32: Preventing IBD Flares and Reaching Remission

The worst part about having IBD is the flares. But what if there was something you could do about it to prevent this from happening?

TOPICS DISCUSSED:

• What flares are and why they happen
• Addressing the root causes and your immune system
• Steps to preventing flares
• How to recover faster 
• Supplements you can take

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Transcript

Josh Dech:

It is no secret that the worst part about IBD flares is the pain, right? The flares are the worst part about IBD. This is what comes with it. It's inevitable. It's unpredictable. There’s urgency. There’s all kinds of stuff, and oftentimes flares land you in the hospital.

And so today I'm going to be giving you the Ultimate Guide to IBD Flares. We're going to talk about—and you're going to learn—why they actually happen, like what causes a flare. We're going to talk about how you can actually prevent them, and of course, when they do happen, what you can do to help them end much more quickly.

Contrary to what your doctors told you, Crohn's and Colitis are reversible. Now, I've helped hundreds of people reverse their bowel disease, and I'm here to help you do it too. Because inflammation always has a root cause—we just have to find it.

This is the Reversing Crohn’s and Colitis Naturally podcast. Now I do these live trainings in my Facebook group every single week and put the audios here for you to listen to. If you want to watch the video versions of these episodes, just click the link in the show notes to get access to our Facebook group and YouTube channel. And for weekly updates, information, tips, and tricks, you can sign up for our email list by clicking the link in the show notes below.

Now, for those of you who don't know me, my name is Josh Dech. I'm an IBD specialist, medical lecturer, physicians consultant, and the scientific strategist and education director for RFCC where you're watching live right now. Today we're going to be going through the ultimate guide for IBD flares.

Now if you have any questions, do put them up. The way the phone is oriented, I can't figure out how to get my camera to mirror, so I'm looking at the back of my phone. But if you do have questions, put them up. I will get to them toward the end here. But let's bang this out really quick.

The first thing I want to talk about is the biggest goal in dealing with IBD. It really is getting it under control in some way, shape, or form. Oftentimes that's through any means necessary. So what I want to do to anchor what it means to control this—I want to get two definitions out of the way. The first thing we're going to do is we’re going to define remission, and we're going to define the word flare, so we give ourselves some context what this actually means.

First things first, remission is a state of inactivity, be it on a spectrum of mild to moderate or no symptoms at all. It’s a state of inactivity—the absence or lessening of symptoms. Some people are having 10 out of 10. If you're somebody who's unfortunate enough to deal with 10 out of 10 gut issues, for you, that’s going to be your flare. Some people, they got very mild symptoms, and a flare is like a five out of 10, right? Some people, remission is here—we obviously want better—but that's what a flare is. It's obviously then the opposite of remission, which is a period of increased disease activity or immune responses leading to more pain, more inflammation, and this worsening of symptoms. That's what it means.

So remission is a decrease, flares is an increase. But if it's all an increase and decrease, then let's talk about what creates the symptoms, 'cause we can't really go to fix something unless we understand how it works or why it’s happening/

So if we can say, okay, my immune system is reacting to something, my inflammation increases... along the way, this is where we say, okay, your immune response is here, right? Something had to enter at this time which created inflammation, which sensitized nerves, which created this pain. That’s how it goes. The more severe, the quicker it is, the faster the response, the faster the pain.

So a flare—it’s an uncontrolled immune response. If I scrape my arm on the sidewalk, no big deal. Whoopie, right? I get a little infection if I’m not careful and it hurts like a two out of 10, that’s it. My immune response to that thing is healthy. In the case of a flare, it’s an unhealthy hyperactive immune response.

If my arm, say, flared, so to speak, my whole hand would swell up, I couldn’t lift it, it would hurt, I’d probably have a headache, I might get blood poisoning—it’s an extreme immune response.

What we have to look at when we’re dealing with this is there’s a direct correlation, okay? Between the severity of the flare and the things that are inflaming you. And I know it maybe sounds redundant, but let me explain this in a different way.

Picture your body like a cup of water, okay? The more things you have filling this cup, the faster you're going to flare. For you, a flare is when that cup overflows and it spills. Now if you're somebody who’s walking around with a constantly full cup, all it takes is one stressful day, one bad meal, it takes one seasonal flu—and you’re in a flare.

