How The Microbiome Talks To The Mind

We go deep on the gut brain axis and how gut bacteria can influence inflammation, stress response, energy, and even brain signaling. We follow a real clinical rabbit hole from unexpected C. diff and severe fatigue to emerging autism microbiome research, plus what’s promising and what’s not proven. 

• gut brain axis basics and why it is bi-directional 
• the four major signaling routes: neurologic, endocrine, immune, metabolic 
• what a GI map stool test looks for and how it guides next steps 
• why C. diff is usually linked to antibiotics or exposure and why “no risk factors” stands out 
• what studies suggest about microbiome patterns in autism spectrum disorder 
• short chain fatty acids like butyrate and why they matter for gut and brain health 
• inflammation markers, cytokines, blood brain barrier effects, microglia, neuroinflammation 
• probiotic strain focus: Bifidobacterium longum and the “psychobiotic” idea 
• why we stress this is not just about autism and can apply to chronic fatigue and chronic inflammation 
• fecal microbiota transplantation basics, evolving options, Rebyota, and real-world cost talk 
• using credible journals, vetting sources, and translating dense studies into plain English 

stay tuned, hamiltontelehealth.com, let us know. Send us a message. You can go to hamiltontelehealth.com. You can email us at contact at myhamiltonhealth.com if you have any questions about it.

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Transcript

Nicole 0:11

Hi everyone, welcome to another episode of Tattoos and Telehealth. I'm Nicole Baldwin, Board Certified Nurse Practitioner, and this is Kelly. She is also Board Certified Nurse Practitioner. We are good friends and also colleagues. And today we are going to

Welcome And Medical Disclaimer

Nicole 0:26

talk about something that Kelly found a couple days ago, went down a rabbit hole. Now I'm going down the rabbit hole, but she's definitely being board certified in functional medicine. This is definitely her realm. So I'm going to let her do most of the talking. But just to be clear, our attorneys make us say this does not constitute medical advice. Please always contact your personal provider for any kind of treatment before starting or stopping any treatment to make sure that everything is safe for you. We are just chatting this up. And so also this watching or listening to this does not constitute a patient provider relationship. So, Kelly, just dive in because I know we got on the video and I was just like started going at you with how what I've found. So let's just so everybody can hear just the whole conversation.

Kelli 1:13

So in in functional medicine, I'm going to kind of back back the truck up a little bit. So in functional medicine, you know, we have a lot of ways that we can tie in different signaling pathways to the gut, right? So we have the neurologic pathway,

Gut Brain Axis Explained Simply

Kelli 1:28

we have hormone signaling, we have inflammation signaling, we have this gut axis that signals everything, metabolic, endocrine, immune, like a lot of different things. And so one of the very, very important pathways, and it's probably one of the best studied that I can see now that I felt like I thought mistakenly, I thought was the least studied and was, I was schooled very wrong. I was schooled yesterday and the day before as I went down this rabbit hole, is the gut brain axis. It's very complex, it's bi-directional, but it links the gastrointestinal tract with the central nervous system. So it integrates that emotional cognitive center of the brain with peripheral intestinal functions. And it offers those four primary pathways. So you've got that neurologic pathway, you've got that endocrine pathway, you've got immune pathways for hormone signal or inflammation signaling, the metabolic pathway for that bacterial byproducts. And what really got me going was the conversation with a patient that has some underlying autistic spectrum disorder. And his is a little different, and I'm not going to get too personal for him because it's not important. But the part of the conversation that was important was his history. He's very young, too young to have the symptoms he was having was this severe fatigue. And that was what was driving this cascade of symptoms. And they were going down rabbit holes, trying to figure out what was wrong with him. Finally got to me, needed a functional set of eyes. And we pulled a GI map and he had C diff.

Nicole 3:09

And I'm like, talk about what a GI map is just for a second.

Kelli 3:13

So to back that up, so a GI map is you send in your stool sample, they do this plethora of testing that looks for all kinds of things, right? So they're

