Kim Vopni (00:01.25)
Hi Michelle, welcome. So happy to have you here talking all about gut health and metabolic health, which seems to be an ever growing, not going away topic. We were just saying offline that I think, you know, gut health became trendy and it just seems like it's, it's constantly being talked about and still being talked about. And I think we, we still have things to, we still have things to learn. And I'm excited for you to share your work and your experience with us. If you can start out by just telling us who you are.
Michele Scarlet (00:10.588)
you
Kim Vopni (00:29.58)
what you do and how you came to this space.
Michele Scarlet (00:32.872)
Yeah, absolutely. Well, first of all, thanks for having me, Kim. I'm really excited about this conversation today. I think it's incredibly important for women to know, you know, be more informed about their bodies, ultimately, right? The more informed we are, the better decisions we can make and the healthier we can become. So that's definitely my passion in life. My name is Michelle Scarlett, guys, and I am a functional medicine practitioner based out of Toronto, Ontario.
I work with women generally between the ages of like 40 and 65, that perimenopause, menopause, you know, midlife chaos is how I would describe it. And yeah, my passion is really about women's health and empowering women to advocate for themselves and investigate deeper into their health because we are not, we are not taught how to be optimally healthy. We are taught how to
react to symptoms. are taught to, we are conditioned to believe that there is a pill for every ill when I just do not believe that that is the case and we can do so much for ourselves and so much self-healing if we do a little bit of research and drown out some of the noise.
Kim Vopni (01:52.674)
Yeah, and it's very noisy out there. It's very noisy. Yeah, I've often said that, you know, I don't want to take away from the importance of what we learn in school. However, we miss out on really important information, which is how to care for this vessel that we exist in. And we are given so very little information. Obviously, I come from the bias of pelvic floor. We learn about our menstrual cycle, not even really that in depth.
Michele Scarlet (01:55.092)
It's very noisy.
Kim Vopni (02:21.016)
We learn about sexually transmitted diseases and birth control, and that's kind of our sex ed, right? That's what we know. And we miss a lot. And really, we live in very complex.
bodies and we deserve way more information about how we learn more about how to maintain our car than we do about our body. And and so we deserve a lot more than we get and and yes, it is a very noisy space. So your role in that noisy space is you focus a lot on gut health and metabolic health. think I want to start with like metabolic health as a term is has not been used historically. It's sort of
Michele Scarlet (02:42.888)
Yes.
Kim Vopni (03:06.092)
I've heard more people talking about it in the last, I don't know, five plus years maybe, but I would say it's kind of a newer term. So for those that maybe haven't heard the term or are confused about what metabolic health is, can you elaborate?
Michele Scarlet (03:21.52)
Yeah, I like to think about metabolic health and oftentimes when we hear the word metabolic or metabolism, women tend to automatically think weight loss or weight gain. And that's where it ends. But because I come from this functional medicine place or this holistic place, what metabolic health actually is, I like to describe it as like an umbrella that covers every single system and cell in your body.
And I always say this, if you went on my Instagram or my website, it's like all over the place. You cannot silo one system of your body. So if there is inflammation somewhere, if it's in your gut, it's in your brain. If there is dysfunction in your thyroid, there is dysfunction in other systems of your body. You cannot have an issue, so pelvic floor health, you cannot have an issue with your pelvic floor and not have issues
upstream because metabolically if one thing is dysfunctional more things are dysfunctional.
Kim Vopni (04:29.314)
Yeah, yeah, and as you say, are, I grew up in this way too. It was very much if something felt wrong or off with your body, you went to your doctor and they would have some sort of a pill for your ill, which usually then would create another ill that you would need another pill for. We go down that cascade that we're all very familiar of now. And I feel like the world has woken up to some extent on
We need more information. We need to be able to advocate for ourselves. Our medical systems are very much sick care systems, which are great when we are really, truly sick or have a trauma. And both of us live in Canada. Not so great from a preventive health or health maintenance perspective at all. But if you have a trauma, it's a great system. We get support. Yeah.
Michele Scarlet (05:18.58)
Yeah. Yeah, there is a place like I am not like anti-doctor or anything like that. I also believe that, you know, they could use more training because they don't know the things that, you know, we need more in depth of. It's just not the way they're trained. And until I had a very candid conversation with my primary care doctor, I felt a lot of resentment going to her as sort of my first, you know, go to place.
Kim Vopni (05:24.333)
Yeah.
Kim Vopni (05:30.414)
thousand percent.
Michele Scarlet (05:48.317)
until she literally said, I'm just not trained that way. And then I was like, thank you for being honest about that because I can accept that, right?
Kim Vopni (05:55.023)
Yeah. Yes. Yeah. It's their training and the system in which they work, which is not set up to support that way, which is why, you know, people have heard me say we need a healthcare village or a healthcare team. It's not just a doctor. So you come from the functional medicine space. Also, some people may not be familiar or they may have heard this term. I talk about it a lot about
Michele Scarlet (06:01.011)
Yes.
Kim Vopni (06:19.774)
seeking out care from functional minded or root cause investigation people, what does it mean to be a functional medicine practitioner?
