Research shows that so much of what sets us up for good gut health later in life happens during early childhood. And yet, it’s often when we take our biggest missteps. In today’s episode, we go beyond SIBO to talk about the rules of greater gut health, why our detachment from the earth is making sick, and how by simply getting dirtier we can correct some of the microbiome mistakes from our youth.
I’m joined by Dr. Maya Shetreat, who is a pediatric neurologist, herbalist, urban farmer, and bestselling author of The Dirt Cure: Healthy Food, Healthy Gut, Happy Child. In our chat, we discuss what’s happening in a developing gut and how some of the popular ills of childhood – like ear infections, fever, rashes, colic, hyperactivity – relate to food sensitivities and a damaged microbiome. More importantly, Dr. Maya gives us some concrete advice on natural alternatives to conventional over-the-counter drugs that might be damaging your kid’s microbiome further.
If you’re someone who is still putting together all the pieces of your health puzzle (or a child’s) this conversation will bring a lot of aha moments, and offer plenty of suggestions for moving forward.
A quick taste of what we’ll cover:
- How the genetic vulnerabilities we’re born with play out via our lifestyle and environmental triggers
- What being out in nature does for our nervous system and biodiversity
- How the microbiome interacts with the microvirome – our body’s ecosystem of viruses
- Why childhood fevers are so important for immune development
- How gut health impacts the nervous system and why certain children present with neurological issues like ADHD or Autism, and others will get an ear infection
- Why early childhood emotional or physical trauma can affect gut health later in life
- Cranial-Sacral Therapy, reiki, chiropractic adjustments and how you can expand your child’s wellness toolkit
- How to approach an elimination diet for children
- Natural tools for your medicine cabinet to fight common childhood ailments like fever, rashes, etc.
- What dietary culprits could be behind chronic ear infections in children
- How we can apply the rules of greater gut health in adult life, even after imperfect childhoods
Resources, mentions and notes:
- Where you can find Dr. Maya Shetreat
- Maya’s bestselling book, The Dirt Cure
- Episode 13 with Aviva Romm: advice on how to rebound from a C section
- Episode 7 with Jason Wysocki on bodywork and SIBO
- Fever breaking kit: peppermint oil compresses + yarrow or elderflower for sweat
- Join the SIBO Made Simple Facebook Community Page
- Subscribe to receive a free download of the episode transcript
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CHILDHOOD GUT AND NEUROLOGICAL DEVELOPMENT
PHOEBE: Dr. Maya Shetreat, it’s so nice to have you on. I’m going to call you Dr. Maya like the kiddos, even though we’ve met in person. Maybe I could just say Maya? I don’t know. Actually, I should tell people how we met.
I had emailed you probably five days prior to podcast guest, Jolene Brighten, being in town, and we were supposed to have tea. She texted me the day of and said, hey, I don’t know if you mind, but my friend Maya is going to come, and I was like, oh, my God. I guess fan girling a little bit since I had just reached out to you. We ended up meeting. Discovering that we are not only both Scorpios but have the exact same birthday, and yeah, here we are now. Thanks for coming on the show.
MAYA: Definitely a fated meeting.
PHOEBE: A fated meeting. All right, so for those who aren’t as familiar with your work, tell us a little bit about your story. You’re a pediatric neurologist. Why neurology? Why children? Go.
MAYA: When I was deciding what to do, I – actually, I like the idea of solving puzzles. That was really what I think got me really into neurology. It’s very logical and also, at the same time, very intuitive. In the nervous system, you localize everything based on the symptoms someone’s having. I like problem solving, puzzle solving, like detective work, and I decided I wanted to work with kids because – well, two reasons. One is because children’s brains are so plastic, so there’s just so much capacity for recovery, or at least that’s what I thought at the time. Now I know that, really, everyone’s brain is plastic and that our bodies are also. I’ve seen amazing recoveries that I never could’ve imagined back then with the work that I do, but at the time, that’s what I thought.
The other reason was that I had a mentor who gave a lecture in my second year of med school about autism, and I was so compelled by this mystery of autism. I decided to do research with her and really got connected with a lot of families and worked with the kids. It became a passion of mine, so that was how I got into my initial field of pediatric neurology way back when.
PHOEBE: Awesome, and then your part two, your next chapter was how you came to write TheDirt Cure, which stem from something that happened with your son. Will you tell us about that?
MAYA: Throughout my training, I got married, and I had three children. I had my daughter in med school, my son in pediatrics residency, and my second son in my neurology fellowship. My second son, my youngest, when he was about a year old, he started to have asthma symptoms and, also, a neurologic plateau or even regression where he’d been an early speaker. He stopped gaining words. He got clumsier. He started falling more, but he wasn’t catching himself, which is a normal reflex. He would hit his face into the ground, and he was just agitated a lot of the time. Coinciding with that, he had all these breathing issues, which looked like asthma. He went in this cycle of being on antibiotics and steroids and inhalers.
