What Most Gut Protocols Get Wrong

In this episode of the Smarter Not Harder Podcast, Dr. Theodore Achacoso, Dr. Scott Sherr, Boomer Anderson, Jodi Duval, and Dr. Allen Bookatz give one-cent solutions to life’s $64,000 questions that include:

• What are the risks and benefits of fecal microbiota transplants (FMT) for gut health?

• Are raw food diets really healthier — or do they damage your thyroid and metabolism?

• How does cooking food change nutrient absorption and human evolution?

• What do colonics and “cleanses” actually do to your microbiome?

• Why do quick-fix gut surgeries fail — and what should you do instead?

What We Discuss:

00:00 Intro: The black market for breast milk and poop?!
00:45 Welcome to the Faculty: Jodi joins from Bali
01:10 Boomer’s gut health confession and “leaky” beginnings
03:50 Dr. Scott Sherr on fecal microbiota transplants (FMT)
05:10 Dangers of DIY fecal transplants and the “poop in a pill” craze
07:20 Why donor screening matters: C. diff, obesity, and the gut connection
09:10 The myth of raw foods: Dr. Ted explains kale toxicity and thyroid damage
11:30 How cooking made humans smarter and healthier
14:30 Food safety, fermentation, and evolution’s role in digestion
18:30 Jodi’s story: from colonic hydrotherapist to gut health advocate
21:00 Cleanses, colonics, and the psychology of “letting go”
25:00 Parasites, myths, and the dangers of extreme gut detoxes
27:20 Dr. Allen’s rant: Surgical “gut makeovers” and medical quick fixes
31:30 Lap bands, gastric sleeves, and the illusion of fast results
35:00 Why optimizing gut health requires patience, not surgery
38:10 “Do not swallow anyone’s poop” — closing thoughts and takeaways

Full Transcript:

Dr. Scott Sherr (00:00)
Has anybody heard of the ⁓ black market for breast milk?

Boomer Anderson (00:05)
Yeah

Dr. Allen Bookatz (00:05)
Thank

Dr. Ted Achacoso (00:06)
Yes!

Dr. Scott Sherr (00:07)
There's also a black market for beautiful farm-grown poop. ⁓ And so this is called the fecal microbiota transplant for those that are listening, FMT. And clinically, FMT has actually been showing for years some amazing results in multiple different things.

Boomer Anderson (00:40)
Hey guys, guess what? Jodi is now in the running for, you're tied currently for best podcast background. ⁓ Jodi, where are you joining us from?

Jodi Duval (00:51)
am

joining you from the lovely Bali, Indonesia and I am staying in Borawa for a moment.

Boomer Anderson (01:00)
⁓

Jodi, I gotta tell you something. You're not original. We've already had somebody who's been on the show from Bali.

Jodi Duval (01:07)
Yup, I know.

Boomer Anderson (01:09)
Yeah.

Dr. Allen Bookatz (01:09)
Yeah.

Boomer Anderson (01:11)
OK. OK, I've got a series here of questions that we're going to do as sort of an icebreaker. And I'm only going to ask one of you because otherwise it would take too much time. Alan, do uncomfortable situations bring out the best or worst out of you?

Dr. Ted Achacoso (01:28)
Definitely the best, for sure.

Boomer Anderson (01:33)
Including that time you were on Eurovision?

Dr. Allen Bookatz (01:36)
Hahaha

Dr. Ted Achacoso (01:38)
The lion of love. Yeah, you have to be there.

Boomer Anderson (01:43)
Yeah, in more ways than one. All right. ⁓ So we got the faculty back here today to have another fun conversation and to set the scene aside from the fact that Jody's and Vali and Alan is apparently both ABBA and the Lion of Love at the same time. We're going to get into a little bit ⁓ of just sort of clinical experiences and ⁓ stories, case studies, things that we've heard about the gut. Now I'll set.

the story here, before I get into the actual question, when I was a young warthog getting into all things health optimization, before I even knew what health optimization medicine is, I have to admit that the gut was the last place I wanted to look for my own health. And this was when I was trying to dissect everything at sort of a surface level, or as Dr. Ted would say, with more deductive logic than inductive logic. And ⁓

The thing that I refused to look at was the gut because the guts not really sexy. I wanted to look at nootropics and all of these really cool devices that would make me on all the time. And I didn't really look at the gut at all. And that was a little bit of a flaw. A leak, if you will. Haha. You see what I did?

