Small-intestinal bacterial overgrowth, or SIBO, is notoriously hard to treat. Patients often experience persistent bloating—and even when they find relief, symptoms can return months later, seemingly out of the blue. After struggling to help patients feel better using the tools of conventional gastroenterology, Dr. Ken Brown began to research compounds that could effectively treat SIBO-related bloating. The result of his work is Atrantil, the only all-natural formulation for treating SIBO-related bloating. In this podcast, Dr. Fitzgerald talks to Dr. Brown about dosing and treating patients with Atrantil, when to run further tests, and what other treatments can be used in conjunction with Atrantil to get the best results.
In this podcast, you’ll hear:
- When Dr. Brown pivoted from conventional gastroenterologist to SIBO research pioneer
- The auspicious coincidence that led the formulation of Atrantil (it involves a member of his team that used to work in public policy (!)
- All about the three main constituents of Atrantil and how and why they work
- Dosing and treatment plans for persistent and refractory cases of SIBO
- Using Atrantil to treat both methane-producing and hydrogen-producing SIBO (and what treatments to pair Atrantil with in both cases)
- Diamine oxidase and mast cell stabilization
- When and how to use the IBS check test
- The amylase tryptase in GMO foods as a contributor to intestinal permeability
- How Atrantil is ideal for all health care practitioners
- How to request free samples through the Atrantil HCP Concierge
Dr. Ken Brown serves as Atrantíl spokesperson, participates actively in new product research and development and ongoing testing of existing products. He’s board certified in both gastroenterology and internal medicine and has been licensed to practice medicine in Texas since 2000. Ken earned his medical degree from the University of Nebraska Medical Center with magna cum laude honors.
He completed his residency in internal medicine and fellowship in gastroenterology and hepatology at the University of Texas Health Science Center at San Antonio. Ken is director of clinical research at Digestive Health Associates of Texas, where he’s served as principal investigator for many randomized, double-blind studies of gastrointestinal pharmaceutical medications. Ken is a member of the American Medical Association, the American College of Gastroenterology, the American Society for Gastrointestinal Endoscopy and the American Gastroenterological Association.
He serves on the Practice Management Committee of the American College of Gastroenterology and the Medical Advisory Board of AMSURG. In 2010, 2011 and 2012, D Magazine named Ken the top gastroenterologist in Collin County, Texas.
Atrantil is the only natural and safe solution proven to get rid of abdominal bloating and discomfort. Atrantil’s patented combination of natural polyphenols gets rid of your bloating and supports your digestive health.
Dr. Kara Fitzgerald: Hi, everybody. Welcome to New Frontiers in Functional Medicine, where we are interviewing the best minds in functional medicine. And today is no exception. I’m really excited to be with the developer, the physician who researched and figured out the Atrantíl product. And I know a lot of us have been using it in practice for our methane SIBO producers. And we’re just going to get the backstory on who he is and how he came up with this product, and some of the research he’s done around it. And we’re also going to look forward into where he’s going.
So let me tell you about him. His name is Dr. Ken Brown. He received his medical degree from the University of Nebraska Medical School. And then he completed his Fellowship in Gastroenterology at San Antonio, Texas. He’s a board-certified gastroenterologist, and he’s been in practice for over 15 years, with a clinical focus on inflammatory bowel disease and irritable bowel syndrome.
For over a decade, he’s been conducting clinical research for various pharmaceutical companies. During this time, he saw an unmet need for something natural that could help his IBS patients find real relief. After working on the development of Atrantíl for over six years, Atrantíl launched in the summer of 2015. Dr. Brown and his research team developed Atrantíl with the intent of helping those suffering from the symptoms of IBS, which we know now are caused by bacterial overgrowth. Dr. Brown, welcome to New Frontiers.
Dr. Ken Brown: Dr. Fitzgerald, thank you so much for having me on your show.
Dr. Kara Fitzgerald: Absolutely. So listen, I want to know about you, your story. I mean, you actually were doing research for pharma. You’re in the conventional gastroenterology trenches. You just told me you had 21 procedures today, right before I started-
Dr. Ken Brown: I know-
Dr. Kara Fitzgerald: Recording, which is-
Dr. Ken Brown: Yes-
Dr. Kara Fitzgerald: Amazing. Like you’re in-
Dr. Ken Brown: I’m still working-
Dr. Kara Fitzgerald: You’re in the deep, deep trenches. And you pull your head up from doing this pharma research, etc. And then you’re like, “Wait, I want to actually do something natural here for my patients.” So how did you, I mean talk to me about that journey.
Dr. Ken Brown: So this journey all started over 10 years ago. I had actually been doing clinical research for Big Pharma. And it was for-profit research. It was the kind of things that these pharmaceutical companies need. They need the numbers to be able to present to the FDA. So I’m doing all this research, and that’s when I met Dr. Mark Pimentel. And he was the, a brilliant man that figured out, “Oh, my goodness. IBS is actually linked to this thing called bacterial overdose, SIBO.” SIBO has been embraced fantastically by the functional medicine community, a little slower in my traditional world over here. But he’s the first guy that showed these models of this. When I was sitting there, doing the research for Xifaxan, it was at that time-
Dr. Kara Fitzgerald: Wow-
Dr. Ken Brown: That he told me, “Look, you’re going to.” We were actually, I was one of the leading enrolling sites for that, for those original studies that got done]-
Dr. Kara Fitzgerald: Oh, isn’t that fascinating? Cool, okay.
Dr. Ken Brown: Yeah, so that was my dive into, I mean like the. I just jumped right off the diving board and into the world of pharmaceutical research. And next thing you know, I’m one of the leading enrolling sites, and I’m just one guy with my Research Manager and a few partners in a suburb of Dallas. We go, “Wow, this is kind of interesting that these are how these studies are conducted. I’m doing a very real-world trial on this.” And a lot of these academic centers, unfortunately, may not represent the type of person that you’re going to see in your clinical practice. Because it’s a little bit different.
So I’m doing this research, Dr. Pimentel and I were talking. And one of the frustrating things I was having was that, all these people that were bloated and constipated were not getting better.
Dr. Kara Fitzgerald: Yes.
Dr. Ken Brown: And that’s when he explained to me, he goes, “Well, here’s the reason. Nobody knows this yet, but there’s this bacterium-like thing called an archaebacter.” And obviously, we now know that it’s its own kingdom. It’s its own type of bacteria, the Archaebacter. And it is a methanogen. It is a bacteria that will soak up hydrogen and produce methane. He goes, “Our modern-day antibiotics will not work on this organism, because it’s a primitive organism. So the drug that we’re looking at right now, Xifaxan, doesn’t help those people.” So I drew that out, and I went, “Wow, it’s methane. It all comes down to methane.” So my Research Manager, who was working with me at the time, Brandi, she comes from a very unique background. She is actually a former policy writer, because she went to law school and did a Master’s in Policy. She pointed out that that’s what they were working on to put in feeds for cattle in the Midwest-
Dr. Kara Fitzgerald: Oh, wow isn’t that interesting?
Dr. Ken Brown: Yeah, and it was like this, kind of a-ha moment where I just looked over and went, “You’re kidding, right?” And she’s like, “No, no, no. We were talking about this eight years ago with Senator So-and-So. Because they were trying to decrease methane production from cattle.” Like, “Get me all that data. Let’s look at all that.” So we just started-
Dr. Kara Fitzgerald: Nice-
Dr. Ken Brown: Sifting through all of it. So I spent about four years looking at all of this. So this is kind of a two-step reason why this product actually got developed.
