about the dangers of wheat with or without celiac disease.

So when I tell you there are four horsemen in the world of celiac disease, I call them the four horsemen. It’s Peter Green at Columbia, Alessio Fasano at Harvard, Stefano Guandalini, University of Chicago, and Joe Murray at Mayo. And Joe Murray, his papers are great to read because they’re very clinician friendly and you walk away and say, wow, that just makes sense. So Joe Murray is one of those guys that’s great to read his papers and he has a few hundred, I don’t know how many, but literally a few hundred. He published, one of the four horsemen published in January of 2016 about a new technology in laboratory medicine called silicone chip technology, and his exact words, quote, “a new era in laboratory medicine”. Now, look, if I had said to you in 1990, you know what, I’m in 25 years, 30, 35 years, I’m going to have this little black thing in the hand about the size of my wallet, and if I just push a couple buttons on this thing, I can tell you within five seconds that the air particulate matter in Chicago is 36 today.

It’s a good day to exercise outside, but San Diego’s 101, do not ride your bicycle outside today, there’s too much air particulate matter. You’re breathing a whole lot of toxins. And I can tell you any place in the world, Maliha, Australia is 45, Jaco, Costa Rica is 33, San Francisco is 61. That’s a warning zone. I can tell you that in five seconds because I’ve got the encyclopedia of the world in my hand. If I had told you that in 1990, you would’ve thought I was watching too much Star Trek. That it wasn’t fathomable that science would improve to that degree where I can tell you anything knowledge base that you want to know in five to 10 seconds. We just couldn’t. Yeah, right. Whatever. You couldn’t have imagined that. Technology improves. Technology improves in laboratory medicine. Why are you using tests from 1986 or 1997?

Silicone chip technology, the sensitivity and specificity according to Joe Murray in that paper in 2016, the sensitivity and specificity is 97 to 100%. It’s right on the money every single time. If the person is producing adequate levels of total immunoglobulins, it’s right on the money every single time. But if their immune systems depleted, you can’t use the test. You’re not making enough antibodies.

Evelyne: I have two questions about that. So are we testing IgG and IgA, and also, does somebody need to have been eating gluten in order to show an immune response?

Tom O’Bryan: Good question. It’s IgG, IgA and IgM.

Evelyne: Okay.

Tom O’Bryan: Boom, boom, boom. And doc, do I need to go back and eat gluten again and do the test? No, no, because you do the test now. And for the vast majority of people that have been gluten-free for three years more, they still come back positive with 97 to 100% sensitivity and specificity. Well, why do they come back? I’ve been really gluten-free, Mrs. Patient, here’s an article in the American Journal of Gastroenterology from Peter Green, one of the four horsemen in 2019. They gave 804 people testing equipment, NEMA testing equipment, which has a sensitivity and specificity of over 94%. And they told them, go out in the community, go to gluten-free restaurants and order seven things off the menu. So 806 people ordering seven things off the menu is 5,624 tests on food, on gluten-free menus. So they order seven things and the waiter, waitress walks away, says that’s a lot of food, but they walk away.

They open their briefcase, they put the testing equipment on the table with seven cartridges. The people come back, the waiter, waitress comes back with the food, they put it in, they test it. Next cartridge. Put it in and test it. 32% of everything on a gluten-free menu is not gluten-free. This is the American Journal of Gastroenterology and it’s Peter Green, 5,624 tests. Who’s going to argue with this? You can’t argue with that kind of, you can if you want to, but that just suggests that you have your head in dark places. Excuse me, but people die on your watch because you’re using the wrong tests. They die on your watch. So what you do, if you haven’t eaten gluten, you still do the wheat Zoomer because you zoom in on the problem. That’s the name of the test. You still do. And I don’t work for that lab. I don’t have any association with that lab. They’re just incredibly efficient at what they do. Compare.

You want to know how bad it is? Next time you do phlebotomy, take two tubes out of the same arm, same draw. Label one tube Joe Smith, send both tubes in separate envelopes to the lab, order the same test. You have to pay for the second test yourself. You can’t bill insurance, but you want to find out if your lab is accurate or not, you do that with five patients. It’ll cost you a couple thousand dollars depending on what tests you’re doing. But you do that with five patients and you’re startled to see that two or three times the results are different to the extent of being not the same interpretation. You’re startled by this. You’d say, what? It’s because the sensitivity and specificity of the labs using ELISA is somewhere in the 70 to 80% range.