Dr. Ted Achacoso (03:03)
personal there.

Dr. Scott Sherr (03:04)
Leak is leaking. Oh, that's too much information.

Boomer Anderson (03:07)
I was talking about my gut. Anyway, yeah, that's probably a whole episode in itself, but this is about you, not me. And so what we want to get into today is common mistakes about the gut. You've already heard mine where I neglected actually addressing my gut for a long time because I just thought, like, hey, if you have an okay diet, it's fine. But with you guys as clinicians,

Dr. Ted Achacoso (03:09)
side effects and things won't boom.

Boomer Anderson (03:36)
⁓ Somebody comes into your door and let's go to the craziest stories and things that you've heard about the gut and what people have tried to improve their gut. ⁓ And since he's laughing so hard right now, Dr. Sher Her is on the mic.

Dr. Scott Sherr (03:55)
Yes, sir. Aaron Burser. Yes. So a couple of things come to mind here. And has anybody heard of the, ⁓ the black market for breast milk?

Dr. Allen Bookatz (04:08)
Yes.

Boomer Anderson (04:09)
Bye.

Dr. Ted Achacoso (04:10)
Yes!

Dr. Scott Sherr (04:12)
Well, ⁓ well, there's also there's also a black market for beautiful farm grown poop.

Boomer Anderson (04:24)
And

so...

Dr. Scott Sherr (04:29)
And so this is called the fecal microbiota transplant for those that are listening FMT and clinically FMT has actually been showing for years some amazing results in multiple different things. The most important is something called C. diff, which is an infection that happens when you've taken antibiotics, you kill off the other bugs, but C. diff grows in the colon and causes toxic exposure. You can die from it. I've seen people die from it. It is uncool. ⁓

That's kind of a maybe that.

Dr. Allen Bookatz (04:58)
Yeah,

it's C. diff is Clostridium difficile for those of you guys who want to know the scientific name of the bug is actually found in the soil, right? And ⁓ it's actually ⁓ very, very lethal, especially in babies and young children. So it was actually the Boston, I think, the Brigham Women's Hospital, who actually started the first ⁓ poop transplants, right? It's a poop in a pill. They make the kids.

Dr. Scott Sherr (05:26)
Yeah,

before this, I said it was actually via colonoscopy, right? So that's before there is poops in a pill, which is something new in coming around now more. was just.

Dr. Allen Bookatz (05:36)
I thought you were going to say bisexual acts,

Dr. Scott Sherr (05:40)
That's for a different podcast that we host after hours. Everybody.

Dr. Ted Achacoso (05:43)
The introducing of the, yeah.

Dr. Scott Sherr (05:45)
This is Dr. Ted's knowledge from being in Paris and training as an anti-aging doctor.

Dr. Allen Bookatz (05:54)
No, no, no, actually, what I wanted to say here is that, you know, there are very few world experts in fecal macrobriety transplants. So you really shouldn't be doing this yourself, right? actually had to bring a couple of my ⁓ patients to Germany to the guy who is actually one of the foremost experts, you know, in ⁓ fecal macrobriety transplants. This was done by, of course, colonoscopy.

The donors were of course screened and took sticks. And as I said before, and I think another podcast, it actually takes them three years to prepare a donor. So they get them young and then they actually, you know, monitor them or courses before they actually get approved as donors. So it's a, it's quite a process just because, because you have healthy poops doesn't mean that it has healthy microbiota. Remember you might get sued too.

with a case in, again, this is a case in Boston where, and this was a legal fecal macrobial transplants, right? But she was able to get rid of her IBS, right? And so on. So everything was copacetic until she started getting obese, right? Because her donor...

while Slim now used to be fat and now she was also getting fatter. So be careful about these things guys.

