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#95 - Bacteriophages: Can Viruses Help Restore Your Gut Microbiome?03 Nov 202600:35:12

What if we could target problematic gut bacteria without wiping out the rest of the microbiome?

In this episode of The Turd Nerds, we're diving into the fascinating world of bacteriophages (phages) — viruses that infect bacteria and are being explored as a more targeted approach to treating bacterial infections and gut dysbiosis.

Dr. Ilana Gurevich takes Rebecca and Ami through the history of phage therapy, why antibiotics largely replaced it, and why researchers and clinicians are taking another look at these tiny bacteria-targeting viruses.

We explore what makes phages so interesting: their ability to target particular bacteria while potentially leaving much of the surrounding microbiome undisturbed.

Ilana also shares her clinical experience using bacteriophages in patients with persistent gut dysbiosis, including difficult-to-address organisms such as Pseudomonas and Klebsiella. We discuss how she approaches stool testing, biofilms, treatment sequencing, and assessing patient response.

And, because we're the Turd Nerds, the conversation doesn't stop there. We get into microbiome restoration, fermented foods, prebiotics, histamine, hormones, gut motility, nutrient absorption, and even a tangent about iron supplementation.

In This Episode:

  • What bacteriophages are and how they work

  • Why phages are different from conventional antibiotics

  • The history of phage therapy and why it's making a comeback

  • How phages target specific bacteria

  • Why matching the right phage to the right bacterium matters

  • Using phages for persistent gut dysbiosis

  • Pseudomonas, Klebsiella, and other difficult-to-treat bacteria

  • The relationship between phages and bacterial biofilms

  • Ilana's clinical experiences and patient cases

  • Potential side effects and limitations of phage therapy

  • How prebiotics, fermented foods, and fiber fit into microbiome restoration

  • Why addressing gut dysbiosis may sometimes help with persistent digestive symptoms

The big takeaway?

Phage therapy offers an intriguing possibility: instead of broadly suppressing bacteria, could we target specific problematic organisms and allow the rest of the microbiome to recover?

There's still a lot to learn, especially about how best to use phages in gastrointestinal disorders, but the science and clinical possibilities make this an area worth watching.

If you're a clinician working with stubborn gut dysbiosis — or someone who's curious about the future of microbiome medicine — this episode is for you.

Music provided by Blue Dot.

👋 Connect with the Turds!

👋 Rebecca Sand ND, LAc, MSOM

https://www.drrebeccasand.com/

@drrebeccasand

👋 Ilana Gurevich ND, FABNG, LAc, MSOM

https://www.openwellnesspdx.com

@openwellness_pdx

@ilana.gurevich

👋 Ami Kapadia, MD, ABFM, ABIHM

https://www.amikapadia.com/


#94 - Why SIBO Keeps Coming Back: Finding the Underlying Cause with Dr. Allison Siebecker20 Oct 202600:30:10

Why does SIBO keep coming back?

Treating bacterial overgrowth is one thing. Figuring out why it developed in the first place is an entirely different challenge.

In this episode of The Turd Nerds, we’re joined again by SIBO expert Dr. Allison Siebecker to dig into the underlying causes of SIBO and, more importantly, how to think through them clinically.

Allison walks us through a simple framework for understanding SIBO: What allowed bacteria to accumulate where they shouldn’t? We look at the body’s natural defenses against bacterial overgrowth, including stomach acid, bile, digestive enzymes, immune function, normal anatomy, and, perhaps most importantly, the migrating motor complex.

From there, we get into the many things that can disrupt those protective mechanisms, including food poisoning, adhesions and abdominal surgery, Crohn’s disease, endometriosis, Ehlers-Danlos syndrome, diabetes, hypothyroidism, Parkinson’s disease, chronic stress, medications, immune dysfunction, and mold illness.

We also tackle some of the messier questions: Do PPIs actually cause SIBO? What about antibiotics? What are GLP-1 medications doing to motility? And why can two patients with the same SIBO diagnosis need completely different approaches?

In This Episode:

✔ Why the migrating motor complex is so important in preventing SIBO
✔ The “river vs. swamp” analogy for understanding bacterial overgrowth
✔ How food poisoning can damage the migrating motor complex
✔ Structural causes of SIBO, including adhesions, strictures, surgery, and altered anatomy
✔ Crohn’s disease, the ileocecal valve, and SIBO risk
✔ Endometriosis and Ehlers-Danlos syndrome
✔ Diabetes, hypothyroidism, Parkinson’s disease, and impaired motility
✔ Chronic stress and the migrating motor complex
✔ PPIs, antibiotics, opioids, and GLP-1 medications
✔ The conflicting research on antibiotics and SIBO risk
✔ Mold illness and difficult-to-treat SIBO
✔ Immune dysfunction and bacterial overgrowth
✔ Why food poisoning may be worth investigating even when a patient doesn’t remember getting sick
✔ Why recurrent SIBO often requires looking beyond another round of treatment

The big takeaway? SIBO isn’t necessarily a one-size-fits-all disease. Understanding why someone developed it can help explain why it keeps returning and may change how we approach treatment and prevention.

If you’ve ever treated SIBO only to have it come roaring back, this episode is for you.


Music provided by Blue Dot.


👋 Connect with Dr. Allison Siebecker

⁠⁠https://www.siboinfo.com/⁠⁠


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM


Ilana Gurevich ND, FABNG, LAc, MSOM


Ami Kapadia, MD, ABFM, ABIHM

#93 - SIBO Testing Has Changed: What You Need to Know with Dr. Allison Siebecker06 Oct 202600:31:17

SIBO testing used to feel pretty straightforward. Take a breath test, look at hydrogen and methane, and make a treatment decision. But the world of SIBO testing is changing fast.

In this episode of The Turd Nerds, we’re joined once again by SIBO expert Dr. Allison Siebecker to break down some of the newest research in SIBO and breath testing, including updates presented at Digestive Disease Week (DDW).

We dig into FoodMarble and how this handheld breath-testing device is being used in research, how it compares with traditional breath testing, and where we still have questions. We also take a deeper look at Trio-Smart, evolving hydrogen sulfide cutoffs, methane interpretation, and the mysterious “flat-line” breath test.

And because we’re the Turd Nerds, we obviously take a few detours, including some fascinating new research suggesting methane production may change during the menstrual cycle. Yes, there may actually be a reason for all that PMS bloating and constipation.

In This Episode:

✔ What’s new in SIBO breath testing

✔ FoodMarble vs. traditional SIBO breath tests

✔ What recent research tells us about FoodMarble

✔ Why timing and test duration matter

✔ Hydrogen, methane, and hydrogen sulfide are interpreted differently

✔ New thinking around hydrogen sulfide levels between 1.5 and 2 ppm

✔ When a “borderline” result may or may not warrant treatment

✔ How to interpret a flat-line breath test

✔ Why methane may increase during the second half of the menstrual cycle

✔ SIBO, constipation, PMS, and endometriosis

✔ Why restrictive SIBO diets don’t have to be perfect to improve symptoms

✔ New evidence addressing whether breath tests actually reflect gases in the small intestine

SIBO testing is evolving, and this episode is a reminder that the number on the test is only one piece of the clinical picture. We’re talking about what the latest research tells us, where the evidence is getting stronger, and where there are still plenty of questions.