They’re the best tests that were available in 1990, but that’s not the case today. Wake up everyone. Excuse me. You don’t think you need to change labs, spend the money so that you’re confident, because I’m telling you, you’re going to be startled. You’re going to get blown away by what you see. Holy cow. So do I talk to Mrs. Patient about the test with good results or the one with a different name with bad results? It’s that black and white sometimes, and you’re startled, and it’s disappointing to recognize those laboratories that you’ve been counting on for years, sometimes they’re wrong. Sometimes.

Evelyne: It’s scary.

Tom O’Bryan: It’s very scary. It’s like, wake up, wake up. I’ve done that with Vibrant Wellness, the Zoomer test, I did three of them, and every single one of them was within three to 5%, which is acceptable. To me that’s acceptable. It’s scary. Evelyne, it’s scary and people don’t know this and they don’t want to spend the money to find out, and that’s the problem, because it’s patients’ lives at stake with the recommendations you give.

Evelyne: I do love your passion, Tom. Always loved it. So in terms of the sequence of lab testing, I know you’re recommending that test for everybody. Do you also do genetic testing for HLA-DQ2 or do you feel like that’s not necessary for people?

Tom O’Bryan: Good question. Good question. The science is really clear. When you read the papers on it, HLA-DQ2 and DQ8 are the two primary genes associated with celiac disease. If you carry the gene and about 30 to 35% of the population carries those genes, depending on which culture you’re testing, what country you’re testing, somewhere just a little bit over a third of the population carries those genes, but one to 4% get celiac disease. Now wait a minute, wait a minute, wait a minute. So we have doctors who say, oh, you’ve got the gene, you’ve got the celiac gene, you have to give up gluten. No, you don’t. No, you don’t. You’re vulnerable that if you pull it a chain it always breaks at the weakest link. It’s at one end, the middle, the other end. It’s your heart, your brain, your liver, your gut, wherever your weak link is. So if you have the genes for celiac, that’s a weak link. So if you pull on the chain too much, it’s going to break.

So those patients that are genetically positive, what you can interpret is that you are vulnerable to this. Let’s do the most comprehensive test possible and see if your immune system is fighting wheat right now, irrespective of how you feel. It doesn’t matter how you feel, the ratio’s eight to one. So if you’re waiting to feel bad when you eat bread as an example, you’ll miss it seven out of eight times and it’s affecting your brain. Oh, well, yeah, I’m on an antidepressant, but I don’t feel bad when I eat pizza. But you’re on an antidepressant or you’re on thyroid medication or you’ve got psoriasis or you got rheumatoid. The list goes on and on. Professor Yehuda Shoenfeld at Tel Aviv University, he’s the godfather of predictive autoimmunity. What do I mean by that? When I interviewed him a couple of years ago, 26 of the MDs, PhDs who received their PhD in immunology from his department, there are many, many more, but 26 chair departments of immunology in medical schools and hospitals around the world.

They’re his students. This is the godfather. He published a paper earlier this year on the contribution of wheat in non-celiac autoimmune diseases, rheumatoid, psoriasis, myocarditis, pancreatitis, thrombocytopenia. The list went on to, I think it was 28 different diseases, 26 or 28 that he looked at. And he did a literature review of over 65 studies, 68 maybe, I’m not quite sure on that. But it was over 60, 65, 68 studies. 78% of the patients get better going gluten-free, and this was confirmed in 65% of the studies, which means that sometimes, more than half the time, any autoimmune patient gets better on a gluten-free diet. Who would you not check when those kinds of numbers, you just have to test accurately. You can’t use tests from the 1980s and 1990s. You can, but you have to interpret them cautiously.

You test accurately just to see, is wheat contributing to the inflammatory cascade that’s manifesting at the weak link in your chain, which is Hashimoto’s thyroid disease or which is psoriasis? And it was Hashimoto’s that Professor Shoenfeld identified as the most frequent one that benefits from gluten-free.

Evelyne: I have so many follow up questions for you. I have so many notes.

Tom O’Bryan: Great.

Evelyne: I’d love to talk a little more about all of the proteins when you are testing because it’s not just alpha gliadin, not just transglutaminase. Are some of them not as bad as others? And I know you and I have had dinners together for over 10 years now, and you’ve watched me eat gluten in front of you. I even had a dream about croissants this morning, Tom. What are the chances? But when I did my test, I had an IgG and IgA reactivity to omega gluten, but not to the others. But then also I had a reaction, I think IgG to some of the non-gluten wheat proteins, serpin and purinin. So in my mind I’m like, well, it’s not the bad ones. You know me. Well, you and I have had this conversation. I’d love for you to talk a little bit more about the other proteins in wheat and if they’re as bad.