I took him to different doctors because I was like why did this happen all of a sudden? Nobody was that bothered. They were like, well – I took him to allergists and pulmonary doctors and neurologists. It was like, well, he’s a reactive kid. He’s going to be fine, this kind of thing. After ten months of him being – literally, every other week being sick and being on nonstop meds, I finally got to the bottom of it myself by looking in the scientific literature and ending up connecting with not the most well-known doctor in the world for food allergies or that kind of thing but, actually, a local allergist.
We discovered he was allergic to soy, which probably happened due to a mold exposure, which is a deeper story. He was allergic to soy, and when he stopped eating soy and, in his case, drinking soy because he was having soy milk – which at the time, I thought he was reacting to dairy. I thought, well, soy milk is a great option. We stopped that, and he stopped having asthma after ten straight months. Then we saw him really improve in his neurologic symptoms over time, but what took a long time was actually to recover his gut and his disruptive microbiome. That from all the medications was pretty much a mess.
PHOEBE: Yeah, I mean, one of the many reasons why I really liked your book is that I found that it wasn’t just a great read for parents because I’m not a parent but, really, anyone who is in adult life and suffering from unexplained symptoms. I think back to all the puzzle pieces from, I mean, certainly my own childhood health history, and I know people listening at home probably are people who have been through the ringer with mysterious symptoms for a long time. First off, what’s happening, really, in the early stages of development with children’s guts? How do some of the popular ills of childhood – like your son’s asthma, ear infections, rashes, colic, hyperactivity, how do these all tie in?
MAYA: It used to be – I’m going to start with birth, really. This I will tell you actually applies to everybody. I wrote my book for families, and that includes kids and adults. I’ve had a lot of adults read the book who are not parents. Even going back all the way to birth, it sounds crazy. What happens in the womb and at birth, our own birth meaning, and through childhood actually does affect our lifelong health, so it’s relevant. Really, we imagine that in the womb we’re completely in a sterile environment. This is what we were told for a long time.
It turns out even the womb and the amniotic sac has its own microbiome with its own unique set of bacteria that maintain that environment or help to maintain that environment. Then, when we’re born – so there are all these factors that impact. When we’re born, generally, we’re intended to go through the vaginal canal. This makes people squeamish, but if we’re talking about SIBO, we’re talking about poop I know, so at least we get to talk about all the different places in the body. Basically, part of how we seed – the baby seeds its microbiome, it’s swallowing vaginal fluids. Actually, even around the perineum right as it’s coming out, it’s getting this exposure to the vaginal microbes. That is what actually is like the initial probiotic of life that basically creates a beautiful diverse microbiome, hopefully, for the baby.
What we know, for example, is that if a baby is born by C-section, they don’t have predominantly vaginal flora, but what they have is actually predominantly skin flora. That changes the makeup of the microbiome. This doesn’t mean if a baby’s born vaginally that all their problems – that there are going to be no problems, or that if they’re born by C-section, they’re running into problems. Probability-wise, statistically speaking, they’re more vulnerable being born by C-section. Now, I will say I had my son vaginally, and he was a home birth for that matter. He still ran into some of these problems, so it’s not foolproof. We’re talking, again, about these different things of having healthy flora. Also, if a mom is given antibiotics around birth or before birth, or she’s gotten lots and lots of antibiotics in her life, her flora’s going to be different. The baby’s flora is going to be different and even getting antibiotics around birth or right after birth, so these are some of the issues that can come up.
Now we know that there’s not just a microbiome that contains bacteria but actually a micro-virome where there are actually viruses that maintain the tasks, let’s say, of the flora in the gut. For example, there was a study done, and it was published in Naturea few years ago. It was really like seminal study that showed that when they did these experiments with germ-free mice – and germ-free means that they wipe out all the flora of the mice using antibiotics. They actually gave a controlled group – they got nothing, and then another group got a certain relatively benign virus. The ones that had the benign virus, were given that, were ingesting that, those viruses totally took over for the bacteria. Literally, everything went without a hitch whereas, normally, in a germ-free mouse, there’s gut breakdown. There is all kinds of disruption that goes on physiologically because our – we are dependent on a healthy microbiome.
Things like steroids and Tylenol and vaccines and all these different kinds of exposures that we have that are normal in our lives, they change up the microbiome and the micro-virome in ways that we really don’t totally understand and can’t anticipate the kind of impact it has. When someone has a disrupted microbiome for any number of reasons and there are many possible reasons, what we know happens is that there could be gut symptoms, and moreover, there’s actually immune symptoms very commonly because the immune system and the microbiome are in close communication and then, in addition, neurologic symptoms. We can actually see all kinds of issues relating to, let’s say, migraines, or seizures, or ADHD, or focus, or mood, or all kinds of neurologic symptoms that basically come from a disrupted microbiome.
