Dr Rangan Chatterjee – A talk on ‘Good Gut Health’

“The health of the gut and its immune system is a fundamental factor for me to assess with every patient. Why? The gut and immune system are intimately related in their interactions and if they are not performing as they should then this can negatively influence the overall health of the person.” So commented Dr Rangan Chatterjee when we interviewed him for our blog in January of this year (Practicing Good Medicine’).

An Introduction to Dr Rangan Chatterjee

‘Doctor in the House’ – BBC1

It is wonderful to see that Dr Rangan Chatterjee is now on prime-time BBC 1 in the new three-part health series Doctor in the House’. Having spent 6 years as a hospital doctor and the last 7 years working in General Practice around Manchester we wrote that he had developed a ‘nutrition based’ methodology when engaging with his patients. His passion is to get to the root cause of problems rather than to just treat symptoms. He specialises in gut health and the immune system, and these areas plus nutrition typically form the core of his new patient consultation and treatment.”

We can now all fortunately see the evidence of this approach in the BBC series which “sees three normal families inviting a doctor into their lives for two months, to undergo the health MOT of a lifetime. Throughout the GP does not prescribe any drugs and only administers, when necessary, vitamins and supplements.”

Cytoplan Seminar, 25th September 2015 – Dr Chatterjee provides a talk on ‘Gut Health’

Dr Chatterjee studies at the Institute of Functional Medicine (IFM) in the USA. We were fortunate enough to have him speak at one of our health practitioner events in September of this year with his topic being ‘Gut Health’. He shared with his audience a wealth of scientific knowledge and practical experience in the management of the gut microbiome and the integral role this plays in the health of the body. Dr Chatterjee discussed scientifically proven live native bacteria therapy and specific dietary interventions for the health of the gut and the immune conferring benefits for the body.

Our gut is intimately linked with our immune system and all other bodily functions, for example producing around 90% of the neurotransmitter serotonin, which has the most profound effect on mood. So with Dr Chatterjee demonstrating his approach of “practicing good medicine” to a wider audience via the BBC it seems timely to review some of the topics he covered in September.

In today’s article we cover the twin topics of vitamin A, plus the ‘aryl hydrocarbon receptor’ (AhR) –  and their importance to gut health and consequently to immunity. In our concluding article next week we cover live native bacteria supplements; recent research on specific gut bacteria and foods that promote their activity; the effects of short-chain-fatty-acids in the gut; and the relevance of apples to selective gut health.

Gut health and the Immune System – The role of Vitamin A

Our immune system is essentially and intimately linked with our gastro-intestinal system; so if the latter is performing poorly it will impact on the former. We all know that what we eat and drink is so important to our health. In his talk Doctor Chatterjee discussed particular aspects of our diet, for example food combinations, that research has shown to be beneficial to gut and immune health.

In particular he covered vitamin A and its immune modulating effects in the gut. And he expanded on how retinoic acid can tune multiple aspects of the immune response, particularly in relation to the small intestine, immune tolerance, and adaptive immunity.

Indeed vitamin A has the permitted health claim of ‘contributing to the normal function of the immune system’.

Forms of Vitamin A

We obtain vitamin A from diet, either from plant foods (Provitamin A carotenoids) or from animal derived foods (Preformed Vitamin A – retinol and retinyl ester).

The body converts Provitamin A carotenoids, the most important of which is beta-carotene, to vitamin A. Both provitamin A and preformed vitamin A are metabolised in the small intestine to retinol and retinal, the active forms of vitamin A. Retinol is the form in which vitamin A is stored, retinal is important for vision. Finally there is also retinoic acid which has hormone-like effects.

Prevalence of low levels of vitamin A

In his presentation Doctor Chatterjee noted the following research:

“In the U.K., 50% of men and 49% of women do not meet current national recommendations for preformed vitamin A when other provitamin A sources are not taken into consideration.

Thus, people with reduced ability to convert provitamin A sources to active vitamin A could be susceptible to wide-ranging health risks. This is especially important since recent research indicates that approximately 40% of all Europeans possess a gene variant that restricts the amount of beta-carotene their bodies can utilise and convert into vitamin A.”