Dr. Kara Fitzgerald: Yeah, do tell.
Dr. Ken Brown: So I’m looking at all this. And then it always takes some sort of deep gut check to get people to really take the big leap. So it was, so 10 years ago, we discovered this. Four years, we’ve kind of looked at all the data. And I’m just treading through it, and I’m just. I kept talking about it when I’d come home, and I have two kids. And so, six years ago, I take my son to a tennis tournament. And he’s six years old. And I get a call from my web developer and he said, “Hey, sorry to inform you, but somebody put in a bad online review about you. And they mentioned something about how you’re supposed to be a very good doctor in Irritable Bowel Syndrome. And you just did the same thing everybody else did.” So there I am, watching my six-year-old son play tennis. And I get this thing where I’m like, kind of challenging my whole core of everything.
So my son ends up getting, he’s six, mind you. He’s six. This is his first tournament. This isn’t a giant. And we get in the car, after the tournament. He got second place-
Dr. Kara Fitzgerald: Wow..
Dr. Ken Brown: And we’re driving home. And he goes, “Boppy, do you not like tennis?” I said, “I love tennis. I’m so proud of you. You got second place in your first tournament. That’s awesome.” He goes, “Well, why were you on your phone all the time?”
Dr. Kara Fitzgerald: Ooh.
Dr. Ken Brown: Uh-oh.
Dr. Kara Fitzgerald: Yeah.
Dr. Ken Brown: So I explained to him. I said, “Well, unfortunately, somebody said that I wasn’t a very good doctor. And they said that I wasn’t treating the thing I do research on very well.” And then he just called me out right there. He said, “Why don’t you treat people in the way that you want to. Because you’re always talking about how you have a different way. And then why don’t you get your other patients who like you to say nice things about you?” I go, “Oh.”
Dr. Kara Fitzgerald: From the mouth of babes.
Dr. Ken Brown: Pretty much sums it up right there. So six years ago was my immediate turn. And it took my son to basically call me out. And that’s when we started making Atrantíl. That’s when I really went, “Okay, I do have something else to offer. And we’re going to change the world with this.”
Dr. Kara Fitzgerald: Well, it takes guts on many, many levels. I mean, kudos to your son. But there’s a few things here: A, you had to design the product. It’s great that you happened to have this bridge to the world of ruminants. I mean, incidentally, just as an aside, when we look at data for the most bioavailable mineral complexes, that comes from looking at animal studies as well. Because they’re paying attention to the feed. Like, they don’t want to waste money on products that don’t work. They want bioavailable minerals. So when you want to look for the complexes that are most bioavailable, that’s where we looked at all the original data. So it’s like, I see a very compelling parallel.
But anyway, there’s a few things that I can see you’re jumping through: A, you’re going front and center in the medical world, in the conventional medical world, with this alternative product, which is really gutsy. A. And B, you’re designing it. You have to figure what to do. And C, you actually conducted your own research studies, which I want to make sure that we talk about. Because as you and I were talking before on the phone, prior to starting our podcast, it’s expensive. I’m actually in the middle of doing a clinical research study myself now. And it is super-expensive. And there’s no funding. There’s massive amounts of funding, as you pointed out, in pharma research. So there’s a lot on the line here for you, in developing this product. So just, comments on that. And then, we’ll talk about what it was like when you finally brought it in.
Dr. Ken Brown: Absolutely. To actually take it from this idea, put it to the test, to ask your patients to take a leap of faith with you. Do these clinical trials, hope that the numbers come out. Everything that goes along with it, everything was this leap of faith. But what was so amazing is that, when we started seeing results, when I would start having those first patients come in in our double-blind placebo-controlled trial. And it was, I’d done enough trials. We’d been doing it for 10 years, that I knew when somebody was probably on placebo, and somebody probably wasn’t. Because when you had a drug that really worked, you’d start seeing it early on. Patients would come in and be like, “Hey, I want to make sure that I stay on this.” Well, I was getting that kind of feedback early on.
And you just go, “Oh, my gosh. Now I need to.” You check your ego at the door, and you go, “I have a moral obligation to push this through. I know something, I have discovered something. Or I have at least put the puzzle pieces together to something that needs to get out there and help people.” And it felt more like a moral obligation than anything else. And yeah, I mean, I’m with a bunch of, I have some wonderful partners. They’re wickedly smart, I love them all. But everybody was looking at me like, “You’re insane. And what are you doing?” Because you could sit there and go to the endoscopy lab and just scope. And pay your bills, consider yourself a good life. And here I am, putting myself out there.
Dr. Kara Fitzgerald: Right, right. Right.
Dr. Ken Brown: I had to go out. And I raised a little bit of money in my community. I had to get in front of my colleagues and say, “Okay, our business doesn’t start with. I need your help, I need your help to support it. And I need your help to raise a little bit of money.” So my reputation goes out in the city, and we raised some money, and everything. And it all came down to one thing: I know that it helps x amount of people.
Dr. Kara Fitzgerald: Yes.
Dr. Ken Brown: I have an obligation to try and get it out there. I’m not saying it’s going to help everybody. Absolutely not. We’re all doctors. We all know that, if you have a 10% effectiveness rate, and you can help that 1 out of 10 person, that person loves you. And that’s awesome. And that’s what most drugs do. So most of the drugs that I was working with had somewhere between a 2-9% over placebo rate. That’s what most drugs are being FDA-approved now for. And some of those drugs are insanely expensive.
Dr. Kara Fitzgerald: Right, right.
Dr. Ken Brown: So if we could figure something out, then whether I risk my reputation, whether it doesn’t work, at least I tried. I jumped, I got called out by a six-year-old kid, and I had to do it-
Dr. Kara Fitzgerald: That’s a really neat story. I love it. It’s a great story. Let’s talk about, let’s just dig into a little bit of the background about this methane-driven SIBO, and these Archaea. Well like, what’s going on at the cellular level? I mean, what’s the whole pathophysiology of this methane SIBO?
Dr. Ken Brown: So the pathophysiology, I think that most of your listeners understand SIBO. The bottom line is, if you’re going through stress, take antibiotics, have an infection, something shocks your small intestine, which should be relatively sterile. And then, bacteria start to grow. Whenever you eat, starches in particular, the bacteria will break that food down. Now, the kicker is, this whole idea of dissecting down the organism that’s really wreaking the havoc. And it’s this Methanobrevibacter smithii. It is an organism that lives in our colon, so we have methane-producing bacteria. In a situation where you have a high hydrogen content, this type of bacteria, in its own kingdom, will soak up the hydrogen and produce methane.
