Programming Director: Divania Timmal-Jones

If you’ve tried just about every medication under the sun for your persistent skin condition and nothing seems to be working it may be because those medications are not addressing inflammation in the gut. Inflammation is part of just about every chronic skin condition, but it’s often overlooked.

Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn

My friend Kelsey Kinney is a registered dietician specializing in digestive and hormonal health.

Kelsey works with her clients to address all sorts of digestive and hormonal diseases including balancing microbiomes, optimizing motility, regulating the HPA axis, and encouraging a healthy diet and lifestyle. She’s also my go-to person for all things probiotics.

And she was one of the most fantastic experts featured on my Eczema & Psoriasis Awareness Week who spoke on the immune issues associated with Psoriasis!

It turns out that skin problems are often caused by an overgrowth of bad bacteria or a deficit of good bacteria in your microbiome. When bad bacteria get through to where they don’t belong, our immune systems go on the attack and inflammation results. Looking at the microbiome and understanding what’s happening in there is key to getting to the root of chronic skin conditions.

Have you treated a skin condition by balancing your gut’s microbiome? Let us know how it went in the comments!

 

In this episode

  • What inflammation has to do with ongoing skin problems
  • What “leaky gut” is and how it is the source of many skin conditions
  • The importance of the microbiome and the shortfalls of restrictive diets
  • The role that probiotics can play in managing your microbiome’s health
  • How you can use prebiotics and immunoglobulin to build a healthy gut biome

 

Quotes

“There’s this really delicate balance between good and bad bacteria in the gut. What we’ve seen more and more these days is that there are so many people who have imbalances in their microbiome.” [3:47]

“If there’s internal inflammation, which there almost always is, then it’s going to aggravate those skin conditions and cause flare-ups or ongoing issues, and external salves or lotions or even steroid creams are only going to go so far. You have to deal with the root cause of the inflammation.” [7:05]

“If you are someone who has noticed that, across the board, you are not really tolerating probiotics, usually that is an indication that there is definitely some microbial imbalance in your gut that needs to be dealt with.” [17:16]

 

Links

Find Kelsey Online

Follow Kelsey on Facebook | Instagram

Article mentioned in episode: Best Probiotic Strains (And Why They're Important)

Ortho Molecular SBI Protect

 

Podcast Episode 2

002: Wait, What Does My Gut Have To Do With My Chronic Skin Condition?! w/ Kelsey Kinney FULL TRANSCRIPT

Jennifer:              Hello everybody. We are back today. I've got a special guest for you. She's actually a friend that I hang out in real life with when I'm up in New York city and perhaps I will see her soon. I don't know, but I love spending time with her. Her name is Kelsey Kinney. You may remember her as a guest from the eczema and psoriasis awareness week and I had to invite her back because the information that she talked about specifically in regards to inflammation, the immune system, we talked about psoriasis and micronutrients. It was just so great that I was like, we got to keep diving into this area. It's super important and the inflammation piece is really critical for ongoing skin issues. We're going to talk about that today. If you have not heard Kelsey talk before, let me give you a little background on her. She is a registered dietitian in private practice specializing in digestive and hormonal health.

Jennifer:              Now, here's the thing. If you're wondering if you can check her out and see her, you can. She works virtually just like I do. She completed her bachelor's degree in nutrition at NYU and holds a master's degree from the university of Western States in human nutrition and functional medicine. She works with her clients to address all aspects of chronic digestive and hormonal disease, including balancing the microbiome, optimizing motility, regulating the HPA axis enhancing, the gut brain axis, and of course encouraging a healthy diet and lifestyle. And guess what, Kelsey is my number one person when I want to ask things about probiotics. She's a really smart cookie. Kelsey, thanks so much for joining us.

Kelsey:                 Thank you so much for having me, Dan. It's really exciting for me to be here.

Jennifer:              Well now we need to dive back into this inflammation piece. Inflammation and skin, right? That goes hand in hand with pretty much, I dunno, every skin condition that's chronic

Kelsey:                 Pretty much.

Jennifer:              So talk to us a little bit for somebody who is new to this. So they have seen a bunch of dermatologists. They've got a box or boxes full of creams and lotions and salves and medications and pills and they've had shots and all sorts of stuff and nothing really seems like it's working and they're like, what else can I do? What would you tell them about inflammation when it comes to skin that they might not realize? You know, they're there on the patient end of this. They don't know the questions to ask. What does inflammation have to do with ongoing skin problems?

