Dr. Steven Gundry:

Welcome to the Dr. Gundry Podcast. Lately, I’ve been starting the show off with one of your voice notes about how the podcast or my eating protocol has changed your life. But today I’m starting out with a birthday wish. This request is from 15-year-old Nathan, who emailed saying, “My dad is a huge Dr. Gundry fan and his birthday’s coming up. He used to be very unhealthy with his diet, but when he found Dr. Gundry, he has dedicated years to a true Gundry diet and gotten significantly healthier. I’d love to surprise him with something special related to Dr. Gundry. Whenever he’s talking about food, he always references Dr. Gundry in his books. I was wondering if he offered any personalized video messages.”

So, in honor of Nathan’s thoughtful request for his dad, the answer is yes. Happy 62nd birthday, Alan. And here’s to at least sixty-two more vibrant years. Keep going strong.

[1:06]

Welcome to the Dr. Gundry Podcast. Well, folks, today we’re gonna talk out loud about the one thing nobody talks out loud about. Because what lands in your toilet every day is the most honest report card your body will actually ever hand you. So get the giggles out right now and let’s answer the questions you’ve always wanted to ask, but were too polite to say in mixed company.

[1:42]

We’re going to try to do this rapid-fire because you are loaded with questions. All right, number one: how often should I be pooping and how long should it take? Well, normally most people go once a day, but going twice a day is absolutely normal, and going every other day is absolutely normal. Any more than that, you probably are looking at an issue that we’ll get to in a minute.

[2:11]

How long should it take? It depends on how big your poop is and/or how small your poop is. There is really no time period. Believe it or not, the reason there are books like My Daily Bathroom Reader in bathrooms is that sometimes people just like to take the time, catch up on the news, read an entire chapter in a novel, and not really think about “well, do I need to strain, do I need to push?” Just enjoy.

[2:35]

Number two: what should a healthy poop look like? Well, as you probably read in The Plant Paradox, if everything is right, when you look down the toilet, you should see a giant coiled snake looking back up at you. And I do mean that sincerely. I got one here. That’s not a bad look, but it ought to look like a giant coiled snake.

[3:04]

Now, what most people don’t realize is that almost all of your poop is actually composed of living and dead bacteria. It’s not waste. It’s not the stuff you ate; it’s mainly bacteria. If you give your bacteria what they want to eat, they will make lots of baby bacteria, and your poop will get bigger and bigger and bigger. If you don’t give them what they want to eat, then there’s not going to be a lot that you’re going to see in the bowl. It’s basically as simple as that.

[4:00]

Number three: sometimes I see blood in my stool. Should I see a doctor? Yes, you should. But a word to the wise: if it’s on the outside of your stool, or when you wipe, you have bright red blood, or you see bright red blood dripping into the toilet, nine times out of ten it’s a hemorrhoid. Now, these are not dangerous in themselves. But if your stool is actually more of a maroon color, like a glass of red wine, that’s far more interesting. In either case, blood is not a sign of health, and yes, you should have it checked out.

[4:30]

Next: about half of my bowel movements in a week are explosive. Do I need to see a doctor? Well, yes, but here’s the problem. Many well-meaning GI doctors, gastroenterologists, have not been trained in the gut microbiome. They’re far more interested, and I don’t blame them, in looking for polyps, cancer, ulcers. They can look for colitis, and they’ll biopsy for it, but oftentimes they don’t actually know what to do about it.

[5:30]

But if you’re having explosive bowel movements every other day, something’s not working properly in your gut. One of the things I learned a long time ago, and I’ve been at this for over 25 years, is that if your bowels are being irritated by something, then your bowels want to get it out of you as quickly as possible. If you have a virus or a common parasite like Giardia, usually your bowels want to get it out of you quickly. But if it’s coming and going, that’s something different.

[6:00]

Next question: how do I know I actually finished, that it was a complete poop? Boy, that’s a really easy one. If you feel like you still have to go, then you need to go. But there’s no such thing as a complete poop. There’s always stuff coming down the pipeline. So that’s not meaningful.

