In the episode, Dr. Ron speaks with Dr. Tereza Hubkova about the microbiome: what it is, how it evolved, and ways it affects the body.
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Dr. Ron Hunninghake: Well, hello everyone. Thank you once again for joining The Riordan Clinic Real Health podcast. I’m Dr. Ron Hunninghake. I’m the Chief Medical Officer here and today, it’s my pleasure to have Dr. Tereza Hubkova with us to speak a little bit about the microbiome, which is a fascinating topic that she knows a lot about. I wanted to give her a chance, though, to tell us a little bit about her background. Dr. Hubkova, thank you so much for being on our program.
Dr. Tereza Hubkova: Thank you so much for having me. It’s a real privilege.
Dr. Ron Hunninghake: You’re in Kansas City at Advent Health.
Dr. Tereza Hubkova: That’s right. Yeah. I came to Kansas City about two years ago from Massachusetts. I lived in Massachusetts for about 23 years. Initially, I came to Massachusetts from Czech Republic. You probably can detect my accent. After medical school in Czech Republic, I just wanted to live somewhere else and see how people live in other countries. So I came to Framingham, Massachusetts. I did my residency in internal medicine there, and then I worked as a primary care physician for about six years, seeing people from the least fortunate demographics, very, very poor population. Then I worked as a hospitalist for a few years, including working in the ICU and CCU.
Dr. Tereza Hubkova: Then I was very fortunate that I found a position at Canyon Ranch Spa in Lenox, Massachusetts, where I really could do the type of medicine that I am really passionate about, which is helping people be healthier with less medications and more healthy lifestyle. That was a really wonderful experience for me. But yeah, sorry. After 10 years of being at Canyon Ranch, I was itchy to try to open something similar somewhere else. That’s why I was intrigued to come to Kansas City and start an integrative medical center completely from scratch for Advent Health.
Dr. Ron Hunninghake: That’s great. Boy, that’s quite a journey. It’s interesting though, where we share paths is that I went into medical school with the intention of helping people be healthier and to help them seek greater wellness. It was a shocking surprise that the whole concept of health improvement is not as big in conventional medicine as most people would think. Did you have that same experience or were you interested in health and wellness before you went to medical school or was this something that developed later?
Dr. Tereza Hubkova: Hmm. Yeah, I’m trying to remember exactly when I became interested in wellness. I think I came from a family who was pretty healthy and I think in Czech Republic overall, people are more active physically and maybe know a little bit more about herbs and foraging for mushrooms and things like that. But I probably became more interested in wellness during my medical school. My medical school in Czech Republic was oriented much more on prevention than my understanding of American medical schools. We actually had lectures on nutrition. We had lectures on probiotics way back then in Czech Republic. So I became interested in that already during my medical school. But then when I started residency in internal medicine, that was completely absent from my a residency. We had no education on nutrition, on healthy lifestyle. It was really missing.
Dr. Tereza Hubkova: When I then went to practice to be a primary care physician, I became completely disillusioned that I had to see 40, 50 patients a day and quickly dispatch quick band aid their medical issues without really having enough time to dive into their health and try to figure out the root cause, which oftentimes is in our lifestyle. Oftentimes, it is in poor nutrition or lack of sleep or lack of self care. So yeah, I became disillusioned by medicine very quickly, and I started going to different conferences around United States to learn more about herbs and learn more about functional medicine and integrative medicine and this and that. I’m a perpetual student. I was very lucky that I then found a place like Canyon Ranch where I could actually practice that type of medicine.
Dr. Ron Hunninghake: Yeah. I think the whole emergence of wellness as a concept and as a something that did fit into, at least in family medicine for me, I was in a family medicine practice and we realized that if we could help our patients get proper nutrition, proper exercise, sleep, stress management, become more aware of their environment, this was the beginning of the wellness movement. I think more and more people now are seeing that this has been the missing piece in modern medicine. So the term integrative medicine has emerged that we’re integrating illness care and wellness care together. So we hope that we can create a stronger discipline of medicine for our patients.
Dr. Tereza Hubkova: Yes, very much so.
Dr. Ron Hunninghake: So let’s just dive in here. While you were speaking, I couldn’t help but think that when I was in me school, I don’t think I even had heard the word probiotic, let alone microbiome. So can you tell me how did this nomenclature develop? Then this is by way of helping our audience understand what is the microbiome and why is this darn important for our health?
Dr. Tereza Hubkova: Yeah, yeah. Probiotics are basically the beneficial bacteria. So pro is for bios is life. So probiotics are basically bacteria that are giving us benefit to be healthier and feel better. We have a lot of bacteria and even viruses and fungi and other microscopic creatures that live everywhere in our body. We have them mostly in the gut. That’s a perfect environment for them because they get free meal deliveries three times a day, or sometimes more. It’s nice and warm. So it’s a perfect house for them, but we really have microbes everywhere else in our body. We have microbes in our mouth and certain microbes can contribute to dental issues or dental plaques. We have bacteria, women have bacteria in their vaginal canal. When they have healthy microbiome in the vaginal canal, those women are actually less likely to contract sexually transmitted diseases, including HIV.
