99 - Viola Sampson - Long Covid & the Microbiome

Episode 99 of the Long Covid Podcast is a chat with the fabulous Viola Sampson, microbiome analyst and certified health coach. Viola has recovered from ME after a long illness and is passionate about helping people with fatigue conditions through her knowledge of the microbiome.

This is a fantastic dive into what the microbiome is, and how we might be able to improve our own.

Instagram @violasampson_microbiome

Podcast with more detail on microbiome changes can be found at: https://www.biomesight.com/blog

Viral Persistence in children

Products mentioned during the episode (all names are correct in the transcript for reference too). 
Viola says, "These products are all available from Natural Dispensary. If people would like to gift me 10% and get a 15% discount for themselves, they are very welcome to use my practitioner code VS015. (I refuse commission on any treatment recommendations I give clients, but for information I give for free, a small affiliate fee is always welcome!)"

GOS

L Rhamnosus

BioGaia Protectis

Optibac Everyday

For more information about Long Covid Breathing, their courses, workshops & other shorter sessions, please check out this link

(music - Brock Hewitt, Rule of Life)

Transcript

Jackie Baxter  
Hello, and welcome to this episode of the long COVID podcast, I am delighted to welcome my guest today, Viola Sampson, who is a registered microbiome analyst and certified health coach with special interest in chronic fatigue syndromes, including long COVID. So I'm really excited to learn loads today, a very warm welcome to the podcast.

Viola Sampson  
Thank you. Thank you so much for inviting me. It's a real honor to be here.

Jackie Baxter  
I'm so excited to dive into all of this. To begin with, would you mind just saying a little more about yourself and what it is that you do?

Viola Sampson  
So I'm a microbiome analyst, as you said, and what what that looks like is providing treatment plans that are tailored to someone's individual microbiome profile. And we might talk a little bit later about what that actually means. In terms of my background, so my original training a long time ago now was in medical Biosciences. I went on doing lots of other different stuff, but after a short kind of research career, but what I think is really relevant to this podcast in particular, is that I got ME when I was actually 19, when I first started to become unwell. 

And back then it was called yuppie flu. So, you know, mega amounts of medical gaslighting in particular. So I went at least 10 years doing all the wrong things, pushing on through all of these things. And it wasn't until, gosh, it probably was until about 10 years before I got an actual diagnosis of ME finally. And then it was I mean, it was wonderful in a way because it unlocked really a pathway for me to recover. It was five years of hard slog actually, lots of psychotherapy, herbalism. And importantly for me craniosacral therapy, which was really central to my recovery. So I don't know if you've come across cranioacral therapy?

Jackie Baxter  
Only very sort of peripherally. 

Viola Sampson  
So it's, I mean, I think at its most sort of basic, but perhaps at its most profound in terms of chronic fatigue conditions in particular, is it's essentially vagus nerve stimulation, through touch. I think that's probably it - that doesn't do it justice at all, because it's so much more than that. But I think that's the main piece for chronic fatigue conditions. 

So I ended up training in that because it was so transformative. And I went on to practice for 15 years specializing in, as you might imagine, chronic fatigue conditions, because that's something I'm obviously very motivated by, having experienced that myself. 

And then I really turned a corner, it was probably a bit more than 15 years ago. And there was a sudden point where I went, I know I'm not going to relapse again after this point. And then it was yeah, a lot of it was about piecing my life back together. As you might imagine. 

But one of the things that persisted, though that also preceded my journey into ME, was lifelong gut symptoms. So although I recovered from the ME, I was still eating an incredibly restricted diet. So it was gluten free, dairy free, nightshade free. So that's tomatoes, potatoes, chilies, peppers. And if I had even small amounts of those things, I would be on the floor in agony for several days, and it would take several weeks for my gut to recover from even, like I say, a small amount, of one of those things. 

So I guess I got really fascinated in the microbiome because of that. And I started testing my own microbiome, and the first tests came out and sort of 2015. And then I started experimenting on myself and any willing friends. And eventually felt like I had something I could offer clients. And I launched my practice quietly at first, back in 2018. And been working ever since. And then, you know, my practice and my learning has just been exponential. 

