Podcast (Transcript Below)
Georgie Kovacs, founder of Fempower Health, interviews Guy Daniels. He is the Head of Medical Education at Onegevity, a wellness platform designed to solve health challenges and optimize performance. One of their key focuses is the gut’s microbiome. They offer at an-home test kit called Gutbio™ that helps people manage their gut health and offers personalized advice for diet, exercise and supplements. Here is their conversation.
Georgie Kovacs: Tell us about your background and tell us about Onegevity.
Guy Daniels, Onegevity: Sure. My background is actually a little bit unique and puts me in a good spot for this because I was actually diagnosed with Crohn's almost 20 years ago. Prior to that, for a few years, I was suffering from the initial symptoms. And for me, it developed like it does for so many other people where you go through a couple of rounds of antibiotics. Treatment can expose the genetic flaws of different individuals.
For me, I've managed it for all these years, and I do just as well as anyone else walking around out there. So I'm passionate about what I do and I've been able to walk the walk and help people as well.
At Onegevity, my title is Head of Medical Education. We offer a very convenient, at-home test kit. It's a fecal test kit and the goal is to analyze the microbiome. We also have a very comprehensive questionnaire that goes along with that and then we have recommendations in regards to food, but mostly in regards to supplements, primarily probiotics.
We're doing something that really no one else is doing. We're using the gold standard of technology which is shotgun metagenomics.
Georgie: Interesting. So tell us about the gut microbiome and why women should pay attention.
Guy: The microbiome is everywhere. We have them on our skin. We have them in our nose and we have them all over the place. Specifically, we're talking about the gut microbiome. It’s more than just bacteria, although that's primarily what we discuss, but you also have, you know, fungi and other players down there, such as archaea and so forth.
The microbiome changes as you go throughout the GI tract. There are important changes at the end of the small intestine and the large intense. There are roughly ten times the as many bacteria in those areas as there are cells in our body. And those bacteria play a role in influencing our health.
As a woman, you should be concerned about the microbiome from the time you’re an infant to the time you’re elderly.
Georgie: So what causes one to have an unhealthy gut?
Guy: It actually starts at the very beginning: it starts in utero. There's data to show that women who are under chronic stress have changes in their microbiome and gut. There are also changes in the microbiome in a vagina because of translocation. About two-thirds of deliveries are vaginal and one-third via c-section. When you deliver a baby via c-section, the baby’s initial inoculation in life is from skin and hospital room bacteria, instead of the natural vaginal inoculation)
As you can imagine, that’s not ideal bacteria. You want to start life off with as little complication as possible. Even breastfeeding impacts microbiome. The third largest component in human breast milk is oligosaccharides, which are purely there to feed bacteria.
They aren’t digestible (by use) but provide a good jumpstart to the bacteria in a baby’s belly.
Nature is telling us how important bacteria in the gut is. The importance is so extreme that a third of the mother’s milk is going to feed that bacteria. As time goes on, we choose diet for ourselves. Diet plays an enormous role in a healthy microbiome.
Antibiotics and stress impact the gut. Often, people get into age 20-something and then 30-something and a lot of folks don’t have a good, functioning belly.
Georgie: There are so many factors involved. I know when I hear the word stress it’s in the context of someone saying “avoid stress!” It's not like we want to be stressed out. Maybe the stress component is one of the hardest ones to control. What does someone do when they're under stress to try to minimize the negative impact?
Guy: There are a wide array of choices. I'll actually give you an interesting story. I had a patient one time and after talking to her, you know, (for) the usual hour, I said. “Well, I don't have any magical supplements or any magical regimens to give you, but I've noticed two things. And this is purely for you to take at face value.” I said, “it sounds like you're in a toxic relationship and it sounds like you live in a moldy home. And so I would just reconsider those two aspects of your life.” She had previously been complaining about low energy and bad moods and so forth and so on.
So I saw her about a month later, she came back high spirits. Happy, full of energy. And I said, “what's going on?” She said, “well, I broke up with my boyfriend and I moved out of my moldy house.”
That illustrates that sometimes there are lifestyle changes you can make when your life has become too stressful. You can exercise and eat a proper diet. If you have a bad diet and you're feeding “bad bugs,” and then you have stress on top of that, then the bad bugs are able to do more bad things.
Georgie: Thank you for explaining that. Someone who has gone through fertility treatments is always dealing with stress, so I thought that was an important point for our Fertility4Me community.
