This podcast is part of our May 2020 special issue. Download the full issue here.
On this episode, pharmacist, nutritionist, author, and health educator, Ross Pelton, discusses his comprehensive strategy to support and enhance viral immunity. In addition to making the connection between the gut microbiome and the immune system, Pelton talks about diet, lifestyle, and dietary supplements that have been shown to support a healthy gut microbiome. He also discusses probiotic research, dosage, and why multistrain combinations are effective.
Approximate listening time: 35 minutes
About the Expert
Ross Pelton, RPh, CCN, is Essential Formula's director of science, in addition to being a practicing pharmacist, clinical nutritionist, and health educator in Southern Oregon. Pelton earned his bachelor of science in pharmacy from the University of Wisconsin. A certified clinical nutritionist, Pelton was named as 1 of the Top 50 Most Influential Pharmacists in the United States by American Druggist magazine for his work in natural medicine. Pelton teaches continuing education programs for healthcare professionals to use natural medicine and integrate it into their practices. He also has authored numerous books, including The Drug-Induced Nutrient Depletion Handbook, which is a gold-standard reference book for health practitioners.
About the Sponsor
Essential Formulas Incorporated (EFI) was established in 2000 as the sole US distributor of world-renowned microbiologist Dr. Iichiroh Ohhira’s award-winning probiotic dietary supplements and skin care products. Always an innovator, EFI introduced REG’ACTIV in 2015, containing ME-3, a probiotic catalyst that produces the “master’” oxidant glutathione inside the body's cells. A family-owned and operated business, EFI was founded on the philosophy of providing high-quality preventative, supportive, and comprehensive pro-health products for the entire family. EFI continues to flourish and grow through a strong company and product integrity and the knowledge that they’re providing scientifically proven products that positively impact the health and well-being of their customers.
Karolyn Gazella: Today we're going to be talking about the timely topic of enhancing viral immunity. Hello everyone. I'm Karolyn Gazella, your host and the publisher of the Natural Medicine Journal. Before we begin, I'd like to thank Essential Formulas Incorporated who is the sponsor of today's topic.
Viral immunity is our topic, but we're going to be focusing specifically on the connection between viral immunity and the gut microbiome. And I have a leading integrative health expert to help us with this topic. My guest is bestselling author and health educator, Ross Pelton. Ross is also a pharmacist and a certified clinical nutritionist who has been involved in research and integrative health science for 30 years. Ross, thanks for joining me today.
Ross Pelton: Hi there, Karolyn. It's always nice to be with you and your Natural Medicine Journal followers.
Gazella: Yes, and I love this topic. I love writing and researching and learning about the gut microbiome because I think it's so important. Now before we dig into how to properly support gut microbiome immunity, as a foundation, just remind us what the connection is between the gut microbiome and the immune system.
Pelton: Well, sure. We know that approximately 70% of the body's immune system cells reside in the gastrointestinal tract. So this emphasizes why it's so critically important to maintain a healthy microbiome ecosystem and a good balance between your friendly probiotic bacteria and to keep the pathogens at a lower level because this is really the center of your immune system. In fact, there's really 2 different parts of the immune system that I talk about, there's your circulatory immune system that's regulated by your white blood cells, and then there's your gut immune system. And I think that's what we're going to focus on primarily today, the gut microbiome immune system.
Gazella: Exactly. So I mean obviously with our present Covid-19 crisis, viral immunity is on the minds of most healthcare professionals right now. I would probably say all healthcare professionals right now. While it's understood, presently there's no definitive way to prevent and treat Covid-19 specifically. There are ways to enhance viral immunity. So Ross, what's the connection between the gut microbiome and specifically, viral immunity?
Pelton: Sure, Karolyn. And I'd like to start out by saying that the FDA is currently on a bit of a rampage going after natural product companies and practitioners that are making any reference or claims to directly being able to prevent or treat Covid-19 or the Coronavirus. So I want to make sure up front that I'm not promoting a treatment or a cure or even the prevention directly of Coronavirus and Covid-19, just providing information for the practitioners that access our podcast. And with that said, we know that these viral infections primarily attack the respiratory system. And there are a number of studies suggesting that probiotics really decrease both the risk and the duration of symptoms for respiratory viral infections. And I've done database research on this, and we find that there are a number of studies showing that probiotics in cell culture studies and animals, and also human clinical trials, do have an effect on viral infections. And this particular meta analysis that I pulled up when I did my database research reported on 33 different clinical trials, and 28 out of these 33 reported positive effects with probiotics on beneficial effects and outcomes with respiratory tract infections. While only 5 of the studies reported no benefits.
