Healing SIBO & IBS: Glyphosate Detox, Gut Health & High-Dose MSM with Dr. Kathleen Janel

Lisa: Well, hi everybody, welcome to Pushing the Limits again. Fantastic to have you all with me. I have the lovely Dr Janel with me — Dr Kathleen Janel. Welcome to the show, fantastic to have you. Can't wait to share your story, so it's going to be a fascinating dive into the world of SIBO and IBS. So Dr Janel, would you mind sharing us a little bit about your backstory and where you come from, what you do now, and then we'll sort of dive into the whole MSM story and all the stuff that you do with SIBO and IBS?

Dr Kathleen Janel: Sure, okay. I'll give you a brief pre-med school story, and that's that I was really studying to be a regular medical doctor, getting my undergraduate underway and setting myself up for that, applying to medical schools, when I actually got really sick myself. And what I had was this digestive symptom — and that's something that people tell me about all the time now. For me what was happening is that I was just blowing up like a balloon every day, had no idea why. It didn't matter if I didn't eat, it didn't matter if I just drank water, it didn't matter what I ate, it seemed.

Dr Kathleen Janel: And I had exhausted — I was pre-med, actually I was on my way to the University of Toronto in Canada for medical school — and at that point I had exhausted what it felt like to be all of my regular routes. I'd been to my family doctor, saw a couple of specialists, no one really could help me. And so my stepmother actually had recommended, well why don't you go see this naturopath? And it was a big eye roll for me, I was like, I don't want to do that. But I really didn't have a lot of choices, so I did go see this doctor that she recommended, and I got a little bit of relief. At least I got some ideas about what I could eat and what I couldn't eat, and he sort of started me down the road. So I didn't get resolution, but I got some answers.

Dr Kathleen Janel: And then I got really interested about, what is this, and am I going to the right place to be able to help people if this is the kind of thing I'm going to help people with? So I started looking more into naturopathic medicine and saw there were a couple of places to apply to, so I added those onto my applications and ended up going that route.

Dr Kathleen Janel: Well, during the course of that, of course, I learned a lot of different applications that I could use to help myself feel better. So I did all of those things. I did all of the different diets — and this is back in the early 90s, so things were a little different in the landscape there — but I did all of the diets, I did all of the herbs, I did all the nutrients, I did some pharmaceuticals, I did some homeopathics. I mean, really what I remember was being so optimistic, right? There's got to be an answer, I'm not going to stop until I get an answer. I knew it wasn't life-threatening, but it was so uncomfortable to live with, because I knew that the clock's going to strike 12:00 and my stomach's going to start expanding, it's going to be really uncomfortable, to the degree where I don't feel like I can eat.

Lisa: Wow.

Dr Kathleen Janel: And so in addition to that, I was losing a lot of weight. I was really, really thin, because I would come home at the end of the day and just hit the books and study, because maybe I'd have a rice cracker because I couldn't put anything else in there, I was so full of gas. So we've got, now I'm getting down to a really low body weight, and of course my adrenal glands are just shot at this point, so then I'm not sleeping. So all of these things start compounding on each other, coming from that GI problem.

Dr Kathleen Janel: So the years go by and I'm continuing to have this, like, today's gonna be the day. I'm just strong-minded, right? I'm like, there's got to be an answer, and that's just how I am. What's the next thing, what's the next thing? And so went through my residency, was still having the problem, tried a couple of other new things I learned along the way from some of the associate doctors that I was working with there who were also holistic, but still really no movement.

Dr Kathleen Janel: And then a friend of mine said, "You should talk to this compounding pharmacist about methylsulfonylmethane." And I just thought, why would that help? It seems kind of—

Lisa: Exactly, exactly.

Dr Kathleen Janel: Which is what a lot of people say to me, and I'm ready for my answer, right? But I can understand why they would say that, because historically we know methylsulfonylmethane as an anti-inflammatory, as something that helps with osteoarthritis, with joints, muscle, that kind of stuff. And I've actually met doctors since I started lecturing who come to me and say, "Oh yeah, I do that, and I use a high dose as well, but I'm using it for this, and now I'm going to pay attention to what's happening to people's guts when I do this."

Dr Kathleen Janel: So I talked to this compounding pharmacist who was local, and she was pretty business, pretty straightforward, like, you can either trust me or you can go away, kind of lady. So, okay, okay. So she told me what to do, and at that time we couldn't get the quantities of methylsulfonylmethane — she was using a crystallised form, I now use a powdered form, it's easier to dissolve — but at that time it was only available really in mixtures with other anti-inflammatory joint support supplements, so you couldn't get the concentration that you needed. So she actually was supplying it to me and then supplying it to my clinic afterwards.

Dr Kathleen Janel: And I went through the protocol that she said: gradually increase your dose, get up to a 30 gram dose, hold it there. She warned me of all of the things that could happen in terms of die-off reactions and sulfur upregulation reactions in the beginning, and that reassurance that these are good signs. Because it's not like you have a headache, you take an ibuprofen, it goes away, it worked, right? It's not like that.

Lisa: No, no, because you're actually doing a lot of internal changes that are beneficial, but they might have some side effects as you go through it.

Dr Kathleen Janel: But the majority of people, those all go away once they've acclimated inside. So that day came. The day finally came, and it was so long ago now I don't remember exactly where I was in the protocol — was I doing the ramp-up, was I at the full dose, I don't know — but one morning I woke up and was preparing for the afternoon pain, yep, right, all of the pain and all of the etc that comes along with it, and it didn't happen. And that was the first time in 10 years it didn't happen.

Lisa: Amazing. Yeah. So you can't — I was so happy. I just love your tenacity, that you just kept going until you found something. That's a testament to you. I love people like that, because they do find answers eventually. And I'm very much of the same ilk — like, there's got to be something around the corner that I just haven't heard of, I haven't learned yet, I'll just keep going until I find the answer. And more often than not, it might take a year or two or three or 10 in this case, but you have a lot more success that way, plus you learn along the way a whole lot of other things, right? That forces you to learn a whole lot of stuff that then comes to the benefit of what you're doing.