If you're somebody whose cup is, say, empty, right? You don't have a ton of mold, you don’t have a ton of stress, you eat really well, you get exercise, there's red light, you’ve got nutrients and vitamins, you’ve got microbiomes well-balanced—your cup is pretty empty.

But if you have the opposite of all these things, your cup is full. And this makes the difference. For you, if a flare puts in half a liter of water, okay—you’re only up to here—you get irritated. If your cup is full already and you put in half a liter, you overflow half a liter and your flare goes crazy.

That’s sort of the simplest way I can explain this process. And so a flare is an overactive immune response. So what do we do to control it? Simply put, we reduce the amount of things that are filling your cup. That’s how we get a flare under control—even prevent them sometimes.

Now there’s always going to be breakthroughs, there’s always going to be freak accidents, there’s things that are going to happen. We're giving you all the tools we can outside of prescription drugs to manage that flare. Right? That’s what we really want to look at.

And so what does prevention look like? How do we empty this cup? Well, if your body is a cup—we'll maintain this analogy here, okay—your body is a cup. Your cup has a couple of different things that make it, right?

Number one, it's the cup—that’s your body—that’s holding stuff. But two, it fills up with stuff. So if we want to make your body more resilient, we have to, of course, empty it—which means we have to get things out of the body.

Well, there's two ways things can do that, right? We have detoxing. If you think about detoxing like you're collecting your garbage, right? You're accumulating all this trash. Drainage is getting rid of it. It’s bringing your garbage out to the curb. It’s how your body gets rid of stuff.

So your gallbladder, your lymphatics, your bile ducts, your skin, your sinuses, even bowels, kidneys—these are how things exit the body. That is drainage. So if you want to get rid of what’s filling your cup, we have to open the plug and empty it.

So drainage is the first thing. Once your body is emptied, we then need to identify the root causes and contributing factors. You’ve been told so many times: IBD, Crohn’s, colitis—they're random, it’s autoimmune, it’s genetic. I've got a quick 15-minute video that dispels all of that. It's just not true in the vast majority of cases, okay?

Genetics, family history is relevant 24 to 28% of the time. Actual genetic morphologies, I believe, is 12% detection. So 25% of people have a genetic history. So why are we calling 100% of them when it’s only 25% of them being genetic?

Second to that, genetics don’t work in a vacuum. They get turned up and get turned down based on environments, inputs, toxins, nutrients—the works. So they don’t work by themselves. So we can’t blame our genes.

Number two, we say it’s autoimmune. Well, did you know that only 70% of all ulcerative colitis cases have any antibodies at all? 50 to 70% of Crohn’s have antibodies. Most of them are not autoantibodies. So your body is not attacking itself, right?

An antibody is just a specific defender made for a specific invader. If I’ve got a castle, I’m protecting my castle, okay? Back to the medieval—I love medieval—and you got bad guys walking up to the castle, what do you do? You get archers and you snipe from far away. That is your antibody for the specific antigen.

However, what autoantibodies are is: you see your own soldiers walking up, you confuse them for the bad guy, and you shoot them anyway. That’s what an autoantibody is. But most of the antibodies we see in Crohn’s and colitis—they’re not autoantibodies. So you're not attacking yourself.

And to say there’s no known cause when we’ve got a 3,000% increase in 75 years and half the world’s cases are in North America, which is less than 5% of the globe—it’s not that either. So this is where we dispel it and say, okay, there has to be more to it.

So we have to understand there are root causes. Now I’ll touch on this very briefly. I did another talk on this, but I don’t want to get too off track. But here’s the main causes, okay?

Number one is going to be toxins.
 Number two is deficiencies—deficiences, I’m trying to spell and write.
 And the third one is going to be microbes.

Okay, toxins—anything from blood sugar to heavy metals to mold, to glyphosate, to EMF, to endocrine disruptors. Any kind of toxin that didn’t exist 500 years ago—a chemical—it’s a toxin. Microplastics? Major issue.

Deficiencies—vitamins, nutrients, amino acids, short-chain fatty acids. Things your body needs to rebuild and repair itself, okay? Even immune system deficiency can lead to this.

And then microbes—either overgrowth or undergrowth, extinction or infections. Too much candida? It’s a problem. Extinction of good guys like akkermansia and bifidobacterium? They’re necessary for our gut and our immune system. We’re deficient. So bad guys come in. We get infections like parasites and viruses, etc.