We talked about some of the causes of the unhealthy gut. What about the symptoms and conditions someone might have as a result of this unbalanced or unhealthy gut?
Guy: There are obvious ones like IBS, which is irritable bowel syndrome. You could have Crohn's disease and ulcerative colitis.
There are also not-so-obvious ones. There's actually a huge connection between the microbiome and basically everything you can possibly imagine.
This includes things like autoimmune disease, whether it's anything to do with metabolic syndrome which encompasses obesity, which includes non-alcoholic fatty liver, serum lipids, blood sugars all the way to dementia to autism to anxiety and depression.
This is kind of cutting edge stuff right now even though the research on this goes back decades.
But this whole microbiome conversation is relatively new. And so the vast majority of people and practitioners as well don't realize the extreme importance that the microbiome plays in our overall health. And, you know, I'm sure some of the questions you'll ask will dive into that a little deeper.
Georgie: Tell us about Onegevity’s diagnostic tool: how it works and how it helps provide better information around what's going on with the gut.
Guy: It's an at-home kit you order online. It's delivered to you and you know the less than sexy part of this is that you do have to have a little bit of a fecal collection going on there. It's a very small amount, but you have to go through that process.
And then you ship it in. We run the analysis and get back to within a period of time with your results. We're in the process of revising the reports. So in version 2.0 (available in the next couple of months), things will be clarified. By its very nature it’s kind of complicated stuff.
The long and short of it is that we identify which bugs are good guys and not so good guys and which bugs are kind of in the middle and situational. We provide recommendations that basically feed the good guys and they will kind of do battle for real estate with the bad guys.
Georgie: With the diagnostic tests, you said there are questions as well. What does that determine?
Guy: It's a pretty thorough questionnaire. We never want to completely replace the input from the individual or a doctor's practice. We integrate survey responses fully into the treatment regimen in addition to the microbiome findings.
Georgie: Okay, that's very helpful. And you know, I like that. This is an at-home test. And because I had first learned about the gut microbiome in much greater detail about a year ago and started on a probiotic. I've really started following the space and it's absolutely fascinating. I remember asking, “how do you even know if you have an unhealthy gut?” and that’s how I learned about this test.
Now I’m curious if someone went to the doctor’s office to do the test, it would probably be more expensive and time-consuming? I’m curious from a process perspective. Have you found in your research and building this product that doctor’s offices maybe don’t ask such detailed questions, or go through more of a yes/no? I’m not trying to make a comparison saying doctors aren’t as good at the test but just understanding how the dynamic works.
Guy: The vast majority of primary care doctors now work for groups. And so it's dictated to them that they can spend seven, eight or nine minutes on average per patient based off of, you know the bottom line, basically. And so they're not going to ask a lot of detailed questions in regards to everything that I would spend 45 minutes to an hour asking and just have a nice conversation, try to kind of uncover things.
In addition to that difference, this is a cash kit, which means it isn’t reimbursed by insurance. Our system is also just not part of the standard operating procedures.
For instance, with the stress question earlier. Oftentimes, if a doctor doesn’t figure out your issue in one or two visits, they'll go, oh, it's all stress. It's all in your head, when it's much more complicated than that.
The picture is not going to get much better in a gastroenterology practice either. They're not going to have this conversation with you and they're not going to offer this test.
So much of medicine these days is coming down to people seeking out their own health care. People want answers that and they’re sick of suffering and they want answers.
There is an enormous amount of information out there which can help these people accomplish their goals. Doctors are generally aware of the microbiome but there is a lot more that needs to be done in terms of education.
Georgie: Oh, absolutely. I found that in my journey. I had endometriosis and underlying immune issues and that's why it took me so long to have my son. Through that journey I've learned so much about just the intricacies of the body, which is why the gut microbiome fascinates me so much. Even when you go online, or talk to a doctor, there's so much you don't know. You don't know and quite frankly even with research online you have to know enough to even Google the right words to find the right thing and it can feel endless. And this is honestly why I built the Fempower Health platform. We’re crowdsourcing data from women about their own experiences and reporting that back again. That way, women can go online and look for people who have the same experience, find them, identify what they’re doing and create a network of knowledge. I’m not promoting anything or giving any direction, just leveling the playing field for information access.
So, kudos to organizations like yours that are really making a chance and looking for root causes.