Lisa: So methylsulfonylmethane — we'll call it MSM. When I'm working with someone with IBS and/or SIBO especially, we see an upregulation of Methanobrevibacter smithii and Desulfovibrio piger, and these are methane or hydrogen producing bacteria. So it would seem counterintuitive that you would put more sulfur, a sulfur-based product, into someone who's got a sulfur upregulation, the bacteria are upregulated. Can you explain that? Because that took me a while to get my head around, as to why — because it does cause at the beginning more bloating, more things, as you said, you go through this Herxheimer reaction, this die-off of bad bacteria. What's actually happening in the body? Is that the body trying to upregulate these things to help itself, or what's going on there?

Dr Kathleen Janel: Yeah, so that's my working theory, but I can go into detail about those symptoms that come up and let you know what's happening. So the working theory right now is there is some degree of sulfur deficiency in the body, and we don't store sulfur. Sulfur is always moving through in the different chemicals that contain sulfur — alpha lipoic acid, taurine, N-acetylcysteine, glutathione, methionine. So it's always moving through those, sulfate, sulfite, it's never stored.

Dr Kathleen Janel: I think a good analogy is calcium, right? Calcium is another mineral and we store it in the bones. So when we need some, we don't have to get it from our diet immediately, we can just liberate it from the bones, use it for whatever we need, and if we have excess we can put it back into bone storage. Sulfur is not like that. We need a daily intake of up to 1500 milligrams a day for adequate sulfur cycles to be happening, and if they're not happening, it's not going to put you in the hospital tomorrow, but it's going to start to impact your system.

Dr Kathleen Janel: And this is not something that's been proven at this point, but there's a doctor named Stephanie Seneff who's out of MIT who's done a lot of research on sulfur deficiency. So I won't cross over into her area, but I base a lot of my theoretical information based on that.

Dr Kathleen Janel: So let's just take the methylsulfonylmethane and say okay, we're going to ingest that. What is it doing once it gets inside of us? Well, it's not feeding the sulfite pathways, it's not feeding the hydrogen sulfide dominant species, it's not feeding the methanogens or the hydrogen producing species in terms of their ability to make gas. What it is doing at the low levels — and the studies have shown this — is that it's a prebiotic. So that's one of the reasons why people are getting gassier in the beginning at the lower levels, because it's upregulating all the bacteria, including the fermentation species. And it's not exclusive to the small intestine, it's wherever it reaches, right? At lower doses you're going to get more absorption in the small intestine, there's going to be less going through into the large. But as you increase the dose, then you're sweeping through the entire system and you're moving over from a prebiotic effect to an antimicrobial effect at the higher doses. And the studies do show that too.

Dr Kathleen Janel: There's a great study that I've got that does MSM against candida, against aspergillus which is a mold, against E. coli which is one of the major ones that the antibiotic rifaximin targets, right, or is supposed to target, and then a couple of others — staph and, can't remember, there's a fourth one, staph and strep maybe. But it's antimicrobial once you get up to those high doses over a sustained period of time. And I'm not sure how this compounding pharmacist — like, who is she, where'd she go? I don't know. But I would just love to sit down with her at some point if she's still around. I can't find her, and ask her how she knew this, because these studies are more recent, right? So yeah, that would be — sure, there was something going on there, I'm not sure what.

Dr. Kathleen Janel: ...dimension she was tapping into. But there was something going on where she figured this out and no one's ever heard of it, apart from her and then me, and then I've been telling people. But back to what's going on inside your intestinal system.

Dr. Kathleen Janel: So we've got this prebiotic, low-dose antibiotic or antimicrobial, and antifungal at a high dose. Now, the reason it's not playing into the sulfur cycles in terms of any of the hydrogen sulfide-producing species is because that requires taurine or sulfate, and in order to convert methylsulfonylmethane into either of those two, it has to be an internal reaction and it has to happen eventually, right? So those microbes in us, they can't do that. What can do that is — let me just go through this mentally — what can do that is, we've got some bacteria in us that have the potential of converting sulfate into methionine, and then methionine can feed into our sulfur cycles. But that's not going to happen immediately for somebody, that's going to take some time.

Dr. Kathleen Janel: And that's where you run into more of the problems internally for people when you're doing the titration, with things like headaches, possibly rashes — I haven't seen that for a long time though. What are some of the other things? A lot of it's die-off really, what you're seeing in the beginning, and that's yeast.

Lisa: Oh, yeast die-off. Because I'm working with a patient at the moment, really bad SIBO, actually has really extreme glyphosate poisoning, which I want to touch on a little bit later. And one of the things he's getting is headaches as a byproduct of what we're doing — huge improvements in the gut, but this headache. So that might be feeding into that pathway that's causing that. So that's likely to be a transient thing.

Dr. Kathleen Janel: Exactly, yeah. And just go slowly, don't do titration increases until you've got a symptom resolution of any kind of side effect like that, and then you go up by small amounts, and expect that to decrease each time you take another jump. And then when you get up to the full dose, all those things seem to go away, because now the body has upregulated those sulfur cycles, so now it can move the sulfite to the sulfate and use it for all of the good things that sulfate does.

Lisa: I mean, there's literally such a myriad of things that we're discovering. Let's go through some of those, because it is very beneficial not only for people with SIBO and IBS and gut issues, but also for the joints, for the hair, for the skin, the nails, the strengthening of the tissues, all of these benefits. And when you say it's playing into that whole sulfur cycle — is it upregulating your sort of endogenous, like your glutathione pathways? Do you need to take into consideration any sort of genetic things, like the CBS pathway, or if someone's got MTHFR issues or methylation issues? Are there any sort of warning things there? It's a pretty tricky question.

Dr. Kathleen Janel: I've been down before, sorry.

Lisa: It's fine.

