Apatient in the U.K. recently wrote me an email in hopes that I share her letter in this book.
Dear Dr. John,
About 5 years ago, I started to suffer from incredible swelling of the stomach, combined with all sorts of digestive problems ranging from stomach gurgling to occasional constipation, diarrhea, and mucus in the stool, which I just lived with and got on with.
Then things started to get progressively worse. I went to the doctor and they asked me to make a food diary to help identify what foods were causing my problems. To start with, I thought it was wheat/gluten, so I tried eliminating this from my diet, but found that I was still having problems. At that point, I thought it could be a dairy intolerance. My doctor’s advice was to eliminate the foods causing the problem from my diet and gradually reintroduce them.
My other symptoms at the time were that my immune system must have been seriously compromised, as during this time I had shingles (I’m not sure if it has the same name in the U.S., but it’s also known as herpes zoster) and many colds/chest infections. I also experienced an episode where I woke up in the middle of the night struggling to breathe and the doctors diagnosed me with mild asthma. In addition, I had mucus in my stools, but didn’t REALIZE that this was not normal!
Eliminating certain foods from my diet didn’t really have any effect on my symptoms, and it got to the point where, after 1 night out with friends in summer 2014, I had eaten pasta carbonara and, once home, became violently sick with diarrhea.
At this point I knew something had to be done. I was assessed by a doctor and had a range of blood tests performed. I was told that everything was fine. I am generally a healthy, slim person. Of the 20+ different blood tests performed, only one came back outside of the normal levels, but I was told that this one was clinically insignificant. It was my bilirubin levels.
Given this was the professional advice; I thought nothing more of it. Coincidentally, that weekend I read an article in the Sunday Times talking about digestive disorders and how people could benefit from taking digestive enzymes. On the surface, this seemed to be the answer to my problems, but the more I thought about it, the more counterintuitive it seemed to have to take something as a supplement that your body should be producing itself.
I therefore Googled “should I be taking digestive enzymes?” and one of the first articles that came up was one written by you, stating that no, you shouldn’t, and giving the reasons why. I then looked into what bilirubin levels are all about—its relationship to bile and the digestive process, and the whole picture fell into place, thanks to your article.
I read up on all the articles in your LifeSpa website and ordered triphala and manjistha, which I have taken since.
As you may have guessed, my body type is vata and my food intake was variable as I was often too busy to eat and when I did, I wasn’t eating properly. I now ensure that I take the time for meals and eat as well as I can. I am now able to tolerate any food and all my digestive problems seem to have gone.
There is 1 final part to this story, and I am only telling you this to complete the picture, as it may have a bearing on all of the above. Last month, I was diagnosed with breast cancer and I am now undergoing a course of chemo. I have been told that my chances of survival are excellent and my treatment (chemo, surgery, and radiotherapy) should cure the cancer.
I want to finish by telling you how grateful I am to you, as without your article I would still be experiencing the digestive problems and many other health issues. I am now trying to follow the Ayurvedic diet as much as possible and I can hopefully go on to lead a long healthy life (I am 49).
With kind regards and many thanks,
Connie6
When your digestion begins to unravel and you are experiencing signs of indigestion and discomfort, it is important to remove hard-to-digest foods from you diet, just as Connie did. Generally, this will offer some relief, as we are making life a bit easier for the digestive process. Once the digestive problem is solved, these foods can be slowly reintroduced back into the diet. However, they should be non-processed, prepared properly, organic, and in season.
At the end of Connie’s letter, she mentioned how she skips meals and eats on the run. Once again, I cannot emphasize enough the importance of eating in a relaxed manner. Be sure to take time, sit down, relax, and enjoy your meal. Connie was stressed, and the stress irritated her gut to the point where she was producing so much intestinal mucus that she could see it in her stool.
Connie had many signs of lymphatic congestion, ranging from her herpes (shingles) to her compromised immune system in the form of colds, chest infections, and her breathing difficulty. We discussed these and other symptoms of lymphatic congestion in Chapter 4.
As a result of years with a congested lymphatic system, the liver itself can become congested, and bile flow and production can be compromised. The stomach—whose job it is to produce acid to break down things like wheat and dairy—depends on adequate bile to buffer the acid that the stomach produces. In Connie’s case, her stomach decided to hold onto the food as long as possible in an attempt to wait for the bile to be released by the gallbladder. While she had battled with intestinal inflammation and lymphatic congestion for years, it was the logjam in her liver, gallbladder and/or bile ducts that triggered most of her problems.
The sad part of the story for Connie was that, after all she had been through, she was diagnosed with breast cancer. Breast cancer is almost always related to some type of lymphatic congestion. This is a perfect example of why I am so adamant about rebooting the digestive strength we were meant to have throughout our lives. Poor digestion digestion equals poor detoxification, and when the lymph system becomes overwhelmed with toxins, the body becomes much more vulnerable to more serious health concerns.
Our first line of defense against a toxic environment and our ability to convert hard-to-digest foods into nutrients requires a very robust upper digestive system. This requires a coordinated effort between the nervous system, which must be relaxed and calm to sense, with the five senses, what type of food is about to be eaten.
Digestive enzymes are released upon the first sight and smell of food. This is followed by a coordinated digestive response from the stomach’s production of acid and pepsin, adequate production of bile from the liver, and the ability to deliver that bile into the small intestine. The production and delivery of pancreatic enzymes, the coordination of duodenal enzymes, and of course, the creation of an environment based on all the above that supports a healthy upper digestive microbiome are directly responsible for the complete breakdown of hard-to-digest foods like wheat and dairy.
In Connie’s case, her liver was clearly congested and her bile was either not being produced in sufficient quantities or it had become too thick, sluggish, and viscous. Thick, viscous, and congested bile does not often show up on an ultrasound scan of the gallbladder.
