In this episode, I am speaking with Peter Kan, DC – who is board-certified in integrated medicine, functional medicine, and a board-certified chiropractic neurologist. He’s the creator of Neurometabolic Integration, a science-based virtual coaching program that helps clients identify the root cause of autoimmune and other chronic conditions. We will talk about the three major drivers of illness and how to fix it.
Table of Contents
In this podcast, Dr. Kan and I discuss:
- The link between the brain, the immune system, gut health and illness
- The biggest problems with the current reductionist approaches to treating disease
- How real health solutions need to address root causes founded in lifestyle issues, not just address symptoms. (And why “a pill for an ill will never work”)
- The brain-gut axis – and how its dysfunction can cause fatigue
- The biggest mistakes people make when trying to heal their brain-gut axis
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Transcript
Ari: Hey, there. This is Ari. Welcome back to The Energy Blueprint Podcast. I am very excited for today’s guest. His name is Dr. Peter Kan. He supports and manages clients with chronic conditions using a comprehensive approach by merging the exciting advances for functional neurology and functional medicine. Dr. Kan is board-certified in integrated medicine, functional medicine, and a board-certified chiropractic neurologist. He’s the creator of Neurometabolic Integration, a science-based virtual coaching program that helps clients identify the root cause of autoimmune and other chronic conditions. Over 5,000 clients from around the country have come to see about his holistic approach that is changing the lives of those suffering from chronic conditions. Born in Taiwan and immigrated to America at the age of 13, he has a deep appreciation of Eastern wisdom and Western advances in natural healthcare. He believes in the God-given ability of the body to heal and regulate itself, which I can certainly get on-board with. Amen to that. Welcome to the show, Dr. Kan. It’s such a pleasure to have you.
Dr. Kan: Ari, it’s a pleasure to be on this interview with you. Thank you for just the opportunity.
The most common causes of chronic illness
Ari: Yes. Absolutely. Let’s get started with the first question, which is what are the most common symptoms that you find across the board, universally, in patients suffering from chronic conditions of various kinds, whether autoimmune or neurological conditions, or any other kind of conditions? What kinds of symptoms do you see?
Dr. Kan: Yes. That’s a great starting point because as I manage– I’ve done this for a long time. I manage over 5,000 clients in just the past 12 month, a very busy practice. With that, I had a lot of chance to observe and learn. When you really pay attention, my practice is a chronic conditions practice. People show up with Lyme disease, people show up with mold toxicity, a lot of autoimmune cases, thyroid, Hashimoto’s.
The common denominator between anybody who comes in with, “I have a problem that hasn’t been solved,” is that they have these symptoms that are clustered around brain, immune, and gut symptoms. Here’s a picture of somebody. They will show up with brain symptoms. These brain symptoms will be things like fatigue, brain fog, anxiety, short-term memory loss, can’t focus, can’t concentrate. They may even have neurological symptoms like numbness, tingling, or balance problems. They have lists of these brain symptoms. They may have gone to a neurologist, a medical neurologist. They may have gone to a functional medicine doctor who’s trying to figure this stuff out for them. So, they have brain symptoms.
Then, no matter what their diagnosis are, they often have immune system challenges. These are people either they have chronic infection that came clear like chronic viruses like Epstein Barr, and herpesviruses or they have parasites, or they have some type of chronic inflammation. They have chronic pain, or they have some autoimmune disease, or weird reactions to chemicals, or food, and so forth. Those are immune system problems. Very common among these people with chronic condition, no matter the diagnosis.
Then the last category will be digestive symptoms. They all have gas, bloating, reflux, heartburn. Well, not all of them have reflux heartburn, but certainly gas and bloating is really common. Many of them complain of SIBO. Now, it’s like, everybody has SIBO, or they think they have SIBO, or everybody think they have candida.
Before there was SIBO, there was candida. Everybody think they have candida. Everybody got to do their low candida diet. Then, SIBO came along. Everybody think they have SIBO. It doesn’t mean that people don’t have SIBO, but I’m just saying, I think, a lot of times, people self-qualify themselves into that category. Maybe they do, maybe they don’t, but certainly, have had digestive issues and food sensitivity reaction.
As I start to evaluate these people, these are the three most common sets of symptom, brain, immune, and gut. That gave me this big idea. I’m always one for dad jokes and puns. Brain, immune, gut, the acronym is BIG. Really, that is the big idea, though because in healthcare these days, we talk a lot about the brain-gut connection– well, the gut-brain connection, depends on who you talk to, which way you want to order it, but I feel like the immune system is really the go-between those two.
That’s not talked about very much. I feel people need to really have a bit bigger appreciation of the big picture [chuckles] is bigger than they even thought and that there’s these common symptoms where they may think they have SIBO, but the SIBO may not be a digestive problem for them, it may be a brain-related problem, like a vagus nerve issue, or they may have autoimmune disease. They may be– It’s not just an autoimmune problem, maybe it’s involved with the brain and the gut as well.