Michele Scarlet (06:26.918)
It means exactly like you said, it is about root cause. When I look at labs and functional labs, so not just blood labs, when I look at stool tests and urine tests and hormone tests, I am obviously looking at markers that are telling me that there is some dysfunction, but I'm not addressing one marker. That would be very similar to a reactive system. It would be very similar to like a pill for every ill. What I'm looking at is the patterns.
that they're talking to each other, that they're creating, and then correlating them to the symptoms that the patient in front of me is having. I think about the thyroid a lot. The thyroid, where that hormone is metabolized is in the liver. So T4 metabolized to T3 in the liver. If we are struggling with the conversion,
then the issue shouldn't be give somebody more synthetic T4, or sorry, I shouldn't say, the answer shouldn't be give somebody more synthetic T4. The issue is in the liver. Well, what's going on in the liver? Hey, what else gets converted in the liver? Your cortisol gets converted in the liver, your sex hormones get metabolized in the liver. Like, there's so much going on, and just as I said, that cascade, it cannot be siloed to one system. So.
When I think about functional medicine, is a root cause, it is more about patterns than it is about one individual marker.
Kim Vopni (07:57.657)
So let's talk a little bit about thyroid because this is something that I remember when I was going through my hormonal chaos or AKA shit storm. I didn't know the term perimenopause. I didn't know what was happening. I kind of in my gut knew it must be something hormonal, I, you know, I'm too young for menopause. So it can't be that. you know, anyway, going through all that and then it...
Michele Scarlet (08:07.976)
Yeah.
Kim Vopni (08:25.598)
in the end, like being told from my primary care doctor that everything was normal except my ferritin, ferritin being very low. And now I know there's multiple reasons for that, one of which I was bleeding like a murder scene several times a month. So that's gonna be a big contributor to it. that was kind of my, the time where I was like, this is not.
This plays a role for when I'm really truly sick, but it's I have to get really really sick in order for this system to serve me. I need to know what is making me sick first and what can I do about it. So that kind of prompted and I landed in this thyroid space, which then I never really gone down that path, learned about autoimmune stuff and recognize that there's a lot of symptoms that mimic.
the symptoms of perimenopause and it's also a time when a lot of women start to deal with thyroid issues. So in your practice, what do you see specific to sort of that menopause transition phase of life? What role is the thyroid playing and how is that hormonal chaos then also influencing the thyroid?
Michele Scarlet (09:12.926)
Yes.
Michele Scarlet (09:29.496)
my goodness. It could be the rest of the podcast because like I've just like literally just gone through a very similar experience and for me root cause ended up being mold exposure. like, you know, certain types of mold species for me were mimicking perimenopausal symptoms or like they were declining my hormones, my sex hormones, which even just the stress of that on the body.
Kim Vopni (09:31.224)
Could be the rest of the podcast.
Michele Scarlet (09:59.637)
causes thyroid dysfunction. Right? Like if my body is constantly inflamed because there's this mycotoxin kind of hanging around, right? It's my, it's depleting my hormones. That's a stress in itself. The thyroid reacts very closely to stress. So if you ever ask anybody who has Hashimoto's or has been diagnosed with Hashimoto's, Graves' disease, any kind of thyroiditis, whether it be hypo or hyper, I bet you could probably pinpoint
a time in their life where stress was incredibly high and then this cascade effect happened, right? And it doesn't have to be emotional stress. It can literally be just like low grade inflammation for too long, right? I had breast implants put in when I was 25. I had them for 10 years. At about the five year mark, I started having wild symptoms of breast implant illness.
When, and you I was 25, I wasn't getting labs done every day or every year. Like it was, I was like, I feel good. I'm just gonna run with it, right? But it wasn't until I was 35 where I was like, something is seriously wrong. And my thyroid was completely tanked. So were my sex hormones, right? And breast implants, was, you know, I mean, doesn't really matter. They are a toxic bag pushed into my body, close to all of my internal organs.
low-grade inflammation for 10 years, right?
Kim Vopni (11:31.584)
Was that the source of the mold?
Michele Scarlet (11:34.463)
Potentially. I mean, that's the thing about mold, right? I mean, if I think about all the times that I've moved in my life, I think about, you know, in Ontario, our springs and our falls are very wet, lots of leaves. You could just be like, mold exists in our environment, right? And sometimes I think that mold is not actually a root cause. It's like, why is my body susceptible to getting sick with mold?
Kim Vopni (11:35.831)
Interesting.
Kim Vopni (12:01.87)
Yeah
Michele Scarlet (12:02.29)
Right, so then there's the other part of it. There's another system, your immune system. Why isn't my immune system fighting this before it causes an issue?
Kim Vopni (12:09.72)
Yeah, it's like constantly asking questions for that root cause side. What testing would somebody do to reveal mycotoxin, which would be the mold exposure?
Michele Scarlet (12:12.52)
Yeah.
Michele Scarlet (12:22.418)
Yeah, there's a great brand or lab called Vibrant Wellness. That's who I use. I think they come up with like over 35 different species of mycotoxins and it's just a simple urine test. But it's incredible to see like what actually can come out of, like what you've got going on in your body, right?