Since the gallbladder’s bile duct and the pancreatic duct that transports enzymes physically join together before entering the small intestine, congested bile can cause both poor digestive enzyme and bile flow.
As a result, just taking digestive enzymes may make the digestive symptoms better, but Connie wanted to finally get to the root of her health issues and heal from the inside out, not just treat her symptoms. Rarely is the problem a need for digestive enzyme supplementation due to an irreversible lack of pancreatic enzyme production, as is commonly touted. Congestion and inflammation of the bile and pancreatic ducts is typically the culprit. Without optimal flow of bile and pancreatic enzymes, neither digestion nor detoxification function optimally.
In addition, both bile and pancreatic enzymes are major buffers for the HCl in the stomach. If there are no buffers in the small intestine, the stomach will simply hold onto the acid, causing the stomach to swell or cause heartburn and a host of other signs of indigestion. The stomach can also literally decrease the production of the acid. Without the production of a very strong concentration of HCl in the stomach, proteins like casein, soy, wheat, and others will simply not be initially broken down in the upper digestion completely.
If you answer “yes” to 1 or more of the questions below, your liver or gallbladder may need support:
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1. Do you ever get nauseous after a meal? |
Yes or No |
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2. Do you ever feel heavy after a high-fat meal? |
Yes or No |
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3. Do you ever get occasional heartburn after a meal? |
Yes or No |
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4. Do you have trouble digesting wheat, dairy, soy corn or nuts? |
Yes or No |
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5. Do you ever have sluggish, green, or greasy stools? |
Yes or No |
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6. Do you have a history of any gallbladder problems? |
Yes or No |
The gallbladder is a vital organ that stores concentrated bile to be able to help digest good fats, process bad fats and toxins, maintain healthy bowel movements, and buffer the digestive acids from the stomach.493, 494 As I mentioned, if the liver becomes congested as a result of toxins, stress, and/or poor diet and elimination, the bile in the gallbladder can become thick, viscous and congested. In an attempt to keep the thick bile flowing, MRI findings commonly show that bile ducts dilate beyond what is considered normal while liver function is maintained within normal ranges.495 Thick bile affects the ability to digest and detoxify, to maintain healthy weight and mood, and our overall health and vitality.494, 496-498
In Chapter 9, I discussed how beets, green vegetables and apples help support healthy lymph function. I’d like to devote the rest of this chapter to these and other rockstar foods and herbs that also support the liver and gallbladder (and therefore healthy bile production). You’ll find these foods and spices also come with some additional amazing side benefits!
Beets are my favorite go-to food to boost liver function and lymph and bile flow, and they also have some unexpected benefits that are making news. Red beet juice has become the preferred performance-enhancing drink for the Auburn College football team, and based on a handful of compelling studies, beet juice has even made it to the NFL, recommended by the Houston Texans as their pre-game drink!499
Beets happen to be one of the highest sources of performance-enhancing nitrates. Yes, nitrates from plants such as beets, celery, and cauliflower are actually good for you, while nitrates found in packaged meats such as bacon, sausage, hot dogs, deli meats, packaged ham, pepperoni, and salami are quite toxic.
Plant-based nitrates in the diet convert easily into nitrites, which have a powerful vasodilation effect; helpful for opening up congested bile ducts. Vasodilation also refers to the widening of blood and lymphatic vessels, resulting in better circulation and lymph drainage of toxins, more efficient delivery of oxygen and nutrients to the cells, as well as improved physical performance.500 Poor blood flow due to a lack of healthy vasodilation may be a factor in the decline of physical and cognitive function associated with aging.500
Many studies are currently underway reviewing the potential health benefits of nitrites and beet supplements.500 One study demonstrated that running performance was significantly improved by supplementing with beet juice.501 All of these findings suggest that beets are not only great for upper digestive bile flow but support circulation, oxygenation and lymphatic drainage for every cell in the body.499-501
Beet juice also increases cerebral circulation to certain parts of the brain that govern executive function, suggesting that beets may also support the drainage of the newly discovered lymph that drain toxins from the brain.5, 500 Executive function is what allows us to do things like organizing, planning, remembering details and managing time. As a vasodilator, the nitrates in beets may support healthy cognitive function and memory by enhancing blood supply and possible lymph drainage to and from specific areas of the brain.500
The vasodilation effects of beetroot have also been shown to support healthy blood pressure. In one study, drinking just 500ml of beet juice lowered blood pressure by 10 points in 3 hours, possibly due to the blood vessel-dilating and lymph-supporting effects of the nitrates in beets.502
Beets are also very rich in B vitamins, calcium, iron, and powerful antioxidants such as alpha-lipoic acid (ALA). All of these support healthy liver function and lymph and bile flow. Poor bile flow is extremely common and is linked to weak stomach acid, inadequate liver detoxification and poor fat metabolism,203 all of which are required to digest wheat and dairy.
In one study, both beets and okra were found to attach to bile in the intestines.503 Once the bile is attached to certain types of fiber, like beet fiber, its job is to escort the toxic bile to the toilet. This is important because bile, when attached to fiber, carries toxic cholesterol particles, environmental pollutants, and a variety of other fat-soluble toxins it picks up on its journey through the liver and intestines. Without adequate fiber, up to 94 percent of this toxic bile can be reabsorbed back to the liver and back into circulation.203
This is one of the reasons why I recommend blending over juicing. The cellulose fiber is mixed with the juice in blending, but removed in juicing. While there are benefits with juicing, it can supply the body with too much sugar and too little of the much-needed fiber.