If you diagnose or treat SIBO, or you’ve ever stared at a breath test wondering, “What the hell am I supposed to do with this?” — this episode is for you.


Music provided by Blue Dot.


👋 Connect with Dr. Allison Siebecker

⁠⁠⁠https://www.siboinfo.com/⁠⁠⁠


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM


Ilana Gurevich ND, FABNG, LAc, MSOM


Ami Kapadia, MD, ABFM, ABIHM

#92 - SIBO Treatment Is Changing: Herbs, Probiotics & Prokinetics with Dr. Allison Siebecker22 Sep 202600:33:21

SIBO treatment continues to evolve—and Dr. Allison Siebecker is back on The Turd Nerds to break down even more of the latest research on how we treat SIBO and intestinal methanogen overgrowth (IMO).

In Part 2 of our SIBO research update, we move beyond conventional antibiotics and dig into new data on herbal antimicrobials, probiotics, prokinetics, gut motility, and post-infectious IBS.

We start with new human research on an herbal antimicrobial combination containing allicin, neem, and pomegranate peel, including its effects on hydrogen and methane production and SIBO symptoms.

Then we tackle one of the more controversial questions in SIBO care: probiotics. Can probiotics actually improve SIBO treatment outcomes? Allison walks us through new research on Saccharomyces boulardii, Bacillus coagulans, E. coli Nissle 1917, synbiotics, and probiotics used alongside rifaximin.

We also take a deeper look at two of our favorite prokinetics. New research on Iberogast suggests its benefits may extend beyond motility and symptom relief to include prebiotic, anti-inflammatory, and intestinal barrier effects. And prucalopride may be doing much more than helping patients poop—with emerging research exploring cognition, enteric nerve regeneration, visceral sensitivity, and the gut-brain connection.

Finally, Allison gives us an update on research into post-infectious IBS and SIBO, including work targeting the anti-vinculin pathway that could eventually change how we approach SIBO that develops after food poisoning.

IN THIS EPISODE:

• New research on herbal antimicrobials for SIBO
• Allicin, neem, and pomegranate peel for hydrogen and methane
• Can probiotics improve SIBO treatment success?
• Saccharomyces boulardii, Bacillus coagulans, and E. coli Nissle
• Probiotics alongside rifaximin
• Iberogast as a prokinetic, prebiotic, and gut-barrier support
• Prucalopride and intestinal nerve regeneration
• Prucalopride, cognition, and the gut-brain connection
• Motility and visceral hypersensitivity
• Anti-vinculin antibodies and post-infectious IBS
• What future SIBO treatment may look like

Whether you treat SIBO every day or you're trying to understand why it keeps coming back, this episode offers a look at how rapidly the SIBO treatment landscape is changing.


Music provided by Blue Dot.


👋 Connect with Dr. Allison Siebecker

⁠https://www.siboinfo.com/⁠


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM


Ilana Gurevich ND, FABNG, LAc, MSOM


Ami Kapadia, MD, ABFM, ABIHM

#91: What’s New in SIBO? The Latest Research from DDW with Dr. Allison Siebecker08 Sep 202600:30:32

In this episode of The Turd Nerds, Dr. Ilana Gurevich and Dr. Rebecca Sand sit down with Dr. Allison Siebecker, one of the leading voices in small intestinal bacterial overgrowth (SIBO), to break down some of the most exciting new SIBO research presented at Digestive Disease Week (DDW).

From emerging treatments for intestinal methanogen overgrowth (IMO) to new ways of making rifaximin more effective, Allison walks us through what may be coming next in SIBO treatment—and what clinicians can potentially use now. The conversation explores a new methane-targeting molecule designed to reduce methane production without killing methanogens, as well as research combining sustained-release N-acetylcysteine (NAC) with rifaximin to improve antibiotic delivery in the small intestine.

We also dive into surprising new research examining the relationship between methane and body weight, including evidence suggesting a U-shaped relationship between methane levels and BMI, with higher methane levels seen in both underweight and obese populations.

Finally, we take a closer look at new research on the elemental diet. Allison discusses impressive eradication rates for hydrogen SIBO, its effectiveness in methane-positive patients, and emerging evidence that elemental diets may reduce Candida while preserving beneficial small-intestinal commensal organisms.

In this episode, we explore:

• What’s coming next for methane/IMO treatment
• A new molecule that may suppress methane production without antibiotics
• Why sustained-release NAC may make rifaximin more effective
• Whether rifaximin doses could eventually be reduced
• The surprising connection between methane and BMI
• Why clinical observations sometimes precede published research
• New data on elemental diets for SIBO and IBS
• Elemental diets, Candida, and the small-intestinal microbiome
• When an elemental diet may be worth considering clinically

Whether you’re a clinician treating SIBO every day or someone struggling with recurrent SIBO or IMO, this episode offers a fascinating look at where SIBO research—and treatment—may be headed next.


Music provided by Blue Dot.


👋 Connect with Dr. Allison Siebecker

https://www.siboinfo.com/


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM


Ilana Gurevich ND, FABNG, LAc, MSOM


Ami Kapadia, MD, ABFM, ABIHM

#90 - When Acne Isn't Hormonal: The Hidden Gut Causes of Chronic Acne25 Aug 202600:30:20

Can acne start in the gut?

In this episode of The Turd Nerds, we're joined once again by Dr. Megan Larravey for a fascinating case-based discussion exploring the connection between chronic acne, gut health, H. pylori, dysbiosis, and inflammation.

We walk through the case of a woman in her 30s who developed persistent cystic acne despite eating a clean diet, using clean skincare products, exercising regularly, sleeping well, and trying many conventional and natural treatment approaches. With no obvious hormonal pattern and no significant digestive symptoms, her case challenged many of our assumptions about what drives chronic acne.

What we found highlights the powerful relationship between the gut microbiome and skin health—and why some skin conditions may be rooted in underlying gastrointestinal dysfunction, even when the gut appears perfectly healthy.

✔ Why acne isn't always a hormone problem

✔ The surprising connection between H. pylori and chronic skin conditions

✔ How dysbiosis can contribute to persistent acne

✔ The role of biofilms in chronic inflammatory conditions

✔ Why some patients with gut dysfunction have no GI symptoms

✔ Pseudomonas, endotoxins, and systemic inflammation

✔ Leaky gut and its impact on skin health

✔ How we approach stubborn acne from a functional medicine perspective

✔ Stool testing, organic acid testing, and evaluating the gut-skin axis

✔ The role of probiotics, spore-based probiotics, and immunoglobulins

✔ Biofilm disruptors and antimicrobial herbs

✔ Why healing the gut often takes longer than people expect

✔ The importance of fiber, fermented foods, and rebuilding microbiome resilience

Acne is often viewed as a skin condition, but for some patients it may be a manifestation of deeper immune, inflammatory, and microbiome imbalances. This episode explores why chronic acne can persist despite doing "all the right things" and how addressing gut dysfunction may be an important piece of the puzzle.