PHOEBE: Yeah, I mean, it’s fascinating, and I think it’s something that a lot of people don’t understand is why maybe you could even not be experiencing any digestive symptoms but be someone who gets the ear infections, the rashes, and what have you. Why does that happen? Why does it get expressed in different ways, and specifically, with the gut-brain connections, how does that work?
MAYA: For one thing, we all have different vulnerabilities, genetic vulnerabilities. We all come to the table with genetic vulnerabilities. This is when you say, oh, this runs in the family. My dad has it. My grandfather has it, that kind of thing, so therefore, I have it. That’s not a given. It’s very rarely a given that just because other people in your family had something that you have to express symptoms. You may have that vulnerability for eczema, or you may have that vulnerability for seasonal allergies, or food allergies, or migraines, or whatever, whatever it may be. What it comes down to is what are the circumstances? What are the environmental exposures? What are the triggers going to be that are either going to reveal that vulnerability, which means you’re going to have symptoms, and you’re going to express it, or that are going to keep you resilient?
Having a really biodiverse microbiome, meaning lots of different kinds of bacteria – and not too much of any particular kind but lots and lots of different kinds, so we call that microbial diversity. If you have increased microbial diversity, that’s protective, and that actually protects you in a lot of ways. One of the ways is simply by – that’s what your immune system wants. Your immune system wants to see lots and lots of different flora, lots of different microbes. Actually, it becomes more comfortable with lots of different things like different kinds of foods, different kinds of flora, all different kinds of compounds. Things you might find in nature, right? Nature is so biodiverse with lots of different compounds that your immune system becomes more comfortable with all different kind of things, and then it’s less likely to freak out when it sees something strange, which might like a certain kind of cat, or it might be a peanut, or it might be something else. It’s not to say that that’s foolproof, again, but this is the kind of thing that all this diversity is what our body’s evolved with in nature.
Now we’re in a much more sterile way of living in houses where we scrub it down all the time with bleach. We wash ourselves with soap. Not all of us. Some people though or a lot of people. Yeah, I think being clean and being sterile and being hygienic is what we aspire to. Actually, it doesn’t mean we all have to walk around like pig pen but really getting dirty and being exposed – like coming home with – going outside, getting dirt on our clothes, and sitting down in the grass and being in nature and having even a pet. We hear these scary stories, oh, like sponges that you wash your dishes with. They’re filled with bacteria, but the irony here is that you’re less likely to develop allergies if you use a sponge because you’re getting that microbial diversity whereas with a dishwasher you’re not getting that microbial diversity.
Same using bleach, there’s all this data that when kids are in schools or homes where bleach is used really regularly, they’re more likely to have chronic respiratory infections and bronchitis than if they don’t have bleach exposure, so it’s interesting, right? I mean, it could be the bleach, the chemical, all that, but I think it’s also very likely that it’s related to, again, the microbial diversity that we need that. That’s part of what keeps us healthy. These things that we aspire to do and felt like, wow, I want to be clean; I want everything to look just so, it’s actually being a little dirty, or a little messy, or having the pet, okay. Again, pets also increase your microbial diversity because you’re sharing the microbiome of your pet.
WHY SOIL IS THE BEST PROBIOTIC FOR KIDS
PHOEBE: I have a question about this. As someone who lives in New York City with a pet, who already has a compromised immune system – I have Hashimoto’s. I always wonder. I could, of course, walk to the park and, of course, lay down in the grass and roll around and what have you, but I just worry about the fine line between dirt in a city like ours and toxins. What advice would you give to someone who lives in a sterile apartment without a backyard, who has a dog who is often times walking around on pavement that’s not filthy in a good kind of way? How does someone like me get more comfortable with the idea of getting dirty?
MAYA: I think that, if you’re in an area where you think there could be massive heavy metals or something in the soil, that’s the kind of thing that you can just sample soil, and that’s actually not expensive to do. The city generally will come and remediate if there is a significant heavy metal problem, and of course, there could all kinds of toxins. It’s true, even pesticides and other things, but to me, in general, they don’t outweigh getting outside. That could be as simple as going and taking a walk outside. No one says you have to literally coat yourself in the dirt of the city, although I do recommend on a weekend taking your dog and renting the car or hopping on the train and getting out of the city. I do think that that’s something that people can prioritize, or there’s all kinds of clubs you can join or different things where you can go on little hikes, not far. It’s an incredibly healing thing just to get out of the city first of all, period. I think that it’s really regulating to our nervous systems and our immune systems and all of those things, so I think it’s worth doing that regularly.
Then the studies that look at soil microbes – because it’s interesting. There are different soil microbes that have been studied and have been shown to enhance mood, increase focus, improve cognition, so they make you smarter. You feel less anxiety when you’re exposed to these. One of the ones I’m thinking of is called mycobacterium vaccae. There’s a lot of data on that particular one. It’s a soil microbe. Basically, in the studies that were done, what they said was there’s basically – they called it a superhero effect from when you get exposed to that, and you’re exposed to it though light gardening, or being in the dirt, or in through cuts in your hands, or you inhale it, or you eat a little bit because you’re touching the ground and touching your mouth. I mean it doesn’t have to be very much, but the benefits last for three weeks.