Dr. Scott Sherr (07:25)
Yes. You've basically said exactly what I'm trying to convey here, Ted, is that I had a patient that went and got a black market fecal microbiota transplant from a donor that he met on the internet. And this did not go well. Okay. Did not go well at all. We have black markets for breast milk. We have black markets for sperm. Dr. Buchesna knows all about this. think that per ml, I think sperm is the most expensive.

thing you could buy as far on the black market, as far as I'm aware, even more expensive than gold as last I checked maybe, but I don't know gold boomer, you know better about the gold prices than I do. there he goes. So I would highly recommend, as Dr. Ted said, really going to a place that does a lot of screening for poop. You know, it's sort of the wild west out there. mean, even with fecal microarray of transplants, mean, like, again, there could be some collateral.

Boomer Anderson (08:03)
thousand per troy ounce.

Dr. Scott Sherr (08:22)
Side effects like becoming obese, if you don't know the donor sometimes. ⁓ so that would be the first story. I mean, I could tell more, but I think maybe that's a good enough one to start off with, but FMT on its, on its own is being shown having amazing results with C. difficile or clostridium difficile, along with things like inflammatory bowel disease, rheumatoid arthritis, even some autoimmune conditions like MS and others have some pretty interesting.

results using this as a mechanism. And also as Dr. was mentioning, there are new companies that are trying to get poop pills, poops in a capsule kind of thing. We know a couple of these companies. not.

Boomer Anderson (09:00)
Sure.

think they're calling him spiotics now, right?

Dr. Scott Sherr (09:03)
I

sure. mean, that would make sense, I guess, ⁓ but I don't know how rigorous this research in this world, but maybe soon you'll be just swallowing poop to optimize your gut. And there you go.

Boomer Anderson (09:15)
I black markets are a leading indicator, right? So I think the moral of the story there is you got to be working with somebody who seriously knows what they're doing, which in Ted's words, go to Germany, but there might be some other people.

Dr. Scott Sherr (09:28)
Well,

there's some good places around in the U S now that do this record late for sure. Yeah.

Boomer Anderson (09:33)
Well, ⁓ we have been graced here with Dr. Bukats this evening. And so the man who's had more stories about things in the gut than I've ever heard in my life, I'll pass it over to you and let's see what happens.

Dr. Ted Achacoso (09:53)
I yeah, I wasn't planning on going down that route.

Boomer Anderson (09:57)
No, you don't have to. I think you can go now.

Dr. Ted Achacoso (10:00)
I think Scott has covered with the more excellent art-rated versions of this. We'll go with the, we talk about bad myths. ⁓ I think the one that jumps out to me is that raw vegetables are always better than cooked. There's this theme that, it's alive and all the enzymes and the vitamins are all readily available.

and we need to be taking lots of, put lots of kale into our smoothies and it's really interesting. So bringing it to the ER, because that's where all good stories end or begin, guess. I remember having a patient that thought she was being super healthy and all she went on was like a kale smoothie diet. So she's eating kale for breakfast, she replaced all of her potato chips with the roasted kale, which actually is pretty good. ⁓

Anyway, she did this over a series of months and almost replaced everything else with like some type of, you know, spinach or raw, you know, raw plant. And so what's interesting, she came in and her neck was actually quite full. And she actually came in with flank pain. And what this was is that she actually ended up messing up her thyroid. And if for those that don't know, rock kale has these compounds called finals.

It's thiocyanates and what they do is they interfere with your ability to produce thyroid hormone. And I can't remember how they do it. Is it iodine uptake, Ted? I'm sure you know.

Dr. Allen Bookatz (11:38)
is sequestration.

Dr. Ted Achacoso (11:40)
Yeah,

it like takes iodine and yeah, it sequesters your iodine so that your thyroid can actually use it. And then so essentially you become hypothyroid. So she was putting on weight, right? And she's, you know, we're on the gut, right? So she's, you know, more gaseous and she's constipated. And yeah, she's has that she's coming up with the severe side pain because she has this huge kidney stone that she's developed because kale has high levels of these things called oxalates in them.

Dr. Allen Bookatz (11:42)
sequester side.