Dr. Kathleen Janel: What happens for me is that on one of my social platforms like YouTube or Insta or something, someone will come and ask me a question, and if I don't know the answer I'm like, "Drop everything, I've got to go look at that, I've got to figure it out, I've got to get to the bottom of this." And not just because I know the question is going to come up again and I want to have an intelligent answer, but I really want to know what's happening.

Dr. Kathleen Janel: So here's the thing about our sulfur cycles. They start with methionine, right? Methionine is an amino acid, we get that primarily from protein. So methionine is the start part of that whole cycle that you're talking about, which is the methylation cycle. And that methylation cycle spins around and makes homocysteine, and that homocysteine then goes into the transsulfuration cycles, and that's when you're talking about glutathione and sulfate and all of that, cysteine and N-acetylcysteine.

Dr. Kathleen Janel: So methionine is an essential amino acid, right? So we can take any of those compounds and we're never ever ever going to make it, because we can't — it has to be taken in dietarily. And so where we're seeing any kind of conversion of — because what they've done is, they've done studies where they'll tag the MSM and they'll give it to usually some kind of test animal, and then they'll find out, okay, can we find this later on in the body as any of those proteins, right? And we can, eventually. So how is it then — that's the big question, right, how is it getting into that cycle?

Dr. Kathleen Janel: So far the working theory — and again, this hasn't been 100% proven, but there's some data out there — is that some of our microbes in the gut can convert it to methionine and then feed it into our bodies directly that way, and that's where we're getting that methylsulfonylmethane-tagged sulfur, so that we can use it then in those cycles.

Dr. Kathleen Janel: So in terms of being concerned about single nucleotide polymorphisms or SNPs, I've never —

Lisa: It should help, really.

Dr. Kathleen Janel: It depends on what they are and whether they're upregulating or downregulating, right? So the main one is going to be the sulfite oxidase.

Lisa: Mhm.

Dr. Kathleen Janel: So if someone has a SNP that's greatly impacting the sulfite oxidase and the ability to move sulfite, right — which is kind of like, sulfite and histamine are very similar in the sense that people have allergic reactions to those degrees. And so if you're not moving sulfite into sulfate in a healthy way, then yes, you can have some buildup of sulfite.

Dr. Kathleen Janel: Now, the real problems are not SNPs, and this kind of gets taken care of on its own, because unfortunately anyone who has a sulfite oxidase enzyme that's impacted to the degree that they can't tolerate sulfur — they don't leave the hospital, right? They can't survive. And those actually exist, that happens, but obviously not people who made it to adult life.

Lisa: Yes. So this is a genetic thing that comes through in childhood, that you wouldn't make it out of childhood if you had that problem, so you'd know.

Dr. Kathleen Janel: Correct, yeah. So that's a very serious genetic defect. And when we're talking about single nucleotide polymorphisms, that's not a genetic defect that's going to interrupt the pathways that we're looking at to the degree that it's going to cause fatalities, or to the degree that it's going to cause something that's irrevocable — you can't work with it. So one of the ways you can work with it is making sure there's enough molybdenum.

Lisa: Yes, I was going to ask you about molybdenum, because that helps — if you're taking sulfur, always pair it with molybdenum usually is the thing, in order to help the body process it, get it through. It's a cofactor. Are there any other cofactors that you suggest to work alongside when you're taking MSM in these higher doses?

Lisa: I mean, personally, I've got a sulfite issue. So if I have dried fruit or something that's had sulfite in it — because they use that to preserve — I know immediately, my throat shuts down and I can't breathe and I get sort of like an asthma type of effect. But I don't have any issues with the MSM at all, or garlic or onions or any of those sorts of things.

Lisa: Now, here's a question for you. Because a lot of people with SIBO are told to go do the FODMAP diet, which is going low in the sulfur-producing vegetables and other things as well. It would seem contrary to what we're doing with MSM. Can you do the FODMAP diet alongside MSM, or should they be done at separate times? What is the correct thing there?

Dr. Kathleen Janel: I've got two approaches to that. So if someone comes to me and they're on a low FODMAP diet and they're kind of used to it and they understand it, I want to keep things as simple as possible for them and isolate their sulfur to — my product is called the GI1 powder, and that's available in the US, but you can use plain MSM in other countries until we can get it over there. I'll have them exclusively use the methylsulfonylmethane and keep those low FODMAP foods out. And I'm doing that intentionally because there's less moving parts, right, that we can say, okay, this is what we're working on right now, stay on your low FODMAP diet. And at the end of the eight weeks of your full dose of the GI1 powder, when you're feeling better, then we're going to use those low FODMAP foods as prebiotics and introduce them gradually. Because if you sit down and eat a head of cabbage after you're feeling better, anybody...

Lisa: Yeah, they would.

Dr. Kathleen Janel: So what you want to do is you want to actually use those high-fibre foods as prebiotics to re-educate your microbiome and create a bigger alpha diversity, because people that have been on these low FODMAP diets for years, their alpha diversity is low.

Lisa: Okay, yeah. No, they definitely don't want to stay on it long term, because it's so many good foods.

Dr. Kathleen Janel: They don't, and they don't want to stay on it. Some people don't feel like they have a choice, because it's the only thing that makes them feel better. But it's not really treating the problem, it's just helping the symptoms. So that's one avenue: you're on the low FODMAP diet already, just stay on it, we'll deal with that in the end, and we'll use the low FODMAP foods gradually as prebiotics to get you alpha diversity.

Dr. Kathleen Janel: The other one are people that come in and they're not on the low FODMAP diet. It depends. Some people know, oh, I have a problem with the allium family foods, garlic and onions, or I have a problem with the cruciferous family foods — oh, but if they're cooked I can eat them. What I tell people then is, just do what you're doing, whatever is working for you, do what you're doing.

Dr. Kathleen Janel: And then there's the contingent of people who were like me, who — you know what, it doesn't matter what I eat, it doesn't matter what I don't eat. I can be dairy-free, I can be gluten-free, I can eat sugar, not eat sugar, all of those things, I'm still having my symptoms. And for those people I just don't even change their diet at all. Because at this point, a lot of people I'm seeing have had many, many courses of rifaximin.