So yeah, that's where I am today, working online with clients around the world. And I guess, ended up specializing, again, in fatigue conditions, long COVID in particular, because I do think the microbiome is a really important part of that picture for some people. And my waiting list got way too long, two years ago. And so I eventually set up a group practice, and I now work as part of the team with the microbiome group. So that's associates who are all trained in my approach, and we collaborate literally every day. We're talking to each other online about cases we're working on. So it's been an amazing, amazing journey. Really.

Jackie Baxter  
Yeah, that does sound incredible. And we were talking a little bit about this before we started recording, and how you've sort of turned something that was obviously a horrendous experience into something where you're now using what you learned there to help other people And I just think that's incredible that you've done that. So. So yeah. First, would you mind just giving a little bit of an explanation about what the microbiome actually is? And kind of what it does?

Viola Sampson  
Right. Great question to start with. Absolutely. So I think when people talk about the microbiome, in general terms, and it's out there a lot, isn't it nowadays, they're usually talking about gut bacteria. Now, the microbiome, well, there's the field microbiome, there's the bee microbiome, there's this oral microbiome, there's the skin microbiome, and there's the gut microbiome. So microbiome means, it officially means the genetic material within the community of microscopic life forms living in a particular place. 

So usually, what we're talking about is the gut microbiome. And actually, what we tend to be talking about is bacteria, because that's the best studied and most understood. I think it's important to bear in mind that there's not just gut bacteria, probably people have heard about some of the yeasts that live in our gut. So Candida had a lot of press for a lot of years. So there's yeasts and molds even. There's something called a little bit like bacteria called archaea. And there's also single celled organisms like amoeba, people have probably heard of. 

And there's also viruses. So there's something called the virome, which is the viral aspect of our microbiome. And I think that's particularly interesting for people with long COVID, just where there's the question around viral persistence. And there's lots more studies coming out, aren't there, that are showing the viral persistence is likely to be a factor in, I would say, a decent proportion of people with long COVID. 

And guts being one potential site for that like tissue throughout the body. But it's been found in the appendix months after infection. And actually, last week, there was a literature review published in The Lancet, looking at viral persistence and children, and they found it in I think, two or three children they found in the intestines. In theory, the microbiome refers to all of those things. In practice, what we're just talking about generally is gut bacteria.

Jackie Baxter  
And I mean, this is really interesting, isn't it? Because I think, I don't know if this is something that we hang on to from, you know, from school, even. But we see bacteria as bad. Mold is bad. You don't want mold in your house. Bacteria is what makes you sick. We don't want this. But it's not that simple, is it, when we're talking here?

Viola Sampson  
No. And I think that's one of the things that just delights me so much about the microbiome is it fills in all of these missing pieces of the puzzle. And it completely turns health, and our understanding of health and disease on its head. And it places our human health in the context of the wider planetary health as well, because our microbiome is continuous with the soil microbiome and beneficial bacteria, beneficial yeasts. And even, Yeah, beneficial viruses. 

So the viruses, there's also something called bacteria phages, which are viruses that infect bacteria. And what we think they're doing is keeping the ecosystem, so the bacterial populations, a bit like a kind of natural ecosystem, we might study out in nature, that's also going on in our gut where those bacteria phages are keeping the bacterial populations in a kind of dynamic stability.

Jackie Baxter  
Yeah, I mean, it, it's kind of blown my mind, I knew speaking to you was going to blow my mind today, which is why I was looking forward to it so much. But, you know, I guess, you know, when you then think about, you know, everybody says, Oh, your guts really important. You know, when you think about this kind of delicate balance and this whole like ecosystem that exists in there, you can kind of understand it's not just you got to eat well is, you know, easy, why it's so important, isn't it? But also maybe why it can be so difficult to get it right.

Viola Sampson  
Yeah. And I think I mean, it's also a beautiful thing coming into relationship with your microbiome, because you're tending, it's like you're kind of gardening, I suppose. It's like you're attending this incredible ecosystem, you know, and including your oral microbiome and your respiratory microbiome. But yeah, particularly the gut microbiome that's getting a lot of focus nowadays.

Jackie Baxter  
Yeah, definitely. We could talk for an hour just on this, I think. But it would be lovely to kind of talk about how this relates to, I mean, I suppose we're talking specifically long COVID here, but I think there'll be a lot of crossovers with other chronic conditions as well. But I've mean two of the kind of buzzwords that we have in long COVID are inflammation and autonomic nervous system. And I would love to talk a bit about how our microbiome kind of just relates to that? I know that's probably a really big question. 

