Stillpoint, Washburn WI

05/18/2026

This is a great primer, most everything I cover in the class that I teach about gut and microbiome health

https://www.facebook.com/share/v/1bNqDNG3A1/

05/09/2026

If you like learning about human biochemistry, this guy posts solid info. If you are dabbling in Homocysteine, methylation, MTHFR genetics snips etc., pay attention to choline and B6, nit just B12 and folate. If you have a slow MTHFR situation, instead of trying to ram more products into the methylation cycle, try.incrwasing the productive capacity of the recycling and discharging cycles

https://www.facebook.com/share/1CkQU69rpK/

Methylation is one of the most discussed topics in functional health. Most of the conversation centers on folate and B12. The actual cycle has four nutrient inputs, and the one almost nobody is getting enough of is rarely mentioned.

The methylation cycle converts homocysteine back to methionine, which gets activated to SAM, your body's universal methyl donor. SAM donates methyl groups to DNA, neurotransmitters, phospholipids, creatine, and hundreds of other reactions. Once it donates, it becomes SAH, then homocysteine, and the cycle has to turn again.

Two nutrients drive the main recycling step. Folate (as 5-MTHF) provides the methyl group. B12 (as methylcobalamin) is the cofactor methionine synthase needs to transfer it. These are the two everyone focuses on. Post-fortification, only about 12% of US adults fall below the EAR for folate, and 5% for B12. These are relatively well covered in the food supply.

B6 runs the exit valve. When homocysteine accumulates faster than it can be recycled, cystathionine beta-synthase (CBS) shunts the excess into the transsulfuration pathway, producing cysteine and eventually glutathione. Without adequate B6, that exit is restricted. Homocysteine backs up even if folate and B12 are sufficient.

Then there is choline. Your liver converts choline to betaine, which feeds BHMT, a backup remethylation enzyme that works completely independently of folate and B12. This pathway is especially active in the liver and kidney. NHANES data shows 92% of US adults fall below the adequate intake for choline. It is the single most prevalent nutrient gap in this entire cycle, and it is almost never included in methylation protocols.

What this means practically: if you are addressing methylation, checking folate and B12 status is a starting point, not the full picture. B6 status matters independently because it controls the exit, not just the recycling. And choline intake deserves attention proportional to the gap: eggs are the most concentrated whole food source (one large egg provides roughly 150 mg against a 550 mg AI for men, 425 mg for women). Betaine from beets and spinach also feeds BHMT directly.

The pattern worth noticing: the nutrient with the highest inadequacy in this cycle is the one least likely to appear in a methylation product.

Reider et al., Nutrients, 2020.

Wallace & Fulgoni, Nutrients, 2017.

05/08/2026

Good info here. Every health issue has tendrils if not direct relations to the GI tract microbiome and tissue integrity. This is where we start, always. This and nervous system regulation
https://www.facebook.com/share/1azNWVutnS/

THE COMPLETE RESTORATION PROTOCOL

The "Four R" framework.... Remove, Replace, Re-inoculate, Repair... provides the most clinically structured approach to gut restoration.

The following is the mechanistic expansion of each phase.

🔴 PHASE 1 — REMOVE (Weeks 1–4)

Remove the primary drivers of dysbiosis that are pharmacologically or dietarily addressable. This does not mean abandoning medications... it means audit:

PPI reassessment:

If on PPI for more than 12 weeks, discuss with prescribing physician whether a stepdown to H2 blockers (famotidine — less profound acid suppression, lower SIBO risk) or trial of PPI cessation with a structured taper is appropriate.

PPIs should not be stopped abruptly (rebound acid hypersecretion occurs — as established in the PPI Paradox article).

Where PPIs are genuinely required (Barrett's oesophagus, peptic ulcer disease), the lowest effective dose with reassessment every 6–12 months is appropriate.

Dietary refined carbohydrate reduction:

Ultra-processed foods containing fructose, glucose syrup, and refined starches provide the primary substrate for pathobiont overgrowth.