I mentioned probiotics, which I get at my local Whole Foods. They have an entire refrigerator. Even here in New York City, where grocery stores are smaller, it’s an emphasis. Taking probiotics is the one message most people seem to get about the gut microbiome.
Are those really the end all be all? You mentioned diet and other things as well. So maybe you can tell us how probiotics fit in and then we can talk about some of the other ways that someone can have a healthier gut.
Guy: Sure. So this is actually a fantastic question. And the current, I guess, you know, mood is that they are the end all be all but in reality they aren't. We've done a number of very large, very extensive meta analyses and one of the two main bacteria within probiotics is lactobacillus. There are a lot of negative associations between lactobacillus and health. More often than not, people who are obese have high lactobacillus in their guts and the healthy controls had lower levels of lactobacillus compared to the obese.
The bottom line is you can't just be throwing down these blends of probiotics to everyone.
They’ll work for some people but could even be a hindrance to other people. We’ve gone through thousands of published papers. It shows that particular bugs or combinations of bugs were helpful, while other articles will say they weren’t helpful at all.
So you have basically three genera that play a role in gut health:
Bifidobacterium, which is essentially universally healthy for all people
The count of probiotics - the number of bugs that are actually in there - are only two to three genera and only a small portion of what’s in your gut.
To drive health in your gut, what’s even better than probiotics is prebiotics. This is fiber, essentially. It makes its way, undigested, into the gut and becomes food for the good bugs.
Georgie: What was the impetus for initiating this field for gut microbiome? What started this?
Guy: There was a Russian researcher who was eating kefir a hundred or so years ago. But in the past 20 years, the technology has been there to analyze who the players are in the gut. Now, we can identify the players and also look at their DNA. In addition to identifying who they are we can look at all the DNA they possess. This tells us what enzymes they can make and what they can do in the body. Enzymes produce things like neurotransmitters, hormones, cleave off toxins, re-absorb toxins, everything you could possibly imagine.
Georgie: I actually was directed to take a prebiotic before I eat cheese. Every so often I'll have a little sheep’s milk or goat’s milk cheese, but I take the prebiotic first. What about the pill form? Is this even really helpful?
Guy: From a diet perspective, you clearly want fiber in your diet. But in a broken gut, it needs dietary changes and prebiotic supplementation. The analogy is: you blow out your knee playing sports and never really heal after the initial injury. Once you break it with whatever happened to you—antibiotics, stress—reducing issues is the goal. The basis of the platform is gluten-free, dairy-free. Some people still can tolerate gluten, which is fine.
In regards to prebiotic, I’d avoid the capsule and go with the powder. You want to get gram dosage in. The average American consumes less than half of the recommended daily dose for fiber. You’ll need powder to compensate for that lack.
Georgie: Last year I learned about the autoimmune protocol diet and did the cleanse phase. In just that week, my anxiety levels were virtually gone. To the point where I didn’t even recognize how I felt or that I had such a severe baseline anxiety until I started the diet. I’d love to hear about diet and its role.
Guy: You can look at things like generational studies. Take someone from southeast Asia who was eating a certain diet and then immigrated to the west. In a couple of generations, their offspring may become obese and have serious microbiome gut changes. In the grocery store, I look at the people with shopping carts. There’s a pretty clear correlation.
You can also look at allergens in diet. Dairy, gluten, corn, soy, these are all offenders.
Basically, everything you ingest impacts your microbiome. Everything you ingest impacts your health. We have to alleviate symptoms of bad diets, like stomach acid reducers and it can change our ability to digest our food. If you have trouble digesting, your food makes its way further down, it feeds bad bugs in your lower GI. I’m not saying we should all be vegans but we should have a proper, balanced diet.
SIBO is a big buzzword right now but a lot of symptoms of intestinal issues are related to diet.
Georgie: I grew up in the pharmaceutical industry but am learning how significant toxins are to our bodies. If we could reduce that, it would change the cost burden of taking medications. Speaking of healthy, what would you tell people about these diets and how to monitor? I’ll admit that when I did the AIP, I say I do the “light” version, because it’s hard to be so restrictive. How do you know what you should or shouldn’t eat? Is it 80/20? 90/10? 100/0?