These are the only three umbrellas to why human beings get sick. You’re toxic, you’re deficient, or you’re infected. That’s as simple as it gets.

So your root causes are a mixture of some of these three things. Maybe your cup is 80% full of mold. Maybe it’s 90% full of parasites. Maybe it’s 50/50. It’s hard to say. Maybe it’s 20% viruses.

But once we’ve opened your drainage pathways, so your bad guys can then get out—the mold can exit, the parasites can exit—now we can go after it, right?

So the first thing we want to go through is: open your drainage, identify your roots, and now we can begin emptying your cup. Get rid of the plastics and the chemicals. Open up your windows.

Did you know indoor air—for the EPA, the Environmental Protection Agency—the EPA says indoor air is one of the top five pollutants for humans in our modern world. Because we’re recycling. We’re not getting fresh air. So there’s simple ways to empty your cup, okay?

This is how we prevent flares. The emptier you are—the less chance there is of a flare. If water comes in, you’re less likely to overflow your glass. It’s that simple.

Okay, so we have to open drainage: liver, gallbladder, lymphatics, bile duct, etc. Get to the roots, clear these pathways, and reduce the stress on your immune system. Reduce the amount of things filling your cup.

There is another category of people who settle in deficiencies—who do have immunodeficiency. Their body’s not making enough antibodies to actually keep their immune system in balance and defend, etc.—which is a modern problem as well. Comes back down to a lot of things, but that’s another issue altogether. And you can look at certain therapies like IVIG, which is an IV immunoglobulin. So they give you immunoglobulin—these specific proteins.

So that’s the idea right now for sort of preventing flares. It’s emptying your cup. Okay? Emptying your cup. I feel like a 1980s kung fu master teaching you new things to empty your cup. Okay?

But we have to empty it, otherwise you’re going to be in a bit of a pickle.

So the next thing we want to look at—I want to go back to genetics. We say, “Genetics caused my disease.” No. They don’t. They don’t, right?

Genetics are a weakness, but we can sort of patch your genetics. This is something I think is very important to address to prevent flares. Genetics play a big role because they communicate with your immune system.

So for example, we know NOD2, right? One of the most commonly associated genes with Crohn’s disease. Let’s talk about this one—NOD2. NOD2 actually regulates your immune response to bacteria. So if you are somebody who has bacterial dysbiosis, your gut bacteria is a big mess, your immune system is already having an irregular response to it. Therefore, if you can fix your bacteria, you’re going to have a better immune response.

Picture you—if you ever knew anybody—when my gut was at its worst, I was 15+ bowel movements. I had blood. I had nausea. I had 10-minute transit times. Undigested food. I was a train wreck. I had panic attacks like nonstop.

I’ve never had anxiety. I was a paramedic. I thrived on chaos. Suddenly I’m having panic attacks. The littlest trigger would send me into a spiral. Why? Because my cup is already full.

So the littlest trigger—any emotional response, any stimuli, whatever it was—bloating, it would send me into a panic attack. And so the same thing happens to your immune system. It’s already overdrawn. Its cup is full. When you give it more bacteria to have to deal with, it’s already a little imbalanced. It’s going to go haywire.

Yes, maybe you have anxiety already—no big deal. So if you keep a healthy, non-anxious home, you’re not going to have anxious responses—or you’re going to reduce the frequency.

And so when we’re looking at genetics, we can’t blame them. We just have to say, “Okay, where can I patch these? What is causing my genetic response to turn up and go crazy versus turn down to be really chill? Am I deficient in nutrients?”

There’s a whole study called nutrigenomics, which talks about how nutrients influence genetic expression. Nutrients. Genetics. If you’re deficient in something, if you’re toxic—toxins actually increase these expressions and change the genetic expression very negatively, right?

Mold and plastics and all these things—we’re now learning, but we live in a toxic world. Or let’s look at, for example, the common gene associated with ulcerative colitis—it’s an HLA gene. There’s different HLA genes, but these basically encode proteins, and it presents an antigen, rather, to your immune cells.

So it says, “Hey, I’ve made this thing and this is the bad guy. Here you go, immune system. Take a look and identify it.” That’s what it’s doing.