Beets also provide powerful liver-protective support. In another study, mice that were fed beets for 10 days produced a large amount of the body’s 2 most powerful antioxidant liver enzymes, superoxide dismutase and glutathione, which rid the body of toxins.504 Both of these antioxidants have been found to be active in the lymphatic system and are found to reduce inflammation,5, 9 which is the real culprit of most of the symptoms related to food intolerances and the “grain brain.”3
Surprisingly, beets—which are loaded with beet sugar—have been shown to help support healthy blood sugar levels in type 2 diabetics.505 Much of these benefits can be attributed to the high levels of alpha-lipoic acid (ALA) found in beets, which seem to offset the effects of the beet sugar. ALA is both water- and fat-soluble, which allows it to penetrate any tissue in the body. For this reason, it has become a popular skincare ingredient. As an antioxidant, the ALA can support lymphatic movement in the body and help resolve free radical damage.505 I’ll discuss more about sugar in Chapter 11.
Tip: When trying to boost bile production in the liver and bile flow from the gallbladder, try to eat 1 red beet a day. Beets increase bile flow, which helps move the bowels, so do not be alarmed if your elimination improves or the stool turns reddish color.
Beet Tonic Recipe 
Ingredients:
• 1 fresh beet, peeled and grated
• Juice of 1/2 lemon
• 1 tablespoon olive oil—make sure it’s extra virgin, cold-pressed, organic, and stamped with a harvest and/or bottling date.
1. Combine all ingredients.
2. Take 1 beet’s worth of this combination daily for 2–4 weeks to reset bile flow.
Green vegetables are the #1 food for the liver; leafy greens are loaded with micronutrients and minerals that the liver needs to function optimally. In addition to making an effort to have half of every meal as vegetables, here is a classic green tonic recipe that feeds and supports liver and gallbladder function.
Green Tonic Recipe
Ingredients:
• 1 bunch parsley
• 3 medium zucchini
• 1/2 pound green beans
• 5 stalks celery
Directions:
1. Steam all ingredients for just 8–10 minutes, and then mix in a blender. You can drink as a soup, or once cooled, as a tonic/ smoothie. You can add water to get the desired consistency, as well as a good squeeze of fresh lemon juice.
2. Drink 1–3 green tonics per day as a meal or with meals, as needed for gallbladder pain and/or to optimize gallbladder function.
3. Options for more flavor: Any green vegetable can be substituted for the veggies above. Try adding a steamed apple. Or you can try adding garlic and ginger with low-sodium vegetable broth. Avocados add a nice creamy texture as well.
Consume at least 1 apple a day after meals to increase bile flow. Apples have high amounts of malic acid, which helps to open up and dilate the bile ducts. The more sour the apple, the more bile-moving malic acid exists.506
Malic acid, which is found in high concentrations in apples, cranberries, and tart cherries, has been shown to increase alkalinity systemically, which naturally increases lymphatic flow and detox capacity.507 Malic acid supplementation has also been shown to break up calcium oxalate kidney stones, and many experts believe it breaks up gallstones as well.508 Malic acid is also used in liver flushes to dilate the bile ducts. Dietary use of these fruits can be used to support optimal bile flow.
Like most foods, apples have been hybridized for thousands of years to be sweeter. So instead of choosing the sweetest apples, try to get the more tart apples that carry less sugar and more bile-moving malic acid.
Today, fenugreek may be a lesser-known spice, but it was once very common and highly revered. In one study, fenugreek was found to reduce gallstones by 75 percent when participants were fed a high cholesterol diet for 10 weeks.509 Fat levels in the liver as well as cholesterol levels also decreased with fenugreek. Researchers also found that fenugreek increased bile acid content in the bile, making for much more potent bile and lowered liver enzymes,509 which suggest that the liver processed the high cholesterol diet with ease. The overall result of adding fenugreek to your diet is much healthier and thinner bile. Fenugreek is also well-studied to lower blood sugar. This tea with meals may help prevent the sugar belly I discuss in Chapter 11. You can buy the seeds and make a tea to drink with each meal to increase bile function and liver support, or grind or buy it as a spice to cook with. You can mix it with fennel seeds for the lymph and intestinal skin and make fennel, fenugreek tea.
Ingredients:
• 1 teaspoon fenugreek seeds
• 1 cup water
• Milk (optional)
• Nutmeg (optional)
• Lemon (optional)
Directions:
1. Use 1 teaspoon of fenugreek seeds for each cup of tea. Lightly crush fenugreek seeds with a large wooden spoon or the side of a chef’s knife to release flavor and health benefits.
2. Place crushed fenugreek seeds into a tea strainer. (Add 1 teaspoon of whole fennel seeds to make fenugreek-fennel tea.)
3. Place the tea strainer into a small pan and add approximately 1 cup of water per teaspoon of seeds. Simmer for 2–3 minutes and steep for an additional 10–15 minutes. (Fenugreek seeds take longer to brew into tea than many other herbs or spices.)
4. Serve the tea hot or cold, adding sweetener or milk to taste. You may need to reheat before serving hot. Try enhancing with freshly grated nutmeg and a twist of lemon.
Shilajit is one of Ayurveda’s most prized herbal medicines. It is the only herb in the Materia Medica of Ayurveda510 that is labeled a panacea, indicating that it has a beneficial role to play in the health of all the systems of the body. Perhaps one of its most important properties is its ability to break up scar tissue and stones as a result of its high fulvic acid concentration. It is also known for delivering micronutrients into the deep tissues of the body for energy and longevity.511 Traditionally, it was used to optimize liver function and the movement of bile from the liver and gallbladder. I use it effectively to help chelate toxins out of the body as well as to cleanse both the pancreatic and bile ducts for a deep, health-promoting cleaning.512
For liver and gallbladder function, lymph support, and repair and maintenance of the intestinal skin, turmeric may be the most researched herbal spice. As a natural anti-inflammatory and antioxidant for the liver, it has been shown in many studies to boost bile flow and bile production, but its magic extends well beyond the liver.513
Reminder: Turmeric is high in oxalates, which can combine with calcium and form calcium oxalate stones in the kidney or gallbladder. Folks at risk for calcium oxalate kidney or gallstones should avoid turmeric and use my other suggestions to boost your bile flow.