We don’t have to live in a rural area or go off the grid in order to get that benefit, but we do have to show up. We have to go connect with nature. Personally, in the city, I mean, go to Central Park. Go hug a tree. Go have a picnic. You can sit on, literally, a blanket. Again, nobody is saying roll around if that’s not your jam. I do think it’s like – in one teaspoon of soil are as many organisms as there are people on the entire planet.
This is like here we are worrying about microbial diversity and how many billions of CFUs are in a particularly probiotic and stuff like that, but there’s a lot of CFUs in soil and just traces of it. I mean, go to the farmers market and get your food there when you can so that it’s not all power washed vegetables. You’re going to get, again, little traces of soil. You don’t have to eat mouthfuls.
PHOEBE: I’m totally onboard with all that. To go back to the fearmongering side of my brain/society’s brain, what you’re saying is that we shouldn’t worry as much about the idea of city grime equaling toxins per se. Real toxins like the mold, the heavy metals of the world are found in other areas of the city, sometimes your home, but not necessarily you’re going to be affected by those from petting your dog and letting him sleep on your pillow.
MAYA: Yeah, I mean, look, these are the things that can happen, and I think we have to have awareness around it. Honestly, I mean, I think two things. One is whatever traces you might be exposed to, in most cases, they’re not going to impact you in that dramatic of a way. Sometimes they will. I also think by showing up and being out in nature and thinking of nature as us being in relationship with the natural world, that means also that, if they’re going to spray New York City parks just for example, we’re going to show up and say don’t spray my park. I want the microbes that are here, and I don’t care if there’s some wild plant growing that isn’t as nice or might cause an issue. Let’s think of another way to deal with it, which there are other ways to deal with it. Stop spraying poison in my park. One other thing I’ll say about toxins in soil is that, actually, there is some research that shows that the more microbial diverse the soil is, the more the microbes themselves sequester toxins like heavy metals. That means that, if you have really beautiful soil that’s biodiverse and composted and we’re not spraying pesticides on it, it’s less likely if there are toxins in that soil that you’ll even be exposed to them because the microbes deal with them.
PHOEBE: Hmm, that’s really interesting. All right, so going back to the whole category of symptoms , I really loved how you talked about this in the book. Just about how so many kids go through the revolving door of doctors’ offices and just become overmedicated to treat the symptoms and become even more overmedicated to treat the symptoms of the first medication. I’m curious, though. In a lot of your examples, the various symptoms, be it ADHD, autism, rashes, what have you, were a result of a food sensitivity, and a food sensitivity is usually caused by some sort of either toxic burden like maybe in your son’s case with the mold or a gut imbalance. Are those the two main root causes of this plethora of different symptoms? Is that safe to say?
MAYA: I would think of it like this. We walk in with whatever our genetic vulnerabilities are, and those we can’t do that much about. Then either there are things that we’re not getting in our bodies. That could be nutritionally, or microbially, or otherwise, or there are things that we are being exposed to that we shouldn’t be, very oversimplified. I think it’s sort of – it’s a good way to think about it. For me, for example, when someone comes to see me, a lot of times they’ve already seen a lot of doctors or done a lot of things. The first thing I want to do for them before anything else – I mean, unless I see something egregious that we actually need to stop immediately is I just think, wow, when we make demands of people’s bodies to heal, kids’ bodies, or anybody’s bodies, we’re asking a lot of them. Healing is hard. That’s hard.
This kind of expectation like, day one, walk in, we’re going to heal this kid. It’s like, for me, the first thing I want to do is just figure out what can I do for this kid that is just going to be totally nourishing for them? That might be from a diet standpoint. It might be nutritionally. It might be energetically. I have sent kids to get reiki, and we could talk about – people will be like, oh, that’s energy stuff. That’s woo-woo or whatever, but the truth is that’s a whole other conversation we could have another time. At a minimum, we’re stimulating the vagus nerve, which is the parasympathetic – modulating the parasympathetic nervous system. The parasympathetic nervous system is what counteracts our fight or flight, and the parasympathetic nervous system is in charge of rest and digest. It’s very important for modulating the slower heart rate, and it’s very important for modulating inflammation in the body. It actually takes care of a lot of different things that we might not even realize.
When we calm down that nervous system, we’re going to help with a lot of things including bloating and burping and stomach aches and constipation and even sometimes diarrhea. When we stimulate the parasympathetic nervous system, we’re going to see a lot of different kinds of gut symptoms not to mention neurologic symptoms improve. Something like reiki, or craniosacral therapy, or even massages, or meditation, or yoga are all very important as far as I’m concerned in the nourishing, as well as the probiotics and the food and all of that.