Tom O’Bryan: Yeah, of course. Some of them are worse. The amylase-trypsin inhibitors are the very most potent because they’re designed to kill the bug that’s trying to eat the weak plant, and they cause permeability in everyone who eats them. And Detlef Schuppan at Harvard, brilliant gastroenterologist, very famous guy, when you look him up. He’s been pioneering the papers on amylase-trypsin inhibitors in wheat for, I don’t know, 15 years or so. And what we now know is that amylase-trypsin, see, you have a century standing guard in the proximal part of the small intestine. It’s called toll-like receptors 2 and 4. Now they’re throughout your body. But for this discussion I’m talking about the proximal part of the small intestine. They’re sentry standing guard. I think of them as the sentries at Buckingham Palace. Those guys with the big hats, they’re as stiff as can be. They’re dormant, but don’t mess with those guys. Do not mess with those guys.

That’s toll-like receptors in the proximal part of the small intestine. And they’re watching everything that comes out of the stomach, everything. They’re scanning everything. Why? Because you have the same genetics as your ancestors thousands of years ago. And before 10,000 years ago, we were all nomads following the herbs, and the primary concern was food. And you walk around, you find some food, the first thing you do is sniff it, then you nibble at it, and then you eat it. And if you didn’t have indicators of a problem by sniffing and eating, but if there was pathogenic bacteria that hydrochloric acid in the stomach didn’t kill and came into the proximal part of the small intestine, toll-like receptor 4, which is sitting, they go, hey, right there. And two things happen within five minutes, and you see the videos, it’s jaw dropping when you see the videos on this. Very cool to see leaky gut and how it happens.

Two things happen. First, you increase zonulin within five minutes. Zonulin is the protein that has been identified as the mechanism in the development of leaky gut. It’s the mechanism. Zonulin, Mrs. Patient, your cells are one cell thick on the inside of the gut and they kiss each other and they’re hold together by shoe laces. And just like a high school kid that has his shoe laces untied and he’s running down the street, the shoes can flop on his feet. That’s leaky gut. Right? The shoe laces are the zonulin proteins. So when you increase zonulin protein, you undo the shoe laces. You open up the space between the cells, the epithelial cells in the gut. Now, why would you do that? Because toll-like receptor 4, has recognized a potential threat. And so it activates zonulin, open up the tight junctions, water comes into the lumen of the gut to wash away the bug with the bowel movement.

It’s like when you’ve got mud stuck on your driveway, you turn on the garden hose and try and rinse it off, it doesn’t come off. You put your thumb over the opening of the hose for a spray, and now you just spray off the mud stuck on the driveway. That’s zonulin. It’s a lifesaving mechanism. Those that did not have that lifesaving mechanism, they died. They did not reproduce. But those that had that lifesaving mechanism thrive, they reproduce. We carry that genetic lifesaving mechanism today. So toll-like receptor 4 does two things. First, it activates zonulin. The second thing, it activates NF Kappa B, the major amplifier of inflammation. Mrs. Patient, NF Kappa B is the desk sergeant at the police station. He tells, okay, guys, you patrol over there. You patrol over there, you patrol over there. That’s NF Kappa B. He’s the boss in creating inflammation in the gut for this example and throughout the body. But toll-like receptor 4 when it gets activated, does those two things within five minutes.

And you see the videos of that. There was a paper they published. They took 36 patients that were complete failures to all treatment at Harvard and at a university in Germany, failure to all treatment for irritable bowel syndrome. Nothing worked. And the minimum was they’d been treated for at least a year and nothing was working. They injected a dye into the vein of their leg, and they knew that the vascular path was going to go right past the gut. And so the walls of the gut, so the dye was going to go through the walls of the gut. They put a tube down into the proximal part of the intestine and they did, it’s called confocal endomicroscopy. And so it is like electron microscope inside the gut. It’s a camera taking pictures, and they put wheat in there and watch to see does the dye come towards the surface of the lumen of the gut?

Okay, yeah, there it is. It’s in the surface. Okay, everything’s fine. They put wheat in there and the dye starts leaking into the lumen. And within five minutes, the lumen is all white with the dye. That’s leaky gut. And it happened within five minutes. When you see the video, you go, holy cow. And of course, Detlef Schuppan, who’s a very stoic, German gastroenterologist, very formal guy, he wrote “The change was obvious to everyone in the room watching the video.” So that’s his way of saying, holy cow, Batman, look at this. Look at this. Right? That they couldn’t believe what they were saying, every patient it happened to. That’s leaky gut.

Evelyne: So you’re saying that everyone or all gluten and all wheat, because there’s also gluten and other things causes intestinal permeability in everyone. I’ve also heard you say that gluten is not bad for you. Bad gluten is bad for you.

Tom O’Bryan: Well, no, excess gluten is bad for you. Evelyne Lambrecht: Okay?