Turmeric is also one of the most researched herbs for intestinal permeability or leaky gut syndrome. It has been shown to support the healthy function of the intestinal skin and healthy microbiome, which in turn supports both better intestinal integrity and digestive power.232, 514
One of the problems with turmeric is that it is difficult for the body to absorb. That is why many of the studies have been done on curcumin, which is the extract of turmeric and easier to absorb.
While modern herbal extracts have potent therapeutic value, it is difficult to match the blueprint of the original plant found in whole herbs and spices. Additionally, the process of extraction uses alcohol, which kills the beneficial microbes that actually live on whole organic plants. Whole herbs and spices carry specific microbes that support the actions of that plant, meaning the ingestion of the whole plant is necessary to deliver all of the plant’s benefits. In addition, the body may build a tolerance to an extract. Whole herbs and spices, while not as potent as extracts, are foods and have a sustainable effect. In Ayurveda, whole herbs and spices are combined with other whole herbs and spices to boost function, which can be as potent as today’s modern extracts.
Cooking with turmeric has been traditional in many parts of the world for thousands of years. When you combine 16 parts turmeric to 1 part black pepper, this combination can boost the assimilation of turmeric by a whopping 2,000 percent.515 Curry is formulated in a similar ratio. This research was one of the first sources showing how turmeric could have so many medicinal powers once it had some help (from black pepper) being absorbed through the intestinal wall into the bloodstream and lymph.
What is interesting is that in India, curry powder is loaded with turmeric, peppers, and other spices. Turmeric is added to many dishes in India, and during the cooking process, the turmeric is naturally extracted and concentrated. In fact, the average person in India eats about 2–2.5 grams of turmeric a day—that’s equivalent to about 4–6 capsules of turmeric a day—almost every day of their lives. Interestingly, India has among the lowest rates of prostate, breast, colon and lung cancer. Some researchers believe this may be due to the quantity of turmeric consumed on a regular basis.
Perhaps one of our biggest concerns as we age is to find ways to protect ourselves from the ravages of cognitive decline. Turmeric has at least 10 neuro-protective actions that support healthy cognitive function.516
Because the brain is predominately fatty tissue, fat-soluble toxins may accumulate in the brain and cause damage. As a fat-soluble substance, turmeric may have an affinity for chelating (removing) fat-soluble toxins out of the deep tissues. Turmeric crosses the blood-brain barrier, where it may attach to neurotoxins, such as beta-amyloid plaque, and support healthy antioxidant activity.517
New studies, as described in Chapter 4, have found lymph vessels in the brain that drain toxins like beta-amyloid plaque, linked to Alzheimer’s disease.5 Turmeric has been shown to support healthy lymphatic flow, which may be the mechanism of how this herb has such tremendous benefit in supporting brain function and the brain fog associated with gluten sensitivity.5, 468
New studies on turmeric have been exploring its effect on healthy and stable mood. In one study, curcumin was shown to boost the brain chemical norepinephrine, which supports healthy mood, attentiveness, sleep, dreaming, and higher learning.518
Perhaps surprisingly, curcumin also boosted levels of dopamine—the “motivation” hormone that supports pleasure, emotion, satisfaction and locomotion—and serotonin, which plays a key role in mood, memory, learning, appetite, sexual behavior, sleep, and many other functions.518
Turmeric is also believed to act as a brain-derived neurotrophic factor, which means it supports the growth and development of neurons and resists the degeneration of brain cells when under stress.518
In addition to supporting the body, brain, and bile with herbs and spices, there are many foods that help the liver produce more bile while maintaining the integrity of good healthy bile delivery into the small intestine.
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Bile-Moving and Cholagogue Foods |
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The following are foods that offer natural support for the function of the liver, gallbladder, and bile flow. To support your health, increase your consumption of these bile-moving or cholagogue foods: |
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• Garlic |
• Apples |
• Olive oil |
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• Beets |
• Avocado |
• Ginger |
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• Celery |
• Chicory |
• Mustard Greens |
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• Ginger |
• Black radish |
• Turnip greens |
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• Coconut oil |
• Dandelion |
• Peppermint |
• Artichoke |
• Berries |
• Leafy greens |
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• Hibiscus |
• Lemon |
• Cranberries |
When folks complain about gas, bloating, or food intolerances, many experts often suggest HCl (hydrochloric acid) supplements. It is true that the HCl that is manufactured in the stomach can be depleted and cause a host of digestive issues. All proteins and especially gluten, dairy, and the anti-nutrients that surround and protect beans, soy, and nuts require a very strong stomach acid, or HCl, to be initially broken down and digested. So when these symptoms are present, giving HCl seems to make sense.
The body, however, is not equipped with gas gauges that measure HCl, digestive enzymes, or hormones for that matter, so it’s tricky sometimes to know when our levels are low or when we may need a refill. There is always a reason why the body becomes depleted or stops producing enough HCl. If we just take HCl supplements and the body had a good reason why it stopped producing it, we can actually make things worse. The body is very intelligent and does what it does for a reason.
One of the most common reasons why the stomach would stop producing HCl is because the buffers—which include bile from the liver and gallbladder as well as digestive enzymes from the pancreas and small intestine—are not sufficient to buffer the acids needed to digest hard-to-digest proteins. The stomach can respond to this by dialing down the acid production. So before you add more HCl through supplementation, you need to make sure the bile is flowing.