So a significant number of the studies that have been conducted looking at the effect of probiotics on either cell culture studies, animals or human trials in terms of respiratory infections, show that probiotics do have a beneficial effect. So that's a good way to start here. We don't have a lot of human clinical trials, we don't have the big randomized, placebo-controlled, double-blind trials, but there is an indication that probiotics do have a beneficial effect on regulating your immune system and decreasing the severity and the duration of these respiratory viral infections.
Gazella: Okay, perfect. Now let's stay with probiotics because I know that you actually have a very integrative approach where you talk about diet and lifestyle, but you also talk about dietary supplements, but since you've mentioned the probiotics, I want to stick with the probiotics for a minute because there is such an obvious connection between beneficial bacteria and the gut microbial balance. Now you mentioned the research and it looks strong specifically to viral infections. It seems like every time this topic comes up, Ross, for any condition, or even if it's a general application like supporting immunity, there's this huge debate regarding strains and dosage. Now I've been reading more research lately indicating that very high doses of probiotics are not more effective and in some cases can be harmful. What's your take on dosage? What's your recommendation about dosage, specifically regarding probiotics?
Pelton: Well Karolyn, I'm glad you brought that up because it's a really important topic and I speak about it quite a bit. Two of the most critical factors in maintaining a healthy microbiome, our balance and diversity. When we talk about diversity, that means a wide range of different strains of bacteria. And balance is the correct number of these bacteria. And so there's a real misconception by the general public and even by many healthcare practitioners about this term CFU, colony forming units, which refers to the number of viable bacteria in a dose of probiotics. And there's this misconception that bigger is better. And when people take probiotics that contain 30 billion, 50 billion, 100 billion ... There's this competition, mine's bigger so mine's got to be better. High-dose probiotics really work against balance and diversity. So it's good to understand that the healthiest microbiome is a diverse microbiome, and the only way people can get a diverse microbiome is by consuming a diverse range of different types of fiber-rich foods because fiber is the food for your probiotic bacteria. But it's not just the quantity of fiber, it's the diversity of fiber.
One of the studies I presented in a lot of my presentations reported that over 90% of American children and adults do not consume the recommended daily allowance of fiber. So there's millions and millions of people, Karolyn, that are taking probiotics every day and getting very limited effectiveness from them because they're not consuming a fiber-rich diet. And if people don't learn how to feed their probiotic bacteria, well they won't thrive and survive. So there's really 2 pieces to the puzzle, probiotic bacteria and a fiber-rich diet. And it has to be a diverse range of different types of fiber. So that's what's really important, not so much the number of bacteria that you ingest in a commercial probiotic product, but it would be better to have a multistrain probiotic.
And then I guess another topic I'd like to toss on the table right now, we're starting to learn, and that the microbiome scientific community is starting to realize, that it's not the bacteria that are so important, it's the compounds that the bacteria produce when they digest and ferment the fibers that you supply them with. And these secondary compounds are called postbiotic metabolites. And we're learning that these compounds that the bacteria create when they digest your fibers are master health-regulating compounds that regulate every single system in the body, including the brain and your immune system. So it's really critical to understand that the whole microbiome scientific community is starting to shift their focus away from just naming and identifying different strains of bacteria. We're starting to explore this vast new area post biotic metabolites. And I wrote an article about this that's titled Postbiotic Metabolites, the New Frontier in Microbiome Science that was published in the Townsend Letter, and when we finish up I can give you the URL that you can post in the notes so anybody can have access to this article. [Here's that link]
Gazella: Okay, that sounds good. So let's stay on this topic of postbiotic metabolites specifically regarding the immune system. Give us some examples of metabolites that are produced that help the immune system.