Kim Vopni (12:44.204)
And is that a test that you could order, you have to order through a practitioner or is it something you can just order and then ideally have a practitioner help you understand and evaluate?
Michele Scarlet (12:54.15)
As far as I know, you have to have a practitioner order it. Yeah, so I would definitely be somebody who would order it for one of my clients. It's not my first, it's not my go-to. It's not like my foundational lab. But I do believe that if nothing is moving the needle for a woman, like once we start balancing the gut and we start balancing the hormones and we get food and the basics under control, if things are not shifting the way I want.
Kim Vopni (12:57.196)
Okay. Okay.
Kim Vopni (13:04.078)
Mm-hmm.
Kim Vopni (13:16.632)
Mm-hmm.
Michele Scarlet (13:23.464)
or the way they want, we start digging deeper into things like mycotoxins or like total tox burden. So like plastics, microplastics, that kind of stuff.
Kim Vopni (13:33.391)
Right, right. So maybe like if I think about the, you again, growing up, we would, you would have an annual or a physical and there would usually, you know, there's a physical exam and there would be usually a round of a very kind of standard, usually blood tests that you would do to have kind of classic standard markers. Is there a role still for that and what other ones in addition? So if we were thinking of what we could be checking in on,
on an annual basis. Some may not be necessarily supported by the allopathic model. So we may need to pay privately, but for those that choose to or want to potentially further optimize, what are some of the other things that we, what are the basics that you think people should be testing and what are the additional tests you think would be helpful to kind of monitor how we're doing?
Michele Scarlet (14:25.576)
Yeah, so when it comes to just regular blood work, so you go to your doctor, they order the standard. I think that that's still important. mean, know, like it wouldn't, my husband is a firefighter and I joke about the fact that he checks vitals, right? And I'm like, what does that even tell you about somebody's health? And him and I talk about this all the time, but like really, if you're breathing and your blood pressure is good, like, you his job from his perspective, that's a good thing.
And so from a doctor's point of view, same thing. I think that there is a place for just standard blood work. I don't think it tells the whole story. To your point, you have to get really sick in order to be looked at in more depth when it comes to the medical system, at least here in North America. So I definitely, yes, I do think our white blood cell counts, our red blood cell counts, I think that they do test TSH for thyroid.
TSH is not actually a thyroid hormone. It's a pituitary gland hormone. It doesn't tell the story. And our lab ranges are a bit out of whack when it comes to medical versus functional. So I think that every woman over the age of 35 every year should have a full thyroid panel done. So what does that look like? Yeah. So TSH is a part of it. Perfect. T4, free T3.
Kim Vopni (15:25.23)
you
Kim Vopni (15:43.822)
Can you, can you, yeah, I was just gonna say, can you tell what the full thigh rule is? Yeah.
Michele Scarlet (15:52.893)
Reverse T3, both types of antibodies, so your TPO and your TRAB, as well as your total T4. So there's like six markers that you need to ask your doctor about. Now, will your doctor do it? In, I would say, 99 % of the cases I see, they will not. My doctor will allow me to run T4, as well as TSH. So I'm like, okay, we'll do it, that's fine. And then you do have to pay privately for the rest.
But it is well worth it because I've seen women who are on synthetic T4, you know, and their doctors are like, this is great, you're balanced, everything's fine. But their T3 is still tanked. So there's that conversion issue. And their antibodies are off the charts. You know, like this T4 is not the solution here. So.
Kim Vopni (16:43.918)
And if the antibodies are off the chart, what is that indicating?
Michele Scarlet (16:47.86)
Like I can't legally diagnose, so there's my disclaimer there, but yeah, like typically over 250, a value of 250, you're looking at Hashimoto's, you're looking at an autoimmune disorder, right? And you can get it under control, and I'm not saying that that's like a label and now this is who you are, but yeah, like typically over 250, and I have many women who, whether I see in my practice or just friends,
Kim Vopni (16:50.072)
Sure. Yeah.
Michele Scarlet (17:14.836)
They're like, my doctor's telling me everything's fine. My TPO is like 1200. Like nothing is fine about that. Right? You know, things like thyroiditis, hypothyroidism, Hashimoto's can, the downstream effect could be infertility, could be miscarriage, constant miscarriage, right? I have friends who are trying to conceive and that's like their situation. Their doctor won't do anything about it.
Kim Vopni (17:22.52)
Mm-hmm.
Kim Vopni (17:41.356)
Mm-hmm. Yeah.
Michele Scarlet (17:42.643)
Right, so definitely a full thyroid panel. If not, for just more data, right? Thyroid tells a lot about your optimal health and what's going on in your other systems, and they're easily accessible when you ask for them. So definitely full thyroid panel. Depending on what your, and then like the next one I would say, depending on what your genetic makeup is.
So for instance, in my world, heart disease runs rampant through my family, genetically. And I do have high cholesterol. As somebody who is, I would consider very optimally healthy, I'm very conscious about my lifestyle and keeping up with my labs and stuff. Cholesterol, LDL and HDL don't actually tell the whole story either. There are other lab tests that you can get.