This is why we troubleshoot the liver and gallbladder first. Once bile flow has been restored, you can then successfully turn on the stomach acid. I prefer herbs and spices over HCl supplementation to reboot the body’s HCl production, as herbs train the body to do the job and avoid the risk of the body becoming dependent on digestive supplements.
• Tip 1: Drink 8–12 ounces of room temperature water 15–30 minutes before each meal.
• Tip 2: Add a pinch of salt and/or a pinch of black pepper to a large glass of water, and drink it 15–30 minutes before the meal. Both of these condiments boost digestive fire naturally. Conveniently, every restaurant has salt and pepper right on the table.
• Tip 3: Get fancy and order a cup of hot water with lemon first thing when eating out, or add a squeeze of lemon to the pre-meal water. Typically, you may wait 15 minutes before the food arrives, which allows the water to prehydrate the stomach lining that buffers stomach acid, and the lemon juice helps to increase HCl production.
• Tip 4: Order a salad with the classic dressing of oil and vinegar. The oil increases bile flow from the liver and gallbladder, and the vinegar is acidic, which increases HCl acid production naturally.
• Tip 5: Sip hot water during the meal. This helps keep the food you are eating in a soupy consistency, which allows the HCl to more easily break down all the food in the stomach. Too much water during the meal can dilute your stomach acid, so don’t overdrink. Avoid cold, iced drinks.
In addition to the above HCl-boosting techniques, I also suggest some ongoing upper digestive support to help permanently reset function. Whole, organic spices have been used for thousands of years for cooking, and delivering time-tested health benefits that are now well supported by science.
For example, there is compelling research and thousands of years of clinical use to suggest 5 digestive spices—fennel, coriander, cumin, cardamom, and ginger—deliver significant benefits for gas, bloating, and rebooting the natural strength of the digestive system,519-525 as you will see below. Perhaps the most profound aspect of these spices is how gentle yet powerful they are. I find that even folks with the most sensitive digestive systems can do well on these 5 spices.
Chewing a handful of cumin, fennel, cardamom, and coriander seeds after a meal is still a common practice in India. This is why you will often find a bowl of fennel seeds awaiting you at the door as you exit your favorite Indian restaurant.
For re-training the body to digest wheat and dairy again, I find these 5 spices invaluable. Numerous studies suggest that cumin, fennel, cardamom, coriander and ginger build digestive self-sufficiency in these ways:
• Increase bile flow (no need for bile salts)519
• Increase pancreatic enzyme activity (no need for digestive enzymes)519
• Increase small intestine enzyme activity (no need for digestive enzyme supplements)519
• Decrease gas and bloating (no need for HCl supplements)520
• Increase fat and sugar metabolism519
• Are powerful free radial scavengers521
• Support optimal weight522
• Support microbiology health (especially ginger)520
• Improve gut health520
• Support a healthy growth rate of good bacteria (especially ginger)520
• Discourage H. pylori from adhering to stomach522
• Are digestive stimulants523
• Quicken the transit time in the intestines, supporting better elimination521
What is fascinating about these studies is that these 5 spices seem to support the body’s natural ability to digest, rather than just treat its problematic symptoms. For example, while the studies show that these spices improved fat and sugar metabolism, they seem to do so by boosting more bile acid and pancreatic enzyme flow.519, 523, 524
Digestive enzyme supplements provide the enzymes we need to digest protein and starches, while these spices amp up the body’s own production of digestive enzymes and bile.519, 523 This is an example of resetting digestion, rather than brewing dependency on digestive aids.
To further illustrate this point, in one study, ginger was shown to support healthier cells of the intestinal wall as well as boost the proliferation of good microbes in the gut, many of which are responsible for digesting gluten.520 In another study, these spices blocked the bacterium H. pylori—linked to indigestion and stomach ulcers—from proliferating and adhering to the stomach lining.522 The spices seem to work with the body’s digestive intelligence by supporting better digestive function, a healthier environment for the digestive microbes, healthier villi and improved intestinal function.519-521
Cooking with these spices is a great way to make the meal more digestible, or you can take these spices in capsule form before meals to boost digestion. Alternatively, they can be made into a tea to have with the meal.
The magic of these spices takes place when they are all taken together to boost digestive strength. They each have well-documented benefits as individual herbs or spices, but when they are combined, the result is quite another story. Let’s take a look at these spices individually.
• Coriander is perhaps the most cooling of the 5 digestive spices. The seeds are commonly used in herbal medicine for a host of ailments; the leaves are commonly known as cilantro. The seeds are best known for their digestive properties by cooling excess heat, inflammation or digestive acid in the body and intestinal tract, and are thus soothing for the digestive tract. Therefore, coriander is used effectively for occasional heartburn. It is a natural carminative, which means it prevents or relieves gas from the intestinal tract, and is beneficial for numerous heat-related conditions in the body.526
• As a member of the ginger family, Ayurvedic texts celebrated cardamom’s ability to make foods easier to digest and enhance the taste of most ordinary foods.525
• Its taste is most recognizable in a cup of Indian chai tea, allowing the chai to boost the digestive process. Cardamom is known to reduce the extreme acidity of many foods and caffeinated beverages, including coffee; it is also the signature spice in traditional Turkish coffee. When cooked into your food, it reduces excess mucus, gas and bloating in the stomach and small intestine while supporting healthy blood sugar and cholesterol levels.525
• Cumin is perhaps the most powerful digestive tonic of the 5 spices of digestion. It has a strong taste and, while very effective alone, it blends well in both taste and effectiveness with the other 4 spices for boosting digestion and reducing gas and bloating. It is much like coriander in that it cools the digestive system while boosting digestive strength. It supports healthy assimilation and the proliferation of good microbes, as well as the detoxification of the intestinal tract.527
Fennel not only combats gas and bloating in the digestive tract, it is one of Ayurveda’s favorite lymph-movers. As a lymph-mover, it supports new mothers’ healthy lactation and radiant skin on both the outside and inside (intestinal skin). It has a strong balancing effect on all types of bodies and constitutions. It is one of the best herbs for digestion, as it strengthens the digestive fire without aggravating excess heat, and is beneficial for intestinal cramping, nausea, and dispelling flatulence.528
In Ayurveda, ginger is called “the universal spice” because of its many health benefits. It is heating for the upper digestion with its pungent taste, but cooling and soothing for the lower digestion as a result of its sweet aftertaste. It is the classic kindling to start the digestive fire in the stomach. Scientific studies have shown that it supports healthy microbes, a healthy intestinal wall, and acts as a digestive stimulant for nutrient assimilation.520
Tip: For best results, do one of the following:
• Mix these 5 spices and encapsulate them.
