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New Podcast

Panoramic Microbial Assessment: The GI360TM Stool Test

David Quig, PhD and

Kara Fitzgerald, ND

The novel, focused, PCR-based Dysbiosis Index in Doctor's Data GI360TM stool profile is a key feature in this lively podcast discussion between long-term colleagues. Practitioners will learn about the advances in research-based stool testing by Doctor's Data, including why it is so crucial to evaluate the methodologies used by a lab, as well as applicability in your own practice. 

 

Laboratory, Endocrine, & Neurotransmitter Symposium

14.5 CMEs

Online Only

August 28-30, 2020


Topics include:

Systemic Inflammation

• Stress and Chronic Disease

Testosterone and Cardiovascular Disease

Gut Microbiota-Host Interactions

Neurotransmitter Markers and Lab Interp

PTSD Recovery and Support

Advanced Case Studies

Register today at the early bird price of $379. Additional discounts available for a 2-pack of tickets (one for you, one for a colleague.)

 

Taking Action: Hormone Testing and Prescribing

By: Laura Neville, ND

August 5, 2020

Learn the historical basis for BHRT and understand the advantages and disadvantages to utilizing compounded hormones. Become familiar with the history of compounded hormone and current regulations/quality control. Easily determine dosing starting points and schedules as they pertain to estradiol, estriol, progesterone, testosterone, DHEA and cortisol. Become familiar with delivery options and the benefits and drawbacks as they pertain to each hormone. Identify laboratory monitoring schedules, and obtain clinical pearls from decades of BHRT prescribers’ expertise. 

 

Non-nutritive Sweeteners, Obesogenic Dysbiosis and Metabolic Disruption

 

By David Quig, PhD | July 7, 2020

The presumption that non-nutritive sweeteners (NNSs) aid in prevention of obesity and metabolic comorbidities is contentious. Replacement of sugars with NNSs in food and beverages might directly contribute to decreased caloric intake, but such may be associated with inimical metabolic disruption. Use of NNSs may adversely affect gut microbiota composition and function, which disrupts metabolic processes associated with postprandial glycemic control and appetite regulation. Feasible mechanisms for such NNSs effects will be discussed.


Obesity is an urgent public health challenge. There are well-established associations among sugar intake, obesity, type 2 diabetes and cardiovascular disease. Recommendations to decrease sugar intake are reasonable, but simple substitution with NNSs is not. NNSs provide few or no calories, but they are not metabolically inert. Randomized controlled trials in adults indicate that NNSs replacement of sugars may facilitate marginal weight loss. However, beverages sweetened with aspartame, monk fruit or stevia did not influence overall postprandial glycemic responses, nor total daily caloric intake compared to a sucrose-sweetened beverage (34 healthy subjects). In fact, NNSs-associated increases in food intake have been linked to dysregulation of satiety signaling.


Consumption of NNSs may adversely affect gut microbiota composition and function. Among 89 morbidly obese adults, daily consumption of NNSs was correlated with deviation from normobiosis (dysbiosis index, score 1-5) and lower levels of fecal butyrate. Detailed microbial analysis with the PCR-based Dysbiosis Test indicated that the NNSs-dysbiosis was characterized by higher abundance of Ruminococcus gnavus and Streptococcus spp., and lower abundance of Bacteroides fragilis and Faecalibacterium prausnitzii. The abundance of other main butyrate-producing bacteria in the Dysbiosis Test, Eubacterium rectale, Eubacterium hallii and Lachnospiraceae (family), did not appear to be altered by consumption of NNSs. Other observational studies have reported higher incidence of dysbiosis for obese and prediabetic subjects verses non-obese healthy subjects, without consideration of NNSs consumption.  


Faecalibacterium prausnitzii is a predominant butyrate producer; its abundance is positively affected by intake of complex carbohydrates and microbiota accessible polysaccharides. Butyrate is a pivotal messenger in microbial-host crosstalk. Butyrate and propionate have anti-obesogenic effects via stimulation of the release of glucagon-like peptide-1 (GLP-1) from mucosal enteroendocrine cells. GLP-1 controls glucose-stimulated insulin release, glucose-dependent inhibition of glucagon secretion, adipocyte adiponectin production (inflammation and insulin resistance), the rate of gastric emptying, appetite, and food intake. Butyrate also stimulates release of antimicrobial peptides, and mitochondrial fatty acid oxidation in enterocytes which lowers O2 in the microenvironment in close proximity to the mucosa. A more anaerobic environment disfavors colonization of pro-inflammatory Proteobacteria. The aforementioned study did not address effects of specific NNSs, but synthetic and naturally derived NNSs have been reported to negatively affect gut microbiota, glycemic control and appetite regulation.


Appropriate provision of microbiota accessible polysaccharides and limitation of simple sugars, but not substitution with NNSs, may contribute to effective management of adiposity and prevention of cardiometabolic risks. NNSs are not inert and have disruptive effects on gut microbiota composition and function. Targeted assessment of fecal microbiota and short-chain fatty acid levels provides an effective means for assessment of interventions to establish and maintain non-obesogenic gut microbiota.

References

Farup PG, Lydersen S, Valeur J. Are non-nutritive sweeteners obesogenic? Associations between diet, faecal microbiota, and short-chain fatty acids in morbidly obese subjects. J Obesity (2019) doi: 10.1155/2019/4608315


Gerard C and Vidal H. Impact of gut microbiota on host glycemic control. Front Endocrinol (2019)10:29 doi: 10.3389/fendo.2019.00029


Sylvetsky AC and Rother KI. Non-nutritive sweeteners in weight management and chronic disease: A review. Obesity (2018)26:635-40. Doi: 10.1002/oby.22139


Tey SL, Salleh NB, Henry J et al. Effects of aspartame-, monk fruit-, stevia-, and sucrose-sweetened beverages on post-prandial glucose, insulin and energy intake. Int J Obesity (2017)41:450-7 doi: 10.1038/ijo.2016.225




Free Webinar

The Neurotransmitter Connection to Stress: Case Studies and Clinical Applications

By: Scott Theirl, DC

July 15th, 2020

Case studies are always a great opportunity to solidify clinical applications. At this time, it seems appropriate to focus on the stress that patients are reporting. Responses to stress vary patient by patient. Insomnia, fatigue, anxiousness, depressive episodes, poor attention, increased pain, GI distress, and weight gain are some of the most common presentations to our offices. Looking for common threads is crucial to supporting patients on their road to health. The nervous system uses neurotransmitters all day, every day, and stress places an increased demand on these neurotransmitter systems.

Join Scott Theirl DC as he discusses why neurotransmitters, along with hormones such as cortisol, are key to understanding your patient's stress responses and symptoms. The basic concepts involved in neurotransmitter interpretation will be reviewed. Case studies will then be utilized to personalize therapeutic recommendations. A Q&A session will follow the main presentation.

Disclaimer: All information given about health conditions, treatment, products, and dosages are for educational purposes only and do not constitute medical advice.