Read the Episode Transcript
I'm Dr.
Alexa Neynaber with Virasoap Natural Medicine.
I'm a naturopathic medical doctor and certified functional physician in Meridian, Idaho,
and our clinic specializes in natural health, wellness, and aesthetics for the whole human.
Today, I am in Chicago for the AANP's National Convention, and I have the pleasure of talking to Dr.
Cory Szybala.
Cory, first of all, say your name and where you came from.
Cory Szybala.
So S is silent.
Okay.
Yep.
Cory Szybala in Chicago for the AANP conference, 2024.
Came from Ketchum, Idaho, Sun Valley, Idaho.
And that's where you've lived for how long?
Lived there for six years now.
Practiced there for five and a half years.
Okay.
Yeah.
And you went to the Portland School?
Yep.
NUNM.
NCNM when I went there.
NUNM now.
That's right.
So, yes.
It's a hard habit for you.
It changed while I was there, or right after.
I can't remember.
Yeah.
It was really weird.
Yeah.
And what's your practice name in Sun Valley?
Sun Valley Natural Medicine.
Oh, well that's easy.
Okay.
Yeah.
I can remember that.
And you and your wife are the practitioners there?
Yeah.
So my wife, Molly Parker Szybala and me are the two practitioners there.
And we've been, yeah, we set it up to basically help out the local
community and be able to provide integrative care in Ketchum.
Cool.
Yeah.
Super cool.
It's a lot of fun.
Yeah.
And did you practice anywhere else before that?
I did in Portland, Oregon.
So I did that for three years?
Okay.
Yeah, give or take.
Tell me more about how you got into, like, gut health and This whole thing.
So I got into gut health purely through my wife.
So weirdly enough she has been doing my micro biome care
Health for ever since she started her naturopathic program.
Okay, and she actually worked underneath the initial individuals
Mark Davis and Carmen Campbell to help create a encapsulated FMT
So, I mean, 2010 it was already a known factor For C diff and recurrent C diff at that point.
So it was like, it wasn't like a
You've heard of like fecal transplants, but they were not oral.
Correct.
Yep.
So colonoscopy was the main aspect of it.
They do nasogastro tubes.
They did enemas as well, quite a few.
Right.
No oral capsules.
Right.
So like that's a potentially newer concept.
So is that the concept you were exposed to at first or was it actual transplants?
Colonoscopy was the initial one just because that's what the gastroenterologists were doing.
And that's what the, you know, if you're in a hospital setting, you can get recurrent C diff.
That's what they're going to use.
And it's also approved for babies, right?
With C diff?
Like newborns?
Yeah.
I mean, I don't know the whole entire like back and forth of
that, but there is some level of, You need to help someone with C.
diff, period.
The easiest way to do it, they will always start with like, their first
line of defense is Vanco, Dificid, and then they'll go on to the next steps.
Yeah.
Yeah.
This entire, just, concept of using an oral transplant for something
that is going to be inoculated in the colon, how does that work?
Why did you think like, okay, this works?
Is it just because you saw people get better?
Or, how did you be like, this seems like a good idea?
Yeah, so at that point, the group that my wife was a part of
were already utilizing it and already seeing the effects of it.
So that was easy to buy in.
Since then, research has come out and actually seen that
capsules versus colonoscopy are very similar in efficacy.
Yep.
So, you know, you're looking at somewhere and I know the numbers change, some people say
80 to like 95, 92 percent and like it kind of bounces around based off of what's going on.
It's going to, right?
There's variables with all of this.
So with the donors, with how you actually track a donor, with how you look at what
a donor is and, and you know, they were looking at donors a little bit differently,
but there were still utilizing like the FDA's kind of like regulation for it.
Like what OpenBiome was using, which is like the main stool bank back then.
Right.
I heard about . And do you typically see that the oral is all people
need in terms of when they're utilizing a treatment like this or
for recurrent C dip?
No, more so for other different types of conditions.
But that's good to know that C.
diff could just be treated that way stand alone.