GI MAP Testing And Surprise C Diff

Kelli 3:22

checking for H. pylori, they're checking for normal bacteria, normal yeast, if there's an overgrowth, undergrowth, that signals to let us know if you have what was called quote unquote leaky gut, which is basically letting us know if you have high or low levels of normal intestinal IgA levels, if you have calprotectin, if you have high levels of calprotectin, which is sometimes can signal someone that has celiac. So there's a lot of things that that report will tell us. But it also drives a lot of or a ton of really, really good information that will push me down different pathways. And it, but it also can signal if you just have a good old infection. Like if this this young man had C. diff, which for those that don't know, C. diff is an opportunistic infection. It shows up when you have either been given antibiotics that are big gun antibiotics that can lead to an overgrowth of bacteria because they kill off your good bacteria. So typically we see that in someone that has been given antibiotics recently for a bad infection, they were on it for a long period of time, or they were given a big gun antibiotic for something and it led them to get C. diff, or they're in healthcare, like you and I, and they were physically at the bedside taking care of someone with C. diff and they were exposed physically. And those are typically the two big reasons why we see someone get C. diff. This young man had neither of those risk factors and zero reason why he should have. Otherwise, young and healthy, otherwise, no indication. And I'm like, that's really pretty weird. So, other than that, and this chronic fatigue, I just started rabbit holing and I'm like researching and researching and trying to find from a functional standpoint what the heck? Let me tell you, there actually is a substantial and rapidly growing body of research on the gut brain axis in autism spectrum disorder. It exists. Not only that, but there are

What Research Shows In Autism

Kelli 5:20

specific data points that say that children with ASD show a lower abundance of your good bacteria, bifidobacterium, and higher abundances of bacterioids and clostridium, which is C. deaf species, compared to siblings in control trials. I'm gonna say that again in layman's terms. People with autism have lower levels of healthy bacteria and higher levels of bad bacteria and C. diff species compared to the normal bacteria compared to the normal population.

Nicole 5:54

So that means that those people who have who are on the spectrum may have C diff just because may have C diff just because they have it, not because they contracted it, but because they have less of the good bacteria and more of the bad bacteria.

Kelli 6:12

Yep. So I was like, okay, explain this to me. Why? So in a other, in other words, an otherwise healthy person, me as a functional medicine provider, think of it as, okay, well, let me go back to birth. Was this a child who was born via C-section and didn't go through the birth canal and didn't get the good bacteria that a vaginal delivery child would have received? Or does that matter in an in an ASD person? Or is this something that is specific to them? Turns out it is very specific to that interconnected pathway in ASD. So the gut brain axis operates through several interconnected pathways in ASD. Short chain fatty acids, neurotransmitter dysregulation, they have immunatory pathways like we talked about earlier. I'm gonna get to another one here in a minute that's gonna blow your mind. Vagus nerve signaling and the HPA axis. What do a lot of children with autism spectrum disorder have? Vagus nerve signaling issues. They have their own little issues with signaling, right? They each have their own tick, whether it's a movement or a snap or words or they have something. It's directly related. So they have lower fecal levels of acetic acid and butyrate, which butyrate is a biome builder. It's a healthy biome builder for the microbiome of your gut. So they have lower levels of that, which is generally very neuroprotective and anti-inflammatory. So now we're connecting the inflammation in their gut to neuroprotectiveness while they have other associations with outcomes related to social and cognitive impairments. They will have elevated inflammatory markers. And because of those elevated inflammatory markers, we start to see those pro-inflammatory cytokines like interleukin 6, tumor necrosis factor, that cross the blood brain barrier. Those start to go up. And now we've activated microglia, which contributes to neuroinflammation. So we started here, we've made our way all the way over to here, and I'm like, now I can see where my young man went from here way over to here, all these years later, is now suffering from severe chronic fatigue. And I know that was a whole lot in a short period of time, and there's a ton more science behind it. But I was just like mind-blown, fascinated. I'm a nerd. That thing, that those things fascinate me. And so I was like, great, how are we gonna fix this? I'm glad you asked. There are there are ways that you can reset that gut brain axis. So remember in the beginning, Nicole,

Inflammation Pathways And Chronic Fatigue

Kelli 8:45

I told you that they have low levels of that bifidobacterium. Well, that's a certain kind, it's bifidobacteria longum. Okay, so it acts as a probiotic and what they're calling like a psychobiotic combo. In other words, it's like it promotes like a healthy stress response by resetting that gut access for a healthy GI and mood balance. Fascinating. It was absolutely fascinating. So, of course, the nerd that I am, I pick up the phone, I call Nicole and I go, guess what? And so she was, she and I are both going down this rabbit hole. So I sent you down the rabbit hole.