Tom O’Bryan: Maureen Leonard, very famous gastroenterologist once again at Harvard, did a literature review in 2017. This is six years ago, and there was over 60 papers that she looked at on this topic. Her conclusion, gluten activates transient intestinal permeability in all humans, every human. So if you’re human, you put it down there, it activates toll-like receptor 4, increasing zonulin, increasing NF Kappa B in all humans. Now that’s to gluten because the signs started with gluten. Detlef Schuppan now tells us, they just published a book this year, which is a Bible on amylase-trypsin inhibitors, and they demonstrate that amylase-trypsin inhibitors activate toll-like receptor 4 in nano molar concentrations. That’s a billionth of a gram.

Evelyne: Wow.

Tom O’Bryan: A billionth of a gram. So yes, not just sweet, the serpins, the omega-gliadin have a tendency to irritate more the mucosal linings like your lungs and your blood-brain barrier. You get leaky brain. The serpins are more associated with some patients often have depression, they have brain fog. So once again, brain function. It’s not just gluten, it’s just not alpha gliadin. There’s a whole world that’s coming out now about this, and it’s the only food in the human diet that does this. Dairy doesn’t do it. Soy doesn’t do it. Sometimes soy will activate toll-like receptor 4 if you’ve crossed a threshold. But not every human. Once again, if you are human, your wife might not think you are at times, but if you are human, this means you, irrespective of how you feel.

Evelyne: I have many follow up questions to this too. How much do you think that glyphosate in our food supply has an impact on this? Does it make it worse? Are we reacting more to wheat because of the glyphosate? And then also in terms of healing the gut, is there any way, because we’re all eating poorly as a society, right? Maybe not you and me, especially not you, but is there a way to where we wouldn’t mount an immune response to these foods if we healed the gut in some way? Or does it not matter?

Tom O’Bryan: Theoretically, yes, and I’m doing an N of 1 right now. My son will be three in a couple of months, and I’ve exposed him to a wheat cracker, I think two or three times in the last four or five months. So minute amounts. Unfortunately, fortunately also, but we planned this beautiful home birth, but we had a traumatic emergency C-section, and I did his microbiome analysis in his first poop, and it was terrible. It was exactly what you would expect. The pathogenic bacteria in the air in the emergency room was the primary. He’s now two and a half years later, a little more than that, and his microbiome is perfect because we did all that, which is great. But I’m exposing him to just a little bit of wheat at a time, and we’ll see in the future how it goes. My premise was initially to start with ancient grains for him with minor exposure to see if he can build up tolerance, because there are a few people that come back testing negative. It’s quite rare.

Somewhere around eight out of 10 come back positive, whether they’re gluten-free or not because we’re getting contamination. But occasionally there’s someone that comes back negative, which is great. And I say, look, here’s the science and here’s what we know so far. You’re likely to cross the line of tolerance somewhere in the future. Who knows? Might be next year, might be 10 years. But when you do, that inflammatory cascade that will come from this, will pull at your chain and you might manifest Hashimoto’s thyroid or multiple sclerosis or rheumatoid, it doesn’t matter, wherever your genetics and your lifestyle, wherever the weak link is. So you just want to test this every couple of years to make sure that your immune system is still not fighting wheat.

So that happens rarely, but on occasion, and that’s the way I counsel them. But everyone else comes back positive and people who have been gluten-free for years, they come back positive. It’s because of the contamination issues.

Evelyne: I was actually going to ask you about your son. So you’ve sort of already answered that, but at what age did you start with the exposures and what does the research say about that?

Tom O’Bryan: I waited until he was two.

Evelyne: Okay.

Tom O’Bryan: I waited until he was two years old. A child’s microbiome is pretty well established by the age of three, so I was kind of wrestling, should I do it or not? But by the age of two, his microbiome was good. He’s had five microbiome evaluations in life already.

Evelyne: Of course.

Tom O’Bryan: Of course. Right. So by the age of two, he was good. And so I said, all right, all right, so let’s give it a shot. Let’s see what happens here. And so far we’ve done one more stool evaluation. We’re doing another few months for another one, I think. But so far there’s not a problem.

Evelyne: Do you think that in adults we can ever, quote unquote, “heal our gut” to the point where we could ingest wheat without issues?

Tom O’Bryan: Excellent question. And I didn’t really answer your glyphosate question, and-

Evelyne: I want to go back to that too.

