1 00:00:00,040 --> 00:00:03,000 Hey, I'm Hyper mobile and if you're listening to this, I'm 2 00:00:03,000 --> 00:00:06,480 guessing you might be too. Hi, my name is Alex and I'm your 3 00:00:06,480 --> 00:00:09,280 hyper mobile host. And today we are talking all 4 00:00:09,280 --> 00:00:14,520 about hyper mobility and your gut and this is one of those 5 00:00:14,520 --> 00:00:17,000 things that needs to be talked about more. 6 00:00:17,040 --> 00:00:20,720 So thank you for joining and I hope that you maybe share this 7 00:00:20,720 --> 00:00:23,600 with a friend or talk with other people you think who might be 8 00:00:23,600 --> 00:00:27,520 hyper mobile because this is an issue which has a lot of stigma. 9 00:00:27,520 --> 00:00:29,920 Firstly, gut issues are embarrassing. 10 00:00:30,160 --> 00:00:32,320 You know, we're going to, we'll talk in a second about some of 11 00:00:32,320 --> 00:00:34,720 what's going to be in this episode, but you know, it's not, 12 00:00:34,760 --> 00:00:37,520 it's not fun. It's also a sensitive subject. 13 00:00:38,040 --> 00:00:40,480 There are, you know, I'll do the trigger warning now let's just 14 00:00:40,480 --> 00:00:43,040 get out of the way. There are a lot of issues here 15 00:00:43,040 --> 00:00:46,360 which are very sensitive and very challenging to talk about 16 00:00:46,360 --> 00:00:49,750 for a variety of reasons. There are people out there who 17 00:00:49,750 --> 00:00:53,470 have different kinds of eating disorders and there is evidence 18 00:00:53,470 --> 00:00:55,910 to suggest that they are more prevalent in the hyper mobile 19 00:00:55,910 --> 00:00:58,150 community. Of course, we're also going to 20 00:00:58,150 --> 00:01:00,550 talk about things that are just embarrassing for some people 21 00:01:00,550 --> 00:01:04,980 like diarrhea and Constipation. So if this is an episode, maybe 22 00:01:04,980 --> 00:01:05,980 you're listening to with your kids. 23 00:01:05,980 --> 00:01:08,420 I don't know what people listen to these days for fun, but if 24 00:01:08,420 --> 00:01:11,740 you're listening to this and you want something which is 25 00:01:12,020 --> 00:01:17,260 definitely going to be a super like family friendly, happy, yay 26 00:01:17,260 --> 00:01:19,460 kind of vibe, this, this might not be that episode, but it'll 27 00:01:19,460 --> 00:01:21,100 be really cool and really interesting. 28 00:01:21,300 --> 00:01:25,660 So without a further delays, let's get started. 29 00:01:25,900 --> 00:01:30,820 So gut issues and hyper mobility, they go together like 30 00:01:30,940 --> 00:01:33,540 peanut butter and jam. They just, they they are two 31 00:01:33,540 --> 00:01:35,100 things which I see for the most part. 32 00:01:35,100 --> 00:01:38,580 Now I have to stress again my, my clinical role is as a UK 33 00:01:38,580 --> 00:01:41,580 registered osteopath. So I'm not a medical doctor, but 34 00:01:41,580 --> 00:01:43,820 I work with patients. They often come to see me 35 00:01:43,820 --> 00:01:45,100 because of their muscle and joint pain. 36 00:01:45,100 --> 00:01:47,660 And then I try my best to support them in terms of 37 00:01:47,660 --> 00:01:50,180 improving all the other stuff they have going on by making 38 00:01:50,180 --> 00:01:52,500 sure that they're getting that correct medical care and that 39 00:01:52,500 --> 00:01:55,700 correct medical management. But gut issues are one of those 40 00:01:55,700 --> 00:01:59,780 things I see in the vast majority of my patients for me 41 00:01:59,780 --> 00:02:02,380 to see a hyper mobile patient. So typically this will be 42 00:02:02,380 --> 00:02:06,780 someone with Hgds or HSD, occasionally another condition 43 00:02:06,820 --> 00:02:09,500 or someone who's undiagnosed and on that diagnostic journey. 44 00:02:09,820 --> 00:02:13,860 But for me, I'd say probably close to like 90% of my patients 45 00:02:13,860 --> 00:02:15,980 have got issues. And bear in mind my patient 46 00:02:15,980 --> 00:02:18,340 population are mainly people in their like 20s and 30s. 47 00:02:18,340 --> 00:02:21,420 I do have patients of all ages, but I have a lot of patients on 48 00:02:21,420 --> 00:02:24,100 that, kind of like younger side, 20s, thirties, 40s and so on. 49 00:02:25,000 --> 00:02:28,720 So for them to be having serious gut issues at this age suggests 50 00:02:28,960 --> 00:02:33,000 that there might be a link. Research of course is still 51 00:02:33,000 --> 00:02:34,200 ongoing. I'm going to talk about one 52 00:02:34,200 --> 00:02:36,480 study in particular in this episode which is super 53 00:02:36,640 --> 00:02:39,080 informative and helpful, in which I suggest you maybe read 54 00:02:39,080 --> 00:02:40,680 or speak with your medical doctor about it. 55 00:02:40,920 --> 00:02:43,200 The whole point of what I've just said is gut issues are 56 00:02:43,200 --> 00:02:47,440 common, OK? However, there are the 57 00:02:47,440 --> 00:02:50,320 occasional patients who don't have any gut issues and I'll 58 00:02:50,320 --> 00:02:51,560 I'll be doing their medical history. 59 00:02:52,110 --> 00:02:54,950 And I typically start off because I try to be sensitive 60 00:02:54,950 --> 00:02:57,190 when I ask people questions during a medical, medical 61 00:02:57,190 --> 00:02:59,110 history. So I'll say tell me about your 62 00:02:59,110 --> 00:03:01,670 relationship with food. That's how I typically like open 63 00:03:01,670 --> 00:03:03,390 the door to that kind of questioning. 64 00:03:03,750 --> 00:03:06,630 And then this occasional, very rare patient will just be like, 65 00:03:06,630 --> 00:03:08,710 oh, it's great. And I ask them, you know, any 66 00:03:08,710 --> 00:03:09,950 issues or, you know, blah, blah, blah. 67 00:03:10,430 --> 00:03:13,910 And they're like, yeah, I eat pizza with no issues. 68 00:03:14,470 --> 00:03:17,270 I can do whatever I want. My gut function is fine, No 69 00:03:17,270 --> 00:03:20,150 issues with my stools, no family history. 70 00:03:20,150 --> 00:03:23,310 Everything's like super rosy. And I'm just sitting there a 71 00:03:23,310 --> 00:03:26,350 little bit jealous, quite frankly, because gut issues are 72 00:03:26,350 --> 00:03:29,110 something that I do not personally have the best time 73 00:03:29,110 --> 00:03:32,830 with, but there are hyperbole. Patients who do not have gut 74 00:03:32,830 --> 00:03:34,510 issues. However, for the vast majority 75 00:03:34,510 --> 00:03:36,630 of people who do, this episode's for you. 76 00:03:36,990 --> 00:03:39,550 So I do have some notes with me today. 77 00:03:39,550 --> 00:03:41,550 You're going to see me glancing off them okay, because it's hard 78 00:03:41,550 --> 00:03:45,990 to remember all this stuff on camera, but gastrointestinal 79 00:03:46,430 --> 00:03:50,510 symptoms and disorders of the the gut brain interaction are 80 00:03:50,510 --> 00:03:52,950 common. So we need to think about why 81 00:03:52,950 --> 00:03:55,070 this happens a little bit and how we get that kind of 82 00:03:55,070 --> 00:03:57,830 connection, And we'll delve into that more later in this episode. 83 00:03:57,830 --> 00:04:00,350 But we know that people with anxiety often have altered gut 84 00:04:00,350 --> 00:04:02,820 function. We know that even in some 85 00:04:02,820 --> 00:04:05,220 neurodivergent conditions like autism, we're starting to see 86 00:04:05,220 --> 00:04:08,340 more and more evidence of gut dysfunction presenting in those 87 00:04:08,340 --> 00:04:10,020 individuals as well. And again, I'm not an expert on 88 00:04:10,020 --> 00:04:13,140 that subject, but we're seeing evidence clearly of a link 89 00:04:13,140 --> 00:04:15,620 between gut and brain function, which is not surprising when you 90 00:04:15,620 --> 00:04:17,700 consider that there are nerves that go to your gut and there's 91 00:04:17,700 --> 00:04:21,339 connective tissue there and it all makes a complex system. 92 00:04:21,899 --> 00:04:25,300 Now in terms of these individuals, these people who go 93 00:04:25,300 --> 00:04:28,860 on to become people who get disorders of gut brain 94 00:04:28,860 --> 00:04:32,470 interaction, my hunch is that these are going to be people and 95 00:04:32,470 --> 00:04:35,230 they're often hyper mobile children who are the ones who 96 00:04:35,230 --> 00:04:38,510 are saying, like, hey mom, my tummy hurts when I'm sad. 97 00:04:38,830 --> 00:04:42,630 And if this is you, if you're an adult and your tummy hurts when 98 00:04:42,630 --> 00:04:47,590 you're sad or your gut hurts when you're angry or you feel 99 00:04:47,590 --> 00:04:50,150 things in your gut, maybe there's a link. 100 00:04:50,430 --> 00:04:52,750 But again, we don't have research on that yet. 101 00:04:52,990 --> 00:04:58,510 Now in terms of causation and corelation and association, what 102 00:04:58,510 --> 00:05:03,160 we can say about gut issues, and we're talking here things like 103 00:05:03,480 --> 00:05:07,080 diarrhea, Constipation, we're talking about things like 104 00:05:07,520 --> 00:05:09,600 flatulence. And in all honesty, I mean, you 105 00:05:09,600 --> 00:05:11,320 need to talk about it, which because it's hard when you're 106 00:05:11,520 --> 00:05:14,120 when you're a young person in your 20s and you know you're 107 00:05:14,120 --> 00:05:15,960 trying to navigate all that and then you're having issues with 108 00:05:15,960 --> 00:05:20,480 upset tummy and flatulence, That's embarrassing early, early 109 00:05:20,480 --> 00:05:23,680 feelings of fullness. We see things like rumination, 110 00:05:23,680 --> 00:05:25,440 where food is coming up when it shouldn't. 111 00:05:25,440 --> 00:05:31,680 We see things like different types of digestive pain, all of 112 00:05:31,680 --> 00:05:36,560 these different things we see in hyper mobile individuals and we 113 00:05:36,560 --> 00:05:39,160 know and the researchers at this present moment are very 114 00:05:39,160 --> 00:05:41,800 confident in saying that there is certainly an association and 115 00:05:41,840 --> 00:05:43,400 a correlation. So we know. 116 00:05:43,760 --> 00:05:47,560 So when we look at a hyperbole population, there is a greater 117 00:05:47,960 --> 00:05:50,880 there seems to be evidence of some kind of a link between 118 00:05:51,040 --> 00:05:54,480 hyperbole individuals and gut issues that we see in people. 