So, I seek to help people understand that there’s a connection between the brain and the gut symptoms. They’re not crazy. It’s not like they have 20 problems. They may have this missing link that can explain why they have brain immune gut symptom all at one time.
Ari: Why is there this common set of symptoms that you see in so many people with different conditions?
Dr. Kan: The reason for having brain immune gut symptoms is again, back to the big idea that there’s this brain-immune-gut axis. A lot of people talk about as you talk a lot about the HPA axis. We have the hypothalamus thyroid axis. Then, people also talk about apply that to brain and there’s that gut-brain axis.
When there’s a axis, we mean that there’s a feedback loop. There’s some type of communication between one organ and another. I started calling it the brain-immune-gut axis instead of just the brain-gut axis, or the gut-brain axis because the immune system is really, at the end of it, is kind of interplay between the brain and the gut.
What I mean by that is the brain and the gut communicate through hardwired neurological pathways. We can use the vagus nerve as an example. There are other nerve innovations and so forth. There’s hardwired neurological innovations. There’s also lymphatic system in connections between the brain and the gut. Really, a lot of how the brain and the gut communicating with each other though is through messengers. These are peptides, neuropeptides, endorphins, bradykinins, and even inflammatory cytokines.
These inflammatory cytokines, at the end of the day, is really what, really the communication between the gut and the brain. For example, a common thing that we say is leaky gut leaky brain. What’s the reason for leaky gut leaky brain? Is it because somehow your gut gets inflamed then you brain just magically gets turned on? Well, no. It’s really the inflammatory cytokines that are at play here.
We know that the gut, the architectural structure of the gut, the cyto structure of the gut is very similar to the cyto structure of the blood-brain barrier. They both have occludin and zonulin and claudins. They both have the actin-myosin network. When you develop antibody and leaky gut, when you have antibody to zonulin and antibody to actin, that same antibody is not just sitting in the gut, because every time your heart pumps, the blood is flushed throughout the entire body. So that antibody circulates and when it meets the blood-brain barrier and they see the same tissue, actin, myosin, and zonulin, the antibody is going to say, “Oh, this is something I was born and trained to attack. I’m going to attack it.” That’s why we say leaky gut leaky brain and this brain-gut connection. Many of these are mediated by inflammatory cytokines and other times by literally hardwired neurological connection such as the vagus nerve.
So, when somebody says they have SIBO, or chronic candida issue, we want to ask bigger questions, “Is this really just purely that you have SIBO and we need to take antibiotic or natural antibiotic microbial to wipe out all the bad bacteria in your gut? Is that you may have some brain dysfunction that’s causing decreased vagus nerve function, therefore you have lower motility, so things just sits there and for men, that’s why you have SIBO?”
If that’s the case, then you can take antibiotic and natural anti-microbial all day, it may not clear up for you because the brain is a contributor to the gut problem. It’s all about just stimulating people to ask better questions to arrive at a better answer because if you keep doing the same thing over and over again, it’s not helping, then you better have backup plans an alternative to explain why you have that symptom, instead of just doing the same thing and not getting results.
Why modern medicine approaches are too narrow
Ari: I think this whole topic is really interesting and needs more awareness around it. The fact that there are so many common symptoms across the board of many different conditions. I’m thinking on the fly here and I want your commentary on this paradigm that I’m going to present here. I think on the one end, you can think of conventional medicine. If you picture a spectrum, one end of the spectrum, you have conventional medicine and their take on disease is, generally speaking, to find the one aberrant biochemical pathway that’s “the cause” of Alzheimer’s disease or of diabetes or of this autoimmune disease or that autoimmune disease.
They’re looking for one or two specific biochemical pathways that have gone awry and then the goal is to develop a drug that interferes with that aberrant pathway, and therefore, with the idea that that’s going to resolve the issue. As an example, there’s many possible examples we can give. Depression is a good example where they kind of– everybody knows they’ve zeroed in on this one particular biochemical abnormality, that low serotonin levels in the brain, that’s the thing that causes depression.
Yet, we now have all this research that has been accumulated over the last 20 years showing, for example, mitochondrial dysfunction involved with depression, inflammation, and oxidative stress involved with depression, psychological parameters, for example, meaning and purpose in life involved with depression, exercise versus being sedentary involved with depression. Gut variables, gut health can be involved with depression.
On and on and on, there’s many different environmental toxicants, and all these other layers of the story that we know are linked with depression and yet, from a conventional medical perspective, it’s still very much this narrative of, “Oh, it’s serotonin deficiency. Therefore, you need to take your serotonin-altering drugs. That’s the cause and solution for depression.” Whereas, if you really took a big picture approach, a systems thinking approach, and you understood the web of interconnectedness of the entirety of human physiology, you realize that there’s all of these different layers that can be contributing to that.
What a solution would look like in that context is comprehensive lifestyle and nutrition overhaul to alter gut health, to alter inflammation and oxidative stress and mitochondrial health, and so on and so forth, and in detoxification for environmental toxins, and improve gut health, and all of those things would be the answer instead of, “Hey, just take your antidepressant drugs to fix your serotonin deficiency.”