Pelton: Sure. One of the biggest classes of post biotic metabolites are called short-chain fatty acids. Specific ones are probiotic acid and acidic acid and butyric acid. And these compounds, the short-chain fatty acids, work in several ways to influence your immune system. One thing they do is that they create a slightly acidic pH in the microbiome ecosystem, and that slightly acidic pH is the optimal environment that promotes the growth and proliferation of your probiotic bacteria and that suppresses the growth of pathogens. And in addition to short-chain fatty acids, there are nucleic acids and organic acids and fulvic acids. All of these post biotic metabolites that have weakly acidic characteristics create the correct acid-based balance that promotes a healthy microbiome.
Some of the short-chain fatty acids are powerful anti-inflammatory agents. And when people have dysbiosis, they have inflammation in their gut and you need to suppress that inflammation, so that's another one of the immune system–enhancing characteristics of some of the different postbiotic metabolites, specifically some of the short-chain fatty acids, that they have anti-inflammatory activity. And butyric acid is really unique because it is the number 1 source of energy for your enterocytes. The cells that line your, gastrointestinal tract. And if you have dysbiosis and inflammation, the cells that line your GI track are highly inflamed and you need to have quick turnover and replace those inflamed cells with healthy new epithelial cells. And it's the butyric acid that is the number one energy source that facilitates and speeds up the replacement of your healthy new epithelial cells.
Gazella: Now you've mentioned multi-strain probiotics, why aren't ... Because I remember, Ross, reading about probiotics not that long ago, and it was the scientific literature always would focus on single-strain and they would only research single-strain, but now I'm reading a lot more. There's a lot more evidence showing that the multistrain probiotics are more effective. Why is that?
Pelton: Well, I mentioned balance and diversity. And so when you're taking a high dose of just 1 or several strains, you're working against balance and diversity. So the multistrain probiotics are providing different strains of bacteria that are capable of producing different types of post biotic metabolites and doing a better job of regulating your microbiome ecosystem. And Dr. Ohhira's probiotics, I think Dr. Ohhira was one of the first scientists that ever recognized the importance of a multistrain probiotic where he started out using 12 starter strains to produce his commercial product. But now there are more and more types of commercial preparations that are using multiple strains because they're starting to realize this is what really makes the microbiome ecosystem work, balance and diversity of different types of organisms.
Gazella: Yeah, that's so true. And before I leave probiotics, I want to get back to dosage for just one quick question. During this time of crisis, when we all have some potential vulnerability to this particular virus and other viruses, I actually increased my dose of my daily probiotic just to shore up my immune system. Is that something that you're recommending folks do or are you pretty much saying, you know what, just stick with your general maintenance dose even during these times and you're going to be good to go?
Pelton: Well, rather than recommending that people increase their dose of probiotics, which by the way is not a bad idea, but I think a better approach is for people to search for commercial products that contain these postbiotic metabolites because those are the compounds that regulate so many different aspects of health in your gastrointestinal system. When people take commercial probiotics that just contain bacteria in a capsule, those bacteria have to survive transit through the harsh acid environment in the stomach, and then when they arrive in the small intestine, they have to seek out and find fiber-rich foods and start the process of breaking those fibers down to produce the postbiotic metabolites that are the key health regulating compounds. That all takes time. When you take a product that contains these postbiotic metabolites, when you ingest them, they immediately start to transform the microbiome ecosystem by reducing inflammation directly, killing pathogens, rebalancing the acid-base level, re-establishing gut-brain communication, reestablishing the immune system activity. So ingesting postbiotic metabolites directly is a much faster, more effective way to elicit change in the microbiome ecosystem. And the pharmaceutical industry is now starting to understand this. They're starting to explore postbiotic metabolites as a whole new frontier for drugs in the pharmaceutical industry.
Gazella: Yeah. Well, that's good. It definitely seems like the science is headed in that direction. Now, I know that you definitely promote and utilize an integrative approach that talks about not just dietary supplements but diet and lifestyle, I want to go back to diet because you mentioned fiber and I think that's such a good point. Is there anything else that practitioners should have on their radar when it comes to diet and supporting the gut microbiome?
Pelton: Yes, there are some other things. I think that people need to avoid sugar. And I've been doing a lot of teaching about this recently, teaching how sugar destroys your immune system. And this is a little off our topic because it's not directly related to the gut microbiome, but we're talking about the immune system here in general and how to strengthen your immune system. So one of the things I'm teaching people is that over 4,000 species of animals, almost all species of animals, can synthesize their own vitamin C, humans are one of the few species that cannot. It's estimated that about 60 million years ago, the predecessors of human evolution, the primates and some of the animals, experienced a mutation in one of the genes that's responsible for bio synthesizing vitamin C. The way all the animals that can synthesize their own vitamin C do this process is that they convert sugar, glucose, into vitamin C. The structure of glucose and the structure of vitamin C are very similar, and it's a four-step process requiring four enzymes to convert sugar into vitamin C.