119 00:05:54,480 --> 00:05:57,760 However, as of this point in time, what is it? 120 00:05:57,760 --> 00:06:00,240 It's August 2023. Summer is almost over. 121 00:06:00,620 --> 00:06:04,300 We don't know the exact mechanism that's causing this, 122 00:06:04,580 --> 00:06:07,940 and I'm going to share my unresearched hypothesis on that 123 00:06:07,940 --> 00:06:09,900 today. So if this interests you, you're 124 00:06:09,900 --> 00:06:11,420 going to get to hear my theories. 125 00:06:11,540 --> 00:06:15,330 However, oh by the way, I'm going to put some tips at the 126 00:06:15,330 --> 00:06:17,210 end on things that I do with patients, like little tips, 127 00:06:17,210 --> 00:06:19,410 strategies, things you can speak with your medical doctor about 128 00:06:19,410 --> 00:06:21,690 that might help you. So stay tuned for that. 129 00:06:21,850 --> 00:06:25,210 However, before we go any further, we have to talk about 130 00:06:25,210 --> 00:06:29,290 something really, really serious and this is something I hate in 131 00:06:29,290 --> 00:06:31,570 my clinical work. It's the single hardest thing 132 00:06:31,570 --> 00:06:34,650 about my work. It causes me an overwhelming, 133 00:06:34,650 --> 00:06:36,010 sometimes an overwhelming amount of stress. 134 00:06:36,010 --> 00:06:39,490 It's so stressful, but when you work with patients who have 135 00:06:39,490 --> 00:06:42,410 chronic health issues and especially the hyper mobile 136 00:06:42,410 --> 00:06:45,430 population who are my favorite forever and always, however, 137 00:06:46,150 --> 00:06:50,310 they do cause me stress. We see the situation where this 138 00:06:50,310 --> 00:06:55,230 person has, for example, gut pain and they have a change in 139 00:06:55,230 --> 00:06:57,990 bowel habit and we play the I call it a game. 140 00:06:57,990 --> 00:07:00,030 I don't mean in like a funny sense, I mean kind of, you know, 141 00:07:00,030 --> 00:07:02,910 in a maybe dark humor sense. We play this game of like, is 142 00:07:02,910 --> 00:07:05,470 it, is it HEDS stuff? Like, is it HSD stuff? 143 00:07:05,470 --> 00:07:07,990 Is it, you know, one of their diagnosed condition stuff or is 144 00:07:07,990 --> 00:07:11,070 it something sinister, something else, something perhaps even 145 00:07:11,070 --> 00:07:14,730 like bowel cancer? And this is where things get 146 00:07:15,010 --> 00:07:17,330 hard, they get clinically complicated and they get 147 00:07:17,330 --> 00:07:22,250 downright dangerous sometimes. So I want to just read actually 148 00:07:23,170 --> 00:07:26,010 a a quotation from Deborah James. 149 00:07:26,170 --> 00:07:29,890 She's a she was a Dame in the UK How a woman in the UK who 150 00:07:29,890 --> 00:07:32,130 received a Dame hood, as they do over here. 151 00:07:32,610 --> 00:07:37,530 And she writes about her experience and her kind of like 152 00:07:37,570 --> 00:07:40,010 how she first presented with bowel symptoms. 153 00:07:40,740 --> 00:07:45,260 And this struck A chord with me because it sounds exactly like 154 00:07:45,260 --> 00:07:48,940 what I hear from my patients. And although most of the time 155 00:07:49,300 --> 00:07:53,460 it's nothing serious, if we if we say that sometimes it is. 156 00:07:53,660 --> 00:07:56,060 And as regardless with anyone, I don't care if the patient's 90. 157 00:07:56,060 --> 00:07:58,900 I think we need to manage everyone like their life really 158 00:07:58,900 --> 00:08:00,620 matters. And like we, you know, we want 159 00:08:00,620 --> 00:08:02,580 to protect their best health outcomes. 160 00:08:02,940 --> 00:08:06,380 However, especially for younger patients, we really, really need 161 00:08:06,380 --> 00:08:09,660 to be on it and we need to not be missing cases where we could 162 00:08:09,660 --> 00:08:11,900 potentially, you know, save someone's life, protect that 163 00:08:11,900 --> 00:08:14,700 person who maybe she's someone's daughter, maybe she's someone's 164 00:08:14,700 --> 00:08:18,020 mother. May, you know, we people, I try 165 00:08:18,020 --> 00:08:20,100 and remember that every single patient I see, they're they're 166 00:08:20,100 --> 00:08:23,420 usually loved by people and they matter and they bring good into 167 00:08:23,420 --> 00:08:25,700 the world. So we need to always, always be 168 00:08:26,020 --> 00:08:28,860 taking everything so seriously and on the lookout for those 169 00:08:28,860 --> 00:08:33,500 scary and serious causes of symptoms, which most of the time 170 00:08:33,500 --> 00:08:35,710 are going to be nothing. But anyways, here's the quote, 171 00:08:35,710 --> 00:08:37,870 OK? Deborah James says I'm the 172 00:08:37,870 --> 00:08:40,470 perfect example of a hypochondriac, one that 173 00:08:40,470 --> 00:08:43,789 immediately thinks dizziness means a brain tumor, a cough 174 00:08:43,789 --> 00:08:47,230 means lung cancer, and blood in the stools means bowel cancer. 175 00:08:47,430 --> 00:08:51,310 However, years of CBT has meant that I've learned to rationalize 176 00:08:51,310 --> 00:08:55,190 almost every ailment inducing symptom, the last year of a 177 00:08:55,390 --> 00:08:59,190 change in bowel habits that I put down to too much wine, a new 178 00:08:59,190 --> 00:09:02,750 job, and stress of trying to be that fulltime working supermom. 179 00:09:02,950 --> 00:09:05,630 If only someone believed me earlier that I wasn't crying 180 00:09:05,630 --> 00:09:08,270 wolf. When in my normal nervous GP 181 00:09:08,270 --> 00:09:11,710 Question Time, I tell the doctor that I think I have bowel 182 00:09:11,710 --> 00:09:14,470 cancer. I'm actually laughed at not one 183 00:09:14,470 --> 00:09:18,590 time, but three times over the course of six months, despite 184 00:09:18,590 --> 00:09:22,950 being reassured on numerous occasions that I must have I BS 185 00:09:23,070 --> 00:09:26,790 hemorrhoids or at worse colitis. My blood test and stool sample 186 00:09:26,790 --> 00:09:29,030 came back normal, so everything must be fine. 187 00:09:29,230 --> 00:09:32,810 And yet I was still losing weight, passing blood, going 188 00:09:32,810 --> 00:09:35,250 what felt like 100 times a day and feeling shattered. 189 00:09:35,450 --> 00:09:39,970 So this quotation really struck A chord with me because as like 190 00:09:39,970 --> 00:09:42,250 this is from someone who had bowel cancer and who died of 191 00:09:42,250 --> 00:09:45,410 bowel cancer, I believe she passed away when she was 40 and 192 00:09:45,410 --> 00:09:47,210 it was about a year ago, I think now. 193 00:09:47,370 --> 00:09:51,010 But anyways, this quotation could have been just as easily 194 00:09:51,010 --> 00:09:53,650 from someone who's hyper mobile. I see patients all the time who 195 00:09:53,650 --> 00:09:57,870 have chronic diarrhea who have issues with hemorrhoids, for 196 00:09:57,870 --> 00:10:00,430 example, and sometimes it is hemorrhoids causing blood in the 197 00:10:00,430 --> 00:10:03,710 stool. But what scares me is just when 198 00:10:03,710 --> 00:10:08,850 there's what I believe to be not careful enough management. 199 00:10:08,850 --> 00:10:12,410 So I'll see patients who tell me about all these symptoms and and 200 00:10:12,410 --> 00:10:14,010 people do tend to open up to me a bit. 201 00:10:14,010 --> 00:10:17,050 I think it's just because I'm, I'm lucky in that in my work as 202 00:10:17,050 --> 00:10:19,210 someone who works in the private healthcare system, I do have 203 00:10:19,210 --> 00:10:21,970 more time with my patients and that does that helps patient 204 00:10:21,970 --> 00:10:24,330 safety immensely. But I'll talk with my patients 205 00:10:24,330 --> 00:10:26,770 and they say, you know, I was told that I had IBS through a 206 00:10:26,770 --> 00:10:29,890 phone consultation that lasted 5 minutes and I had no testing. 207 00:10:29,890 --> 00:10:31,850 And we didn't really talk about anything. 208 00:10:31,850 --> 00:10:34,490 Like, you know, the way that you've talked with me and that 209 00:10:34,690 --> 00:10:37,570 always makes me scared. I don't like that. 210 00:10:37,890 --> 00:10:40,690 And that's why part of my work is that I, I do try and support 211 00:10:40,690 --> 00:10:42,530 patients and make sure, you know, I'll tell the patient, 212 00:10:42,530 --> 00:10:44,170 look, you know, I think this was okay. 213 00:10:44,170 --> 00:10:46,570 If, if it's a situation where it sounds okay or I'll say, you 214 00:10:46,570 --> 00:10:48,250 know, I am quite concerned about this. 215 00:10:48,250 --> 00:10:51,450 I am quite concerned that you didn't have time to talk with 216 00:10:51,450 --> 00:10:54,250 the doctor about the blood in your stool or whatever, right. 