Dr. Ted Achacoso (12:09)
which bind to minerals like calcium and magnesium, and then they precipitate actually in the kidney because your body's like, hey man, this is really bad for me. And it tries to get rid of it and it gets concentrated in the kidney. ⁓ going back to, ⁓ let's evaluate this potential myth. So when we look at a recommendation like that, I think we have to explore the evolutionary perspective and that's what we do really well on Home Hope. And so if we look,

we actually have evidence that humans have been cooking for thousands and thousands of years, right? We don't see, we don't really see, you ⁓ know, humans eating raw tubers. It's actually very well documented that we will boil tubers, right? And we will actually cook vegetables, we'll cook meats. so not only from a, ⁓ obviously fire was a huge catalyst of this, but cooked foods, ⁓

you know, are they are easier to digest in a way we actually are liberating energy and we're liberating those nutrients so that the time that we have to spend on chewing and digesting and it's very energy expensive for us to do that. And if you look at our actual anatomy, we have, you know, we don't we only have the stomach and we have the small and large intestine. And if you look at animals that actually can eat, can eat like rock hill and a lot of grasses.

not only is their dental structure different, but they actually have multiple different rumens that have different species of microbiota, but also different enzymes that break it down along the stage to.

Dr. Allen Bookatz (13:45)
So

guys remember when someone says you're ruminating say you're not a cow.

Dr. Ted Achacoso (13:50)
Exactly. So anyway, was ⁓ a very, ⁓ that was sort of ⁓ always, always brought me home to ⁓ why we cook. so for those that are listening, right, it's okay to lightly steam your vegetables. Obviously, you can if you boil them, then you are going to denature the vitamins. And so we want to be thoughtful with our application of thermal energy or heat, right, so we can lightly steam it, you can blanch it. And that way, you're

breaking down the cellulose, you're liberating, think about it. You just want to briefly liberate the, liberate the enzymes and liberate the vitamins ⁓ and the polyphenols so that you can easily digest it. And also you're inactivating those phytonutrients or the phyto, the phyto toxins and the, ⁓ other compounds that will, that will actually bind. And those are like the plant defenses that actually cause smaller animals to become very ill. So if you have.

Dr. Allen Bookatz (14:45)
This is actually good, Alan, because before we started our meeting earlier, there was actually a patient who just emailed me just to lose a few more pounds. She went on a raw food diet and it was all plant-based. And now she says, I don't know, I've taken out a lot of your supplements and I still have this headache that they can get rid of. Should I take out more of your supplements?

It's like, you know, and I just responded very politely and said, you know, if you really, I said, I suspect ⁓ it's ⁓ one of the macronutrients is probably missing or at a very low level. Why don't we test your levels, you know, and see what's actually driving your metabolism these days. If you're already on a one month mark, you know, we probably, you probably have induced a lot of deficiencies already because, you know, we don't have the enzymes for

most of these raw foods, right? That's why, in fact, in evolution, the discovery of fire and the invention of cooking, you know, for this, minimized actually, ⁓ maximized one thing, which is growth of humans, right? After cooking, humans were able to eat a lot more, so they started to grow more in stature, right? So those actually ⁓ humans that cook,

they actually were able to absorb more nutrients and so on. So their lines persisted, right? And they started to grow bigger also. If you take a look at the stunted growth of the earlier ⁓ species, that was before actually the discovery of, know, that you can actually cook your food. So there's an evolutionary ⁓ line for this that shows us getting bigger actually with food.

So ⁓ with cooked food, right? ⁓ The other thing that is minimized was actually it minimized a lot of infection because a lot of the viral bacterial, ⁓ viruses and bacteria in food or in soil were actually ⁓ inactivated or killed by cooking. So those two are actually of benefit, but they actually also were a non-benefit to us because then humans became overpopulated. But anyway, that's another story.

Dr. Ted Achacoso (17:12)
Ted, you probably, if anyone's been watching the news lately, There are like, it feels like there's just these continuous recalls for spinach and, know, spinach and different leafy greens with Listeria is one of the non-commensurable bacteria species that causes ⁓ profound diarrhea and vomiting and abdominal cramps and lot of sickness. And so we're actually seeing that, I mean, there are, even in today's world where we think

mass agriculture production. And triple wash should mean something, but it's triple wash and what, like just some water. So if we're looking at, you're thinking, I don't want to heat something, well, there are also other ways to prepare foods. And so if you look at ways that we would do this that align with our human evolution, fermenting foods, right? So we're allowing the microbiota, which are commensal, to do that digestion for us and break it down. Plus they're also

helpful for our own microbiota ⁓ or they help replenish. ⁓ Also sprouting would be another option available to reduce ⁓ the anti-nutrients. Then you're also also delivering a lot more energy because that plant is you're converting starches to now early proteins and ⁓ other phytonutrients that are going to be more bioavailable.