Again, you'd have to pay for them privately, but they can tell you how big or how small the particles of your cholesterol are and the likelihood of them actually blocking an artery. Right? And so the high or low of cholesterol doesn't actually mean much. And most people don't know that high cholesterol actually could mean inflammation in the body. Most people don't know that almost every single hormone in your body relies on cholesterol to be made.
And so if you are somebody who's deciding, I have high cholesterol, I can't eat red meat, I can't eat eggs, I can't eat cheese, and you're lowering your cholesterol intake, then the cascade effect is gonna be potentially hormonal chaos, especially for women in perimenopause and menopause.
Kim Vopni (19:26.944)
or if they were put on a statin blocking. yeah. Okay, so thyroid, looking at the other blood markers. What about from a hormone testing perspective? There's different schools of thought with blood versus saliva versus like a dried urine test. Do you have preferences or do you use both? Do you use all three? What are your thoughts on that?
Michele Scarlet (19:28.819)
Yes.
Michele Scarlet (19:52.701)
Yeah, yeah. So my go-to when it comes to hormone testing is both blood and dried urine. I like both. Serum, blood, is gonna give us the picture of what your body is producing right now. The urine test is gonna show how your body is metabolizing it, how it's detoxing it, which are two really important pieces, especially for women in perimenopause and menopause who are considering going on
hormone therapy. If we are seeing on a Dutch test, for instance, that the 4-OH pathway is the preferred detox pathway of estrogen, it's more inflammatory, it's potentially carcinogenic, we don't want to put somebody on a bioidentical hormone or a synthetic hormone knowing that that's the pathway that is preferred. And so the blood won't give us that information, but the urine will.
Kim Vopni (20:51.404)
Okay.
Michele Scarlet (20:52.072)
So that's really important for me in my practice. And also, so if we're talk about hormone testing, if we're gonna talk about it for the purpose of hormone replacement therapy, I like every three to six months testing. And then as symptoms of perimenopause or postmenopause are under control, it can be six to 12 months. But I find that a lot of doctors either don't test,
put people on estrogen patches or oral estrogen or whatever, to send people on their way, yeah. Right, so.
Kim Vopni (21:27.736)
Don't check the pathways. Yeah. Yeah. So somebody was down, let's say, as you say, so there's the three detox pathways. If you can tell a little bit about the three of them, but then also what can somebody do if they were predominantly favoring the four pathway versus the others.
Michele Scarlet (21:47.497)
Yeah, so you want most of your estrogen to be going down the 2-OH pathway, which is like 80 % of your estrogen, even if you're not producing a lot of estrogen in midlife. You want about 80 % of it to be going down that pathway. It is the least inflammatory. It's the way your body is optimally made to go. And then minimal down the 4-OH and the 16-OH, which are just more inflammatory. If you have an...
a not so ideal ratio going down the two more inflammatory pathways. Depending on how high it is, there are supplements that you can take, you can change the way that you're eating. like for instance, broccoli sprouts and flaxseed is actually another really good one to help your estrogen metabolize down the right pathway. But if it is significantly higher, for me, I would be sending
them to their primary care doctor to have that looked at in greater depth or have more investigation because I have seen women end up stage zero, stage one, women's cancers with those. That's like the indicator right there, right? And we want to catch it way sooner. So depending on how high that is, that would be my kind of go-to routes. If it's just like a little bit higher, a little bit elevated, we start with a supplementation.
we monitor, but if it's exaggerated, I definitely would be sending them to a doctor for that. Yeah.
Kim Vopni (23:20.246)
And are there any other tests that you would do from a, like when we think about metabolic health, which I understand is all systems, I also kind of want to pinpoint into the gut in a moment too, what you would do there. But is there any other tests that you would recommend for people from a metabolic health perspective?
Michele Scarlet (23:33.523)
Yeah, definitely stool. So we wanna know what's going on in the gut. The gut is our second brain. It is the powerhouse of our metabolism. Like again, that metabolic health, that's like the number one thing that I will work on with clients first before we start addressing other systems. Because what you can heal in the gut can help just innately heal a lot of the rest of the body, right? And if you don't start there,
If you start with hormones, for instance, you ignore the gut, well, your problem, it's gonna be that sort of pill for every ill scenario, right?
Kim Vopni (24:09.902)
Alright and could your gut, could the health of your gut influence the pathways that you are detoxing?
Michele Scarlet (24:16.872)
Big time, yes, absolutely it can. And I've seen that in myself as well and just like going through my journey, my gut, in sort of the thick of it, that was kind of the reason I went down my health journey was my gut issues. Or that's like what woke me up to it is what I should say. And then when we saw that I was metabolizing my hormones really poorly, it wasn't even a focus, it was just like more information, like, okay.
Great, we see that this is the cascade effect of what's going on in the gut.