The transition is not about alkalisation or restriction — it is about removing the specific macronutrient that Candida albicans, Bacteroides-imbalanced species, and SIBO-associated bacteria disproportionately metabolise.

Low-FODMAP dietary trial (where SIBO or IBS is suspected):

Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols — specific carbohydrates that are incompletely absorbed and rapidly fermented by bacteria — can drive significant symptomatic dysbiosis in susceptible individuals.

A 4–6 week elimination followed by structured reintroduction is the evidence-supported protocol (Tier 1 meta-analysis, Gibson 2017).

🟠 PHASE 2 — REPLACE (Weeks 2–6)

Replace what the dysbiotic gut cannot produce sufficiently:

Digestive support:

Betaine HCl (250–750mg with protein-containing meals) to restore gastric acid in confirmed hypochlorhydria.

Digestive enzyme supplementation (broad-spectrum lipase, amylase, protease complex) to support pancreatic enzyme activity — relevant in elderly patients and those with SIBO-related brush border enzyme impairment.

Bile acid support:

Taurine (1,000–2,000mg daily) supports bile acid conjugation and bile flow — important for fat-soluble vitamin absorption and for maintaining the bile acid concentration gradient that normally inhibits bacterial overgrowth in the small intestine.

🟢 PHASE 3 — RE-INOCULATE (Weeks 4–12)

Re-establish commensal populations. The two intervention categories with the strongest evidence:

Targeted probiotics:

The clinical evidence for probiotics is species- and condition-specific — not a generic "probiotics are good" endorsement.

Targeted probiotics (species- and condition-specific — NOT a generic "probiotics are good"):

• L. rhamnosus GG → antibiotic-associated diarrhoea, C. difficile prevention (Tier 1)
• B. longum + L. acidophilus NCFM → IBS symptoms (Tier 1)
• L. rhamnosus GG in pregnancy/infancy → reduces childhood allergy (Kalliomäki 2001 Lancet, Tier 1)
• Saccharomyces boulardii (yeast) → AAD and C. difficile recurrence prevention (Tier 1)

The critical point: Multi-strain products without clinical evidence for t heir specific strains cannot be assumed to have equivalent benefit to strains tested in RCTs.

Prebiotic fibre:

This is the superior long-term intervention for microbiome restoration — because prebiotics feed and select for the desired commensal species rather than providing transient colonisation.

• Inulin (chicory, garlic, leeks, onions)
• Pectin (apple, citrus peel)
• Beta-glucan (oats, barley)
• Resistant starch (cooked-then-cooled rice/potatoes, green bananas, legumes)

Wastyk HC et al. (2021, Cell — Tier 2 RCT): A high-fermented-food diet (kefir, kimchi, sauerkraut, kombucha) increased microbiome diversity and reduced inflammatory markers including IL-6 compared to a high-fibre diet — suggesting that fermented foods may be the fastest route to microbiome diversity restoration in adults.

The high-fibre arm of the same study produced greater SCFA output but more variable effects on diversity — the two dietary strategies appear complementary rather than competitive.

🔵 PHASE 4 — REPAIR (Weeks 6–24)

Restore the structural integrity of the intestinal barrier:

L-glutamine (5–10g daily, divided):

The primary fuel substrate for enterocytes (intestinal epithelial cells) — which preferentially oxidise glutamine rather than glucose for energy.

Multiple small Tier 2 trials and mechanistic studies (Tier 3) document L-glutamine supplementation reducing intestinal permeability markers (lactulose:mannitol ratio test) in IBS and post-surgical patients. The most established mucosal repair nutrient.

Zinc carnosine (75mg daily — providing approximately 17mg elemental zinc):

A chelated form of zinc and L-carnosine that exhibits gastroprotective effects specific to the gastric and intestinal mucosa.

Multiple Tier 2 trials document zinc carnosine reducing intestinal permeability, protecting against NSAID-induced intestinal injury, and improving tight junction protein expression.

Playford RJ et al. (1999, Gut — Tier 2 RCT) and multiple subsequent studies document gastric and intestinal mucosal protection.