Yeah, so recurrent C.
diff is the one thing that, in the United States, the FDA allows FMT to be used for.
So live FMT can be utilized for it.
Anything else, you have to use something else.
When you say live, what do you mean?
That means that the actual bacteria are alive.
And so live FMT is ultimately kind of like the short term of like what you're looking at.
And that is not what's in an oral capsule?
It is what's in an oral capsule.
Of live FMT.
In the realm of the microbiome, there was a study done in 2017 , Yeah.
Yeah.
that showed that the bacteria is actually not the main component.
The live bacteria is not actually the main component of an FMT.
It's from the study in 2017 and my wife's friends and people that she worked
with colleagues that she worked with during that initial live FMT, went off
and started their own practice and actually created their own live FMTs as well.
Then a pandemic happened.
And you could not use live FMT anymore because of the potential for infection risk.
Specifically with COVID?
Correct, yeah.
So viral infectious risk is a potential.
We weren't sure how COVID was being transmissible.
Right, there was a lot of questions.
And so we just wanted to be very cautious and careful with it.
So the last thing we want to do is say, hey, let's share this or that.
Absolutely.
When they did that, there's a lot of folks who were utilizing
or wanted to utilize the live FMT, but were unable to.
So seeing this study in 2017, and they even did a comparison of a C.
diff patient.
So they actually gave a healthy donor, removed the bacteria, live bacteria, and actually
saw their microbiome change to a healthy microbiome is how this all got started.
Wow.
Yep.
And so the idea to, how do you stabilize it, how do you reduce the infectious risk,
how do you make sure that this is a supplement that is going to be potentially
beneficial is you sterilize it, so through an autoclave, and then you freeze dry it.
Well, if you're sterilizing it, aren't you killing off the things you want?
100%.
But you're making something as well.
That's the coolest part.
Okay.
So you're, you're, you're killing off the bacteria, you're killing off the viruses, you're killing
off a lot of the things that are a part of it, but you're developing and creating the postbiotics.
So postbiotics are a component of bacteria and it can either be the metabolism
of the food, so like prebiotic, or it can actually, when the bacteria die.
They're actually creating a post biotic, and that post biotic is then a signal,
basically like a cellular signal that can then talk locally to the GI tract or
go into the circulation and actually talk to like the different organ systems.
Well, yeah, I mean, you've heard of prebiotics, you've
heard of probiotics, but I've never heard of a Postbiotics
check.
Had you ever heard of that in school before?
Something like this?
Not at all.
No.
I mean, is that the terminology you use when thinking about something like this, is a postbiotic?
This is a little bit more complex than just a postbiotic, but it's the
term that we went with because that is the majority of what's there.
And if I'm understanding what you're saying correctly, it's a bacteria,
something it's creating in the process of the way you're creating it?
Correct.
It's kind of like the end product of a bacteria, whether it's life or it's like through metabolism.
Okay.
Yep.
And then you have metabolites and that's from like the whole
entire other thing of like digestion and things like that.
So like there's two components of like the human microbiome.
Right.
There's probably more, but postbiotics and metabolites are like the two most, like, well known.
So, one of the lectures that was this last hour was all about the extremely
specific stool different tests that you can do in terms of mapping out
the different genus and species of what's currently in someone's colon.
You know, and the different types of treatments that you can use, really honing in around,
like, LPS risk and, you know, the things that you want to utilize to make butyrate.
And a lot of those things are herbs.
A lot of those things are you know, antimicrobial type of mechanism of action.
So how does something like this kind of fit into that whole approach when you
are seeing people for that holistic, how you're going to approach someone's gut?
Yeah.
So no matter what, whenever you look at GI health, you have to meet people where they're at.
And part of that idea of removing something is part of, you
know, the whole concept of like the four R's with digestion
okay, if we're gonna remove something, that's great.
But that means that antimicrobials or antibacterials
or, you know, anti whatevers are gonna be utilized.