217 00:10:54,530 --> 00:10:58,450 So it's about that, that's it's about safety, patient safety. 218 00:10:58,450 --> 00:11:02,080 Ultimately, this is what it's all about and with gut issues, 219 00:11:02,080 --> 00:11:04,400 it is very nuanced and very, very complex. 220 00:11:04,400 --> 00:11:08,600 And I do think that perhaps diagnosis of IBS, Irritable 221 00:11:08,600 --> 00:11:10,920 bowel syndrome, that they're thrown out like, I don't know, 222 00:11:10,920 --> 00:11:15,400 like it's a a free it's thrown out with a lot of without the 223 00:11:15,400 --> 00:11:17,800 correct medical investigation that it should have in a lot of 224 00:11:17,800 --> 00:11:19,720 the time. And you can go to your research 225 00:11:19,720 --> 00:11:22,600 online, you can look into what a diagnosis of IBS should entail. 226 00:11:22,880 --> 00:11:26,760 But it's not just something that you can say without having 227 00:11:26,960 --> 00:11:29,120 checked that patient, without having done investigations, 228 00:11:29,120 --> 00:11:30,400 without making sure that they're safe. 229 00:11:31,140 --> 00:11:33,860 So anyways, gut issues. I'm going to talk about them 230 00:11:33,860 --> 00:11:34,940 here. I'm going to provide a lot of 231 00:11:34,940 --> 00:11:37,940 reasons why things might happen in hyper mobile bodies and why 232 00:11:37,940 --> 00:11:41,060 things might be a bit weird. But at the end of the day, if 233 00:11:41,060 --> 00:11:44,820 you leave with one message from this episode, the most important 234 00:11:44,820 --> 00:11:50,260 thing is to firstly to know your normal and to know what's 235 00:11:50,340 --> 00:11:53,100 abnormal from your normal. And knowing your normal is so 236 00:11:53,100 --> 00:11:55,100 hard when you're a hyper mobile person because your body's 237 00:11:55,100 --> 00:11:56,740 constantly changing. It's in a flux. 238 00:11:56,900 --> 00:11:59,380 You don't know if it's going to be a good day or a bad day or 239 00:11:59,620 --> 00:12:02,410 you know it's that. I talk about it being like a 240 00:12:02,410 --> 00:12:04,970 tropical island, like in your body, instead of having a 241 00:12:04,970 --> 00:12:07,210 constant climate, you have these, you know, thunderstorms 242 00:12:07,210 --> 00:12:09,370 in the morning and sunshine in the afternoon and maybe a 243 00:12:09,370 --> 00:12:12,010 rainbow later, maybe followed by hail like though it becomes 244 00:12:12,010 --> 00:12:14,730 unpredictable. But as much as possible 245 00:12:14,730 --> 00:12:17,650 hyperbole, patients need to be supported in learning what their 246 00:12:17,650 --> 00:12:20,770 normal is, that if something gets weird, they're able to 247 00:12:20,770 --> 00:12:23,570 clock it and they're able to flag it to their healthcare 248 00:12:23,570 --> 00:12:26,530 provider, who they hopefully have, who is a hopefully 249 00:12:26,530 --> 00:12:29,210 appropriately qualified and that they trust and that they feel 250 00:12:29,210 --> 00:12:32,250 able to communicate to them about this stuff that that is 251 00:12:32,250 --> 00:12:34,850 the most important thing. So that is my message for you. 252 00:12:35,130 --> 00:12:40,690 Now moving on, there is an absolutely brilliant research 253 00:12:40,690 --> 00:12:41,770 paper. It's a narrative review. 254 00:12:41,770 --> 00:12:45,610 I believe it was published in 2022 and it's called hypermobile 255 00:12:45,610 --> 00:12:47,650 elders dental syndrome and disorders of the 256 00:12:47,650 --> 00:12:50,810 gastrointestinal tract. What every gastrointesterol 257 00:12:50,930 --> 00:12:54,210 gastroenterologist, Well, I'm losing my words today, needs to 258 00:12:54,210 --> 00:12:57,130 know if you are someone who's trying to get investigated for 259 00:12:57,130 --> 00:12:59,810 gastro issues or if you're a gastroenterologist who's 260 00:12:59,810 --> 00:13:02,050 listening to this and maybe you keep having these like 261 00:13:02,050 --> 00:13:04,250 hypermobile people showing up and you don't know what's going 262 00:13:04,250 --> 00:13:06,610 on. That paper looks awesome to me. 263 00:13:06,690 --> 00:13:07,930 I've read through it a few times. 264 00:13:08,090 --> 00:13:09,170 I think it's really well written. 265 00:13:09,170 --> 00:13:10,890 I think it's very clear and it's very short. 266 00:13:11,130 --> 00:13:16,320 Who doesn't love a short paper, but there they talk really about 267 00:13:17,120 --> 00:13:21,440 the prevalence of different types of of gut issues that we 268 00:13:21,440 --> 00:13:25,960 see in patients. We are seeing things like, for 269 00:13:25,960 --> 00:13:28,640 example, an increased rate of celiac disease. 270 00:13:28,640 --> 00:13:30,770 Potentially. We are seeing things like 271 00:13:30,770 --> 00:13:33,210 potentially an increased rate of interception, which is when the 272 00:13:33,210 --> 00:13:35,010 bowel kind of folds in on itself. 273 00:13:35,210 --> 00:13:38,050 And those are two examples of different kind of things. 274 00:13:38,130 --> 00:13:40,490 And that leads us into the next part of this episode. 275 00:13:40,490 --> 00:13:42,290 We talk about like what's actually going on? 276 00:13:42,290 --> 00:13:43,850 Why are hypermobile got so weird? 277 00:13:44,090 --> 00:13:47,290 So here's my theory. Hypermobile got so weird for two 278 00:13:47,290 --> 00:13:48,650 reasons. We have them. 279 00:13:48,930 --> 00:13:51,170 Well, three, but we're going to start with two, OK. 280 00:13:51,690 --> 00:13:54,010 Firstly, there's a mechanical side of everything. 281 00:13:54,130 --> 00:13:57,090 So if you listen, if you've been listening to this long enough, 282 00:13:57,090 --> 00:14:00,030 you know I always end up talking about mechanical issues and 283 00:14:00,030 --> 00:14:03,870 inflammatory issues. So your gut is a tube. 284 00:14:04,110 --> 00:14:07,510 It is a tube of connective tissue, which as you can imagine 285 00:14:07,830 --> 00:14:10,110 is not the best thing for a lot of people who have connective 286 00:14:10,110 --> 00:14:14,210 tissue disorders. I want to stress to you that you 287 00:14:14,210 --> 00:14:17,330 are like a donut. So if we took your body, and I 288 00:14:17,330 --> 00:14:19,490 promise this will make sense in a second, just just bare me out. 289 00:14:19,930 --> 00:14:22,850 So just hear me out or bear with me or do both. 290 00:14:22,890 --> 00:14:25,450 It's up to you. You are a donut, so you have a 291 00:14:25,450 --> 00:14:29,250 tube, Your mouth is the start of the tube, your your bum is 292 00:14:29,290 --> 00:14:33,210 banned and basically that space is hollow inside you. 293 00:14:33,210 --> 00:14:37,250 So if you imagine a donut, your body is like the part that you 294 00:14:37,250 --> 00:14:40,540 would eat and your gastrointestinal tract is that 295 00:14:40,740 --> 00:14:42,620 hole in the middle. That's what that tube is. 296 00:14:42,780 --> 00:14:45,820 Your gastrointestinal tract is where your body has to deal with 297 00:14:45,820 --> 00:14:48,020 the outside world. When you eat food, you're taking 298 00:14:48,020 --> 00:14:50,380 the outside world and you're putting it inside you. 299 00:14:51,060 --> 00:14:53,740 And that's firstly, that's really, really cool and just 300 00:14:53,740 --> 00:14:55,940 normal Physiology. I think guts are so interesting. 301 00:14:56,380 --> 00:15:00,220 But secondly, that's why we see a lot of these different types 302 00:15:00,220 --> 00:15:02,340 of issues with food sensitivities and allergies and 303 00:15:02,340 --> 00:15:05,120 all these different things because you're being exposed to 304 00:15:05,120 --> 00:15:07,160 your outside the outside world through your gut. 305 00:15:07,160 --> 00:15:10,160 Because you, even though you might not have known it until 306 00:15:10,360 --> 00:15:12,240 right the second you're a doughnut. 307 00:15:12,480 --> 00:15:15,960 Now the problem is that the food you don't just like, take it and 308 00:15:15,960 --> 00:15:18,680 you don't just go like lip, like drop it in your mouth and then 309 00:15:18,680 --> 00:15:21,200 it just magically goes down. That's not how this works. 310 00:15:21,720 --> 00:15:25,960 There are many, many steps to getting food from here to the 311 00:15:26,040 --> 00:15:29,720 end of its journey. So starting at the the mouth, we 312 00:15:29,720 --> 00:15:31,120 look from a mechanical perspective. 313 00:15:31,120 --> 00:15:33,120 Again just talking about hyper mobile patients and some of the 314 00:15:33,120 --> 00:15:35,680 mechanical issues they might encounter on the the journey of 315 00:15:35,680 --> 00:15:39,160 food. You have to firstly chew the 316 00:15:39,160 --> 00:15:42,080 food and a lot of hyper mobile patients have issues with their 317 00:15:42,080 --> 00:15:44,160 teeth. We see gingivitis, we see 318 00:15:44,160 --> 00:15:47,280 patients who have lost teeth, we see all types of dental issues. 319 00:15:47,280 --> 00:15:49,080 We'll do a dental episode one day, don't worry. 