• Sprinkle 1/2 teaspoon on your food.
• Cook with this mixture or make a tea out of them to drink with the meal.
• You can make a tea in the same way you did with the fenugreek seeds previously mentioned.
• You can also find this combination in a capsule form at LifeSpa. com called Gentle Digest.
Once the bile is flowing optimally and the digestion and elimination have been strengthened, it is sometimes necessary to relight the stomach’s digestive acid production. The following technique is for stubborn, boggy digestion with chronic gas and bloating and no heartburn symptoms at all. Again, this technique is for wet, boggy and dull upper digestion—not overly hot or acidic digestion.
The classical Ayurvedic formula used for this procedure, called trikatu, is made up of equal parts pippali (long pepper), ginger, and black pepper. These spices work synergistically to stimulate the digestive fire, allowing for more efficient digestion in the stomach while promoting proper bile flow, healthy detoxification and fat metabolism. The gentle heating action of this blend primes the digestive tract to digest food, absorb nutrients, and efficiently remove wastes.529-535
Reminder: If there is a tendency for heartburn, or the digestion is sensitive, do not use trikatu—use the “5-spice mixture,” described earlier.
You are going to take increasing amounts of capsules of trikatu (or the 5-spice mixture) before each meal until you feel a comfortable warmth around your belly. Then, you will slowly decrease each dose by 1 capsule while maintaining the sensation of warmth.
Tip: You can find the formula, Trikatu in most health food stores or as Warm Digest at LifeSpa.com along with the 5 spices formula in capsules, as Gentle Digest.
• Take 1 capsule before breakfast.
• Take 2 capsules before lunch.
• Take 3 capsules before supper.
• Take 4 the next day before breakfast.
Continue until you find your Maximum Dose (details below). Do not take more than 6 capsules at a time.
Note: If there is any pain or discomfort at any time during this reset, stop the protocol and read the upcoming section on heartburn.
Keep adding 1 capsule before each meal until you begin to feel some warmth around your belly—either before, during, or after the meal. This is your Maximum Dose. You may feel warmth after taking 2 capsules or after taking 6. Do not take more than 6 capsules.
If you experience any burning or loose stools at any time and no warmth around your belly, consider this the limit and stop increasing the digestive herbs.
Once you feel the warmth in or around your belly, begin to decrease your dose by 1 capsule at the next meal. Continue taking this until you feel heat again. This may take 1–2 meals, or even a few days.
Once you feel warmth again, decrease by 1 capsule at the next meal and continue this dose until you feel warmth again. Continue this protocol until you have weaned down to 1 capsule and then to no capsules at all. You may need to stay at 1 capsule for a few weeks.
She began to feel warmth in and around her belly on the second day after breakfast while taking 4 capsules of trikatu. This was her maximum dose. At her next meal (lunch), she decreased to 3 capsules and took this dose until she felt warmth again the next day (also at lunch). She then decreased to 2 capsules before each meal until she felt warmth again the following day at breakfast. At breakfast, she decreased to 1 capsule and continued that dose for 3 days until she felt warmth.
This protocol is designed to reset your digestive furnace, which is often too weak due to stress or other digestive imbalances. The warmth felt around the belly is a sign that the digestive spices are helping the stomach increase production of HCl (hydrochloric acid). Slowly decreasing the dose of the spices based on when you feel warmth ensures that your stomach continues to produce HCl and your digestive fire stays abundant even when you wean down to 1 capsule before meals and, finally, completely stop taking the herbs.
For the body to break down gluten, it must have a strong, balanced stomach acid (HCl) production. The stomach acid is the trigger for the rest of the digestive process. If the HCl is too high or low, then the ability to digest gluten will be compromised. Let’s make sure the stomach acid is optimal before we begin to reintroduce foods like wheat and dairy back into the diet. Please see your MD if your heartburn symptoms persist.
There are many types of heartburn, but commonly, the acid-burning feeling is part of a condition known as GERD (Gastroesophageal Reflux Disease). This is caused by stomach acid building up in the stomach and refluxing or moving up into the esophagus, irritating the esophageal lining. This can cause burning, an acid taste in the mouth, coughing, wheezing, hoarseness, ulcers, cancer and/ or pain.
GERD is a chronic problem. When it happens over time, the lower esophageal sphincter (LES), which separates the stomach from the esophagus, fails to function optimally, and acid is allowed to reflux up into and irritate the delicate tissue lining the esophagus.
The conventional understanding is that excess production of stomach acid (HCl) causes heartburn. When HCl is produced in excess, it will burn the stomach lining and, in the case of GERD, the esophageal lining as well.
Excess spicy foods as well as citric fruits, tomatoes, garlic, onions, hot spices, sugar, rich foods, and fried foods can all contribute to the excess production of stomach acid and heartburn. Chronic stress will trigger the release of excess cortisol, a stress hormone, which stimulates the release of excess stomach acid as well and can also cause heartburn.
