The Truth About IBS Tests: Legitimate Options vs. Red Flags to Watch For

Jessie Wong 00:00:00 Welcome to the IBS Nutrition Podcast, your go to source for navigating the complex diagnosis of irritable bowel syndrome. Here, we dive deep into IBS and discover the power of diet and lifestyle to find freedom from your IBS symptoms. I’m your host, Jesse Wong, Fodmap dietitian and a gut expert. For years, I suffered from debilitating gut symptoms that kept me out of work, feeling constant discomfort in my body and anxious around food. Today, I’m in control of my IBS. Able to eat the food I love again, travel whenever I want and spend quality time with loved ones. It is my mission to help you do the same and transform the way you live with IBS. Let’s get started. Hi everyone! Welcome to another episode of IBS Nutrition Podcast. This is a podcast where we talk about all things IBS, and sometimes we debunk things that are not so evidence based so that you can save your money. And these are things that we hear from our clients all the time where they’ve wasted thousands of dollars trying different tests, supplements, being on really extreme restrictive diet for long term.

Jessie Wong 00:01:09 And it doesn’t help with any of their symptoms because these are not evidence based approach. And we are sharing that on here so that you can avoid them and understand the science why we need to avoid them. And today, I am really honored to have a friend and colleague who I can proudly call colleague Doctor Andrea Love here with us. Doctor Andrea Love is an immunologist and microbiologist with over a decade of experience in basic science, translational medicine, and clinical research. She works full time in life science biotechnology in the field of vaccinology, immunology and immunotherapy, cancer cell and gene therapy, and more. She is passionate about improving science literacy and addressing pseudoscience and misinformation as it relates to science and public health. She is also the founder of immunologic. A newsletter and science communication organization, and the executive director of the American Lyme Disease Foundation. She’s also a columnist for Skeptical Inquirer and was the 2023 American Medical Writer Association McGovern Award recipient. She also recently did a wired tech support interview on pseudoscience support, and you can watch it on YouTube or on her Instagram page at doctor Dot.

Jessie Wong 00:02:40 Andrea. Love, Andrea. Thank you so much for joining us today. We are so happy that you are here to help us debunk the biggest myths and things that we actually really do here all the time, and it breaks our heart every time a client tells us how much money they’ve spent on different types of tests, and then the test results come back, that prompts them to the next step, right? So hope business model, next step is taking supplements or trialing different things and then retest to see if anything changed. Now let’s talk about all of these crazy tests here. And let’s talk about the science behind it and why sometimes it may be very convincing for, let’s say, the vulnerable population of people with IBS, or just people who wants to be healthier.

Dr. Andrea Love 00:03:25 Yeah. Thanks, Jesse, for having me. You know, I think, you know, a lot of the the health and medical information around these complex gastrointestinal issues because they’re so complicated. It’s it’s really an avenue that’s that’s rife with misinformation and ultimately really does, you know, exploit the vulnerable people who are not feeling well and they’re just trying to find, you know, the best way to move forward.

Jessie Wong 00:03:53 Absolutely. And we are not shaming patients here because it is confusing. And I’ll be frank, I think a lot of providers also don’t understand the difference between evidence based and non evidence based approach because these companies are really smart. They create teaching materials to teach providers on how to use their test. All right let’s get started. So we have a few tests to go over. I’m going to list them out here so that you know what we are going to talk about. And you can stay and listen to that part that you might be interested in. We’re going to talk about food sensitivity test, gut microbiome test or GI map, hair mineral analysis test at home, breath test for food intolerances, stool tests for food intolerances, and then if there’s anything else which had more at the end. But here are the few that we are going to focus on and tell you why the science is not there to use them. All right, let’s go. The first one, and probably one that we hear most often is the food sensitivity test.

Jessie Wong 00:04:54 Tell us everything we need to know.

Dr. Andrea Love 00:04:58 So yeah. So you know this is really obviously a big market. And so these tests they are promoted as something that you can buy as a consumer. Often you can order it online or you can even buy it at certain, you know, pharmacies or general purpose stores. And they say that with a single finger prick blood sample, it can allow you to conveniently assess your reaction to certain foods. And so, you know, they’re sold direct to consumer. They make it sound very appealing, very straightforward. And, unfortunately they don’t actually have any science behind them. And so this is really stemming from a misunderstanding about what a food sensitivity is and what it is not. And so maybe it makes sense to start from some of the science behind that. And so, you know, when we talk about things that you can react to in the context of food, we’re really talking about food allergies or food intolerances. And and also there are autoimmune disorders that are related to certain food components, which is basically immunologic response.

Dr. Andrea Love 00:06:02 That’s not a stereotypical allergy. But but ultimately food allergy is kind of one bucket and then food intolerance is a different bucket. Food allergies typically affect about 2 to 3% of the population. And these are going to be diagnosed by a clinical allergist immunologist. Food intolerances are going to be digestive issues. And maybe I’ll talk about that in just a second. But it’s a kind of a different bucket criteria. But you do present with symptoms after eating certain foods. Now, if you look at kind of the general population and their perception, there’s about 25% of adults who actually self-diagnose as being sensitive or intolerant to foods. And these increased prevalence is increased. Self-reporting is really coinciding with these this market of these food sensitivity tests, sometimes they’ll they’ll be labeled as a food intolerance test. Sometimes they’ll be labeled as a food sensitivity test. But they they advertise themselves very aggressively to say that you can test your reaction to hundreds of different foods all at once. So when we’re talking about allergies, we’re talking about these typically rapid immune mediated reactions when you encounter specific molecules in a food.

Dr. Andrea Love 00:07:11 And so typically these are inappropriate responses. They’re officially called a type one hypersensitivity reaction. When you encounter a molecule chemical that realistically, your immune system shouldn’t respond to. But it happens in two phases. So typically the first time you’re exposed to this substance, it’s it’s an antigen, meaning it’s something that elicits an immune response. Now in the context of allergies, we call those specific antigens allergens. It’s just a different name in the context of an allergic reaction. So let’s use peanuts as a hypothetical scenario because everyone is familiar with peanut allergy. So the first time you eat peanuts, you maybe wouldn’t experience anything but in your GI tract while you’re digesting those peanuts, the certain proteins in the peanuts are being exposed to your immune system in your GI tract. It’s called the the gastrointestinal associated lymphoid tissue. And all of your immune cells live in there. And your B cells are like, hey, I don’t recognize this. This doesn’t look great. And it starts to produce a particular class of antibodies called Ige.

Dr. Andrea Love 00:08:17 These are called immunoglobulin globulin E. And what happens here is that the B cells produce all of these Ige antibodies, which are secreted out of the B cells. And then those go over to this other type of immune cell called a mast cell. And they bind to a little protein that sticks out on the outside of the mast cell, called an FC receptor. So now you’ve got this protein sticking out of the mast cell. And then you have this Ige from the B cell that’s bound to the mast cell. And so those are just going to hang out on the outside of the mast cell and just do their thing for for the time being. So basically what you’ve done is you’ve now created this trigger point and that’s the sensitization process. So initially you’re not going to have any reaction because what’s happened is your B cells have created this immune response. But it’s not leading to symptoms when you actually develop symptoms of an allergy. This is a this is on the subsequent exposure. So you’ve already produced these Ige.