Boomer Anderson (18:34)
Jots in the house.

Dr. Ted Achacoso (18:36)
You go get, I'm gonna go you to quest bar now. With some kale chips.

Boomer Anderson (18:42)
I might bleep that one out. Tom Bellowa is going to come out. Anyway, Adam Jody in the land of raw everything.

Dr. Ted Achacoso (18:51)
Are you concerned or?

Jodi Duval (18:55)
raw smoothie bowls and all sorts going on here. ⁓ Well, I used to be on that train of raw food many, many, many years ago. And it was funny because I also worked ⁓ when I was studying, working my way through my degree, I was actually a clinic hydrotherapist. So I would say the most incredible cleansers and some clients had been on cleansers for maybe

Boomer Anderson (19:24)
These are the things

I don't know about Jody.

Jodi Duval (19:27)
I know. I did my course on it and everything. it was very interesting. So that's actually how I met some of my colleagues that I know now and how I started my business, Revital Health. I met ⁓ my business partner at the time through this. So yeah, it was very interesting. And so I got into raw food. I was living in London after this and actually got into

doing some of the raw food, pure plant foods. And yeah, was, I lost a lot of weight, but then transitioning, and I think we had a podcast not too long ago about my brisket that broke me, coming back onto meat, it was a really tricky thing to then digest meat again. And so ⁓ I didn't, and I didn't feel the greatest. Like my energy was good to start with, but it wasn't great afterwards.

And so I realized I was missing quite a lot of things from the diet that I had. And so what I naturally saw was a lot of clients coming to me that were on raw food, vegan diets. And I've commented on this before and I saw a lot of them getting really sick, really bloated, really unwell ⁓ and missing out on test results. Not only the B12 and iron, but the other... ⁓

associations with some of their vitamin A's and obviously the fatty acids and the multitudes of those that were coming through and energy production for them were especially on the metabolic testing was really low. So I was seeing some big discrepancies in that. So meat as medicine is how I got them back onto that and very gently and using digestive enzymes and helping support the gut function. But

What I saw was in these times of doing my colonic hydrotherapy is yes, the extent that people were willing to go to for cleansers. So there was parasite cleansers, was juice cleansers, there was ⁓ taking huge amounts of herbal, sorry guys, one second.

Boomer Anderson (21:40)
Get the editing mojo going

Dr. Ted Achacoso (21:42)
And

for those of us that are interested in hearing.

Boomer Anderson (21:45)
⁓

Yeah, hold on. Before Jody comes up, can we just talk about Jody was a chronic hydrotherapist?

Dr. Allen Bookatz (21:48)
little bit a

Dr. Ted Achacoso (21:54)
This is something that

we need an episode about, you

Boomer Anderson (21:57)
No, this is like, this is high. Clearly we didn't, like nobody got references before Jim came on scene.

Dr. Scott Sherr (21:59)
Thanks Jerry.

Jodi Duval (22:06)
was an experience for sure, sticking pipes up people's bottoms. I used to study a lot of poo, so I've seen first-hand a lot of different types of poo. So I must say that that's something that I pride myself on.

Dr. Allen Bookatz (22:21)
⁓ Are you sure they were just not addicted to the procedure? ⁓ Because it was pleasurable to them?

Dr. Ted Achacoso (22:27)
Yeah.

Jodi Duval (22:27)
thing.

Yeah, no, no, but I found that they got a bit of a hit from it and so I used to get repeated clinic. I had to turn people away so they would be coming in sometimes twice a week and I'm like it's not ideal that you're doing this to your body. So I would get people who are coming through even with anorexia and so I started to work with a lot of clients with eating disorders ⁓ as well and yeah I had a few clients faint.

Dr. Ted Achacoso (22:41)
If you lie now.

Jodi Duval (22:58)
on me, on the table. there was, yeah, was a very interesting time. So some of the cleansers that I saw taking herbal supplements and taking herbal strong berberine herbs ⁓ and they were getting quite sick, some like aches, cramps, pain, inflammation and causing themselves more harm than good. ⁓ Some of the myths I would get ⁓ asked would be does the colonic hydrotherapy wash out?

our natural bacteria, so do we remove it? Obviously for a short point of time you actually do remove the bacteria as the water washes through but it never completely removes it and you get re-inoculation after only 20 minutes or so but generally the gut will re-inoculate itself ⁓ and change within two to three days. So the other ⁓ ones I used to see would be people with chronic constipation.