Kim Vopni (24:49.358)
What would, like what would you see? What are some common things that you see on a stool test? So I guess first of all, what are the recommendations from stool testing that you like? And then what are some of the things that you see on a stool test in again, kind of that perimenopause postmenopause phase that are more common in that population?
Michele Scarlet (25:09.81)
Yeah. OK, so my go-to is the GI map. That might be controversial. Not everybody likes a GI map. Fine. You know, whatever. I think if I said any test now, somebody out there is going to be like, that's not the best one. But I can tell you why. So it tests for a wide range of pathogens, viruses, exposures.
Kim Vopni (25:22.624)
Yeah, yeah,
Michele Scarlet (25:35.765)
Dysbiosis or an imbalance of gut bacteria just like good gut bacteria opportunistic bacteria But it also gives us digestive health markers. So like how well are you actually absorbing protein? How well are you absorbing fat? Do you have enough digestive enzymes? How is your liver functioning and? Inflammation right so things that we need to know and I think part of the reason why it's a bit controversial stool testing in general is because
It really is just a snapshot of like one sample of stool. And pathogens or parasites are very stealthy by nature. They don't wanna be found. They don't wanna die. Their sole purpose is to feed off of whatever you're giving them. They're not just sort of readily coming out of your stool, right? So often I don't see parasites show up on a GI map. That doesn't mean that they aren't there.
I usually treat parasites through symptomatic assessment rather than what we find on there, but I mean they do come up sometimes. And I feel that way, again, if we're gonna talk about functional medicine, I'm not looking at each individual marker as like, what am I gonna do with this piece of information? I'm looking at things as a pattern. So if there is a major dysbiosis in the gut, so that means if there's a major imbalance in your microbiome,
Is it likely that your terrain, your internal terrain has so much chaos that things like heavy metals are stuck there, that things like mold is stuck there, that things like parasites or candida are surviving there and it's not coming out because they're thriving? Right? Then yes, absolutely. That's sort of how I would look at it and investigate it, like symptoms.
What are we finding? What could it mean? Right?
Kim Vopni (27:36.974)
got it. Yeah. So in the gut then, so let's say, you've noticed a pattern and potentially there's the, you've noticed there's a metabolic thyroid issue, poor metabolism of their sex hormones, dysbiosis in the gut. Where do you start?
Michele Scarlet (27:58.065)
I start in the gut. I start in the gut every single time. If there is a dysbiosis in the gut, depending on what it looks like, if there's like a severe overgrowth, then we would be looking at like antimicrobials or herbal antibiotics to kind of get that under control. Then it could depend again, you know, if we see a lot of inflammation or if we see signs of things called like leaky gut, meaning that mucosal barrier.
Kim Vopni (27:59.663)
Okay.
Michele Scarlet (28:26.258)
that basically starts in your mouth and ends at the full other end, that's thinned. And that's actually part of the problem of that internal terrain causing issues or allowing that overgrowth to begin with. So after we get that opportunistic bacteria to kind of back off, then we re-feed and repopulate good bacteria. And then we have to seal that mucosal barrier. that's basically your immune system.
That's like the barrier to your immune system, which strengthens your immunity and doesn't allow a relapse of that opportunistic growth. So we would start there for sure. As you see that happening, things like constipation, things like loose stools, those things start to clear up on their own, right? And then if you're having a great bowel movement every day,
your detoxification systems have just improved. Therefore, your hormone situation has improved, right? Now, somebody who is in perimetapause or post-metapause, we can't necessarily balance your hormones naturally. is a decline of hormones, but can we optimize the system so that when you do use HRT or bioidentical hormones, that it works even better? Yes.
Kim Vopni (29:54.227)
And things like, so starting in the gut too, if somebody was using HRT and potentially when they are retested, the levels aren't, even though they're taking the dose that should be bringing their levels to kind of the dose that we're looking for for effectiveness, that could also be a gut thing from an absorption perspective. Is that correct? Yeah.
Michele Scarlet (30:17.588)
Absolutely. Absolutely, yes. Absolutely, yes.
Kim Vopni (30:21.624)
So getting the gut in check. when you talk about, clearing out the negative, refeeding and repopulate, I want to ask how we do that. And then you talked about resealing. I want to ask about that. So how do we refeed and repopulate once we, well, I guess let's start from the beginning. So we want to eradicate, that you mentioned herbal microbials, is this like anti-parasitic like wormwood and black walnut and that type of thing, or are there others that you would use there?
Michele Scarlet (30:46.856)
Yeah, not necessarily anti-parasitic would I go, but that if there is a parasite or if symptomatically that is what it looks like, then yes, that would definitely be on the radar. But you could go as simple as like oregano oil or berberine. You could use potent garlic, not just garlic that you eat. has to be, it's capsulated and very, very potent.
Kim Vopni (30:52.386)
Mm-hmm. Could be part of it. Yep.
Michele Scarlet (31:14.502)
Yeah, I would probably lean toward more of that depending on if we were just working with some general dysbiosis, if it wasn't as extreme as parasitic infection. And then when we repopulate, it's not just probiotics. Again, this might be controversial. I hate when people tell me they're on probiotics. Not because I don't think probiotics are good for you, but like.