But because the structures are so similar, this is where the immune system challenge comes in because your white blood cells, neutrophils and macrophages and your acidophils and basophils, these white blood cells are your circulatory immune system. These white blood cells circulate through your system on the lookout for viruses and bacteria and other pathogens. And it's important for people to realize that white blood cells concentrate vitamin C inside the white blood cell anywhere from 50 to 100 times more concentrated than in the plasma or lymph outside the white blood cell. So your white blood cells concentrate vitamin C to an enormous degree, and when you ingest sugar, which has a structure very similar to vitamin C, sugar competes with the vitamin C for entry into the white blood cells. There's a tremendous reduction in the amount of vitamin C in the white blood cells, which decreases their ability to kill viruses and bacteria, so it's a hit to your immune system. When people ingest 100 grams of sugar, it depresses your immune system by 50% for 4 to 5 hours. So I really like to emphasize this diet-sugar connection and how sugar destroys your immune system because it decreases the ability of your white blood cells, that part of your immune system, to function and fight against viruses and bacteria. So that's one section I wanted to emphasize.
We're talking about diet, Karolyn. It's important for people to avoid processed foods, I recommend that people avoid GMO foods and gluten. So those are some of the key dietary recommendations that I make. One term that I really like when people ask what's a good diet? Food without labels. Stop and think about that a minute. An apple doesn't have a label on it with a whole bunch of extra ingredients in it or a date or cabbage or lettuce. Food without labels is healthy food. And so that's one way to think about a healthy diet.
Gazella: Yeah, that is. Now, what about lifestyle? What lifestyle factors have the most influence specifically on the gut microbiome?
Pelton: Well, an important one is sleep. So many people don't get adequate sleep. In fact, sleep problems are an epidemic in our culture. And there are studies that show that your microbiome is affected by sleep. And when you don't get enough sleep, there are adverse effects in your microbiome, so that's one critical factor. People need to get blackout shades, they need to darken their room, they should stay off their iPads and their phones at night and start to let their system calm down and shift from a sympathetic nervous system mode into the relaxation parasympathetic mode so they can get into a deep, restful sleep.
Exercise is another critical lifestyle factor. I've got numerous studies that show that exercise has beneficial effects on your microbiome and it also affects the gut-brain axis, the communication between your gut and your brain. So exercise is really critical. And on my website and my blog, I have a study that documents the number 1 factor for healthy aging, and this is not directly to the microbiome, but this is a study that was conducted in Italy by a group of gerontologists. They studied 75 people, they were 80, 90 and over 100 years old, up to 105, and these elderly people were healthy. And the gastroenterologists who conducted this study had the concept that instead of looking at old people who are sick and trying to figure out why they got sick, let's look at these old people who are healthy and figure out what they did to stay healthy. So they took every type of blood test and lab test imaginable and looked at home life and work life and environment and relationships, the number 1 factor for healthy aging, maintain your muscle mass.
To do that, you have to do some form of regular strength-building exercise. And so that's, I think, a really critical factor for people to realize when we start thinking about a healthy aging process, you've got to do exercise. Aerobic exercises, good cycling, swimming, jogging, but that's not strength building. People have to get into some form of resistance training or strength building exercise to maintain their muscle mass or they will gradually lose it.
Gazella: Yeah, good point. And these are stressful times, how do we talk to our patients about stress management? And does stress affect the gut microbiome?
Pelton: It really does, and it's a big issue. And I think when I talk about Coronavirus hysteria, I think that maybe 0.0001% of the world is infected with Covid-19, but just about 99% of the world's infected with Covid-virus hysteria. And it's creating an enormous amount of depression and anxiety and people are out of work and losing their jobs, and so this is a big issue. And so I encourage people to engage in things like yoga and Tai Chi and breathing exercises, things that will calm your immune system. And try to focus on the moment and the minute that you're in and appreciate nature and appreciate yourself and the life you've been given. And try not to devolve into depression and anxiety because that will have a negative effect on your immune system. And right now, we really want to focus on everything we can do positively to strengthen our immune system. And one thing I talk about on a regular basis, people don't realize that they have an enormous amount of control over their own immune system, their own health and their own aging process. So I like to promote people being proactive with natural therapies and natural lifestyle habits that will strengthen their immune system.
