People often say, “go with your gut.” But if the microorganisms that live in your intestines are out of whack, it might lead you to make unhealthy choices, according to integrative neurologist Kulreet Chaudhary, M.D.

A pioneer in integrative neurology and the author of The Prime, Dr. Chaudhary draws from both Ayurvedic knowledge and Western medicine to treat her patients. In this interview, we talk with Dr. Chaudhary about the microbiome and how it affects our mind, body, and emotions.

vpk: The microbiome seems to be making quite the splash in health research news these days. Can you tell us, in layman’s terms, what is the microbiome?

Kulreet Chaudhary, M.D.: It’s really a host of a variety of different microorganisms — bacteria, yeast, and so forth — that live in your body, particularly the gut, and what we’re realizing is that, just like our activities directly impact the health of planet earth, the activities of the microbiome directly impact our health. If we look at the body as a planet, the microbiome is the citizens that inhabit that planet. It’s not a static population that’s just kind of hanging out. The microorganisms are intricately involved in whether we are healthy or sick; they help with the production of different vitamins in our bodies; they help with the production of different neurotransmitters. When you have the right balance, you are functioning properly, and when you have the wrong balance — meaning you have an overgrowth of more of the more parasitic populations that live off of us and deposit their waste products — that seems to be associated with a variety of different disease states. It’s not like what we had believed in the past, that these are germs that all need to be wiped out. The health of our body actually depends upon the health of our microbiome. I look at it as almost another organ in the body that is dispersed throughout.

vpk: Just this month, a study published in Nature found that there’s a link between brain disease and the gut microbiome. Can you tell us why that might be, both from the perspective of a neurologist and an Ayurvedic physician?

Kulreet Chaudhary, M.D.: Well, from the perspective of a neurologist, the way that neurologists are currently being trained, there’s no connection. Neurology as a field has not actually accepted this connection and it isn’t being taught. So if you ask me to speak purely as a neurologist my response would be that there is no connection. That’s basically what the party line is.

vpk: Even with the studies like the one we just discussed coming out?

Kulreet Chaudhary, M.D.: Yes, as I mentioned in my book, even when research like this comes out, you might hear of it even before a physician hears of it, because it’s not the kind of information that is part of the traditional core requirement in medical school. Typically, when studies like this come out it takes twenty to thirty years before it’s actually taught to med school students.

I get asked this a lot, things like: “Oh, the neurological community must be going wild about that!” But according to the neurological community, even what we eat does not impact brain health. I still see patients who have seen a neurologist and were diagnosed with multiple sclerosis, and when they asked their doctors what they should be eating, the physician said, “Well, your diet has absolutely nothing to do with brain health.”

So it’s really important to keep it in mind that even though neuroscientists are making the connection, neurologists, who are the ones who are actually treating patients, are mostly uninformed about this. To be honest, the only reason I started to look into it wasn’t because of my neurological background per se, but it was because of my training in Ayurveda. As a neuroscientist I’ve been involved in many different clinical trials. It’s hard to watch something work and then not start to ask questions. It was only because the Ayurvedic recommendations worked so well for neurologic conditions and because the focus of Ayurveda is always on the power and strength of digestion, it opened up this question of, “What’s the connection between the gut and the brain?” Because Ayurveda works and because that was the basic premise of Ayurveda, I then had to go out and research the topic, and lo and behold: there was all of this information. So now I can talk to you as an Ayurvedic neurologist about the relationship between the microbiome and the brain, but it should really be made clear that this is information that neurologists have yet to be taught and it’s just barely creeping out there in medicine in general.

“Scientists are starting to realize that the bacteria, or the microbiome, that exists in the gut in particular, has an enormous connection with brain health.”

vpk: It was really only when you yourself started to have frequent migraines that you started returning to your Ayurvedic roots, right?

Kulreet Chaudhary, M.D.: Exactly. And I by no means mean to vilify neurologists as a whole, because really if I hadn’t developed migraine headaches I wouldn’t have gone this radical myself! I would have had no reason to believe any differently than what I was taught as well. But scientists are starting to realize that the bacteria, or the microbiome, that exists in the gut in particular, has an enormous connection with brain health. Now this is all old information from the perspective of Ayurvedic medicine. This is the way we treat brain disorders in Ayurveda: we always address the gut first.