Whether you're struggling with acne yourself or you're a clinician looking to better understand the gut-skin connection, this conversation offers a practical and thought-provoking look at how the microbiome influences skin health.



Music provided by Blue Dot.

👋 Connect with Dr. Meghan Larivee

⁠https://www.integrativedermatologysolutions.com/about⁠


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

#89 - The Gut-Skin Connection: What We've Been Missing11 Aug 202600:37:21

Why Acne Isn't Just a Skin Problem: The Gut-Skin Connection

What if your acne, eczema, rosacea, or chronic skin condition isn't actually starting in your skin?


In this episode of The Turd Nerds, we're joined by naturopathic physician and acupuncturist Megan Larivee for a deep dive into the fascinating world of the gut-skin axis.


We explore why the skin is much more than a protective barrier—it's actually the body's largest immune organ. From the skin microbiome and immune signaling to leaky gut, leaky skin, acne, eczema, rosacea, and psoriasis, we unpack the growing evidence connecting gastrointestinal health to chronic skin conditions.

We discuss how gut dysbiosis, inflammation, barrier dysfunction, hormones, diet, and environmental exposures may all contribute to skin symptoms—and why simply treating the skin often isn't enough.

✔ Why the skin is considered an immune organ

✔ The relationship between the skin microbiome and the gut microbiome

✔ Leaky gut and leaky skin: what they are and why they matter

✔ Acne, eczema, rosacea, psoriasis, and other chronic skin conditions

✔ How H. pylori and gut dysbiosis can influence skin health

✔ Why skin conditions often persist despite topical treatments

✔ The role of fiber and the microbiome in acne management

✔ Dairy, insulin signaling, and androgen-driven acne

✔ Candida, fungal overgrowth, and skin symptoms

✔ The impact of personal care products, soaps, and environmental chemicals on skin health

✔ Why skin barrier function is critical for long-term healing

✔ Clinical pearls for evaluating chronic skin conditions through a gut-health lens

The skin and gut are constantly communicating through immune, inflammatory, hormonal, and microbial pathways. When that communication breaks down, chronic skin conditions may develop—or become difficult to resolve.

If you've struggled with acne, eczema, rosacea, psoriasis, or unexplained skin symptoms, this episode offers a new perspective on where to look and what questions to ask.

Because sometimes the best way to heal the skin is to start with the gut.


Music provided by Blue Dot.

👋 Connect with Dr. Meghan Larivee

https://www.integrativedermatologysolutions.com/about


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM


Ilana Gurevich ND, FABNG, LAc, MSOM


Ami Kapadia, MD, ABFM, ABIHM

#88 - The Gallbladder Recovery Toolkit28 Jul 202600:33:04

What can you actually do to support gallbladder health—before or after gallbladder removal?

In Part 3 of our Gallbladder Series, we move from theory into practice. After exploring the relationship between the gallbladder, microbiome, hormones, and bile acids in Parts 1 and 2, we discuss the clinical tools, supplements, dietary strategies, and testing considerations we use to support patients with gallbladder dysfunction, bile acid disorders, and post-cholecystectomy symptoms.

We explore why some patients continue to struggle with digestive symptoms long after gallbladder removal, how hormone fluctuations impact bile flow, and why supporting the microbiome may be one of the most overlooked pieces of gallbladder care.

Whether you're dealing with gallstones, bile acid diarrhea, digestive symptoms after surgery, or simply want to better understand how to support healthy bile flow, this episode is packed with practical takeaways.

✔ Conventional approaches to gallbladder disease and gallbladder removal

✔ Why removing the gallbladder doesn't always solve the entire problem

✔ The long-term microbiome consequences of cholecystectomy

✔ The connection between gallbladder function, metabolism, and insulin resistance

✔ Taurine and glycine for bile acid conjugation and bile production

✔ Bitter herbs and how they support bile flow and gallbladder function

✔ Dandelion, gentian, chicory, and other classic digestive bitters

✔ Phosphatidylcholine, lecithin, and cholesterol balance within bile

✔ Choline supplementation and gallbladder support

✔ Magnesium and gallbladder motility

✔ Ox bile, TUDCA, UDCA, and digestive enzyme support

✔ Psyllium fiber and bile acid regulation

✔ Butyrate and microbiome support after gallbladder removal

✔ The estrogen–microbiome–gallbladder connection

✔ DIM and calcium-d-glucarate for estrogen metabolism

✔ NAC, milk thistle, and liver support

✔ Hormone replacement therapy considerations in patients with gallbladder disease

✔ Functional testing options for patients with gallbladder concerns

✔ How these concepts have changed our clinical approach to patient care

✔ Gallbladder removal may be necessary, but it should also prompt a deeper look at why gallbladder dysfunction developed in the first place.

✔ Taurine, glycine, bitters, magnesium, and phosphatidylcholine can all play important roles in supporting bile production and flow.

✔ The microbiome is central to bile acid metabolism and should be considered in patients with ongoing digestive symptoms.

✔ DIM and calcium-d-glucarate may help support healthy estrogen metabolism and reduce gallbladder stress in susceptible individuals.

✔ Post-cholecystectomy patients may benefit from additional support for digestion, microbiome balance, fat-soluble vitamins, and bile acid regulation.

✔ Hormones, bile acids, the liver, and the microbiome are deeply interconnected systems that influence one another in meaningful ways.

Part 1: Gallbladder Physiology, Bile Acids & The Microbiome

Part 2: The Estrogen–Gallbladder Connection: Hormones, Menopause & Bile Acids

Part 3: Practical Strategies for Supporting Gallbladder Health Before and After Surgery


Music provided by Blue Dot.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM


Ilana Gurevich ND, FABNG, LAc, MSOM


Ami Kapadia, MD, ABFM, ABIHM

#87 – The Hormone Organ Nobody Talks About14 Jul 202600:32:35

Most people think gallbladder disease is all about gallstones. But what if the real story is hormones?

In Part 2 of our Gallbladder Series, we take a deep dive into the fascinating relationship between estrogen, progesterone, menopause, the microbiome, and gallbladder function. We explore why women are significantly more likely to develop gallbladder disease, why perimenopause may be a perfect storm for biliary dysfunction, and how both high and low estrogen states can increase gallbladder risk.

Along the way, we unpack the surprising idea that the gallbladder behaves like a hormone-responsive organ, discuss how oral contraceptives and hormone replacement therapy may influence gallbladder health, and explain why the microbiome may be one of the most overlooked pieces of the puzzle.

Whether you're navigating perimenopause, supporting patients with digestive issues, or simply curious about the intersection of hormones and gut health, this episode offers a fresh perspective on a commonly overlooked organ.