And you're naturally gonna kill other things in the process.
Correct.
Yeah, there's nothing that is super specific on like, hey, this is the one bug I'm gonna touch.
Right.
So when you use something that has systemic effects, you're gonna see systemic effects.
Right.
And so that's always a concern whenever you're dealing with someone who
may have, and may be more prone to developing an infection because they
may have an overgrowth or they even may be more prone to having like a C.
diff infection.
Right.
We've seen people who have had C.
diff from something like ADP, which is like oregano.
Right.
And that is scary.
Which is why I'm super cautious about giving people oregano and people look at me like I'm crazy.
Yeah.
But, yeah.
I swear, there's so often, especially in the COVID time, right?
Patients would come in and be like, Well, I'm taking oregano every day, so I'm going to be good.
And I'm like, I don't directly start saying this, but you know, we start breaking down that their
gut is off, and they don't feel well, or they're really constipated, or they have a ton of diarrhea.
And I'm like, well, you are taking a really high dose of this
antimicrobial herb that could be killing off the good microbiome.
And they're like, I've never heard that.
And I'm like, you know, and that's sad because I think, you know, people
see it at super supplements of like, this is gonna kill all the things.
It kills all the things.
The trouble or potentially problematic effects of like
direct to consumer versus like professional formulas.
So it's like, I mean, yes, anybody can go out and buy some of
these antimicrobials without even like thinking twice about it.
Right.
And people think because it's an herb, it can't hurt me like an antibiotic.
But like, I mean, we were exposed to that, you know, within the first year
at school, , and sometimes you have to remind yourself that that's not
how people think, or it's just not intuitive because we're made to believe
just on this macro marketing level of herbs are natural and they're good.
What's in the sample bag?
The samples.
Seven capsules or crapsules, I should say.
We trademarked crapsules.
You did not.
Yeah, so.
Oh, those are seven crapsules of, than in my mouth.
I think I have seven craps in my bag too.
I, I just, I'm a little scared, scared about it.
If you, we'll, you some.
No, no, no.
You did.
I just,
we'll take 'em together.
Okay, so, personal question.
Yes.
Do you feel like you poop better since you used this?
100%.
Like, were you constipation or diarrhea predominant?
IBSD.
D, okay.
And so, how long did it really kind of take for you to feel like you had benefit?
The hard part about that is, I was taken originally because I had a TBI and I broke my back.
That's wild.
Yep.
So that was a moment of trying to reduce the
That's an entirely different treatment protocol.
Correct.
Yeah, so I did the other protocol along with this But this has
the potential to reduce inflammation and provide oxidative stress.
So sometimes you're utilizing this and more of the
holistic perspective of Inflammation not just the gut.
100%.
Yeah, I mean you have to imagine the gut is a component But this is not the only thing
that it's touching which means that you have to think about it in a holistic factor.
Yeah Okay.
And how'd you make it back?
Mountain biking.
Oh, did you have fun at least?
No.
Oh.
Well I did, yeah.
But it was up in Stanley.
It took three hours for the helicopter to get there.
It was pretty brutal.
Oh my gosh, I'm really sorry.
How long was that?
Hudson was four months old.
So that would have been about two years ago.
. A year and a half ago.
What was the recovery like?
I was in a Brace for three months, and then I did PT for three months.
The biggest thing was the TBI.
Sure.
I had to kind of learn how to like, talk and walk and all of that.
Were you wearing a helmet?
I was.
helmet?
It got crushed.
Okay.
Yeah.
That's why you always wear a helmet.
Yeah, 100%.
Yeah.
Wow.
Yeah.
And so you were with other people that were able to get emergency services to you?
Ish.
Yeah.
So I was riding with somebody.
They were ahead of me, and then someone else found me, and then the person
who was ahead of me actually got to the end and realized I wasn't there,
and then they came back to find me, and then we got emergency services.
I feel like I want to just talk to you about just that for a long time, but like, but you're
a walking, talking example that there's hope after someone goes through something like that.