Viola Sampson  
It is. And I'm going to scoot over the surface in a way that I hope still keeps it understandable. So that I think, first of all inflammation, I don't think we can talk about inflammation nowadays without talking about the gut microbiome. A lot of people do still, but they'll get there. 

So the microbiome is absolutely integrated into our inflammatory processes in our body. So our microbiome profile can be pro-inflammatory, or it can be anti-inflammatory, or it can be somewhere kind of in the middle, that's just a little bit neutral, but not actively anti inflammatory. And what we want is a microbiome that's actively anti inflammatory. 

What does that mean? That means that the population of bacteria skewed towards beneficial bacteria who are, it's sort of like their waste products in a way, I mean, I think you can't call them waste, because they're so useful to us. They're producing things like, you might have heard of people talking about short chain fatty acids, such as butyrate, has an anti inflammatory effect, both locally in the gut where they're producing it. And that tends to be in our large intestine where most of our gut microbiome lives. But also it can be absorbed through the body and have systemic anti inflammatory effects. Butyrate has amazing beneficial effects all around the body, including on nervous system health. 

Then there's also, and this bit is a lot less studied, a lot less understood, well, I think probably the inflammation is a vast topic. And we really can scratch the surface on that too. But think the nervous system dysregulation, or the regulation and dysregulation of the nervous system. And first of all, there is an inflammatory component to that. And also vagus nerve helps dampen inflammation. So there's this loop. 

And I think that's the loop that the relationship between the autonomic nervous system dysregulation, so the kind of I guess what people would talk about being in fight flight, or I would think more freeze flop is more relevant, the kind of more that what's something that's more like the kind of trauma response is more relevant, I think, to the chronic fatigue community, perhaps than fight flight. But anyway, so that's what I mean by autonomic nervous system dysregulation. 

And then you've got the other arm, which is inflammation, and the two of them drive each other. And I think it's that sort of stuck circle, that stuck the picture, that is the kind of what makes chronic fatigue conditions so hard to get out of. And you kind of need to address both of those things for most people. 

So well, there are specific species of gut bacteria, particularly Bifidobacterium, which some people might recognize from the labels on probiotic bottles. There are certain species which interact with our nervous system, either through the products, well, mainly through the products that they produce. And the vagus nerve, as you know, the Rest Digest nerves, it interfaces with our digestive system. 

Jackie Baxter  
Yeah, I think what's really fascinating, and it's something that I've kind of realized, but I'm obviously now looking at it through the lens of the microbiome, is just how connected everything is. You know, it's that, you know, if you have inflammation, then it's going to trigger your nervous system, and your nervous system actually not working very well is going to trigger more inflammation. And it's this kind of vicious cycle, isn't it, where it's, like you say, very difficult to get out of, and, you know, trying to sort of target different things to help that. 

I think it was kind of having this kind of understanding of at least how it was working, was quite central to me understanding what was going on in my body. But I think then also understanding how that also affected other things like your immune system, and your mental health, and all of these things that are other things that are all extremely important and also massively impacted when you're sort of chronically unwell. 

Viola Sampson  
Yeah. And that can be also important intervention points, like, you know, that obviously, this is really tricky territory, isn't it? Because fatigue conditions have been so dismissed as psychosomatic conditions. And certainly that was what was the overriding message for any kind of medical interaction I ever had. But it does show why, if you can manage your stress response through psychological intervention, that can help somewhat manage symptoms. But it's as we know, it's not the whole picture. And I think the inflammation and the microbiome in particular helps add in a kind of, you know, more of that picture that's really helpful.

Jackie Baxter  
Yeah, absolutely.

Viola Sampson  
I think this subject really sparks so many thoughts. It happens to me all the time. Actually. It's gonna happen now because it's like, oh, because there's so many, because it's so connecting, particularly the microbiome, you can go off on so many different angles. So yeah,

Jackie Baxter  
yeah, I think that's the thing is until you know, and I have a sort of personality that very easily gets obsessed with things, which is why I sort of tend to go down all these rabbit holes. So it's like, right ooh breathing, you know, and I get completely obsessed with that, and then you know, oh, cold water, I'll get completely obsessed with that. And I feel like after I've finished speaking to you today, I'm probably got myself another rabbit hole I'm about to go down. 