These are two fundamentally different paradigms and different architectures of thinking about the same problem, both technically scientific, but I would argue one of them is a lot smarter form of science that is based on systems thinking and really understanding the whole of human physiology. I think this is what you’re getting at by focusing on the big, the brain immune gut connection. Anyway, I wanted to present that and I’m curious to get your thoughts on that.
Dr. Kan: I think you brought up an excellent point and I think a lot of people don’t think about it very deeply or not aware of how medical research is conducted and what their end-goals are because if the end goal is to come up with a drug to target a specific symptom, you’ll conduct your research very differently than if your end-goal is to find out what are all the different mechanism for why that symptom even occur.
Most of the medical research is, “Okay. We’re going to take this depression symptom,” or cancer, or whatever they’re trying to fix, a symptom or a disease state, and they’re trying to identify a pathway, or have a target with a drug, a chemical that they can, as you say, interfere with, that it can get to that endpoint to say, “Oh, depression improved by 50% when I gave this chemical.”
Well, even if you gave a chemical to somebody and improved the depression by 50%, you’re no closer to understanding why they had the depression in the first place. There’s no guarantee that 50% of people that improved, the symptom won’t return or what’s the long-term outcome, do they have to take this drug for the rest of their life just to maintain some semblance of function? That also doesn’t explain why the other 50% of the drug didn’t work for them. What happened to them? What do we do for those people?
So, you can have these very smart scientists and medical doctors developing drugs, and they’re all great, and probably many of them have great intention to save the world and help the world become a better place, but when you’re coming from a different thought process altogether, you can arrive at the right answer to the wrong question. That’s my whole point. We have to ask better questions.
To your question about looking at the bigger picture, yes, but I think that problem exists in natural alternative field as well, in functional medicine field. The example of that is a lot of people, they go to natural alternative doctoral functional medicine doctor and they say, “Oh, I have fatigue.” You and I, we had an interview about this. When somebody hears fatigue, it’s very common for a lot of natural alternative doctors to say, “Oh, you have adrenal problem. Here’s adrenal supplement.”
That thinking exists in both natural and conventional. It has nothing to do with whether they’re natural, conventional, because you can be natural, but suffer from the same fallacy of logic to where you’re treating a symptom with a pill.
Ari: Yes. Totally. Suffer the same myopic and reductionistic focus on, “It’s this one thing,” instead of really systems thinking and understanding the complexity of all of the different systems and how they’re all affecting things.
Dr. Kan: Yes. Reductionistic. Again, everything has its time and place. There’s a time for reductionistic thinking, but I think the reductionistic thinking had to be taken within the context of system thinking. You use the reductionist thinking to rule out different things to see what are the– things that’s not a possibility. When somebody comes to me with fatigue, my job is to use systems thinking to see, “Okay. What are all the possibilities for fatigue?” Then, use reductionist thinking to derive at which one of those possibility is the most likely.
That’s really as physicians and doctors were trained to think like that. You’d be surprised how many doctors don’t think like that though because conventionally, a trained doctor don’t– they either don’t have the time, or they’re just not willing to entertain that because they’re told that, “Hey, if you have heartburn, just give them acid stoppers.” That’s the end of the day– that solves the problem.
When we’re doing it in a systems thinking way, we have to make that connection between, I will say, brain-immune-gut axis, yes, that’s the big idea for many people suffering with brain-immune-gut symptoms, but you’ve got to even think even beyond that because sometimes, it could be just a simple blood-sugar imbalance or somebody is anemic, they have poor circulation, and blood pressure’s low all the time. The doctor tell them, “Oh, your blood pressure is so good. It’s so low.” Like, “Really?” [chuckles]
They’re thinking because high-blood pressure is obviously a problem, it’s a risk for cardiovascular disease and stroke. I literally heard doctors say this, “Hey, high blood pressure is bad, so you want your blood pressure to be as low as possible.” As low as possible, so what’s the lowest possible? The lowest possible will be zero. [chuckles] When you have zero, you’re dead. Obviously, lowest possible is not the answer. Plus, because they have that thinking when people show up with blood pressure of 90/60, they say, “Oh, it’s so good. You don’t have to worry about that. Let’s continue on with the visit. You have depression and fatigue? Oh, here’s a drug for that.” They fail to recognize that that low-blood pressure may be contributing to this person’s fatigue and depression.
The whole point is just getting people to realize that there’s more to it than just a simple, “Leaky gut? Take L-glutamine.” We have to think bigger in both natural field, and in conventional medical-doctor field. That’s really the impetus for me to talk about this, and put on the masterclass to get people to not get stuck in the same thinking, because they’re going to get better results if they can think in a different way.
Ari: Yes. Absolutely. As you were talking there, I kept thinking of Type 2 diabetes as a great example of this problem of thinking. Unfortunately, as you said, there can be really high IQ people. There can be people with all kinds of impressive credentials in pharmacology, and chemical sciences, and whatever else that can be involved in research.