Yeah.
Yeah.
I mean, ultimately, you know, when you have a four month old kid at home.
It turns out you try to heal as fast as possible.
I bet.
Yeah.
Yeah.
There's no doubt about that at all.
Everything for our families.
Yeah.
Wow.
Well I had no idea about any of that.
I'm really glad you're okay.
When we first met actually I was probably in a brace.
No kidding.
Yeah.
I just wore it underneath my business shirt.
Huh?
Yeah.
Well I guess you can't really tell on zoom.
That's the beauty of it.
No one can tell.
I'm just sitting up super straight.
Well, tell me, like, what are like the, the key three things to take away from something like this?
Because when you first kind of talk about this crapsule and
come talk shit with me and all of this, it's a little scary.
So like, how do you talk about this?
What are like the three key takeaways you want people to know about it?
Okay, so ThaenaBiotic®, as far as what it is.
, it's the first ever stool derived post biotic.
Okay.
Which is amazing.
It is a complex ecosystem based approach to health, which
means that you're not just trying to touch one thing.
A lot of people come to us and are like, oh, GI health.
Yeah, but GI touches a lot of other aspects.
Sure.
When I started taking it for my broken back and TBI,
I also noticed my IBSD and my anxiety both improved.
And so mental health A component of how the GI tract actually does digestion,
like, takes care of everything, yes, that's going to be a component.
Yeah.
But it touches so many other aspects that you have to imagine that's also part of it.
The cool thing about it is, it does both, it works both ways.
So it can work for diarrhea, it can work for constipation, and that can be a amazing
kind of like, way to see how the body has a balance, a homeostasis, and it has this
effect to find where you're at and help you where you need to go and so our goal
is always to kind of say hey we should be having a healthy Bristol, you know three
or four every day bowel movement and if we're not then that's a potential issue.
I know exactly what you meant by that.
What you're talking about is the poop chart.
The Bristol stool chart is awesome and everyone should look at it.
I would say if it makes the best white elephant gift on a mug
that you could ever give anyone is this Bristol stool chart.
You would enjoy our marketing team.
I love it.
Cause we created one with a stool chart on it.
That's incredible.
Okay.
So that's the number one.
What's the number two?
I kind of said a lot of things there.
The cool thing about it is you don't need a lot.
So it's low and low is always kind of like a good, process to look at whenever you're
doing like GI health or when you're trying to like migrate or move the microbiome.
Because of the fact that if you go too hard too fast, then you're
gonna notice it and it's going to affect that individual It is.
Yeah, and so it is because of the fact that like if you're messing with someone's communication.
So cellular communication for a GI tract and the microbiome, You're going
to see the effects of the cells trying to understand too much communication.
So it's like going out into like a busy restaurant and trying to think.
Sometimes you can't because there's a lot going on and too many people are talking.
You will walk into a separate room very quietly and like one person
comes in, you can have communication, you can have something going on.
You can develop a relationship from that.
So that's kind of how I look at this where it's like, we usually
start with one capsule a day and usually that's sufficient.
We can change it from there based on what we've got.
You can always go up.
Yeah, you can always go up.
You can even go down from there.
Yeah.
Because of the break cap slope.
Which is super cool.
Oh, interesting.
And then like use it in food?
Yep.
Yeah.
Absolutely.
Okay, what's the number three?
Number three is, I don't know.
I mean, the cool thing about this is, you are touching
so many different aspects from what a healthy donor is.
The goal of single, the whole component of this is you have to use somebody
else's healthy lifestyle to make sure that you feel as good as possible.
And that's kind of what we're doing here.
The goal is how do we get you to have a healthy
lifestyle so you don't need to utilize somebody else's.
Got it.
And that's where we actually get to use these really healthy donors.
We get to use these really healthy individuals and we get to take the benefit from them.
So your hope is that it's a timeline?
Yeah.
And that, like, someone kind of re establishes a healthy microbiome
and they're good on their own feeding it with their diet?
100%.