Colostrum (bovine, 10g daily):

Contains immunoglobulins (particularly IgA), lactoferrin, growth factors (IGF-1, TGF-β), and proline-rich polypeptides.

Multiple small Tier 2 trials document reductions in intestinal permeability and improved tight junction function — particularly relevant in athletes (exercise-induced gut permeability) and post-antibiotic gut barrier restoration.

Butyrate supplementation or butyrate provision through dietary means :

Butyrate is the primary fuel for colonocytes, the primary HDAC inhibitor maintaining tight junction gene expression, and a direct anti-inflammatory signal through GPR41/43 receptor activation on immune cells.

When gut microbiome diversity is significantly compromised, direct butyrate supplementation provides the signal normally generated by F. prausnitzii and other butyrate producers — "scaffolding" the repair process until the microbial community recovers.

Deglycyrrhizinated licorice (DGL, 380–760mg 20 minutes before meals):

Removes glycyrrhizin (which can cause hypertension at high doses) while retaining the gastric and intestinal mucosal coating and anti-inflammatory properties. Tier 2 evidence for gastric ulcer management; Tier 3 for general mucosal support.

THE SCIENTIFIC DEBATES (Honest Calibration)

🤔 The "Leaky Gut" Controversy:

Increased intestinal permeability is measurable (lactulose: mannitol, zonulin, serum LPS) and documented in IBD, coeliac, T1D, NAFLD, and sepsis.

The controversy is whether it's a primary cause or a consequence of systemic disease — the evidence increasingly supports bidirectionality (self-reinforcing cycles).

The dissenting view worth respecting: "leaky gut" has been adopted in functional medicine far beyond evidence base.

Many patients labelled with "leaky gut" have other primary conditions. Maintain mechanistic validity. Avoid diagnostic overreach.

🤔 FMT Beyond C. difficile:
✅ C. difficile: ~85–90% cure (van Nood 2013, NEJM, Tier 1)

⚖️ Ulcerative colitis:
Modest benefit (~24–32% remission vs 5% placebo) — not consistent enough for routine use outside trials

⚖️ Metabolic syndrome:
Vrieze 2018 (Gut) — temporary insulin sensitivity improvement, not sustained at 18 weeks

The open question:
Whether full microbiome transplant is necessary, or whether targeted diet + probiotics + prebiotics can produce equivalent shifts without the procedural complexity.

THE BOTTOM LINE

Your gut is not a digestive tube. It is the headquarters of your immune system, the conversion station for your hormones, and the upstream regulator of your brain, heart, and metabolism.

Standard medicine rules out disease. It does not measure function. The 5–15 year diagnosis gap between sub-clinical dysbiosis and clinical disease is where most chronic disease is silently built.

Reverse it with the 4R framework: Remove, Replace, Re-inoculate, Repair. Timeline: 3–6 months for meaningful functional remission.



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Written by Edward Paul Mshani, BPharm
Registered Pharmacist By,
The Pharmacy Council Of Tanzania
Registration No: [0102390]
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Disclaimer — VitalDrop Rx

This content is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. Do not stop or modify any prescribed medication or supplement regimen without consulting a qualified healthcare professional. Individual clinical decisions require personalized medical assessment.
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Sources: Peer-reviewed pharmacology and clinical medicine literature.

05/06/2026

Good list, focus on eating these whole foods and significantly reducing processed food-like substances. You will feel the difference in every cell of your body, promise.
https://www.facebook.com/share/19PbweFPPj/

04/29/2026

We will break this into baby steps at May's Myofascial Movement classes @ Washburn Meditation Center.
Every 1st and 2nd Monday of the month @ noon.
See ya there 😀https://www.facebook.com/share/18wWBYerch/

04/28/2026

Delivery style isn't particularly inspiring but the information is good. The subtitles aren't always accurate with the Latin terms. Text me if you want the specific spellings of any terms used.

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04/27/2026

Good list for menstruators

10/29/2025

often the culprit related to feeling tight hamstrings and low back pain

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