PHOEBE: What is craniosacral therapy exactly?
MAYA: I don’t really want to make a misstep in how I describe it but I think that the idea of it is that it’s making very tiny adjustments in our alignment physically but also energetically that can have really significant effects. It’s a form of bodywork. It can have really significant effects both on a physical level but also on an emotional and energetic level, and so it’s very, very, very gentle touch in order to shift in very tiny ways different joints in the skull and down the spine.
PHOEBE: The reason why I ask is, to me, it feels like reiki meets visceral manipulation or some combination of the two. I don’t know. Because the movements are so small, it really feels like it’s energy work, but I guess maybe it’s not.
MAYA: It definitely has energy work, and at the same time, it does have a physical basis. That actually is scientific. I think it’s based in some of the principles of osteopathy, which does have a strong scientific basis, but reiki is different because it’s actually a spiritual practice too. In the same way – I mean, not exactly in the same way, but martial arts are not just like, oh, this is something to use for defense, or attack, or something like that. It actually has a whole spiritual practice and philosophy. Reiki does also. Either way, these different practices, the many things that they do, we could talk about the whole variety, but the parasympathetic stimulation is an unequivocal benefit.
PHOEBE: The vagus nerve is at the center of the gut-brain connection. How is the nervous system involved in all this? This is actually one of my listener questions, which was how does gut health impact the nervous system/neurological functioning? This one was maybe answered a little before, but why do some people present with neurological issues and not gastro ones?
MAYA: Yeah, I mean, I have a couple things to say to that. I think one is – so we have a few different ways that the gut and the brain communicate. One way is the vagus nerve. It’s an ancient part of our nervous system, and it connects the gut. A meandering nerve that connects the gut all the way – which the gut has its own nervous system, okay? The vagus nerve connects that all the way through the diaphragm and the lungs and the heart, and it goes to the brain stem. There is this very powerful connection through this nerve that is bidirectional, meaning the gut influences the brain, and the brain influences the gut.
What I want to say about that that’s really interesting is there’s a study that just came out this week that I was actually asked to comment on for an article. It showed that kids who experience trauma in childhood actually have less microbial diversity in their gut, and they also have differently developing certain structures in their brain. Their prefrontal cortex develops differently as well, and their electrical activity there is different. That’s an example of let’s just say you had a trauma, right? There’s something emotional going on, and that impacts your gut flora. It impacts your brain development. Actually, in this case, it was recognizing I think emotions. Emotional cues in other people’s faces is somewhat impaired.
These are things that can affect you in all kinds of ways in terms of your function and your relationships in life. Here we are thinking, oh, anxiety – we have to treat anxiety in people, or we have to treat migraines, or we have to treat seizures, or we have to treat – but really, we could be looking at the gut. Then thinking even deeper now because this study was so interesting is, well, there’s a relationship that goes backwards too to what’s happening and how we’re feeling in our emotions and may be root cause for a lot of this stuff that we’re talking about. Whether it be Hashimoto’s, whether it be neurological symptoms, whether it be headaches or whatever, maybe that goes back also to childhood traumas and emotional disruption, so it’s very complex is what it comes down to.
PHOEBE: Yeah, I feel like so much of this gut stuff is like a chicken or the egg. The question there is, yeah, I mean, obviously, maybe the first trauma was emotional, but then it’s a two-way street once the gut’s disrupted. What ways besides talk therapy can you try and begin the healing side of the brain, or is it actually just easier and has a bigger impact to come at it from the gut side first?
MAYA: I’m a big believer – in my practice, the way I look at things – and I think, again, more and more data is supporting this approach which is I’ve studied with indigenous healers and elders for a long time. This is the old paradigm, the ancient paradigm, which is also very cutting edge at the same time, is our physical health reflects not just physical things but also our emotional health and our spiritual health, and so when someone comes to me, I’m looking at supporting them in their physical body, their emotional body, and their spiritual body. You can come at it in different ways. I don’t just say, oh, well, this is a physical problem, and then deal with it in a physical way. I’m also not just going to say, well, go – you’re having all these physical symptoms. Go get therapy. I’m not going to do anything to help mitigate these symptoms.
We don’t always know what that in is going to be and what kind of – the body is healing itself. That’s what it comes down to. From my point of view, the way I see my work is I’m just making suggestions to the body. I might give an herb, a botanical. I might give a supplement or a probiotic, or I might change the diet, or I might work – do some kind of energetic or spiritual work or recommend that they get it. There’s so many different ways. You just have to find your in, and then the body does the work. It’s not their body, your body, right? I mean, it’s not my body doing the work. It’s the body that needs to heal.
You need to just make those little what I think of them as suggestions rather than coming at them with a sledgehammer and saying I’m here to fix you. This is about getting back into alignment and balance.