So got very good at treating conservation ⁓ and Clostridium is a huge component of that. now I see Clostridium in really high amounts and we see this in the GIFX. We see this ⁓ also in the organic acids testing that we do in Metabolomix. And it's ⁓ very interesting to see that some of these differences and changes in the bacteria can actually cause, and our population changes can cause conservation and a lot of trouble for those clients.

So they would come in, they would try and have colonics to help support them. ⁓ had one client who had been on for 20 years. She'd taken PrEP for, so it's not drug PrEP, but she'd been taking PrEP for ⁓ before you do a colonoscopy. And the gastroenterologist had her on it for 10 to 15 years, every single day, or every second day, actually.

⁓ And then she started to have issues with that so then they put her on Epsom salts every single day. And she would show me the amount of Epsom salts she would put in the container and it was half a cup of Epsom salts that she would take every second day to actually be able to go to the toilet. And this lady had low energy brain fog.

She was going through menopause at the time. She had bloating, distension, pain. She had daggers in her stomach and she was also coming for ⁓ colonics as well. So I had to work with her for that and it was again, as we look at, especially in home home, we look at all systems. We look at the matrix and it was a lot of emotional connection for her. And what I found was there was a lot of holding on and a lot of letting go, literally.

So that was very interesting. So yes, I've seen my fair share of cleansers and that's where ⁓ today there's a lot of myths around trying to get rid of parasites, but the parasites actually aren't there. So if you test them, they don't exist. Yeah, that's my story.

Boomer Anderson (25:56)
I'm sort of left speechless here. Where to get so many questions?

Dr. Ted Achacoso (26:00)
Yeah.

Dr. Scott Sherr (26:01)
service.

Dr. Allen Bookatz (26:05)
You still can't over the fact that she was a colonic eye therapist. No, get over it already! ⁓

Boomer Anderson (26:13)
Sorry. No,

but there's a lot of questions. But I think that the parasite discussion is a very relevant one. I'm sure everybody here has had somebody come in who thinks they have parasites out the wazoo and usually, not usually, but sometimes they test out and there's nothing there. ⁓

Dr. Allen Bookatz (26:33)
Well, there's also the other part where, you know, ⁓ would you like to have some tapeworm so you can have some weight loss?

Boomer Anderson (26:40)
The OG Ozempic.

Jodi Duval (26:43)
Clients just apply online to come in and say, oh, I've just found this best weight loss pill. It's got a tapeworm in it. I'm like, what? What are you talking about?

Dr. Scott Sherr (26:51)
Helminth therapy is a real thing. Helminth therapy is a real thing. Let's not knock it, okay?

Jodi Duval (26:59)
Is it really in there though? Is it really?

Boomer Anderson (27:01)
But maybe I have like a different set of clients than you guys. I don't know. This is interesting. Okay.

Jodi Duval (27:08)
You need to venture out into the wild wild west boomer. It's fun.

Boomer Anderson (27:12)
Yeah, yeah. You want worms? Come talk to me.

Dr. Ted Achacoso (27:17)
Is this one of the don't knock it to try it or?

Boomer Anderson (27:20)
Yeah, I think it is. I think it is just a knock. ⁓ But all right, let's dismount over to Dr. Ted here, who's going to take us through his favorite ones.

Dr. Allen Bookatz (27:33)
No, actually, my favorite one is sort of like, I think a failure of logic on our parts, ⁓ you know, especially if we are looking at ⁓

mostly metabolic issue and solving it with something surgical. Ever heard of like gut health makeovers by surgery in order to lose weight? You know, I've been in practice for such a long time that I was scratching my head when people were recommending intragastic balloons, right? You put in a balloon in there so that you decrease the drastic volumes. And I have patients actually asking me for this. you know, I said,

Well, it doesn't solve the problem, right? And actually, ⁓ there's a lot of complications for intragastic balloons. But that was just the beginning. I don't know why we're insisting because we're so good on quick fixes, right? And they're actually selling this in the market as gut health makeovers.