Kelsey:                 Sure. Which is a great question by the way. And there's something to clarify here too, which I think is overlooked, especially when we're talking about dermatologists and that is this key component of what's going on internally, because with dermatology, of course we are very focused on the outside. We're focused on our skin, what's happening right on the skin, the inflammation in the skin right there causing those symptoms. But what else is happening underneath that is that there's this kind of widespread systemic inflammation that is happening just in your body overall. And what that has to do with is your digestion, your microbiome in your gut. And it's, it's kind of hard to think about being connected, right? Like we, our gut, our digestion. Like why does that have to do with our skin at all? But the truth is that when we have imbalances in our, our good and bad bacteria in the gut, because your, your microbiome is chockfull of bacteria.

Kelsey:                 It's got more than a hundred and a hundred trillion bacteria hanging out there in your intestines. And so you want to have, of course, mostly good bacteria and not a lot of bad bacteria. And so there's this really delicate balance between good and bad bacteria in the gut. And what we've seen in the research and what I see as a clinician and what I'm sure you see as well more and more these days, is that there are so many people who have imbalances of good and bad bacteria in their microbiome. And we can look at that by, by testing, but also just symptoms. You know, if someone, for example, if someone has a skin condition, I pretty much right away know off the bat that their microbiome is messed up to some degree, it's imbalanced, and they probably have too much bad bacteria hanging out there. And the reason why that's a problem is because when you start to get this overgrowth of bad bacteria or there's not enough good bacteria, there's this phenomenon that happens called leaky gut or hyper intestinal permeability.

Kelsey:                 And, most people probably have heard of it as leaky gut versus intestinal permeability. But that's what you'll see in, in the scientific literature. And what that means essentially is that when you've got this imbalance of bad bacteria, good and bad bacteria, it creates localized inflammation first of all, within the gut itself. So right there in your intestines, you've got inflammation going on, because of a particle called LPS that's produced by some of these bad bacteria. It's sort of really this aggravating toxic, piece of bacteria that causes inflammation right on the, the tissue of your gut. And when that tissue gets inflamed and irritated, it starts to pull apart. So it's actually like a single layer of, of cells and those cells, they normally are pretty close together. And so only things that are supposed to flow through there into your bloodstream, get through.

Kelsey:                 That's things like, you know, nutrients of course are vitamins or minerals, water, things like that. And what it keeps out are things like bacteria, of course, those toxic particles that we just talked about, LPS, and you know, all sorts of stuff that you can imagine come in through your mouth because it's a whole lot of stuff, let me tell you. And so your, your digestive system acts as sort of part of your immune system and a very important part of your immune system at that. So it's really helping to keep those bad things from getting into your bloodstream and thus getting into your body as a whole. So what happens is those cells split apart, not split apart, but they move further away from each other and they can create a gap there. And so then these larger particles like whole bacteria or LPS or you know, broken down pieces of food that are normally too big to fit through there, get through and then your immune system freaks out about that because it's like, what the heck are these things coming in?

Kelsey:                 I'm not used to this. I don't know what this is. I'm going to attack this essentially. And so it causes this, this sort of a mean storm to happen where you just create a lot of inflammation. And so research has shown that that inflammation and actually those high levels of LPS, that toxic particle, are associated with a whole host of chronic diseases. And that includes things like skin diseases. Because of course when you think about skin diseases, inflammation is huge. Not even just the localized part, but like we talked about that internal inflammation. And so we know that those two things are connected. And so for me, and I'm sure for you as well, it's one of the first things I look at, when I have someone with skin disorder, because if there is internal inflammation, which there almost always is, then it's going to aggravate those skin conditions and cause flare ups or just ongoing issues, issues with that skin conditions that you know, external salves and lotions and even things like steroid creams, they're going to only go so far. You have to kind of deal with that root cause of the inflammation that's, you know, leading to these symptoms happening in the first place.

Jennifer:              So quick question. I am not a big fan of fixating on food as a trigger for skin issues because it's like trying to like throw a dart in the dark top of it. I don't believe that a lot of times the food is really the root cause even if you are sensitive to something, something caused, right? Something had to cause the gut to become permeable in the first place. So what would be your quick little answer? Do you can disagree with me, but if somebody is like, Oh, let me try taking out eggs next, let me try taking out sugar. Let me try taking out this. Let me get take out night shades. What do you think's more worth it? Looking for the foods that you're sensitive to and just fixating on that or saying, hey, I probably have to look at the microbiome.