Dr. Andrea Love 00:09:10 They’ve already bound to the mast cells. And the next time you eat that peanut those same peanut proteins are going to come in. And instead of saying to the B cell will produce these Ige, they already have Ige. So Ige are like catch. You know they’re basically sticky that are going to grab on to the protein that they match. And so those Ige that are sticking out of the mast cells are going to grab onto those peanut allergens. And that’s going to lead to a chain reaction of the mast cell leading to activation. And this process causes a phenomenon called granulation, which is essentially the mast cell is just spitting out all of these chemicals. And these chemicals are inflammatory chemicals. And so they secrete histamine, they secrete leukotrienes, they secrete prostaglandins, they secrete other cytokines. And so this this second exposure is called the elicitation phase, meaning that you release all of these chemicals. You elicit this inflammatory allergic response, and all of those chemicals lead to this really pronounced a physical reaction. And so all of these chemicals cause, swelling, vasodilation and increased blood flow, redness, flu vascular permeability, meaning you have a fluid leaking out of the blood vessels into the tissues, which causes swelling.

Dr. Andrea Love 00:10:29 So you might have swelling in the lips and the tongue in the face. it can also lead to future immune cell activation. And so it can cause, skin issues, hives and eczema. It can cause GI symptoms like nausea, vomiting. It can also cause, respiratory issues like, bronco constriction and difficulty breathing and wheezing. And in really rare and severe cases, it can cause cardiovascular collapse, a really severe drop in blood pressure and possibly death. And this is an anaphylactic reaction. So this is not something that people want to experience, but it is something that is diagnosable and treatable, which is great. And obviously the treatment for this is typically to avoid the foods that you are actually allergic to. But there are other things like immunotherapies that can train your immune system to not have this inappropriate reaction to. And so that’s that’s your allergy. So when we’re talking about allergies these are often proteins found in food. So when we’re talking about milk it’s things like casein and whey and eggs. These are things like proteins like albumin or ovo transferrin which are proteins in the whites and the yolks.

Dr. Andrea Love 00:11:39 Peanuts are usually proteins in the peanut. era H1, H2, H3, H6, and so on. But that’s kind of your allergic reaction. When we talk about food intolerances, this is usually a result of a digestive issue. So not your immune response per se. But typically when you’re digesting food, you’re breaking the large substances down into smaller molecules so that ultimately you can liberate glucose or byproducts that can be metabolized into glucose, that your body is going to use for energy in the form of ATP. And so you need enzymes. You need proteins that have these, these abilities to break down these molecules into smaller and smaller molecules. And so typically you have all these different enzymes that live in your GI tract and you produce different levels of them. But if you lack a certain enzyme or you don’t produce enough of that enzyme, you might not be able to digest those specific chemicals and that can lead to symptoms. So a common example I use is lactose intolerance. Right. And so basically what happens is lactose is a sugar that’s found in dairy products just like sucrose or maltose or galactose.

Dr. Andrea Love 00:12:50 But we need a specific enzyme to digest lactose called lactase. And so sometimes we stop producing it as we age, or people just don’t produce enough of it over time. And what ends up happening is that you have all this lactose that you’re not able to digest, and it leads to bloating, abdominal cramps, flatulence, diarrhea, nausea and vomiting. And so this is not an immediate response like an allergic reaction, but it’s typically a delayed response usually once those things get down to your GI tract. So 30 minutes to 2 hours. And one of the key differences here is that with an allergic reaction, the symptoms are going to present, no matter how small a quantity of that thing you eat. Whereas with intolerances the severity will often depend on how much of it you can eat. So like if you have lactose intolerance, maybe you can get away with eating a tiny bit of like dark chocolate, which has a really low quantity of dairy in it. But you couldn’t eat milk chocolate because it has a lot more dairy in it.

Dr. Andrea Love 00:13:47 So. So those are kind of the buckets. So when we talk about food sensitivities, this is a third category. That actually doesn’t mean you’re having a reaction to food at all. And so these these tests are actually looking at a type of antibody called IgG which is in the context of food and antibody of tolerance. So Ige is the allergic associated antibody. Food intolerances are not related to antibodies at all. And rather you’re lacking enzymes. And so these these tests are looking at IgG. But what IgG means in the context of food it actually means that you have tolerance to it. It simply means that you’ve been exposed to this. Your B cells produce this antibody because they were like, hey, I recognize that. It’s all good. It’s supposed to be here, and you produce it every time you’re exposed to that food product. And so it literally is telling your body, I recognize this molecule, I don’t need to attack it. And so this food, this oral tolerance is basically saying your body can tolerate that food and digest it without the elicitation of an allergy.

Dr. Andrea Love 00:14:50 And so what you’re testing for is has nothing to do with whether or not you have a reaction to that food. It’s often just indicative of how recently you ate that food or how much of that food you eat. So, you know, if I took a food sensitivity test, I probably, you know, have sky high levels of like, broccoli. If I happen to eat broccoli a ton in the previous week. And so these IgG levels are really just an indication of recent history of eating that food. And so what ends up happening is that people will take these tests, and then they’ll start avoiding all of these foods that have these ingredients in them when they shouldn’t be avoiding them in the first place. And often a lot of these things on these food sensitivity tests are really healthful and nutritious. They have high fiber, and those are good for people with IBS. and so, you know, these are often marketed to people with gastrointestinal issues. And so, they actually looked at there’s a study that’s often cited and it’s patients with IBS.

Dr. Andrea Love 00:15:47 And they took an ECG test. And so they had in the group, they had one group that eliminated foods that were identified in the food sensitivity test. And, and then the other group eliminated the same number of foods, but not ones that were identified by the test. So they both eliminated, you know, x number of foods. The first group was the ones that the test scored. The other group was completely random foods. And when they looked at self-reported symptoms which are not quantitative symptoms, the test group said that they reported a 10% improvement between the the test group and the sham group. But both groups reported improvement because both felt like, oh, well, I’m eliminating something, it’s probably doing something. And that’s really an indication of the placebo effect. And when you actually look at how they plot the data, the data sets actually overlap. So they’re not really demonstrating any benefit. and if you actually look at, you know, the study groups, you’re looking at people with IBS, you’re looking at people with, you know, gastrointestinal issues and a lot of the food products that are being scored or coming up on these tests are things that are often avoided in clinical context.

Dr. Andrea Love 00:16:56 When you’re trying to identify what foods are actual triggers for people with IBS, so things like nuts and legumes and barley and so on. many of them would also be eliminated if someone was undergoing a low Fodmap diet, which are, these fermentable, you know, short chain carbohydrates that is implemented for people who do have clinically diagnosed IBS. And so, you know, you’re kind of cherry picking your data here. So when you look at kind of a larger population level study which had 21,000 individuals, you found that the the changes in the IgG, the food sensitivity, antibody levels were completely irrespective of anything. And, you know, they were, you know, elevated and symptom free people, you know, all across the board. And so this is one of the reasons why all credible allergy organizations around the world recommend against using these tests.