Because it is, it's just, it's so interesting. And I find when I find something that helps me, I then want to know why, and I want to look more into it, so I can understand it more, so I can then get it to help me more. Because if it's like, if I found a thing, then it's a thing, and I'm gonna kind of hold on to it as much as I can. And I don't know, I suppose this is why different people find different things that really help them, because they find something that helps a little bit. And then they can dive much more deeply into it.

Viola Sampson  
And I love that about my client base, actually, because especially early on, you know, the first people who found me, were people who were deep down rabbit holes, and they're fantastic, because they will bring some of the latest research with them to consultations. And you know, they are fascinated. And you know, that's been a real joy to work with people who are pushing the boundaries of microbiome, applying microbiome theory into practice. 

And there's lots of people out there who are experimenting on their own microbiomes, some of which I'm concerned about and others, which is just like, this is fantastic. You know, these are people who are, yeah, pushing the boundaries of our knowledge.

Jackie Baxter  
Yeah. So if somebody was to get their microbiome tested, what are you able to kind of glean from that? Are you able to kind of tell if there's inflammation, and tell if there's autonomic dysfunction going on in there, to help you to kind of tailor to the person? 

Viola Sampson  
That's such brilliant question. So I think the first thing to say is we're still working with the very tip of the iceberg in terms of knowledge. I think what's unusual about our practice at the microbiome group is that we use whole microbiome testing, that's bacteria, whole bacterial profile. Whereas there's a lot of practitioners who've now started working with the gut microbiome, who are using very limited tests. So they might test maybe 30,40 species. Or the ZOE app will, their kind of high number of species diversity, something like 150. For me, I mean, the Biomesite test, which is the one that I use, tests for thousands of bacteria, all bacteria known, known to science, not just a few. 

And then so someone who's got highly diverse microbiome may have like more than 400 species. Now, we only know what a fraction of those species actually do. So the first thing I will look at is the overall balance. And that's another reason why I need that whole microbiome or the whole bacterial profile picture. And I'm looking at whether it's a pro inflammatory microbiome in very basic terms, or whether it's anti inflammatory or whether it's somewhere in the middle, where there's not an overgrowth of pro inflammatory species, but the anti inflammatory population is fairly low. So yes, we can infer that. 

What we can see is presence, we can't necessarily see, well, we can't see their behavior. There are other tests that we can look at for genetic expression. But those tend to be much longer lead times and much more expensive, and therefore harder to use usefully in clinical practice. Whereas we look at just the kinds of bacteria that are present. And then certain cases, I will dive into that extra detail as needed. 

So there's certain bacteria that have, that are referred to as gram negative. So their cell membrane has got something called LPS in them. Lipopolysaccharide, which has just a kind of passively inflammatory effect on the body, locally in the gut, if there's there's too many of them there. But also then if the gut is inflamed, it starts to kind of leak out, it becomes more permeable it starts to leak out, that LPS. So it has systemic inflammatory effects. So that's what we'd expect to see to be happening to somebody who's got fatigue, like kind of brain fog, fatigue, that sort of thing. So that's how that relates, and aching joints and chronic pain. 

And then what we've seen in the research, but what I've seen in my practice, but we don't necessarily have microbiome tests of people before they come to see me and before they got sick. But what we've seen in research where they have been looking at the impact of SARS cov-2 on the gut, is that the virus itself pushes the microbiome into a pro inflammatory state. So it seems to enhance the growth of certain species. 

And so if you've gone into it with a gut microbiome that's not especially robust, that hasn't got a strong anti inflammatory population, you're much more likely to be pushed further along that. And we certainly saw that with people who were most susceptible, most vulnerable to severe COVID. So when they first listed those groups, you know, cardiovascular disease, diabetes, all of those different groups, many of those had in common was a pro inflammatory microbiome. So they were like actively pro inflammatory, and missing the anti inflammatory species or the populations of those being really low. 

Which is why I, like many people in the kind of wider ME community, spotted long COVID coming along. And shout out to any ME people who have longer term chronic fatigue community listening to this podcast. And so I ended up setting up a case study, it was back in August, September, to try and actually study what was happening in the long COVID microbiome. So I enrolled six people in to see if we could actually intervene using microbiome interventions. And that obviously, that information just kind of carried forward into my practice. 