Tom O’Bryan: … yeah, I wanted to, but I’ll do this one first. Mrs. Patient, when you get a vaccination for measles, they give you a shot of the bug and your brain says, what’s this? This is not good. Better fight this. Yo, General. And in your immune system, you’ve got Army Air Force, Marine Corps, general sitting around with nothing to do. General, you now are General Measles. General Measles’ job is to build an assembly line. The assembly line takes a few months, but it starts building soldiers, special forces. They’re trained to go after measles, nothing else, and they go after measles, they’re killing all the measles bugs from the vaccination that you got. When General Measles sees that the bugs are gone from the bloodstream, he says, okay, turn off the assembly line. We don’t need you guys out here right now. And you turn off the assembly line. You shouldn’t have measles antibodies in your bloodstream right now unless you’ve been exposed.

But General Measles is vigilant the rest of his life that if you’re on a plane and the guy behind you is just coming from Mozambique and he coughs in the air, measles, and you inhale measles, now it’s in your bloodstream, General Measles, whoa, wake up! Here we go! And he just has to flip the switch. He doesn’t have to build the assembly line that takes months. He just has to flip the switch and in one day you’ve got measles antibodies. So the measles that you inhaled or you were exposed to never has a chance to populate. General measles is called a memory B cell. Okay? He never forgets. Just Google memory B cells and gluten, and then Google memory B cells and eggs. You can’t find anything on eggs or soy or dairy or corn or rice. All you can find memory B cells papers on is with wheat. It’s not a food for humans. Why?

Because Alessio Fasano tells us why. Why does it activate toll-like receptor 4? Fasano, who is professor of medicine at Harvard Medical School, professor of nutrition, Harvard School of Public Health, the chief of pediatric gastroenterology mass general, Harvard. The director of the Celiac Research Center, Harvard. The director of Mucosal Immunology, Harvard. This guy has five titles. Any one title is a lifelong goal for someone at the top of their game. He’s got five. What does he tell us about this? And everyone should download his article. Just Google Fasano, all disease begins in the (leaky) gut. Read the article. It’s paradigm shifting when you do. And what he tells us is that gluten is misinterpreted by the immune system in gut toll-like receptor 4 as a harmful component of a bug.

That the amino acid structure of poorly digested wheat looks like the amino acid structure of a pathogenic bacteria. So gluten activates toll-like receptor 4 and zonulin in every human. It’s a lifesaving mechanism. Just read the science, take my CGP course, and if you don’t like it, just tell me. You get your money back. I don’t care. I’ve never had anyone ask for their money back, ever. We get lots of great testimonials. Just got a testimonial last week from a gastroenterologist at Princeton, teaching faculty at Princeton. Oh my God, I learned so much. Thank you. And that’s like a feather in our cap. It’s like, yes, Yes. Because it’s hundreds of articles. I just show you the science study after study after study. And you can’t argue with the science.

Now, there are people out there in the world like you, Evelyne say, well, it’s the serpins. It’s not the alpha gliadin. So it’s probably not so bad. Yes, it is. Yes it is.

Evelyne: I know. I know. I will keep being like, oh, come on. Okay, so I have another sort of challenge to you. I’ve probably asked you this before too, but so obviously our society changed, right? With agriculture revolution. Are you saying that since wheat and bread was introduced in our society, that we as humans have reacted to it?

Tom O’Bryan: Yes.

Evelyne: For all of these years?

Tom O’Bryan: Every human produces, in Maureen Leonard’s words, transient intestinal permeability, transient leaky gut, and NF Kappa B. It happens in every human. The problem today, now this is back to your glyphosate question, the problem today and why it’s so, Shoenfeld’s article on reducing 78% of the patients with any autoimmune disease that they check, and that’s not quite accurate. You have to read the papers. But the autoimmune diseases that were identified, there were 26 or 28 of them, was just jaw dropping, how many there were. Autoimmune myocarditis or autoimmune pericarditis, autoimmune pancreatitis, autoimmune hepatitis, psoriasis, Hashimoto’s, rheumatoid, multiple sclerosis, they get better. 65% of the people get better on a gluten-free diet. You can’t argue with that. You just can’t. You can if you want to. Go ahead.

So why today is it such a problem compared to in the past? There’s been a fivefold increase in celiac disease between 1950 and 1985. Fivefold increase. Glyphosate didn’t come on the market until the 1990s, so there was a fivefold increase. And coincidentally there was a fivefold increase in wheat consumption after the development of dwarf wheat. So the guy won the Nobel Prize, I think it was in the 1960s. He won the Nobel Prize. I’m not sure when, because he designed dwarf wheat, because wheat was a five foot, six foot plant, and with wind it would fall over and break. And so the harvest per acre was not so good. When they developed dwarf wheat, the harvest per acre was so much higher and food was being produced to feed the populations of the world. Really great thing that happened. Guy won the Nobel Prize for it.