  • Why women develop gallbladder disease more often than men

  • The role of estrogen in bile production and gallbladder function

  • How both estrogen excess and estrogen deficiency can increase gallbladder risk

  • Why perimenopause creates a unique challenge for gallbladder health

  • The relationship between oral contraceptives, hormone therapy, and gallstones

  • How progesterone influences gallbladder motility

  • The estrogen–microbiome connection

  • Changes in the microbiome that occur during menopause

  • The role of Lactobacillus, Bifidobacterium, Akkermansia, and other key organisms

  • Why menopause may increase the risk of biliary dysfunction

  • How hormone fluctuations impact bile flow and gallbladder emptying

  • Why oral estrogen carries different risks than transdermal estrogen

  • Clinical considerations for hormone replacement therapy in patients with gallbladder concerns

  • The importance of antioxidant protection for the biliary system

  • How this information has changed the way we evaluate and treat patients

✔ The gallbladder is highly responsive to hormonal signaling, particularly estrogen.

✔ Both high and low estrogen states can negatively impact bile acid production and gallbladder function.

✔ Perimenopause may be one of the highest-risk times for gallbladder dysfunction due to fluctuating hormone levels.

✔ The microbiome and estrogen metabolism are deeply interconnected and may influence gallbladder health.

✔ Menopause doesn't just affect reproductive hormones—it also changes the microbiome, bile metabolism, and digestive physiology.

✔ The route of hormone therapy matters, especially for patients with a history of gallbladder disease.

Part 3 of our Gallbladder Series: Practical treatment strategies, supplements, and clinical tools for supporting gallbladder health before and after gallbladder removal.

In This Episode We Discuss:Key TakeawaysListen Next


Music provided by Blue Dot.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM


Ilana Gurevich ND, FABNG, LAc, MSOM


Ami Kapadia, MD, ABFM, ABIHM

#86 – Gallbladder Chaos: Hormones, Microbes & Bile30 Jun 202600:35:07

Most people think gallbladder problems start and end with gallstones. The reality is much more complicated.

In this episode of The Turd Nerds, we discuss the hidden connections between the gallbladder, hormones, bile acids, estrogen metabolism, and the gut microbiome—and why these systems become especially important during perimenopause and menopause.


We cover:
✔ Why women develop more gallbladder disease than men
✔ The estrogen–gallbladder connection
✔ How the microbiome influences bile acid metabolism
✔ What changes after gallbladder removal
✔ Gallbladder dysfunction without stones
✔ DIM and calcium-d-glucarate for estrogen metabolism
✔ Taurine, glycine, bitters, phosphatidylcholine, magnesium, and bile support
✔ Bile acid malabsorption and chronic diarrhea
✔ How we approach gallbladder health in clinical practice


If you've ever been told your only option is to remove your gallbladder, this episode explores the physiology behind gallbladder dysfunction and the tools we use to support patients before and after surgery.


Music provided by Blue Dot.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM


Ilana Gurevich ND, FABNG, LAc, MSOM


Ami Kapadia, MD, ABFM, ABIHM

#85 – Lyme and Co-Infections: A Hidden Driver of Gut and Chronic Symptoms with Dr. Crane Holmes16 Jun 202600:30:27

Could Lyme disease or co-infections be contributing to gut symptoms that aren’t improving?

In this episode, Dr. Crane Holmes and the turd nerds break down Lyme disease and common co-infections - including Bartonella and Babesia - and how they can impact not just the gut, but the entire body.

We explore how these infections can present as chronic digestive issues, brain fog, inflammation, and multi-system symptoms that don’t respond to typical treatments.

In this episode, we discuss:

  • What Lyme disease actually is (and why it’s often misunderstood)
  • The role of co-infections like Bartonella and Babesia
  • How these infections can affect the gut, nervous system, and immune system
  • Why symptoms often go beyond digestion (brain fog, fatigue, joint pain)
  • When to consider Lyme or co-infections in complex cases
  • Challenges with testing and diagnosis
  • Treatment approaches, including antimicrobials, herbs, and biofilm support

This episode is for anyone dealing with chronic gut symptoms, unexplained inflammation, or complex health issues that haven’t improved with standard approaches.


Music provided by Blue Dot.


👋 Connect with the Dr. Crane Holmes

https://www.drcraneholmes.com/


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM


Ilana Gurevich ND, FABNG, LAc, MSOM


Ami Kapadia, MD, ABFM, ABIHM

#84 – When It’s Not SIBO: Mold, Mast Cells, and Chronic Gut Symptoms with Dr. Crane Holmes02 Jun 202600:30:25

What if your gut symptoms aren’t SIBO—and aren’t improving despite treatment?

In this episode, we explore a common clinical scenario: patients with bloating, gas, and digestive issues that look like SIBO but don’t respond to standard therapies. We take a deeper look at mold exposure, mast cell activation, and histamine as overlooked drivers of chronic gut symptoms.

Dr. Crane Holmes joins us to break down how mold can impact the gastrointestinal system, why symptoms often extend beyond the gut, and how to recognize when something more complex is going on.

In this episode, we discuss:

  • When to suspect something beyond SIBO
  • How mold exposure can drive gut inflammation and symptoms
  • The connection between mold, mast cells, and histamine
  • Why patients may have multi-system symptoms (brain fog, fatigue, sinus issues)
  • The role of environmental testing (ERMI) vs lab testing
  • Practical approaches to treatment, including binders, detox support, and reducing exposure


👋 Connect with the Dr. Crane Holmes

⁠https://www.drcraneholmes.com/


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM


Ilana Gurevich ND, FABNG, LAc, MSOM


Ami Kapadia, MD, ABFM, ABIHM

#83 – The Vagus Nerve Explained: Gut–Brain Connection, IBS, and What Actually Helps19 May 202600:27:28

What does the vagus nerve actually do—and why does it matter for gut health, IBS, and anxiety?


In this episode, we break down the vagus nerve in a clear, practical way, focusing on how it connects the gut and brain and why low vagal tone is linked to conditions like IBS, IBD, anxiety, depression, and chronic inflammation.

We also explore why common advice like humming, gargling, or cold exposure which often isn’t enough on its own, and what actually makes a meaningful difference clinically.

You’ll learn how the vagus nerve regulates digestion, stress response, inflammation, and gut motility, and how disruptions in this system can create a cycle of persistent symptoms.


In this episode, we discuss:

- What the vagus nerve is and how it connects the gut and brain

- Why low vagal tone is linked to IBS, anxiety, and inflammation

- How stress and the microbiome impact vagus nerve function

- Why gut symptoms and mental health symptoms often overlap

- Evidence-based ways to support vagal tone (breathing, cold exposure, exercise, social connection, and more)

- When vagus nerve stimulators and clinical tools may be helpful


This episode is for anyone dealing with IBS, chronic gut symptoms, anxiety, or feeling “stuck” despite trying multiple approaches to gut health.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM


Ilana Gurevich ND, FABNG, LAc, MSOM


Ami Kapadia, MD, ABFM, ABIHM

#82 – Chronic Diarrhea That Won’t Resolve: Understanding Microscopic Colitis05 May 202600:33:16

Why does chronic diarrhea continue even when testing is normal?