Gazella: Right. Yeah, and that goes back to the importance of sleep, like you mentioned. Getting sleep is going to also take the edge off, help people cope better with the stressful situation as well. Now I want to get back to dietary supplements. We talked a lot about probiotics, but are there other ingredients that you recommend when it comes to supporting the gut microbiome health?
Pelton: Well, when you say that there are other ingredients supporting the gut microbiome health, you need to have lots of fiber. I mean, that's the one critical thing. I mentioned earlier that 90% of American children and adults are not getting the RDA of fiber. So I call the fiber gap America's number 1 nutritional deficiency. And some people push back and say, "Well, fiber is not really a nutrient." It's a nutrient for the 100 trillion bacteria that reside in your gastrointestinal tract, and we need to get a better appreciation for the fact that our life is not just us, it's us plus them. We're a human superorganism that's us and our bacteria and we need to learn how to feed our bacteria well so that they thrive and survive. So I would say that fiber is the most important dietary recommendation for a healthy microbiome.
And then I mentioned sugar, stay off the sugar, get into whole foods and non-processed foods. And I mentioned ... actually, I didn't mention yet, but vitamin D is another supplement that's really critical for the immune system and so I always like to recommend that people consider getting tested for vitamin D and being on a vitamin D supplement because most people need a vitamin D supplement. Sunlight striking our skin is our major source of vitamin D, and most people don't get enough outdoor time and sunlight. And some health-oriented physicians now call the winter cold and flu season of vitamin D deficiency disease because people are bundled up and they're not getting any sunlight exposure on their skin. So I highly recommend vitamin D supplementation. Vitamin D regulates over 3,000 genes, and many of the genes that vitamin deregulates are genes that regulate your immune system. So this is a critical factor for strengthening your immune system. But I do recommend that people get some recommendations from their physician or healthcare professional and do testing to find out where their level is at. Vitamin D is a fat-soluble nutrient and we don't absorb fat-soluble nutrients very effectively, so it's good to take your vitamin D at your largest meal of the day, where you're more likely to have fat in the meal, which will enhance the absorption of your vitamin D.
Gazella: It's such a good point. I was talking to an immunologist the other day and she mentioned too that one of the reasons the typical cold and flu goes away or gets better is because of vitamin D. And people are outside more, they're in the sun more, they're active more, they're not closed inside. And she too promoted vitamin D as well. Now you mentioned vitamin C as it related to that whole sugar connection, which I had not heard about that, so thank you for that, what do you feel about the importance of vitamin C? That's another one that I personally have increased during this chaotic time. What about vitamin C?
Pelton: Absolutely. I brought up vitamin C and its relationship to the immune system for that very purpose. And when people are stressed, your vitamin C levels get depleted very quickly. And if you get a virus or a bacterial infection, your body has to produce more white blood cells to fight that infection. But those white blood cells, as I mentioned, have 50 to 100 times more vitamin C inside them, so your body requires enormous, larger amounts of vitamin C to fight an infection. And Dr Robert Cathcart is a physician who developed a worldwide reputation for successfully treating HIV and AIDS patients with high dose vitamin C, and Dr. Cathcart discovered and then started promoting the concept vitamin C to your bowel tolerance. The only side effect of too much vitamin C is diarrhea and you can use loose stools as an endpoint to realize that you're reaching your bowel tolerance of vitamin C.
So Dr Cathcart discovered that, on average, normal people can tolerate somewhere between 10 and 15 grams of vitamin C in divided doses over a 24-hour period without reaching bowel tolerance or maybe just starting to come close to getting loose stools. But when people have an infection, they might be able to tolerate 50 grams or a hundred grams or even more vitamin C without getting diarrhea because their body is using so much of it so that they can fight the bacterial or viral infection. And so Dr Cathcart started categorizing illnesses by how much vitamin C it takes an individual to get to bowel tolerance. So he talks about a mild cold being a 50 gram vitamin C cold or a severe cold being a 100 gram illness and the influenza might be 150 gram illness, and mononucleosis or pneumonia might be 150 to 200 grams of vitamin C. So the body can tolerate enormous amounts of vitamin C under illness conditions.