You can have these smart people with PhDs in the lab doing research on diabetes for decades with billions of dollars behind them, looking for a chemical solution to Type 2 diabetes, and they can literally never arrive after all of that research over decades and billions of dollars of funding, they can never arrive at an actual understanding of what are the root causes of diabetes, and an intelligent paradigm of how to go about fixing those root causes. You know what I mean?
You can either do science on Type 2 diabetes in a way that arrives at, “Hey, we’ve got the chemical solution that can decrease blood glucose by 20%, and this is the best we’ve got,” or you can arrive at, “Here’s a comprehensive understanding of the fact that this is a lifestyle-driven illness, and here are the specific lifestyle and nutritional factors that cause this illness. We know that you can completely reverse this illness by addressing these root causes.”
These are two fundamentally different paradigms. I think that issue both for the average person who doesn’t have this kind of knowledge that you’re speaking about here, both of those two approaches can appear equally scientific, even though one of them, I would argue, is way smarter, and way better science.
Dr. Kan: The funny thing is that, Ari, that even if science shows and it did the right research and shows that, “Hey, this is a thing that you need to do,” it doesn’t mean that it trickled down to the medical-doctor practice. Many times, doctor does the same thing over and over again, even though in the face of new evidence that shows that, for example, heart disease is not a plumbing problem, it’s not a cholesterol problem, it’s an inflammatory one. Depression is an inflammatory one. Hashimoto’s is an autoimmune disease, not a thyroid problem. We can go on and on.
Yes. The problem is you have those smart people doing research. They can come up with, “Hey, there’s a drug for Type 2 diabetes that will lower your glucose,” but the same lifestyle problem is still there, this person drinking Coke, and not eating healthy. This is why you have people who have four heart bypasses later. What happened after the first heart bypass? Did nobody have a conversation with this guy to change their lifestyle? Right?
This is what I see what the problem is, not really just with medicine, it’s also what– unfortunately, it’s what the patient want. They just want something quick and easy. Their paradigm, their story, what they tell themselves about their heart disease or heart attack is that, “Oh, I had blockage, my doctor cleaned it out, so I’m good now.” They don’t have to change anything. Well, that’s a story surrounding that. The doctor don’t give them information to change that, then this person will continue to live the lifestyle that’s going to get them the second heart attack, the third heart attack, and [crosstalk]–
Ari: Or manifest as some other disease.
Dr. Kan: Right, or turn into something else. Then, we’re treating maybe instead of a heart disease, next thing you know, they’re diabetic because a lot of these heart medications basically promotes diabetes.
Yes. I think the primary thing is that we suffer with that even in the natural alternative field as well, because people show up with certain conditions. For example, leaky gut, it’s so talked about right now, and it is a real entity, and it causes a lot of problem, but I think a lot of people just automatically go straight to, “Okay. What supplement do I take for it?” My goal is to help shift the general public’s mentality so that they even know to ask better questions, instead of asking, “What do I take for it,” ask, “What’s the mechanism? How does this come about? What’s causing it? What can I do lifestyle-wise?”
For leaky gut, for example and this can go for every other condition, there are probably multiple mechanisms that can cause that. There are many things besides diet that can cause leaky gut. You can have gut infections. You can have stress. You can have a lot of different things that can cause leaky gut.
For people with Hashimoto’s, same thing. It could be multiple mechanisms or root causes for that particular person having Hashimoto’s. You can’t take every single person with leaky gut or Hashimoto and say, “Here’s a nutritional supplement protocol that’s going to be good for everybody because it’s not necessarily going to be good for everyone.
In my catch, a percentage of people that happen to have L-Glutamine deficiency or my catch is a specific population that people with thyroid problem that just happened to have selenium deficiency. That’s the only reason why they have thyroid problem, but certainly, that’s not the reason for every single person with thyroid, Hashimoto’s, or leaky gut.
My goal is to try to get people to understand that there’s more than that and consider other possibilities. Nobody’s ever teaching them this, so my goal is to teach them how to think through it. Then, I say, they can think like me, they probably do what I do, too. I just try to show them my thought process. Then, hopefully, they can adopt some of that and get better results.
The most common factors of dysfunction in the brain-immune-gut axis
Ari: Yes. Absolutely. Well said. You have this brain-immune-gut axis that you see as the core of most chronic conditions that are going on in the world today. Of course, we have an epidemic of cardiovascular disease, neurological disease, cancer, autoimmune disease, on and on and on.
If we conceptualize the brain-immune-gut axis as arguably the single biggest core driver of those conditions, dysfunction in the brain-immune-gut axis, what do you think in turn, since we’re talking about a root cause paradigm, what do you think are some of the biggest root causal factors and why this brain-immune-gut axis is dysfunctioning in the first place?
Dr. Kan: Yes. The brain-immune-gut axis, I believe is a more complete way of describing why people have chronic problems. Now, there’s been recent research, for example, Dr. Alessio Fasano, just in 2020, published a great article that talk about the five pillars of why people have chronic inflammatory disease. He was describing the interplay between the immune system and the gut, how chronic exposure to environmental toxins and food sensitivity, like gluten and stress, and all these things start to impact your barrier function and causes this inflammatory cascade that eventually leads to autoimmune disease, but the brain is left out of there.