In this episode, we walk through a case of microscopic colitis and how to approach persistent gut symptoms that don’t respond to standard treatment. We break down what microscopic colitis is, why it’s often missed on routine colonoscopy, and how it can present as long-standing, non-bloody diarrhea.

We also explore how medications like PPIs, NSAIDs, and SSRIs may contribute, and how overlapping factors like dysbiosis, inflammation, and even constipation can complicate the clinical picture.In this episode, we discuss:- Chronic diarrhea and when to look beyond IBS- What microscopic colitis is and how it’s diagnosed- Why colonoscopies can miss key findings- The role of medications in gut inflammation- Treatment approaches, including budesonide, bismuth, and bile acid binders- Functional medicine perspectives on persistent gut symptomsMusic provided by Blue Dot.👋 Connect with the Turds!Rebecca Sand ND, LAc, MSOM⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drrebeccasand.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@drrebeccasand⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Ilana Gurevich ND, FABNG, LAc, MSOM⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.openwellnesspdx.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@openwellness_pdx⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@ilana.gurevich⁠⁠⁠⁠⁠⁠Ami Kapadia, MD, ABFM, ABIHM⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠⁠⁠

#81 – When Digestion Stalls: A Chinese Medicine View of Bloating and Brain Fog with Ellen Goldsmith21 Apr 202600:34:13

In this episode, we revisit bloating through a Chinese medicine lens with Ellen Goldsmith, focusing on digestion as a process of movement, not just intake.


We explore how patterns like stagnation, dysregulation, and impaired “downward flow” contribute to symptoms like distension, brain fog, and discomfort. The conversation highlights common contributors such as stress, irregular eating, cold foods, and dietary excesses.

We also discuss practical strategies like meal timing, warming foods, and simple dietary adjustments to support more efficient digestion.

It’s a systems-based approach to understanding why bloating happens and how to address it in a more individualized way.


Music provided by Blue Dot.


👋 Connect with the Ellen Goldsmith

⁠https://pearlnaturalhealth.com/⁠

⁠Nutritional Healing with Chinese Medicine by Ellen Goldsmith⁠


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM


Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

# 80 - A Different Way to Think About Digestion with Ellen Goldsmith07 Apr 202600:32:48

In this episode, we’re joined by Chinese dietetics expert Ellen Goldsmith to explore how traditional food systems approach digestion, health, and prevention. We discuss the framework of the five flavors, seasonal eating, and how these principles influence digestive function, satiety, and overall physiology. The conversation also highlights how modern dietary patterns can disrupt these regulatory signals, leading to persistent symptoms and cravings. Rather than focusing on restriction, this approach emphasizes restoring balance through everyday food choices. It’s a practical, systems-based perspective on how to think about food as part of long-term digestive health.


Music provided by Blue Dot.


👋 Connect with the Ellen Goldsmith

https://pearlnaturalhealth.com/

Nutritional Healing with Chinese Medicine by Ellen Goldsmith


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

#79 -Unlocking the Secrets of Fiber and Prebiotics with Dr. Mark Davis 24 Mar 202600:36:02

In this conversation, the Turd Nerds are joined by Dr. Mark Davis and the hosts discuss the significance of fiber and prebiotics in gut health, emphasizing personalized approaches to treatment. They explore the challenges of microbiome testing, the management of conditions like C. diff and chronic candida, and the role of prebiotics in treating constipation. The discussion also touches on SIBO testing and treatment perspectives, highlighting the evolving landscape of gut health and the importance of individualized care.

Music provided by Blue Dot.


👋 Connect with the Dr. Mark Davis

⁠https://www.foundational-medicine.com/⁠

⁠https://www.probioticinfusions.com/about⁠


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM


#78 -Fecal Microbiota Transplant with Dr. Mark Davis 10 Mar 202600:30:34

In this episode of The Turd Nerds, the Turds are joined by Dr. Mark Davis, ND and we take a deep dive into the strange but powerful world of fecal microbiota transplantation (FMT)—what happens when you transplant an entire microbial ecosystem into the human gut and why it can be so effective for certain diseases. We explore why FMT is nearly curative for C. difficile, how dosing and delivery affect outcomes in ulcerative colitis and Crohn’s disease, and share striking clinical stories of severe inflammatory bowel disease improving after repeated treatments.


Music provided by Blue Dot.

👋 Connect with the Dr. Mark Davis

https://www.foundational-medicine.com/

https://www.probioticinfusions.com/about


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

#77 - Navigating Menopause: Hormone Therapy Insights24 Feb 202600:38:44

In this conversation, the docs discuss the treatment of menopause, focusing on hormone therapy, diet, herbal remedies, and the importance of movement. She emphasizes the role of estrogen and progesterone in managing symptoms, the significance of a balanced diet rich in fiber and polyphenols, and the benefits of herbal supplements. Additionally, she highlights the necessity of regular exercise and monitoring health markers to improve overall well-being during the perimenopausal and menopausal stages.


Music provided by Blue Dot.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

#76 - The Hormonal Shift: Understanding Insulin Resistance in Perimenopause10 Feb 202600:40:35

This conversation delves into the intricate relationship between perimenopause, insulin resistance, and the microbiome. Dr. Rebecca Sand discusses how hormonal changes during perimenopause affect insulin sensitivity, fat distribution, and overall health. The importance of dietary adjustments, particularly increasing protein intake and maintaining gut health, is emphasized as a means to manage symptoms and improve well-being during this transitional phase. The discussion also touches on the implications of aging and inflammation on mental health, highlighting the need for a holistic approach to treatment.


Music provided by Blue Dot.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

RECAP: Travelers Constipation 13 Jan 202600:28:59

In this recap episode, the docs dive into the often-overlooked topic of travel constipation. Join her as she explores the challenges of maintaining regularity while on the go, shares personal anecdotes, and offers practical tips to keep your digestive system in check during your travels. From the importance of hydration and electrolytes to the benefits of peppermint oil and magnesium, Dr. Sand provides a comprehensive guide to managing travel-related digestive issues. Tune in for an engaging and informative discussion that promises to make your next trip a little more comfortable.


Music provided by Blue Dot.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

RECAP: Travelers Diarrhea30 Dec 202500:31:17

In this recap episode about travelers diarrhea, the docs discover a comprehensive protocol designed to prevent and treat this common travel ailment, featuring insights on enzymes, probiotics, and immunoglobulins. Learn how to protect your gut health while exploring new destinations, and hear real-life stories from patients who have benefited from these strategies. Whether you're planning a trip or just curious about gut health, this episode is packed with valuable information to keep you healthy on the go.