Now the problem is—if this gene is performing poorly—what ends up happening is it starts to blur the lines. It produces an antigen: “Hey, here’s the bad guy. Here’s the good guy. It’s black and white. Do not kill these guys. Do kill these guys.” That’s what HLA does.

The problem is—it starts to express poorly. It starts to get a little bit inflamed. It gets brain fog. It’s not thinking well. It goes, “Well, maybe that’s the same thing. I don’t really know.” Now your immune system is like, “Well… let’s just kill them all.”

This is where autoimmunity can also come from. And so we have to give your genes the best possible chance to express positively. So—emptying your cup. Getting your nutrients where you’re deficient. Getting rid of the toxins that impact these expressions—that express negatively. This is what we have to look at.

Okay? So this is what a flare is—and how we really prevent them.

But there’s an important conversation to have now—and that’s on what to do when you get into a flare.

And so really quick—I want to remind you, I’m going to get to questions here in a couple of minutes. Drop them now in the chat, and when the time comes, I’ll have to turn my phone around, because I’m looking at the back of it, talking to no one right now… so lonely.

But I want you to keep an eye on that—so drop your questions, I will get to them.

Here’s the first thing: What do we do when you’re in a flare?

Here’s what I will say—as a holistic practitioner, oftentimes people kind of assume that I’m anti-drug. I am not. I am pro-integrative, which means: Dude. When you’re in a flare—get the drugs. Doesn’t matter. Get it under control.

If I’m going for surgery—I’m not going in with lavender oil and a little bit of chloroform. Like—knock me out. Give me the anesthesia. Give me the blocks. Whatever you gotta do.

We have modern medicine for a reason. It is great for short-term use. The problem is—if you’re constantly going into flares and constantly relying on medications to suppress it, you’re not getting it fixed. You’re just managing it.

Medications can be great to control things—to give us the latitude we need to get in there and get to the root cause. If I need you to take supplements, or change your diet, or do something—and you can’t even get out of bed and you’re locked in the house—get the drugs. This will give us the latitude we need to apply the proper program to get you the help that you need.

This is what’s so important.

So drugs are step number one when you’re actively in a flare. Don’t be afraid of them. If you respond well to a prednisone taper, go after it. Amazing. I’m not worried about that. We help people all the time who are on drugs, who are off drugs—doesn’t matter. It’s just—we want your body in a state to be able to receive treatment and protocols, and for you to be able to do something about it.

Okay, so the next thing we want to do—let’s get the drugs. But we talk about your cup, right? We want to reduce the stimulus on your immune system. Reduce the things that are filling your cup.

This can be really simple—diet. The issue with diet is: doctors say food doesn’t cause this disease, which I have seen it in like 1% of cases where you literally change the diet and they’re fine for the rest of their life. On the other hand, they say food doesn’t cause it, therefore food is not the solution. They take it a step too far and say, therefore, eat whatever you want. That’s not—this is third-grade biology. It’s nonsense.

What you eat and go put into your gut obviously affects your gut. The fuel you give your living, active microbes determines whether or not they live or die. It’s a big, complex process, but it’s as simple as that.

If it’s something your great-great-great grandmother did not recognize as food 500 years ago—don’t eat it today. It’s that simple. Whole foods. Tolerable foods. Low-histamine foods. That’s what we do for diet.

Next to that one—try to avoid getting the flu, if you can. Sometimes you can’t. Get sleep. Sleep where you can. If you need supplementation, if you need drugs to get to sleep—getting your body to rest… I don’t mean like sleeping pills, but I mean if you need prednisone to get a good night’s sleep, do what you have to do. Melatonin—there’s different ways to get you to sleep.

If you’re waking up in the middle of the night, that also tells us what your root cause might be. But there’s different things—blue light. We get about a hundred times too little light during the day because we’re indoors and we’re locked inside in offices. We get about a hundred times too much light at night staring at our cell phones.

That is your circadian rhythm. We need light in the day and dark at night to put us to sleep. Get rid of the blue light. Get blue light-blocking glasses at night if you have to work late.

Fresh air—again, indoor pollutants: major toxin for humans. Open the windows. That’s going to be a great one.