Kim Vopni (31:37.326)
You
Michele Scarlet (31:43.317)
Tell me why you're taking them. I would like to know the honest answer of why you're taking them. well, everybody tells me that they're good for me. Yes, but if you have an overgrowth of bacteria and now you're just putting more bacteria in, you're not actually helping the situation. So it's not that the probiotic is bad. It's that we are like searching for random supplementation to hopefully help a situation without testing. I just don't buy that.
If we have low commensal bacteria, low good bacteria, then yes, a probiotic can help. But that's only one part of the equation. A probiotic introduces the bacteria. How do you feed it? So that it thrives and then it takes back over the environment. So we need prebiotics. So prebiotics can be done in food form. We can absolutely fiber depending on the type of fiber.
Or you can just have a actual probiotic supplement depending on how you like to, you know, go. Yeah, sorry, say that again.
Kim Vopni (32:47.148)
prebiotic supplement.
We should have a, you said a probiotic supplement, but did you mean a prebiotic supplement? okay. Gotcha.
Michele Scarlet (32:55.304)
So both, if you're gonna use probiotics, yeah, you definitely need prebiotics as well, and you can do it in two forms. You can do it as a prebiotic supplement, or you can do it through food. And it just depends on how dedicated you are to wanting a diverse vegetables and fruit and fiber source. Because that's what you need. You need diversity in your gut. When you don't have that diversity, that's when that opportunistic bacteria will take over.
Kim Vopni (33:03.053)
Yes.
Kim Vopni (33:21.07)
Okay and then reseal. How do we reseal?
Michele Scarlet (33:25.064)
Yeah, so reseal, you know, I'm gonna make it sound complicated. It's not as complicated as I'm gonna make it sound. You can do it through supplementation, okay, but you can also do it through stress management. So one of the first things that happens when we are so chronically stressed is that our mucosal barrier or our defenses lower, right, and it gets thinned out.
And that's exactly how opportunistic bacteria thrive. That's how when we then eat things like gluten or sugar or take in alcohol, those things stress our bodies and thin all of that out and make our bodies more susceptible to, you know, pathogens, parasites, heavy metals, mold, et cetera. Because that layer
That mucosal barrier is what's protecting you from your immune system reacting every time. And then we could come full circle to autoimmunity. If your body, if your immune system is always reacting, eventually we're going to be getting to a place of inflammation and autoimmunity.
Kim Vopni (34:30.926)
Yeah.
Michele Scarlet (34:44.798)
So supplementation and managing stress, emotional and physical, and what you're actually ingesting.
Kim Vopni (34:51.598)
So I'm going to assume that your stance on gluten is that most people, if not all people, would benefit from no gluten.
Michele Scarlet (35:04.338)
I would say yes in our world today.
Kim Vopni (35:07.726)
in our world or our country.
Michele Scarlet (35:10.77)
in our country. Yes, that's not a personal experience. I do know that if I were to go to Europe, a few things are different. If I were to eat a sandwich or some pasta or some pizza in Europe, I am on vacation. I am not nearly as stressed out as I am as I am at home. They have far better standards for their crops, their wheat crops, all their crops.
and how things are processed there. And yeah, you're probably just way happier that things just don't, things just don't bother you so much. So yes, our country, but that's not to say that it's not causing some type of inflammation or reaction, right? It just,
Kim Vopni (35:47.532)
Yeah. Yeah.
Kim Vopni (35:58.419)
What about gluten causes inflammation? What is it about gluten that does that?
Michele Scarlet (36:03.838)
So it's like wheat's defense mechanism for animals eating it. And so we are an animal eating it. And so it's the lectins in it that cause irritation in the gut, ultimately. And so if we were, I don't know what innately eats wheat out in a crop. So I don't know, like mice or rabbits maybe. If they feel sick after eating that,
they aren't likely going to go back. Whereas humans, we're not quite as in tune with our bodies if we feel sick eating it. We either don't recognize that that's what it was, or we don't care.
Kim Vopni (36:45.486)
Mm-hmm.
Right, right. And then we get in this cycle of the constant inflammation. And then with Hashimoto's, there's also, as I understand it, the body recognizes the molecular structure of wheat similar to the antibodies, sorry, similar to the thyroid tissue, and then produces more antibodies to fight that off. Yeah, yeah.
Michele Scarlet (37:04.521)
Yes.
Michele Scarlet (37:10.322)
Yes, exactly. you are Hashimoto's, if you've been diagnosed with Hashimoto's, gluten is just, it's a no. You know, like there's, it's so black and white, it's just a no. You cannot, if you do not wanna feel like garbage, you just, can't, you can't.
Kim Vopni (37:26.744)
Yeah, yeah, okay. So, okay, so we've refed, repopulate, reseal, and then like in my world, in my community, a lot of people struggle with constipation. Sometimes that is physically as a result of prolapse. Sometimes it's physically as a result of tight pelvic floor muscles. Sometimes it's physically with...
always being on guard and being anxious and not allowing for the rest and digest and the calming. So there's that component. There's also, as you're saying, there could be dysbiosis, could be other reasons why the inflammation, why we aren't pooping well or why we're pooping too much. You've talked about diversity of food.
and potentially some supplements that could be helpful. Is there anything else that from a gut health perspective in the interest of pooping well every single day, like Bristol stool chart number four, at least once a day, is there anything else that we've missed?