Music provided by Blue Dot.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

#75 - Revolutionizing IBD Treatment: Rectal Ozone 16 Dec 202500:36:34

In this conversation, the docs discusse the therapeutic use of rectal ozone therapy, particularly for inflammatory bowel disease (IBD). She explains the mechanism of action of ozone, its benefits, and shares clinical experiences and case studies that highlight its effectiveness. The discussion also touches on the safety profile of ozone therapy, its applications in various medical conditions, and the future potential of this treatment in naturopathic medicine.


Music provided by Blue Dot.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM



#74 -The Magic of Qing Dai: Transforming Ulcerative Colitis02 Dec 202500:33:56

In this episode, the doc discusse the herb Qing Dai, known for its transformative effects on treating ulcerative colitis. The conversation covers its historical uses, mechanisms of action, clinical studies demonstrating its efficacy, safety considerations, and broader applications in treating conditions like psoriasis and fistulas. The discussion emphasizes the importance of individualized care in Chinese medicine and the potential of Qing Dai as a valuable tool in integrative health.


Music provided by Blue Dot.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

#73 - The Bug Battle: Tackling GI Disorders Head-On18 Nov 202500:24:39

In this episode, the hosts, Dr. Rebecca Sand, Dr. Ami Kapadia, and Dr. Ilana Gurevich, delve into the complexities of gastrointestinal health, focusing on conditions like SIBO and protozoa. They discuss their personal experiences, treatment approaches, and the importance of proper testing and diagnosis. The conversation highlights the interplay between diet, lifestyle, and gut health, as well as the challenges faced in treating chronic infections. The hosts share insights from their practices and patient experiences, emphasizing the need for individualized care and the exploration of alternative treatment methods.


Music provided by Blue Dot.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

#72 -Poop, Prep & Polyps - Colonoscopies04 Nov 202500:35:11

In this episode, the docs discusses the importance of colonoscopies, especially as colorectal cancer rates rise among younger populations. They shares personal experiences and insights on the screening process, preparation, and post-procedure care. The conversation covers various screening options, the significance of early detection, and practical tips for managing the colonoscopy experience, including dietary recommendations for after the procedure.takeaways

  • Colorectal cancer screening is now recommended starting at age 45.
  • Colonoscopy is a highly sensitive method for detecting colorectal cancer.
  • Alternative screening options include FIT tests and Cologuard.
  • Proper preparation for a colonoscopy is crucial for a successful procedure.
  • Post-colonoscopy care includes dietary adjustments to aid recovery.
  • The microbiome can be affected by colonoscopy procedures.
  • Patients should be aware of the risks associated with delayed screenings.
  • Using anti-nausea medication can improve the prep experience.
  • Vaseline can help alleviate discomfort during the prep phase.
  • Screening for colorectal cancer can save lives by detecting issues early.



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM



#71 - Getting off PPIs (proton pump inhibitors) for GERD21 Oct 202500:36:33

In this conversation, The doctors discusses the implications of long-term use of Proton Pump Inhibitors (PPIs), their efficacy, risks, and the importance of tapering off these medications. The discussion covers the physiological effects of PPIs, the necessity of addressing underlying causes of reflux, and the potential for natural and herbal alternatives to support patients in tapering off PPIs. The conversation emphasizes the importance of patient education and the need for a gradual approach to discontinuing PPIs to avoid rebound symptoms.


Takeaways

  • PPIs are effective for short-term use but not for long-term.
  • Tapering off PPIs should take three to six months.
  • Natural alternatives can help manage reflux symptoms.
  • Melatonin can improve lower esophageal sphincter function.
  • Nutrient deficiencies are a risk with long-term PPI use.
  • DGL has been shown to improve quality of life in patients.
  • Patient education is crucial in managing PPI use.
  • Underlying causes of reflux should be addressed.
  • Herbal remedies can provide additional support during tapering.
  • A gradual tapering process is essential to avoid rebound symptoms.



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM



#70 - Gut Struggles in Scleroderma07 Oct 202500:15:31

In this conversation, Dr. Ilana Gurevich discusses a complex case involving a patient with scleroderma who experienced chronic diarrhea. The discussion covers the patient's journey, the challenges of treatment, and the surprising outcomes related to fertility and pregnancy. Dr. Sand emphasizes the role of nitazoxanide in managing the patient's symptoms and the considerations for treatment during pregnancy.


  • The patient had chronic diarrhea due to scleroderma.
  • Nitazoxanide was used as a treatment for Giardia.
  • Standard treatments like metronidazole had failed for the patient.
  • The patient unexpectedly became pregnant after treatment.
  • Managing diarrhea during pregnancy poses unique challenges.
  • Functional medicine approaches can provide alternative solutions.
  • Probiotics and dietary changes were attempted but were ineffective.
  • Nitazoxanide is considered safe during pregnancy.
  • The patient's symptoms improved significantly with treatment.
  • The case highlights the importance of individualized patient care.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

#69 - Soothing the Pregnant Belly Blues23 Sep 202500:31:16

This conversation delves into the gastrointestinal issues that arise during pregnancy, focusing on common problems such as morning sickness, reflux, constipation, and hemorrhoids. The speakers share personal experiences and professional insights on effective remedies, including acupuncture, dietary adjustments, and the importance of hydration. They emphasize the need for pregnant individuals to be proactive about their digestive health and provide practical tips for managing symptoms throughout pregnancy.


  • GI issues are common in pregnancy and can be severe.
  • Morning sickness often lasts beyond the morning hours.
  • Acupuncture can provide significant relief for nausea.
  • Dietary changes, including ginger and protein intake, are crucial.
  • Reflux is exacerbated by hormonal changes and physical space constraints.
  • Constipation can worsen nausea and should be addressed promptly.
  • Hydration is essential due to increased blood volume during pregnancy.
  • Pelvic floor health is important to prevent complications during childbirth.
  • Papaya enzymes are effective for digestive issues in pregnant women.
  • The first bowel movement postpartum can be particularly challenging.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM



# 68 - Candida - Fungal Allergy or Overgrowth?09 Sep 202500:34:54

In this conversation, Dr. Ami Kapadia discusses the complex relationship between Candida and allergies, emphasizing that many patients may not just have a fungal overgrowth but could also be experiencing an allergic reaction to Candida. The discussion covers the importance of understanding Candida as a commensal organism, the connection between allergies and Candida, testing methods for diagnosis, and treatment options including sublingual immunotherapy. The conversation also touches on the role of the immune system, the impact of diet, and the connection between heavy metals and Candida.


Takeaways

  • Candida can be an allergen, not just an infection.
  • Terminology in medicine is crucial for patient understanding.
  • Allergic predisposition can lead to Candida allergies.
  • Testing for Candida allergies often requires allergist involvement.
  • Sublingual immunotherapy can be effective for Candida allergies.
  • The immune system's response to Candida is complex.
  • Chronic conditions may complicate Candida treatment.
  • Diet plays a significant role in managing Candida.
  • Heavy metals may influence Candida overgrowth.
  • A thorough patient history is essential for effective treatment.