Eat organic where you can. Get rid of pesticides. If you can’t afford inorganic fruit, don’t get the fruit. Or buy organic frozen berries or something that’s affordable that gets you that fruit. But you can’t put toxins into your body—they’re going to be filling your cup.

Microplastics—I just did an episode on my podcast Reversible on microplastics. They create macro problems. They’re very, very dangerous.

And actually, it’s assumed now—there was a study out of Belgium or somewhere—that actually assessed that we eat about five grams of microplastics every week. To give you an idea, that’s about the weight—a size and weight of a credit card, or one of those plastic disposable grocery shopping bags. That’s about five grams.

Now, nanoplastics—we just recently have technology to detect them. Estimates are we eat up to 200 times that of nanoplastics. Just imagine taking 200 plastic disposable grocery shopping bags, getting a fork and knife, cutting it up, and just munching it down—every single week. That’s how toxic our system is.

So getting these really basic things—that’s going to help empty the cup. Your immune system has less to worry with. This is the first step to reversing these flares—give it less to deal with.

Second to this one—I’m very careful about these—is probiotics. Now, I’m not telling you to try probiotics while you’re in a flare. That is dangerous. Doing anything new in a flare is asking for trouble.

Certain probiotics can be higher in histamines or liberate some histamines, but some can help control your immune system. There’s two common strains—or species, I should say—of bacteria that we see in probiotics most commonly. They’re the most abundant. It’s either a lactobacillus or a bifidobacterium. We’ll call them L & B for simplicity.

But the two that you can really use oftentimes that tend to be highlighted as the most effective for your immune system are going to be lactobacillus rhamnosus—oops, that’s supposed to be an “n”—and bifidobacterium infantis.

These, in higher doses of multiple tens of billions, have been shown to help kind of control some of those responses. But try them in low doses first, outside of a flare, and then you’ll know how you respond to see if they might help you in a flare. Always test before you’re in the deep of it.

The next one that’s going to really help you guys—a car doesn’t run very hot... it actually runs too hot—does not run very well without lubricant. Therefore, you want H—you want lubricant for your body. Hydrate. Water. Electrolytes.

However, another major toxin is our water. So for example, I have a colleague of mine in Houston who actually runs a microbiome company—she’s a researcher. Her gut’s been perfect for a decade, two—two, three decades now. She moved to Houston, her gut started getting wonky. She tested her water—aluminum, uranium, I think there was mercury or something—and there was all kinds of junk in there. Heavy metals and toxins.

Our water is horrific. It really is. It’s just the way it is. You’ve got 300+ million Americans who are consuming pharmaceuticals—and they pee, and it goes into the water. Can’t get rid of some of those. There’s hormones and toxins and pharmaceuticals. There’s heavy metals. And we’re now calling PFAS—these “forever chemicals.” There’s pesticides and glyphosate. There’s stuff in our water we can’t get rid of.

But a simple filter gets rid of most of it. Like a distiller. Brita water filter is not so great. But a water distiller will get rid of most of it, so you can have clean water.

There’s other stuff we can look to—for example, like peptides. Now these are really quite safe—some of them. Some of them—don’t mess with. I’m going to give you some here for research only. Do not attempt them without a practitioner. Safe or not, you never know what you’re messing with.

But for example: BPC-157. I should say—extremely safe. Oral dosing. If it’s made for an oral capsule—injection. But I find for the gut, oral is better.

Another one that might help re-regulate your immune system is actually called KPV.

So there’s a lot of peptides that can help you manage your inflammatory responses.

But on the other hand, you’re also inflamed. Let’s talk about soothing and cooling—basic stuff, right? Aloe vera. Slippery elm. That can help soothe and cool your gut and your gut lining when it’s already active and inflamed.

Another really good one—it’s a derivative of omegas—is called PRMs, which are pro-resolving mediators, which are going to help—well—mediate that inflammatory response. These can be really, really powerful.

Now, we talked about other reasons we get sick—deficiencies. Let’s talk about some really basic vitamin and mineral deficiencies—things that can help you with your immune responses and replenish what you’re lacking.

First of all, if you need nutrients and you’re in a flare, a good elemental diet—not like that Nestlé crap—but like a good medical-grade, bioavailable, methylated vitamins, proper elemental diet—you get what you pay for—can really help. Even if you’re intermittent fasting, taking it when you can—it’s better than nothing.

