The first functional medicine training I ever took was the gastrointestinal module from the Institute for Functional Medicine. It blew my mind.
As a Columbia-trained doctor, I had been taught in medical school to think about gastrointestinal health as an isolated subspecialty. Conventional medicine looked at GI health in a vacuum.
What I learned in that course was that gut health is part of an ecosystem inseparable from brain health, heart health, immune health, and metabolic health.
Fundamentally, good health starts in the gut. So does disease; if you have an imbalance of bacteria or your gut lining is compromised, your immune system triggers, your brain can become inflamed, your metabolism slows down. In other words, gut health is ground zero.
My training in functional medicine completely changed the way I approached patient care. Suddenly grasping the role of the microbiome and key metabolites became integral to getting to the root cause of my patients’ symptoms. (And not just the most common gastrointestinal complaints like SIBO.)
At Parsley, we use a stool test called the GI Effects test to assess microbiome health. This full microbial analysis looks at dozens of biomarkers including markers of yeast overgrowth, inflammation, pancreatic function, and parasites. It also gives us a comprehensive view of your microbial metabolites—i.e. the things the bugs in your gut make when you feed them.
Just like gut bacteria, the metabolites your bugs produce can be either helpful or harmful. Trimethylamine N-oxide (TMAO), for example, is linked to cardiovascular disease, kidney failure and colorectal cancer.
Then there are the good metabolites, the ones I want to see a ton of on a microbiome test. N-butyrate is chief among them.
What is N-butyrate & where does it come from?
N-butyrate is a really important type of fat known as a short chain fatty acid, key for maintaining gut barrier health.
We can get butyrate through external sources (it’s found in certain foods like butter, cheese, and milk in addition to supplements) but the best way to increase your levels of butyrate is to get the bugs in your gut to create it. Butyrate is produced when “good” gut bacteria ferment dietary fiber—i.e. fruits, nuts, whole grains, and legumes—in your large intestine.
When I see low butyrate on a GI effects test, what that tells me is that the balance of good and bad bacteria in the gut is off. That means this patient is not only at risk for symptoms like bloating and brain fog, but may have increased risk of developing IBS, colon cancer, cardiovascular disease, and Alzheimer’s.
Key benefits of butyrate
Most of my patients could benefit from increasing the levels of N-butyrate in their gut. Butyrate has outsized benefits for gut health, which in turn impacts brain health, immune health, and metabolic health:
- Gut health: Butyrate’s most direct impact is on the gut itself where it helps repair gut barrier function and heal leaky gut. It also decreases inflammation and promotes a healthy balance of bugs. This combination of factors may help explain why butyrate demonstrates protective effects against gut diseases like IBD and colon cancer.
- Brain health: If you’re not well-versed in the mind-gut connection, study up. Butyrate impacts the brain via the vagus nerve. It acts as a signaling molecule that impacts neuroinflammation, neurotransmitter production, and cognitive function and may even be a potential treatment for neurodegenerative diseases.
- Immune health: Butyrate is a powerful modulator of immune health. Specifically, it promotes the production of anti-inflammatory cytokines and inhibits the production of proinflammatory cytokines in the gut and beyond. Research suggests that this effect may help reduce symptoms associated with conditions and autoimmune diseases related to chronic inflammation from rheumatoid arthritis to allergies. One 2021 study found that one-year-olds with a higher concentration of butyrate in their gut microbiome were less sensitive to food and environmental allergens and less likely to develop asthma.
- Metabolic health: Butyrate may also play a key role in weight and metabolism via a few different mechanisms. What I find most interesting is recent research that shows the metabolite regulates energy metabolism and promotes fat oxidation, while also influencing appetite. Butyrate stimulates the production of GLP-1, a hormone that influences blood sugar regulation and appetite.
- Sleep: Butyrate may also help promote sleep via the gut-brain connection. One study published in Nature Scientific Reports in 2019 found that mice who were given a butyrate-promoting drug experienced a 50% increase in non-rapid eye movement sleep.
What I’m doing for my own body
The TL;DR: we want to increase our body’s ability to produce butyrate. To do this, I employ a two-part strategy:
Increase my dietary fiber
The current RDA for fiber is 38g for men and 25g for women. But almost no one is getting that. Estimates suggest less than 10% of people meet the dietary fiber guidelines.
My personal fiber guideline: 30g is a good day, 50g is a great day.
In addition to eating fiber-rich foods like cruciferous veggies, nuts and seeds, lentils and whole grains, most people could benefit from adding a fiber supplement to their diet. I’m a fan of Sakara’s Fiber Super Powder. Use my code ROBINBERZINSAKARA for 20% off.
Take a probiotic clinically validated to produce butyrate
Long-time readers know how much I love Seed. I use their VS-01™ Vaginal Synbiotic to support my vaginal microbiome and always recommend their daily probiotic DS-01® to support gut health.
Given Seed is such a favorite brand, I was super excited to see the results of their latest research on butyrate. In a recent study among healthy participants, DS-01® increased the production of butyrate, making it the first multi-strain synbiotic (probiotic and prebiotic) clinically validated to produce butyrate in healthy individuals. Use my personal code DRROBIN25 for 25% off your order!
What I recommend for you
- Seed your gut with prebiotics. Fiber feeds good gut bacteria, especially the strains that produce butyrate. Aim for at least 30g from resistant starches like legumes, whole grains, fruits like apples and berries, and cruciferous veggies.
- Take a probiotic with both prebiotic and probiotic strains. Back up the prebiotics you’re feeding your gut in the form of fiber with a probiotic like DS-01® that also contains prebiotics.
- Test your gut health. If you’re dealing with things like acne, psoriasis, eczema, autoimmune conditions, brain fog, or anxiety, a gut health test that assesses your gut biomarkers including butyrate can be the key to unlocking the right treatment protocol. Come test with us at Parsley and use my code RBMDCREW for $150 off your membership.
As always, this newsletter is for informational and educational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any health decisions or changes to your treatment plan.