So we do see that COVID does seem to favor the growth of certain species. And I'm actually going to do a podcast, I promised my testing company Biomesight to do a podcast exactly on the microbiome changes. So I'm not going to go into that today. Because I think that's way beyond most people's listening capacity here. But for people who are already testing their microbiome, I'm gonna go into more detail on that. And I've got blogs on my website that summarize some of the latest research both for long COVID. But also, they've recently been some fantastic studies published on the microbiome and ME.

Jackie Baxter  
Yeah, I mean, that's fascinating, isn't it? I mean, like, like you say, most people who were kind of, quote unquote healthy individuals before getting long COVID, probably won't have any idea how their microbiome was functioning, because they were functioning and they were fine, or they thought they were fine. So they wouldn't have given it a second thought. I don't think I even knew that microbiome even existed, let alone what it was, until sort of more recently. So I suppose it will be quite difficult to kind of compare long COVID microbiomes with previous microbiomes. 

Viola Sampson  
Yeah.

Jackie Baxter  
But you seem to be suggesting that it's likely that certainly quite a few people, their micro biomes maybe weren't perfect beforehand.

Viola Sampson  
So I mean, I've got various hypotheses about this from working with now hundreds of clients with long COVID and fatigue conditions. And there seem to be, I would say, certain groups where there may have been predisposing factors. Now, I think we have to heavily caveat this with these are people who have found me. So they had some kind of interest in the microbiome, which means they possibly had longer term gut conditions anyway. So they are - the medical term would be - over represented in my client group. That makes them sound unwelcome. And they're not, they're hugely welcome. They're not over represented at all. But. 

So I would say one of the big factors is slow transit time, constipation, bloating, so anyone who's got a diagnosis of IBS C. And anyone taking PPIs. And that would also include antihistamines, that suppress stomach acid as well. So that makes the small intestine vulnerable, it lowers stomach acid that keeps us more in - one of the things that keeps our small intestine healthy. It's kind of a complex cascade of relationships that we're not going to go into. But we do know that people who are on PPIs have a very, very high risk of developing something called SIBO, or small intestinal bacterial overgrowth, SIBO, which often gets a diagnosis of IBS in the kind of conventional medical world. So that's one group of people. 

And then there are others who maybe through diet, lifestyle, other kinds of factors have had their anti inflammatory species reduced. So I've had several clients who took antibiotics within six months of developing long COVID or been six months of getting the COVID infection in the first place. So I think those are all important predisposing factors. And then there are others, like we know ADHD is a risk factor for long COVID. And often that goes with the ADHD picture is a histamine picture as well. So that kind of MCAS, mast cell activation syndrome type of symptoms.

Jackie Baxter  
And when that's really interesting, you'll be able to tell me much more about the sort of histamine and how that's related. But there was definitely something that I saw relatively early on, that said that people who suffered more severe hay fever, were more likely to get long COVID. 

And I was someone who used to get really bad hay fever. So I was like, Oh, is this why I got long COVID? And you know, I don't think the answer is as simple as that. But it was just made me wonder when you just mentioned about antihistamines having a impact on the microbiome, I thought, well, actually, I did used to take antihistamines for quite a lot of the summer. And I used to do that every year, because it was the only way that I could actually function. So could that be related?

Viola Sampson  
There are different types of antihistamines, there's h1 h2 blockers, one targets, receptors within the gut in the stomach in particular, and that has the effect on the stomach acid. The more commonly ones taken over the counter, not needing prescription, target the histamine receptors elsewhere in the body. So that's not so much a factor, in terms of the medication, I would think. We might find things out later about how that interacts with the gut microbiome. 

But we know that the gut microbiome also has a really important role in stabilizing our mast cells. So we've got mast cells that line the gut, they're throughout the body, line the gut. And there are other ones that particularly destabilize mast cells, so those species often come up in testing. And also, interestingly, in the recent ME research, they will also show, it's those small intestine, those gut bacteria that like to colonize the small intestine. So that also came up in the recent research on ME that was on my website. 