Dr. Tereza Hubkova: We have bacteria everywhere on our skin and there’ll be different microbes in the scalp and different maybe on your back or in your armpits. Maybe that’s why different skin conditions happen in different areas of our body. So we are a home for trillions and trillions of microbes and the collective of all these microbes and their genes is sometimes called microbiome. So it’s the collection of all the microbes and their genetic material.
Dr. Ron Hunninghake: The big shift is that I think growing up, we would’ve called this germs. These were bad guys. They would hurt us. So we needed to wash our hands. When we went into the hospital even, you go into a patient’s room, you have to put the antimicrobial gel on your hands and make sure you’re not spreading germs around. Yet, this seems the opposite that these germs are now being looked at, I guess, in the right a composition, they are our friends and they help us to maintain good health. What has happened here? One other little thing, it’s not unusual for doctors to prescribe antibiotics often. So are these having an effect upon these friendly germs?
Dr. Tereza Hubkova: Yes. I mean, it’s really fascinating. These microbes have evolved with us for millions of years. They have been part of our history forever. So they live in a symbiotic relationship with us. We benefit from them. They benefit from us. We feed them, we give them house, we give them transportation in a way, and they do a lot of good things in return. So for instance, the good bacteria, they produce many vitamins in our body. In our gut, they produce B vitamins. They produce vitamin K2, which is important to direct calcium into our bones so we wouldn’t have fractures. They produce many anti-inflammatory substances. They protect us from even things like colon cancer. They produce something called short chain fatty acids, which are really signals that travel everywhere around your body, including to your brain, and may even affect your ability to learn, to have good memory, good mood, energy.
Dr. Tereza Hubkova: I mean, they have just profound, profound effects on entire body from head to toe, but in a way, these good microbes want to live in a good neighborhood. So they don’t want you to get bad microbes. So they produce their own antibiotics. They produce their own antiviral compounds. They produce their own antifungal compounds against bad yeast. So if you have good microbes living in your body, they are protecting you from the enemies. They want to live in a good neighborhood. It’s almost as if there is only certain amount of seats on a train. If your intestine was like a long, long train, it just has certain amount of seats. If the seats are occupied by the good microbes, you are less likely to get in trouble with some infection like e-coli or salmonella or something of that sort.
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Dr. Ron Hunninghake: The other part of that is that these microbes have their own DNA and their own, I guess you would say, information system. There are people that are talking about how they enhance our ability to sort through all of the otherwise potentially harmful environmental things that we can come in contact with. So we actually rely upon the information in their DNA to help us stay healthy.
Dr. Tereza Hubkova: Yeah. Yeah. They have vastly more genes than our own human genes. We only have about 23,000 genes in our human body and the microbes have a hundred times more. So absolutely, we cannot be without them. This is now surfacing because, as you mentioned, as we have been ignorant and giving people antibiotics like candy each time somebody would develop a sore throat or ear ache in the past, we would treat them very easily with antibiotics. Now, we recognize that yes, antibiotics can get rid of a bad microbe like strep if you have strep throat or if you have pneumonia, but there is always collateral damage. Unfortunately, antibiotics also kill these good friendly bacteria. So each time you take an antibiotic, you’re dropping a bomb on your microbiome and there is going to be a consequence and it may take weeks, few weeks, or even a few months to recover from a course of antibiotics.
Dr. Tereza Hubkova: Some people may take even two years to recover from a course of antibiotics. This is even more important in children, little children, especially whose microbiome is still not completely fully developed. So if they are given antibiotics in the first year of life, it’ll affect them negatively much, much more than if they took antibiotic in adulthood. So basically, each course of antibiotic wipes out portion of the good microbiome and then paradoxically, those children or adults would be more prone to next infection because part of the role of the good bacteria is that they talk constantly to our immune system and 70% of our immune system is in our gut. So the friendly probiotic microbes are fine tuning constantly our immune system. So the immune system stays on its toes and it’s ready to fight infection, but it also is regulated. So it doesn’t fight food.
Dr. Tereza Hubkova: So you wouldn’t have unnecessary food allergies or food sensitivities or even autoimmune diseases. So the microbiome is absolutely crucial for a proper function of your immune system. The more antibiotics we are exposed to, the more we damage this, and then we are having more infection, more allergies, and more propensity towards autoimmune diseases.
Dr. Ron Hunninghake: Yeah. Where do we get the microbiome?
Dr. Tereza Hubkova: Yeah, so we basically inherited from our moms when we are born. Childbirth is messy. When baby is born as nature intended, that would be through vaginal canal. So as the baby is born, it’s messy, the baby swallows some of the vaginal fluid, it gets in the baby’s ears, nose, lungs, they breathe it in, they swallow it. So they get inoculated with the microbiome from mom’s vaginal fluid. That has a lot of the beneficial bacteria from the mom’s intestines. So this messiness is part of nature. It’s meant to be. That’s how babies get jumpstarted with their mom’s microbiome. Their mom got her microbiome from her mom and she got it from her mom and she got it from her mom. So we basically are inheriting microbiome of our ancestors really for thousands and thousands and millions of years until now, until now, until this past, these past few decades, when we started messing with that by C-sections. So that is already one big change that more and more children are born by C-section in a sterile surgical suite where everything is sterilized.