The genetic variation referred to is called a Single Nucleotide Polymorphism (SNP). A SNP may change the structure and function of a gene. For example one of the most discussed SNPs, MTHFR, affects how the body metabolises folic acid.

A study in relation to provitamin A conversion and certain SNPs “further demonstrates that provitamin A metabolism is influenced by multiple SNPs and that genetic variability should be taken into account in future recommendations for provitamin A supplementation”. One of the SNPs referred to is BCMO1. This is a gene which codes for a key enzyme in beta-carotene metabolism. The consequence of this SNP is a 48% reduction in enzyme activity.So if BCMO1 results in compromised conversion of beta-carotene, vegetarians and vegans in particular may be at increased risk of low levels of vitamin A.

 The role of Vitamin A in maintaining Immune System health

Vitamin A has a role in both the innate and adaptive immune systems. In the innate immune system it helps regeneration of mucosal barriers and supports the function of neutrophils, macrophages, and natural killer cells. Vitamin A is also required for adaptive immunity and plays a role in the development of both T-regulatory cells and B-cells.

Retinoic acid, is important in immune tolerance this means that we are able to:

  • consume a wide variety of foods (ie foreign substances) and not react to them;
  • tolerate the commensal microbes in our gut and finally;
  • tolerate ourselves!

Our gut immune system is exposed to more antigens in a single day than the systemic immune system meets in a lifetime. Vitamin A does this by promoting the production of T-regulatory cells – these help quench inappropriate inflammation from other immune cells, specifically Th1, Th2 and Th17 cells.

“Although it was originally thought to have a selective role in the induction of tolerance, it is now clear that the effects of retinoic acid on adaptive immunity are context dependent and that it can tune multiple aspects of the immune response.”

Food Combinations

An example given as part of the talk was research demonstrating the increased absorption of vitamin A if eaten with healthy fats; in this specific example an avocado. The research study compared a raw carrot eaten alone with one eaten with the addition of one avocado. Compared to a raw carrot meal without avocado, the addition of one avocado (150 g) showed:

  • Significantly increased beta-carotene absorption 6.6 times
  • More than quadrupled (4.8 times) alpha-carotene absorption
  • Significantly increased (12.6 times) the conversion of provitamin A (inactive vitamin form) to vitamin A (active vitamin form)

The Aryl Hydrocarbon Receptor

Continuing the themes  of gut health in relation to diet and genes Doctor Chatterjee talked about the ‘aryl hydrocarbon receptor’ (AhR) and its importance to gut health and consequently to immunity. And in particular foods that cause AhR to be ‘expressed’. A range of research confirms the importance here towards gut and immune health, for example in support of IBS sufferers.

The ‘aryl hydrocarbon receptor’ is a protein that in humans is encoded by the AhR gene. Intraepithelial cells (IELs) from the intestines and skin express especially high levels of AhR. IELs defend against assaults from the environment. Essential functions of these cells include promoting epithelial repair following injury and limiting epithelial cell invasion by commensal bacteria that inhabit the gut. AhR signalling is required for IEL maintenance in the intestinal epithelium.

There are a number of ligands that activate AhR. A ligand is a molecule that binds to a receptor and elicits a response. Our diet contains a number of ligands for the AhR receptor including the phytochemical indole-3-carbinol which is found in cruciferous vegetables such as broccoli and cabbage; flavonoids such as quercetin, which is found in apples and resveratrol which is found in red wine.

Research has commented that “AhR is joining the ranks of other regulatory proteins critical for the development and maintenance of crucial components of the immune system, including gut-associated lymphocytes that mediate mucosal immunity”.

As such specific dietary compounds found at high levels in vegetables such as broccoli and cauliflower are essential for sustaining intestinal immune function. Moreover they show that the molecular basis for this link involves the aryl hydrocarbon receptor.

A problem here may be low stomach acid. Dietary compounds, such as indole-3-carbinol (I3C) from cruciferous vegetables are converted into high affinity AhR ligands after encountering the acid environment of the stomach. This is therefore another mechanism by which low stomach acid (eg due to antacids or age) could have a negative effect on gut health.