Jessie Wong 00:17:51 Well, thank you for sharing. That in-depth scientific explanation with us is really, really helpful, especially explaining why you know, these tests are not valid. And in fact, we went to a conference last week.

Jessie Wong 00:18:02 It was the Digestive Seas week and we had a session about food intolerance tests and why none of them are valid. I think there’s one that Michigan is looking at. But then as soon as they presented certain things, a lot of the guy came out and say, that’s not valid. Please stop what you’re doing. and we just don’t have any good science to back up any of these. And these tests are extremely expensive. And what’s worse is not just, you know, paying the money. It’s causing a lot of food fear and causing people who already are in a vulnerable situation to cut out more food and actually really devastating their gut function. Further, when they’re taking out things that could be beneficial to manage their symptoms. Okay, so that is the food sensitivity test. Thank you. Let’s move on to the next one. Oh my God. This is a big one. And it’s we are seeing it way more often nowadays compared to maybe 2 or 3 or 4 or 5 years ago, because there’s more available.

Jessie Wong 00:18:57 There are more companies and labs that are doing these tests, and it is the gut microbiome test. And sometimes we hear it as the GI map or some very fancy name tell us everything.

Dr. Andrea Love 00:19:11 Yeah. I mean, they label it to make it sound like it’s super legit and there’s all sorts of acronyms associated with it. And I think the first thing that people need to understand is just like the food sensitivity test, none of these are standardized or validated or FDA approved. I think I maybe, I maybe I skirted that in the beginning, but none of these tests are actually FDA approved for use, diagnosis, treatment, etc.. And so that’s really important. And, you know, I want people to have a better understanding of, like the stringency that regulatory review involves because because these kind of fall under the unregulated landscape of wellness products. And so they they kind of get through these legal loopholes to sell products, but they’re not actually based in reality. And what they’re really premised on is pseudoscience, which again, has this nugget of truth that like, yes, the gut microbiome is important, but then they kind of extrapolate it to things that we can actually say.

Dr. Andrea Love 00:20:08 And the same is true for the food sensitivity test, right. They’re looking at antibodies but not the right antibodies. Right. And so again it sounds very convincing because they use this jargon. So microbiome tests are typically taking a stool sample and using that to essentially isolate bacteria that would be shed in your feces. And from there they’re usually doing a type of nucleic acid processing to determine the quantity and proportions of different species of bacteria. So they’re usually isolating either DNA or RNA. And this is an important distinction because DNA is the full genome of an organism. So it’s kind of like the encyclopedia of an organism. Whereas if you’re sequencing RNA of bacteria, it’s only the expressed genes at a given point in time. And so it’s like ripping a few pages out of the encyclopedia, but it’s not necessarily the full scope. So but the problem is, is that different companies are using different approaches. Right? Some are using DNA, some are sequencing RNA. And the other thing is that they’re usually only sequencing or detecting a few a select number of species of bacteria that may live in your GI tract when there are potentially thousands of different species in the trillions, when we talk about numbers of them.

Dr. Andrea Love 00:21:32 And so you’re again, you’re cherry picking kind of this select group that you’re going to look at and then making some sort of conclusion about it. Right. And there’s a few problems with that. First, you’re relying solely on things that are shed in feces. And if we’re talking about the diversity of bacteria that live in your GI tract, they live in all different areas, right? Some might live in the, the small intestine, which is higher up in the GI tract. Some might live in the large intestine, some might hang out, you know, closer to the colon and the rectum. And so, you know, whether or not they actually get into your feces in an intact, you know, shape in order to then be isolated in sequence. Some of that depends on where they’re hanging out in your gastrointestinal tract, doesn’t guarantee that they’re actually going to get into your stool sample on top of that, because you have all of these different species in your, in your GI tract. They produce a lot of proteins that allow them to hang on to the the intestinal lining, these adhesion molecules, some of those species are better at producing those.

Dr. Andrea Love 00:22:34 They’re going to cling better. They’re not going to be shed in feces as much. Some of that is evolutionary. So some of these bacteria, they want to stay in the GI tract indefinitely, whereas some like ones that might cause potential pathogenic illness, they want to be shed into the stool because that can help propagate their life cycle. Right? If they get into wastewater, then they could be picked up by another organism and continue their life cycle. So something like the bacteria that caused Colla and the Vibrio family, they actually don’t adhere as well to intestinal walls as something like an E.coli mite. And so again, what you’re sampling in the stool is what’s been pooped out of your body. It’s not necessarily what’s actually living in your GI tract. It’s not a representative cross-section. And so you can’t really make any determination based on what you’re sampling in your stool. On top of that, they use these tests to make insinuations about what’s a healthy microbiome and what’s not. And that’s just that’s just an exaggeration.

Dr. Andrea Love 00:23:34 Every single person has a different and distinct microbiome in their GI tract, and that’s a result of so many factors. It’s a result of your own immune system. It’s a result of foods that you recently ate. Because we have to remember that this population is a living. I was going to say living, breathing and not really breathing, but living, fermenting, you know, dynamic population. And so what’s happening is every time they encounter food, which is the stuff that gets into your GI tract, the ones that are better able to digest certain compounds are going to reproduce more efficiently if you feed them that food and and vice versa. So that population, those proportions are going to be changing all the time. And so if you’re not monitoring this over the long term with a baseline of a single individual, you can’t make any claims about what the populations, what the proportions actually mean, especially if there’s no definition of what a good microbiome is, that that good microbiome is going to be different for every single person you know.

Dr. Andrea Love 00:24:35 We know that diversity seems to be good, but we can’t say, oh, well, you need 3% of this species of fur and this, you know, 10% of this species of Bacteroides. That’s not the way it works. And so people that are making claims about, you know, hacking your microbiome are doing it solely to sell you a product. And, and many of these companies are even selling like a prescription afterwards, right. You do your gut microbiome test, they give you your results, and then they and then they can tell you all the things to do to improve your, augment your microbiome. And and that is actually illegal because this is not a regulated product. They’re legally prohibited from, talking about treating or adjusting or curing any sort of medical issues. And, you know, it’s really hard for FDA to get involved with these tests. But but those those claims are illegal. And so these companies, like Valium, for example, is a really prominent perpetrator of this. They’re telling people to take certain supplements, they’re telling people to eat certain foods, and none of it is actually based on real science.

Dr. Andrea Love 00:25:36 And so again, you’re getting into this pattern of, are you, you know, fomenting an eating disorder with these people, and you’re making these claims that probably, you know, aren’t actually real in the context of what’s going on in their GI tract.

Jessie Wong 00:25:50 Right? It’s a whole business model, right? Selling. Well, the first they train the clinicians to sell the tests, and sometimes they’re directly selling it to consumers. But a lot of the times they train the clinician to sell their test to educate them on this is what the tests do. This is what the test results means. And then and then the next step is selling dumb products or educating the clinicians on what products you use when the results is what x, y, z. And then of course after a period of time and then they do the retest and then reevaluate and maybe sell the consumer another set of products or supplements or medications to try to fix their guts. And it is a vicious cycle, and we see it a lot in our clinic.