Kelsey:                 I definitely look at microbiome first. So that's the, that's the short answer. And I'll answer a little bit more in depth here too. Well, it is that, you know, and I, because I'm a dietitian, people think I focus on food and the truth of the matter is I really don't. And to say that I will, I'll preface that with the idea that of course you want to eat a generally healthy diet. You know, we want something that is providing a lot of different, foods for the microbiome because the foods you eat do feed your microbiome. So it is important to eat overall a healthy diet. So that's not to say go crazy and eat whatever you want. But when you start to think about sensitivities and food triggers in terms of causing either skin issues or digestive issues, my approach is really not to even think about that very much.

Kelsey:                 Until we've dealt with the microbiome. And then at that point, you know, if there are some sensitivities that truly still remain there, then yeah, we can deal with them at that point. But for most people, first of all, it's incredibly difficult to suss out those triggers when your microbiome is imbalanced because of course it's causing all of that localized inflammation. So, and I'm sure you hear this too, a lot from your, your clients and it's something I hear all the time. They're like, I feel like food has something to do with this, but I'll try taking things out. And like one day it feels like it works. And then the other day I'm still having tons of problems or I'll try something I think I'm sensitive to. And one day I tolerate it fine and the next day it feels like, it makes me feel horrible. And the reason why that happens is because of that inflammation. If it's there and it's causing all sorts of issues, you know, you're going to respond to different foods differently on different days depending on like what the inflammation, what the inflammation scene is doing in your gut. So yeah, I truly don't focus that much on food when it comes to like food sensitivities and triggers causing skin issues or digestive issues.

Jennifer:              Yeah, I'm right there with you. I think that, you know, and this is so funny story. I've had some people who follow these really restrictive diets that are written about. There are some books that are very popular. I'm not gonna mention them here and there were very restrictive diets. Okay. So they work for some people.

Kelsey:                 Yes.

Jennifer:              But go and try to reintroduce any of those trigger foods. You can't do it. And the reason why is because the gut was not resolved. The issues gut aren't resolved just by taking the foods out. You still have the bacterial issue or parasites or yeast or any number of things going on. You could have a GI dysfunctional issue that needs to be resolved and the inflammation is still there. So of course you feel better being out like the needles, you know, that you were sitting on. But the problem is still rampant.

Kelsey:                 Exactly at the end of the day, it's like you're not solving anything with that approach. And because I work so much with digestive health clients, like what they really want of course, is to be able to tolerate a huge amount of foods and like eat a normal normal diet, and you know, be able to tolerate things. So that approach really does not work in terms of a longstanding, I don't, I, I hesitate to say cure, but, you know, just a longstanding approach to really dealing with any sort of digestive or skin issue. It's just, it's not going to happen.

Jennifer:              Yeah. And we're not saying by any way, shape or form that you can't take a food out and you're not going to see an improvement. I took gluten out when I found out I was gluten sensitive and my skin rashes at that time went away. However, when my eczema, when I had eczema, that was game over. I could be free of whatever you wanted. My hands were a complete wreck. Now and that's my clients. They've tried all these different diets, free of laundry lists of things and they still aren't making improvements.

Kelsey:                 Exactly.

Jennifer:              I think it's important to specify we're not, we're not in any way shape or form discouraging you, but you should be realistic about what you're going, what you should expect long term from that approach because it may not be. You might be walking down a road to of ending up with more nutritional deficiencies when your skin really needs, your skin is like a sponge. It needs a lot of nutrients. So let's talk about this issue of like the immune system and your skin. So if you get your immune system all riled up, like the guts are unhappy, you got all this stuff pouring in through these junctions, these cellular junctions that should be sealed but are not. Your immune system, does your immune system or can it play a role in the rashes? It just won't, or rashes or plaques or you know, flaking skin, etcetera, that just won't go away.