But that happened somewhere in the 1950s, 1960s. So the gluten content or gluten consumption went up in the next 30 years because of dwarf wheat. Well, celiac disease went up in the next 30 years because a fivefold increase in gluten consumption and a fivefold increase in celiac disease in the next 30 years by 1985. Glyphosate is a problem. It absolutely is. But it’s peripheral. Glyphosate kills the microbiota, the beneficial microbiota, it impacts on the shikimate pathway, and you kill the good guys, and then the bad guys rear their ugly head. So you create a lot more dysbiosis with glyphosate containing foods. It’s a nasty, there’s no benefit to it whatsoever that I know of, but it’s not the cause of this. The cause of this is the increase in dysbiosis, the increase in pathogenic bacteria, which create the intestinal permeability in every human.

When you read Fasano’s article, he talks about the perfect storm in the development of chronic inflammatory diseases, and there’s five things to the perfect storm versus genetics. You can’t turn genes on and off. Stop saying that. Genetics operate on dimmer switches, and you can dim down genes of inflammation and you can ramp up genes of anti-inflammation, but you can’t turn them on and off. So please let’s get our language correct. That’s genetics. Number two of the five, environmental triggers. It’s the environmental triggers that have their hands on the dimmer switch, turning them up or down. So our environmental triggers, the most common environmental trigger is what’s on the end of your fork. The second most common is what’s going up your nose? Our olfactory scent. Dale Bredesen tells us that of the five types of Alzheimer’s, 60 to 65% of all Alzheimer’s is inhalation Alzheimer’s.

It’s the environment that you’re breathing and the olfactory nerves are the only nerves in the body, ask any neurologist, they’re the only nerves in the body that have no screen going back into the brain. There’s no anastomosis, there’s no screens, there’s no filters. Right back to the hypothalamus, right back to the memory center of the brain. Why? Our ancestors had to sniff to see is this food safe or not. And when they’re walking down the trail, if they smell saber tooth tiger, they better turn around really quick and go the other way. Our sense of smell is a lifesaving mechanism inherited from our ancestors. There’s no screen. And so environmental triggers activating your genes, every child that they check in Mexico City, every single child has evidence of the mechanisms of Alzheimer’s. Right now, every single one.

Increased inflammation in the brain, increased antibodies to the blood-brain barrier causing leaky brain, every single one of them, because it’s air pollution. We have to wake up. You’ve got these beautiful plants right behind you. NASA did the studies on houseplants, because the astronauts were going loopy in space. Hello, Houston, blah, blah, blah, blah, blah. And Houston say, hello, shuttle, could you repeat that please? And they say it again. And they just look at each other and say what? What? What? They were going loopy. And they found out it was the amount of phthalates in the air, in the space capsules that they were breathing. The toxins causing inflammation in the brain. So NASA financed the studies and demonstrated two six inch houseplants in a 10 by 10 room absorb 74% of the toxins in the air. The formaldehydes in your press board furniture, if your nightstand is not solid wood or your kitchen cabinets are not solid wood, they’re formaldehyde soaked.

The flame retardant chemicals in your bedsheets and your blankets, the organophosphate and the carpets, that all of this that we’re breathing every day, this is the mechanism that’s causing this inflammation, contributing to the four to 9% increase every single year in autoimmune diseases. Four to 9% a year, every year. So NASA did finance the studies on houseplants. You can go to my website, thedr.com/plant and get the handouts and give them to your patients. You’re welcome to use them, tweak them any way you want. But I put the handouts together with pictures of the plants and you say, oh, I’ve seen those before. And they’re not expensive. So I tell every patient, Mrs. Patient, go to the nursery store. How many rooms do you have in your house? Well, we have eight. Okay, go to the store and buy 20 little houseplants. Here’s the list of the plants to get.

Well, I don’t have a green thumb. They’re going to die eventually. Then buy more. Because you put the houseplants in your children’s bedroom. So they’re cleaning the air that they’re breathing all night long. We have to learn to think about this low grade chronic inflammation that’s under the surface that nobody’s paying attention to. Women that are putting 160 different chemicals on their body every day. Men, it’s somewhere around 120 chemicals on your body every day. And I know you use organic stuff, Evelyne, organic shampoos and all of that, but we think this is all okay. This is what has contributed to the increase in wheat related disorders. They’re not transient anymore because you’ve altered the microbiome so much, it’s an inflammatory microbiome.

You constantly have leaky gut and you’re not going to take some pills for a couple of months and change that. You have to rebuild the microbiome. And that’s what my CGP course is all about.

Evelyne: I want to talk about how to rebuild that. I also have a follow-up question on the transient leaky gut. I just read, I think yesterday that zonulin actually can fluctuate throughout the day. And so did the studies show that you have a leaky gut for a couple hours or after a gluten exposure?