In closing on the topic of diet and AhR Doctor Chatterjee included a prescient quote from the research paper “You AhR what you eat: linking diet and immunity” (Hooper LV).

“From childhood we learn that vegetables are good for us, and most of us eat our veggies without giving much thought to the evidence behind this accepted wisdom or to the mechanisms underlying the purported health-boosting properties of a vegetable-rich diet. …… a link between diet and immunity, showing that specific dietary compounds found at high levels in cruciferous vegetables such as broccoli, cauliflower, and cabbage are essential for sustaining intestinal immune function. Moreover, they show that the molecular basis for this link involves the aryl hydrocarbon receptor (AhR).”

Dr Rangan ChatterjeeDr Rangan Chatterjee qualified from Edinburgh University Medical School in 2001 and has been practising medicine ever since. He has completed Membership for the Royal College of Physicians as well as Membership for the Royal College of General Practitioners. Initially, he worked as a hospital doctor for 6 years and has spent the last 7 years working in General Practice. Rangan also holds a BSc Honours Degree in Immunology and is a member of the Institute of Functional Medicine in the United States where he has undergone extensive training. You can find out more about him on his website.

If you have any questions regarding the health topics that have been raised, or any other health matters please do contact me (Amanda) by phone or email at any time.

amanda@cytoplan.co.uk, 01684 310099

Amanda Williams and the Cytoplan Editorial Team: Joseph Forsyth, Simon Holdcroft and Clare Daley

References are available upon request.

Last updated on 5th March 2020 by cytoffice


42 thoughts on “Dr Rangan Chatterjee – A talk on ‘Good Gut Health’

  1. I was diagnosed with chronic ITP in 2009. I’m now 72 and having been tried unsuccessfully on all available treatments, I’m back on steroids permanently.
    I’ve had several skin allergy/rash problems which an AHA blood test has proved that the steroids are not the cause.
    I try to eat a very balanced diet but am wary of taking additional supplements which might boost my immune system. I’d be interested to hear any suggestions which might help my constantly itching skin.

    1. Hello Valerie,

      With any condition of this nature, the exact causes and treatment are very much dependent on the individual. I would suggest filling in a health questionnaire with your lifestyle and dietary information just so that we can take a closer look at what the problem could be and therefore we can suggest supplements accordingly. I will send you one via e-mail shortly.

      All the best,

  2. Thank you for putting this up again Amanda. It is a while since September (or seems it anyway!) and it was such a high-content day, with so much information in a short time, it is useful to be reminded of this section. Out of it all I remembered the carrot/avocado link so I generally have an avocado if I make coleslaw – so something stuck! : -)
    Best wishes, Wendy

  3. I didn’t know that 90% of serotonin levels were in the `gut’….As someone who has struggled with low serotonin levels – this is a life changing piece of information. Thank you.

  4. low stomach acid must have a cause any thoughts about this or am I on digestive enzymes and kilos of cocoa powder forever

  5. Very interesting article by Dr Chatterjee. I’m interested because I feel my diet and lifestyle are very healthy yet I have IBS and a poor immune system. Any suggestions ?

    1. Hi Jeremy,

      The key point to make is that everyone is different and although a good diet and lifestyle can help most people to be “healthy” and is a good place to start – some people, by virtue of genetics and/or life challenges do need individualised programmes in order to become ‘healthy’. If you are happy to complete one of our health questionnaires we would happily help you to understand why it is that you are still unwell despite having a good diet and lifestyle – the likelihood is there are other underlying causes.

      I will e-mail you shortly with a health questionnaire.

      All the best,

  6. I would be interested in completing one of your health questionnaires. I have Hypothyroidism/Hashimotos and do take supplements as well as Levothyroxine but still have symptoms. I would like to know if there is anything else I can do.

    Many thanks

    Jenny Ward

  7. A slightly unrelated topic.on t.v last night angela rippon had an analysis of her body system by an et scan and was found, despite being slimmish, to have high levels of visceral fat. It was suggested that inulin might be of help in reducing this visceral fat round her heart and liver etc. Surely its not as simple as that.