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM



Summer replay - Treatment options for SIBO varieties - SIBO part 226 Aug 202500:30:53

Treatment strategies for different varieties of SIBO.


A continuation of our burning SIBO questions.

Topics for part two:

  • Most effective treatment strategies for methane and hydrogen SIBO
  • Making sense of hydrogen sulfide SIBO,
  • Dr. Gurevich's favorite herbal treatment options
  • How and why to support patients through the dreaded elemental diet. 



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

Summer replay - SIBO - pathology and testing12 Aug 202500:31:03

Pathology and testing for SIBO.


Dr. Gurevich leads us in a discussion about small intestinal bacterial overgrowth (SIBO).  We discuss pathology and underlying causes of SIBO as well as SIBO testing options.  In this episode we also discuss SIBO and the microbiome, parasites and protozoa effecting the microbiome, endometriosis, gastroparesis, adhesions and SIBO.  There is also discussion about testing including breath testing and the IBS smart test.  We also look at a variety of treatment options including visceral massage and others.



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

Summer Replay - Botanical and medications for management of fungal overgrowth.- SIFO Part 329 Jul 202500:29:51

Botanical and medications for management of fungal overgrowth.

Dr's Sand, Kapadia and Gurevich continue their discussion on SIFO, Small Intestinal Fungal Overgrowth. In this episode Dr. Kapadia leads us through more details in a discussion of fungal overgrowth in the GI tract. 

Topics covered in this episode:

  • Botanical and medication treatment options for SIFO
  • Gluten sensitivity and candida
  • Sugar and candida
  • The mold yeast elimination diet
  • MCAS


Links to Dr. Kapadia's courses on SIFO:

Practitioner course on SIFO and Mold: ⁠https://drkapadia.teachable.com/p/a-minimalist-s-approach-to-mold-related-illness-and-small-intestinal-fungal-overgrowth-sifo⁠

Patient course on SIFO:  ⁠https://drkapadia.teachable.com/p/sifo-in-integrative-course-for-patient-education⁠



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM


Summer Replay - Fungus and the GI track - SIFO Part 215 Jul 202500:26:21

How fungal overgrowth changes the intestinal tract.


Dr's Sand, Kapadia and Gurevich continue their discussion on SIFO, Small Intestinal Fungal Overgrowth. In this episode Dr. Kapadia leads us through more details in a discussion of fungal overgrowth in the GI tract. 


Topics covered in this episode: SIFO treatment, foundations of GI health, stress the gut and limbic system retraining, dietary changes and SIFO, nutrient deficiencies in SIFO, acid suppression and SIFO, medications and botanicals in treatment of SIFO


Links to Dr. Kapadia's courses on SIFO:

Practitioner course on SIFO and Mold: ⁠https://drkapadia.teachable.com/p/a-minimalist-s-approach-to-mold-related-illness-and-small-intestinal-fungal-overgrowth-sifo⁠

Patient course on SIFO:  ⁠https://drkapadia.teachable.com/p/sifo-in-integrative-course-for-patient-education⁠



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

Summer Replay - SIFO - Testing and treatment01 Jul 202500:28:44

Testing and Treatment


Dr's Sand, Kapadia and Gurevich do a deep dive into SIFO, Small Intestinal Fungal Overgrowth. In this episode Dr. Kapadia leads us in a discussion of fungal overgrowth in the GI tract. 

Topics covered: Symptoms Testing and Treatment of SIFO, Organic Acid Testing, Stool Testing, Protozoa, tongue coating, association with allergies, MCAS, skin, Vulvovaginitis and candidiasis, IBS, IBD and SIFO, Biofilm and SIFO


Links to Dr. Kapadia's courses on SIFO:

Practitioner course on SIFO and Mold: 

⁠https://drkapadia.teachable.com/p/a-minimalist-s-approach-to-mold-related-illness-and-small-intestinal-fungal-overgrowth-sifo⁠



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

#67 - A Case of Bloating & Hormones10 Jun 202500:31:14

In this conversation, Dr. Rebecca Sand discusses a complex case of a 34-year-old female patient suffering from bloating, constipation, and other gastrointestinal issues. The discussion covers the patient's medical history, diagnostic tests, treatment strategies, and the exploration of potential underlying conditions such as SIBO and endometriosis. The conversation emphasizes the importance of a comprehensive approach to diagnosing and treating digestive health issues, particularly in women.takeaways


  • The patient had a long history of gastrointestinal issues starting from childhood.
  • Initial treatments included dietary changes and medications, which were not effective.
  • Lab results indicated significant nutritional deficiencies, particularly low ferritin and B12 levels.
  • SIBO was diagnosed and treated with herbal remedies, leading to some improvement.
  • Endometriosis was identified as a potential underlying condition contributing to symptoms.
  • Management strategies included dietary adjustments, nutritional supplementation, and lifestyle changes.
  • The importance of addressing inflammation in the treatment of digestive issues was highlighted.
  • Regular monitoring of symptoms and lab results is crucial for effective treatment.
  • Walking and physical activity were emphasized as beneficial for digestive health.
  • Understanding gynecologic conditions is essential in managing women's health issues.



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM



#66 - Thaena - Post-Biotics! (Sponsored)27 May 202500:51:38

The Turd Nerds interview fellow naturopathic physician, friend, and scientist, Dr. Andrea McBeth, the CEO of Thaena, makers of the one-and-only ThaenaBiotic®. Here, the Turds dive into the data behind this human-derived postbiotic supplement crafted from healthy donors' microbiomes. Unlike typical probiotics, ThaenaBiotic® delivers a rich array of microbial signals without live bacteria, aiming to support gut balance and resilience. Join us as we pick Dr. McBeth's brain to uncover more about the clinical utility of this product and how the Turds have used it in their practices. Curious about the science? Two study links are nestled below for the nerdy and the nosey.


🤩 THAENABIOTIC DISCOUNT LINK ➡️ https://thaena.com/turdnerds


Ott et al 2017 - Sterile Fecal Filtrate

Thaena blog about Enteric Endocrine Cells w/ citations


Sponsored episode by our friends at Thaena, makers of ThaenaBiotic.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

⁠⁠⁠⁠⁠⁠⁠⁠https://www.drrebeccasand.com/⁠⁠⁠⁠⁠⁠⁠⁠

⁠⁠⁠⁠⁠⁠@drrebeccasand⁠⁠⁠⁠⁠⁠

Ilana Gurevich ND, FABNG, LAc, MSOM

⁠⁠⁠⁠⁠https://www.openwellnesspdx.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@openwellness_pdx ⁠⁠⁠⁠⁠⁠

Ami Kapadia, MD, ABFM, ABIHM


#65 - Nerve Reset: How Neural Therapy Heals Pain, Gut, and Emotion13 May 202500:39:48

In this conversation, Dr. Gurevich discusses the innovative field of neural therapy, focusing on its applications, mechanisms, and emotional aspects. The discussion covers the use of procaine as a tool for resetting nerves, the concept of interference fields, and the emotional implications of scarring. Dr. Gurevich shares insights on how neural therapy can be beneficial for various conditions, including GI issues and women's health, while also addressing chronic pain and inflammation. The conversation highlights the importance of understanding the emotional connections to physical pain and the effectiveness of neural therapy in holistic treatment approaches.takeaways

  • Neural therapy is beneficial for scarring and inflammation.
  • Procaine is used to reset nerve function.
  • Emotional aspects play a significant role in physical pain.
  • Neural therapy can be applied to GI conditions effectively.
  • The concept of interference fields is crucial in understanding nerve pain.
  • Neural therapy can help with women's health issues, including fertility.
  • Chronic pain can be alleviated through targeted neural therapy injections.
  • Procaine IVs can reset the nervous system for various conditions.
  • Neural therapy is a cost-effective treatment option.
  • Injections should not be the first line of treatment.