Lisa: Yeah, that's the problem.

Dr. Kathleen Janel: And that's just really clouded the picture up, and now they likely have yeast fermenting on top of bacterial fermenting, right? And yeast — the fungal kingdom, they're probably going to be the last ones living on this earth, because they're so adaptable. If you stop eating carbohydrates, they'll switch to fats. If you stop eating fats, they'll switch to proteins. They will use whatever. Even if you're not eating anything, they can eat the shedding off of the wall of the intestine. We're always shedding — every four days we get a new intestinal lining — they can eat that. So they'll find a way.

Lisa: Little bastards. Yeah, they really are hard to get rid of.

Dr. Kathleen Janel: And the methylsulfonylmethane is a treatment that works for fungal species as well.

Lisa: That's so cool. Yeah, I didn't know the E. coli — my mum's had massive gastrointestinal problems, diverticulitis, gastrointestinal bleeding, which she nearly died. It was about a year and a half ago, massive bleeding, and then sepsis and UTI infections. So I'm always looking for answers to help with the UTI, because she's had antibiotics over and over again, and we're using...

Lisa: ...methylene blue now, which seems to be holding the UTI at bay, touch wood, for the longest time now. But the yeast overgrowth, the fungal overgrowth because of the repeated rounds of antibiotics — which at that point I didn't have a choice, she was dying of sepsis, so you're like, what are you going to do? You're going to chuck everything in there, right? Would they — you mentioned E. coli, that it could actually help with E. coli, because that's one of the nasties we've had problems with. I've titrated Mum's dose up now to about 20 grams of the MSM. I'm still titrating her up and so far really good, no problems at all. But I didn't realise it could actually help with that side of the equation as well. So that's really...

Dr. Kathleen Janel: Yeah, I mean, I think that's the first thing that we knew about sulfur. It's been used in farming as an antifungal, right? And it's the only one that can be used in organic farming at this point. I want to touch on something you said about antibiotics, and that's that I'm not anti-antibiotics.

Lisa: No, we need them when we need them, but there's a time and a place.

Dr. Kathleen Janel: There's a time and a place. And it's interesting, because recently one thing I've been looking into is specifically around Xifaxan and rifaximin, the SIBO antibiotic. It's not really — it's not approved for SIBO. It's approved for hepatic encephalopathy, which is where it started, right? Now, those people don't have a choice. They've got a problem with their liver and they can't process the chemicals that E. coli is making in their gut, that it will damage their brain, and so that's fatal. So these people have to stay on rifaximin long term.

Lisa: Wow.

Dr. Kathleen Janel: So that's one category, and that's where this whole thing started. And then someone had the idea, well, let's test it for traveller's diarrhoea, which is E. coli based typically. And that was the link, right? It's like, well, this works for E. coli, let's test it for this. It's a one-and-done, though, right? It's either going to work or it isn't. You don't go back. And then the next thing that came along was, okay, how about irritable bowel syndrome D, IBS-D, diarrhoea? It's got a 50% recovery rate for that. And that also makes sense too, because that could also be E. coli based.

Dr. Kathleen Janel: So now you've got these three things, two of them are diarrhoea conditions, and 50% of the time it works. So this is the standard of care. This is what you'll find if you read the recommendations. You do one round and you get 50% resolution. Those people are done, they're happy. Unless they travel again and have a problem, you can repeat it. Otherwise, you don't repeat it. So this repeating the course after course after course for SIBO — first of all, it's not even designated for that treatment. And the place where I run into problems is, I can say okay if you see a patient who has this crossover of IBS-D and SIBO, which happens, and you give them a round of Xifaxan and it works, rifaximin and it works, then great, you treated what you were after. If it doesn't, I don't think it's arguable to go back in there and treat again with it.

Dr. Kathleen Janel: And that's what I see: people that have had — I've seen people that have had up to eight rounds of Xifaxan. And what happens is that they reach a roadblock or an end point with a certain provider, and then they go to another provider who's going to offer them the same thing.

Lisa: Yeah, yeah.

Dr. Kathleen Janel: And they'll take it, right? Because they are desperate to get better, and they'll take it. And it seems to work less and less as you go along. And that also doesn't make sense to me, because antibiotics are very targeted and they're very strong. It's either going to work or not. And if it doesn't work, then start looking for some other avenues, because — especially people who have been trained in functional medicine and in naturopathic medicine — I think once is enough.

Lisa: Yeah, exactly, exactly, and taking other approaches. What are your takes — I was going to ask you — oh God, what was it? I did want to go back to glyphosate, because glyphosate is everywhere. Everybody's on the planet pretty much impacted to some degree. We use it on our crops, they use it as a weed killer. But is this part of the problem that we're seeing? Do you think that glyphosate is affecting people's gut microbiome, and how does that work if that's the case, and how would MSM help in that case?

Dr. Kathleen Janel: Oh goodness, yes. So, two different questions there. One is, let's do this: how does it affect the gut microbiome? So what the glyphosate does — for your listeners, glyphosate is called Roundup here, it might be called...

Lisa: Yep, okay.

Dr. Kathleen Janel: So what glyphosate does is it blocks something called the shikimate pathway, and humans don't have the shikimate pathway, so that's the argument for, okay, it's safe for humans. But most microbes do have this shikimate pathway. So let's say you want to grow a corn crop. Corn is one of the first ones that were made Roundup Ready, right? Roundup Ready means that they've made it so you can't kill the corn. The corn has the shikimate pathway too, but they've genetically modified the crop they want so it can't be killed, but everything else around it can be, including the soil microbiome.

Dr. Kathleen Janel: So the soil microbiome — what I found is that the specific bacteria that fix sulfur in order for the plant to use it, right, plants can only uptake sulfate, and the microbiome in the soil will convert the form of sulfur that arrives in the rain and goes into the soil — and this is part of the ecosystem, the sulfur cycle of the globe — that these microbiome will convert it to sulfate so the plant can use it. Well, they're greatly impacted by glyphosate. And so if they're being killed, then that's a deficit to the sulfur content of our plant species.