320 00:15:49,480 --> 00:15:53,800 But we also see all TMTMJ issues, which makes chewing food 321 00:15:54,080 --> 00:15:56,150 painful. So of course we have problems 322 00:15:56,150 --> 00:15:58,550 there to begin with, and not even that's without even 323 00:15:58,550 --> 00:16:01,110 considering about issues involving not feeling hungry. 324 00:16:01,110 --> 00:16:03,670 And we're going to get into some of the neurology stuff later in 325 00:16:03,670 --> 00:16:06,070 this episode. But you have to chew the food, 326 00:16:06,430 --> 00:16:07,790 You don't have to swallow the food. 327 00:16:08,070 --> 00:16:11,950 Swallowing is complicated. It's a series of movements which 328 00:16:11,950 --> 00:16:15,070 is incredibly complex, and it's one of those things, if it 329 00:16:15,070 --> 00:16:17,070 happens for you, you just take it for granted. 330 00:16:17,350 --> 00:16:19,910 But for patients who have issues with it, it's something which 331 00:16:19,950 --> 00:16:23,790 really does affect their quality of life and requires sometimes 332 00:16:23,790 --> 00:16:26,030 very complex medical management. And it's one of those things 333 00:16:26,270 --> 00:16:28,710 that I'm always looking out for in patients because I want to 334 00:16:28,710 --> 00:16:30,310 make sure that we catch it early. 335 00:16:30,550 --> 00:16:33,670 I don't like to miss things that can lead to problems because 336 00:16:33,670 --> 00:16:35,670 then it sucks for the patient, It sucks for me. 337 00:16:35,990 --> 00:16:38,430 So swallowing issues or something, I try to be very, 338 00:16:38,430 --> 00:16:43,160 very quick to identify, but some people have very, very mild 339 00:16:43,160 --> 00:16:44,200 issues. Maybe they'll just have a hard 340 00:16:44,200 --> 00:16:46,200 time swallowing a pill, maybe their Airways. 341 00:16:46,200 --> 00:16:47,680 A little bit different in terms of the anatomy. 342 00:16:47,680 --> 00:16:49,920 But other people will have very serious issues where they they 343 00:16:49,920 --> 00:16:53,200 really do struggle to swallow anything anyways. 344 00:16:53,200 --> 00:16:56,000 So you have to swallow the food. Now the food goes down your 345 00:16:56,000 --> 00:16:59,280 esophagus and you might not notice you've like little valves 346 00:16:59,280 --> 00:17:01,240 along the way. So little like flaps throughout 347 00:17:01,240 --> 00:17:03,200 your body. And their job is to hold stuff 348 00:17:03,200 --> 00:17:05,000 in certain places. So you have little flaps which 349 00:17:05,000 --> 00:17:07,400 are meant to like once food goes through it, hold it down in the 350 00:17:07,400 --> 00:17:11,660 stomach and sometimes hyper mobile people have issues with 351 00:17:11,660 --> 00:17:13,579 those flaps. From a mechanical perspective 352 00:17:13,579 --> 00:17:17,980 with those valves, you're not going to be surprised. 353 00:17:18,099 --> 00:17:21,700 Sometimes they're hyper mobile. And what this means is that food 354 00:17:21,700 --> 00:17:24,700 that has gone down and should stay down does not always do 355 00:17:24,700 --> 00:17:26,420 that. Sometimes it will kind of come 356 00:17:26,420 --> 00:17:29,180 back up and that can present as different things. 357 00:17:29,460 --> 00:17:31,820 You can have rumination where food is coming up all the way 358 00:17:31,820 --> 00:17:33,860 back into the mouth and it's actually undigested. 359 00:17:33,860 --> 00:17:35,380 So it's coming back up very, very quick. 360 00:17:35,820 --> 00:17:38,620 You can also have things like hiatal hernias, which is where 361 00:17:38,860 --> 00:17:40,900 one of the valves in your esophagus is not quite working 362 00:17:40,900 --> 00:17:43,260 as it should. And that food is, is coming back 363 00:17:43,260 --> 00:17:46,140 up and presenting almost as symptoms that we would refer to 364 00:17:46,140 --> 00:17:49,300 as heartburn. However, moving on, let's 365 00:17:49,300 --> 00:17:51,340 pretend that the food has made it to the stomach. 366 00:17:51,840 --> 00:17:54,360 The food then has to get digested in the stomach. 367 00:17:54,440 --> 00:18:00,000 Now there's a whole, like, you know, biochemical situation that 368 00:18:00,000 --> 00:18:02,040 happens down here involving acid and all these other things, 369 00:18:02,040 --> 00:18:03,600 which is really cool. We're going to leave set that to 370 00:18:03,600 --> 00:18:05,440 the side for a SEC. But there's also a whole 371 00:18:05,440 --> 00:18:07,720 mechanical process like where your stomach is literally 372 00:18:07,720 --> 00:18:09,200 helping to kind of smoosh the food. 373 00:18:09,200 --> 00:18:11,520 So your stomach does all these like, squishing motions. 374 00:18:11,880 --> 00:18:13,240 I'm. I'm showing it with my hands if 375 00:18:13,240 --> 00:18:16,680 you're watching on YouTube, hi. But like your stomach, it's 376 00:18:16,680 --> 00:18:19,640 squishing the food to try and further smoosh it so it can then 377 00:18:19,640 --> 00:18:23,220 go into your small intestine. So the food then gets into the 378 00:18:23,220 --> 00:18:26,140 intestines. And this is where things start 379 00:18:26,140 --> 00:18:28,380 to get, I was going to say more problematic, but there's 380 00:18:28,380 --> 00:18:30,380 problems along the whole track. So this is just like different 381 00:18:30,380 --> 00:18:33,540 problems, OK, but this is where some new problems crop up. 382 00:18:33,820 --> 00:18:37,540 So we do a lot of absorption of nutrients in the small 383 00:18:37,540 --> 00:18:40,690 intestine. It's very, very important And 384 00:18:40,730 --> 00:18:44,570 unfortunately sometimes hypermobile people do have 385 00:18:44,730 --> 00:18:46,330 issues with this. And This is why you'll see these 386 00:18:46,330 --> 00:18:48,970 patients who thought like instead of just having normal 387 00:18:49,210 --> 00:18:51,890 blood values for different vitamins and so on, they'll have 388 00:18:51,970 --> 00:18:54,130 like slightly low but not that low that it's concerning. 389 00:18:54,130 --> 00:18:56,330 But just they'll always they'll be patients who kind of they 390 00:18:56,330 --> 00:18:58,930 have things going on in their blood work that aren't causing 391 00:18:58,930 --> 00:19:00,610 them immediate harm, but we don't know why they're 392 00:19:00,610 --> 00:19:02,090 happening. That's that's kind of like a 393 00:19:02,090 --> 00:19:04,210 classic presentation that I see in my patients. 394 00:19:05,130 --> 00:19:07,770 But with the small intestine, we will have issues with vitamin 395 00:19:07,770 --> 00:19:09,770 absorption there, especially B vitamins. 396 00:19:09,930 --> 00:19:13,530 And I think that that might happen partially and this is 397 00:19:13,530 --> 00:19:15,890 just my hypothesis. Again, there's no research to 398 00:19:15,890 --> 00:19:17,890 prove this at this point in time, although hopefully there 399 00:19:17,890 --> 00:19:21,410 will be one day. But the food is moving either 400 00:19:21,410 --> 00:19:25,010 too slowly or too quickly through the the small intestine 401 00:19:25,010 --> 00:19:27,290 and the large intestine that that's my thought and let me 402 00:19:27,290 --> 00:19:29,330 give you an example. So imagine that you have a 403 00:19:29,490 --> 00:19:32,690 factory in a conveyor belt and certain things need to happen 404 00:19:32,690 --> 00:19:35,010 along the conveyor belt at certain points in time. 405 00:19:35,290 --> 00:19:37,930 So let's pretend that we're making little like wooden fire 406 00:19:37,930 --> 00:19:38,610 trucks. I don't know. 407 00:19:38,610 --> 00:19:39,850 We're make whatever we're making. 408 00:19:40,320 --> 00:19:43,400 The belt cannot move too fast because if I have to assemble 409 00:19:43,400 --> 00:19:45,960 the truck and then the next person has to be like painting 410 00:19:45,960 --> 00:19:49,040 it and the final person has to like put a sticker on it, I 411 00:19:49,040 --> 00:19:52,640 don't know if that belt is going too fast. 412 00:19:53,320 --> 00:19:55,680 It's not going to happen. It's the end product is going to 413 00:19:55,680 --> 00:19:59,730 look like a hot mess, but if the belt is moving too slow, then 414 00:19:59,730 --> 00:20:02,610 the person at the end of the you know, the conveyor belt, they 415 00:20:02,610 --> 00:20:05,170 might just go home at a certain point to go to sleep. 416 00:20:05,170 --> 00:20:07,570 So again, we're gonna end up with a problem that that product 417 00:20:07,570 --> 00:20:10,370 is not happening as it should, that series of events is not 418 00:20:10,370 --> 00:20:12,770 happening as it should. So This is why. 419 00:20:13,290 --> 00:20:17,250 Normal gut motility is very, very important. 420 00:20:17,250 --> 00:20:21,250 Your food must move through you at the correct rate in order for 421 00:20:21,250 --> 00:20:23,530 the correct things to happen at the correct time. 422 00:20:23,690 --> 00:20:25,930 We could kind of just an episode there, to be honest with that. 423 00:20:26,330 --> 00:20:31,010 That is like gut function summed up okay things need to happen in 424 00:20:31,010 --> 00:20:33,530 the right way at the right time and stuff has to move through 425 00:20:33,530 --> 00:20:36,550 you at the right speed. Now hyper mobile patients 426 00:20:36,630 --> 00:20:40,190 classically will present when we get to kind of the the end 427 00:20:40,190 --> 00:20:43,070 product of human digestion if you call it that's we're talking 428 00:20:43,310 --> 00:20:45,230 stool, let's let's use that word for today. 