I feel it brings a very big part of it because when you have immune system dysfunction and gut dysfunction, invariably, your brain starts to get impacted. When your brain started getting impacted, that’s how you experience the world. Then, the fatigue, the ability to have good mood, and ability to solve problems, and have relationships, all can stem from that.
That’s an overview how I think about that, the brain-immune- gut axis, because you mentioned that I– you’ve put out that I think this is a thing that’s causing a lot of the chronic problem out there. I just want to make sure people understand that this is not something that’s brand new or invented by me. I think there’s a lot of brilliant people already talking about the gut-brain axis or the immune system and the gut. I just feel like there’s– it’ll help people to understand that the brain-immune-gut is really a three-way triangle that interplay is what causes a lot of people to have brain symptoms, immune symptoms, and gut symptoms, all at the same time.
With that said, what are some of the root causes? Again, I really want to try to make it clear that because in the natural medicine world, a lot of the focus is on– if you’re the Lyme guy, then every single person with brain-immune-gut problem is Lyme. If you see it through that lens, and it’s very easy to like, “Oh, yes. I’ve seen a lot of people with Lyme. They all have brain-immune-gut problem. This must be Lyme”.
If you go to a mold guy, they are looking through everybody with a lens of mold, and guess what people with mold have? Brain symptoms, [chuckles] immune symptoms, gut symptoms, so then, they’re going to say, “Oh, yes. That sounds just like mold. You have mold.” If you go to somebody who’s a candida person, same thing, brain- immune-gut, “Oh, yes. That’s Candida.” The thing is with the root cause, though, is many times, it’s the simple lifestyle things. It’s not necessarily mold or Lyme or some crazy virus or something like that. Many times, it’s just lifestyle. It’s sleep. It’s circadian rhythm. [chuckles] It’s blood sugar dysfunction. I see that so commonly that people are either hypoglycemic or they’re insulin resistant, or they have fluctuations of blood sugar that’s just not working for them.
That’s a simple fix. That’s very lifestyle modifiable, or they’re stressed, or they have post-traumatic stress, living with somebody who’s stressing them out or having a job that’s stressing them out.
I see those as a primary root cause, lifestyle triggers, either their diet sucks, they skip meal, they go to bed too late, because they’re indulging in Netflix, or they’re not making their sleep environment proper, they’re not active during the day, or they’re just eating processed food that’s just chemically laden, or they have stress in their life. I see those as a primary root cause for most people. That’s immediately fixable, by the way. Well, maybe if you’re married to somebody crazy, maybe that’s not immediately fixable. [chuckles] It depends.
Then, secondarily, it’s just this– besides those lifestyle thing is environmental exposure because certainly, it’s no news now that we’re all exposed to environment cumulatively, not very many people have acute lead poisoning or acute mercury poisoning. It’s all gradual accumulation over many, many decades. That doesn’t mean you can’t cause problems. It certainly does. Research bears that out. I feel that’s another piece that’s a constant.
If we’re going to talk about things that are constant, the things that’s constant is environmental toxin exposure. If your diet’s not great, then that’s a constant exposure as well. If you live in a stressful environment, that’s constant. If you never exercise, that’s every day you’re being affected by those negative factors, where a virus, we can say that there’s a virus everywhere. We’re constantly exposed to them. Our immune system just disposes them but it’s not every day that you get sick with the virus.
I feel the mold and the virus and the one– that’s not an everyday thing where environmental toxins, stress, and good nutrition is an everyday thing. When it’s every day, then it has a potential to, over time, really build up into a big factor for you that can really cause brain-immune-gut axis dysfunction.
Those are the things I want to put forth out there because a lot of times, people are looking for the sexy answer, or the shiny new object syndrome, or, “Oh, the person with–” The problem with people with brain-immune-gut dysfunction usually have either gone through multiple doctor, they’ve gone to the Lyme guy, they’ve gone to the mold guy, they’ve gone to the candida– whoever guy, and they try those things and it didn’t work because they’re focusing on just that one part. Then, they start to Dr. Google everything. They’re finding stuff online, and that may or may not apply to them.
Then, they just get jaded, and then they start to just keep chasing the next thing. I want people to know that they don’t have to chase the next thing. They just have to apply the right thinking process to their problem and they’re going to have a higher probability at arriving at the right answer and get better, instead of constantly looking for, “Oh, it could be SIBO.” It could be mercury and next day it’s– arsenic is a little bit different. What do you do that’s different for mercury versus arsenic? That’s going to go down the rabbit hole, that’s going to end you up with 50 supplements, and you’re still no closer to your goal.
The brain gut axis and how it is linked to fatigue
Ali: I want to dive into some of the physiology interplay between the brain-immune- gut axis. This is something that to talk about all the facets and nuances of how this connects to all the different layers of physiology, hormones, and mitochondria, would be many, many, many hours of discussion. I want to maybe just dive in briefly for a few minutes to discuss maybe just a couple layers of the story.