[6:29]

The next question: why do I only get little hard pellets? Two good reasons. Number one, you didn’t give your bacteria anything to eat. We usually see this when people do an Atkins diet or a high-protein diet or a keto diet, where really all you’re eating is fat and some protein. The second thing that I see is you’re not getting enough fluid in your system. Particularly, that’s true in the summer. Also, in the summer, you tend to sweat out a lot of electrolytes: sodium, chloride, and magnesium. All three of those are essential to make muscles in your GI tract and elsewhere work properly. That’s why it’s a really good idea, particularly in the summer, to make sure you’re taking an electrolyte powder or drink.

[7:54]

Next question: is something wrong with my digestion or gut health if I often see undigested food in my stool? Yes. We test stools on most of our patients, and a great number of my patients have either bile insufficiency or pancreatic enzyme insufficiency. We often see undigested protein and/or vegetable matter in people’s stool tests. That’s something you really want to know. Usually, we can put people on a very simple digestive enzyme, which you can get over the counter, and when we see the stool tests the next time, usually that solves the problem. However, there can be bigger problems lurking upstream, particularly in your liver and your pancreas. If a simple enzyme replacement doesn’t solve the problem, that’s when we have to look further.

[8:51]

Next question: when am I officially constipated? Like, how many days of not pooping? Well, as I said, going every other day is not unusual for a number of people. But if it’s taking three, four, five days, then you’re officially constipated.

[9:17]

Next question: why did going low-carb carnivore back me up? Well, I think I’ve already mentioned this. If you do not feed your gut buddies what they want to eat, and that is primarily soluble fiber, then they’re not going to make a lot of themselves, so you’re not going to have a big poop.

Next question: everyone says eat more fiber. Does soluble fiber alone fix it? Well, if you’ve read any of my more recent books like Gut Check, you should know that no, soluble fiber alone does not fix the problem. What we’ve learned now is that bacteria in the gut actually have to be supplemented with fermented foods, postbiotics, to get the benefits of you eating more fiber.

A beautiful study out of Stanford University showed that just adding fiber to people’s diets did nothing to improve their bacterial diversity in their gut, which is a good thing, and did nothing to improve their inflammation markers. However, when that fiber was supplemented with fermented foods, in this case yogurts and kefirs, then and only then did the gut diversity get better and the inflammation markers get lower. I detail this in Gut Check, so check out that book.

[10:44]

Next question: why did my poops get so much bigger when I started eating more plants? Well, duh, the plants have a lot of fiber, and that’s exactly what your gut buddies want to eat. That’s why they got so much bigger.
Next question: why does my poop smell so terrible? Maybe it’s you. There are many, many smells and gases that a normal set of bacteria can make. For instance, the famous hydrogen sulfide smell, a rotten egg smell. Hydrogen sulfide gas is actually a normal product of digestion, and in the right amount, it’s actually good for you. Methane, the so-called cow fart, is a normal product of bacterial fermentation. Depending on which bacteria are getting what they want to eat, the smell of your poop will change.

[11:39]

Next question: is all this gas normal or a problem? Well, here’s the deal: when you start feeding bacteria more and more soluble fiber, they ferment that soluble fiber and make lots of gas. That gas is actually beneficial, although it may be uncomfortable. What’s interesting is that if you change nothing, within two or three weeks all that gas production subsides because you’ve now reached a new normal. So what I ask my patients is simply to step on the gas. It’s going to go away, but that gas production is a very beneficial finding.

[12:37]

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[13:45]

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[15:24]

All right, next question: my poop floats and looks greasy. Should I worry? Yes, indeed you should. The reason your poop floats is usually one of two things. Either you’ve added a whole lot more fat to your diet, and fat floats in water, or you now have a digestive enzyme problem, particularly bile and pancreatic enzymes that break down the fats in your diet and allow them to be absorbed. If that’s what’s going on, the first thing you do is lower the amount of fat you’re eating. If that solves the problem, no worries. If the problem is still there, then it’s time to worry and get yourself a stool test. Not the one that your doctor orders, but an actual one from a stool-testing lab.

[16:23]

Next question: why does coffee make me run to the bathroom? Well, it turns out, two reasons. Number one, caffeine is really good at stimulating muscles, as any athlete knows. Usually, the caffeine in coffee does it. But coffee also has a number of polyphenols and fermentation products that can contribute to bathroom regularity. So, two reasons.