Jessie Wong 00:26:30 In fact, a lot of the times patients would come to us saying that they’ve worked with somebody in the natural health side of things for like five, six years and nothing resolved. And all they have now is an eating disorder because they’re so afraid of food, because they try supplement. They tried elimination diets. Nothing is working. Nothing is really getting down to what is really causing their symptoms. And a lot of the times for patients or population with IBS, right, there could be a food intolerance that’s lurking in the background, but it doesn’t mean you need to cut out everything. They really means you need to identify what it is. And with the gut microbiome test, we just don’t know. And I think I’m not on top of the science, but I think from last time what I read, most of the data about gut microbiome actually stems from North America. The rest of the world we know very little about. So it really speaks to volume or it speaks to everybody that, hey, these data are not complete.

Jessie Wong 00:27:23 We just don’t know. And even in North America, right? I live in Seattle. Where where are you in?

Dr. Andrea Love 00:27:28 I’m near Philly. So yeah, I mean, our microbiomes are going to be different. Just, just even if we ate the same exact foods, our microbiomes would be different for for a whole slew of reasons, including the environment that we live in.

Jessie Wong 00:27:40 Exactly. Yes. And so if you are listening, if you’ve done these tests, if you’re trialling any sort of protocol, please know that it’s not helpful and it’s probably best to stop whatever you’re doing and work with a legitimate health care provider.

Dr. Andrea Love 00:27:55 Yeah. And I think, you know, Jesse, you made such a great point because, you know, these people are coming to you and they’re they’re already feeling vulnerable. They’re already feeling desperate. They they feel like they’ve exhausted all these options. And that’s really when they’ve they’ve kind of fallen into this, this rabbit hole. And you know, on top of having malabsorption issues because of their underlying disease pathology, now they’re depriving themselves of foods that they probably don’t need to be depriving themselves of.

Dr. Andrea Love 00:28:20 But you’re also exacerbating health anxiety and stress, which we know are not good for our immune system, just kind of carte blanche. And so you’re really just kind of compounding the problem. And then when you tell them, hey, you know, like, you don’t actually have to omit this, you can try reintroducing it. Well, you know, they have they might be paralyzed with fear and like be so averse to even trying again that, that it’s really hard to get out of that, that cycle. and it’s and it’s. Yeah, it’s hugely problematic. Yes.

Jessie Wong 00:28:52 Okay. Now move on to the next test. This is actually not a test that was on my radar until more recently, because there are some dieticians or health care providers in a few who are very prominent, who holds PhD degrees are promoting it. And when I looked it up, I could not find any science to it. And in fact, any article that were ever written or studies about it was from the 1980s. And this is drumroll.

Jessie Wong 00:29:23 The hair mineral analysis test. Oh my God. Yeah. Tell me, tell us everything. This is so.

Dr. Andrea Love 00:29:30 Yeah. And so this is, this is fascinating because I think you’re absolutely right. I think, you know, when we talk about the more mainstream predatory, like, gut health tests, it’s really the food sensitivity and the microbiome test. But we’re seeing a lot of these other fringe tests getting traction because, like you said, people who sound like they have legitimate credentials are amplifying and elevating them and giving them this, appearance of legitimacy. And I think it’s it’s a big problem where we can’t simply just take someone at their word, you know? I mean, there’s a lot of bad apples in every field, right? There are PhDs in immunology that spread misinformation. There are PhDs and all sorts of other scientific fields. Or there are healthcare providers, you know, medical doctors and dogs and dogs and all sorts of people that that can also spread misinformation. And so, you know, when when you’re looking at whether or not this thing is credible, it can’t just be, well, this one person said it right.

Dr. Andrea Love 00:30:24 And I have this emotional connection to this person and I trust them. Therefore it must be reliable. Like you really do have to see okay, what is the scientific, you know, community say at large because there’s always going to be like a contrarian, right? There’s always going to be someone in a field that’s saying something that is in conflict with what the data on a topic say. And that’s why we look at consensus, which is not just a bunch of people agreeing on something. It’s what is the comprehensive set of data, say, on this topic. And so you’re absolutely right. There is no evidence to support these hair mineral mineral analysis tests for food or digestive issues. And so I’ll run down what they essentially are. So basically they take a sample of hair and they claim to test for the quantities of minerals like calcium, magnesium, potassium, sodium, zinc, iron, copper, manganese, etc. they also say that they can test for heavy metals. So lead. Mercury, arsenic.

Speaker UU 00:31:21 Cadmium, cadmium, aluminum.

Dr. Andrea Love 00:31:23 and so typically you’re going to take a sample from like the back of the neck, close to the scalp because your hair kind of grows out from the follicles. And so you want something that’s close to, to recent growth. so it’s representative of, like, what was in your body recently? and then they’re going to use some, some chemical, analytical chemistry equipment, usually a technique called, inductively coupled plasma mass spectrometry, which basically allows you to separate different chemicals or elements based on the mass of them, the atomic weight of them. and so these tests say, you know, they can, assess, like your ability to absorb or have deficiencies in some of these elements, these things that you should be getting in your diet that should be, you know, that many of them are essential for function, right? We know that all these micronutrients are great. We also know that excess of them isn’t better per se. but, you know, again, these tests are kind of marketed as saying, well, we can test these different minerals and tell you what sort of nutritional deficiencies you have, whether you have a malabsorption issue, whether or not you have a GI issue, or whether or not you have just a nutritional deficiency.

Dr. Andrea Love 00:32:40 And so it’s just not true because there’s so many factors that are going to affect what actually gets deposited in your hair. And so for people that don’t know, hair is a protein. It’s essentially, they’re not cells. So basically you you produce protein. It grows out in this fiber out of your hair follicles. And so this is not a living organism. And so things get deposited with the protein. And that’s going to change for a variety of reasons. It can also change by like what hair products you use or how frequently you wash your hair or you know, all sorts of things, whether you dyed your hair or not, whether you have a chemical treatment like a relaxer or a perm. And none of these are validated for use for any sort of nutritional, you know, intervention or interpretation. There’s no standardized method for collecting the samples, for analyzing the samples, for washing the samples. And so you could run the same exact sample at ten different labs and get different results. And so you can’t actually draw any conclusions about them.

Dr. Andrea Love 00:33:37 and there’s actually no relationship defined between how much minerals are in your hair and your overall health, particularly your nutritional health or your, you know, these, these, the the quality of the food or your digestive processes. So, you know, as you said, there’s no there’s no causal relationship between this. and so again, there’s no scientific basis for that, on top of the fact that none of these are FDA regulated or anything. So you can pretty much just like, say you’re running a test. Who even knows if you’re running the test and And they’re just going to, like, report back some results. But there’s no oversight. There’s no quality control. There’s no, you know, there’s no evidence to support it. And then, of course, you have this very, you know, buzzy sounding marketing, and they’re making these false promises to people where they’re getting, you know, they’re like, oh, we’re using this highly sensitive chemistry equipment, but it’s not actually telling you anything that’s relevant to your health.