WHAT SKIN ISSUES HAVE TO DO WITH FOOD SENSITIVITIES AND GUT HEALTH
PHOEBE: Yeah, and I loved how you put it that you can get any symptom from any root cause. Some people are skin people. Some people are gut people. I recently had a woman participating in one of my free challenges who was complaining about her eczema and saying that she had gone gluten free and dairy free, and it hadn’t helped her skin at all. I asked if she had done a full elimination diet, and she’s like, well, I haven’t really found evidence about corn or soy and eczema. I, of course, had in the back of my head, well, anything could be causing it, really. I don’t know. What would you have said to her?
MAYA: I think a few things. I mean, I think for sure flora is going to be an issue there. My feeling about elimination diets is, sure, cut the gluten and dairy because for some many people that is the issue. I’ll just tell you, myself, recently I got a patch of eczema. I have not had eczema since I was a kid. I was like what is this? What’s going on? I couldn’t figure out what was going on. It was so itchy. I was like, God, what is this?
It turned out I’d been eating clementines every day, and apparently, my body is not a fan in this particular period time of my life of citrus, of oranges. I cut that, and I was like, wow, I feel so much better. I think it is really important to be a little bit of a detective and cut certain things, even if it’s just – my feeling is you could do anything for a month. I don’t think doing things for more than a month makes sense unless you see real results, but for a month, you really can do anything. If you’re going to do an elimination diet, do the elimination diet, or if there’s a food you eat a lot of that can be a really allergenic food, cut that out. That doesn’t mean do it forever. You know what? Even though right now clementines are bothering me, it’s quite possible in three months or in six months I’ll be fine with them again. For whatever reason, at this moment in time, it wasn’t working for me.
I think of it as it’s just – it’s really about listening to your body. We’re not really taught how to do that. Most of us are not very good at it. We have to learn.
PHOEBE: Yeah, and is there anything to keep in mind about shifting the diet of a child versus an adult and doing an elimination diet in someone who’s still developing, I guess?
MAYA: Yeah, anyone who’s going to be on a prolonged elimination diet should work with an integrative doctor, or a functional doctor, or a nutritionist, somebody who’s going to be able to keep track and make sure that you’re not hurting yourself while you’re trying to help yourself. When it comes to children, I mean, if they’re really young, you have to be even more careful because that’s a period where they’re growing really rapidly. They have a lot of brain growth going on, so you want to make sure they’re getting all the fats that they need, different kinds of fats. I’m really cautious about going vegetarian or vegan with really small children. It’s not impossible, but it’s much more challenging to make sure they’re getting everything that they need in those years of development. I think, again, for a month, in general, it’s possible to do these things.
There are a lot of doctors that will give parents grief about doing elimination diets or even cutting one food, like gluten. I cannot tell you how many pediatricians have gotten so upset with patients or families because they’ve cut gluten, even when they have seen dramatic improvement. I have had a lot of families – unless someone is egregious, I don’t ever like to get in between a relationship with a pediatrician and a family or a doctor and a patient. I mean, they have a relationship. My job is to just support the person with what they’re going through, but not to disrupt other relationships. I will say that many people have left their pediatricians because they’re like why does this person not care that my child has literally transformed coming off of let’s say dairy or gluten? They’re not having migraines anymore. They don’t have eczema anymore. They’re sleeping at night, and they’re growing. Literally, you could say the whole list of things that could happen, and the pediatrician is like, wow, I think this is a terrible idea. I think it’s dangerous.
PHOEBE: It’s like a different language.
MAYA: Yeah, I think also people feel – I think sometimes doctors feel threatened if they don’t know. They feel like, well, I don’t know about this. I don’t want them to think I’m stupid, and so I have to stand up for what I’ve recommended.
PHOEBE: Yeah, well, I liked the time stamp of a month is a really good point. Maybe a good segue to talk a little bit about SIBO, which we weren’t going to talk about too much today because I wanted to focus more on the tools of greater gut health. I’m curious if the low-FODMAP diet is something you ever employ with kids, or since you’re overlying mantra of TheDirt Cureis all about diversity, if you choose to nourish in other ways or just focus on herbs?
HOW TO TREAT CHILDREN WITH SIBO
MAYA: No, I mean, I use all different kinds of approaches. I’ve used FODMAPs. I’ve used SIBO-friendly diets. My goal is to use what works, as long as the potential for a benefit is great and the potential for side effects or the risk is low. Shifting diet around in a smart way I don’t have a problem with. I definitely do rely on herbs, though, I will say, when it comes to treating SIBO. I like using botanicals. I tend not to do antibiotics as a rule. I do it in rare circumstances because herbs do the trick for me when used in combination and used in combination also with diet and probiotic and other things like that.
PHOEBE: Yeah, totally, so in terms of maybe some people who are thinking about the checklist of hardcore medications they were put on as kids either for skin issues, or for ADHD, or what have you and thinking about maybe what some of those downstream consequences have been in their adult life, what is the advice you give to them? Is it too late for us? What can we do to right the imbalances?