429 00:20:46,470 --> 00:20:48,670 But they will end up with a mixture often, very often of 430 00:20:48,670 --> 00:20:50,950 diarrhea and Constipation and they don't know which. 431 00:20:51,350 --> 00:20:57,270 But the the question that I ask patients is, have you ever had a 432 00:20:57,270 --> 00:21:00,590 normal stool, which seems weird. But if you're a hyper mobile 433 00:21:00,590 --> 00:21:03,030 person listening to this, perhaps this will actually seem 434 00:21:03,030 --> 00:21:04,190 like a very normal question to you. 435 00:21:04,190 --> 00:21:07,790 Because so many of my patients look at me and they say no, I do 436 00:21:07,790 --> 00:21:10,510 not feel like I've ever had a normal stool. 437 00:21:10,950 --> 00:21:12,710 And I've done social media content where I show like the 438 00:21:12,710 --> 00:21:14,990 the Bristol Stool Chart which has pictures of different types 439 00:21:14,990 --> 00:21:17,710 of stool and what's normal and what's considered Constipation 440 00:21:17,710 --> 00:21:19,030 and diary and all this different stuff. 441 00:21:19,430 --> 00:21:22,230 And like the hyper mobile person's a dream is to be. 442 00:21:22,230 --> 00:21:26,580 I think it's a three on that chart and basically it very few 443 00:21:26,580 --> 00:21:28,700 people are. Again, there are those hyper 444 00:21:28,700 --> 00:21:31,620 mobile patients who have wonderful guts and I hate you. 445 00:21:31,780 --> 00:21:34,540 I just just kidding. No, I'm very, very happy for 446 00:21:34,540 --> 00:21:36,580 you. I just wish that every I wish 447 00:21:36,580 --> 00:21:38,300 all of my patients could have normal gut function. 448 00:21:39,500 --> 00:21:44,460 And of course one thing I don't want to forget to mention of in 449 00:21:44,460 --> 00:21:46,860 terms of serious things And again, this episode is not 450 00:21:46,860 --> 00:21:48,660 comprehensive. We need to do a whole series on 451 00:21:48,660 --> 00:21:50,340 gut function. I would love if we could get 452 00:21:50,340 --> 00:21:53,180 someone on here who knows a lot more than me about gut function. 453 00:21:54,110 --> 00:21:56,230 But anyways, another issue I do want to mention, just because it 454 00:21:56,230 --> 00:21:58,990 shows up on social media quite often too, is something called 455 00:21:58,990 --> 00:22:02,110 gastroparesis. So this refers to when your 456 00:22:02,110 --> 00:22:06,670 stomach stops digesting food. So again, a lot of things have 457 00:22:06,670 --> 00:22:09,990 to happen to make that stomach work and to make food move down 458 00:22:09,990 --> 00:22:12,980 the digestive tract and sometimes it stops. 459 00:22:12,980 --> 00:22:17,980 And this is incredibly serious. This can result in this is I 460 00:22:17,980 --> 00:22:20,420 would say, a life threatening. It is life threatening if it's 461 00:22:20,420 --> 00:22:22,060 not managed appropriately. Absolutely. 462 00:22:22,300 --> 00:22:25,260 But this is something which needs to not be missed. 463 00:22:25,260 --> 00:22:28,260 And so often I will see patients, you know, these are 464 00:22:28,260 --> 00:22:31,180 people who are losing weight and so on, but they're they're young 465 00:22:31,180 --> 00:22:33,500 and they're often quite slender patients to begin with. 466 00:22:33,500 --> 00:22:35,910 And then they're telling, you know, I've spoken to my doctor, 467 00:22:35,910 --> 00:22:38,590 my doctor's ignoring me and that's when I have to get in 468 00:22:38,590 --> 00:22:40,430 that position. So you know what, we we cannot 469 00:22:40,430 --> 00:22:42,750 be ignored here because I don't feel happy with this management. 470 00:22:42,750 --> 00:22:44,630 So you know, I'm going to figure out what we can do. 471 00:22:44,630 --> 00:22:48,150 We we've got to sort this because it can lead to this 472 00:22:48,150 --> 00:22:50,550 basically the stomach not being able to work properly anymore. 473 00:22:50,630 --> 00:22:53,790 And then we have to of course look at different types of TPN 474 00:22:53,790 --> 00:22:55,710 and different nutritional options which which involve 475 00:22:55,710 --> 00:22:58,880 tubes and so on, which can of which are wonderful for the 476 00:22:58,880 --> 00:23:00,960 patients who need them. But my goal is to always of 477 00:23:00,960 --> 00:23:03,680 course, prevent people from from getting to that point ideally. 478 00:23:04,240 --> 00:23:06,280 And again, remember I am a UK registered osteopath. 479 00:23:06,360 --> 00:23:09,040 I'm just trying to support my patients when I see that they've 480 00:23:09,040 --> 00:23:11,320 had certain things perhaps missed in their medical 481 00:23:11,320 --> 00:23:13,720 management. But does everyone get 482 00:23:13,720 --> 00:23:15,440 gastroparesis? No, they don't. 483 00:23:15,440 --> 00:23:17,120 Not every hyper mobile person will get it. 484 00:23:17,120 --> 00:23:18,560 Do some people get it? Absolutely. 485 00:23:18,880 --> 00:23:20,880 And it's something we want to make sure that we're looking out 486 00:23:20,880 --> 00:23:25,340 for 100%. And again, we will do a separate 487 00:23:25,340 --> 00:23:27,260 episode on that. But in short, if you're having 488 00:23:27,260 --> 00:23:31,260 people who are not able to keep food down, they're never hungry, 489 00:23:31,260 --> 00:23:34,580 they're not eating, they're having things. 490 00:23:34,580 --> 00:23:37,940 For example, a symptom of it can be that you are having food come 491 00:23:37,940 --> 00:23:41,180 up, so you're being sick with food and it's hours later, but 492 00:23:41,180 --> 00:23:43,900 it's still like it, you know, it hasn't been digested if you 493 00:23:43,900 --> 00:23:45,740 don't get into too much detail there, but it looks like it 494 00:23:45,740 --> 00:23:48,820 hasn't really been broken down. Those are some of the symptoms 495 00:23:48,820 --> 00:23:51,720 of gastroparesis. Again, this is not an episode on 496 00:23:51,720 --> 00:23:52,840 that. I'm not going to get into detail 497 00:23:52,840 --> 00:23:55,520 here, but it's something which we really, really need to be 498 00:23:55,520 --> 00:23:58,240 careful to not miss in patients and that every person should be 499 00:23:58,240 --> 00:23:59,960 aware of. And I think patients should be 500 00:23:59,960 --> 00:24:03,840 aware of these things because it helps the patients health at the 501 00:24:03,840 --> 00:24:06,000 end of the day. And there's nothing wrong with 502 00:24:06,000 --> 00:24:08,760 being a knowledgeable patient. I love my patients who are 503 00:24:08,760 --> 00:24:10,400 knowledgeable. They teach me so much. 504 00:24:10,560 --> 00:24:12,840 I call them my expert patients and we get to really work as a 505 00:24:12,840 --> 00:24:16,160 team, which I think is the best way to do healthcare. 506 00:24:16,910 --> 00:24:18,590 But yeah, gastroparesis, it exists. 507 00:24:18,590 --> 00:24:21,150 It really sucks. And we need to get better at 508 00:24:21,150 --> 00:24:25,190 identifying it in young people who look well but who feel 509 00:24:25,190 --> 00:24:28,150 horrible before it gets to a point where it starts to cause a 510 00:24:28,390 --> 00:24:31,950 lot of significant harm. Now I think we've talked about 511 00:24:31,950 --> 00:24:34,270 most of the mechanical issues. I'm sure there's stuff I missed. 512 00:24:34,270 --> 00:24:36,710 You know, if I missed stuff, put it in the comments, come, I 513 00:24:36,710 --> 00:24:39,310 don't know, find me on e-mail, reach out to me. 514 00:24:39,310 --> 00:24:41,750 I love hearing from this community, but moving on to the 515 00:24:41,750 --> 00:24:44,350 inflammatory side. So we talked about, we talked 516 00:24:44,350 --> 00:24:46,870 about the mechanical side. That's the ability of the stiff 517 00:24:46,870 --> 00:24:50,230 tissue to to stretch and to compress and to function and 518 00:24:50,230 --> 00:24:54,030 move stuff where it needs to be. However, we start to get into 519 00:24:54,070 --> 00:24:56,310 the inflammatory side. We kind of touched on it a 520 00:24:56,310 --> 00:24:59,430 little bit with the small in intestine. 521 00:24:59,430 --> 00:25:01,310 Some of the how the inflammation there. 522 00:25:01,310 --> 00:25:03,070 We didn't talk about the inflammation, we talked about 523 00:25:03,070 --> 00:25:05,390 how the speed of food moving through the small intestine can 524 00:25:05,390 --> 00:25:08,830 be problematic. But just to show how one part of 525 00:25:08,830 --> 00:25:10,790 the gut can have two different issues. 526 00:25:10,990 --> 00:25:13,270 You can also of course have inflammation in that small 527 00:25:13,270 --> 00:25:15,190 intestine which affects nutrient absorption. 