Kelsey:                 Yeah, absolutely. I mean, I think. So when I'm talking about inflammation in essence, I am also talking about the immune system because that inflammation affects the immune system and vice versa. So they're kind of like one in the same, I guess I would say, because inflammation of course it's caused by the immune system sort of overreacting to things that are coming through the gut. So when we're talking about inflammation, we are in essence talking about the immune system. So of course then when you have this sort of low grade systemic inflammation that happens because of leaky gut, what happens with the immune system is like all over the place. I mean, you know, it's highly associated with autoimmune diseases, um, things like, you know, psoriasis, all that kind of stuff. So you definitely see improvements. Then when you start to take away that inflammation and you start to sort of calm the immune system down, and remove those big particles that are crossing, the gut barrier into the bloodstream, your immune system, then it's like, okay, I can relax now.

Kelsey:                 There's not such a threat to what's going on in the body, then I need to kind of create this huge reaction to. So you then start to see a lot of improvement in skin issues. Whether it, and that can be anything from, you know, psoriasis to eczema, which are more of those like autoimmune type of, skin conditions that we see. But also things like acne, can really improve too. Even though that's less of sort of an autoimmune thing that happens. We see kind of improvements across the board when you start to lower that inflammation.

Jennifer:              And so if we want to talk, cause I gotta ask you like if you left and I didn't ask you about probiotics, you're like my queen of probiotics. You got to ask you.

Kelsey:                 Off course.

Jennifer:              So people are going to be like, all right, wait, I should start a probiotic. But you and I know that not all probiotics are created equal. And probiotic, you could take a probiotic and feel way worse. Oh, what are your thoughts around that? Like for somebody who's listening to this and they're like, well, I'm trying to get my gut in order. I'm at the beginning of this. I know I should take them. I don't know. Like am I, you know, Hey, maybe I'm making this up. I mean, I don't know. I've seen it with clients time and time again. What's your take Kelsey? What do you think about probiotics causing more problems and just being cautious with them?

Kelsey:                 So I will say, I do think that idea is slightly overblown that like probiotics can be bad. And there recently was this study that I'll refrain on commenting too much about it, but you know, that kind of showed that people with SIBO were getting brain fog from probiotics and it was just, in my opinion, somewhat of a poorly designed study where they didn't, you know, they were also treating these people for SIBO at the same time. So there was a lot of other things going on that like made it kind of a weird study and people have kind of taken that study and blown it up to probiotics are bad. So I think there is this, this, this change now in how people are thinking about probiotics, which I think is a good thing because as you said, probiotics are not created equal. There are different strains of probiotics that do very, very different things. And as a whole we can say, you know, based on the research, probiotics are very helpful. And I want people to remember that piece because they're not, they're not bad. They're not necessarily problematic, but you have to sort of choose them for the right thing. And so I have a whole article on this on my website. So I'll lead people there. Hopefully we can connect them with that.

Jennifer:              We can, if you send us the link, we'll put it in the show notes everybody so you can just go through and check it out because Kelsey has got an amazing site with good content. So we will link to this so you can read more.

Kelsey:                 Perfect. Yeah. Cause it's sort of a big topic, but the essence of it is that every probiotic strain, and when I say strain, that means not just like lactobacillus acidophilus. That's the species. You should see something else after those two names that indicates the strain of bacteria. And most probiotic companies do not tell you the strain. And that's because it's hard to, you know, it's more expensive to get good strains. That way they can also switch their strains at any point. As long as it's within the same species, let's say somebody else them a better deal. So it's sort of a sneaky little thing that they do to just make you think that what you're taking is great. When in essence it could be something totally different than what you want. So, so a probiotic effects are strain specific, so you have to make sure you're taking a strain that is shown to benefit whatever you're working on.

Kelsey:                 And for skin issues, you know, there's certain ones that help with certain skin conditions and not with others. So you have to be really careful about that. So you have to make sure that you're taking one that makes sense for what you're dealing with. And then if you are someone who has noticed kind of across the board that you're not really tolerating probiotics, usually that is an indication that there is definitely some microbial imbalance in your gut that needs to be dealt with. Because some people, for example, some people with SIBO don't tolerate probiotics very well. And that's completely normal based on, you know, what we know about SIBO and it means that we kind of need to deal with the SIBO first before we can have somebody on probiotics. So if you don't tolerate them, it's an indication that you should get some testing done and kind of figure out what's going on with your microbiome before you start taking probiotics. But I do think for most people, as long as you're choosing a strain that makes sense for you, even if you haven't had microbiome testing, you can try it out and see how it works for you. And you may have to do a little bit of trial and error based on, you know, how you respond to certain strains. But if you're noticing across the board all probiotics do not do well for you, then yeah, you really want to dig in a little deeper.