Why the methane is relevant is because the methane works as a local paralytic. So once methane’s being produced, you take a small little sewer pipe. And because it paralyzes the rest of the intestine-
Dr. Kara Fitzgerald: Jeez-
Dr. Ken Brown: It makes it into a bigger sewer pipe. So now we have our cyclical thing. For years and years in my GI practice, we would have the person that would say, “Hey, I went on a honeymoon to the Dominican Republic. I got really sick there. And I’ve never been right since.” These people would come to me, and they would be told they have IBS. “Okay, so you went like, 30 years normal, you have this event, and now you have IBS, which is an idiopathic functional-type problem? That doesn’t make any sense at all.” So the doctors were calling this, or the researchers were calling it “post-infectious IBS.” Now we realize, it’s probably post-infectious SIBO-
Dr. Kara Fitzgerald: Yes-
Dr. Ken Brown: Creating all the problems. And just being able to tell somebody that and say, “Hey, it’s not your fault. I mean, you ended up having this situation.” So when this Methanobrevibacter smithii starts setting up shop, it actually goes through an enzymatic process. It soaks up the hydrogen and produces the methane. The methane slows everything down. More bacteria grow. And then, this is the next layer of what’s going on with bacterial overgrowth: We’re creating inflammation. There is bacteria growing in the lumen of the intestines. Your body, these dendritic cells, reach up through the intestinal barrier, sample the outside world, hand it to a B cell. And it’s up to the B cell to decide, “Is this friend or foe?” Well, over time, if you have bacterial overgrowth, the B cell finally goes, “This is clearly foe, let’s fight it.” And that’s the inflammatory cascade that we talk about. And I think that’s the future of where functional medicine is heading: realizing that health really begins and ends in the gut. And if we can protect that barrier, then we can help a lot of other systemic diseases.
So the methane allowing this machine to grow is really the thing that could be the beginning of a lot of other problems. The problems being inflammation. And as you’re aware, as a functional medicine doctor, inflammation is the root cause of a lot of problems, including well, in my world, liver disease, pancreas issues. And of course, we’ve got autoimmune disease.
Dr. Kara Fitzgerald: Right, okay. So you’re basically fingering this displaced Methanobrevibacter smithii triggering the whole paralysis process, basically displaced. It’s up in the small intestines, vs. the colon. And it just shuts things down. And this whole process is kicked off by some exposure or collection of exposures. And then people head downhill. And then, there’s the insult, the damage of this methane production and the whole initiation of the inflammatory cascade and damage to the gut wall. Is that basically what you’re saying? And then you can get extra intestinal conditions as a result?
Dr. Ken Brown: Yes. I mean, I’m just saying that the Methanobrevibacter smithii is a key component to setting this cascade off. And so-
Dr. Kara Fitzgerald: Yeah, I get it-
Dr. Ken Brown: I’m not going to finger him and say, it’s all because of him or her. We don’t know if it’s gender-neutral archaebacter-
Dr. Kara Fitzgerald: Yes, you should be-
Dr. Ken Brown: But-
Dr. Kara Fitzgerald: PC with that-
Dr. Ken Brown: Yeah-
Dr. Kara Fitzgerald: But, yeah go-
Dr. Ken Brown: So, but we do know that it’s one of the suspects-
Dr. Kara Fitzgerald: One of the players-
Dr. Ken Brown: It’s really-
Dr. Kara Fitzgerald: Yeah-
Dr. Ken Brown: It’s one of the usual suspects. And then, when you start realizing how complex it gets after that. So one of the-
Dr. Kara Fitzgerald: Yes-
Dr. Ken Brown: I’ve given, I have a lecture that I’ve given to a couple functional medicine societies. And on a quick side note, I love lecturing to functional medicine, because I learn as much as I’m teaching. Like, the Q&A becomes, “Have you ever considered using this?” I’m like, “Never even heard of it. Why would I want to consider it?” Then somebody will tell me it, and I’m like, “I’m going to write that down. That is awesome. I am absolutely going to do that.” So the way that I describe it is, when we have this cascade, and we have all this intermingling of everything, unfortunately, I think you have traditional medicine doctors that stick their heads in the sand, and choose not to listen to terms like “bacterial overgrowth,” or “a leaky gut” or whatever. And then, you have this other population, which is the uninformed Internet population that reads a lot of things, which are probably not completely encompassing, let’s put it that way.
So we’ve got, this one group that’s sticking their head in the sand. We have this other group that is viewing it like this big, gaping hole coming through. Somewhere in the middle lies the real science. And I’ve met a lot of PhDs, and that is my next level, where I’m just fascinated by. I believe that we can actually help a lot of the systemic effects of the body, the brain health, all that, by protecting the intestinal barrier. So if we can do that.
So I’m talking to PhDs, that they are doing their research on one particular cytokine in the tight junction. And their whole life is this one Zonula occludens-1 or Claudin-A, or whatever. And you go, “Oh, my god, this is way more complex than what I’m trying to do. I’m just trying to explain a general concept.” So what I love is that, we’re knocking down barriers. And each barrier that you knock down, or each door that you walk through, you see 1,000 more doors. And you go, “Whoa, this is exciting,” that we are now on a new frontier here.
Dr. Kara Fitzgerald: But you know what? I absolutely agree with you. And I want to hear about your next-generation thinking. But before we jump too far ahead, I want to just circle back to Atrantíl. Because the fact of the matter is, it’s a really cool product. And when I found it a couple years ago, I was pretty dang excited. I was like, “Where the heck did this come from?” It looked creatively designed, and we brought it into our practice. I don’t keep actually many products here. We drop ship most of the things that we use to patients.
But I brought that in so that we would have it handy, because of course, we see this constipation SIBO all the time. And by god, it worked. And it’s true, as Pimentel was saying, our arsenal for how we can address it is so, so limited. So I was thrilled when I got wind of Atrantíl and started to use it, and saw some decent clinical outcome with it. So talk to me about what it is. Let’s go through the three botanicals and a little bit about them. And let’s start with quebracho. Or actually, you want to just say the overview of what the design is, and then we’ll pick it apart a little bit?
Dr. Ken Brown: Sure. So let’s go back to, it was the 10 years ago where we came across this. And Brandi came up to me and said, “We were using these, we were looking at different things in cattle feeds.” So what I was privy to was a lot of information, tons, thousands and thousands of pages. And that’s when we looked at different things, and we realized, “This person figured this out over here. This person figured this out in this country. This person figured this out.” Nobody had communicated and talked together.
But what we did is, we put the three ingredients together to work synergistically, to get rid of this particular problem. The three ingredients are peppermint leaf. And I want to qualify that, because there’s peppermint oils out there. But we needed the polyphenols in it. The key to this thing is polyphenols. So we needed the peppermint leaf, because we did not really want it to be the typical oil, to get ahead. Remember, when you have any type of liquid, you have what’s called a linear excretion from the stomach, meaning it is a predictable amount that will leak. When you have a solid, the stomach has to process it.
Dr. Kara Fitzgerald: Hmm-
Dr. Ken Brown: So we wanted-
Dr. Kara Fitzgerald: Interesting-
Dr. Ken Brown: All three ingredients to sort of be together. So the peppermint goes in there, the M. balsameas, the genus and species that we were choosing. What it does is, it calms the area down. The second ingredient is, by far, the most important, and the thing that we have run into the biggest issue is that, nobody understands what it is. It is the Quebracho colorado. This is-
Dr. Kara Fitzgerald: Yes.
Dr. Ken Brown: A very large, beautiful polyphenol known as a proanthocyanidin. It is a tannin. You have been probably taking Quebracho without knowing it, if you’ve ever had a beer or wine. It’s in certain foods. It comes from South America, and in our research when we were looking at this, it’s the only thing that has a natural defense against fungus and archaebacter.