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM


Ilana Gurevich ND, FABNG, LAc, MSOM


Ami Kapadia, MD, ABFM, ABIHM

  • ⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠
#64 - More Bloating... and How to Help29 Apr 202500:36:04

Dr. Sand continues the discussion on underlying cause of bloating. We do a deep dive on various histamine causes, how inflammation can cause bloating, and various ways we can support better movement. Did you know hypermobility can cause bloating?!


www.turdnerdspod.com



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM



#63 - Bloating: Commonly Missed Underlying Causes15 Apr 202500:30:32

Dr. Sand leads us through part I of a two-part series on often missed underlying causes of bloating. Bloating can impact quality of life for many of our patients and sometimes it will persist even after treating common underlying causes, like SIBO. Tune in to learn what else can cause bloating - and what to do about it!


www.turdnerdspod.com



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM



#62 - Elemental Diet: A Powerful Tool for Complex Cases01 Apr 202500:19:28

In this episode of the Turd Nerds podcast, the hosts discuss a complex case of microscopic colitis, exploring various treatment options including the use of Budesonide and the elemental diet. They delve into the challenges faced by patients with gastrointestinal issues, the importance of a holistic approach to treatment, and the emotional toll on both patients and providers. The conversation highlights the significance of understanding the patient's experience and the need for innovative solutions in functional gastroenterology.



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drrebeccasand.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

⁠⁠@drrebeccasand⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠


Ilana Gurevich ND, FABNG, LAc, MSOM

⁠⁠⁠⁠⁠https://⁠www.openwellnesspdx.com ⁠⁠⁠⁠⁠


Ami Kapadia, MD, ABFM, ABIHM⁠

#61 - NSAIDs and the Gut18 Mar 202500:37:39

NSAIDs might be the go-to for pain relief, but they come with some gnarly gut side effects. The Turds unravel how these common meds can lead to gastritis, ulcers, and even long-term digestive issues—sometimes in as little as a week. From topical alternatives to protective strategies like H2 blockers and mucilaginous herbs, they weigh the pros, cons, and sneaky risks of these over-the-counter staples. If you've ever popped an ibuprofen without a second thought, this episode might just change your approach to pain management.

#60 - Sleep Reboot & Personal Stories04 Mar 202500:41:40

Welcome sleepless turds! In this episode we have decided to revisit the topic of sleep in all it's facets: the microbiome, digestive function, and a huge player... histamine! We talk through our personal struggles and triumphs on this topic.



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drrebeccasand.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

⁠@drrebeccasand⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠


Ilana Gurevich ND, FABNG, LAc, MSOM⁠⁠⁠⁠https://www.openwellnesspdx.com⁠⁠⁠@openwellness_pdx⁠⁠⁠⁠⁠⁠⁠


Ami Kapadia, MD, ABFM, ABIHM⁠

#59 - Travel Constipation18 Feb 202500:28:48

Join the Turd Nerds as we discuss one of the most uncomfortable aspects of traveling for a lot of us... the constipation! We will guide you through some of our personally tested strategies for combating this and ways you can prepare for your next trip.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

  • ⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠
#58 - Building a Metabolism-Supporting Microbiome04 Feb 202500:32:46

In this episode, Dr. Sand covers the intricate relationship between diet, the microbiome, and overall health. The turds discuss the impact of dysbiosis and bile acid malabsorption on metabolic dysfunction, emphasizing the importance of probiotics and prebiotics in weight management. The conversation highlights practical strategies for incorporating gut health into daily life, including the role of fiber, exercise, and detoxification. The hosts share personal anecdotes and insights, making the discussion both informative and relatable.



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

  • ⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠


#57 - Metabolism, Weight, and the Microbiome21 Jan 202500:33:16

In this episode of the Turd Nerds podcast, the hosts delve into the intricate relationship between the microbiome and metabolism. Dr. Sand leads a discussion on how gut health influences weight management, the role of hormones, and the impact of inflammation. The conversation also touches on bile acids, testing for gut health, and the potential benefits of probiotics and prebiotics. Dr. Sand emphasizes the importance of understanding these connections to improve overall health and well-being.



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

  • ⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠


#56 - Eosinophilic Esophagitis - Part 207 Jan 202500:24:46

In this episode, the Turd Nerds discuss Eosinophilic Esophagitis (EOE), exploring symptoms, diagnostic testing, and treatment approaches.


The conversation delves into dietary interventions, the role of histamine in gastrointestinal health, and the importance of comprehensive diagnosis in managing EOE.

The episode highlights the evolving understanding of EOE and the potential for integrative treatment options.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

  • ⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠



#55 - Eosinophilic Esophagitis - Part 124 Dec 202400:36:53

In this episode, the hosts discuss Eosinophilic Esophagitis (EOE), a condition that has gained recognition in recent years. They explore its symptoms, including dysphagia and food impaction, and the importance of accurate diagnosis through endoscopy and biopsies. The conversation delves into risk factors, potential triggers such as food allergies, and the role of diet in managing EOE. Treatment options are discussed, including pharmaceutical interventions like Budesonide and PPIs, as well as dietary management strategies such as elimination diets. The hosts also touch on herbal remedies and the importance of monitoring for fungal overgrowth during treatment.



👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

  • ⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠


#54 - Unmasking the World of Parasites - Part 210 Dec 202400:32:12

Join the Turds for part 2 of the parasite and protozoa series. In this segment, they cover natural, herbal, and pharmaceutical options often used in their practices to address all variety of of these intestinal critters.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

  • ⁠⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠⁠


#53 - Unmasking the World of Parasites - Part 126 Nov 202400:35:07

Join the Turds for Part I of the exploration of intestinal parasites and protozoa. In this episode, they cover testing, a thorough recap of the wide variety of protozoa and parasites that can exist in humans, and a discussion on the controversial "gray areas" with this topic.


👋 Connect with the Turds!

Rebecca Sand ND, LAc, MSOM

Ilana Gurevich ND, FABNG, LAc, MSOM

Ami Kapadia, MD, ABFM, ABIHM

  • ⁠⁠⁠⁠⁠https://www.amikapadia.com/⁠⁠⁠⁠⁠


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