Jennifer:              And I also want to add to that that the potential side effects that you could feel in case you don't know this maybe outside of your digestive system. So you could have brain fog, you could feel fatigued, you could feel any number of things. That's the one thing about, you know, when you're stuck in the conventional model of medicine, they're like, just look at where things are that it's localized to that one point, you know, it's your skin, it's your eyes, it's your brain, like they cut you into pieces. But Kelsey and I, we both look at the full piece. We want to know, we want to look at every single symptom that you're experiencing, what's going on as a whole because they are connected. So it's a different way of approaching your health puzzle in a sense.

Kelsey:                 and it makes more sense.

Jennifer:              It does. So I think we should, we definitely want to wrap this up. I know that we need to just, I want to touch quickly on some options for a healthy microbiome and we've talked about probiotics and then tell us what prebiotics are and immunoglobulin therapy.

Kelsey:                 Yeah, I know that's a tough one to say, but, so yeah, essentially what you're talking about is my, I'll call it my trifecta of things that I tend to use for people who have an imbalanced microbiome. So you're right, we talked about probiotics. Gotta make sure you're taking the right kind, but then there's also prebiotics. So prebiotics are carbohydrates basically, that feed good, only good bacteria in your gut. So it's a little bit different from things like fiber or just of course carbohydrates as a whole, which can feed more than just good bacteria. But the specific definition of probiotics means they can only feed healthy beneficial bacteria in the gut. So there's very specific compounds that do that and they are amazing. And in fact, I, I tend to kind of think that prebiotics are actually more important than probiotics. And of course it's a little bit easier to kind of say, well, here's a prebiotic.

Kelsey:                 You know, most people are going to benefit from this just because it's feeding your good bacteria. Whereas probiotics, as we just discussed, they're a little bit more specific, a little bit harder to determine, like what makes sense for a specific person. But most people are going to benefit from a prebiotic just because it's going to do so much to balance out your microbiome. Because when you feed good bacteria, really what you're doing is pushing out bad bacteria. So it sort of, if you've got too much bad, not enough good, and then you increase the good, there's only so many, I like to call them parking spots in the gut. So as those beneficial bacteria are taking up more parking spaces in the parking lot, there's not as many left for the bad bacteria. So it really is this cool balancing effect that is amazing. And then immunoglobulins, so fun name of course as we just discussed, even I messed up, you know, it's like a tongue twister almost.

Kelsey:                 But, those are basically antibodies that you can take, orally, so on. There's a couple of companies that are making some, cool products with this concept in mind. One of them is orthomolecular. They have a product called SBI Protect, that is an immunoglobulin supplement. And so you just take those immunoglobulins, which are, like I said, antibodies. So they're sort of helping you kick out bad bacteria. They're also preventing that, that bad bacteria and those bacterial toxins from wreaking havoc. So they prevent that in that first of all localized inflammation from happening within the gut. So they prevent leaky gut from happening in the first place. So they sort of seal that up. So then any LPS or bad things in the gut already, they're not getting into the bloodstream and then causing all these sort of problems systemically. So it's a really cool concept and I think we'll start to see more and more of this, in the gut health world as, as it becomes more popular. And I'm very excited about that because it's something that just even from a theoretical standpoint, based on the research that we have, has really awesome implications when it comes to helping people heal, not only their gut, but of course then all of these other systemic problems that happen when you develop leaky gut.

Jennifer:              That's awesome. Well, thank you so much Kelsey. This has been very informative. This is why I go to you.

Jennifer:              You are my go to person anytime I have a probiotic question. Kelsey is the first person I text. We have long conversations via text about probiotics, but I'm I everybody, please go and check Kelsey out. Kelsey, your website, how can they find you?

Kelsey:                 Kelseykinney.com so and we will link to it.

Jennifer:              And we link to it. You've got a Facebook page and Instagram account. We're going to link to all of that in the show notes. And again, we will link to that article that you talked about as well, so everybody can go and check that out. This is an important part of the process, no matter what type of skin condition you have, your gut has to be one of the, one of the spots you look at, not just your skin. Thank you Kelsey for joining us.

Jennifer:              Thank you Jen this was really, really fun.