[16:42]

Next question: is there a right way to sit on the toilet? You see this on YouTube, you see it on TikTok: you gotta sit up like an animal or bend over. However you’re comfortable sitting on the toilet is the right way to go. Next question: what do you think of the Squatty Potty? Like I said, however you want to sit on the toilet is just fine. Just remember, nobody had a toilet to sit on for millions of years. Your dog doesn’t sit on a toilet and seems to do just fine. So, however it works for you. In Boy Scouts, we had no toilets. We sat on a log. Seemed to work just fine.

[17:19]

Next question: you talk about all kinds of different microbiomes in the body. Does the anus have one too? If so, do adult wipes disrupt this? Well, every last inch of you has a microbiome. Your skin, your anus, everything in you. Your breast tissue has a microbiome; your prostate has a microbiome. Wiping it away from the anus with an adult wipe really isn’t going to change anything. But the first question you have to ask is, speaking of dogs, your dogs do not use adult wipes after they go. One of the things that strikes my patients as so amazing is that after they work at this, they no longer need toilet paper. Just like your dog doesn’t need toilet paper. So if you’re using an adult wipe, there’s a problem.

[18:13]

What does the color of my poop mean? is the next question. Well, it can be the food you eat. For instance, when you’re on a beet kick, your stool looks kind of beety. On the other hand, when you’re on a pale-food kick, it looks kind of pale. The one thing you really want to look for is that you don’t want to see a burgundy-colored stool consistently. That’s usually a sign of intestinal bleeding. And you don’t want to see a clay-colored stool, which is even worse. Clay, very, very pale. That usually means there’s a bile obstruction or one is starting to develop.

[19:00]

Next question: are laxatives okay to help with constipation? Well, having never taken a laxative in my life, I’m a bad person to talk with. But most of the time, the only laxative you ever really need is some form of magnesium. In fact, the original laxative was milk of magnesia. Magnesium is really critical to make your intestinal wall move properly. So the first guide is to get yourself some magnesium. The most potent of the magnesiums are magnesium citrate, which is usually in a liquid form, magnesium glycinate, magnesium glycine, and magnesium aspartate. Everybody’s got a particular brand they like.

One of the things I’ve seen is that most people who are using it to help them have bowel movements aren’t taking enough. That’s usually the problem. Most women need three to four hundred milligrams of magnesium a night, but I’ve seen some men and some women need 1,600 milligrams of daily magnesium to be regular. So if you’re taking magnesium and it’s not working for you, it’s usually the amount you’re taking.

[20:25]

Which leads me to the next question: I’ve taken magnesium for constipation, and it doesn’t help. Why? Well, usually because you didn’t take enough. Simple as that.

[20:39]

Next question: how do I start with psyllium? Psyllium fiber is a great soluble fiber. It’s from the psyllium seed. Usually you get it as psyllium husks, either as a powder or in capsules. What you want to start with is about a teaspoon of psyllium powder a day, and work your way up. There’s no upper limit to fiber. Just remember, our hunter-gatherer ancestors usually got about 150 grams of fiber a day. Most Americans don’t even get five grams of soluble fiber a day. So think about that.

[21:08]

What do you think of colon hydrotherapy? I think it should be banned. That’s what I think. The idea of cleaning out your colon with colon hydrotherapy started in the late 1800s with a movement called autointoxication. It actually had a really good reason initially, which was wrong. It was thought that all these products of bacteria growing in our colon were very dangerous, and that these byproducts of bacteria, which we now call endotoxins, were the cause of all diseases. So the idea was that we should get rid of all these bad guys and clean the pipes, as some say. The problem was that it was taken to extremes: in the 1930s and ’40s, a number of people, I kid you not, had their entire colons removed and all of their teeth pulled so that there could not be a chance of autointoxication.

[22:05]

Now, having said that, we now know that the problem is not the bacteria themselves, but the porosity, the leakiness of the wall of the gut. So rather than trying to clean out the bacteria, what I do with my patients is have them stop swallowing razor blades that rip open the wall of the gut, and that solves the problem. In fact, we know now that the more diverse your microbiome is, the better. The better the balance between good guys and bad guys, the better you’re going to do long term.

[23:01]

Next question: when I travel, sometimes I hold back from pooping due to being in a strange place. Is that bad? Yes.