Nicole 9:21

Yes. And so this morning, and yesterday, of course, after we talked, but this morning, I was looking at all of these studies, and I found this study that's the title of it is gut microbiota and its metabolism and autism spectrum disorder from pathogenesis to therapy. And so this is so Kelly and I are both board-certified nurse practitioners, but Kelly has a specialty in this specific area. So for me, I understand it on on a like a surface level. My other degree is in healthcare law, not helpful for this. But she gets down to it deeper than this, even on the cellular level. So I read the study and I I I I I understood it, but I wanted to know okay, how do I talk to patients about this? And I probably shouldn't be, it should be Kelly. But right, we don't know, we don't know. You wouldn't go to your cardiologist for something wrong with your foot, right? You just you you have to go to the right specialist. So I took this article that I read, and patients

Probiotics And Resetting Stress Response

Nicole 10:32

can do this too, and I put it in chat GPT and I said, in plain English, what the fuck does this say? Okay, so it says pretty much to break it down, the article says that bacteria living in the gut may affect autism symptoms, especially because many people with autism also have stomach problems like belly pain, diarrhea, or constipation. The gut and brain talk to each other through nerves, hormones, and immune system and chemicals made by the gut bacteria. When the bacteria are out of balance, they may produce different chemicals that affect inflammation, brain signaling, mood, behavior, and digestion. The article says that some treatments aimed at improving gut health, like diet changes, exercise, probiotics, prebiotics, and possible fecal microbiota transplant, we'll talk about that in a minute, may help some people with autism, especially with stomach symptoms and possibly behavior-related symptoms. Lastly, the big caution is this doesn't mean that gut bacteria cause autism. And it does not mean that there's a guaranteed cure on anything. That's not what we're saying. But the research is promising in very in very much still early. Different people respond differently, different people respond differently. So treatments should be personalized. But the bottom line is a healthier gut may improve symptoms for some people with autism, but it's not a magic fix. But with autism, there's so much that goes on with it, and so other comorbidities that go on with it that if you can improve one, you know, there's so many things that go, right? But if you can improve one or two of those dysfunctions, it's gonna help everything else. And so that's really what this is saying is that there's a little bit more to this than we've previously given it credit to, right? Yeah.

Kelli 12:21

And and I'm picking on autism only because, um, and I hope none of our listeners get this wrong. Um I'm only going to autism because that was the case I was presented with that got down this rabbit hole. But the interesting thing is, this gentleman's um mother is also a patient of ours. Um, she's actually Nicole's patient. And while we were talking, she goes, Kelly, I really think this could help me because she has been dealing with chronic fatigue and chronic inflammation and chronic illness. And so as I was explaining this connection, this gut brain access to her in regards to her son, she was like checking the boxes in her mind for herself. And so I want to, I want to really, really express that and stress that this is not just for autism. I'm simply using it as the case that I was presented this week. Because what I'm pointing at first and foremost and stressing significantly is that link between the gut and the brain, that axis between the gut and the brain, and why that stress response is so significant. It is such a significant driver of functional GI disturbance symptoms. And so adding back in that bifidobacterium really reduces that stress response and really decreases that functional GI disturbance that we see in healthy people. And knowing that bifidobacterium species just by itself has a very unique and powerful ability to truly, truly, truly support and reduce that inflammatory response. It upregulates cytokines, dampens the responses that inhibits the release of cytokines. And so I'm truly wanting to hit home with the fact that there really is a lot of science and research behind that axis. And I think that that's the most important thing that I want people to take away from this is that the studies behind it, you know, while all this time, you know, functional medicine has kind of gotten a side eye. There's studies behind it. There's there's a lot of research behind it. And I think that had I not been presented with this case and been able to do a lot of research specifically for this young man, I wouldn't have gone down this rabbit hole and I wouldn't have been able to see that because of his specific and unique disorder, I was able to find the research attached to all of this because it was those trigger words that got me dig that got me digging. And I think that it's it's incredibly important for people to realize that, you know, there's help out there. Nicole, I'm gonna let her elaborate on the transplant here in a minute, but I want people to hear that there are studies that are open, ongoing, and continuing. Like the study that she mentioned about the fecal microbiota transplantation, there's one open right now in children with ASD that has developed or that is showing significant improvements, significant improvements in GI symptoms as well as autism-related behaviors at the two-year mark. So they have consistently, two years later, shown persistent and consistent improvements, two years later, after fecal transplantation. So they're continuing to follow this, these, these people. So I think that that's amazing from a healthcare standpoint because there's a lot of things that we do in the functional medicine world that those retrospective studies don't exist. This one is here and it's happening. Um, fecal transplantation is not cheap, it's expensive. Um, but the fact that there is a study happening right now is super exciting. And it's amazing to know that the thing that people get hung up on the most, that retrospective study, that well, where's the data? It's there. So I'm gonna stop talking and let Nicole dive into fecal microbiota transplantation because I think it's super cool.