MAYA: I don’t really think that – I don’t think it’s too late, no.
PHOEBE: Okay, thank God.
MAYA: Yeah, I mean, I’ve seen things like Hashimoto’s reverse. I’ve seen lupus labs reverse. I’ve seen dramatic changes happen to the immune system. Usually, the way it works in my experience is it means really showing up, doing the – maybe doing the diet changes and taking the supplements sometimes for a period of time or the herbs or whatever and doing also the emotional work too. Almost inevitably there is something more to the story than just there’s something wrong physically. I will say something else. I don’t know if you hear this too often, but a really important part of the process for me of recovering is being kind to yourself, which means that, look, I’m not saying that getting off gluten 100% – if gluten’s bothering you, you want to get off it 100% for at least a good period of time, so you can see that your symptoms improve and all of that. I’m not saying just go and eat whatever you want all the time or things like that.
I’ve seen, also, people suffer more sometimes from being exceptionally rigid, and so just self-love and kindness to yourself is a really, really important part of the healing process. I think it’s always important to include that, even with all the regimens and all the dietary things and going to the healers and the doctors and all the different things. I also think just getting out into nature is actually – it’s tremendously therapeutic, and there’s a lot of data to support that. It’s not just because it sounds nice, but it actually really improves your microbial diversity. It improves your parasympathetic tone, like that rest and digest component, your focus and your sleep, which is important for healing. Executive function all improve. Your mood will improve. Even your cortisol levels drop, so stress hormones go down. Your anticancer proteins and natural killer cells go up, meaning you’re fighting cancer and other kinds of infections that might be going on in your body either in obvious ways or in latent ways simply by forest bathing, like immersing yourself in the beauty of the forest every once in a while. This is, for me, a real therapeutic recommendation, and you’re obviously gaining so much more than that too.
PHOEBE: Yeah, you’re getting to spend the day in the forest. In addition to the kind of physical dirt and earthen category and eating whole foods, for those, maybe in particular parents, who are maybe facing an onslaught of symptoms still on their kids, like for headaches, maybe ear infections, fevers or what have you, in place of the go-to over-the-counter remedies, can you give us just a few tangible suggestions that people can arm themselves with as part of their new natural medicine cabinet?
MAYA: I would say, for many people, a good basis if they’re having symptoms is – assuming they tolerate all of them is fish oil, a good quality probiotic, and a B-complex. I put most people on that. If they’re experiencing significant symptoms, those are just good foundational things. If they’re having anxiety, or headaches, or seizures, or constipation, and/or I should say, or even a lot of times ADHD, magnesium, which they can take orally. They can also do Epsom salt baths. Sometimes if your gut is not in great shape, you’re not going to absorb the magnesium. It’s just going to give you a loose stool, so Epsom salts are great because it’s magnesium sulfate. You’re sitting in the bath and absorbing the magnesium through your skin. Magnesium is just a wonderful tool for almost all neurologic symptoms, so that’s one that I really like.
For me, I tend to be cautious saying what I use to treat SIBO only – in kids simply because they‘re botanicals, but they’re strong. I use goldenseal as one of them. There are things that I think are powerful and very effective in combination especially, but not things I would want kids to be on for months or years of time. Some of that, I would say it’s best to have someone holding your hand through that. I do think also – ear infections, I would say number one is really cutting dairy 100%.
PHOEBE: Really? That has a real correlation, the dairy and the ears?
MAYA: Yeah, and sometimes people who react to dairy cross-react to soy, so I always tell people to come off dairy and soy. Soy lecithin that’s in tiny amounts and things, that’s not an issue, but if it’s soy milk – you’ve stopped dairy, so you can have soy ice cream and soy cheese and soy yogurt. Don’t do that. Sometimes they overlap in terms of reactivity, but I will say, the ear infection thing, dairy is just – it’s a big one. What I say about ear infections is, that tube that gets blocked up, basically, when you get an ear infection, it’s basically the diameter of a hair on your head. If you’re a little bit inflamed, then it just stops up. There’s no movement. No flow of fluid, and then that stasis leads to bacterial growth. That’s how you get the ear infection. When you reduce inflammation simply by let’s say cutting dairy – I’m not going to say that’s 100% of the time, but it’s close to that that I see. Then I say definitely stop dairy.
The other thing I actually, believe it or not, recommend is going to a chiropractor who’s really comfortable doing pediatric adjustments. I don’t always send to chiropractors for different things. It really depends, but for ear infections in children, there are several papers on this. I actually did it for my own daughter. She had an ear infection when she was a baby, and they put her on antibiotics three times. It didn’t go away, and I took her to a pediatric chiropractor. They adjusted her one time, and she literally never got another ear infection.
PHOEBE: Wow, bodywork’s incredible.