I’ll zero in on two layers that I would like you to speak to, that I think will be insightful for people. One is I want people to understand the brain-gut axis a bit. How do those speak to one another? Then, perhaps, you can tie that into how that can contribute to fatigue as a common symptom that you see in people with brain-immune-gut dysfunction. Does that seem like a reasonable request?
Dr. Kan: Yes. Absolutely. I’ll give it my best shot. The brain-gut axis or the gut-brain axis, it’s interesting. There’s no imminent literature. You see some literature says the gut-brain axis and some people describe the brain-gut, but, really, it’s a two-way communication. It’s not necessarily just a brain talks to the gut and not back the other way, or it’s just a gut to the brain. I wouldn’t say the brain is more important or the gut is more important. Of course, if you talk to the person who’s really focused on the gut, they’re going to say, “The gut is a second brain. There are more neurons in the gut than all the spinal cord combined.” It’s true but I wouldn’t necessarily say that’s more. It’s like saying, “Your liver is more important than your kidney.” I’ll keep all of them.
The brain and the gut have two-way communications through neurological connections. We talk about the vagus nerve. The vagus nerve is a long winding nerve that starts in the medulla oblongata in your brainstem. This nerve goes all the way down to your heart, has integration to your lung, branches out to your gut, your liver, gallbladder, all the way down into even your ileo-cecal valve.
This is really important controlling motility and controlling the motoric output. When it’s efferent, going from brain to the gut, those are efferent outputs that are controlling motor activity. When we think digestion motor, that’s your Paracelsus.
Then, there’s also Afrin activity from the gut back up to the brain that tells the brain what is going on at the gut, if there’s any dissension or stretch, what is the volume of food there, and just giving sensory information back. There’s actually about a nine to one ratio of Afrin information comparing to efferent information. It just tells you how important it is for the gut to actually monitor its own activity.
A lot of these interoceptors, in the periphery, we have the proprioceptors, which detects joint position sense in the musculoskeletal system. In the gut, we have the interoception. These interoceptors tells your brain not the joint position sense but about the general sense of function and what’s going on in the gut. There’s a lot of nerve senses there.
That’s why they say there are more neurons in the gut than an entire spinal cord combined. Gut is more as much as a neurological organ as it is a digest organ due to the abundance of neurological tissue. That’s one way that they communicate neurologically but then, obviously, the other way it communicates is through inflammatory cytokines and various neuropeptides and so forth.
For example, we have things like even leptin hormone, which brain-gut, it’s about feeling satiety and in communicating to the brain so effect our behavior. When we talk about cytokines, but we can overlook the peptides and the hormones as well, there’s a lot there, but the primary thing that’s really causing a lot of problem for most people is these interleukins and cytokines that communicate between the brain and the gut, so that if you have these microbiome disturbances, the microbiome disturbances will actually start to ramp up or ramp down the production of inflammatory cytokines.
Even as inflammatory cytokines are really just a messenger, I likened the inflammatory cytokines. Cyto means cell, kine means messenger. Cytokines are nothing more than your immune system sending text messages to each other to say, “Hey, we got a bug here. Hey, we have an injury here. Send more guys over there to clean up.”
Cytokines are immune messengers that relay information. If your gut microbiome isn’t just stress or some type of dysfunction, that’s going to epigenetically turn on these cytokines and these cytokines will have the ability to go into your brain and communicate with the brain about what’s happening in the gut. Then, you can start to get these people with anxiety because they have gut issues, the nervous stomach, so to speak, or why some people with depression that can start at the gut, and you fix the gut, the depression goes away.
Now, I also believe a lot of these gut-brain issues is not necessarily that the gut dysfunction, so therefore, you have brain problem, or the brain dysfunctions and therefore, you have a gut problem. It may. A lot of time, the brain-gut axis or brain-immune-gut axis is dysfunctional because of the root causes that we talk about, the lifestyle things. For example, blood sugar. For example, eating just the hydrogenated fats. For example, stress.
These things end up creating a adaptive or maladaptive compensatory process that we call disease or symptoms. Then, that’s what’s thrown off the brain-immune-gut axis. It’s not necessarily that the brain is causing the gut problem or the gut is causing the brain problem is really that our body is trying to adapt and trying to reach homeostasis, but we can’t because there’s just too much of that stress are coming in so we maladapt and that’s leading to these changes in the brain-immune-gut system that leads to brain-immune-gut symptoms.
Ari: Is there a specific way or a specific example you can give because I know there’s multiple different mechanisms, but what’s an example of how that brain-gut dysfunction would lead to the symptom of fatigue?
Dr. Kan: Oh, great. That is a second question. For example, let’s start with brain. Let’s just say somebody has poor fuel delivery. Your brain, your neurons, especially in the brain, are heavily dependent on fuel stability. The primary source of fuel for the brain is glucose and oxygen.