And I recommend when anybody starts to feel like they're getting sick, amp up their vitamin C intake. Start taking maybe 3 to 4 grams every 20 to 30 minutes until you get loose stools to get yourself to that bowel tolerance point very quickly. It's one of the most important proactive things that people can do to support your immune system. In one mouse study that I reviewed, they used the vitamin C knockout mice, so mice can normally make their own vitamin C but they created the vitamin C knockout mice, so they have a strain of mice that can not make their own vitamin C. They infect them with one of the respiratory viruses, and the knockout mice all die within 7 days, but the knockout mice that are administered vitamin C all survive after 7 days. So this shows how powerful vitamin C is at preventing the virus from causing death.
But the important point in this study that the authors pointed out is that when the mice were given vitamin C prior to being inoculated with the virus, they all survived. But if they inoculated the mice first and then started giving them vitamin C, they died. So you have to have vitamin C on board early in the game in order for it to be optimally effective. If you wait until you get really sick, it's much harder for it to build up the amount of steam and the power that it needs to suppress the infection.
Gazella: Yeah, it's such a good point. I know that a lot of our practitioners really rely on and utilize high-dose vitamin C, so I appreciate that. Well, Ross, we've actually covered a lot today, but I'm wondering if you have other final thoughts on this particular subject that you'd like to share with our listeners?
Pelton: Sure, I do have another topic I think is pretty important when we're talking about our immune system, and that's glutathione. Glutathione is called the master antioxidant. It's a critical regulator of our immune system. It regulates all of our detoxification. So I think one of the most important proactive things that people can do to boost their immune system and their overall health is to boost their glutathione levels. And for a long time that was not an easy thing to do because glutathione, when it's taken orally, it gets broken down and destroyed and it's not effective. But now there's a strain of probiotic bacteria that has been discovered called lactobacillus fermentum ME-3. We've referred to it as ME-3 for simplicity. And this remarkable strain of probiotic bacteria synthesizes glutathione in the human gut, so now we can effectively boost our glutathione levels on a daily basis by taking products that contain lactobacillus fermentum ME-3.
In human clinical trials, people ingesting lactobacillus fermentum ME-3 daily for 3 weeks got a remarkable 49% increase in the ratio between reduced oxidized glutathione, got a 16% decrease in oxidized LDL cholesterol, so lowering cardiovascular risks, and also this remarkable strain of bacteria also synthesizes manganese superoxide dismutase, which is another really critical antioxidant enzyme. So this is a revolutionary breakthrough in healthcare and medicine to be able to boost your glutathione levels on a daily basis. And that's another thing I think would be helpful for people during this global crisis that we're going through right now with the Covid-19 disease.
Gazella: Yeah, it's such a good point, I think glutathione is such an incredible ingredient and I'm glad that this ME-3 has human clinical trials. Does the glutathione actually help the gut microbiome or is it specifically helping just generalized immunity?
Pelton: Well, it does have an effect on the microbiome. I haven't seen studies that show that it actually affects the microbiome, but there are studies that show that ME-3 has direct action against several different types of gut pathogens, so it does influence the microbiome in that respect that it can kill some of the common gut pathogens, but I haven't seen reports showing that it actually increases the ratio between good bacteria and bad bacteria. However, there was a recent study published in a peer-reviewed journal coming out of France that was ME-3, lack of lactobacillus fermentum ME-3, in a diabetic mouse model, and produced tremendous outcomes. So this is an indication that lactobacillus fermentum ME-3 can also be a very good strain of bacteria to be taken for people that have type 2 diabetes because it reduced many of the markers of type 2 diabetes, and one of the things is obesity and some of the metabolic syndrome markers that are so common in this mouse model ... And I'll send the link to you for this study after our presentation here so that you can make this available to people also.
Gazella: Yeah, it'll be interesting to look at the future research and to see how the human clinical trials progress with this ME-3. I love ending with glutathione. It's one of my favorite nutrients, so that is a great way to end, Ross. So thank you so much for giving us such good information today. It was really helpful. And I'd also like to, once again, thank the sponsor of today's topic, Essential Formulas Incorporated. Thanks for listening everyone and have a great day.