And when a patient comes to me, it's like, ⁓ asking one of these, I just have to present them with the data of what complications they're going to have. The other one is the lab band. Remember when the lab band was so popular among the Hollywood stars? And I had some patients in there, in that crowd who were actually asking me about the lab band, right? So there's a... ⁓

30, you know, I'm looking at the data now, it's like 36 to 66 % re-operation at 10 years, right? And then, you you remember the endoscopic sleeve gastroplasty, I would put that surgical sleeve location, right? So, they essentially, they're folding the stomach unto itself, right? So, they cinch the stomach, right? So, it's smaller, it's like...

Yeah, but you're still not going to stave off the appetite and everything, right? It's just like this mechanical way that we're looking at this thing. And of course, ⁓ one of the ones that I actually was throwing up at was the duodenal-geogonal bypass. Remember those, Alan? Did you have patients from LA who had duodenal-geogonal bypass entering your ⁓

ER with fulminant hepatic abscess. And the one that I was glad that actually came off the market was what's called the medically sanctioned bulimia. It was called Aspire Assist, aspiration therapy. There's a percutaneous tube that lets patients drain 20 to 30 % of a meal into the toilet. And it was called medically sanctioned bulimia. ⁓

Dr. Scott Sherr (30:27)
So

I have never. Wow.

Dr. Allen Bookatz (30:30)
You know,

I've heard of this and, you know, because the crowd that I was with before was the Hollywood set, right? They wanted, you know, they didn't want to wait two weeks, you know, to fit into a little black dress. They wanted like, tomorrow, I need to fit in there, right?

Dr. Scott Sherr (30:33)
I heard of that.

Dr. Ted Achacoso (30:50)
And their teeth, right? mean, yeah, can't be messing up the teeth.

Dr. Allen Bookatz (30:53)
And

then ⁓ the last one is ⁓ the one that was also taken ⁓ off market, right? ⁓ there's a pulse generator is called the V block. It was by Maestro. ⁓ I don't know whether or not any of you heard of this, but essentially it's a vagal nerve blockade, right? So there's a pulse generator that curbs the hunger signals, right? But they found out it actually doesn't beat the sham and

the surgeons described the system as a pacemaker looking for an indication. They were actually just putting it in to see whether or not it will curb your hunger. So because ⁓ there's a society center in the brain, right, that is triggered by ⁓ the increased volume of the stomach, ⁓ and it's a vagal nerve signal, right? So that's actually quite interesting.

that we are actually, ⁓ surgeries for the gut for weight loss are some of the worst ideas that I've ever encountered is because we're looking at the most limited metabolic issue and solving it with something surgical, right? And that's because of our instant gratification thing. It's kind of like health optimization medicine and practice, right? We balance the hormones and the nutrients. ⁓

of the body, it may take us three months, six months, nine months, right? And what I tell my patients and my clients is that you did not get into this state overnight. It took you 40 years to get here. What makes you think that overnight you can get fixed, right? And that kind of mentality, the silver bullet mentality that one procedure is gonna do it, it's sort of anathema to the practice of optimizing health because optimizing health is continuous.

Right? The goal is to optimize it every day. Every day you have your, you know, you're balancing out your nutrient metabolism sample, and then you're also optimizing your lifestyle. Right? ⁓ And this is actually, you know, ⁓ based on the cellular performance and also based on your age. Right? So ⁓ the other things that, you know, annoy me are,

exercises or diets that they recommend for people, but they don't actually show which age group is actually appropriate for. These are the things that are very bothersome because these various different age groups would have different nutrient requirements. The only time that you could definitely objectively say what the requirements are is when you test where the metabolites are. All of this gut advice,

cleaning up your, you it's actually very timely that Jody mentioned something about the colon, you know, in during the last episode that we had, I had a patient actually wanting to take off all of the hormones and nutrients because she was feeling so good after her colon, after her colon hydrotherapy, right? And it's like,

Yeah, this is exactly why we measure stuff, right? It's just just because you you experience a tiny blip in feeling good doesn't mean that you can remove everything else, right? In fact, probably the reason why you feel good after you got it was because you were balanced enough to withstand the assault of what was done to you. Right. So