Next question: what should I do starting tomorrow morning for perfect poops? Boy. Which book do you want to read first? All of my books are really dedicated to helping you have perfect poops. In fact, I have a huge painting in my office that says, “The road to health is paved with good intestines.” And I couldn’t agree more. Starting tomorrow, one of the first things you can do is start adding more soluble fiber and fermented foods to your diet.

[23:45]

Next question: which of your products will help me have the perfect poop? Well, really the number one and two products of mine, which were designed to help with this, are Biocomplete 3 and Total Restore. Biocomplete 3 was the first product with probiotics, friendly bacteria, prebiotics to feed the friendly bacteria, and postbiotics in the form of a short-chain fatty acid called butyrate that could actually get to the colon, that was ever designed. And it’s still my number one selling product. Total Restore was designed to heal what the razor blades were doing to the wall of the gut. And you actually have to have both. If you keep swallowing razor blades, you can have the perfect microbiome, but you’ll still have leaky gut. On the other hand, you could have a wonderful wall of the gut but a horrible set of bacteria. So you gotta have both at a time to fix everything.

[24:59]

Do bowel habits change as I age? No, that’s a misnomer. As you age, your bowels do not slow down. What happens is the damage to the wall of your gut intensifies as you age. And that’s what’s really the problem.

[25:21]

Next question: I’ve heard you reference in lectures before about fecal transplants. Do you recommend getting one? And how do I get the right fecal transplant from a healthy person? Well, the good news is you can’t get a fecal transplant in the United States unless you are suffering from an uncontrollable infection from C. difficile, an overwhelming bacterial infection of the colon. The FDA does not allow fecal transplants except in those circumstances. Yes, you can get them in foreign countries, but no, a normal person does not need them.

The second thing that’s interesting is that we have had researchers who have visited modern hunter-gatherers like the Hadza and gotten themselves a fecal transplant from the Hadza. And sure enough, their bowels changed for about a week. Their feces completely changed over to that microbiome, but then it completely changed back when they returned home. Why? Because the foods that we eat here are totally different from the foods hunter-gatherers eat. So you could get a new transplant, but it’s not going to take.

[26:30]

All right, so that’s probably more than you ever wanted to know about poops. But remember, the road to health is paved with good intestines.

[26:57]

Now it’s time for the question of the week. This comes from Carol Armcharbot 7560 on my YouTube video on creatine. They asked, “My husband and I have been wondering if creatine only applies to people who train a lot. We walk a lot, but that’s about all.” Well, the research is getting stronger and stronger that creatine isn’t just for bodybuilders. In fact, creatine is an essential component of ATP production, and more and more research points to its effect on brain health and memory. So no, it’s not just if you’re pumping iron. You want to pump iron in your brain, if you will. Five grams, maybe ten grams of creatine per day looks like a winner for almost all of us. That’s why I made my new formula, Myoptide Complex, which includes a full five grams of creatine in every scoop.

[27:56]

Now it’s time for the review of the week. This one comes from MathMark100 on my YouTube video on olive oil shots. They said, “I bought The Plant Paradox and I’ve been doing the program for about a year. It’s been easy. I haven’t been hungry. I’ve lost 65 pounds. I started working out again. I’m starting very slowly. So far I’m feeling really good. I’m starting to gain strength and stamina. I can’t wait to get back to living a normal life again. Thank you for all your help.” Well, thank you, MathMark. This is why I do this. This is why I still see patients six days a week: to get letters like yours that show it really helps. Thanks for writing in, and keep up the great progress.

[28:54]

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[29:31]

That’s a wrap on today’s episode. Before you go, I want to leave you with one task. If anything you heard today made you think, made you want to dig deeper, or gave you something you’re going to pass along to someone you care about, please take fifteen seconds and leave a five-star rating and review on Apple Podcasts or Spotify. I know that sounds small, but those reviews are how Apple and Spotify decide which shows to surface to new listeners, and this show only grows when people who’ve never heard of it suddenly find it.

That person finding this podcast today could hear something that genuinely improves their life or the life of someone they love, maybe even saves one. Everything I share here comes from my research when writing my next book and my clinics, where I’ve been seeing patients six days a week for over 25 years, working with nutrition and supplements as the primary treatment. This is real-world medicine. Help me get it to more people.

And thank you. Truly, thank you. I’m Dr. G, and I’m always looking out for you.