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Scott Webb: The gut brain connection is complex and fascinating and here to help explain how our nervous system affects digestion and how important proper eating habits and digestion are to our mental health is Dr. Maureen Schwehr. She's a Naturopathic Medical Doctor at Sierra Tucson. This is Let's Talk: Mind, Body, Spirit by Sierra Tucson. Sierra Tucson- Ranked #1 Best Addiction Treatment Centers 2020 in Arizona by Newsweek. I'm Scott Webb. Dr. Schwehr, thanks so much for being on today. I'd like to have you start by telling us a little bit about your background, your philosophy, and just your general approach to treating patients.

Dr. Schwehr: I am a naturopathic doctor, and naturopathic doctors are sort of a hidden gem in our medical system. I love what I do, and I love the chance to actually explain what that is. So there's actually six schools in the United States and two in Canada that have four year degrees in naturopathic medicine. So just as osteopathic doctors and chiropractic doctors have their own schools, naturopathic doctors do as well. So as we have sort of the best of both worlds education, the first two years of my schooling were really highly science-based. Anatomy, biochemistry. A lot of my professors actually were from other medical schools, but in addition to learning how to diagnose and treat from sort of an allopathic perspective, we had a lot more training in nutrition. I learned about herbs and body work. I had a broader training on natural alternatives.

So, every State is different, and a part of the reason I came to Arizona is because in Arizona, I'm a fully licensed doctor. I can prescribe most medications, I can order labs. It really lets me practice fully. So from a naturopathic perspective, when I meet with someone I'm trying to get to the cause of things as much as possible. So I'm interested in the biochemistry, as you'll hear, when we talk about the gut brain connection, but besides that I'm listening to people's stories and I'm trying to figure out where the stressors in their lives, whether that be diet, lifestyle, nutritional deficiencies, hormone imbalances, I'm trying to get to the bottom of what's causing the disease so that we cannot just cover up symptoms, but actually help the body heal itself.

Host: That is really great. And the hidden gem. I love that. And I love this approach and I'm really excited to dig into some of this today. So let's do that. You mentioned the gut brain connection. So what is that? What is the gut brain connection? How do each of those things, the gut and the brain interact and affect each other?

Dr. Schwehr: I work in the mental health field. I work with addiction and trauma and chronic pain and mood disorders. And what I've really seen is that all of those parts of our health are really impacted by our digestive system. We have this kind of myth that in our culture, that whatever we eat really doesn't have that much to do with our health, but nothing could be further from the truth. So we're really biochemical beings. And so as biochemical beings, every single molecule, every neurotransmitter, every muscle, every hormone has to be created from something. And we get those building blocks from our digestive system. So at a really basic level like that old saying, we are what we eat is true.

Host: That is really interesting. And so in doing some reading in preparation for this, I was really fascinated by and never really thought about this and connected these dots, but it makes a lot of sense, great to have an expert on that. What we're experiencing in our brain is going to affect our gut and digestion and vice versa, right?

Dr. Schwehr: Yes. And there's actually three big ways that our mood and our digestive system interact. And so the first is actually through our nervous system. So our nervous system has this amazing mechanism that helps to keep us safe. Whenever we think we're not safe, we have real or perceived danger. Our body goes into this sympathetic mode, and sympathetic mode is that fight or flight mode. And one of the things that happens when we do that is actually the first thing that happens is we turn off our digestive system. So all of us have heard those, you know, sayings like, I felt like I was kicked in the gut. I can't stomach this. Those are part of our vernacular because we have such a direct link between our brain and our digestive system. For instance, before we're born, we have one set of tissue that as it separates, half of it becomes our brain and our nervous system. And the other half actually becomes our digestive system.

So, as they separate, we have a whole separate nervous system called the enteric nervous system that remains intact. And part of the reason that it is there is that when we're under stress, it's very important to turn off our digestion. So when we don't feel safe, one of the first things our body does is turns off our digestion because our digestion takes a huge amount of energy. It takes a lot of blood flow to move our nutrients and to digest our flow. So the minute we're in a fear place, our digestion turns off. The problem is that so many of us live in a world where we're afraid of losing our job or of COVID. And under those circumstances, our body will actually turn off our digestion because it thinks we need to run away from something really dangerous. And the problem with that is once digestion goes offline, we don't have the ability to break down our food properly and to make the neurotransmitters and the other molecules, we need to feel well and to be happy and healthy.

Host: This is so fascinating. And I'm thinking about times when I've been nervous about something, whether it's one of my kids, you know, baseball games or something, and I have this inability eat in the morning before games. And I'm just wondering now, is that that gut brain connection, is it my brain, my nervous system being nervous about the, you know, the outcome of the game and therefore it shuts down my gut, and doesn't allow me to eat as I normally would. Is that a thing? Is that right?

Dr. Schwehr: Yeah, I think so. Stress affects all of us. And so when we're in that highly stressed mode, we don't, we just don't digest properly because our, our bodies are trying to prepare for something bigger. And so it's funny how something, you know, like that can be exciting. Like your kid's game can also be scary because we care about how they're going to do and worry that they're going to not do well. And then that's going to feel awful. Most of us sadly have had that experience of someone tells us bad news, and it literally feels like we're kicked in the gut. And so it's so interesting to understand that it is because our body literally just goes into this other mode. And when we're in that danger mode, it doesn't make sense to be digesting your food.

Host: That sounds so right. And makes so much sense and so great to have an expert on, to explain all of this. I wanted to transition now and talk about the connection between trauma and inflammation. What is that connection?