Michele Scarlet (38:31.156)
I don't think so, but to your point about just speaking about pelvic floor, it can kind of go both ways. So meaning we could have an issue with dysbiosis that causes constipation, that causes weak or tightness in the pelvic floor. But you kind of touched on it and I want to just expand on it. It could also be that you are a very anxious person. Maybe this is a mental health thing.
Kim Vopni (38:39.095)
Okay.
Michele Scarlet (38:58.674)
you're a very anxious person, you're very chronically stressed, you, you know, maybe you're A type and you're go, go, go, and you're very clenched all the time. Your pelvic floor is tight. You now struggle with constipation. Struggling with constipation leads to dysbiosis. So it can literally go both ways. Or if you experience, so a lot of the women that I work with have been dealing with constipation most of their life.
And now we probably aren't thinking about pelvic floor as a 13-year-old girl, but if you think back to somebody's childhood, if there is major emotional trauma, if there is sexual trauma or sexual abuse, and I don't even want to just put it to sexual abuse, it can be mental. And what you're doing inside of your body is creating that tension, right? As you get older, IBS is normal, right?
But when you're not having a great bowel movement every day, that backup is creating more bacteria to be fed. That backup is not allowing your hormones to fully metabolize. That backup is backing your body up with toxins. So now your detoxification pathways are blocked. And it's like creating the cascade effect in both directions. So correcting both or balancing both the pelvic floor.
and the overall metabolic health, they're so closely related.
Kim Vopni (40:27.63)
Yeah, yeah, yeah. yeah, you're confirming what so many other people say. It's all, it's the gut and we have to start with the gut and that usually, it's not gonna be the answer to absolutely everything, but it will start to get the other things under control as well. And as you know, we said thyroid and metabolic health. Yeah. So you've talked about the stool test. You talked about some of the other tests.
Michele Scarlet (40:43.38)
So.
Kim Vopni (40:56.906)
What are some other signs, I guess, if we didn't have the availability of testing, what could potentially be some of the symptoms that could indicate dysbiosis? We've talked about constipation or IBS or loose stools. What are some of the other things that might point to a gut health challenge if we aren't in a position either financially or we don't have a practitioner who could help us with testing?
Michele Scarlet (41:21.938)
Yeah, so mental health, big time mental health, anxiety, depression, circular thinking, waking up in the middle of the night, not being able to kind of control your thoughts, not being able to get back to sleep, waking up even after eight hours of sleep, not feeling refreshed. my gosh, could go on forever. Food cravings, sugar cravings, cravings for carbs.
you know, this is not quite the symptom, but maybe the reaction to the symptom, living on caffeine, right? Headaches, migraines, living on Advil, Tylenol, know, Aleve, those types of things, just to get through your day. We think it's normal to drink coffee all day long, because our culture drinks coffee all day long. But if you need it to get through your day, something is up.
Energy crashes. Weight gain that's unexplained. Inflammation, your rings don't fit anymore, right? That's a big one. Or if you take your socks off at night and you've got like a ring from the elastic of your sock, that's a big one. Joint pain. Like so much. Like, reoccurring injury. So for 12 years I owned a gym in here in Toronto before I went into functional medicine and
Kim Vopni (42:43.15)
So many things, yeah.
Michele Scarlet (42:52.326)
If I saw somebody who had reoccurring injury and I'm watching them and they're doing things correctly, but like there's just that damn shoulder pain that won't go away or something like that, or like my knee, it's arthritic, that's what it is. Well, no, arthritis is inflammation. So yes, you have been diagnosed with arthritis, but what's going on in your body that's causing all the inflammation? Again, it cannot be siloed to your knee. So all of those symptoms could easily...
be, especially if it's more than one or two, could easily be related to what's going on in your gut, especially in our world today. We are so chaotic. We are go, go, go all the time. If we are not productive, then we're lazy. And we have that expectation, and we've just been conditioned that way. And all of that affects the gut.
Kim Vopni (43:45.039)
Yeah. When you talk about the inflammation piece, think, you know, I think of the term that's talked about a lot now with it, which is inflammation. you know, a big contributor to a lot of the diseases of aging is inflammation. And when we think of inflammation, we can think of like hot red swollen from an acute injury. It's the chronic inflammation that we may not even see. Sometimes we might see. So you mentioned like, if you see the band of
the mark around your socks or clothing that you wear. Other things like you said swollen, when you can't take your rings off, your fingers are fat. What are some other external signs potentially? And if we see it externally, does that mean that it is now progressed? Is it worse because we're seeing it externally than if it was just contained internally?
Michele Scarlet (44:38.46)
That's a good question. I don't know if we would call it worse or if it's progressed. But there is definitely argument in the homeopathic world that says our body tries to protect us and push things outward. So potentially, yes, that could mean that it has progressed and gotten worse. Sometimes I like to think that your body presents physical ailments in a way that you individually are going to notice them. Right?