528 00:25:15,190 --> 00:25:17,630 So you can have mechanical issues and most people will 529 00:25:18,110 --> 00:25:21,430 interacting with inflammatory issues, which is what makes this 530 00:25:21,430 --> 00:25:24,510 so complicated. But if we look at inflammation 531 00:25:24,510 --> 00:25:29,470 for a second, we see of course a lot of of chronic what I refer 532 00:25:29,470 --> 00:25:32,270 to as like subclinical inflammation in these patients 533 00:25:32,750 --> 00:25:36,630 or they will have episodes that would potentially result in 534 00:25:36,630 --> 00:25:39,070 higher markers of inflammatory markers showing up on blood 535 00:25:39,070 --> 00:25:41,270 tests if they were tested. But at this point they feel too 536 00:25:41,270 --> 00:25:42,630 well obviously to leave their home. 537 00:25:42,630 --> 00:25:45,910 So they're kind of stuck there and what I'm talking about and 538 00:25:46,270 --> 00:25:48,470 many of you're going to be familiar with this already, but 539 00:25:48,470 --> 00:25:51,670 I'm kind of getting into the whole mast cell diseases and and 540 00:25:51,670 --> 00:25:55,830 histamine area of all of this. So this is another area which is 541 00:25:55,830 --> 00:26:00,540 quite contentious currently. There are a lot of unfortunately 542 00:26:00,540 --> 00:26:04,420 medical doctors who seem to think that this is like a trend 543 00:26:04,420 --> 00:26:06,660 and the patients are coming to them concerned about the stuff 544 00:26:06,660 --> 00:26:08,900 because it's a trend. It's not, it's not. 545 00:26:09,900 --> 00:26:14,740 So mask cells are a type of immune cell and they live in 546 00:26:14,740 --> 00:26:17,380 your gut and in your connective tissue especially. 547 00:26:17,380 --> 00:26:19,140 And I believe they also live in your brain as well. 548 00:26:20,340 --> 00:26:22,940 But I I didn't double check my research before filming today. 549 00:26:22,940 --> 00:26:24,660 So we'll do another episode of mask cells. 550 00:26:24,660 --> 00:26:28,790 But anyways, mast cells live in different places in your body, 551 00:26:28,790 --> 00:26:31,550 which are hugely problematic to hypermobile people and mast 552 00:26:31,550 --> 00:26:33,390 cells. When they sense something that 553 00:26:33,670 --> 00:26:36,230 that they think is a threat that your immune system thinks is a 554 00:26:36,230 --> 00:26:38,670 threat, they rush to the scene of the crime. 555 00:26:38,990 --> 00:26:43,270 So say for example, I eat something that they have some 556 00:26:43,270 --> 00:26:45,510 spinach and spinach is high in histamine. 557 00:26:45,510 --> 00:26:47,870 Who would have thought that a health food could potentially be 558 00:26:47,870 --> 00:26:53,550 problematic for some people but mast cells will rush into the to 559 00:26:53,550 --> 00:26:56,110 the gastrointestinal tract and they're going to start to 560 00:26:56,110 --> 00:26:58,990 degranulate and dump histamine as well as a bunch of other 561 00:26:58,990 --> 00:27:01,430 things. But again for another episode 562 00:27:01,910 --> 00:27:05,590 histamine irritates tissues. It it does a lot of other things 563 00:27:05,590 --> 00:27:11,190 but it it is an inflammatory, it's technically it's an auto 564 00:27:11,190 --> 00:27:13,830 quite just halfway between a neurotransmitter and a hormone. 565 00:27:14,150 --> 00:27:17,830 But it was going to up inflammation not at the site 566 00:27:17,830 --> 00:27:20,510 where it is being dumped, basically. 567 00:27:20,510 --> 00:27:22,390 So you're going to have start to have a lot of inflammation as 568 00:27:22,390 --> 00:27:24,910 part of that reaction. And in simple terms, think of 569 00:27:24,910 --> 00:27:27,630 like you know what a mosquito bites and you get a huge Weld 570 00:27:27,630 --> 00:27:30,430 from it that, you know, maybe it's a lot bigger than what you 571 00:27:30,430 --> 00:27:32,270 see on your friends or your other family members. 572 00:27:32,630 --> 00:27:35,830 That can be, in some individuals a sign of something that's not 573 00:27:35,830 --> 00:27:38,630 quite right potentially with their mass cells or they could 574 00:27:38,630 --> 00:27:41,430 just have a histamine intolerance or something on the 575 00:27:41,630 --> 00:27:43,990 the other side of that kind of diagnostic spectrum. 576 00:27:44,190 --> 00:27:47,710 So we see issues with mass cells and histamine. 577 00:27:47,710 --> 00:27:49,510 And I know I'm being broad here, but thank you for your 578 00:27:49,510 --> 00:27:51,430 understanding because that's extremely technical stuff. 579 00:27:52,120 --> 00:27:55,800 And this means that we see in these hypermobal patients a lot 580 00:27:55,800 --> 00:28:01,560 of confusing stuff regarding food intolerances that doesn't 581 00:28:01,560 --> 00:28:03,880 make sense for a lot of the patients and it often doesn't 582 00:28:03,880 --> 00:28:05,480 make sense for the healthcare providers. 583 00:28:05,760 --> 00:28:08,280 So these are people, these are patients typically who come to 584 00:28:08,280 --> 00:28:10,240 me and I say, OK, so tell me about your relationship with 585 00:28:10,240 --> 00:28:13,400 food and tell me what kind of like different nutritional 586 00:28:13,400 --> 00:28:15,640 strategies you've tried or ways of eating. 587 00:28:16,000 --> 00:28:17,480 I'm not a big fan of the word diet. 588 00:28:17,480 --> 00:28:20,100 I kind of try to avoid it in my medical terminology, but I'll 589 00:28:20,100 --> 00:28:23,180 say tell me about what kind of foods you eat, or if you avoid 590 00:28:23,180 --> 00:28:27,060 any, and patients will tell me Often I've tried everything. 591 00:28:27,380 --> 00:28:32,740 I've been like pescetarian, vegan, glutenfree, lactose free 592 00:28:32,740 --> 00:28:35,660 keto, intermittent fasting. Like, these are patients who 593 00:28:35,660 --> 00:28:39,660 will come to me and literally list like every nutritional, 594 00:28:40,060 --> 00:28:42,740 strategy, diet, way of eating, whatever to ever exist. 595 00:28:43,250 --> 00:28:44,890 And they're like nothing seems to work. 596 00:28:44,890 --> 00:28:47,970 It seems like some things help a bit, but I'm so confused and I 597 00:28:47,970 --> 00:28:49,090 can't figure out what's going on. 598 00:28:49,370 --> 00:28:54,410 Now, My hunch is that often these people may have a 599 00:28:54,410 --> 00:28:58,250 sensitivity to histamine. So what I then end up talking 600 00:28:58,250 --> 00:29:00,570 with them about is how histamine can affect the gut and how we 601 00:29:00,570 --> 00:29:02,210 need to start thinking about that. 602 00:29:02,210 --> 00:29:06,330 However, it's not ever as straightforward as one thing I 603 00:29:06,330 --> 00:29:08,410 wish it was I I would be so well rested. 604 00:29:08,850 --> 00:29:11,930 My life would be so simple. But it's not that simple. 605 00:29:12,710 --> 00:29:15,230 So of course histamine and muscle issues can play a role in 606 00:29:15,230 --> 00:29:18,790 some patients got dysfunction and patients are going to be 607 00:29:18,790 --> 00:29:22,350 like very concerned about this is where they're having extreme 608 00:29:22,950 --> 00:29:24,950 symptoms after eating. So this could be like 609 00:29:24,950 --> 00:29:27,190 debilitating gut pain. They're lying on the floor. 610 00:29:27,190 --> 00:29:29,750 They're not sure if they're going to have diarrhea or vomit 611 00:29:29,750 --> 00:29:32,070 like these types of like stronger reactions are things 612 00:29:32,070 --> 00:29:35,390 where I'm thinking more potentially muscle issues or 613 00:29:35,390 --> 00:29:38,310 histamine issues. However, there are many other 614 00:29:38,310 --> 00:29:41,750 types of issues that affect hypermobile people as well in 615 00:29:41,750 --> 00:29:45,830 terms of inflammation and the gut moving a bit further down 616 00:29:46,030 --> 00:29:48,990 the gastrointestinal tract, we end up at the end. 617 00:29:49,230 --> 00:29:52,630 And the most common symptom probably I do see in my 618 00:29:52,630 --> 00:29:55,510 hypermobile patients is diarrhea, although often they 619 00:29:55,510 --> 00:29:57,230 will have had Constipation issues as well. 620 00:29:57,390 --> 00:30:02,600 But diarrhea because it's, it's stuff happening when it 621 00:30:02,600 --> 00:30:04,720 shouldn't and where it shouldn't, it starts to damage 622 00:30:04,720 --> 00:30:06,480 the, the tissue down there. If you're having chronic 623 00:30:06,480 --> 00:30:11,320 diarrhea over time, it is not kind to the patient's rectum and 624 00:30:11,320 --> 00:30:14,360 that again we can have injury occurring and inflammation. 625 00:30:14,360 --> 00:30:16,480 They start to get very, very sensitized. 626 00:30:16,720 --> 00:30:19,240 And this is where from an inflammatory perspective and 627 00:30:19,240 --> 00:30:21,440 from a chronic pain perspective, and this is mentioned in that 628 00:30:21,440 --> 00:30:24,830 brilliant narrative review that I referenced at the start, we 629 00:30:24,830 --> 00:30:28,430 can start to potentially maybe even have sensitization of 630 00:30:28,430 --> 00:30:32,390 different organs in terms of pain when you have different 631 00:30:33,270 --> 00:30:35,350 injurious events. If you think of it like that 632 00:30:35,350 --> 00:30:37,550 when you're eating food that's irritating your gut and you're 633 00:30:37,550 --> 00:30:39,510 having an inappropriate inflammatory response and you're 634 00:30:39,510 --> 00:30:42,910 having pain and nausea and diarrhea, that's that's an 635 00:30:43,030 --> 00:30:45,310 that's an injury. It's like an ankle sprain. 636 00:30:45,310 --> 00:30:48,870 It's, it's the same thing, different system, but that can 637 00:30:48,870 --> 00:30:52,950 potentially result over time in a sensitization of tissues in 638 00:30:52,950 --> 00:30:56,120 that region, which is maybe potentially partially wise. 639 00:30:56,120 --> 00:30:58,400 Patients symptoms seem to get worse as they get older. 