⁓ So these are the things that I still find it very bothersome that we would rather aspirate the SOMAC and actually let out the food in the toilet, ⁓ rather than actually address this for the longer term. So that's what ⁓ this advice that our patients get.

you know, because they're exposed to all of this, they're exposed to the social pressure, to pressures of their job. You know, it's really our ⁓ mandate to educate them when they come with us. So we come with these funny stories, we come with icky stories, we come with horror stories about surgeries, right? For those of you who have managed, you know, like I have, for example, I've managed ⁓

lap bands and intragastic balloons personally, and one patient with a duodenal-gygienal bypass, which was horrible, right? ⁓ But the aspiration therapy, I only found out about that in Hollywood really is like shit, you know? And these are the kinds of things that show us our impatience towards taking care of our health.

So when we take care, when you optimize health, we have to be patient, right? Because as I always say, you you have to coax grandma. We have an ancient system, right? We have a ⁓ system that evolved to the environment of the time, right? It is not to this world that we have created, but to the environment at the time. So we're definitely have the hunter gatherer habitus, right?

And then we have created a world that is essentially ⁓ an impedance mismatch with our Megan model. And so when we get all of these types of advice, you basically shocking the system, right? And, ⁓ you know, we ought to use, you know, the science that we have today, like metabolomics, et cetera, to determine exactly what's going on, right? ⁓ You know, obesity, for example, as I said.

can be linked to lack of sleep or can be linked to ⁓ excessive use of antibiotics. There was a doctor before who actually told me, said, Ted, if you want a gastric microbiome reset, just give your patient a ton of antibiotics. And of course, this guy was an infectious disease person. It's just like, pow. These are the kinds of things that you get from specialists.

And if it's GERD, hey, you have to give proton pump inhibitors. ⁓ These are the kinds of things that are now not funny. They're bordering on the horror mode for me if you see the longer term effects of these drugs and surgeries, cetera. So guys, my thing is that if you want to have a gut health makeover,

get your nutrient metabolome taken, get your poop tests, take a look at what you have in there, get your food sensitivities done, and then we can start slowly working with you. What a concept, right? We're not telling you what to do. We will work with you on how to actually make that gut healthy. And remember, it's not an overnight affair. And that's how I would like to close this.

Do not swallow anyone's poop.

Dr. Ted Achacoso (38:18)
Yeah.

Yeah, everyone cross it off your.

Dr. Scott Sherr (38:22)
Do have to say that really? Is that something that we have to really have to really say?

Dr. Allen Bookatz (38:28)
Well, you know, Scott, it's a fetish for some people. Ever heard of coprophagia? ⁓ I mean, Cleveland Seamers are not enough, you know, you have to be coprophagic.

Dr. Scott Sherr (38:34)
It's a thing.

Boomer Anderson (38:36)
Yes, yes. All right.

Dr. Ted Achacoso (38:37)
Yes, yes.

Dr. Scott Sherr (38:45)
That's the late iPod. Okay, I'll stop now. 1900, Dr. Ted.

Dr. Allen Bookatz (38:46)
What's up now?

Boomer Anderson (38:49)
Just we might want to start buying keywords on Google on coprophagia, but. ⁓

Dr. Scott Sherr (38:55)
I think they're gonna be pretty inexpensive. Inexpensive keyboards. You know, those kinds of things.

Boomer Anderson (38:58)
Yeah, you'd be surprised, right?

be quite expensive. All right. Anyway, guys, thank you for joining us. And I am continually baffled at these conversations as to where we end up in everybody's department. whether it's learning about colonic hydrotherapy, or you know, some of the things that Dr. Buchhass was talking about, and actually kale and the kale queen, or, you know, here in

stomach stapling blues traveler style to dismount. ⁓ anyway, thank you guys for joining and ⁓ everybody have a wonderful day and to those listening, please continue life smarter. Good.

Dr. Scott Sherr (39:43)
Thank you so much, all of you, for tuning in to the Smart Not Harder podcast, where we give you one-cent solutions to $64,000 questions. You've been here with the hosts of the Smart Not Harder podcast. We're so excited to have you. Please come again, like and subscribe. Until we see you next time, good evening, good morning.

Dr. Allen Bookatz (39:59)
Goodbye.

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