We also want to make sure you’re getting things that help your immune system. Big deficiencies in Crohn’s especially—vitamin D and zinc. But particularly a form of zinc called zinc carnosine, which has actually been shown to help with the gut—specifically gut inflammation and the integrity of your gut lining. These can be really beneficial to help you get out of a flare as well.

And the last one—where you’re able to—because obviously, you’re in tormenting pain—is movement. I’m not saying go to the gym. But get up and walk around the house. Just try to move. Lay on your back and just move your arms and legs. Pump your lymphatic system to get things moving around the body.

But here’s what we also have to keep in mind: your body does things not by mistake. When you’re in a flare and you’re like—you’re shutting down—your body’s saying, “Hey. Go to bed.” Do it.

You’re tired for a reason. Your body only has so much fuel to go around. And so—I don’t know why this came to mind—but like, you’re stuck in space, for example. You’ve only got so much fuel to propel the engines. You’ve only got so much oxygen. There are only so many resources to go around.

And so if your body is telling you, “Dude, we’re like—we’re tired. Go to bed”—go to bed. Because it’s trying to help buffer. Your immune system is redistributing resources. It’s really important to listen to our body.

That’s what we got for you for now for how to really manage a flare. But how to come out of them—we want to know why it happens so you can understand your cup is filling up. This is why you’re so prone to flares. Empty your cup—you’ll have a lot more latitude. Number one.

Number two—prevention means keeping the cup empty and removing those root causes and opening the drainage pathways so those root causes—toxins, metals, mold, parasites, whatever—can exit the body.

And then, of course, when you do get them—get on the drugs. That’s fine. And combine them with these tools and natural remedies to get a double-whammy effect on helping your body soothe, cool, and calm down.

That’s all we got for you for tonight.

Right now, I’m going to go into the comment section. I’m gonna see what you guys have. I’m gonna flip my phone around so I can see you—I did promise I would get to the comments here.

Let me see… all right. See, when I look this way, I have this giant head—maybe that’s why I thought space. I got this giant forehead—an alien.

So here’s what we got for questions. Let me get into this… just scrolling the whole list. Now is a great time, guys—put your questions in because we’re wrapping up right after this.

“I’m from the UK. It’s very late here.”
 So glad you’re here and tuning in. The lives are always available. I do have a YouTube channel and a podcast—all free resources available as well. Send me a personal DM at josh.dech.health, because I am on the Crohn’s and Colitis account here. I’ll be tagged in the replay, but send me a DM if you like—that’s josh.dech.health—and I’ll make sure we can get you any of our free resources. YouTube channel, podcast, that works—you can access all of those.

“Oh, going in a flare for over 18 months is devastating, and it’s so long to be in a flare and dealing with this as well.”
 The more we can do to get you out of there, the better. So yeah, feel free to reach out. We’ll get you some information.

“Starting biologics, and I’m keen to find out what the root cause is so I can try to reverse this naturally. Any support will be gratefully received.”
 Happy—that’s what we do. Reach out to the account, reach out to me. We have all the information here. Like I said—podcast, YouTube channel—it’s all free to help you understand this stuff from another level.

“You see—Matthew Wolf, author—says…”
 That is such a cool name. “I was 100%, now at 95%—tiny flare after a cold, but it feels the same, inflamed. I had small ulcers before. I did all the healthy things—took lemon, cayenne, coconut. But should I lean toward acid or basic, like baking soda? I don’t want to aggravate it.”

Here’s the hard part. So let’s go back to your immune system, right?

Your immune system—the comp... think of your immune system like an octopus. Different arms do different things. It’s going to balance out. One will deal with viral infections. One deals with innate immune responses, like allergies. One deals with parasites and fungus or bacteria. The arms do different things.

The arms we see dominant in IBD, right, are called TH2 and TH17. We also see some TH1, but oftentimes, even actually deficient—where we’ll see these guys are actually overactive.

Well, if you’re overactive in an immune pathway like TH2 or 17, and you get an infection—well guess what? It’s filling that cup. And you over-respond. Now you go back into a flare.

This is why it’s so common—when you get the flare or you get a flu—to go into a flare. It’s because it’s overactivating that same immune system. It’s filling that same cup, and now you’re having these negative responses. That’s typically where it comes from.