So, if somebody has fuel delivery problems, for oxygen, if they are anemic, if they’re iron-deficient, if they have low circulation or poor perfusion, that’s going to lead to low oxygen states, which will impact mitochondria as well, since you’re a mitochondria expert.
Also, if you have blood sugar dysfunction, insulin resistance, or hyperglycemia, both of those will impact blood sugars stability and delivery to your neurons. Therefore, your brain cells are starting to suffer and not work well. Imagine if you’re trying to do heavy lifting bicep curls, and you haven’t ate for three days or ate very sparingly, you may not have as much energy to do that bicep curl and making your new personal record compared to if you’re well-fed and even have time to recover.
When your brain cells are not at a hundred percent function, you feel foggy, you feel lower energy states. In fact, I tell people– this is my opinion, is that fatigue is a brain symptom. I get people to recognize, first and foremost fatigue, it may be caused by mitochondrial problem, or blood sugar dysfunction, or anemia, but where you are experiencing fatigue is in your brain. If you have fatigue, just go ahead and say, “I have brain symptom and that’s fatigue.”
That’s important to recognize that. If you have fuel delivery problem, you’re already going to have a brain that’s going to suffer and start to get brain symptoms. Now, of course, once your brain start to suffer, then the brain’s output remember the motoric [unintelligible] and output through the vagus nerve to the gut is going to suffer as well. Then, you get decreased vagus nerve activation. This is where all this vagus nerve talk. Where does it come from? It’s not the vagus nerve. Vagus nerve require cortical output.
The brain is a top-down model. It’s a descending influence. For you to have good brainstem function and good autonomic function, you need to have good cortical function. If your cortex, the top here is not working, the midsection of your brain, the brainstem, and the autonomic centers is not going to function very well. Then, you get this decreased output from the brain because it’s weak, because of fuel delivery problem that leads to decreased vagus nerve function. Then, now, you have decreased motility perhaps. Then, with the decrease motility, then food just sits there. Now, you get fermentation. Now you have SIBO.
Now, you’re treating SIBO instead of addressing the fuel delivery problem, which is an [unintelligible] blood sugar that this person may have. This is where somebody just like, “I’ve been doing SIBO for three years. I’m still not better.” This whole time, nobody’s ever caught their anemia. Nobody’s ever caught the fact that their blood sugar stinks and they teach them to fix that because they’re just– or this person never even consulted someone. They just Google it online and say, “Oh, my symptom look like SIBO. I’m going to treat SIBO.” They think SIBO is causing the brain symptom. It could but that’s the brain-gut.
Ari: Got it. Where do people go wrong? Where’s the most common way that people make mistakes? I think you just alluded to one of those, but what do you think are some of the biggest mistakes that people make when trying to fix the brain-gut [inaudible]?
Dr. Kan: In addition to just thinking in a way that’s not efficient, or having a mindset that you’re just treating a symptom, or treating one aspect of it, and not looking at the big picture, the other thing that I really tried to teach people is that there’s this sequence. There’s a step-by-step that people should take when it comes to healing their brain-immune-gut axis or any kind of chronic conditions for that matter. The sequence is like– really, in medicine, it’s called triage. You treat the most important thing first.
The example that I give is, let’s say, somebody’s passed out on the side of the road unconscious. You come upon this person. You want to help them. You find that this person has no breathing and has a broken leg. Which one do you fix first?
Ari: I think I’m going to go with the breathing.
Dr. Kan: [chuckles] Not the hang now? Right. You go with the breathing because that’s the thing, that’s the most important for that person, fuel delivery. Remember? No oxygen, no fuel delivery. This person who’s laying there unconscious, you wouldn’t think, “Oh my gosh. This person is unconscious. Hurry. This person needs some testosterone replacement.” [chuckles] In natural medicine, in functional medicine, even in conventional doc who’s doing a hormone replacement thing, many times, that’s what they do. “Oh, you have fatigue? You just need some testosterone.” “Oh, you don’t feel good? You must just need some hormone replacement. I got some bioidentical stuff. Because it’s bioidentical, it’s better for you.” Is it?
Ari: I know a few guys who think that testosterone is the answer to all health problems.
Dr. Kan: Always not? No. I’m just kidding. No. I’m being facetious here. Just so the audience know, I’m being facetious to make a big contrast in various ideas, so it’s easier for them to see like, “Okay. If that doesn’t make sense, then–” this is how you learn by contrast. I do jokes like that, not because I’m a jerk– Well, sometimes, [chuckles] but I’m trying to make a point.
Again, a lot of people in natural alternative field will go for the things that’s like it doesn’t really matter or the testosterone may still matter, but might matter down the road, but if you don’t fix the most important thing first, this person don’t get better.
The other example is kind of like having a cell phone. If you have a password to unlock your phone is 1234 and you type in 4321, guess what? It’s all the right numbers. Even the right number of numbers, but you put it in the wrong order. Guess what? Your phone doesn’t unlock.