Dr. Schwehr: There was a study done in the 1990s by Kaiser Permanente, and it was called the ACEs study. And they actually did a survey of 17,000 of their members and the survey had two parts. Part of it was they asked them to list their adverse childhood events. They gave them a list of things that adversely affect children like addiction in the home, a parent leaving illness. And then they also had them do a survey on their health status. And what they found is that there was this really big connection between adverse childhood events, people. First of all, they found that adverse childhood events were really common. So many people in our culture have had events happen that we as children that were really upsetting to us and were difficult on us. And then what they also found is that people who had four or more of those adverse childhood events, that they were so much more likely to have negative health effects.

And so, some of it was things that we would have expected, like people are over 12 times as likely to attempt suicide if they had adverse childhood events, but they also found that they were more likely to have bronchitis and emphysema, that they were more likely to have heart disease. And so that was sort of the beginning of the science, starting to look at what's going on here and what we're seeing. And from a naturopathic perspective, this makes so much sense to me. What we're really seeing is that people who are under chronic stress, that chronic stress, it starts to impact our health in so many ways. And so underneath, if we don't feel safe in the world, our body is always producing these stress hormones. So it has high cortisol levels. It also, as I just said earlier, turns off our digestive system. It messes with our hormones when we're chronically in a stress state, our body thinks it's always an emergency.

And under those circumstances, it impacts our health. It impacts our health at almost every level from our mood to the stress on our cardiovascular system, to the inability for our digestive system to work properly. And so what we really find is there is a direct connection between chronic stress and trauma. And trauma can be, we always think of trauma as these really big traumatic things like someone living through an earthquake, but trauma can also be the stress of living in a home where your parents are constantly fighting because they don't have enough money to be able to pay for things, that doesn't feel like a very safe place for a child. And that ends up setting up the nervous system even in adulthood. And what we're really finding is that that causes inflammation. Inflammation is our immune system kind of overworking and inflammatory processes lead to most of the chronic diseases we have today.

Host: Yeah. And it does sound like inflammation definitely impacts mental health and pain. So there's a direct correlation there, right?

Dr. Schwehr: Yes. So there's been some really interesting studies that have been done. I mean, I think one of my favorite was they found that taking anti-inflammatories, NSAIDS are sort of common anti-inflammatory drugs that we use. And what they found is that they actually helped, especially existential angst. So people who have just sort of worries about the world in general. So our body's immune system's job is to try to clean things up. And so for instance, a healthy immune system, I often talk about it as being like a healthy city where you have your garbage collection, where you have your people who repair your streets, where you have your police and you have your firefighters. And so our immune system was actually set up. So for instance, if you sprain your ankle, then it brings in all the different molecules and cells it needs to clean up the damaged tissue and to help heal it. With chronic inflammation, what happens is that system goes awry and you end up with too much destruction and not enough repair. And what they found is that that process is accelerated by stress. It's accelerated by unhealthy diet, it's accelerated by lack of sleep. And what they found is that once that inflammatory process goes on, it leads to increased pain in the body. It slows down healing. And they're also finding that that process also affects our mental health.

Host: Wow. There's just so much to take in here and you do such a great job of explaining all of this and it does sound like so many things really, and maybe quite naturally, but now that you say it, so many things affect and impact our overall health, but certainly our digestion. So how can we improve our digestion?

Dr. Schwehr: That's a great question. And I'm going to back up for a second. So when we look at the areas of how our digestion impacts mental health, there's actually three big areas. So the first is just basic absorption. If we're not absorbing our food properly because of stress, because of some sort of disease process, then we don't have the basic nutrients to make our neuro-transmitters or to make our hormones or to repair our body. The second is that gut brain connection in that when we're under chronic stress, our body actually turns off our digestion. And so then we're not going to get the nutrients we need. And the third is actually this new, really interesting area that talks about the gut biome. So we have a couple of pounds of gut bacteria in our bodies, all of us do, and that's normal. That's what we're supposed to have. We've developed in a world. We're not supposed to be sterile.

These bacteria in our digestive system are our friends, and what's happened in the last several years is new research has really started to show us how important that is. So it turns out that some of our important neurotransmitters, including serotonin and GABA are actually created or partially created by the bacteria in our gut. And so what new research is showing us is that different kinds of bacteria in our gut can actually lead to improved mood and decreased anxiety. It also has shown us that there are certain gut bacteria that increase the likelihood of obesity, that increase the likelihood of inflammation. So we're finding that these gut bacteria are really important. So I talked about that because when we talk about how to improve our digestion, the first thing I really talk to about with people is to have us understand that we need to realize that we need to feed our good bacteria.

And our gut bacteria, what they love to live off of is real food. They flourish with fiber, from vegetables and fruits. They do well with whole foods. When we eat processed foods, often processed foods, contain chemicals and molecules that are designed to improve the shelf life. The thing is that the shelf life is improved. If bacteria cannot break down the product, so something sits on the shelf and it's very shelf stable, it's because bacteria can't break it down. That's why we need to actually eat food that is real, that hasn't been processed. That real food can be broken down by our gut bacteria. And they actually end up creating the molecules we need to feel healthy.

Host: This is so fascinating. I could talk to you all day and I'm thinking about this. I'm like, okay, so we've got the good bacteria. We need to feed the good bacteria, good foods, good natural real foods. So much more I feel like we could talk about, but we're going to leave it here today. Dr. Schwehr, thank you so much for your time and your expertise and you stay well. Call (800) 842-4487, or go to Sierratucson.com for more information, Sierra Tucson, where change begins. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Health Talk from Sierra Tucson. I'm Scott Webb. Thanks for listening.