Dr. Andrea Love 00:34:32 And so again, you’re giving these people just you’re misleading them about what this information actually means.

Jessie Wong 00:34:38 Yes, exactly. And again, it’s that kind of business model right. It comes back with a result. And then it’s a supplement to fix the result. And then maybe they retest again in the future. It’s an endless cycle of testing trialing things. And it really doesn’t help with anything since there’s no science to it. Yeah. Like the next one. It’s I think it’s a big one that I’ve seen the last maybe 2 or 3 years is at home. Breath test for food intolerances. Yeah. Oh. Go ahead. These tests are made by the same ones who make also make the food sensitivity test made by the same companies.

Dr. Andrea Love 00:35:13 Yeah, yeah. So, you know, typically you’re going to find a lot of these tests and they’re going to be marketed towards people who have, you know, digestive issues or concern that they have digestive issues and things like that. And so, you know, these are often marketed by saying, okay, well, you’re going to you’re going to be able to detect malabsorption of certain carbohydrates or bacterial.

Dr. Andrea Love 00:35:35 They use the phrase dysbiosis a lot. I notice and, you know, it’s often co-opted. And again, a lot of these nebulous science sounding terms are just really not applied correctly here. But basically, these tests are saying that you’re going to collect your breath and they’re going to look for various gases that you’re exhaling. And so this is often hydrogen, sometimes methane. And the they’re presented as you know, you can monitor these levels over time over the course of this test period where you’re usually you’re going to consume something like glucose or fructose or lactose, and then they’re going to collect these breath samples, and then they’re going to tell you whether or not you’re able to break down these, these sugars because they have to be fermented. And then you’re going to produce gas as a byproduct. And so then they’re going to measure these gases. So one of those is also sold for Sibo the small intestinal bacteria overgrowth. And again like there’s a little bit of science behind this. There’s a little bit of no science behind that.

Dr. Andrea Love 00:36:39 And so, you know, it’s really it’s kind of this overlap of this predatory wellness landscape. and so, you know, there are there are some that are used in clinical practice that utilize clinically validated tools and methodologies. And so it kind of takes that nugget of truth that there are ways to assess this for certain medical conditions. And they’re like, oh, well, I’m going to create an at home one that’s way more convenient and people can just buy it and then they can just do it themselves. The problem is, is that those ones are not regulated or approved or standardized or monitored or controlled. And so again, they’re taking these nuggets of truth where, you know, there are, actual clinical procedures to assess sorts, these sorts of things. And they’re like, well, you can do it at home in the convenience of your own space and blah, blah, blah. And the problem is, is that if you’re actually doing a clinical test like this, it’s very strict. You have to consume X amount of thing.

Dr. Andrea Love 00:37:41 You have to wait X amount of time, you have to collect this amount of gas and this amount of time interval. And it’s supervised and monitored by people who are trained to administer it at home. It’s the Wild West. There’s no there’s no regulation of what you’ve consumed, what things are maybe impacting the sample collection. And because these kits are not regulated by anybody there, the quality is wildly variable. And there’s no there’s no standardization or controls to actually interpret the values you’re getting. So you can’t actually use it to to diagnose anything. And so it gives people either false confidence if they get a negative result or or anxiety if they get a positive result. And in reality, if you have legitimate concerns about some of these GI problems that can be diagnosed by legitimate gas byproduct testing, you should be seeking a clinical care team to walk you through that. And I get it because, it’s really hard to sometimes find specialists and we don’t have medical care and all of that. But these tests are also very expensive.

Dr. Andrea Love 00:38:44 So it’s not, you know, it’s not like you’re getting them for free. And so, you know, I understand the frustration, but you’re spending money for, for falsehoods. And, and I think that is really the biggest, the biggest problem. and then you have the added layer of like now you’re going to be in incorrectly self diagnosing with, with things that maybe are not actually true. And that’s going to just compound the problem.

Jessie Wong 00:39:10 Yes, exactly. And I want to add on to that, even the ones that are clinically done, what we see a lot in our clientele is the lactose intolerance breath test and of course, the fructose breath test. But oftentimes, what patients need to understand is that your tolerance of lactose and fructose can fluctuate over time. And one time you are, you know, have to cut out fruits forever or cut out dairy with lactose forever because it can fluctuate depending on where your gut symptom is at. And oftentimes what we see is when people improve their gut function, improve like the fundamentals of their gut health, your tolerance level to these foods, which are actually FODMAPs, will improve, and you don’t have to cut them out forever.

Jessie Wong 00:39:50 And that’s not what these tests are telling people. And they’re creating a lot of fear and causing people to, again, cut off food unnecessarily and causing more stress and anxiety, which does not help when it comes to improving their gut function or managing their IBS.

Dr. Andrea Love 00:40:05 Yeah, it’s a it’s a great point. And that’s really why you need a clinical team to to use the context, the whole clinical picture. And these things are done over time. They’re done over the course of a, you know, extended period. So you can revisit things and and yeah, absolutely. Like I said, you know, you might have higher levels of that enzyme, you know, at one point or another. And those those levels can actually fluctuate by a variety of things.

Jessie Wong 00:40:31 Exactly. All right. Last but not least, this is a newer one. And I think the first time I heard it okay. This is a stool test for food intolerance. It is so crazy because the first time I heard this was at a physician’s office, I went to this integrative MD and she pulled up Zoe.

Jessie Wong 00:40:53 And I think Zoe is one of the companies that does it. I know right? And she pulled up Zoe. And so we of course, is this huge brand name that quote unquote says that they are backed by science. But I think a lot of the products that they have sounds a lot like the things that we are discussing here. They prey on the population that wants to improve their health and they’re using or they’re creating a tool before that tool is quite ready or quite mature to be marketed to consumers. So let’s talk about this one. There’s two tests for food intolerance. Yeah.

Dr. Andrea Love 00:41:26 And and you know you you hit the nail on the head there Jesse. You know these tests, they’re not ready for public consumption because the science isn’t there isn’t caught up. But they make those claims like science backed or there’s evidence. And I think what people don’t realize is that when when they say science backed as a marketing tool, it doesn’t mean that there’s a clinical trial to support it. It means that there’s some paper that’s tangentially related to something that they’re testing, usually in a petri dish, usually in a simulated environment.

Dr. Andrea Love 00:42:01 And they’re saying, oh, well, you know, in mice, we looked at this thing and we saw a relationship between this and that. Therefore, we can say that this is science backed because there’s a study that exists somewhere in, you know, the ecosystem that is related to this topic. And we see that really commonly with supplements where they say it’s science backed. And we actually look at the science that they’re citing. It’s like a petri dish study. And if you ever heard me talk, you’ll hear me say that you can do anything to cells on a piece of plastic. It’s not what happens in your body. and so the stool tests for in food intolerances is, is the probably the most nebulous of the categories because it really could mean anything. It basically means that people are going to collect a stool sample at home, and they’re going to send it to some laboratory that the company that’s offering the stool test is contracted with, and the lab is going to run tests for, I don’t know, a bunch of stuff.