And I’m not like Michael Jackson dancing shuffling—I’ve had ankle surgery recently. I’m not supposed to stand on it. So I’m like shuffling to and from here, guys.

But as far as going with acid or something more basic like baking soda—it really depends.

I can tell you this with confidence—I have never in my entire career, over a decade now in functional health, I have never seen anybody with too much stomach acid. Ever. Not once.

And so if you’re worried about it, start slow. Grab a very low dose, like HCL of some kind. It’s not medical advice—I can’t tell you what to do—but if you feel confident experimenting, you could look into something like HCL as a low dose to start introducing some acid to see how you feel. If you feel terrible, you’ll aggravate it—and of course, you can drop some baking soda in to neutralize it.

But if we go too neutral, that’s a problem. But you’ll notice your GI tract—right, not notwithstanding the mouth, because it is acidic but not terribly, right—the highest level of acid is in the stomach. And it’s acidic through the small intestine, and it gets more and more neutral as you go through to the large intestine.

And so—acidity is needed in the body. If we neutralize it too much, you’re going to have back-end issues anyway.

Josh Dech:
“What’s your preferred brand for Elemental diet?”

Oh—you know what, Ally, if you can answer that one for me—I don’t know. There are so many out there and it’s not something I’ve had to actually rely on a whole ton in my career. I’ve used a couple, but off the top of my head—honestly, have no idea.

Ally Manzella actually has a phenomenal amount of knowledge on this stuff. If you have any preferred brands, Ally, let us know in the comments. Because it’s not—like I said—it’s not something I have enough knowledge on to confidently say: use these brands. I just know the ones I would like to avoid.

Charwei says:
“What if the elemental formulas flare you—or worse? Maybe there’s a better brand or option. How to handle a flare when the root cause is mold, but you can't get out of the environment?”

Okay—so two things on this one. First, Ally says: Elemental Heal, Low Carb, and Absorb Plus. I will personally look into those ones as well.

But here’s what we can say—what if the elemental formulas flare you up or worse? Is there a better brand?

Quality is everything. A lot of elementals—especially the cheap ones—they are known to have highly toxic, inflammatory ingredients in them. So you’re going to experience things like high-fructose corn syrup, you’re going to have non-natural vitamins and artificial forms.

In fact, there was actually a recent study—because we know your body is designed to use what it’s designed to use, right? Natural stuff. A recent study actually showed that folic acid—right, folic acid, which is artificial vitamin B9—it’s fake, okay? 44% of the population can’t actually utilize it. Arguments might be up to 80%.

But folic acid—the fake form—actually blocks folate. So the good form, the healthy, normal form of folate from actually crossing the blood-brain barrier. These artificial vitamins actually block your body’s ability to use real vitamins.

And so—you do get what you pay for.

So if you’re finding an elemental diet that’s cheap, it’s going to have cheap ingredients. It’s going to have corn syrup and other fillers. And it’s also going to have what we call non-methylated vitamins.

So for example, if I’m looking at vitamin B12—it’s called cobalamin—what I want is something called methylcobalamin. Not cyano, not any other form bound to junk—it’s methyl. It’s methylated. It means methylation.

Best analogy I’ve heard was actually from Gary Brecka—it’s like, your body can’t use crude oil from the ground. But what it can do is actually take modified, processed oil—and that, it can use.

Your body cannot use... it has to methylate vitamins. It has to take the crude form and convert it into a usable form. That’s what I’m trying to say. And so methyl means it’s pre-methylated. It’s pre-converted. Your body can use it. It’s ready.

Or like folate—like a really nice L-5-methylfolate, for example. These are really good, available forms.

So make sure you’re looking for those when you’re looking at your elemental diet—to make sure it’s a clean, bioavailable form. Otherwise, things like cyanocobalamin—artificial B12—what we actually have seen, especially...

Let me back this up. People who get artificial—like folic acid, artificial—they end up actually having issues with their liver detoxification. Like again, we said the blood-brain barrier. It could actually even drive up amino acids like homocysteine, which can drive up blood pressure—all kinds of stuff.

So it’s all about balance. And the further away we get from natural forms, the closer we get to disease. So you do get what you pay for.

The next question was:
“How do you handle a flare—when the root cause is mold—but you can’t get out of the environment?”