The sequence or triage or this roadmap that I call it, it’s the order of things that guide you. It’s not a hard and fast rule, but it’s just a guide to help you to see, “Okay. I should probably address this first if I have that. If I do, then the other stuff that I do like detox, or SIBO, or whatever else, or hormones, might work better when I get there.
A lot of times, people just skip the basics and they think it’s just the fancy stuff. What happens is even if they do have mold or candida, they don’t get well because they’re missing the fundamentals.
This is what I see where people go wrong is that they jump out of sequence. They go straight for the adrenals. They go straight for the detox and while they’re– the fundamental is not working right. Then, these are the people who get the Herxheimer or detox reaction, “Oh, I don’t feel good when I detox. It must be working. Right?” No. it means your mitochondria sucks or your blood sugar sucks. You’re just not ready for that because you need to fix some foundational things first.
The Brain Immune Gut masterclass
Ari: Yes. Absolutely. Dr. Kan, I know that you have, of course, I know because I’m a speaker in it. You have a brand-immune-guts masterclass coming up, which is the BIG Masterclass, which works well as an acronym for multiple reasons. I would like, as my final question to you, for you to maybe talk about two or three of some of the most surprising or interesting takeaways from some of the speakers that you’ve had on the summit. I know that, of course, I had all the best information. You can exclude me from this answer. I’m just kidding by the way. [chuckles]
Dr. Kan: I was going to start with you, but if you want me to exclude, then I’ll just let people watch it.
Ari: Yes. Mention two or three maybe some of the most interesting or surprising takeaways that you got from some of the speakers and give people a little maybe teaser for what they can expect to learn in the BIG Masterclass.
Dr. Kan: Sure. Yes. Again, for most people watching your podcast, they probably are familiar with your teachings, but that was one of the things that I really loved about your philosophy and what you taught in this interview is that the circadian rhythm. Then, also, creating that some simple things that you can do to reset your circadian rhythm, like creating that light differential.
Those were really interesting. It makes so much sense. I think that was one of those things that’s jaw-dropping moment for a lot of people who are not familiar with those. Then, other things that we talked about, that Dr. Tom O’Bryan has spoke. He brought up the Dr. Fasano interview. He went in detail about the five pillars that he extracted from Dr. Fasano’s research about why people have chronic inflammatory disease and from a 30,000 feet view of how that impacts what most people are experiencing. That was a really great interview. If you catch nothing but just Ari’s and Dr. O’Bryan’s interview, you’re going to do really well.
The third thing, it’s not really a takeaway or some surprising thing from the speakers, but it’s just that the structure of this masterclass is meant to be a masterclass. It’s really not a traditional summit interview. What I did is that not only do we have interviews, but the interviews are people that are addressing the different steps of the roadmap.
To corroborate what I’m saying about there’s a sequence, there’s a way to triage this, so you’re doing the most important things first, and what are the steps. I have expert interviews that corroborate that, but then, within that, in the masterclass, I have mastery sessions where I teach people one-on-one in detail about that particular thing, to give them more context, the deduction stuff, but then, also, the system stuff, kind of give them all at the same time. I create a lot of value there so I think people will walk away with a lot of practical things. I think people will walk away with more of a different way of thinking, which is what I really want. I don’t want them go through the summit and just pick up another two tips about, “Oh, there’s two more supplement I can take on top of the 50 that I’m already taking.” I’m not interested in that. I’m interested in getting people to be their own detective and start to have an algorithm for thinking through their own conditions so they can get better.
Ari: Amen to that. Well, Dr. Kan, it is always a pleasure to meet a like-minded brother who is a systems’ thinker and thinks in terms of root causes and in terms of piecing together this web of interconnectedness and physiology, solving things at a systems at root-cause level.
So, really, it’s been a pleasure to get to know you over these last couple of interviews, you interviewing me, and I’ll be interviewing you. To everybody listening, I highly encourage you to go sign up for the BIG Masterclass. We’re going to have a link to this at theenergyblueprint.com/bigmasterclass, all one word, “bigmasterclass.”
As Dr. Kan just said, there is a whole lot of great stuff that you get to learn from the speakers as well as his solo teachings, going in-depth on a lot of these individual topics. I am super excited for this masterclass. It’s, of course, 100% free. So, go to theenergyblueprint.com/bigmasterclass and opt-in and sign up for this.
Dr. Kan, thank you so much. Really, it’s such a pleasure. I suspect we have much more that we could potentially talk about and dive into, so maybe we’ll have to do another interview with you over the coming months.
Dr. Kan: I look forward to it.
Ari: Yes. Great. Everybody listening, go to theenergyblueprint.com/bigmasterclass. Sign up for this. I think you’re not going to want to miss it and enjoy. Thank you again, Dr. Kan.
Dr. Kan: Thank you.
Show Notes
The most common causes of chronic illness (03:22)
Why modern medicine approaches are too narrow (11:07)
The most common factors of dysfunction in the brain-immune-gut axis (26:06)
The brain gut axis and how it is linked to fatigue (32:52)
The Brain Immune Gut masterclass (46:45)
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