Dr. Kara Fitzgerald: That’s fascinating-
Dr. Ken Brown: So it’s in the. Oh, it’s super cool. It’s from the bark of a tree in Argentina, called axe breaker. And it’s a very, very old tree, so it has a natural defense against these things. So nobody had ever put Quebracho colorado into a supplement before. So we were able to figure out, it’s already being produced for humans. We just.
Dr. Kara Fitzgerald: Wow.
Dr. Ken Brown: Were able to have this company produce it for us, in a very distinct extracted manner. And then, what that does is, that weakens the archaebacter, and the Conker tree is in there because it has a known ability to block the enzyme that produces the methane. So essentially, we calm the area down with the peppermint, the Quebracho works, it’s a very large polyphenol. It doesn’t get absorbed, and it works because it absorbs the fuel for the archaebacter. And it weakens the archaebacter. And then, the Conker tree comes in and stops the enzymatic production. So I knew that we were really onto something when I was at a meeting in Philadelphia a handful of years ago. And when I was really trying to launch this, and thinking, “We’ve got this idea, we have this whole thing.”
I found a very brilliant man, his name is Bruce Burnett. He helps us, and him and I have collaborated on some different things. He wrote this incredible article on, the only article I’ve been able to find, on the safety of polyphenols and flavonoids in intestinal health. And so, I’d tracked this guy down. I basically stalked him. I took him out to dinner. I got about halfway through this presentation, and he just goes, “I did my PhD on this. How did I miss this?” He goes, “That’s brilliant.” He’s like, “Let me help me in any way I can.” So he’s been with us ever since. But it was really cool, because I’m sitting there at dinner, throwing. You talk about feeling a little bit insecure. I mean, this guy’s a PhD that wrote the only review article on the one product that I’m going to tell him, and I fully expected him to say, “Oh, you missed this, this, and this.” He just went, “Dang, that’s good. I’ll help you.”
Dr. Kara Fitzgerald: Wow, wow. That’s just, it’s a neat story all around. So have they used Crevat, Ker, I’m not-
Dr. Ken Brown: Quebracho-
Dr. Kara Fitzgerald: Quebracho in animal feed? I mean, did they ever incorporate it? Or did they just do the preliminary research, it never made its way there? Just out of curiosity.
Dr. Ken Brown: No, they totally did. That’s what’s beautiful-
Dr. Kara Fitzgerald: Oh, they did. Okay, so that did
Dr. Ken Brown: They had…
Dr. Kara Fitzgerald: So okay-
Dr. Ken Brown: They had safety data. They had all this stuff-
Dr. Kara Fitzgerald: Ah, they did-
Dr. Ken Brown: Just there. It was absolutely beautiful. Now, Bruce actually was working for a company at the time, where they were doing something very similar, where they were taking bovine immunoglobulin and so-called EnteraGam-
Dr. Kara Fitzgerald: Yep-
Dr. Ken Brown: And so, it was just, it was very beautiful in how this just like, “Yo, just ..” It’s just weird. You sometimes wonder if there’s.
Dr. Kara Fitzgerald: It’s a small world-
Dr. Ken Brown: Well-
Dr. Kara Fitzgerald: Like, “What’s going on”-
Dr. Ken Brown: Is it a small world? Is it kismet? Is it fate? Whatever it is. Or is it just that you’re paying attention and you’re passionate, and you’re willing to make the phone calls and harass people enough till they quit ignoring you?
Dr. Kara Fitzgerald: Yeah. Yeah, that’s right. Well, a lot of us are using EnteraGam, too, believe me, in conjunction with your product. All right. So how are you dosing it?
Dr. Ken Brown: So the dosing that we, the initial studies that we did were really modeled after the Xifaxan studies. We know that, if you have significant bloating after you eat, and you’ve had it for maybe a period of time, I know that you may have a high bacterial burden. Doing two capsules three times a day, for 10-20 days, our clinical studies were for 14 days, showed that well over 85% of the people are really going to improve. The hardest part is, that we have, as you know, most patients want to take something and just get better. So even when we were doing the Xifaxan studies, Dr. Pimentel discovered that taking 220 milligrams was not sufficient. Taking it twice a day was not sufficient. He had an exponentially higher result by doing it three times a day. So based off those models, that’s kind of where we went with it, and we’re having similar results from our original studies.
We’ve been out for a little while now. I think we’re two years out. And I encourage all kinds of feedback. We have 100% money-back guarantee. I just want to know, “Did you take it right? Tell me what didn’t work.” I’m not telling you that I have the best thing in the entire world. I’m telling you that, as a group, as a tribe, we can figure this out. And if you learned something, I want to know about it. If my stuff doesn’t work on you, tell me. Because I want to figure out, “What is it about you that didn’t work?” So two, three times a day, for 10-20 days, until you feel better. Most people, at that point, either take it daily as a digestive supplement, for the polyphenol effect, or they just wait for symptoms to return. A small percentage of people will have a dysmotility disorder, where they’ll have to rotate it. But a lot of the people I did the original studies on, they’re still fine. So-
Dr. Kara Fitzgerald: Oh, that’s great-
Dr. Ken Brown: It was..
Dr. Kara Fitzgerald: And did you-
Dr. Ken Brown: It was super-exciting-
Dr. Kara Fitzgerald: Did you, I mean, you didn’t do, in your studies, you didn’t change diet. Is that correct?
Dr. Ken Brown: Did not change diet in the studies. I’m having better results with people. It’s funny. Maybe I’m having better results because it’s true. Maybe it’s because I’m a little bit passionate about certain diets. I have learned that I just feel better on a gluten-free diet, so I just tell my patients, “Look, I feel better on it. Maybe you should consider doing this.” And they get great results. So it’s both the product, and maybe they start thinking about their lifestyle. Maybe they start moving to something different. Maybe it’s bigger than just the product. Maybe we start getting people thinking functionally about what they’re going to do for the rest of their life.
Dr. Kara Fitzgerald: Right, right. Well, I mean, of course, gluten is one of the big “FODMAPs.” I mean, just the fact that you actually were successful without dietary change. And then, now you’re doing it with suggesting a gluten-free diet, and getting good outcome, I mean, we’re doing. I’ll put people on more restrictive diets than you’re doing. I mean, it’s just nice to hear that you’re seeing good outcome in what you’re doing.
Dr. Ken Brown: Yeah, I guess I’m a little bit, I’m being a little. I’m withholding, let’s put it this way. So the deal is that, the person I talked about earlier, Brandi, I ended up diagnosing her as being Celiac. So through the years, when we would go out to lunch, out of respect, we would go to a gluten-free restaurant, and I would eat gluten-free. And then I would come back to my office, to see the rest of the patients. And she pointed out to me, she was like, “Hey, we’re not doing the whole, ‘I’ve got to go back to the office like, right now,’ kind of thing.”
Dr. Kara Fitzgerald: Wow.
Dr. Ken Brown: And I’m like, “What?” And she’s like, “Haven’t you noticed that, since you quit eating gluten, you don’t have this like, panic moment”-
Dr. Kara Fitzgerald: Urgency-
Dr. Ken Brown: “Or you have to.” Yeah, and so, I was in complete denial of the fact that, half the time I was seeing people in the afternoon, and I felt worse than they did. And they were making an appointment to see me.