This is tough. And I see this all the time.

Here’s the thing—if you know mold is in your environment, the only way you’re going to truly get better is getting out of the environment. It’s like—I broke my leg jumping on the trampoline. Can it heal if I continue to jump on the trampoline? The short answer is no. You can’t. Not at least fully or properly.

And this is a really difficult part. Now, the question is: can you bounce a little bit lighter in a brace, and it might heal some of the way? Possibly.

And this is where we can look at things like—again—drainage, that we talked about. We can look at binders. We can look at trying to reduce the day-to-day mold exposure by opening up your windows, maybe getting an air filter. Or even as much remediation as you can get inside the house, like mold remediation. Sometimes insurance will pay for that.

But this is the thing—if you’re constantly re-exposing to the toxin that causes the problem, the question is: can you empty that cup faster than it’s being filled up?

And then—even if—you’re always going to have a little bit of a battle, we have to get change in those environments. And the challenge is too—70% of US homes have a mold issue. So it is hard to find a clean home.

I’ve actually got a client of mine who got a 5-year-old boy. Their home had mold—really gnarly mold infection. One of the worst I’ve ever seen. He had this big issue—I checked his mold. He had, what, 16, I think, strains of toxic mold—super high levels. His gut bacteria was a mess. Symptoms, the works.

He got out of the environment. His symptoms were 80% gone within a couple of weeks. Young kids can do that. Adults take a little while longer—sometimes years—to get rid of it. But the environment is everything.

So if you’re constantly re-insulting your immune system, you’re never truly going to get better in the way that you would hope or think that you would. And this is a really, really challenging part to deal with.

So that being said guys—there’s no more—oh, there’s one more question, I lied.

“We’ve been moving and looking for two years straight.”
Yes. That’s the tough part. So do what you can. Get an air filter. Grab like an Air Doctor—something like that. There are industrial air filters if you have the money for them. But opening your windows. Getting rid of it.

If there’s a section of your house you know is particularly moldy—quarantine it off if possible. Plastic on everything. Open the windows and close the door. Just don’t go in there. Right? That’s a better bet.

Even if it’s like under a bathroom cabinet and you simply just walk by—with the doors even closed—that little crack between the doors gets enough air in there to move those mold toxins, those spores around. Or, if there’s multiple strains of mold competing for space, they actually will shoot spores out in the air.

So it’s airborne. All the time. We have to be extremely careful. Mold is really nasty and it’s a huge root cause.

So I hope that helped give you some sort of defensive steps. But ultimately—the environment has to be adapted, modified, or changed entirely if you truly want to get better.

That’s all we got for questions for tonight. Which means—it’s all we got for me for tonight. We’re back here every Wednesday night, same time, 5:30 Mountain here—dropping some information for you guys.

And if you want access—I’ll give you some information here. If you want access—I do these lives every week. I’ve been doing lives for years now. We got a podcast dedicated to you guys, to helping you with this.

You can get all the information, of course, on my profile here on Instagram—it’s josh.dech.health. I’ve got a YouTube channel with all these videos on them—like dozens and dozens. I just recently started, but I’ve been doing these for years. And they’re also a podcast.

The podcast is called Reversing Crohn’s and Colitis Naturally. It’s all about the root causes—where it’s coming from, what to do, information like today. It’s all free resources. So feel free to grab those. You can get the links from my profile or search them up yourself. That’s @josh.dech.health and Reversing Crohn’s and Colitis Naturally.

Thanks so much for being here, guys. Love the questions and participation. We’re going to see you all next week.

One of my favorite things to hear as an IBD specialist is something along the lines of:
 “I learned more from you in 15 minutes than from my doctor in 15 years.”

And if this—for the first time—is really starting to click, and it’s starting to make sense, and you’re going, “Wait a minute—this might be reversible. I think there’s more that I can do. This condition came out of nowhere. It happened to me out of the blue. I was healthy for 10, 20, 30, 40 years, and suddenly I wasn’t.” And you’re telling me there’s no cause?

If you’re understanding—finally—that there is a cause, that something is driving this… I want to invite you to check the link in the show notes below. Send me an email. Ask a question. See if a program is the right fit for you.

Because I promise you this—this doesn’t have to be a lifelong sentence. You’re not doomed to this. And IBD can be reversed.