Dr. Kathleen Janel: And then let's go into — so that's the soil microbiome is impacted, limiting sulfur in our diets. And then we go to the human microbiome. 50% of the human microbiome has the shikimate pathway. That means that we're killing that.

Lisa: And what's — yeah, that's going to free up real estate inside.

Dr. Kathleen Janel: And with microbes, something has to be there. It'll fill the gap, it has to. That's just the way ecosystems work. And a healthy ecosystem has the greatest diversity. An unhealthy ecosystem is a monocrop like the corn we're talking about, so obviously unhealthy ecosystem for many reasons. So now if you go in there and you kill 50% of the microbiome by ingesting glyphosate on the foods, then that's an automatic setup for small intestinal bacterial overgrowth. Automatically, because you've freed up that real estate so something else can be there. So yeah, it's not good for our microbiome.

Lisa: And then you have a deficiency in sulfur as well, which leads to all the other problems that we just talked about, sulfur deficiency, the third most...

Dr. Kathleen Janel: Yeah, exactly. So, you know, Monsanto, who's the company that developed and markets Roundup, is getting their data — when I looked for soil studies, most of the data was coming from them, and the spin was, oh, but the bacteria are cleaning it up. But those bacteria in the soil are being sacrificed in that cleanup process.

Lisa: Yeah. And I think we're kind of — I mean, who knows, I'm not sure where things are at right now, but there's definitely some countries that won't — that's why I think in Europe there's a lot more stricter rules around glyphosate, I believe. And people say, look, they can't have flour, they can't have bread, they can't have pasta in America or in New Zealand, but when they go to Europe they do okay when they have Italian pasta or Italian bread or German bread, because it's not got these high levels of glyphosate over there. That's a hypothesis, that that's why.

Lisa: And I've just signed a petition here — our government is trying to increase the level of allowed glyphosate, and I'm just horrified. We've already got an epidemic of people that have so many troubles with the gut. I have a biotech company, AAM Labs, and we work on the immune system and the ageing of the immune system and trying to reverse that. And we've got an amazing formulation called Rejuvenate Pro, and it's going after the healing and sealing of the gut, which MSM also helps with, the leaky gut sort of side of the story.

Lisa: And we're using extract of colostrum, which is really, really powerful, much more powerful than your standard colostrum extract, because it's taken all the rest of the things out and left the bioactives. And then we've got something called immune defence proteins, which has got a suite of 50 bioactives that is produced by the cow in the whey side of it — so not the colostrum but the whey side — and that was made by nature to protect the cow, and it contains like 40% lactoferrin. And lactoferrin is sort of one of the key players here, and lactoferrin is just one of the most marvellous things on the planet. And so it's embedded in a suite of 50 bioactive whey proteins, and it's the synergy of these 50 together that makes it super powerful when you put it with the Immunel, our colostral whey extract. And you've got all these transfer factors, immunoglobulins, your leaky gut, your growth factors, IGF-1, all of these things helping.

Lisa: And then we've also paired up with kawakawa, which is a native New Zealand plant here that's been used for hundreds of years by my people for gastrointestinal issues, for pain. It downregulates COX-2, it lowers NF-kappa B and TNF-alpha and all these great things that it does. And then the last thing we have in there is carnosic acid, which really helps with a chemokine called CXCL9, which is one of the ones that they've identified recently as being a really key player in cardiovascular health, but also for neuroprotection we use the carnosic acid, and for the gut health as well. So a really powerful formula. And we're never going to run out of patients, unfortunately, that need gut support.

Lisa: And I love your formulations. You've got the GI — so on GIJanel.com, which is where I highly recommend everybody go and visit Dr Janel's website and have a look at the product lineup that you have, especially if you're in the States because you can get it. But maybe we can chat offline about possibilities of getting it down here. In the GI Janel one, you've got MSM as your major component, but you've also paired it with slippery elm and acacia gum, and what was the other one — sorry, marshmallow root.

Dr. Kathleen Janel: Yes, marshmallow.

Lisa: Marshmallow root, thank you. Why those other pieces of that puzzle, and how do they work synergistically in that combination?

Dr. Kathleen Janel: Yeah, I did it so that the sensitive patients could start to get a little bit of all of these things while they're doing their titration in the powder. The acacia primarily because it's a non-fermentable fructosaccharide, non-fermentable fibre, soluble fibre, so it's very gentle. So that way we're introducing some prebiotics gradually, so as people go up in their dose they're getting more of that as well as the methylsulfonylmethane. Because I want the body to get used to having some stronger forms of prebiotics going in there, that then we can take over using the foods with once they're completed.

Lisa: ...together, which you don't find in your standard sort of digestive enzymes.

Dr. Kathleen Janel: Yeah, a lot of them are focused more on the pancreatic aspect, but I find that especially with people who have digestive issues, they need all of that until their digestion has healed and they're stronger and they can make their own.

Lisa: There's certain genetic predispositions to, like, a lactase deficiency, right? Can't break down lactase, so that's something that's pretty well known. And theoretically, if you took your supplement with all of those bits and pieces in it, all of those enzymes, you might be able to tolerate some dairy or tolerate some lactose or whatever food. I mean, if you get your gut right, you should be able to eat most foods again.

Dr. Kathleen Janel: Yeah, exactly. That's my goal, and that's one of the impetuses. I think my big marching orders are: get people to stop using antibiotics as much, and the second one is expand the diet. Let's get people back into more of a whole foods diet. Because let's go back to aloe, right? There's nature sitting there growing this stuff for us that's basically medicine. And our food can be medicine for us. So it's right there in front of us to use. I kind of lost my train of thought there — it was the whole foods diet, right?

Dr. Kathleen Janel: So yeah, as a holistic practitioner, if we're restricting and restricting and restricting diets down as a solution, as a long-term solution for people, I think we're creating other problems.