Dr. Kara Fitzgerald: Wow.
Dr. Ken Brown: So the whole gluten-free thing hits a little too close to home. And I’ve talked to a lot of people about that, where I’ve talked to. I have a lot of triathletes, high-end athletes. And we start talking, and they’re like, “Yeah, when I get into a race, and I start taking my supplement, I have to pull over and use the Port-A-Potty and whatever.” Then, we start, you start realizing, “Oh, what you take in does that.” So as long as I eat gluten, or if I’m going to eat gluten or cheat, I can have a little Atrantíl and I can actually have some gluten, with no issues. So we know that there’s some component with that.
Dr. Kara Fitzgerald: That is pretty neat. That’s actually a really nice way to consider using it. Are you ever suggesting to patients who’ve got really, really. I mean, methane SIBO is a pain in the butt, quite frankly. I mean, so are you ever going higher than the two three times a day? Have you experimented-
Dr. Ken Brown: That’s-
Dr. Kara Fitzgerald: That a-
Dr. Ken Brown: That is a great question. Because my whole practice right now is essentially an ongoing case study. What I get are people that have. I mean, forever I had this ace in my hole, where I could just, when nobody knew about it. They’d make an appointment, and they’d come to me. Patients would come to me, and they would be labeled as irritable bowel. And the first thing I’d say is, “I don’t believe in IBS. We’re missing something. What are we missing? Is it food sensitivity? Is it bacterial overgrowth? Is it an occult Crohn’s? Is it Celiac?” Whatever. But they loved to hear the fact, they’re not going to dismiss them. Well, the evolution of my practice is, they’ve already seen everybody else, and they show up holding my box. And they’re like, “I’m still sick. What are you going to do now?” And so, we’ve gone through a bunch of different things, where we’re looking at it.
Certainly, I’ve had, let’s just, I’ll throw out really quick, and we can talk about this in a minute. But like, I’ll have a breath test where, somebody will have a very high methane level early on, or very late. And I’ll realize, “Okay, that tells us where the bacteria is growing. Let’s modify what we’re doing. You’re going to need a higher dose or more repetitive dosing.” So I had multiple people that have actually, they keep coming to me, because they’ve been every place else, or whatever. And I’m still willing to try. I mean-
Dr. Kara Fitzgerald: Yes, yes-
Dr. Ken Brown: All of a sudden, it’s just like, a month into it, they’re like, “Hey, doc. You’re not going to believe it, but it’s finally kicking in.” It’s like, “Really?” And I’d just say it with as much confusion. I’d just look at them and go, “Well, good. I’m excited. But that’s fascinating.” And so, we’re just trying to collect the data on all this. And then, other people that have, that don’t get better at all, that I find out that they’re having methane peaks really early on. Maybe the drugs or maybe the product is not dissolving quick enough, making Xifaxan, Neomycin, you know, whatever.
Dr. Kara Fitzgerald: Okay, so then, so it’s worth trying a higher doses in, three times a day. But then, we might also suggest to somebody, “Why don’t you take one capsule every hour”? I mean, like, how would I think about it? When I hit somebody who’s really refractory? I mean, do you actually-
Dr. Ken Brown: Okay-
Dr. Kara Fitzgerald: Have them open up the capsule, if you want to improve the immediate impact? I mean, I don’t know. Just like, give me some ideas. Because I know folks are wanting it. Actually, I am, and for my practice. So I just want to pick your brain. What do you-
Dr. Ken Brown: So-
Dr. Kara Fitzgerald: I mean, well, what do you suggest?
Dr. Ken Brown: All right, so everything comes down to, the same thing we were taught back in medical school. It all comes down to history, right? “So let me hear what’s going on. Let’s talk about what’s happening. Are you getting any relief from your bloating?” Number one, “Do you bloat after you eat?” And I have a lot of people that they’re like, “No, no, no. I’m bloated all the time. Look, I’m bloated.” And they grab themselves, and you’re like, “Okay.” And then, we start realizing there could be other things going on. I have a lot of people, I have all kinds of other diagnoses, carcinoid tumors, strictures, things like that, that they’ve been labeled IBS. And I kind of feel it’s my job to make sure that we don’t miss something. And I’m finding some weird stuff. So let’s exclude all those people-
Dr. Kara Fitzgerald: Yeah, exclude-
Dr. Ken Brown: Where I do-
Dr. Kara Fitzgerald: The zebras-
Dr. Ken Brown: Yeah, exclude-
Dr. Kara Fitzgerald: Yeah-
Dr. Ken Brown: The zebras, yeah. So now, we’re back to these people that really sound, and they look like a SIBO person. They quack like a SIBO person, they’re clearly a SIBO person. So why aren’t they getting better? That is when I actually institute my breath test. I don’t start with the breath test, because if they really act like somebody who is a SIBO person, then the breath test-
Dr. Kara Fitzgerald: Just treat it-
Dr. Ken Brown: A recent. Well, unfortunately, a recent. At the end of last year, there was a consensus statement by Dr. Pimentel and William Chey and Dr. Rao, and all these guys that are kind of thought leaders in my field. Their consensus statement on bacterial overgrowth breath tests was, ultimately, there’s a lot of heterogeneity with the tests. The sensitivity and specificity is all over the map, and there’s so many variables that can affect it, but it’s the best thing that we have. So I don’t completely hang my hat on it, but and what I really like to do is, the person that is disciplined enough to go through everything. They’re not getting better, that’s when I like to do it. And then, we can determine those things. Like, “Do you have a high peak? Is this?”
Dr. Pimentel will say that, if you have a methane positive, then the sensitivities goes way up. Other than that, it’s kind of variable. But I can at least sit there and go, “Okay, look, you’re at least having a peak very late. Maybe we need a higher dose for you. Maybe we need more frequent dosing. Maybe we need adjuvant therapy.” So Atrantíl plus Neomycin, if it’s methane. If it’s a hydrogen producer, Atrantíl plus the Xifaxan, if we want to. Those are the two pharmacologic agents that I can use. We always talk about, “Okay, maybe we’re getting rid of the bacteria during the day. But when you go to bed at night, you don’t have that housekeeper phenomenon, or the phase three contraction.”
So that’s one of the premises that Dr. Pimentel described originally, that you can have this area of your small intestine that doesn’t move when you sleep. Every time we go to bed, we have this big rapid contraction of the stomach, down to the colon, the housekeeper. Well, if you don’t have a housekeeper, then bacteria can grow. So you might want to add a motility agent when you go to bed at night, Azithromycin, used to use Zelnorm. Some of the functional medicine doctors liked using Iberogast. Those are a few little tricks. And then, since I’ve been going around lecturing a little bit, I’ve met some fantastic people. There’s a guy named, and an author and a big Paleo expert named Robb Wolf. And I did Robb’s podcast, and him and I, we kept in contact. And he contacted me and said, “Hey, I’m having really good success with Saccharomyces boulardii plus Atrantíl.”
Dr. Kara Fitzgerald: Yeah.