    Would be interested in your comments. Thanks amanda.

    Wonderfully interesting and informative article on alzheimers.

    Viv Hesketh

  8. I would be interested in completing one of your health questionnaires please. I have hypothyroidism which I take Levothyroxine for and also have quite severe IBS which I have tried many things to improve with no great success.

    I would be grateful of any suggestions.

    Many thanks

    Issy Davies

  9. I lived in a very deprived area of Oldham too. Wish Dr C had been there then!
    I now eat raw carrot with my avocados… delicious 🙂 So sensible and caring… I already do a lot of what he suggests and more. It really boosted my confidence.

    Question: If one has SIBO as well as systemic Candida is it counterproductive
    to use Fosadophilus? I have read that prebiotics can feed the SIBO baddies while helping the Candida goodies!

    Lastly: a big thank you for all your articles. They are beautifully written and make me sit up with enthusiastic curiosity 🙂

    1. Hi Patricia,

      Thank you for your comment. For Candida alongside SIBO I would suggest starting with Saccharomyces boulaardii which is a live yeast, rather than taking a live multistrain bacteria supplement. You might also like to consider a supplement containing eg garlic, oregano and caprylic acid. To rebalance the gut flora it is also really important to support the immune system – so for example ensure you are getting plenty of vitamin D (between 10 am and 2 pm on sunny days, but don’t redden), eat good quality protein and avoid sugary foods (which suppress the immune system as well as potentially feeding undesirable bacteria and yeast).

      With regard to your query regarding FOS – taking large quantities of FOS with SIBO would not be recommended; however the quantity in our products is not sufficient to have a FOS-like effect in the body – it is intended for the bacteria in the product, rather than the gut bacteria as a whole. Nevertheless there is some debate about taking live bacteria with SIBO – as concern has been expressed the live bacteria may contribute to the overgrowth. This is why I recommend Saccharomyces boulardii in the first instance, alongside anti-microbial nutrients and supporting the immune system to rebalance the gut flora.

      I hope this information is useful to you. If you have any questions please contact us.

      All the best,

  10. Thank you for these articles. I qualified at ION in 1990 and practised in the Chichester area until we emigrated to New Zealandf 8 years ago and so find them extrmely useful in helping me keep up with the latest research.
    I still have a small ‘word of mouth’ practise out here and as before specialise in gut related problems. I was particularly interested in this article as we have an avocado orchard as our main business out here and I am always passing on nutritional information on this amazing fruit to our industry leaders. Even to the extent I was recently featured on a food programme talking about the benefits of avocados on national television in New Zealand when an an avocado orchard was visited

  11. Ironic that all doctors take the Hippocratic oath – Above All Do No Harm, yet the medical colleges ignore the very basis of Hypocrites’ teaching, which is that all disease begins in the gut! The medical profession treats the symptoms rather than the cause and is largely subservient to Big Pharma. How many drugs used by our doctors actually cause more harm than good?

    Although our GPs may advocate eating a good diet they are unaware or oblivious to the damage that grains and sugar do to the gut. It is all very well advocating good nutrition but as our food is subject to intensive farming – and I have yet to see the BMA advocate testing the produce for toxicity. We are seeing an epidemic of cancer yet we continue to seek a ‘cure’ rather than the cause – which is easy-enough to find; stress, toxic food and air. As a start, the BMA should be pressuring our government for subsidies to organic farmers so that organic food is affordable for everyone.

    I welcome this article but until student doctors are taught that dis-ease may be the result of nutritional deficiencies, be able to diagnose the cause and prescribe an appropriate nutritional remedy, they will continue in ignorance to the detriment of their patients.

    With the NHS under extreme stress and the population getting fatter by the day, the situation can only get worse.

    1. Excellent comments Kristina, my thoughts exactly.. it’s ridiculous the tiny amount of nutrition training that doctors receive, and as you say largely treating the symptom not the cause . This has to change .