So it's always different things are kind of falling into place. And it's early days to be working with this stuff. And I think it you know, it's a huge privilege, really to be taking this really new knowledge, and working with it in practice. And, you know, there's some, I'm sure conventional medics who would go, this is way too soon to even be doing this. But I'm like, but there is actually - it's having a positive impact, like who am I to be withholding this knowledge from patients, especially where there are clinical trials that showing effectiveness of pre and probiotics and on other conditions or on particular microbiome imbalances? Not yet so much with long COVID. But, but we can actually apply that knowledge in a new way into a new context, and have positive effects. 

Jackie Baxter  
Yeah, I mean, I remember somebody saying that it's a very exciting time to be in sort of medicine, and in practicing and in these sorts of areas, because of this new illness. And all of these new people to experiment on, I think was the gist of it. 

Viola Sampson  
People are experimental guinea pigs.

Jackie Baxter  
Yeah, you know, in a way, I think, you know, yeah, as a practitioner, it probably is quite exciting. You know, there's new research coming out, there's new people, trying all these new things, and learning all these new things. But then I suppose the flip side of it is, it's not a great time to be a patient.

Viola Sampson  
There is that, there is that and actually, that is something I wanted to get across in today's podcast actually, is it's so important when we're talking about the gut microbiome, I do worry that there are practitioners and individuals experimenting on their own microbiome, who are being really gung ho about this. The very first principle is first do no harm. And people are using anti microbials. And antibiotics, sometimes, in a context where they don't really understand that, first of all, that they're using, like, narrow testing, so they're only looking at a few species. 

So there are really common anti microbials, like Oregano, essential oil, and other essential oils and capsules. Berberine is a really popular anti microbial, it's been used a whole lot within the functional medicine community in particular. And actually, it's having really negative impacts on the bits of the microbiome that they might not be able to see. 

So I've had clients who've been taking strong anti microbials like that, and their microbiome's in a real state. So I think there's that's really, really important to know, don't mess around with it. Because once you make a species extinct, you can't reintroduce them. There's lots of this sort of the kind of weed seed feed protocol, which is kind of like a functional medicine sort of structure. It's like, it doesn't make any sense ecologically. You can't re-seed the gut microbiome unless it's by fecal transplants, and that's a whole other topic we're not gonna go into today. 

But probiotics do not re-seed the gut, they do good on the way through, but they're transient. They you have to keep taking them to get their benefits. They might persist for two or three, sometimes six weeks, or just a few days. So yeah, don't mess around with it. 

And I think the other thing is focus on feeding up the beneficial bacteria, because it's those beneficial bacteria that keep the population healthy. So most of my work, and I think that's probably where it differs from not all microbiome practitioners, but differs from a lot of them, is focusing on something called prebiotics. So probiotics are the live beneficial bacteria, there's prebiotics that feed so I think is the E, feeding prebiotics, that feed up beneficial bacteria. And they're the ones that create the kind of long lasting, large scale shifts in the gut microbiome. 

And I wish I could go into details about different prebiotics people could try, I think what's really tricky here is it's very easy to give general recommendations for maintaining a healthy gut microbiome. When you're talking about treatment, changing the balance of the gut microbiome, you need to know which species you want to feed up. And also certain prebiotics can have a negative impact, particularly if you're struggling with bloating or constipation. So I can't give out, you know, recommendations, although there's possibly one that I could that most people would have a positive benefit from. 

It's something called GOS – galacto-oligosaccharides. That feeds up Bifidobacterium, which is one of the ones that some species interact with the gut microbiome, brain access to that autonomic nervous system aspect, and tends to generally only have a beneficial effect on most people's microbiome makeup. And Bifidobacterium seems to be one of the ones that usually very low in pints with chronic fatigue. So that's generally one so there's Bimuno, is one product. The better version is for GOS that's available from Invivo healthcare. So that's one thing. 

Another thing that people can try is, there are probably three probiotics. And the important thing to remember about probiotics is strain - is really important because different strains have different effects. And when you're talking about strain, you're generally talking about so species would be lactobacillus acidophilus, which you might recognize from a side of a yogurt pot. But strain would be something like Roselle, 52 or RO52. Because that's the strain number. 

And that one in particular is very good for - their clinical trials on medical students going through their exams, their finals, and the ones that were taking this one and another one called Bifidobacterium longum RO175 - it's really catchy, this, they had much lower stress scores. So I often prescribe those two probiotics to clients where anxiety, that nervous system dysregulation is a really big part of their picture. And one of the places that you can get those two in combination is a probiotic known as Optibac For Every Day. Not every day extra strength, or everyday Max, those are completely different strains but Optibac For Every Day. So that's a nice one for the people who feel like they need some support, calming their nervous system. 