Lisa: I agree. I agree totally. I think there's a time and a place for certain things when you want to be cutting out, when you're in the extreme phase or you're doing something specifically. But when you cut out massive food groups for long periods of time, you're going to run into troubles down the track with deficiencies and other problems.

Lisa: I had Dr Ross Pelton on my show, and he's a wonderful — he calls himself a natural pharmacist — and he talks about the diversity and the importance of that. Because when we go to our supermarkets, at least here in New Zealand, we've got the same old broccoli and cabbage, and we've only got a dozen different vegetables. We don't have the hundreds that we used to have when we were hunter-gatherer people that had a little bit of this and a little bit of that, and it was all seasonal, and we'd have changes throughout the year of what we were eating. Now we're eating the same broccoli, the same thing every day, and then you get your favourites, right? So you tend to eat the same thing. And the broccoli may be really good for you, but you need a diversity.

Lisa: So he talks about trying to have like 24 different vegetables and fruits a day — a little bit of parsley and a little bit of marjoram and a bit of this herb and a bit of that veggie — trying to mix it up, because you're feeding an army of a trillion down there, different microbes that need different things. So you don't want to skew it in one direction, even if it's a good thing. You want to have that diversity there. And he aims for six to nine cups of vegetables a day, which is pretty out there for most of us to try to achieve that, but I always have that in my brain as the goal.

Lisa: And if you do that from the get-go, you're probably, like you say, going to have gas and you're going to have bloating as your body has to change. But as soon as we start eating more diversity, our microbiome is changing on the daily, so we can adapt. Sometimes you will have an initial reaction as things change, but don't necessarily give up at that point. And the same with the MSM.

Lisa: Just coming back to the MSM story: can you walk us through titrating up? What would be a good sort of idea of a protocol — and obviously work with your practitioner ideally — but for people that are wanting to try MSM, where should they start as a starting dose, and where should they escalate to?

Dr. Kathleen Janel: At this point I have three different protocols, depending on who I'm talking to. And I've made videos of this — these are on my YouTube channel and on my website.

Lisa: Go to the YouTube. Yeah, we'll put a link.

Dr. Kathleen Janel: Yeah. So three different channels. Let's start with a very, very sensitive patient. So the person who just is reacting to everything, maybe they've had several doses of antibiotics and then that's adding to it, and they have a very, very limited group of foods they can eat. People who are eating only super clean animal protein and some really well-cooked vegetables, and that's pretty much all they're doing, and if they stray from that they're not feeling good, they're getting GI symptoms.

Dr. Kathleen Janel: For those people, I'm going to start them with a pinch dose. I'm going to have them just take a pinch of the GI1 powder, put it in some water or juice and drink that every day, and just gradually build themselves up. And the person that I did this with that took the longest — it took her two years, but she did eventually get rid of her symptoms. So we just kind of met every month or every couple of months and talked about how it was going, and then just kept on encouraging her. So it worked, but it took a long time. So that's your very sensitive patient.

Dr. Kathleen Janel: And then I've got a moderately sensitive patient, where I'll do pinch doses until you reach a quarter of a teaspoon, and then what they'll do is try and jump up another quarter from there, try and go to a half. If that doesn't work, go back to the quarter plus a pinch, and keep on doing that. Eventually there's a time where everything falls into line: you're no longer having die-off reactions, you're no longer using it as a prebiotic to make you a little more gassy, and you're no longer having sulphur cycle upregulation reactions.

Dr. Kathleen Janel: Almost 100% of the time people tell me this — and I've managed people all over the country at this point, and internationally as well — but the people who are like, "I'm having the headaches," or "I feel more stimulation from this," I think it's actually the intact MSM itself that's doing that, not one of the SNPs or pathways. And so when the body is able to process and acclimate to that, it just all goes away. Like suddenly it all goes away. So that's a lot of encouragement for people, and providing hope.

Dr. Kathleen Janel: And then the strong patient. I had one guy — I think it was like 30 years into the bloating symptom, and he lived in Washington State, so we have a ton of practitioners, we have a school here. So he'd done every diet under the sun, he'd done every treatment under the sun: biofilm busters, anti-quorum sensing, antimicrobials, antibiotics. Everything, he'd done it all, and nothing ever changed his symptoms. I was like, "You know who that sounds like? Sounds like me."

Dr. Kathleen Janel: So he wanted to go in guns blazing. I told him to do a titration, and he's like, "I'm doing the full dose tomorrow." I was like, "Listen, A, I'm not going to come and rescue you, and B, you're your own person, you do what you want to do." So he did, and I said, "Let's talk in four weeks." So he told me that around week three — he didn't actually, he tolerated it really well, luckily, but I had prepped him for it — and he said about three weeks in, for the first time his symptoms were gone. First time in 30 years.

Lisa: Wow.

Dr. Kathleen Janel: And he kind of gave me a talking-to, too. He was like, "Well, why are you the only person doing this?" And I was like, "You know what, you're right. I better start talking about this, and before I retire from practice I better start getting the word out." And especially being in a high concentration of naturopath practising areas: please start at least considering this as a treatment option for your patients. Because nothing is 100%, no, but where's the — I used to say 80%, but now it's more like 90, just because my practice is so focused on GI. When I do a follow-up visit with my patients, I'm expecting to hear things are better.

Lisa: Wow. And that's gold, isn't it? I think it's just absolutely really important, the work that you're doing, and now getting out on podcasts, having your own YouTube channel and writing books — you've written a book as well. Send me all those links, I will link them all down below, because you can help people worldwide, and it's a simple, easy thing to do, whether they're working with your products, which would be gold if you're in America — and maybe we can talk about getting them down here — or if you're just trying the MSM yourself.

Lisa: This could be saving so many people from so much suffering for so many years. It's really gold that you're already getting out there and talking about it, because we've got to share the gems that we do find along the way and share them freely with people, so that they can get that. And that's what this podcast is all about.

Lisa: So Dr Janel, I just wanted to wrap up and say thank you very, very much for your wisdom and your experience. And obviously you were meant to have that horrible time back in med school so that you could share all this wisdom with the world, and for continuing your incredible dedication to learning all that you have done and putting these great supplements together. So tell us where people can find you. Can people work with you one-on-one if they wanted to? Where do we find your book and all of that sort of good stuff?