  12. My 16 year old has had IBS for quite a few years which has hone from copable to delbilitating. He has now been nauseous most of the time for 6 months and you cam imagine it is getting him down. An endoscopy revealed excess bile in his stomach. He has had various blood tests and the diagnosis is IBS largely driven by anxiety. He has just started CBT . He could cope if he wasn’t feeling nauseous ALL the time. We have been on various anti-emetic medication with no results. He is also losing weight (and he was skinny to start with). He has to wait yet another 6 weeks for a follow up gastroenterologist app. He is having a hydrogen breath test. he is really feeling as if his life is going to be like this forever. He has AS exams next week which isn’t helping but he sailed through his GCSE exams without a problem. He works hard and doesn’t usually get worked up about exams. He is more worked up about having to do them feeling sick which of course is now a vicious circle. Any help so much appreciated.

    1. Hello Anita,

      I am sorry to hear about your son suffering constant nausea, especially during his exams. If anxiety is the cause, there are some supplements that I could suggest for anxiety – magnesium, pantothenic acid and Ashwagandha. However I would not suggest introducing anything new on a day when he is taking an exam. I would also suggest taking a live bacteria supplement. If his sleep is disturbed then magnesium and Ashwagandha can be useful at bedtime. Ginger is sometimes used for nausea. Also sea sickness bands would be worth trying – these work on acupressure points on the wrist (available in Boots).
      Food sensitivities can be a contributory factor as well. I would consider a trial elimination of dairy and gluten for a period of 4 weeks and see if there is an improvement. We did write about gluten elimination on our blog last week. If avoiding gluten, it is important to choose naturally gluten-free foods, rather than gluten-free products (which should only be eaten in small quantities).

      Breakfast is a time when dairy and gluten are often eaten together. If you would like to email me I can send you some breakfast ideas.

      We do offer a free health questionnaire service which may be of interest. If your son completes and returns a health questionnaire we will send some written diet and supplement recommendations. You can find a link to download the health questionnaire via this link.

      All the best,

  13. Hi just watched the doctor program on TV . I would like to have my gut bacteria analysed. I have always suffered from asthma IBS now weight gain and under active thyroid and lots of auto immune problems. I’ve taken many courses of antibiotics too. I feel my gut bacteria is so very out of balance and could be causing these problems. How can I get this analysed? Thank you Julia

    1. Hi Julia,

      You would need to visit a nutritional therapist who could organise this for you. You can find a local nutritional therapist on the BANT website – http://www.bant.org.uk. You may also be interested in a blog we wrote on leaky gut which can be a factor in the development of autoimmune conditions. We do also offer a free health questionnaire service – if you complete and return a health questionnaire to us, we will send you some written diet and supplement suggestions to support your health goals.

      All the best,

  14. Hi there
    I have had so many UTI’s I am now antibiotic resistant. I.e. Now developed large kidney stones too
    Addtinonally. I suffer with recurrent abscesses which always require surgery. Ive had many courses of antibiotics for those too, over the past ten years, One of the abscesses produced a large amount of clear mucin! I believe this has wreaked havoc on my gut flora.
    Could you please give me ideas on how to build up my immune system in order to cope with the abscesses and infections?

    1. Hi Rachel,

      Thank you for getting in touch. I would suggest you complete one of our health questionnaires, so we can understand more about your health history and tailor an individual programme for you based on diet and other factors. You can fill download the form via this link.

      Best wishes,

  15. I had my gallbladder out about twelve years ago.
    Knew nothing back then about the cause of my problems. Had suffered from about age twelve. My diet was poor due to likes and dislikes. Didn’t like meat. Ate fish when available. Wasn’t like now when it’s available all week. The bread was always white and i loved butter. So a lot of bread and butter was eaten. On Sundays there would be a big roast, well boiled vegetables and potatoes. My mother gave up and so I never ate a dinner on Sunday. We were a family of eight children. I was second last and a nuisance. We hadn’t the knowledge we have now.
    My problem now is, I’m two stone overweight and my digestive system is never right.
    Myself and my husband take 5000 vit D, fish oil, and a multivitamin.
    I still don’t like meat. I eat free-range chicken but it needs to be in curry or smothered in some other sauce. The thoughts of eating body parts is disgusting to me. Even with free range I’m early turned off. Now you know what my poor mother had to deal with.
    My question is, what do you suggest I eat to help my poor liver and digestive system? We eat full fat yogurt for gut bacteria. Now I read that I shouldn’t be eating dairy. Can you advise me please? Love your TV programme.
    Thank you.