640 00:30:58,640 --> 00:31:03,320 Now on top of all that, we do see increased rates of 641 00:31:03,320 --> 00:31:06,880 inflammatory conditions in patients with HSD&HEDS including 642 00:31:06,880 --> 00:31:09,760 celiac disease and research is still emerging, but the research 643 00:31:09,760 --> 00:31:11,600 that is there suggests that this is the case. 644 00:31:12,880 --> 00:31:15,800 And of course, I want to stress that with celiac disease, 645 00:31:16,160 --> 00:31:19,020 although there are blood tests to test for it, these blood 646 00:31:19,020 --> 00:31:21,100 tests are not perfect. And there is a percentage of 647 00:31:21,100 --> 00:31:24,020 patients who will have celiac disease who will be missed on 648 00:31:24,020 --> 00:31:26,820 the blood test and who will only show up if they have a small, 649 00:31:27,140 --> 00:31:30,460 small intestine biopsy. However, that's expensive. 650 00:31:30,460 --> 00:31:32,020 Our public healthcare system is going to do that. 651 00:31:32,380 --> 00:31:34,820 I don't know. And if you're a hypermobile 652 00:31:34,820 --> 00:31:38,100 person who's trying to kind of avoid surgical procedures, maybe 653 00:31:38,100 --> 00:31:42,010 because you're worried a bit about outcomes from that, should 654 00:31:42,010 --> 00:31:44,930 you be having a small intestine biopsy, you know, do the 655 00:31:44,930 --> 00:31:47,130 benefits outweigh the risks? And maybe is it better to just 656 00:31:47,130 --> 00:31:48,890 go onto a celiac diet as a trial? 657 00:31:49,130 --> 00:31:51,730 Again, I don't know. I'm not a gastroenterologist, 658 00:31:51,890 --> 00:31:54,570 but what I do know is we see increased rates of celiac 659 00:31:54,570 --> 00:31:58,890 disease in hypermobile people. We also see increased rates of 660 00:31:58,890 --> 00:32:02,090 inflammatory bowel disease. So this includes Crohn's disease 661 00:32:02,090 --> 00:32:05,170 and ulcerative colitis. But in particular, we see an 662 00:32:05,250 --> 00:32:08,890 increased prevalence of Crohn's disease in hypermobile 663 00:32:08,890 --> 00:32:11,810 individuals. And again, we don't know if 664 00:32:11,810 --> 00:32:14,330 one's causing the other, what exactly the interaction is, but 665 00:32:14,330 --> 00:32:15,810 we do know that we see that there. 666 00:32:16,130 --> 00:32:19,370 So again, that's just further evidence that we do have 667 00:32:19,370 --> 00:32:23,250 inflammation in the gut, which affects how people feel and 668 00:32:23,250 --> 00:32:26,410 affects how you digest food. And finally, the last thing 669 00:32:26,410 --> 00:32:28,570 which I'm going to touch on very, very briefly because I 670 00:32:28,610 --> 00:32:30,450 don't want to make this episode too long because I think it's 671 00:32:30,450 --> 00:32:32,930 going to be a pretty long one. But we have the neurological 672 00:32:32,930 --> 00:32:35,290 component. So your gut is controlled by 673 00:32:35,290 --> 00:32:38,250 your neurological system. I'm specifically your autonomic 674 00:32:38,250 --> 00:32:41,360 neurological system and I'm sitting here digesting food and 675 00:32:41,360 --> 00:32:46,040 I'm not having to say like, OK, stomach go, OK, swell intestine, 676 00:32:46,040 --> 00:32:47,560 do your thing. Like, I'm not having to like, 677 00:32:47,680 --> 00:32:50,160 control my guy. It's just it's doing stuff on 678 00:32:50,160 --> 00:32:52,280 its own. Luckily for now, yeah. 679 00:32:53,320 --> 00:32:56,440 However, how does that neurological control happen? 680 00:32:56,440 --> 00:32:57,840 That's not something we think about enough. 681 00:32:58,160 --> 00:33:01,080 And one mechanism through which that neurological control 682 00:33:01,080 --> 00:33:05,640 happens is a stretch reflex. So the tissue in the gut, when 683 00:33:05,640 --> 00:33:09,840 food goes through it, it gets stretched and the stretching is 684 00:33:09,840 --> 00:33:12,520 what starts to stimulate the mechanoreceptor. 685 00:33:12,520 --> 00:33:15,400 So these are little bits of nervous tissue that are 686 00:33:15,400 --> 00:33:18,160 sensitive to certain types of mechanical stimulation. 687 00:33:18,160 --> 00:33:20,920 So in this case, when they experience stretch, that's when 688 00:33:20,920 --> 00:33:22,160 they start to fire their signals. 689 00:33:22,510 --> 00:33:26,630 And if you have someone with a hyper mobile gut, if their gut 690 00:33:26,630 --> 00:33:30,630 is extra stretchy, are those those little neurological 691 00:33:30,630 --> 00:33:33,710 stretch mechanoreceptors that are sensitive to stretch, are 692 00:33:33,710 --> 00:33:36,790 they going to be receiving the same information? 693 00:33:36,790 --> 00:33:41,470 Absolutely not as someone who has normal connective tissue in 694 00:33:41,470 --> 00:33:43,950 their in their gut. So again that normal person, 695 00:33:43,950 --> 00:33:46,750 they're going to have the group say we both eat a burger, normal 696 00:33:46,750 --> 00:33:49,310 connective tissue person, they eat the burger and it's going to 697 00:33:49,310 --> 00:33:52,750 stretch their gastrointestinal tract the right amount in the 698 00:33:52,750 --> 00:33:54,950 right way at the right time and they're going to have the right 699 00:33:54,950 --> 00:33:56,710 signal. So the right thing happens, the 700 00:33:56,710 --> 00:34:00,910 hyper mobile person has the burger and then their gut is not 701 00:34:00,910 --> 00:34:03,470 going to get the right amount of stretch because it's it's too 702 00:34:03,470 --> 00:34:05,310 stretchy, it's too lax potentially. 703 00:34:06,000 --> 00:34:08,280 They're not they're they're not getting the right information 704 00:34:08,440 --> 00:34:10,760 and then their body can't do the right further actions. 705 00:34:10,760 --> 00:34:14,760 So it's a whole series of of knock on consequences. 706 00:34:15,199 --> 00:34:19,920 So neurological function is a a huge issue and there are even 707 00:34:19,920 --> 00:34:23,120 things like viscera optosis which refers to organs 708 00:34:23,120 --> 00:34:25,800 potentially sitting slightly lower than they should. 709 00:34:26,239 --> 00:34:28,880 And of course, we have organ prolapse as well, which is when 710 00:34:28,880 --> 00:34:31,679 organs are moving further down, especially in the pelvic region. 711 00:34:31,679 --> 00:34:33,480 We talked about pelvic organ prolapse. 712 00:34:34,130 --> 00:34:38,370 And will the will the position of an organ potentially affect 713 00:34:38,370 --> 00:34:41,210 its function and in terms of neurological supply, intention 714 00:34:41,210 --> 00:34:44,050 on the nerves, potentially. So it all gets really 715 00:34:44,050 --> 00:34:45,570 complicated. And with the gut, we need to 716 00:34:45,570 --> 00:34:47,969 think about, in summary, mechanical issues, inflammatory 717 00:34:47,969 --> 00:34:51,409 issues and neurological issues. Now, what is something that you 718 00:34:51,409 --> 00:34:53,810 can take away from today? What is something that you can 719 00:34:53,810 --> 00:34:56,530 do so that you leave on a positive note and you feel like 720 00:34:56,530 --> 00:34:58,970 you can do something maybe while you're waiting for that doctor's 721 00:34:58,970 --> 00:35:01,490 appointment or maybe to talk with your doctor about your next 722 00:35:01,490 --> 00:35:03,330 appointment. Here's what you can do. 723 00:35:03,710 --> 00:35:05,510 Firstly, think about your normal. 724 00:35:05,550 --> 00:35:07,870 What's normal for you? What's not normal for you? 725 00:35:07,870 --> 00:35:10,390 Has stuff that's not normal for you been happening lately? 726 00:35:10,510 --> 00:35:14,670 If so, definitely please please speak to your doctor or speak to 727 00:35:14,670 --> 00:35:16,750 someone who's a qualified healthcare provider who cares, 728 00:35:16,750 --> 00:35:19,750 who can then support you in speaking to your medical doctor 729 00:35:20,030 --> 00:35:22,190 as well. I think it can be helpful to be 730 00:35:22,190 --> 00:35:23,950 aware of histamine content in foods. 731 00:35:23,950 --> 00:35:28,670 And again, I am extremely cautious when it comes to 732 00:35:28,990 --> 00:35:30,870 anything involving eating disorders. 733 00:35:31,310 --> 00:35:34,510 They are they, they kill people, they're harmful, they're 734 00:35:34,510 --> 00:35:36,150 dangerous. And we have to be so careful 735 00:35:36,150 --> 00:35:39,830 when talking with the patient population who which seems to 736 00:35:39,830 --> 00:35:41,310 have a higher prevalence of them. 737 00:35:41,670 --> 00:35:45,030 However, my thought on eating disorders and hypermobile 738 00:35:45,030 --> 00:35:49,710 patients is how can you not have a complex relationship with food 739 00:35:49,710 --> 00:35:53,190 when you keep trying to eat it and you keep feeling bad when 740 00:35:53,190 --> 00:35:54,470 you eat? Of course, that's going to 741 00:35:54,470 --> 00:35:57,510 complicate things. So something which I in my 742 00:35:57,510 --> 00:36:00,110 clinical capacity as an osteopath, I very carefully try 743 00:36:00,110 --> 00:36:02,880 to support my patients. And looking at and considering 744 00:36:02,880 --> 00:36:05,880 and ideally speaking with the gastroenterologist about, is 745 00:36:05,880 --> 00:36:09,880 looking at low histamine foods. Not in a restrictive sense, not 746 00:36:09,880 --> 00:36:12,720 in a sense of avoiding it entirely because spoiler 747 00:36:12,720 --> 00:36:15,330 histamines and everything. But if saying you know what, 748 00:36:15,570 --> 00:36:18,250 maybe I'm not going to eat a chocolate bar at 10:00 PM at 749 00:36:18,250 --> 00:36:20,210 night because I know my histamine levels are going to be 750 00:36:20,210 --> 00:36:22,690 a bit higher due to my circadian rhythm and how that affects 751 00:36:22,690 --> 00:36:24,050 that. Maybe I'm going to have one 752 00:36:24,050 --> 00:36:25,810 square of chocolate earlier in the day. 753 00:36:26,090 --> 00:36:28,650 Or maybe you know what, I hate spinach. 