Dr. Andrea Love 00:42:52 It could be a microbiome test. Sometimes they’ll look for like enzymes, digestive enzymes that they claim that they can look at. Sometimes they say that they’re going to look at undigested food particles, like, you know, pieces of corn or whatever. And then sometimes they’re going to look at nebulous inflammation markers. one of the common things that we see with these, stool tests is actually linked to that leaky gut, kind of the false claims of the leaky gut, where they look at the online test, which is purportedly assessing the intestinal permeability. And again, you know, that’s not really based in science. And so what they’re doing is again, they you know, you’re given the sense that, okay, you’re gonna you’re gonna give them a stool sample and they’re going to assess, you know, levels of inflammatory chemicals, cytokines, they’re gonna, you know, assess for the microbiome profile, which we already talked about. And then the online test is is another one where they look at, you know, a protein called xylene, which is involved in these tight junctions in between cells and the intestinal lining.

Dr. Andrea Love 00:43:55 And so they they claim that by looking at levels of that xylene, it’s an indication of, of, you know, elevated levels mean that, you know, you’re, you’re basically kind of excreting it and it’s not holding the tight junctions together. And therefore, you know, your gut is leaky and you’re not digesting things and all that. But these these methods, again, are not validated. They’re not specific. Insulin is highly variable as a result of many, many things. And it’s not, you know, used or recommended as a diagnostic. And so you can’t really look at that and say, you know, ASN and and level corresponds to GI function or gastrointestinal integrity. The other things that you might see, you know, these markers of inflammation. And so they’re going to look for just generic things like interferon gamma and TNF alpha and all these cytokines, which yeah, are technically involved in various inflammatory processes. But in a stool sample, when there’s no standardization or interpretation or baseline or anything, you can’t say anything, you know, your, your levels of these inflammatory chemicals are constantly changing because everything that you do causes inflammation.

Dr. Andrea Love 00:45:05 That’s another word that is just very frequently weaponized. exercising causes inflammation. Digesting food causes inflammation. You know, all of these things cause inflammation because it’s an essential process for our body. And so, you know, taking these tests where they’re going to report out these just kind of generic outputs, you know, they also say they’re going to look at things like pancreatic enzymes, like elastics and so on. But again these these don’t have scientific basis. Right. Especially because these are not being monitored or administered by a clinical team. And so you’re using these companies that haven’t actually submitted their product for any sort of clinical or regulatory approval. And what that means is that they can say whatever they want because nobody’s actually studied the accuracy of their tests. And so again, you’re going to misinterpret things because the thing the tests are not accurate. You’re going to maybe inappropriately self-diagnose yourself. And then if you’re using that for self-diagnosis, maybe you’re overlooking actual medical issues that you could really address, but you’re being misled about because you, you know, took this this stool test that is just kind of reporting, you know, these vague outputs that don’t have context.

Dr. Andrea Love 00:46:22 You know, there’s no there’s no interpretation of what they actually mean in the context of your health.

Jessie Wong 00:46:26 Absolutely. And again, for anybody listening, you know, if a test is sell directly to you or is marketed directly to you, Beware most of the time. I mean, I think probably 99% of the time they’re not valid unless they’re like a Covid test or flu test. One of those newer things that we now are more comfortable doing at home versus at the clinic. But there’s still, differences when you do it in a clinical setting versus doing it at home, because people are actually trained to collect samples appropriately. But these tests that we talked about that really target the population. We’ve got disorders. They are oh, they are not based on science and they are not I think of good faith. That’s what I think. I think a lot of the clinicians that sells these tests, some of them are maybe they don’t understand the science. And I hope if you are a clinician listening to this, you know, you can rethink your approach and maybe change appropriately and actually go to conferences.

Jessie Wong 00:47:25 If you’re in the GI space, go to conferences like ACG conference or the Digest Disease Week conference. It’s you learn so much and you actually learn what the science is saying and what where we are. And think with science on these kind of tools as well, because we we do talk a lot about gut microbiome food sensitivity tests in the conferences, but really not in a positive way just yet. But there is a lot of potential in the future, but in the near future, I just don’t see it becoming a valid tool since there’s so much we still don’t know, especially when it comes to the gut microbiome space. And it’s a huge it’s a huge marketing opportunity right now for these companies because there’s so much we don’t know. We can’t say that they don’t work, but we know that they don’t have the science to back them up. So again, well, there is one thing I want to ask you and maybe kind of touch on a little bit, because you mentioned supplements just now.

Jessie Wong 00:48:26 I don’t know if we need to do another episode just talking about supplements because or maybe not, but maybe really an overview of where supplement is in the US or maybe worldwide, because they’re not regulated, they are not tested. We are. I think one of the things we always talk about is always look for third party testing for safety, efficacy and purity, right. And safety. We’re talking about not having heavy metal or chemical contamination, which most people are not aware of. But supplement is one of the leading costs to having liver failure or kidney injuries in people taking supplements, detoxes and supplements is such a big category. Let’s talk maybe real quick five minute talk about different types of supplements and maybe what we also see a lot in the GI space.

Dr. Andrea Love 00:49:17 Yeah, absolutely. So you’re absolutely right. Especially in the US supplements are not regulated by the FDA for safety efficacy, quality control, etc. and that was actually born out of a law passed in 1994. and before that, they did fall under the same category as medications and regulated cosmetics and so on.

Dr. Andrea Love 00:49:39 But but then when the 1994 DHEA was passed, it essentially kind of opened the door and really removed all of the regulatory oversight for dietary supplements and dietary supplements include anything that is a non FDA approved medication or a food product. So it’s everything from single ingredient vitamins and minerals, multivitamins, herbal supplements. It actually includes herbal teas, as well as any sort of fiber supplements. nowadays the the buzzy word is prebiotics. Your probiotic supplements which have live microorganisms any sort of like workout supplements, amino acids, protein powders, creatine. I mean, everything kind of falls under that umbrella. And so, you know, I think the biggest thing that people need to realize is that none of them have had the requirement to conduct clinical trials and demonstrate that they even offer a benefit. And so for the vast majority of people, supplements do nothing, and in many instances they can, you know, depending on the supplement, they can be harmful. Even when we’re talking about the single ingredient, like micronutrients, like vitamin C, vitamin D, zinc, etc., you only need tiny quantities of those things, and taking too much of them can actually lead to adverse effects, including gastrointestinal issues or, you know, bladder stones, malabsorption.

Dr. Andrea Love 00:50:58 They can actually compete with the absorption of other things that you need. So, you know, overdosing on even things that are essential is not a good thing. But then it gets worse, because then you get into these like proprietary blended supplements that are often marketed to like, boost gut health. And they’ll say they have prebiotics and probiotics and herbs and vitamins and minerals and all of these things that are supposed to heal your gut barrier. And they use all these signs, sounding words. And the problem is, is that many of these companies not only are these complex mixtures of things, but they often get away with not disclosing the ingredient list by saying it’s a proprietary blend. So now you’re consuming things that you don’t actually know what you’re consuming. And I think people, you know, fall into this appeal to nature fallacy trap where they, you know, if the label says it’s derived from nature, it’s all good. But nature is not all good. Like there’s lots of things that are natural that can be very toxic at pretty low doses, and the source of a chemical has nothing to do about its safety.