    1. Hi Joan,

      Thank you for your query. To support your liver and digestive system I would suggest that you reduce the amount of bread you are eating and increase the amount of vegetables as a start. Dairy is sometimes recommended to be avoided for people with liver or digestive issues, initially reduce the amount you are eating and focus on plain natural yoghurt (avoid cheese and milk). Choose alternatives to bread and other wheat products for breakfast and supper, it is easier to avoid wheat at these meals. Regarding vegetables, you may want to focus on lightly cooked vegetables initially and increase them gradually. Sugary foods are also best avoided for both liver and digestive health. Good food choices are dark green leafy vegetables, chicory, onions, carrots, beets, herbs (eg coriander), cooked Bramley apple with skin, sweet potatoes. However, sometimes vegetables can initially aggravate the digestive tract so I would need to know a bit more about your specific digestive symptoms in order to be able to advise (ie are your bowel movements constipated or loose, do you get bloating/pain etc). Ensuring you are eating enough healthy fat is important and if you are not absorbing fat well due to the lack of gallbladder you could consider some lecithin which emulsifies fat. Fat is important for health and also for the absorption of fat soluble vitamins (A, D, K, E). We do offer a free health questionnaire service. If you complete and return a health questionnaire to us, we will send you some written diet and supplement recommendations. In the meantime you might like to start taking a live bacteria supplement eg Acidophilus Plus (1-2 per day on an empty stomach) and Golden Phospholec (soya lecithin granules to take with meals). I hope this helps.

      All the best,

  16. Hi,

    I believe strongly that our daily food intake has an impact on our health. Although feeling healthy myself, I was drawn to the story of Kiki in one of the episodes of Doctor in the House. During his visit, the doctor showed a chart of various food categories in different colours helping to get a healthy gut. After a long search I cannot find this chart, but I’m very interested in finding out where I can download it?

    Kind regards,

    1. Dear Annemarie,

      Thank you for your question. The chart you refer to may have been showing different colours of vegetables and fruit which is important for gut health? Eating prebiotic vegetables is important for gut health eg artichokes, onions, chicory, garlic, leeks, bananas, asparagus, peas and green tea are some examples. These vegetables are high in fibre that is used by gut bacteria so they encourage the growth of bacteria. Eating a rainbow of vegetable and fruit colours is also important ie white, red, orange, yellow, green and purple. Studies have shown that eating a wide variety of vegetables and fruit is important for encouraging gut diversity (and gut diversity, ie having many different types of bacteria, has been shown beneficial to health). Many people eat only a limited variety of vegetables and fruit each week. There are various images showing the rainbow of different colours to eat at this link

      Best wishes,

  17. Hi, so much interesting information! I can’t get enough. I have recently been diagnosed with Diverticular disease. I don’t seem to be able to find a lot of information on this. Just a few bits not bobs here & there. I have not had any follow up help or advice since I had the colonoscopy. Also I suffer from bloating, my tummy swells up in front of my eyes until I look about 7 months pregnant! I also suffer with awful acid reflux. Omeprazel does nothing first me. So I am very uncomfortable most of the time.

    I was diagnosed with fibromyalgia 12 years ago, bombarded with bad advice & pillsee. I put on 3 & 1/2 stone with it. Then read a book by Dr Paul Armand called What the Dr’s don’t tell you about fibromyalgia. Started walking (even though it was excruciatingly painful) & followed his diet almost completely. I lost 4 &1/2 stone & became addicted to walking! Mango hours a day. Almost carbon & wheat free. Anything that containeducation natural aspirin. It helped me so much. Just have flare ups now & then. I was diagnosed with IBS 32 years ago, withouf any tests.. but found out 5 weeks ago that I do not have IBS! Very frustrating! Please can you recommend what I can do & how I can get help & help myself please. I am so tired all the time. Instead October being a happy bubbly person, I have a grimace on my face because of the constant discomfort.
    Please help me.
    Kind regards Sonia