Tom O’Bryan: That’s really good question. Zonulin, the lifespan of zonulin is four minutes to four hours. That’s it. So if it comes back positive for elevated zonulin levels, you caught it right in the midst of that. Now, where is the contributor coming from? Is it from the dysbiotic microbiome and you’ve got a whole pocket of Klebsiella that’s triggering inflammation and tearing the cheesecloth lining of your gut? Or is it the food that you just ate? Who knows? Who knows? So looking at zonulin levels is okay, but it’s a shotgun. You don’t really know because of the lifespan. Looking at zonulin antibodies is a much better indicator. You have elevated zonulin antibodies, you got a problem, because the antibodies, that’s an autoimmune mechanism attacking the protein zonulin.

Evelyne: Let’s talk more about the autoimmune antibodies. You mentioned before that Hashimoto’s thyroiditis is-

Tom O’Bryan: Most common. Evelyne Lambrecht: … one the biggest. Yeah, one of the most common related to gluten and that people see the most benefit. Why is that? Why the thyroid?

Tom O’Bryan: That’s really a good question. I’ve never seen an explanation in any of the studies that I’ve read. I have an opinion, but it is my opinion. My opinion is the society we live in starting at an extremely early age, has taxed our adrenal glands to the point of producing hypoadrenia. Selye, 70 years ago they showed us a healthy young man who unfortunately died of trauma. His adrenal glands were the size of a walnut, but young men of the same age who die of disease, their adrenal glands are the size of a peanut. And that started the whole world of understanding because Selye coined the word stress and associated it with health. Before that stress was a term for cables on bridges, it was an engineering term before that. But Selye pointed out that it’s the stress of life. And his book is still a classic to read, The stress of life.

And so you understand about hypoadrenia and how it develops over a lifetime. But with our kids now and the amount of toxins that they’re exposed to from day one, you’ve heard that cord blood at birth, umbilical cord blood has, what was it? How many chemicals? I don’t remember. Was it 68 or 168? I think it was 168, but I don’t remember. Sorry on that one. Chemicals that aren’t supposed to be there, pesticides, insecticides, heavy metals in the cord blood. So baby trying to develop in utero is swimming in this soup, this toxic soup from birth, right? We are exposed to so much stress so early in life now, and it taxes our stress response system, which is our adrenal glands. And when the adrenal glands are having difficulty functioning at adequate levels, where are you going to get your energy? Well, who controls metabolism? Who has their hands on the thermostat on the wall of the furnace of your house? Who controls your metabolism?

That’s how I explained thyroid hormone, is that the thermostat in the house in the winter, you turn it down at night to save on fuel, and in the morning it turns up automatically, kicks up before people wake up when you set it. That’s thyroid hormone. It controls your metabolism. It controls the heat in every cell of your body. So the thyroid has to pick up the load when the adrenals are so worn out, they’re having a hard time functioning at adequate levels. Now, this is my theory. I haven’t seen that written anywhere, but that’s how I explain it to people. So yes, of course we deal with hypothyroid, but we also have to deal with the adrenals and reduce the gasoline on the fire, the inflammation throughout the body.

Evelyne: So let’s talk about teaching patients to implement gluten-free diets correctly, whether they have celiac disease or whether they have Hashimoto’s. And you have a resource on your website, which we’ll link to about the dangers of gluten-free diets. And you say that mortality actually increases in people with celiac disease on a gluten-free diet. So how can someone do this successfully?

Tom O’Bryan: So this is in the Journal of the American Medical Association, and they said, their language, this is the largest study on mortality and celiac disease ever done, and the number of subjects is larger than all of the other studies put together. So this is the big kahuna study. And they looked at 350,000 endoscopy biopsies. This is from Sweden. They have socialized medicine. They got records on everybody. So 350,000 endoscopy biopsies. These are patients that went to their doctor. They were referred to a gastroenterologist who referred them to endoscopy biopsy. The patients had something going on, don’t know what it was, but they had something. 29,000 of those 350,000 were diagnosed with celiac disease. 1300 were diagnosed with positive blood work for celiac, but negative biopsy. Okay?

And 3,736 were diagnosed with inflammation in the gut, which meant increased intraepithelial lymphocytes. They followed the patients over 25 years, something like that. What happened to these people? And what they found was that those diagnosed with celiac disease had an 86% increased risk of dying within one year of a cardiovascular incident compared to the other 300,000 that were not celiacs. If you were diagnosed with celiac disease, you had an 86% increased risk of dying from cardiovascular incident, and a 386% increased risk of dying from cancer in the first year after diagnosis, compared to the other 300,000 sick people who went for endoscopy. Some had colitis, some had Crohn’s, some had cancer, whatever they had. Some were normal. But if you were diagnosed with celiac, your risk of dying in the first year was so much higher.