Guy: That’s really an individual thing. Generally speaking, as a nation, our health would be much better off without dairy products. There are more digestible and less offensive options. Gluten is number two. It depends on the luck of things, a little bit, in terms of what you can tolerate. This can become trial and error for the individual person. Diet is hard to follow. We live busy, stressful lives. 40% of all American meals are eaten in the car. It’s inevitable. There are an enormous amount of challenges built into the system. Food quality is an issue in some cases. This is an entire field in and of itself.
Prebiotics, and diversity in prebiotics, are important. You want to vary your diet. Eating chicken breast and white rice for a living is not a great idea. People with a broken gut can’t tolerate fresh fruits and vegetables. Those are good but sometimes you need a professional to help you understand.
Georgie: I need to tell my four year old, not as much corn! I don’t want him to have a reaction later!
Guy: It depends on him. When food proteins were introduced into his diet, genes, antibiotic history, etc., he may never have a problem.
Let’s talk about type 1 diabetes. The highest rate of type 1 diabetes (not the obesity part, the autoimmune part) is in Finland, which is also the highest dairy consuming nation in the world. There’s the introduction of dairy protein in the young infant before they should be introduced. The American Academy of Pediatrics recommends that babies be exclusively breastfed until six months of age. If you’re introducing milk proteins (like I was!) to an immature gut. It starts attacking self in the form of beta cells and you can no longer produce insulin.
Georgie: Let’s talk about the scientific community. You said that this is a newer field and how it all seems to be about probiotics. I’ve read that the strain you take is whatever you’re trying to solve for. What would you advise people who are working with a clinician in regard to specific symptoms? For instance, I went to numerous doctors who never diagnosed me with endometriosis. Undiagnosed conditions are frustrating. As microbiome emerges but is still growing in understanding, what would you advise patients to do?
Guy: That’s the million dollar question. Half the battle is getting the appropriate diagnosis. Sometimes you go from practitioner to practitioner because you aren’t satisfied with the outcomes. That can be a challenge. Hopefully you get lucky and get the correct diagnosis early on. I wrote a book years ago in which I described a study with hospital autopsies. In this study, the causes of death in reality were different from the documented causes roughly 40%-50% of the time.
The body is immensely complicated. If you’re not satisfied, go to someone else. Do your own research. You may or may not find the answer. Seek out specialists. That’s not an easy solution.
Georgie: Maybe everyone struggling with these diagnoses can just take your test. What do people get back from the Onegevity test and how do they take that to a medical provider with more information?
Guy: Essentially none of your medical professionals will be able to interpret the bugs on there. Version 2.0 will be a little better with that. If you do the analysis and go to a conventional gastroenterologist, they will poo poo the whole thing (no pun intended). If you take it to more of an integrative, natural medicine or functional medicine practitioner, they’ll understand it better. They’ll know about leaky gut and other premises. That’s why we go the extra step to provide recommendations and an exact regimen to the consumer.
Georgie: Generally, when people don’t understand something they dismiss it. Our healthcare system doesn’t give doctors a lot of time with each patient. I can see how the system limits our ability to get answers.
What would you say inspires you?
Guy: You can take someone who’s been feeling terrible for years and even decades, who have seen multiple practitioners, and turn their life around significantly in a short amount of time (days, weeks, months). That's really moving. It inspires you to be better at what you do.
Georgie: It’s clear from our conversation that the gut microbiome isn’t biased toward men or women. But because Fempower Health is focused on women’s health, what’s one thing you’d want to share specifically with women about their gut health?
Guy: Women suffer more from gut disorders than men. They suffer more from anxiety and depression than men. These are all closely tied to the gut microbiome. Women may experience symptoms or not. Women do pass a microbiome off to their children. The gut microbiome also plays a role in longevity.
The microbiome is incredibly complex but at this stage of the game we know enough to make a difference in people’s lives. Generally speaking, the bugs that are good when you’re 15 are the same bugs that are good when you’re 40 and 80. We know who the good guys and bad guys are. We know what they like to eat. If you’re feeding the bugs in your gut with the right fuel, you’ll generally have better outcomes. If you’re feeding the bugs in your gut with the wrong fuel, you’ll generally have poor outcomes.
Georgie: There does seem to be momentum and research going into this space. It is controllable and women can use this Onegevity test to determine issues. This is a great tool to empower women to change diets and find the right supplements. It’s incredible to see where we are now and I can’t wait to see where we go in the future! Thank you for sharing your wisdom and the product that is out there to help people better understand their gut.