754 00:36:28,650 --> 00:36:29,970 I'm not going to eat spinach anymore. 755 00:36:29,970 --> 00:36:32,290 I'm going to have pack toy and Asian greens instead because 756 00:36:32,290 --> 00:36:34,970 spinach is high in histamine and pack toy is low. 757 00:36:35,170 --> 00:36:38,930 Again, don't ask me why, I don't know, but making those little 758 00:36:38,930 --> 00:36:41,170 kind of food swaps I think could be a really helpful place to 759 00:36:41,170 --> 00:36:44,690 start. I will link a histamine food 760 00:36:44,690 --> 00:36:47,650 list in the show notes. Again, I urge you, if you're 761 00:36:47,650 --> 00:36:49,170 someone, especially if you're some of the history of 762 00:36:49,170 --> 00:36:51,490 disordered eating, please speak with your healthcare provider 763 00:36:51,490 --> 00:36:52,770 who's looking out for you, hopefully. 764 00:36:53,090 --> 00:36:55,530 But it can be one of those things which starts to make 765 00:36:55,610 --> 00:36:57,330 everything make sense for patients. 766 00:36:57,370 --> 00:37:01,250 And I think it's just so, so helpful to be aware of Okay. 767 00:37:01,250 --> 00:37:04,610 But I'm not in any way advising A restrictive diet to anyone's. 768 00:37:04,650 --> 00:37:07,930 The show is not medical advice. This is literally my thoughts on 769 00:37:07,930 --> 00:37:09,810 a bunch of stuff for informational purposes. 770 00:37:10,290 --> 00:37:15,080 Now moving on as well, eating in smaller meals at regular 771 00:37:15,080 --> 00:37:17,520 intervals can be helpful. So if you think of that conveyor 772 00:37:17,520 --> 00:37:20,520 belt of chaos, we've stopped moving too fast, too slow, and 773 00:37:20,520 --> 00:37:23,240 all of this going on. It can be helpful sometimes, I 774 00:37:23,240 --> 00:37:27,000 think, to have to try to impose some regularity onto it. 775 00:37:27,240 --> 00:37:30,000 Now of course if you're someone with a DHD this really 776 00:37:30,000 --> 00:37:32,680 complicates things and I think it's about 1/3 of hyper mobile 777 00:37:32,680 --> 00:37:36,200 people have a DHD so this gets really hard. 778 00:37:36,830 --> 00:37:39,910 But if you can try and say look, I'm going to eat 4 meals during 779 00:37:39,910 --> 00:37:42,190 the day and they're going to be at regular time intervals so my 780 00:37:42,190 --> 00:37:44,830 gut kind of can start to learn what's happening. 781 00:37:44,830 --> 00:37:47,790 I'm I'm, I'm imposing some structure on my hypermobile and 782 00:37:47,790 --> 00:37:51,030 kind of chaotic gut that helps a lot of people often. 783 00:37:51,390 --> 00:37:55,950 And finally a fun fact that many people won't be aware of, many 784 00:37:55,990 --> 00:37:59,110 probiotics are histamine producing. 785 00:37:59,430 --> 00:38:02,670 They actually are going to do the opposite of what you want. 786 00:38:02,670 --> 00:38:05,130 So there are some probiotic supplements that are histamine 787 00:38:05,130 --> 00:38:08,450 sequestering or histamine neutral and those are what you 788 00:38:08,450 --> 00:38:10,890 want hyper mobile patients to be having. 789 00:38:11,570 --> 00:38:15,010 I I cringe when I think of all the years like I did this, like 790 00:38:15,010 --> 00:38:17,250 I would just buy probiotics, just look which ones are on 791 00:38:17,250 --> 00:38:20,010 sale, what's on the shelf, what marketing looks cool, whatever, 792 00:38:20,490 --> 00:38:23,340 it's not that simple. So please, please, when you're 793 00:38:23,340 --> 00:38:26,020 buying probiotics, firstly make sure that the subspecies is 794 00:38:26,020 --> 00:38:29,380 listed, so it should have like the the name of the probiotic 795 00:38:29,380 --> 00:38:31,620 itself, but then it should have a little series of like numbers 796 00:38:31,620 --> 00:38:34,460 and letters at the end of it. Please look for that because 797 00:38:34,460 --> 00:38:36,580 that's a sign firstly that it's a good quality one because that 798 00:38:36,580 --> 00:38:39,420 the subspecies matter and different subspecies can do 799 00:38:39,420 --> 00:38:42,260 different things even within the same species. 800 00:38:43,140 --> 00:38:45,380 Secondly, of course, be sensitive to the fact that you 801 00:38:45,380 --> 00:38:47,340 need to be careful which ones you're taking. 802 00:38:48,050 --> 00:38:49,810 So you can do stuff like what I do. 803 00:38:49,810 --> 00:38:52,290 I literally call probiotic brands and I like try and speak 804 00:38:52,290 --> 00:38:55,650 with a nutritional team or go do research online, but definitely 805 00:38:55,650 --> 00:38:58,890 look into which one might be right for you in terms of a 806 00:38:58,890 --> 00:39:02,130 histamine perspective. And finally, of course be 807 00:39:02,130 --> 00:39:05,170 thoughtful about what you're taking and why you're taking it. 808 00:39:05,170 --> 00:39:07,650 So even if something like a probiotic, I would say take it 809 00:39:07,650 --> 00:39:11,010 for three months and try and have some type of an outcome as 810 00:39:11,050 --> 00:39:12,930 you know maybe for you it's diarrhea, Has that frequency 811 00:39:12,930 --> 00:39:14,370 decreased? Like, what are you trying to 812 00:39:14,370 --> 00:39:17,490 achieve by by what you're doing? Don't waste your money on things 813 00:39:17,530 --> 00:39:19,930 like. Be thoughtful about it. 814 00:39:20,290 --> 00:39:24,690 And one last bonus tip, it might be worth looking into a 815 00:39:24,690 --> 00:39:26,490 supplement called dimine oxidase. 816 00:39:27,090 --> 00:39:30,970 So dimine oxidase helps to break down histamine, and we touched 817 00:39:30,970 --> 00:39:33,530 on histamine briefly. It'll get its own episode one 818 00:39:33,530 --> 00:39:37,330 day, but dimine oxidase literally goes and it mops up 819 00:39:37,330 --> 00:39:38,850 the histamine. So the mast cells make the 820 00:39:38,850 --> 00:39:42,130 histamine mess and the diamine oxidase goes and cleans it up 821 00:39:42,130 --> 00:39:44,930 and puts it away. However and hyper mobile people, 822 00:39:44,930 --> 00:39:47,090 we often see issues with diamine oxidase. 823 00:39:47,090 --> 00:39:49,850 Their body's not producing enough of that enzyme, so 824 00:39:49,850 --> 00:39:52,130 diamine oxidase is available as a supplement. 825 00:39:52,130 --> 00:39:54,170 Again, be careful taking supplements. 826 00:39:54,170 --> 00:39:56,010 Treat them like medicine. Speak with your medical doctor, 827 00:39:56,010 --> 00:39:57,770 make sure they're not going to interact or cause any issues. 828 00:39:58,130 --> 00:40:01,330 However, taking diamine oxidase can make a difference for a lot 829 00:40:01,370 --> 00:40:05,050 of hyper mobile people and it's something which is one of those 830 00:40:05,050 --> 00:40:08,210 supplements that I certainly put up there for my a lot of my 831 00:40:08,210 --> 00:40:09,850 patients in terms of recommendations. 832 00:40:10,750 --> 00:40:12,870 And it seems to do what it says on the 10th, and there's some 833 00:40:12,870 --> 00:40:15,110 good research emerging. So that's exciting. 834 00:40:15,670 --> 00:40:18,230 I hope you've learned something about gut issues today. 835 00:40:18,230 --> 00:40:20,710 I hope you've managed to stay with me and I hope it's been as 836 00:40:20,710 --> 00:40:25,190 straightforward as I could make this complex and convoluted 837 00:40:25,190 --> 00:40:28,550 subject which really fits with hyper well guts themselves 838 00:40:28,550 --> 00:40:30,670 because they are complex and convoluted often. 839 00:40:31,290 --> 00:40:34,330 I of course if you have any questions please don't hesitate 840 00:40:34,330 --> 00:40:37,650 to write in and be sure to check out my Hyperbole HQ Discord 841 00:40:37,650 --> 00:40:38,770 membership. It is awesome. 842 00:40:38,770 --> 00:40:40,330 We get into the nitty gritty on there. 843 00:40:40,330 --> 00:40:42,810 It's nice having kind of more time in terms of these 844 00:40:42,810 --> 00:40:45,450 consistent twice a week lives that I do and of course the 845 00:40:45,450 --> 00:40:49,010 forum is amazing and I think there are still some founding 846 00:40:49,010 --> 00:40:52,770 membership rates left so definitely go check that out 847 00:40:52,770 --> 00:40:55,850 because they are limited and I think it's I think it's really 848 00:40:55,850 --> 00:40:57,610 really helped a lot of people. I've gotten so much awesome 849 00:40:57,610 --> 00:41:01,210 feedback on it and I, you know, I I'm happy because it feels 850 00:41:01,210 --> 00:41:04,010 like it's the best corner of the Internet ever for hyper well 851 00:41:04,010 --> 00:41:06,730 people and I'm just so proud of it and all honesty. 852 00:41:07,610 --> 00:41:10,770 But yeah, thank you for joining me and see you next time. 853 00:41:11,010 --> 00:41:11,530 Take care.