Kim Vopni (44:52.056)
Mm-hmm.
Kim Vopni (45:06.734)
Mm-hmm. Mm-hmm.
Michele Scarlet (45:08.274)
So for me, again, I owned a gym. My physical body, how lean I was, how strong I was, how I was able to perform in the gym was really important to me. And in my health journey, when those things started to decline was when I really woke up to it, right? And so if that's not important to you or to somebody else, that might not be the thing that shows up for them. But.
Kim Vopni (45:10.062)
Interesting.
Kim Vopni (45:27.64)
Hmm, yeah.
Michele Scarlet (45:36.737)
Some physical symptoms on the outside, hair loss or hair thinning, doesn't necessarily need to be hair loss, you don't need to be going bald. I could show you pictures of when I was in the thick of my stuff to now, and I cannot believe the difference in hair. Nails, brittle nails, breaking all the time, chipping, peeling. Have you ever heard of moon face?
Kim Vopni (45:52.366)
Hmm.
Michele Scarlet (46:04.838)
Okay, so it's big on social media. It's kind of a buzzword. But moon face, and I could show you photos again, same thing, like I was the same weight I was, but my face looked so round and puffy. Right? And then if I look at who I look like today, and I just have like way more of a jawline and way more cheekbone, and if you were to hold that side by side, you'd be like, how did I not see that? Right?
Kim Vopni (46:29.59)
Yeah, yeah, interesting.
Michele Scarlet (46:32.862)
And then I think midsection, bloating. That's a really big one. I would say probably 99 % of the women that I talk to on a daily basis talk about how they feel bloated most of the time.
Kim Vopni (46:44.162)
Yeah. Yeah. I still struggle with that too. I still struggle with, I feel fine in the morning and then progressively, even though I have a great bowel movement every day and I eat all the things, I still struggle and haven't hit the nail on the head with that one, with bloating near the end of the day.
Michele Scarlet (46:45.832)
So not being able to spend.
Michele Scarlet (47:00.37)
Yeah. Yeah, it's not unusual. Doesn't mean that it's normal. Right? If I can give you some advice, I would definitely test GI map and see what's going on there. I would also maybe look at like, even though you're eating well, what we consider well, what is healthy is so bio individual. And I would start writing down.
Kim Vopni (47:04.878)
Mm-hmm.
Yeah, yeah, yeah.
Kim Vopni (47:25.709)
Totally.
Michele Scarlet (47:28.404)
what you're eating and when you feel it most and try to start sort of whittling it down to see if it is actually a food issue and then maybe look at like blood sugar regulation and see if it's a if it's something to do with that, but yeah
Kim Vopni (47:37.986)
Yeah. Yeah. Yeah. Yeah. And the interesting, I forgot to ask this question earlier. You mentioned berberine, which I know berberine as, like it's like a natural GLP one. It's supposed to help you with managing blood sugar, but it can help with the gut as well, which I didn't know.
Michele Scarlet (47:56.307)
Yeah, it's an antimicrobial. Yeah, but I also use it when I see that there is some blood sugar dysregulation. It's one of my go-tos because it's kind of like a two-for-one. Yeah.
Kim Vopni (47:58.197)
interesting.
Kim Vopni (48:09.068)
Right, interesting. Cool, I didn't know that about it. That's awesome. And there's different types, like I've seen people talk about you want to have dihydroberberine because it's more, it's better absorbed. Is that accurate? Yeah. Yeah, yeah, okay.
Michele Scarlet (48:22.334)
Yeah, I would say that that's accurate, yeah. But again, what is the state of your gut? Right? Right, why aren't you absorbing? Exactly.
Kim Vopni (48:27.724)
Yes. Why aren't you absorbing?
Yes. Yeah. Yeah. Yeah. So fascinating. Well, I mean, I could talk to you all day, but let's have so many more questions. However, we're running out of time and I would love for people to find out where they can follow along. You've mentioned your Instagram. So what, where can people find and follow and learn more from you?
Michele Scarlet (48:48.52)
Yeah, so I'm definitely most active on Instagram. So it's at MichelleScarlett underscore. Michelle is with one L and Scarlett is with one T. I actually had to look at my name there for a second to see. My mother did me dirty. She did not spell either of my names like everybody else. So at MichelleScarlett underscore on Instagram. I also have a podcast called Michelle Scarlett's True Health podcast where we discuss all of this with the intention of
Kim Vopni (49:05.986)
the standard.
Michele Scarlet (49:18.9)
kind of like debunking, you know, the myths of women's health and like really getting down to the root and advocating for yourself and investigating further. Or you can head to my website, michellescarlett.com.
Kim Vopni (49:32.846)
Awesome. One L one T. There we go. Thank you so much for sharing your wisdom and it was super fascinating. Learned a lot and yeah, I appreciate your time very much.
Michele Scarlet (49:34.372)
One L, one T.
Michele Scarlet (49:45.471)
Thank you so much, Kim.