Dr. Andrea Love 00:51:57 It’s about the chemical. and so, you know, they they greenwash it and they kind of, you know, suggest that it’s just as good as eating produce or just as good as doing that. But in reality, because there’s no regulation of them, many of them actually are mislabeled. They contain things that they’re not disclosing, or they say they’re they contain things that aren’t actually detectable. And I think people don’t also realize that these things can not only interact with each other, but they can interact with medications you might be taking. They could interact with foods you’re eating. They can cause actual organ damage. You know, you mentioned acute liver toxicity. that’s a major reason for that are particularly herbal supplements. because herbs are plants that contain hundreds or thousands of chemicals, and plants produce a lot of chemicals to prevent things from eating them that are really noxious if you if you consume them. So, you know, just because it’s a plant doesn’t mean that it’s benign. But again, you know, they’re kind of exploiting like people want to do what’s best for their health.

Dr. Andrea Love 00:52:56 They want to take control. They want to, you know, you know, kind of layer all the protections and, you know, amplify whatever they can. And so it sounds very convincing if they’re like, well, this is going to help with your, you know, gut function, when in reality it’s not. And, and some of the ones that have live microorganisms like probiotics, not only is there really no evidence to support their use, but people in particular that have digestive issues or who may have immunodeficiency or immune to dysfunction particularly like autoimmune disorders related to gut health. Like celiac, consuming live micro or more microorganisms can actually cause serious harms. And we’ve seen very, you know, instances of this happening after consuming probiotics. And so, you know, again, it’s always best to avoid supplements unless there’s a legitimate medical need for a very specific supplement that should be administered by and recommended by your clinical team. And we really have to get away from this kind of perception that just because the label says it’s all good doesn’t actually mean that it’s all good.

Dr. Andrea Love 00:54:00 And, you know, in reality, if there were clinical data to support them, then scientific organizations would be saying there’s data to support these uses. That’s why we have the US Preventive Task Force. They actually evaluate the evidence on these things. You can’t just trust the supplement company that’s telling you that.

Jessie Wong 00:54:17 Absolutely. And just come up to the, I just thought of a really good resource that can be helpful for anybody who may want to evaluate your own supplements and see if it’s safe. And that is the NIH supplement, directory. And they have a directory for consumers, which is written more in plain English. They also have a directory for clinicians, where they will go more in-depth about clinical studies that have been done. And what I love about them is that they list out the tests or clinical trials that have been done, or research that have been done on it, and they also evaluate the quality of the research because not all researcher created the same. It’s really easy to manipulate the results. So a company that is selling you the products, they may say it’s backed by research.

Jessie Wong 00:55:05 We’ve done this. This is and this is the result. But when you dig deeper, sometimes you can see or people who are experienced in evaluating research would be saying, hey, this is manipulated. We really don’t have the data to support that. To support your conclusion. And the NIH supplements directory actually are very plain and say certain things. It’s only been done on my studies and or is very small sample and the quality is not good. And that can be a very helpful guide. And what is listed on there are probably things that they’ve looked at that have researched and what’s not listed on there. Probably things you should not be trying because there’s no data on them. All right. And that I think concludes, well, we I wanted to also talk about legitimate tests for IBS as well. But, do you want to maybe sum it up in a few sentences? We do have one. Yeah.

Dr. Andrea Love 00:55:54 I’ll go I’ll go quickly and I’ll let you kind of jump in as well. But ultimately, I think the big tldr here is that this needs to be, you know, diagnosed and evaluated by trained clinical individuals.

Dr. Andrea Love 00:56:08 Typically you’re going to go to a gastroenterologist or colorectal specialist or things like that, and it’s going to involve pretty comprehensive medical overview. So it’s going to be looking at a clinical evaluation. So medical history really thorough kind of symptom review. So you know they’re going to ask you about specific symptoms like abdominal pain and bloating and changes in bowel frequency and habit and consistency. And so get ready to talk about poop if you’re going to be going to get diagnosed for IBS or anything, but they’re going to look at things. how does it change after this? How does it change after that? They’re going to be trying to parse out, is this something related to a specific food? Because that’s that could be an intolerance and not IBS. Or it could be a psychological thing. Certain certain stressors can cause GI issues, or it could be a medication you’re taking. So they’re going to want to parse out a lot of these things. There’s also other criteria. So like IBS you have to have these symptoms for at least six months.

Dr. Andrea Love 00:57:08 And they have, you know, not be resolving. And they’re going to be looking at at patterns amongst these symptoms. They’re also going to probably ask questions about family history. So do you have other sorts of gastro gastrointestinal disorders in your family? Inflammatory bowel disease, celiac, IBS, diverticulosis, diverticulitis, a lot of things that are related to disruption in GI health. And then they’re going to use a symptom based criteria called the Rome four. And so these are kind of clinical criteria where they’re looking at like abdominal pain that’s recurrent. and they’re looking at how frequently and for how long. it’s often going to be related to stool. So, you know, when you’re pooping before you’re pooping after you’re pooping, is it changing? Is it does it change with the frequency of your pooping? Does it change with or is it linked to a change in the the consistency or the form of the stool? They’re also going to ideally do a very thorough exam. They’re probably going to do laboratory tests to exclude other things that can present with symptoms.

Dr. Andrea Love 00:58:10 So they’re going to check for infections, anemia, other things that can lead to other symptoms. so probably gonna run some blood tests. They might even run some stool samples, but not the at home stool samples. The real stool sample tests. They’re probably also going to try to eliminate other sorts of GI things, like doing blood tests to assess for autoantibodies which might be implicated in celiac disease. they might look at other sorts of inflammatory conditions, like thyroid disorders. They might do thyroid hormone testing. They probably will do some sort of breath testing for lactose intolerance. But again, with the caveat that that can’t, you know, necessarily include exclude everything. And they probably may also do some, some blood testing for like, C-reactive protein, which might be an indication of inflammatory bowel disease. They’re often also going to do some imaging testing because they want to get a look at what your GI tract looks like. So they might do a colonoscopy, which is kind of going up the back using a camera.

Dr. Andrea Love 00:59:11 And they’re going to look for things like polyps, structural abnormalities that that might also show things like diverticulosis, diverticulitis, inflammatory bowel disease. They might even take a biopsy while they’re in there to assess the tissue. there’s another way that they can use another camera called a sigmoid scope. So it would be a sigmoidoscopy. and this would maybe not be quite as extensive as a colonoscopy, but would allow you to look at parts of the colon. They might do a CT or an abdominal MRI to see what’s going on with like your other organs, liver, pancreas, stomach and so on. and they’ll probably ask you to start keeping a journal of your, your symptoms and your food intake because they’re really trying to assess it’s kind of like a single person epidemiology study, right? They’re trying to identify trends, patterns, etc. because IBS is not, like taking a swab of your throat and doing a rapid strep test. Right? It’s a very complex, multifactorial disease, and we don’t actually know every single cause and every single trigger.