    1. Dear Sonia

      Thank you for your comment on our blog. With regard to diverticular disease, it is important to prevent constipation which is a cause of the disease and which can lead to further diverticular (ie pouches) forming in the large intestine. If these pouches in the intestine become inflamed then you can suffer a flare-up of diverticulitis and the treatment for this is antibiotics. So ideally you want to prevent any flare-ups. Eat a diet that is high in fibre (but not bran) – so plenty of vegetables and you could use smoothies and soups to increase your intake. Gradually increase your intake of vegetables so that you are eating at least 6 portions per day. You can also eat fruit, however fruit that contain small seeds eg berries may be best in a smoothie to avoid the seeds getting stuck in the diverticular. Taking additional fibre eg ground flaxseeds or psyllium husk can be useful ie take daily to help keep bowel movements regular. I would also recommend a live bacteria supplement is taken daily. Foods containing gluten are probably best avoided and I suggest you could carry out a trial elimination of all gluten foods from your diet for 4 weeks and see how your symptoms are. Whilst there are lots of gluten free foods available now, be careful not to eat too many of these as they are highly processed and low in nutrients etc. If taking gluten out of your diet it is really important to ensure that you obtain sufficient fibre from other sources (wheat provides about 75% of the fibre in the Western diet), that is from vegetables, nuts and seeds (ground).

      We do offer a free health questionnaire service that may be helpful to you – if you complete and return a health questionnaire we will send you some written diet and supplement advice. This is a free service.

      I hope this helps.

      All the best,

  18. Hi,Sonia again. Sorry for the spelling mistakes, predictive text!!
    I am also over weight & have very little energy. In short I would mainly like some info & help with the Diverticular disease
    Thank you

  19. My son is 5 years old but wears 3-year-old-sized clothes. He has a good diet consisting of bone broth, vegetables and meat.

    He is milk intolerant and I was going to ask if there is anything I could get him tested for or introduce to him?

    He is currently on calcium and vitamin D supplementation and eats all of his meals.


    1. Dear Imaan – thank you for your query on our blog. I think in order to answer we need a little more information about your son and any specific symptoms he is experiencing. You mention that he is 5 years old and wears clothes aged 3. Is he underweight? What calcium and vitamin D supplement does he take? His diet sounds good – does it also include some healthy fats and carbohydrate foods?We do offer a free health questionnaire service that you may be interested in.

      If you complete the questionnaire at this link https://www.cytoplan.co.uk/nutrition-advice/educational-literature/health-questionnaire which would provide us with further information, we can send some diet and supplement recommendations.

      Best wishes,

  20. How do you find out if you have SIBO or Candida? My doctors seem unaware of the possibility that the IBS and GERD and oesophageal spasms could be due to this. I took antibiotics three times a year as a child and had thrush a lot in my twenties. When I breastfed my child age 30 she got thrush on her tongue. But can Candida alone cause all these issues? I don’t eat gluten, sugar or dairy. I have rosacea also. I’ve started food combing and do all sorts of things to aid digestion such as ginger and lemon, hymalain salt, HCL. I am determind to get to the bottom of this!

    1. Hello Gem,

      Please see our blog on Candida. Supporting the immune system is really important for managing Candida, which is actually present in over a 1/3 of the population. It can become a problem when it gets the opportunity – stress, antibiotics, reduced immunity can all give it the opportunity. Doctors can test for antibodies to Candida, which can indicate a recent or current infection. Stool tests and urine tests for Candida are also available through nutritional therapists. As well as supporting the immune system, the use of antimicrobial herbs can be useful and repopulating the gut with live bacteria, eating prebiotic foods.

      We have also written a blog on SIBO. Again you would want to remove aggravating factors (and anti microbials may be useful) and support the immune system. Initially live bacteria may need to be avoided (but would be introduced later in the programme). Some people also need to remove foods that contain FODMAP carbohydrates (see our blog on FODMAPs). These are found in a variety of grains, fruits and vegetables and navigating this may be difficult to do without some professional help so a consultation with a nutritional therapist is worth considering.