Nicole 16:09

Yeah. So really quick, we're gonna talk about this, and then I'm I'm I'm so excited because back to the patient who the mom who is my patient, she had come in for some specific

Fecal Transplant Options And Rebyota

Nicole 16:25

things, but she also had some things that seemed like she needed Kelly, like she really needed to dig this fatigue, this, and it was sort of hormonal-ish, and also related to some other conditions that she has, but it was like, I think we need to dig into this. So, what so when she told me about her son, and I said, look, he needs he needs to see Kelly. This is like I know what I don't know, then that's when kind of things just started like going, okay, wait a minute, maybe I yeah. So that's where the kind of the lines have crossed, and it's been it's been absolutely absolutely amazing. As far as the fecal transplant, so back in the day when Kelly and I first started medicine 100 years ago, when someone had C. diff, which is the infection in the colon that causes chronic diarrhea, cramps, all the things, the only way, if hardcore antibiotics did not work, the only way that we had to fix it or cure it was to take stool from a family member and put it inside the rectum, inside the colon of the infected family member, and you let their good bacteria call just take off, right? Just take off and attack all of the bad bacteria, and that was curative, right? So you you would you essentially would have a donor, they would go through their stool would go through testing to make sure blah, blah, blah, blah, blah. But it has all the good bacteria in it that the patient is lacking, so they do a transplant. So they take they take the poop, they put it up into the sick patient, and the good bacteria take over, and then it's cured, right? Because it puts back the good bacteria. So as technology and you know things have advanced, now there is other options where there's a medication called, there's two ways. There is now it's volunteers that donate their stool, it gets washed, cleaned, tested, all the things, right? And then that gets implanted. It I want to say there's also a pill that once it gets into the where it needs to be in the intestines, the it breaks open and has all the good bacteria, but the procedure where it's implanted is called rebiota. And that's where the donor, which doesn't have to be a family member, it's a volunteer, like I said, is implanted in the patient, and that's curative. So there's so many, and it's it's done in the office, like it's it's literally done in the office. And when you have chronic diarrhea that affects your life, where you cannot go anywhere, you cannot cough or sneeze sometimes with the elderly patients who have you know less sphincter tone. You can't like it affects your life, like it changes your life. One of my family members went went through about it. They had to be on IV antibiotics for an a uh joint infection, and it wrecked havoc on their system. And so I was that's how I know the Rebiota, we were gonna pay cash for it because like we were gonna like all pitch in as a family. It was more than it's about nine thousand dollars, a little bit more for cash. Insurance will cover it sometimes, but it really, it really just depends. But the point being is that that is also a way for patients who suffer from chronic C. diff, whether on the ASD autism spectrum disorder, ASD, whether on the spectrum or not, it is a way to get rid of C diff to get that healthy gut back. And so that's just what that is. But what we're learning now, and then I'll I'll wrap this up about our poop story, but what we're realizing now is there's other ways besides having to have a fecal transplant to help patients improve their gut health. And Kelly, do you know? I know we were working on it the week before last. We have a page on our website where we list things that we recommend, like from Amazon, right? Vitamins that we recommend or blood pressure cups that we

Practical Next Steps And Where To Ask

Nicole 21:05

do you know if that is live? I don't know. We can find out. Okay. I just want to know because I think I think the prebiotic and the probiotic that that we like so much, I think it'd be good to put that on there if it's not live. So stay tuned, hamiltontelehealth.com, let us know. Send us a message. You can go to hamiltontelehealth.com. You can email us at contact at myhamiltonhealth.com if you have any questions about it. We can certainly go down a rabbit hole with you. But we want to get a page up that kind of has all of our recommendations for Amazon. So you can click on it. And then I think it gives us like a few pennies, and then we donate to animal shelters every month. But anyway, that's my story on that. So that's really, really great, amazing rabbit hole news. So go to your credible websites, your credible, you know, journal of medicine, Google it, just really, really do some research. Search and uh put it in Chat GPT and say, summarize this. What the hell does this mean?

Kelli 22:04

So and there, like I said, there's a lot of research out there, guys. So just you know, do your due diligence, vet your sources. We're here if you have any questions. I'm certainly happy to have a chat with anybody that wants to discuss it, you know, further and in detail. But there's a lot of exciting things on the frontier, and I think it's I think it's fantastic. I think it's fantastic that the world of science is starting to embrace the functional aspect of medicine because it's certainly there.

Nicole 22:25

I love it. I love it. All right, guys. Thanks for joining us, and we'll see you next time. Bye, guys.