Dr. Tereza Hubkova: When the baby doesn’t go through the vaginal canal and it’s instead taken out through surgery, it doesn’t get exposed to mom’s microbiome, and instead it gets exposed to the skin microbes and what more, it gets exposed to the microbes of the hospital staff, of the nurses, not necessarily the best bacteria to start your life with. So C-section unfortunately can have consequences on the baby’s microbiome that can sometimes last really for the rest of the child’s life. Then breastfeeding is very important. Breast milk contains not only nutrients for the baby, breast milk contains nutrients for the baby’s microbiome. It contains certain oligosaccharides. They are like starchy molecules that the baby cannot digest. They are not there for the baby. They are there by design for the microbes and the baby’s belly. So breastfeeding is absolutely hugely important. I don’t know about you, Dr. Ron, but when I was a child, my mom was told that it was better to bottle feed. So she believed the doctor.
Dr. Ron Hunninghake: I was bottle fed and I have allergies. So everything you’re saying, I can relate to from personal experience. I’m sure a lot of our listeners, they’re thinking, “Oh my gosh.” Now, there has been a movement in the last 10, 20 years for more natural births and for nursing, breastfeeding. So we do see that there’s a wake up occurring where people are realizing that we do need to, in a sense, take care of, nurture this nurturing process that nature has built into the birthing process.
Dr. Tereza Hubkova: Yeah.
Dr. Ron Hunninghake: Do you feel like the message is getting out there? I’ve heard there still are a lot of… There’s a very high C-section rate in the United States and around the world.
Dr. Tereza Hubkova: Yeah. I think one out of three children in the US are still born by C-section, one out of three. In some countries like China and in Brazil, it’s as much as 56%. So it’s really shocking that the message still needs to be heard, and every now and then when I speak about this, some moms get offended that they gave birth by C-section. If it was necessary, if it’s medically necessary, then of course, sometimes C-section can save life, but really in all honesty, oftentimes the C-sections are done for comfort, whether it’s the comfort of the doctor or for some other not really completely necessary reason. I have one of my best friends from medical school is a gynecologist, an obstetrician in Czech Republic. I asked her some years ago, how many C-sections she has done in her career?
Dr. Tereza Hubkova: She gave birth. I mean, she gave birth, she delivered, she delivered thousands of babies, over 5,000 babies. I asked her how many C-sections she did? I thought she would give me percentage, maybe 10% or 20% or something of that thought. But instead she started counting on her fingers how many C-sections and she has maybe done just 12 C-sections out of thousands of deliveries. So it’s really a cultural decision. It’s not medical necessity often. It’s a sad decision because then it has consequences for the children. It’s not like don’t panic, it’s not like you cannot to some degree overcome the C-section later on if the child is breast fed and if the child is eating healthy diet and is in a good environment, hopefully they’ll catch up. But the sad truth that it’s often not the case. Oftentimes, the diet of our children is full of artificial ingredients, sugar.
Dr. Tereza Hubkova: It really can be lacking nutrients. Oftentimes, their life is stressful and stress damages our intestinal microbiome. Lack of exercise is not good for the microbiome. Lack of sleep is not good for the microbiome. So we end up doing a lot of things in our life that continue to damage the gut microbiome, including exposure to antibiotics, not necessarily just by prescription, but we get exposed to all of antibiotics in our food. They are in the burger that we eat or the chicken that gets on our plate because antibiotics are so often given to the animals that end up on our plate. So that’s a big problem. Then pesticides, pesticides act like antibiotics. So as we spray our crops and then we eat them, we are basically damaging our gut microbiome on a daily basis. Now, we see the consequences of all the epidemics of allergies, autoimmune diseases, asthma, even heart disease, obesity, diabetes. Now we know that even these epidemics have something to do with our gut microbiome, mental health problems, depression, everything has something to do with our microbiome.
Dr. Ron Hunninghake: It’s phenomenal. I was just thinking about glyphosate or Round-Up. It was actually the patent on it. It was patented as an antibiotic and when it didn’t sell very well, then it was turned into something to be sprayed on the crops. So that’ a whole big story. You know what? I think we have more to talk about here. I think this part of our presentation needs to come to an end, unfortunately, but I hope our listeners will come back again because what I would like to do part two of Dr. Hubkova’s presentation on the microbiome is how can we fix our microbiome? I’ll bet you so many people listening saying, “Oh my gosh, we’re in such deep troubles. What can we do to optimize the functioning and health of our microbiome?” So Dr. Hubkova, thank you for this wonderful introduction. I hope you’ll join me again and we’ll do part two of healing the microbiome.
Dr. Tereza Hubkova: Thank you so much for having me and I look forward to being here again.
Dr. Ron Hunninghake: Thank you.
Dr. Tereza Hubkova: Thank you. Have a great day.
Dr. Ron Hunninghake: You too.
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