We talked a little bit about PPI use, and anyone who has sort of potentially those digestive symptoms in the kind of upper part of their tract. So shortly after eating and like come over with brain fog or fatigue, that real slump after eating. Bloating that starts fairly soon. Constipation, so that would be Biogaia Protectis - it's a bacteria known as L reuteri DSM17938. But the product is Biogaia Protectis and it comes in capsules or drops. 

And then another one I use a lot is lactobacillus rhamnosus GG, and the GG stands for the researchers who isolated this strain, studied it and they found it actually in the gut I think about a healthy Swedish man. So thank you healthy Swedish man, because this is one of the best studied probiotics, hundreds of clinical trials showing effectiveness in all kinds of conditions. But where it's super important for the like kind of long COVID picture, is it degrades histamine in the gut, or it certainly does in in a petri dish, so hopefully does in the gut too, it has been shown to change markers of inflammation in the blood. And I mean, it's a great one for the respiratory microbiome as well. So it prevents viral infections and decreases the length of viral infections if you do get them. So it's a really, really wonderful probiotic. 

So I hope that sort of give something, kind of cramming in there towards the end of this, there's some practical things that people can try. Some people have wonderful effect with the Biogaia Protectis. So it really helps speed up their transit time, because they struggle with constipation. For a lot of people, it's not going to be enough on its own. But these are perhaps things that people can kind of introduce as some additional support for their microbiome or their health.

Jackie Baxter  
Yeah, that's huge, isn't it? But what you were saying there about the one that would help, you know, with viruses, when we pick them up. I mean, this this is something that has been a huge concern for me, and I'm sure is similar for many other people is this kind of idea of, I'm already sick. What on earth would happen if I were to pick up COVID again, or even anything else? 

And I suppose this as part of, you know, we can't avoid everything forever. So how can we make ourselves as healthy as we possibly can, so we can deal with whatever life does throw at us. And some of that is going to be, you know, viruses of whatever form they take. So yeah, that interests me on a personal level as well, just hearing that.

Viola Sampson  
Absolutely. Absolutely. And I think what's great about the rhamnosus GG, is it has that capacity. And I think just want to add to that these are ones that are generally safe to take for people who have MCAS type symptoms. Sometimes they don't get on well, with the Biogaia Protectis, but a lot of them do. But the Optibac range is all tested to be safe for people with histamine issues. And rhamnosus GG actively helps people who have also allergic rhinitis and things like that. So

Jackie Baxter  
yeah, fantastic. I will make sure that when I do the transcript, I will make sure that all of those things are spelled correctly. So if anybody's sort of frantically trying to make notes and thinking, Oh, my goodness, what are all those numbers? I'll make sure that they're correct in the transcript. So. 

But that's so helpful to get some kind of practical ideas. Because, I mean, I'm certainly thinking, wow, this is such a huge thing. I mean, even speaking as myself, and I'm saying, well, actually, I'm recovered. But I feel like I want to make myself as healthy as I possibly can. And I think this is something I need to look at. Because you know, I think then again, this is something I'm coming to realize is that nobody is 100% perfectly healthy. And everybody's health can be better. 

And obviously, when you have long COVID or chronic illness, you're looking at it in a completely different way, aren't you? You're saying how can I get better? How can I make this hell that I'm living a bit less hellish? But yeah, I think, you know, it's kind of realizing as well, as I've worked my way through it, that well I don't need to stop trying to be more healthy, when I'm calling myself recovered. So yeah, I'm totally gonna dive into this, this is amazing.

Viola Sampson  
And you know that by the time we've got to midlife as well, our gut microbiomes have weathered an awful lot. Like we've probably had several rounds of antibiotics of various things. We may have had a period of binge drinking, we may have had a period of eating junk food, or, you know, lots and lots of different things impact or, you know, long term stress or something like that, or illness or viral infection that we also now know, impacts our gut microbiome. So it does make sense to do that in a way, that midlife checkup or earlier if we can, but to set yourself up for healthy aging as well. There's so much potential here for gut microbiome.