Dr. Kathleen Janel: Yes, I think the easiest place is if you go to GIJanel.com — everything is linked from there. So we have an application for consultations page that gets managed by my admin, so if people are appropriate, then I'll do a one-on-one consultation with them and see them through things. But I'm focused on the GI stuff. After 30 years, you know a lot about a lot, and some things you don't know a lot about, but you know a lot about a lot. But I try and keep it focused to the GI and then send people off to other experts if it's something else.

Dr. Kathleen Janel: The supplements are there, and we can ship out anywhere in the US. Like I said, we do have an ability to ship to a doctor who's able to get things into Canada, so that's another option for Canadians. And a lot of those people up there have learned this protocol and are using it, which is wonderful. And then if people have PO boxes in the US, then we can ship to them as well.

Lisa: Right, ship to a PO box and they can have it sent forward from there. Right, okay.

Dr. Kathleen Janel: And my book is available on that as well. I've done so many videos, because what I realised over the course of opening a YouTube channel and stuff is that this is my passion. When somebody asks me a question, like I said earlier, and I don't know the answer, I will literally drop everything and go into a biochemistry vortex, looking at studies and comparing things and looking at who did it and who funded it. And I just love it. I love it.

Dr. Kathleen Janel: So I've got a ton of videos out there, and in terms of general questions, when people ask me questions I'm happy to help them out. If they need dosing things or something more specific, then they'll have to either go to somebody I've trained or go to a local provider, or do a consult with me. But otherwise, I like when people ask me questions, because it really gets me thinking.

Dr. Kathleen Janel: And I found the only social networking site that I don't like to really go to is Reddit, because it seems like there's a lot of opinion happening on Reddit, right? And so if I go in there and try and inject some logic and science, it doesn't go well.

Lisa: So I haven't even tried Reddit. I haven't even got — I don't know.

Dr. Kathleen Janel: So if anyone's listening to this and they're on Reddit, just tell people to go over to my other platforms, like Instagram. I love TikTok, but that's a little silly. And also just my web page.

Lisa: And the videos are really good for deep dives. Yeah, I love YouTube and getting things out there, but it takes time and it takes a lot of work. I know it takes a lot of work to do all of this sort of media work and get it out there and get the word out, and trying to beat the algorithms. But yeah, it's worthwhile, because you are helping people. So Dr Janel, thank you so much for your time today. It won't be the last time we talk, I don't think, but really nice to connect with you. So thank you very much.

Dr. Kathleen Janel: It's great to be here.

Lisa: ...together, which you don't find in your standard sort of digestive enzymes.

Dr. Kathleen Janel: Yeah, a lot of them are focused more on the pancreatic aspect, but I find that especially with people who have digestive issues, they need all of that until their digestion has healed and they're stronger and they can make their own.

Lisa: There's certain genetic predispositions to like a lactase deficiency, right? Can't break down lactose, so that's something that's pretty well known. And theoretically, if you took your supplement with all of those bits and pieces in it, all of those enzymes, you might be able to tolerate some dairy or tolerate some lactose or whatever food. I mean, if you get your gut right, you should be able to eat most foods again.

Dr. Kathleen Janel: Yeah, exactly. That's my goal, and that's one of the impetuses. I think my big marching orders are: get people to stop using antibiotics as much, and the second one is expand the diet. Let's get people back into more of a whole foods diet. Because let's go back to aloe, right? There's nature sitting there growing this stuff for us that's basically medicine. And our food can be medicine for us. So it's right there in front of us to use. I kind of lost my train of thought there. Oh, the whole foods diet, right. So yeah, and as a holistic practitioner, if we're restricting and restricting and restricting diets down as a solution, as a long-term solution for people, I think we're creating other problems.

Lisa: I agree. I agree totally. I think there's a time and a place for certain things when you want to be cutting out, when you're in the extreme phase or you're doing something specifically. And when you cut out massive food groups for long periods of time, you're going to run into troubles down the track with deficiencies and other problems.

Lisa: I had Dr Ross Pelton on my show, and he's a wonderful — he calls himself a natural pharmacist — and he talks about the diversity and the importance of it. Because when we go to our supermarkets, at least here in New Zealand, we've got the same old broccoli and cabbage and we've only got a dozen different vegetables. We don't have the hundreds that we used to have when we were hunter-gatherer people that had a little bit of this and a little bit of that, and it was all seasonal and we'd have changes throughout the year of what we were eating. Now we're eating the same broccoli, the same thing every day. And then you get your favourites, right? So you tend to eat the same thing. The broccoli may be really good for you, but you need a diversity.

Lisa: So he talks about trying to have like 24 different vegetables and fruits a day — a little bit of parsley and a little bit of marjoram and a bit of this herb and a bit of that veggie — trying to mix it up, because you're feeding an army of a trillion down there, different microbes that need different things. So you don't want to skew it in one direction even if it's a good thing. You want to have that diversity there. And he aims for six to nine cups of vegetables a day, which is pretty out there for most of us to try to achieve that. But I always have that in my brain as the goal. And if you do that from the get-go, you're probably, like you say, going to have gas and you're going to have bloating as your body has to change. But as soon as we start eating more diversity, our microbiome is changing on the daily, so we can adapt. So sometimes you will have an initial reaction as things change, but don't necessarily give up at that point.

Lisa: And the same with the MSM. Just coming back to the MSM story, can you walk us through titrating up? What would be a good sort of idea of a protocol? And obviously, work with your practitioner ideally, but for people that are wanting to try MSM, where should they start as a starting dose and where should they escalate to?

Dr. Kathleen Janel: At this point I have three different protocols depending on who I'm talking to. I've made videos of this — these are on my YouTube channel and on my website.

Lisa: Go to the YouTube. Yeah, we'll put links.