While excess HCl is a major cause of heartburn, heartburn symptoms may not be caused by too much acid, but too little! That’s right; heartburn can be caused by not enough acid production in the stomach. If there is too little stomach acid produced, the food and the stomach acid (even though there is less of it) will linger in the stomach and delay the emptying. The longer the food sits in the stomach, the higher the risk of irritation to the stomach lining.
Imagine all the foods you eat entering into a stomach that had little or no acid to break it down. In short order, the foods would be an irritant to the stomach lining. In a low-acid stomach environment, undesirable microbes such as H. pylori that are often synonymous with heartburn can proliferate and irritate and further inflame the stomach lining, causing low acid-related heartburn.536
• Reduction of stomach acid due to lack of bile flow.
• Eating excess over-processed foods that are difficult to digest, depleting stomach acid.
• Eating while stressed will initially increase cortisol and increase stomach acid. But over time, with chronic stress, the cortisol will underperform and acid production will be less than adequate.
• Drinking large amounts of cold beverages or alcohol with meals.
• Overeating at night will bog down the digestive fire.
• Eating excess heavy and rich foods will bog down the digestive fire.
Determine Your Type of Heartburn Quiz
• Too Much Acid: Mix 1/4 teaspoon of baking soda in 1 cup (8 ounces) of water and drink during acid symptoms. If the burning is caused by too much acid, the baking soda—which is extremely alkaline—will buffer the acids and relieve the pain.
• Too Little Acid: Mix 1 tablespoon of apple cider vinegar in 8 ounces of water and drink this during acid symptoms. This will increase acid and reduce the burning if this is due to too little acid.
If the heartburn is caused by insufficient bile flow from the liver or gallbladder, the heartburn usually kicks in at night, or 30–60 minutes after a meal. This happens because it takes some time for the stomach acid to build up and/or spill small amounts of acid into the small intestine that has produced inadequate amounts of bile to buffer it.
Eating heavy, rich, fatty or fried foods—more so than spicy foods— can cause heartburn due to a lack of bile flow. This is because bile is responsible for the breakdown of fats. If there is inadequate bile flow, the fatty meal will sit in the stomach undigested and burn, causing burping or nausea.
Pancreatic enzymes are involved in digesting fats, proteins and carbs so a lack of these enzymes can cause just about any type of indigestion. The best way to explore your own pancreatic enzyme balance is to take some over-the-counter digestive enzymes and, if you feel better after taking them, you can deduce that the bile ducts that carry the bile and pancreatic enzymes are likely congested. As we have discussed, the beets, apples, fenugreek, turmeric and 5-spice mixture are all excellent to open up those ducts.
In Chapter 9, I discussed the use of apple cider vinegar (ACV) to be used in supporting the body in many ways, such as moving lymphatic congestion and boosting HCl production. Taking 1 tablespoon of ACV with 8 ounces of water 15–30 minutes before meals can be used for heartburn caused by either too little or too much stomach acid. ACV has been shown to reduce heartburn, increase digestive strength, balance blood sugar and mitigate many of the symptoms of gluten intolerance.482, 483
When heartburn is caused by low HCl production, it is commonly due to poor bile flow as well. Follow the food, herb and spice recommendations I described above to boost bile flow.
When stomach acid is too high, I suggest the following strategies (discussed in detail in Chapters 8 and 9):
• Apple Cider Vinegar—Can be used for too low or high HCl production
• 5 Spices—Can be used to balance HCl, bile and enzyme production
• Amalaki—Supports healthy repair of the intestinal skin
• Brahmi (Centella asiatica)—Cooling and helps repair stomach and intestinal lining
• Colonizing probiotics—Restores a healthy microbiology found to support digestion
• Slippery Elm—Protects stomach lining from acid irritation
• Marshmallow Root—Protects stomach lining from acid irritation
• Licorice Root—Protects stomach lining from acid irritation
In Ayurveda, there is a condition called “udvarta,” where stomach acid builds up in the stomach and is forced up into the esophagus causing heartburn, GERD, or acid reflux. Over time, this condition can cause the stomach to press up onto the diaphragm instead of hanging freely from it. There are many reasons for this condition, including stress, poor elimination, poor bile flow, and excess stomach acid.
In some cases, the upward pressure of the stomach can cause irritation, inflammation, and pain on the abdomen just under the rib cage. In extreme cases, it can adhere itself to the underside of the diaphragm, rendering the stomach unable to digest hard-to-digest foods like wheat, dairy and fatty foods. With part of the stomach bound to the diaphragmatic wall, this can a make it harder for the stomach to effectively empty the stomach’s contents into the small intestine.
In severe situations, the stomach can put so much pressure on the diaphragm that it can actually herniate through the diaphragm and cause a common condition called hiatal hernia. Where the esophagus passes through the diaphragm, there is a sphincter called the lower esophageal sphincter, which opens and closes, which allows food to pass through and keeps acid out. After years of upward pressure, this sphincter gives out and part of the stomach pushes up through the diaphragm.
• Hay fever
• Occasional headaches
• Breakouts
• Brain fog
• Sore throats
• Occasional heartburn
• Indigestion
• Occasional constipation
• Weight gain
• Gluten intolerance
• Dairy intolerance
• Achy neck and shoulders
• Issues with the eyes, ears, nose and throat
The diaphragm is a big, flat muscle that separates your chest cavity from your abdomen and regulates breathing depth and patterns. The stomach is designed to hang underneath the diaphragm. But after years of:
• Stress
• Shallow breathing (through the mouth)
• Pregnancies (due to upward pressure from the baby pushing up on the stomach and diaphragm)
• Lack of exercise
• Lack of yoga, and
• Indigestion
…the diaphragm can begin to tighten and pull the stomach up towards itself. This is common after childbirth causing chronic post-partum digestive problems.