Dr. Andrea Love 01:00:14 And so it’s going to be very different for different people. And so all of these factors have to be weighed against each other. And so a really good clinician is going to include all of these really comprehensively in order to come to the diagnosis. And that’s really why taking these at home tests is really not advisable in this instance, because it really can lead you astray when you need someone that has both the clinical experience but also, you know, the the, the scientific fundamentals and the resources with the actual legitimate diagnostic procedures to allow them to use the process of elimination and check the boxes that fit versus ones that don’t fit and, and kind of solve that mystery there.

Jessie Wong 01:00:54 Yeah, absolutely. I agree with everything you’re talking about. And for those of you listening, you know, we do have a really good free resources. Our symptom tracker on PDF. Org and what Andrea.

Dr. Andrea Love 01:01:06 What’s the website?

Jessie Wong 01:01:07 It’s poop pedia.org.

Dr. Andrea Love 01:01:10 I love that.

Jessie Wong 01:01:11 forward slash resources. it’s our free symptom tracker. And I think the most important thing for anyone with a GI disorders is really tracking your symptoms before going to your doctor, because we’re really looking at the nuances or like nuances or differences in bloating and pain where it is and how long it lasts til you bloat or have pain over nights like these are all indications of maybe different GI conditions.

Jessie Wong 01:01:33 And what IBS really is, is that there’s no test to confirm that you have IBS. But what we need to do is ruling out other conditions like celiac disease, inflammatory bowel disease and our diverticulosis, or maybe even exocrine pancreatic insufficiency or bile acid absorption. Like all these other conditions to give you an IBS diagnosis. Now, one of the most difficult thing we hear from clients is that their GI’s don’t listen to them. They feel like they’re written off by their doctors, and it’s challenging in the way our healthcare is structured. I wouldn’t blame the doctor on everything. However, I do think that there are some doctors that are more passionate or more compassionate than other doctors, and one of the things I tell them to do is go on Google and search for gigs around your area and look for somebody who has good review and read the review before. Maybe you make the appointment, because these appointments can be really expensive, and on top of it you will have to do some testing. So find a good provider for yourself that will actually spend time and listen to you.

Dr. Andrea Love 01:02:37 You know, I think I think that’s a huge part, right? It’s it’s born out of this frustration. Right. And it can be hard to find someone you click with. And it can be hard to find a provider that you feel like is taking you seriously. And I think you’re absolutely right. I think we have to remember that health, you know, clinicians are not a one size fits all. There are some that are, you know, more thorough, more passionate, more invested. I mean, I had colorectal surgery about four years ago, and I went to four different consoles before I settled on the surgeon that I went with. Because because of that, because I felt like the first three people were not exploring all options, and they were just presenting me with like, the status quo and not considering my full medical history and like, my quality of life. And, you know, it felt very, dismissive and, you know, and I say that was someone with pretty good health literacy to understand that I can go look at literature and understand like, well, there there are some other clinical guidelines, you know, why aren’t these people willing to explore this? But the general public doesn’t necessarily have that ability.

Dr. Andrea Love 01:03:38 And so, you know, I think it’s really important to not get too frustrated if you find that you’re not, you know, finding that connection, but also to realize that there are doctors out there that do really care. And I get that it can be really annoying to have that burden on you. But but don’t let that lead you to like the unproven wellness stuff.

Jessie Wong 01:04:00 Exactly. And we are one of the things that we are actually trying to do on IBS. Dietitian comm is establish a provider list that are compassionate providers in this area. So if you have a doctor that is amazing that you love and you want to share with the world, please email me at info at IBS dietitian. Com so we can reach out to their office and get them listed on our website, so that people in your area can find the care they need and not feel frustrated, and then go into pseudoscience and waste time and money and maybe, you know, not.

Dr. Andrea Love 01:04:33 Worsening health.

Jessie Wong 01:04:34 Too.

Dr. Andrea Love 01:04:35 Right?

Dr. Andrea Love 01:04:36 And listen, you know, when you’re talking about GI stuff, you’re going to be talking about poop a lot. So when you go to that provider, make sure it’s somebody that you feel comfortable talking about all of the bodily functions because you’re going to get into it. And, you know, I love that you’re talking about these things because I think we have to destigmatize all of this because if we ignore GI issues and we don’t talk about poop and we don’t talk about bowel frequency and all of that, like that’s where problems get kind of brushed under the rug. And, you know, I don’t think that bodily functions or things that we have to be shy about.

Jessie Wong 01:05:06 Exactly. And this is also why we created a website put PDF org. It is education for anybody who wants to learn more about poop, different types of poop, and what they actually look like in real life. So what happened was we have a ton of poop pictures from our clients. And and I was like, what can we do with these? You know, because there is no repertoire or no directory of poop on the internet that I could find when I started out in IBS.

Jessie Wong 01:05:33 And there are some that are really wild that you see, it’s like this doesn’t look anything like the poop jar. What does it mean? And, you know, the frustration led me to be like, okay, let’s create one so that everyone gets the resource and they can look at what real poop looks like in different categories. And I would have to say, real poop does not fit into, you know, anything on a Bristol street. It’s always in between. And then also, the one other thing we want to think about is the volume of the poop. Right. For patients with ibs-c. You know, you might be pooping every day, but if the volume is not right, you are still going to be backed up and constipated. So understanding about your body and your poop can be really helpful. Yeah. But anyways, I want to thank you, Andrea, for joining me today and sharing all these amazing information with us. And people can find you, like, let’s list out all the different resources that people can find you.

Jessie Wong 01:06:22 One is Instagram doctor Dot Andrea love. I love her sites. I love all the videos on there. You are going to love Andrea and then immunologic.com is it? Org.

Dr. Andrea Love 01:06:35 Org.

Dr. Andrea Love 01:06:36 If you go to immunologic com it’s a supplement website which is really funny. but yeah immunologic. Org. and that actually you can find all my social handles there as well as my publications, both in peer review and in and in kind of science writing. you can also send me an email through the website too.

Jessie Wong 01:06:56 Yes. And Doctor Andrea Love also has a newsletter that she sent out twice a week. And that’s something I’m actually going to jump on and subscribe right away. So it’s immunologic, not substack.com.

Jessie Wong 01:07:10 And then of course, there’s the YouTube channel and her most recent wired interview on pseudoscience. Please go check it out and follow along. All right. Thank you so much. And thank you for everybody listening.

Dr. Andrea Love 01:07:23 Thanks for having me.

Jessie Wong 01:07:25 Thank you for tuning into the IBS nutrition podcast.

Jessie Wong 01:07:28 We hope today’s episode has brought you closer to understanding and managing IBS. Remember, you are not alone on this journey and finding freedom is possible. For more on IBS, make sure to follow us on your favorite podcast platforms and please leave us a five star review! We would really appreciate that you can access links mentioned in this episode in the show notes, to learn more about your type of IBS and how to identify your own food or lifestyle triggers, register for our free IPS Masterclass. Three steps to IBS relief for our proven, holistic, three steps approach to managing IPS once and for all. Had two IBS dietitian. Com forward slash masterclass to register. Until next time, take good care of your gut and here’s to your health and happiness.