215 - The gut-brain connection | Michael Gershon, M.D.
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Published 2022-07-25
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Mike Gershon is a Professor of Pathology and Cell Biology at Columbia University and has been at the forefront of studying neural control of the gut for the past 60 years. In this episode, Mike gives a tour de force on the pathways of gut-brain communication but first sets the stage with an overview of gastrointestinal tract development and anatomy. He then explains how the gut communicates with the brain and vice versa, from early observations in physiology and anatomy up to our present understanding of what makes the GI tract so unique and complex relative to other organs. He talks about how the gut responds to meals of different food qualities and how that affects satiety signaling to the brain. Additionally, he explains how antidepressants and other drugs impact digestion through effects on serotonin signaling, and he discusses the effects of antibiotics, and what’s really going on with “leaky gut.” Finally, Mike offers his thoughts on the utility—or lack thereof—of gut microbiome diagnostic tests, and wraps up the discussion by considering how diet, probiotics, and prebiotics impact the microbiome and GI tract.
We discuss:
-Intro [0:00]
-The basics of the gastrointestinal (GI) system [3:45];
-The very early development of the GI system [9:30];
-The unique properties of the blood supply and portal system in the GI tract [12:45];
-An overview of gut anatomy and innervation [16:30];
-Turnover of the epithelial lining and why cancer rarely develops in the small intestine [26:45];
-Nutrient and water absorption in the small and large intestine [30:30];
-Ways in which the gut and brain communicate [34:30];
-The gut's role in the regulation of appetite [43:30];
-The impact of gastric bypass surgery on satiety signals [51:15];
-How varicella-zoster virus (VZV) can infect neurons in the gut and create issues later in life [54:30];
-The relationship between autism and gastrointestinal illness [1:02:45];
-The important role of serotonin in the gut, and the impact of SSRIs on serotonin in the gut [1:09:45];
-Defining “leaky gut” and its most common causes [1:16:45];
-The gut microbiome [1:30:45];
-Fecal transplants: use cases, limitations, and how they illustrate the importance of gut microbes [1:40:45];
-Gut microbiome diagnostic tests: why they aren’t useful outside of special cases such as cancer detection [1:50:30];
-Nutritional approaches to a maintain optimal flora in the gut [1:55:00];
-Prebiotics and probiotics, and getting your GI system back on track after a course of antibiotics [2:02:30]; and
-More.
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About:
The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 45 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.
Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).
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All Comments (21)
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In this episode, we discuss: -Intro [0:00] -The basics of the gastrointestinal (GI) system [3:45]; -The very early development of the GI system [9:30]; -The unique properties of the blood supply and portal system in the GI tract [12:45]; -An overview of gut anatomy and innervation [16:30]; -Turnover of the epithelial lining and why cancer rarely develops in the small intestine [26:45]; -Nutrient and water absorption in the small and large intestine [30:30]; -Ways in which the gut and brain communicate [34:30]; -The gut's role in the regulation of appetite [43:30]; -The impact of gastric bypass surgery on satiety signals [51:15]; -How varicella-zoster virus (VZV) can infect neurons in the gut and create issues later in life [54:30]; -The relationship between autism and gastrointestinal illness [1:02:45]; -The important role of serotonin in the gut, and the impact of SSRIs on serotonin in the gut [1:09:45]; -Defining “leaky gut” and its most common causes [1:16:45]; -The gut microbiome [1:30:45]; -Fecal transplants: use cases, limitations, and how they illustrate the importance of gut microbes [1:40:45]; -Gut microbiome diagnostic tests: why they aren’t useful outside of special cases such as cancer detection [1:50:30]; -Nutritional approaches to a maintain optimal flora in the gut [1:55:00]; -Prebiotics and probiotics, and getting your GI system back on track after a course of antibiotics [2:02:30];
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It is so awesome that such quality and thorough information is available online for free. These are good times.
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(Unrelated to this particular episode) PLEASE! Do an episode focused entirely on cortisol. It's such an important and destructive molecule. It could be a full episode focusing only on the physical effects of cortisol. There have been episodes you made about ways to manage cortisol, indirectly, through mental health and stress reduction. But, there has not been an episode focusing specifically on the cortisol molecule and everything surrounding the physical health of this molecule. Thank you.
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This doctor’s introduction to the gut blew my mind
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Absolutely wonderful shownotes Dr Attia and team. Thank you so very much. As a dyslexic I really appreciate the time taken to find such excellent diagrams. Again, thank you all.
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Brilliant, brilliant, brilliant. Absolutely loved listening to this discussion. Thank you so much
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Thank you Peter and Dr Gershone. Fabulous discussion. I'm so grateful for content like this on Peter's channel.
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i remember reading his book, The Second Brain when it came out in the late 90s. I had just finished an M.S. in nutrition and was totally blown away by the content.
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I have lost some weight this year, only change I made was to start making/eating fermented foods in general but specifically with meals that have carbs. Not very scientific but I am also a shift worker with a sub optimal schedule swinging back and forth from days to nights every work week. Take what I can get where can get it.
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Great podcast! Listed to it 2x already and will listen a third time. Packed with lots of great info!
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Hands down the best interview I’ve ever heard, and Peter has had some great ones. Also, I hope I’ll be as sharp as Michael when/if I get to his age, which I assume to be around 80 since he has a 60yo son.
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Thank you, I learned a lot from this podcast. As a NICU nurse, I know it is suspected that necrotizing enterocolitis may have a bacterial component to it, but the cause is not completely understood. I now have a better understanding as to why. There also have been some trials with probiotics for different indications but with, so far, to my knowledge, little efficacy.
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The probiotic he was trying to remember is solid by the name Florastor. I've been using it when necessary for my family and it has always worked great for us.
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My favourite episode yet! Mark has to be protected at all costs ❤️
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Love your sharing medical foundational knowledge, as undergraduate in Health Science, your ideas and information help me grasp such interesting scientific material. Thank you!,,😊
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Thank you so much for this wonderful podcast. Didn't think I would watch the entire video in one sitting. It was so engaging and informative.
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One of my all time fav podcasts!!
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incredibly interesting, informative, and ACCESSIBLE. thanks to to the attia team and gershon for this overview and introduction to the gut.
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Excellent episode. I am on an antibiotic and my doctor prescribed Florastor which contains Saccharomyces boulardii lyo mentioned in this podcast. Thank you!
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Great discussion thanks