Dr. Ken Brown: And I went, “Wow, that’s so interesting. I’ve never thought of that.” And then I found, I went to a meeting. I think you had JJ Virgin on your show. She’s head of a group that I belong to, where it’s just healthcare entrepreneurs. And I met a New Zealand, a naturopath, who her specialty was in Saccharomyces. And she took the opportunity to explain, oh, how well Saccharomyces would augment Atrantíl, because it works in secretory IgA. I went, “Oh, my gosh,” now we’re starting to have this whole, “If the physiology matches, then we can fix the pathophysiology.” And I’m not playing the knee-jerk reaction, “Show me the studies.” I’m saying, “That makes sense. Let’s try it. It’s safe, it’s been there.” So-
Dr. Kara Fitzgerald: Well, and incidentally, there actually are some studies on Saccharomyces and IgA. But yeah, no I appreciate you moving beyond, not dismissing it based on the I. S.
Dr. Ken Brown: Yeah. Yeah, so she came up with some great data on this whole IgA and Saccharomyces. And I’m like, “Oh yeah, that makes total sense.” So it’s a moving pendulum, and I want to learn. I mean, I want to continue to-
Dr. Kara Fitzgerald: Absolutely-
Dr. Ken Brown: Develop things, and every time you. I mean, you probably see it, when you do meetings, when you have podcast guests. You probably learn a ton.
Dr. Kara Fitzgerald: Yeah, absolutely. Well, that’s why I’m sitting here picking your brain. I mean, believe me. And I’m about to summarize. Okay, so you’re using Atrantíl in both hydrogen and methane producers. Sometimes, if they’re hydrogen, and they’re not responding to Atrantíl alone, you might add Xifaxan. You’ll add Neomycin if it’s indicated. And now, you’re practicing Atrantíl with, you’re trying out Atrantíl with Saccharomyces, as Robb Wolf has done and this Australia ND. And you’re-
Dr. Ken Brown: Mm-hmm (affirmative)-
Dr. Kara Fitzgerald: Also considering higher dosing and more frequent dosing of Atrantíl. So did I kind of corral together what you’ve-
Dr. Ken Brown: Correct-
Dr. Ken Brown: Yeah, yeah-
Dr. Kara Fitzgerald: Perfect-
Dr. Ken Brown: It’s a completely moving target. And then, the next layer that we’re getting into is, the whole idea that SIBO creates inflammation,
Dr. Kara Fitzgerald: Yes-
Dr. Ken Brown: Inflammation mess with mast cells, mast cells release histamine, and tryptase, and all this. And so, every time I get around anybody who’s an expert in this, I just pick their brain. And so, histamine, I was, this past meeting I was at, there was a fantastic person who has a website called Healing Histamine, Yasmina Ykelenstam. And she suffered from it, and it’s so fascinating that when somebody suffers from something, even if they don’t have a medical background for it, that’s the, you have to learn it. Otherwise, you’re going to die. And so, she’s got this website that kind of explains that, so now I’m getting into the whole aspect of, “How do we stabilize these mast cells? And how do we”-
Dr. Kara Fitzgerald: And what are you looking at, out of curiosity?
Dr. Ken Brown: Well, there’s, we’ve got quercetin, luteolin, and then we’ve got cromolyn sodium, which is gastrocrom. We’ve got some different histamine markers-
Dr. Kara Fitzgerald: Have you-
Dr. Ken Brown: That-
Dr. Kara Fitzgerald: Have you experimented with diamine oxidase? I’m sure she talked to you about that.
Dr. Ken Brown: She did, and I have not. Diamine oxidase, I’ve just viewed as a lab test. Can you get it as a-
Dr. Kara Fitzgerald: Mm-hmm (affirmative)-
Dr. Ken Brown: Supplement?
Dr. Kara Fitzgerald: Yeah. Yeah.
Dr. Ken Brown: Really?
Dr. Kara Fitzgerald: Yeah, you-
Dr. Ken Brown: Okay-
Dr. Kara Fitzgerald: Sure can. Yeah, in fact, I think its original research again, was in animals, animal. I don’t know if it was ruminants, but some kind, it was animal feed. But yeah, diamine oxidase is available. Incidentally, speaking of research tests, is there any time that you’re considering actually doing the Pimentel’s antibody tests, the IBS Check Test? Have you used that at all like-
Dr. Ken Brown: Oh, yeah. Yeah, totally. Yeah, yeah. Yeah, yeah. So what you’re referring to is the IBS Check Test. That’s the anti-vinculin, and the anti-CDT antibodies. So basically, what I said earlier was that, you can have SIBO due to an infection, to antibiotics, or a stressful situation. He discovered that, when you have an infection, salmonella, shigella, something like that, the body produces antibodies. So if you were to visualize this: Imagine the thing that I mentioned earlier, the dendrites. So if you get a shigella infection, your dendrite reaches up, grabs it, hands it to a B cell. The B cell sounds the alarm, and goes, “Oh, my gosh, this is a pathogen, mobilize the forces.” Hands it to his T cell, memory cell, and the beautiful cascade of the immunology happens. And then, an antibody is made. That antibody are these soldiers that gets released. So now, we’ve mobilized our troops, the soldiers are out there. And they kill all the shigella and they save our lives. That’s fantastic.
What’s really odd is that, on our pacemaker cells, that’s the electrical current from point A to point B, they have similar structure to the shigella. So we have these soldiers that are so excited to kill these organisms, that they run around and they go, “Ah, this is awesome. We finally got mobilized.” And then they look over at these electrical towers that kind of look like the organism they were fighting. And they attach to the tower. So now, those antibodies prevent the current to go from point A to point B. That is a fascinating theory, that, essentially, that’s autoimmune disease in a nutshell. We used antibodies. Nobody talks about it, but it is essentially, the IBS Check is the antibodies for that. The problem is that, it’s only about 20% of the people that have the infection-
Dr. Kara Fitzgerald: Right-
Dr. Ken Brown: So 80% of the people won’t do that. I like it when I needed to sit with somebody and go, “Why do I have recurrent bouts? Why do I take it, I’m good for 2-3 months, and then, pow, it comes back?”
Dr. Kara Fitzgerald: Yes.
Dr. Ken Brown: That’s when I can sit there and go, “Look, unfortunately, you have antibodies being produced that tried to attack your cell towers. They try to attack your electrical towers. And over time, it allows the bacteria to grow again.” So it’s more of a test that I use to say, “Look, this is”-
Dr. Kara Fitzgerald: Like-
Dr. Ken Brown: “The battle that we’re going to have to fight. Periodically, we’re just going to have to treat this. You are not doing anything right or wrong as an individual. You have antibodies.” Nobody looks at a rheumatoid arthritis person and says, “You’re doing something wrong.” It’s, your body’s attacking your joints. Crohn’s person, “Your body’s attacking your intestines.” “In this particular case, your body’s attacking your electrical current cells in the intestines, and allowing bacteria to grow.”
Dr. Kara Fitzgerald: Got it. So that’s like, a tertiary investigation. I mean, when it first came out, I was pretty excited about it. And I tried it on a number of patients, and I’ve never seen a positive. But you’re saying that, maybe 20% of people will show up. And you really only want to consider it in people who are super-refractory.