      Alternatively, we do offer a free health questionnaire. If you would like to complete and return a health questionnaire, we will send you some written diet and supplement recommendations.

      I hope this helps.

      All the best,

  21. Hi,
    Wondered if you could give me some advice on a long term problem I’ve been having .
    I become terribly bloated (abdominal) usually in the evening .
    It’s very uncomfortable and can make me feel rather weak and fatigued.
    I’ve been checked by my GP for Helecobacter Pylori
    (Blood test) it came back negative.
    The tummy bloating can sometimes be triggered by certain foods … pastry, sausages and melon are definite no no’s.
    My wife read that a good quality pre and pro biotic can be beneficial so purchased some, I’ve had a few to date , I do feel relief for a while but then it comes back . Sometimes I look so bloated that my shirt is too tight to fasten . I’m a slim man normally. Aged 70
    Could you please advise
    Many thanks

    1. Hi Don, it would be useful to understand when this started – was it following a course of antibiotics, a period of illness or high stress for example? There can be a number of reasons for bloating – it could be that you have an imbalance of bacteria in your gut or it could be that you are producing insufficient digestive enzymes/acid for proper and timely digestion of food (or both). Some suggestions:

      • If you are not doing so already, it would be a good idea to take the live bacteria supplement every day, rather than occasionally. You could also take a digestive enzyme supplement with main meals – Cytozyme, 1 with food (not suitable for those with gastritis).
      • Avoid the foods that trigger bloating
      • Cut down / avoid gluten products, however this does not mean you should start eating lots of gluten-free products which are undesirable for a number of reasons
      • Eat plenty of vegetables – both with lunch and supper to support good gut bacteria and provide adequate fibre. Vegetables include prebiotics. Half your plate at both lunch and supper should be vegetables (for this purpose does not include potatoes)
      • Some antimicrobials might also be a good idea but I would see how you get on with above suggestions first

      We do offer a free health questionnaire service – if you complete and return a health questionnaire we will send you some written diet and supplement recommendations. You can find the health questionnaire by clicking here.


  22. Hallo!
    Martin from Sweden. My wife and I have with great interest red The 4 pillar plan. A question: my wife repeatedly catches colds and they last longer than normal colds do. Can gluten be destructive for her immune system? If so – She loves eating bread for breakfast – can a gluten free variant of bread help in the long run?

    1. Dear Martin,

      Thanks for your question on our blog. Regarding your wife frequently catching colds and the colds lasting a long time and whether this could be linked to gluten sensitivity, it is possible but there are also many other factors that can affect immunity. If your wife does decide to trial a gluten elimination then it is best not to eat too many commercially produced ‘gluten free’ products as they often lack fibre are higher in sugar and unhealthy fats. If you would like a handout on foods to avoid whilst conducting a gluten free trial, please email me (clare@cytoplan.co.uk). Also, please see a blog I wrote on some of the problems with gluten free foods here.

      Secondly, gut health is very important for immunity – with 70% of the immune system being located in the gut – and prebiotic and probiotic foods may be useful to support the immune system.

      In addition, there may be other specific nutritional needs that your wife has – in particular vitamins A, B vitamins, vitamin C and D plus the trace mineral zinc are all important for the immune system. Presumably given that you live in Sweden your wife does take a vitamin D supplement. A blood test might be a good idea to ensure the are within the optimal range. In addition I suggest the following supplements:

      • All round multivitamin and mineral either Women’s Wholefood Multi or Wholefood Multi (the former is suitable for pre-menopause, the latter for post-menopause). Take with breakfast
      • Vitamin A 5000 iu – one per day for 2 months, then keep a pot in the cupboard and use at the start and during a cold
      • Immunovite – 1 per day. Increase to 3 per day at start and during cold
      • Acidophilus Plus – 1 per day at bedtime

      There is some vitamin D in the multi, but if your wife is not taking vitamin D (or if she is taking a low dose) then some extra may be needed for a period. We have a product called Vitamin D3 + K2 with 4000 iu (100mcg) per capsule.

      I hope this helps.


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