That’s like, what? That’s something that just drops your jaw. What? Because what do they recommend when you’re diagnosed with celiac disease? What’s the recommendation?

Evelyne: Gluten-free diet.

Tom O’Bryan: A gluten-free diet. Anything else? No, nothing else. A gluten-free diet. You’re saying when a patient changes their lifestyle to implement a gluten-free diet, we increase their risk of dying in a year compared to 300,000 other people who were sick and needed endoscopy, biopsy? Yes. Read the science. And there’s a number of studies on this now. My all day course, you just sit there and you go, what? And the course from Scotland, or the studies from Scotland that show children diagnosed with celiac disease die at much earlier ages than adults diagnosed with celiac disease of the same diseases. But children die much, much earlier than adults. When you see all this science, you go, what? Now, why does that happen? So first I rock your boat. You go, what? So that’s the first thing I do. And then I explain why.

78% of the prebiotic in the western diet comes from wheat. 78%. Put them on a gluten-free diet and tell them to start eating gluten-free crap, which is just white flour, white paste, no enrichment of the food, no nutrients in the food, no prebiotics in the food, but you take gluten out of there, you take wheat out of there, so their inflammation goes down. They lose 15 pounds in a month without counting calories. Their thyroid’s working better. The antibody loads drop dramatically. Their skin clears up from psoriasis, sometimes jaw dropping the changes when you go gluten-free. But in the meantime you’re starving the probiotics who have been dependent for a lifetime on wheat as their primary fuel. You’re starving them and you create dysbiosis in the gut, and the bad guys just prosper in there more for month after month, after month after month until you increase mortality on a gluten-free diet.

So everyone out there, if you don’t know this, you’re putting people at great risk, because you don’t know this. Do my course. Excuse me. But wake up, wake up. People are dying on your watch and you don’t know why. You treat them for fatigue and they feel great, and they come back and they’ve lost some weight and they’re great. You hear three years later they died of a heart attack or they’ve got Alzheimer’s. Oh, that’s too bad. That’s too bad. You don’t realize that the gluten-free diet may have easily contributed to that or fueled an acceleration of it. You don’t realize it. Just read the science and I just show you study after study after study. People don’t like my presentation style sometimes. Okay, shoot the messenger, don’t shoot the message.

Evelyne: So what’s the answer? What sort of diet do you recommend for healing?

Tom O’Bryan: Take my course. Rebuild the microbiome. Teach them how to deal with contamination issues out there. Teach them about digestive enzymes that really work. There are very few digestive enzymes that really work. Almost all the gluten digesting enzymes out there require an alkaline pH to work. So they’re going to work great in the large intestine, and they’ll prevent the inflammation response in the large intestine from inadvertent exposures to wheat. And that’s colitis and those things, but they don’t do diddly in the small intestine. They can’t. So you need digestive enzymes that work in the stomach.

Evelyne: Well, Tom, thank you so much for answering all these questions. I do have three more questions for you that we ask everyone on Conversations for Health. And you already mentioned where practitioners can learn more from you. That’s at thedr.com, thedr.com. What is something that you’ve changed your mind about through all of your years in practice and or all of your years teaching?

Tom O’Bryan: You can lead a horse to water, but you can’t force them to drink.

Evelyne: I feel like you’re speaking directly to me. That’s good. What are your three favorite supplements that you take for yourself, for your own health?

Tom O’Bryan: Colostrum, collagen, and vitamin C.

Evelyne: Nice. And what are your top health practices that keep you healthy and resilient and balanced? I know that you travel all over the world. You have a young son, you’re very busy. What keeps you sane?

Tom O’Bryan: Adaptogens. Evelyne Lambrecht: I love it. Anything else?

Tom O’Bryan: No.

Evelyne: Adaptogens. I love it. I love them too. Well, Tom, thank you so very much for joining us today, and thank you for all of your knowledge. I really appreciate you, and I appreciate you sharing, and I appreciate you allowing me to challenge you a little bit on some of those. It always makes for a fun discussion, so thank you.

Tom O’Bryan: It does. Thank you, Evelyne. It’s really a pleasure to be with you. Thank you.

Evelyne: Thank you for tuning into Conversations for Health today. Check out the show notes for resources from our conversation, and please share this podcast with your colleagues. Follow, rate, leave a review wherever you listen or watch. And thank you so much for designing well world with us.

Voiceover: This is Conversations for Health with Evelyne Lambrecht, dedicated to engaging discussions with industry experts exploring evidence-based, cutting-edge research and practical tips.