We know about the microbiome diet.
We know about all of the components of, like, what feeds a healthy microbiome.
We know it doesn't work for every single person, but we know that it can take time.
And to be able to provide something to them while they're going through
that phase allows them to actually feel better during all of that process.
And what's that donor screening process like?
It's extensive.
I bet.
You would hope so, right?
Yeah, we have a quiz on our website that you can go to.
And it's super fun because it's ten questions.
Okay.
It usually knocks out about 95 percent of the people.
To like, become a donor?
Yep.
So we, you have to be vaginally at birth, you have to have, you have to be
breastfed for X amount of time, you have to have X amount of antibiotic use, period.
Like, you cannot go over that.
You have to have a healthy bowel movement every day, Bristol Stool,
three or four, you know, and we have to be like eating healthy.
We have to have, you know, mental health has to be looked at chronic health.
You still look at your family history has to be looked at.
Like all of this is a component.
So once you get through those 10 questions, there's about 120 to 200.
I can't remember exactly now what we've done, but there's an entire other
questionnaire and then there's a physical exam that goes into it and then there's
testing that goes into it to make sure that we're not seeing infectious disease.
We're not seeing anything else and we're actually seeing health.
Two final quick questions for you.
One, where do people go to find more?
Is it your website?
Yep.
Yeah, www.thaena.Com and that's t h a e n a.
com
For people kind of wanting to know more in terms of how a practitioner would use this
in their office in terms of more of our like functional medicine naturopathic community.
Like what do we need to know in terms of implementing something
like this, In terms of like what you can and can't do.
Yep.
So, you know, generally speaking, we want to use this with a lot of different
people just because of the fact that you look at the potential of live FMT and
you can imagine where that kind of comes from, what this has potential to do.
The, the things that we're always cautious of is our donors have to eat every day.
Which means there are trace amounts of every food in this.
And so that means dairy, it means gluten, it means shellfish, it means peanuts.
So we always tell people, hey, if we need to know about something, we always check their allergens.
If we want to test it, we can.
And what I usually tell people is, You can put a little bit on your
skin, kind of wet it, and just see if it actually affects you at all.
You can try a smaller amount.
You can actually pop it open and just see.
What would you think about a person with like a lactose issue?
Shouldn't be an issue.
Yeah.
Just because of the fact that this is pre digested and pre fermented, right?
So the whole idea of like, post biotics is literally that.
The ones that are on the market originally are yeast that have been fermented in tanks.
This is fermented in the human body tank, and that's kind of what we look at it as.
Cool.
Yeah.
And so it's this, it's a, it's a thing that's pre digested, which means that
you should not have as difficult a time of digesting it, especially with
people who are healthy and able to digest and assimilate their products.
But it's good to know about the people who do have known of the food allergies.
The other aspect or group would be autoimmune condition just because the fact that
this does have an immunologic response because it does have cell signals to actually
talk to those, which means that you could develop or create an acute flare if you
high dose or if you are in a flare already or you're about to go into a flare.
The thing is you want to be cautious.
That's where that slow and low comes in.
Those are the two biggies.
You know, there's obviously more out there that we're still
learning about, but as far as what is necessary to know about it.
You can kind of utilize this for a lot of different things.
What I usually tell people is, Hey, if you're going to be working on someone's gut
and they're not able to digest or assimilate things well, or if they're not able
to eat as many foods as they want to or hope to, this is a great thing to add on.
And is this one of those things that we consider, like with the rest of the supplement industry,
no one supplement is used to treat anything because that is not what the FDA says we can do.
But we can use something to try to promote generally health in these different targeted things.
And we're not doing anything wrong by utilizing these tools.
Absolutely.
So this is a complex item that you can add to your body.
It's ultimately very similar to just eating a healthy diet.
Right.
And if that is treating someone else's healthy diet, it is in the cool thing is it's
eating someone else's healthy diet, but just getting the end product like positive.
My mind is blown right now.
I have so many more questions, but that is so helpful.