Dr. Ken Brown: I give it to the people that are-
Dr. Kara Fitzgerald: Or relapse, yeah, okay-
Dr. Ken Brown: Yeah, relapsed. Yeah. And this is what we can, and that gets into the whole, “Make sure you don’t have any structural problems.” At some point, you got to get an x-ray on them. Make sure they don’t have any duodenal diverticulum, jejunal diverticulum, which allows it to grow. Make sure that they don’t have an altered anatomy. A Roux-en-Y gastric bypass will do it. Make sure that they’re not severe diabetics. All these things predispose to recurrent SIBO. SIBO’s become kind of the new thing that we, or I guess a lot of patients have labeled themselves with. But-
Dr. Kara Fitzgerald: Yes-
Dr. Ken Brown: SIBO, when I was in training, was really limited to a very small percentage of people. And it was those that would qualify, by having altered anatomy, severe diabetes, possibly scleroderma, things like that. So.
Dr. Kara Fitzgerald: Do you think that there’s an actual true increase in the incidents of SIBO, or we’re just putting our spotlight on it?
Dr. Ken Brown: Oh, boy. Okay. So we’re going open up this point.
Dr. Kara Fitzgerald: In our last few minutes, I’m actually. But you’re just throwing out really. The other question I have is: I mean, are you accepting referrals? I mean, it sounds like you’re a really good diagnostician.
Dr. Ken Brown: I don’t know. I don’t know if I’m a good diagnostician. I think what I am is, I’m a good non-
Dr. Kara Fitzgerald: You’re thorough-
Dr. Ken Brown: Dismissal doctor. I will at least listen and try. And then, I feel really bad if I can’t figure it out, because. But what the beauty is, like when I go to a meeting like this, I sat there and I hate to sit there and talk shop the whole weekend. But whenever I get a chance to meet with, I was telling you before we started, that there was a lot of IFM doctors there. And I’m like, “Oh, my gosh, tell me what you do with that.” Like you were saying-
Dr. Kara Fitzgerald: I love that..
Dr. Ken Brown: You use diamine oxidase? yes”-
Dr. Kara Fitzgerald: Yeah-
Dr. Ken Brown: “I’m going to use that. That’s awesome.” I do believe that we are seeing tons more of this.
Dr. Kara Fitzgerald: Yeah.
Dr. Ken Brown: And we can, I do not to want to be the conspirasist or the, any of those any things. But we can’t just even begin to discuss the way that we manufacture our food. And let’s talk about the amylase tryptase inhibitors that we put in the GMO foods, which have now been shown to cause intestinal permeability. And we now know that the gluten results in zonulin production, which causes intestinal permeability.
Dr. Kara Fitzgerald: Yes.
Dr. Ken Brown: All these things results in inflammation. So I think that it is going to get worse before it gets better. I was in, I took my family to Spain this summer. And I was just absolutely shocked. I’m walking around, and it seemed like 70% of the people were smoking, and they weren’t obsessed about their weight or anything like that. And they were eating dinner at night, and we’d wake up and have breakfast, and it was bread and cured meats and cheese. And then, you’d come back and you realize, “We, Americans, have the highest diabetes, coronary artery disease, cerebrovascular.” And I just kind of came back from a country where they were chain smoking and eating at midnight, and outliving us? What’s going on with that? It’s something.
Now, one of the things I did look into is the polyphenol content between the two countries. Spaniards typically eat about 10 times as much polyphenols as we do. And I believe that the polyphenols, which is what makes up Atrantíl, those are the molecules in the Mediterranean Diet, which have been shown to be the anti-aging, anti-inflammatory, and basically, anti-everything. Then, we open packages, which are filled with refined carbs and all this other stuff. And other countries eat colorful foods.
Dr. Kara Fitzgerald: Right, right. Right.
Dr. Ken Brown: And I think that, it all comes down to, your health starts in the gut. You don’t really need to take supplements. You don’t need to do anything, if you’re eating appropriately so.
Dr. Kara Fitzgerald: That’s a really great point. So your money’s on polyphenols. I just, I’m absolutely thrilled with this cool story on Atrantíl. But you know what? As we just come to our close here, I just. You’re buzzing with ideas. I love it, I love to see somebody, especially with your research background, jump into our world and start fusing the two of them. Because you’re going to come up with some cool ideas. So where are you headed in the research world? What are you thinking about right now?
Dr. Ken Brown: Kara, I got to tell you. I went to a functional medicine meeting, and I heard Alessio Fasano, who I’m sure you-
Dr. Kara Fitzgerald: Yeah, there you go-
Dr. Ken Brown: Will know.
Dr. Kara Fitzgerald: Sure.
Dr. Ken Brown: He talked about the epidemic of obesity and autism. And he linked that to intestinal health. And then I go to Paleo f(x), and I listened to David Perlmutter, who wrote Grain Brain. And he has all this data about dementia and gut health. My passion right now is really, heading towards brain protection. I’ve got friends that have played in the NFL, I’ve got friends that have children with autism. I’ve got family members with dementia. If I could sit there and just tie that one thing in, where we can help some of those people, my next. My next product or my next research, wherever this goes, is really going to be about brain health. And that means cradle-to-grave. Let’s, why is there an autism epidemic-
Dr. Kara Fitzgerald: Yeah, but-
Dr. Ken Brown: Why is there a dementia epidemic?
Dr. Kara Fitzgerald: Brain health, do you mean, are you looking like, if you’re going to go to the, into the gut? I mean, are you talking about a product for intestinal permeability, and in so doing, preserving the brain? Or are you actually zooming towards things that are going to be crossing the blood-brain barrier? I mean, are you moving out of your realm of gastroenterology into neurology? Or are you thinking about addressing brain health through the gut?
Dr. Ken Brown: Addressing brain health through the gut.
Dr. Kara Fitzgerald: Cool.
Dr. Ken Brown: Teaming up with some other people that can sort of fill in the gaps specifically, yeah. I’m not-
Dr. Kara Fitzgerald: Well-
Dr. Ken Brown: A neurologist, but I do realize that, when you go to lectures and you watch people that are, like Perlmutter. And he says, “It all comes down to the gut”-
Dr. Kara Fitzgerald: Yeah, yeah, yeah. Exactly-
Dr. Ken Brown: And you’re just like, “Wow, I”-
Dr. Kara Fitzgerald: Well, and you know what? Researching a product for permeability that you actually really get some solid biomarkers and show baseline and then follow-up, and you’re looking at maybe zonulin and lactulose mannitol, whatever you think are-
Dr. Ken Brown: Yeah-
Dr. Kara Fitzgerald: The gold standards for addressing it, I mean, rock on. Believe you me, we will all be paying attention. So I hope that’s where you go.
Dr. Ken Brown: The fun part about this experiment. And I mean the experiment, meaning I did clinical research, developed this product, having some fun. I learned a lot about myself. And what I really realized is, is that, I love the pursuit of something that can make a difference.
Dr. Kara Fitzgerald: Yeah.
Dr. Ken Brown: I joke around. Because I have a…Atrantíl has become a company. And I’m smart enough to know I’m stupid, so I hired a CEO and a Director of Operations. And it’s very funny, because I think I frustrate my team at times. Because I’ll do this, I’ll be like, “Oh, my god. I went to this lecture and I saw this thing, and we need to think about this.” I’m just like, “Whoa.” “Youhave like, people depend on this, we have to, we’re like, 20 people that are working for us now. You got to pay them and the bills,” and I’m like-
Dr. Kara Fitzgerald: “Stop it”
Dr. Ken Brown: “Oh, yeah, yeah.”