Dr. Kathleen Janel: So three different channels. Let's start with a very, very sensitive patient — so the person who is just reacting to everything. Maybe they've had several doses of antibiotics and that's adding to it, and they have a very, very limited group of foods they can eat. People who are eating only super clean animal protein and some really well-cooked vegetables, and that's pretty much all they're doing, and if they stray from that they're not feeling good, they're getting GI symptoms. So for those people, I'm going to start them with a pinch dose. I'm going to have them just take a pinch of the GI1 powder, put it in some water or juice and drink that every day, and just gradually build themselves up. And the person that I did this with that took the longest, it took her two years, but she did eventually get rid of her symptoms. So we just kind of met every month or every couple of months and talked about how it was going and then just kept on encouraging her. So it worked, but it took a long time. So that's your very sensitive patient.

Dr. Kathleen Janel: And then I've got a moderately sensitive patient where I'll do pinch doses until you reach a quarter of a teaspoon, and then what they'll do is try and jump up another quarter from there, try and go to a half. If that doesn't work, go back to the quarter plus a pinch, and keep on doing that. Eventually there's a time where everything falls into line. You're no longer having die-off reactions, you're no longer using it as a prebiotic to make you a little more gassy, and you're no longer having sulfur cycle upregulation reactions. Almost 100% of the time people tell me this — and I've managed people all over the country at this point and internationally as well — but the people who say, "I'm having the headaches," or "I feel more stimulation from this," I think it's actually the intact MSM itself that's doing that, not one of the SNPs or pathways. And so when the body is able to process and acclimate to that, it just all goes away. Like suddenly it all goes away. So that's a lot of encouragement for people and providing hope.

Dr. Kathleen Janel: And then the strong patient. I had one guy — I think it was like 30 years into the bloating symptom, and he lived in Washington State, so we have a ton of — we have a school here, so we have a ton of practitioners. So he'd done every diet under the sun, he'd done every treatment under the sun: biofilm busters, anti-quorum sensing, antimicrobials, antibiotics, everything. He'd done it all and nothing ever changed his symptoms. I was like, you know who that sounds like? Sounds like me. So he wanted to go in guns blazing. I told him to do a titration and he's like, "I'm doing the full dose tomorrow." I was like, "Listen, A, I'm not going to come and rescue you, and B, you're your own person, you do what you want to do." So he did, and I said, "Let's talk in four weeks."

Dr. Kathleen Janel: So he told me that around week three — he tolerated it really well, luckily, but I had prepped him for it — and he said about three weeks in, for the first time his symptoms were gone. First time in 30 years.

Lisa: Wow.

Dr. Kathleen Janel: And he kind of gave me a talking-to too. He was like, "Well, why are you the only person doing this?" And I was like, you know what, you're right. I'd better start talking about this, and before I retire from practice I'd better start getting the word out. Especially being in a high concentration of naturopath-practicing areas — please start at least considering this as a treatment option for your patients. Because nothing is 100%.

Lisa: No, but where's the — I'd say at this point—

Dr. Kathleen Janel: I used to say 80%, but now it's more like 90, just because my practice is so focused on GI. When I do a follow-up visit with my patients, I'm expecting to hear things are better.

Lisa: Wow. And that's gold, isn't it? I think it's just absolutely really important, the work that you're doing, and now getting out on podcasts, having your own YouTube channel and writing books. You've written a book as well. Send me all those links, I will link them all down below, because you can help people worldwide, and it's a simple, easy thing to do — whether they're working with your products, which would be gold if you're in America, and maybe we can talk about getting them down here, or if you're just trying the MSM yourself. This could be saving so many people from so much suffering for so many years. It's really gold that you're already getting out there and talking about it, because we've got to share the gems that we do find along the way and share them freely with people so that they can get that. And that's what this podcast is all about.

Lisa: So Dr Janel, I just wanted to wrap up and say thank you very, very much for your wisdom and your experience. And obviously you were meant to have that horrible time back in med school so that you could share all this wisdom with the world, and for continuing your incredible dedication to learning all that you have done and putting these great supplements together. So tell us where people can find you. Can people work with you one-on-one if they wanted to? Where do we find your book and all of that sort of good stuff?

Dr. Kathleen Janel: Yes, I think the easiest place is if you go to gijanel.com, everything is linked from there. So we have an application for consultations page that gets managed by my admin. So if people are appropriate, then I'll do a one-on-one consultation with them and see them through things. But I'm focused on the GI stuff. I mean, after 30 years you know a lot about a lot, and some things you don't know a lot about, but you know a lot about a lot. But I try and keep it focused to the GI and then send people off to other experts if it's something else.

Dr. Kathleen Janel: The supplements are there and we can ship out anywhere in the US. Like I said, we do have an ability to ship to a doctor who's able to get things into Canada, so that's another option for Canadians. And a lot of those people up there have learned this protocol and are using it, which is wonderful. And then if people have PO boxes in the US, then we can ship to them as well.

Lisa: Right, ship to a PO box and they can have it sent forward from there. Okay.

Dr. Kathleen Janel: And my book is available on that as well. I've done so many videos, because what I realised over the course of opening a YouTube channel and stuff is that this is my passion. When somebody asks me a question, like I said earlier, and I don't know the answer, I will literally drop everything and go into a biochemistry vortex and look at studies and compare things and look at who did it and who funded it. And I just love it. I love it. So I've got a ton of videos out there.

Dr. Kathleen Janel: And in terms of general questions, when people ask me questions I'm happy to help them out. If they need dosing things or something more specific, then they'll have to either go to somebody I've trained or go to a local provider, or do a consult with me. But otherwise I like when people ask me questions, because it really gets me thinking. And I found the only social networking site that I don't like to really go to is Reddit, because there's a lot of opinion happening on Reddit, right? And so if I go in there and try and inject some logic and science, it doesn't go well.

Lisa: I haven't even tried Reddit. I don't know.

Dr. Kathleen Janel: So if anyone's listening to this and they're on Reddit, tell people to go over to my other platforms like Instagram. I love TikTok, but that's a little silly.