To determine if you have this condition, take your thumb and press deeply under the left side of your rib cage and see if it is tender to touch. If it is painful, sore, tender, or hard in this area, you might have a stomach that is pressing unnaturally onto the diaphragm. You may also want to poke under the right side of the rib cage as well and see if that area is sore. The liver hangs closely next to the diaphragmatic surface on the right side; if it is sore, you may need to treat the right side as well.
1. Sit in a chair with a backrest, so your stomach muscles can relax. Take your left thumb and poke the abdomen just under the rib cage on your left side on the sore or tight area. Use your right thumb on top of your left to help put more pressure of the left thumb to push in more deeply. Soreness is an indication that you can benefit from this technique and that you are in the correct spot.
2. With your thumbs pressing into your stomach just under the rib cage, begin to lean forward. This will soften the tummy and allow you to push more deeply into the abdomen and stomach.
3. With your right and left thumbs, begin to pull downwards, towards your navel, in effect pulling your stomach downwards and separating it from the diaphragm.
4. As you are pulling downwards, take a big inhalation, continue pulling down on your stomach with your thumbs while you begin to lean back in your chair, arching your back. Be sure the abdominal muscles do not contract while you lean back. This will extend your back, leveraging the rib cage upwards as you pull the stomach downwards in the direction of the navel.
5. At the end of the inhale, lean forward again in your chair and exhale as you go all the way forward. Poke in again with the left thumb to find a sore or tight area; back it up with the right thumb and pull the stomach down. Inhale deeply again as you pull down with your thumbs and extend or arch your back.
6. Continue working your way across the left and right sides where you felt soreness or tension.
Continue this procedure for 2 minutes twice a day until the area is painless and supple. Be careful not to overdo it. Too much pressure can bruise the area and slow down the progress. The tenderness may take days or weeks to resolve.
Tip: This may be easier to understand by watching a video. You can find an instructional video at http://lifespa.com/learn-stomach-pulling.
Following are a few simple, yet effective tools that can help keep your stomach hanging in the proper way:
• Nasal Breathing Exercise: Deep nasal breathing during exercise is one of the best ways to expand the diaphragm and create space in the abdominal cavity. See Chapter 13 for instructions on Nasal Breathing Exercise.
• Sun Salutations: This series of yoga postures alternates extension and flexion, naturally stretching and massaging the region around the diaphragm and stomach junction. See Chapter 13 and Appendix D for instructions on Sun Salutations.
• Hand Massage Vibrator: Using a handheld electric massager, vibrate the area between the stomach and lower rib cage. Do this for 2 minutes twice a day until all the tenderness and tightness of both left and right sides of the sternum just below the rib cage are pain-free, soft, and supple. For best results, follow this with the stomach pulling technique.
Have you ever eaten a big meal and then used every ounce of energy you had not to fall asleep? Some of the lymphatic research I cited in Chapter 4 suggests that the lymphatic system can take a couple of hours to clear after digesting a meal. Weak digestion and a congested lymphatic system can slow the delivery of energy producing fats from the lymph to the muscles and brain and possibly cause after-meal fatigue or the famous “food coma.”
During my Ayurvedic training in India, I remember eating a very large lunch with my teacher. We were at a conference and I knew if I went back into the hall I would fall asleep in my chair. I told my teacher I was going to lie down in my room and I would come back to the hall later. He quickly rebutted, telling me, “No, lay on your left side and I will come back in 10 minutes and we will go to the hall together and you will be fine.”
I told him that I ate too much and I was sure to be asleep in 10 minutes, and if I did not answer the door to go to the hall without me. I went to my room and did as he told me. Strangely, when he came to my door I was awake, and we went to the hall together; even stranger, I was wide awake the entire afternoon listening to lectures in Hindi—which I cannot even understand!
After the meeting, I asked my teacher how that happened. I was so tired after such a big meal that I was nearly falling asleep at the table. He told me that we did overeat, but the food was fresh, prepared well, and we ate it in a relaxed way. He said what we ate, how we ate it and then resting on my left side after the meal helped me digest the food into energy. When people fall asleep after a meal, it is because of weak digestion. Once you fix the digestion, you can begin to enjoy larger, more relaxing mid-day meals without the food coma.
Relaxing while eating and then resting on the left side after a large meal is an age-old Ayurvedic technique to improve digestion that has been documented by modern science. For example, in one study, researchers measured alertness and task performance after groups took either no nap, a 15-minute nap, or a 45-minute nap after a large meal. The results agreed with the siesta principle: A short nap—as opposed to a long nap—is ideal. The group that took a 15-minute nap after the meal demonstrated better alertness 30 minutes—and up to 3 hours—after the meal. Task performance was also significantly better in the 15-minute nap group compared to the 45-minute and no-nap groups.440
The instruction to lie on your left side is also supported in a handful of other studies. When you lie on your left side after a meal, the stomach is cradled to allow the food to more effortlessly exit the stomach and enter the small intestine. When standing or lying on the right side, there is undue pressure on the pyloric sphincter, which may allow the food to exit the stomach prematurely, causing issues of indigestion, gas and bloating. In one study, babies fed while lying on their left side had better digestion and less colic, while other studies showed that lying on the left side helped ease occasional heartburn.441, 442
• Relax while eating the meal.
• Don’t watch TV or be distracted while eating.
• Dine and enjoy light (not stressful) conversation.
• Rest on your left side for 10–15 minutes after the meal whenever possible.
• Take a stroll after the post-meal rest.
• Troubleshoot your lymph, gallbladder and stomach acid production.
Now that we have some tried-and-true tools for resetting and supporting our digestion, we have to address America’s new pre-diabetic epidemic I call “Sugar Belly.”
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6All names of patients have been changed throughout this book to protect their privacy, and all patients have given permission to share the story of their health journey in this book.