Dr. Kara Fitzgerald: No, I’m sure they appreciate it.
Dr. Ken Brown: Yeah, so there are advantages to a little ADD, a controlled amount of ADD.
Dr. Kara Fitzgerald: Yeah, yeah. Absolutely. Absolutely. That’s how things get done. And Dr. Brown, it’s been such a pleasure to meet you. And I am a fan of the product. I do, I think it works. And I enjoy the, I’m appreciative of these new little pearls to think about, in conjunction with it. And I look forward to meeting you in person, maybe at the IFM Annual Conference. I’m always there. And I’ll be paying attention to what you guys think of next.
Dr. Ken Brown: Dr. Fitzgerald, thank you so much for having me on your show. And yeah, we’re 100% going to be at your annual conference. I was mentioning to you that, I think the topic this year is about gut…
Dr. Kara Fitzgerald: It is-
Dr. Kara Fitzgerald: Oh, yeah, yeah, yeah.
Dr. Ken Brown: I’m showing up with bells on there, so.
Dr. Kara Fitzgerald: Wonderful. All right.
According to the Atrantil website, conker tree extract is a “Saponin/flavonoid, a natural antibacterial from Horse Chestnut (Conker Tree extract), reducing methane production. It binds to the reductase enzyme in the weakened archaebacteria—stopping methane production.”
This is fine and good, but unfortunately, studies are NOT supportive of saponins in preserving the integrity of the intestinal barrier:
That last article had this line:
“Uptake of compounds that are normally not absorbed, especially macromolecules, could possibly enhance allergic responses. In fact, Atkinson et al. (1994) gave Gypsophylla saponins to rats and this evoked an increased sensitization to oral allergens.”
So we might fix one thing with Atrantil, but then we potentially create a new problem: leaky gut and increased food sensitivities.
The benefits of Atrantil should be weighed against the risks in the individual patient, and the period of time it is employed would also be a consideration. I would hesitate to give this dietary supplement to an autoimmune patient.
Thank you for your thoughtful and well-researched comment.
As with any FxMed approach, we always want to consider the whole picture when deciding on treatment. I have to note that in practice, we’ve noticed this approach has been helpful for us for difficult cases. When considering treatment options, considering the effect of SIBO and dysbiosis and the negative impacts on intestinal integrity, so as you suggested the benefits of using saponins may still outweigh potential risks.
Saponins are also one naturally-occurring food component among many that modulate intestinal permeability, sometimes with beneficial effects in otherwise healthy individuals – see our current list is here: https://www.drkarafitzgerald.com/2016/08/01/expanding-our-view-on-leaky-gut-beyond-the-onoff-idea/
Thank you for your helpful response, Kara. There is no doubt that intestinal permeability is an ever-changing phenomenon, depending on the person’s dietary inputs, stress, infections, and many more factors as you pointed out in your excellently written post.
The following comment relates to your referenced blog post on intestinal permeability. I was wondering why vitamin C was listed in the “increase intestinal permeability” column. I read your referenced paper in its entirety (the abstract of which is found here: https://link.springer.com/article/10.1007/s00535-011-0471-1) and then looked up what was in the Abbott Nutrition Osmolite® formula. The authors didn’t specify which of the two versions was used, but in any case, there are a lot more ingredients besides vitamin C in either of the currently marketed formulas.
Here are the ingredients in Osmolite® 1.5 CAL (https://abbottnutrition.com/osmolite-1_5-cal):
Water, Corn Maltodextrin, Sodium & Calcium Caseinates, High Oleic Safflower Oil, Canola Oil, Soy Protein Isolate, Medium-Chain Triglycerides, Magnesium Chloride, Potassium Citrate, Calcium Phosphate, Sodium Citrate, Soy Lecithin, Choline Chloride, Ascorbic Acid, Taurine, L-Carnitine, Carrageenan, Zinc Sulfate, Ferrous Sulfate, dl-Alpha-Tocopheryl Acetate, Niacinamide, Calcium Pantothenate, Manganese Sulfate, Copper Sulfate, Thiamine Hydrochloride, Pyridoxine Hydrochloride, Riboflavin, Vitamin A Palmitate, Beta-Carotene, Folic Acid, Biotin, Chromium Chloride, Sodium Molybdate, Potassium Iodide, Sodium Selenate, Phylloquinone, Vitamin B12, and Vitamin D3.
And here are the ingredients in Osmolite® 1.2 CAL (https://abbottnutrition.com/osmolite-1_2-cal):
Water, Corn Maltodextrin, Sodium Caseinate, High Oleic Safflower Oil, Calcium Caseinate, Canola Oil, Medium-Chain Triglycerides, Calcium Phosphate, Sodium Citrate, Magnesium Phosphate, Soy Lecithin, Potassium Citrate, Potassium Chloride, Magnesium Chloride, Cellulose Gel, Ascorbic Acid, Choline Chloride, Potassium Phosphate, Taurine, L-Carnitine, Cellulose Gum, Zinc Sulfate, dl-Alpha-Tocopheryl Acetate, Ferrous Sulfate, Niacinamide, Calcium Pantothenate, Manganese Sulfate, Copper Sulfate, Thiamine Hydrochloride, Pyridoxine Hydrochloride, Riboflavin, Beta-Carotene, Vitamin A Palmitate, Folic Acid, Biotin, Chromium Chloride, Sodium Molybdate, Potassium Iodide, Sodium Selenate, Phylloquinone, Vitamin B12, and Vitamin D3.
Because of the complexity of these nutritional formulas, I think it would be inappropriate to draw conclusions from this research study regarding the specific effect of ascorbic acid on the intestinal barrier. Moreover, it is unlikely that the ascorbic acid component had a negative effect, since polymeric formula (PF; Osmolite® by Abbott Nutrition) “is as effective as IFX [infliximab] and more effective than HC [hydrocortisone] in rescuing intestinal tight junction integrity and preventing barrier dysfunction by maintaining normal TEER, Isc, permeability and the morphological distribution of tight junction proteins in the presence of the inflammatory cytokine TNF-α. This provides an elegant explanation as to why mucosal healing is achieved with IFX and nutritional therapy, but not with corticosteroid therapy.”
If you are aware of any studies that demonstrate a negative effect of vitamin C on the intestinal barrier, I would be very interested in learning about them. Thank you for your blog – it is such a great service to practitioners.
Thanks so much for reaching out, and so sorry to hear you’ve been having a hard time. I would suggest working with a Functional Medicine practitioner – begin with the Institute for Functional Medicine’s (IFM) website under the “find a practitioner” tab. I popped in Detroit and was able to find a list of Functionally trained practitioners: https://www.ifm.org/find-a-practitioner/?location=detroit%2C+mi&country=US&rad=150&pos=
We also offer remote nutrition consultations if you’d like to work with a nutritionist familiar with MTHFR/methylation disorders. She would be able to work with you on a comprehensive plan and potentially collaborate with a physician locally to help co-manage your care. Please Email FrontDesk@drKaraFitzgerald.com if you would like to learn more.
— Lara Zakaria RPh MSc CNS CN CDN
I loved this interview! Such insight and humility! Great clinical application, thank you!
Thank you Sarah! I’m glad you enjoyed it.
I would love to see a discussion of how research on ruminants applies to the human gut. I would think there are considerable differences in how food is processed.