2500 Hippocrates was correct when he stated that “All disease begins in the gut”. New science has vindicated his intuition. Leaky gut plus endotoxins are likely the main causal factor in many of the chronic diseases we see today. The best part about this diagnosis is that it implodes the low carb / high carb debate. What matters is lowing endotoxins above all else. The gut has a tough job. It needs to both absorb nutrients while kicking out toxic invaders. Think of it like a bouncer at a very exclusive club. Most people give this bouncer a very hard time. Every time you eat, you’re consuming potentially toxic waste that the gut needs to expel. The small intestine doesn’t get nearly as much love as the brain and heart, but it’s just as important. The most challenging and important work at this “nightclub” is being conducted in your small intestine. The small intestine is ~50% of your gut. It is responsible for 90% of food absorption and has the largest mass of immune cells in your entire body. Everything you eat directly touches this vital organ. And it’s very vulnerable. The only barrier protecting what you eat from your bloodstream is just a single layer of mucous, linked together by proteins. But this barrier can be broken, which creates gaps between the proteins in the cellular layers of your gut. Essentially, the lining of your gut is not HOLDING THE DOOOOORRR. And when the lining is open, toxins can pass into your bloodstream. Rightfully so, your body freaks out. It’s like a bartender catching an underage drinker inside. This is what’s called Leaky gut Leaky gut used to be a fringe medical condition. Most mainstream doctors didn't recognize it as a real disease. But recently the gut has become a focus because of its role in a variety of diseases. New research shows that leaky gut plays a role in everything from anxiety to skin issues to cancer and autoimmune disorders. Pictured below are the diseases it’s been linked to...yeah, doesn’t sound like a fun time.

Most of us assume that when we stop taking a medication, its effects end with the last dose. A new study in mSystems suggests the gut microbiome remembers far longer. Researchers linked shotgun metagenomic sequencing from 2,509 adults in the Estonian Biobank to their electronic prescription records, then asked whether drugs used years before sampling still left a mark. They did: 78 of the 186 medications examined showed carryover effects, and for antibiotics, benzodiazepines, antidepressants, proton pump inhibitors, and beta-blockers, the microbial signature was detectable years after use. The effects were also additive; the more prescriptions in a person's history, the larger the shift. And in a subgroup of 328 people sampled twice, the microbiome changed in the expected direction after starting or stopping a drug, which may point toward causation rather than coincidence. To be clear, none of this means you should refuse a medication you truly need. It means these drugs have a longer ecological footprint than we assumed, and that belongs in the risk-benefit conversation. In my experience, few clinicians are aware of these effects themselves, let alone discuss them with patients before writing a prescription. Informed consent should include what we now know about the microbiome.

Einkorn is an ancient grain and is known as the oldest variety of “wheat.” Einkorn is also sometimes referred to as “farro” or “farro einkorn.” Einkorn was first cultivated 5,000 to 6,000 years ago. It is classified as a “diploid” because it only has two sets of chromosomes. Modern wheat varieties are classified as “hexaploid,” having six sets of chromosomes, due to a long history of hybridization. Einkorn is thought to have originated in the upper area of the Fertile Crescent of the Near East (Tigris-Euphrates regions), and is quite probably the main grain recorded in the earliest biblical history. Einkorn became widely distributed throughout the Near East, Transcaucasia, the Mediterranean region, southwestern Europe, and the Balkans, and was one of the first cereals cultivated for food. Another ancient grain, emmer, has four sets of chromosomes and was probably an early hybrid of wild einkorn that was more suitable for a wider range of climates and geographical areas, particularly warmer climates. Emmer became the predominant wheat throughout the Near and Far East, Europe, and northern Africa until about 4,000-1,000 BCE, although it was still cultivated in isolated regions such as south-central Russia into the last century, and even today remains an important crop in Ethiopia and a minor crop in Italy and India. The oldest hexaploid grain and the predecessor to modern wheat is probably spelt. Spelt was a hybrid of emmer with more adaptability then emmer. These three ancient grains are known as “the covered wheats,” since the kernels do not thresh free of their hard coverings, making them more labor-intensive to mill. These ancient grains went through a long history of hybridizations to make them easier to mill and process into our modern-day wheat, and to make them more desirable for bread making with a higher gluten content. But due to gluten toxicity issues in modern times, many are reviving the ancient varieties of grains, and einkorn is the oldest. The ancient grain einkorn is packed with nutrition. It is a rich source of beta carotene and lutein, powerful antioxidants. Einkorn has the highest amounts of lutein of any other wheat variety.

The gut-skin axis is now well-established in the peer-reviewed literature. Multiple 2024-2025 reviews have mapped the mechanisms. Your gut lining is a barrier serving as the last line of defense between the outside world (the food you ate two hours ago, now being broken down by your microbiome) and your bloodstream. When that barrier is intact, and the microbes on it are balanced, you're fine. When it's not, everything downstream gets loud. Damaged intestinal barrier → bacterial fragments + inflammatory signals cross into circulation → systemic immune activation → cytokines and immune cells migrate to peripheral tissues → skin gets the overflow. Acne, eczema, and psoriasis all correlate with measurable gut dysbiosis and intestinal permeability . The pattern is well-documented for psoriasis specifically: Decreased Actinobacteria, increased Firmicutes, and modulation of the Th17/IL-17 immune axis that drives the disease. For atopic dermatitis (eczema), the pattern is reduced beneficial bacteria and increased barrier dysfunction. For acne, dysbiosis correlates with the inflammatory component, making acne more than just a clogged pore. There's honest scientific uncertainty about causation direction: Does gut dysbiosis cause the skin condition, or does an already-inflamed body drive both? Researchers are still working this out. But the correlation is real, mechanistically plausible, and consistent across populations. The dietary drivers are increasingly clear. High-glycemic-load food. Robyn Smith + colleagues at Melbourne’s RMIT University ran the first randomized controlled trial on this in 2007. 43 male acne patients aged 15-25 were assigned to either a low-glycemic-load or standard high-glycemic-load control diet for 12 weeks. The low-GL group's total acne lesion counts dropped ~twice as much as the control (-23.5 vs -12.0, p=0.03), with parallel improvements in insulin sensitivity, IGF-1, and free androgen index. Multiple follow-up trials have replicated this.

Dear Friends, ​ ​One of the most fascinating discoveries in medicine over the past decade is just how deeply connected the gut and brain truly are. ​ Most people think of the gut as simply a digestive organ. In reality, it's constantly communicating with your brain through the immune system, nervous system, microbiome, and countless signaling molecules. In fact, about 90% of the body's serotonin is produced in the gut, highlighting just one of the many ways gut health can influence mood, sleep, and cognitive function. Researchers have also discovered that the brain's immune cells, called microglia, respond directly to signals originating in the gut. When the intestinal barrier becomes compromised, inflammatory compounds can influence these cells, contributing to neuroinflammation that may play a role in brain fog, memory changes, and mood disturbances. Perhaps even more exciting is the growing body of research suggesting that supporting gut health may also help support brain health. As our understanding of the gut-brain axis continues to evolve, we're gaining valuable new insights into how addressing the gut may improve cognitive resilience and overall wellbeing.