Jackie Baxter  
Yeah, and I guess that's the exciting thing, is that it is evolving. And as time goes on, I guess, you know, we will - you people who understand - will learn more, and you know, we'll be able to sort of share that knowledge. So as time goes on, there will be more knowledge about this. So I suppose yeah, it's another reason to keep learning, I guess isn't?

Viola Sampson  
Absolutely and that's one of the reasons I'm really passionate about conversations like this, particularly targeted at the fatigue community that I really want to have this information, but also my Instagram profile and blogs. It's like actually getting information out there and importantly, free information out there, because obviously, working with a microbiome practitioner is expensive, it's not accessible to everyone, especially if you're not able to work due to chronic illness. So, you know, to actually have that information getting out there, and in responsible ways as well. I think is really, really important.

Jackie Baxter  
Yeah, definitely,

Viola Sampson  
I think the only thing I haven't touched on is probably the importance of poly phenols. And that's colors and flavor in food, and therefore pleasure. Which is another reason why I love it. It's like, yeah, a lot of the tips are about how to make food more delicious, because that it actually does nourish our gut microbiome. So in a kind of diet that's now - there's so many diets out there, aren't there? But the diet that has been proven over and over again, to have the most kind of positive health outcomes, and over long periods of time, is the Mediterranean diet. 

So there's lots of things in there that nourish the gut microbiome, including fermented foods, if you're able to tolerate them, like yogurts, and olives, and obviously, sauerkraut and kimchi and those things, too. But also the bright colors and the strong flavors, the bitter flavors and the berries and things like that. So I put a lot of those sorts of tips on my Instagram profile, partly because they photograph beautifully because they're brightly colored. But there are sort of general tips that you can, it's about adding foods in more than it is about taking foods out. 

And I think when you're struggling with a long term health condition, one of the places you can get joy in life is food. Now, obviously, sometimes that's hard to do like, but there are things like olives that you can just keep in a jar in the cupboard and add on to your plate, that are really low spoon way of boosting your gut microbiome health. Olives are very high in poly phenols, their kind of black color and the bitter tannins that they have. So there are things like that, then I've done various posts on low spoon ways of boosting your microbiome health. So it's kind of minimal energy.

Jackie Baxter  
Yeah, I'll make sure I put a link to your Instagram in the show notes as well. So anybody can can follow that up. I suppose maybe just one final thing that I just thought of, you know, there's a lot of people that either through their own experimentation, or through help have, you know, discovered that they're now intolerant to things that they weren't intolerant to before. And, you know, trying to sort of cut things out of their diet, whether it's, you know, histamine foods, or lactose or gluten or whatever. And you were just saying, you know, more about adding things in and taking them out. What would your sort of, again, very sort of general disclaimered advice be for people that are really struggling to get things into their diet? 

Viola Sampson  
Gosh, I think that is a hard one, because generally, that does suggest that microbiome repair is needed. And I guess what I didn't say earlier is like, I started off this podcast talking about how limited my diet was. Through repairing my gut microbiome, I eat everything now, including really unhealthy stuff that I probably should eat less of, especially being a microbiome analyst, telling everyone else to eat healthy food. But you know, I'm making up for lost time. 15 years of not being able to eat croissant, there's a lot of croissant going on, and pizza. 

That is a hard one. It probably does need working with someone who can provide really targeted advice to the particular microbiome imbalances that you've got. I don't think there is an easy answer. You could try the GOS that I mentioned, you could try particularly Biogaia Protectis. That might be enough for a small number of people. But I imagine there's more, there's bigger microbiome shifts, and before you can start reintroducing foods. And it's one of my favorite bits of my job actually, is when someone comes in with very restrictive diet, and they come back a few sessions later and go, I can now eat this and I can now eat that. You know, it's just the mental load of restrictive diets. And the joy of being able to expand your diet again is quite something. 

Jackie Baxter  
Yeah. It's amazing. Well, thank you so much for joining me today. This has been absolutely fascinating. And I have so many things I need to go and Google now. So thank you so so much, I will make sure that I drop a link to your website in the show notes. So again, if people want to follow up your blogs or with you, then they can do that. And yeah, thank you so much for giving up your time.

Viola Sampson  
Look it's been like it's a real honor to join me on this. I think it's an amazing resource that you're putting out there into the world. So I'm really delighted to be part of that.

Transcribed by https://otter.ai