MAYA: It is, and that’s that whole idea of you can make the suggestion to anything. You could do it through bodywork, through energetic work, through diet. There’s so many ways that we can find our in. That’s why what works for one person may not work for the other person. It didn’t mean it wasn’t effective for the first person. It’s just that you have to find that – what makes the right energetic suggestion, what your body answers to.
NATURAL HOME REMEDIES FOR FEVER
PHOEBE: Yeah, I love the example – well, just thinking as a parent, seeing your kid with an ear infection, seeing them with a fever or a headache, it’s distressing. I understand why people want to jump at the first substance, or pill, or what have you that can partially alleviate it, but you had such an interesting example in your book about how fevers are actually really productive for long-term immune development. I’m just curious what advice you would give to parents in terms of watching and waiting or in terms of something natural to lessen the symptoms without getting in the way of allowing your immune system to do its job. How can you make that determination as a parent, and what other tools do you have at your disposal besides Tylenol?
DR MAYA: For fever, if we’re talking an infant, especially under three months, you see the doctor. Over that, as kids are 4 months, 5 months, a year, 2 years and up, it’s actually possible to watch with a fever, and actually, there are interesting studies that show that our definition of fever has gotten lower and lower and lower. Where it was once maybe 103, people are like, yeah, that’s a fever. Now it’s 99 that people think or even less that they freak out about the fever. We’re really over treating where actually, the American Academy of Pediatrics says that fever is safe, in most kids – okay, there are some exceptions, but in most kids, fever is safe under 104. Like I said, I mean, there are kids that are immunosuppressed or that get febrile seizures or things like that. This is maybe a different category here, but if we’re talking about a generally healthy kid that gets a fever, it’s actually not necessary to chase it. It’s actually like the body is learning how to fight infection, and so it’s part of a whole immune response. There’s really nothing to be afraid of. You can measure the temperature.
The main thing to look at, though, for me is does the child look really toxic? Are they tired? Are they sleeping but they’re drinking? That’s one thing. I mean, in your gut, you’re like something is really off, and they’re really not themselves. Fever of no fever, you’re going to get them checked out. What I usually will give, if I’m comfortable that my child, for example – I’ll talk about my children. If they have a virus, I have things like elderflower or yarrow, and you can give this as a way to help the child sweat. Once you sweat, your fever comes down. It might not go to normal, and we’re not necessarily trying to achieve that.
It can help the fever come down if the child is really, really what I will call kind of poopy. They’re really just like a noodle. You know what I mean? You want to perk them up a little bit because they’re so hot and they’re so miserable. You can do that, and I use also peppermint oil compresses. You just make a glass of ice water, and put a couple of drops, that’s it, of peppermint essential oil. Put a washcloth in there and squeeze it out. That is very cooling, so that’s a way to help them feel comfortable. Then you watch them, and you watch to see if the fever comes down on its own, and they get better. I think there are people who would argue with this, obviously, but there’s really generally no reason to treat a fever in most kids that is under 104.
PHOEBE: How about for adults? Does all of this apply for us too, even though we’re less plastic and more fragile in a different kind of way?
MAYA: Adults don’t get fevers as often as kids do. Kids’ immune systems are so learning so much. That’s why it’s important for them to have these opportunities to fight off whatever it is they’re fighting off. When I said no need to treat, what I actually – I just want to clarify. I meant no need to treat with Tylenol, or Advil, or that kind of thing immediately. Not no need to treat –I obviously have my own little fever treating armamentarium. For adults, yes, all of these things can be applied as well, and usually, the most common reason an adult would have a fever would be they have the flu, for example, something like that. Obviously, you want to be watching a lot of different things. Yes, to treat fever, you can take those same kinds of things, and they will give you some relief.
PHOEBE: Amazing. I think it’s important for people to hear in general just to wean ourselves off of just the trigger happy nature that we use for over-the-counter drugs. We’ve talked about on past episodes how some of these things contribute to a dysregulated gut and, down the line, SIBO perhaps. I think all of the advice that you’ve given to day is really useful just in thinking about our greater gut health going forward for everyone involved. Is there anything you want to add before we say goodbye to our listeners today?
MAYA: No, I don’t think so. I mean, I think the only thing I would say is really don’t be afraid to get dirty. Actually, that’s one of the best ways to increase microbial diversity in a good way for all of us, including if you have SIBO. We really need to be rebalancing that gut flora, so getting outside, getting into nature, gardening, all of that stuff is just a really effective and, hopefully, fun way to improve your gut health.
PHOEBE: I love it. Thank you so much, Dr. Maya. I will link to your book in the show notes and your website so everyone can find you and read more about your work.
MAYA: Thank you for having me.
Disclaimer: The information shared in this podcast is not meant to provide medical advice, professional diagnosis, or treatment. The information discussed is for educational purposes only and is not a substitute for medical or professional care.
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