And it’s effective in two ways. First, the population directly impacts the brain by the type of chemicals that the microbiome can produce in the gut. So they can either produce chemicals that help the brain, or they can produce chemicals that harm the brain. One example is when you have the right population of bacteria in your GI system — I’ll just say microorganisms, because it’s beyond just bacteria — they’ll help to produce healthy neurotransmitters in response to eating good food. But the population changes oftentimes following a stressful event or just through poor eating habits; then the microorganisms produce neurotransmitters that give you a high from eating the wrong food. Second, in addition to this, when the unhealthy population dies, they actually have toxins in their cell walls that, when they die, are released into your bloodstream and are directly toxic to your neurons, your brain cells. That’s another way that the microbiome affects the brain.

But another part is that when there are disorders of the nervous system — and again, oftentimes it’s related to a change in the microbiome — the nervous system in the gut becomes damaged, further harming your healthy gut microbiome.

vpk: The gut’s nervous system — in your book, you mention that’s called “the enteric nervous system,” right?

Kulreet Chaudhary, M.D.: Yes, the enteric nervous system. And that’s when you can have things like failure of the ileocecal valve functioning properly, and then you can get bacteria growing in places where it’s not supposed to be growing. So there’s this whole dynamic of not just how the bacteria of the gut affect the brain, but also how neurological disease can further worsen the issue in the gut.

“90 percent of the body’s serotonin — our feel-good neurotransmitter — is produced in the gut.”

vpk: From your book, The Prime, I understand we’re carrying a mix of good, bad, and neutral bacteria in our own personal microbiome. The goal is to obtain the perfect balance of those three, is that correct?

Kulreet Chaudhary, M.D.: Exactly. We have this idea of needing to wipe out the bad guys, and there’s never really a need to wipe out the bad guys when you create balance. When you create balance they all basically know what to do and where to be. It’s not this idea of having zero percent of bad bacteria. It’s having them in populations that are well controlled. Because it seems that our body actually needsthat biodiversity. In other words, having even small amounts of some of the so-called “bad guys” helps our immune system to fight off other pathogens. It really is about maintaining balance.

It’s an extremely dynamic process — even just in one day. Let’s say you have a stressful event: within twenty-four hours your microbiome will have changed. It’s important for people to look at the microbiome as something that’s not set in stone; it’s something that’s constantly changing. This is exactly why you have to understand the signs of when it’s in balance and when it’s out of balance so you can do something.

That doesn’t mean that once you attain a state of balance that nothing’s ever going to throw it off. Life happens! But now you have the tools to get back into balance. You begin to recognize, “Oh! When my tongue gets coated, when I have a hard time waking up in the morning, when I get bloated after I eat… these are all signs that there’s something wrong with my microbiome.” So once you recognize those signs and you have the tools to help reverse that, then you understand that this is really a dynamic equilibrium. It’s just like a garden where you’re constantly having to pull out certain weeds, and you’re watering the flowers you want to grow, and it changes from season to season. It really is a constant partnership with the citizens that live in the “planet” we call our body.

vpk: I was amazed to discover that 90 percent of the body’s serotonin — our feel-good neurotransmitter — is produced in the gut.

Kulreet Chaudhary, M.D.: I was surprised too! It’s not anything we learned whatsoever in medical school or neurology residency. So even before we give antidepressants, we should really be looking at how can we just fix the microbiome so that your body starts making more serotonin.

vpk: In The Prime, you offer readers a comprehensive program to help repair digestion and foster a healthier microbiome. For those who haven’t read the book, what is The Prime and how does it work?

“You have to biomechanically prime your body first before you can make behavioral changes.”

Kulreet Chaudhary, M.D.: The Prime is a program that I came up with as I was working with patients over a decade, and I created it to help reverse neurological conditions. It’s a program that acknowledges the role of the microbiome in neurological health, and it also acknowledges the so-called obstacle to being able to change the way that patients eat and being able to remove the toxins from their body.

What I found was that if I just told my patients, “Hey, to get healthy you have to make all these dietary changes,” about fifteen percent were able to do it. But eighty-five percent of my patients were not able to change their habits, and this is where I really started looking into why that was. I wondered, “What exactly is this connection between the gut and the brain that prevents people from being able to change their eating habits?” What I realized is that — and this is why it’s called The Prime — you have to biomechanically prime your body first before you can make behavioral changes.

The steps in The Prime help to heal both the microbiome and the connection between the gut and the brain, so that you then have a smartgut rather than a dumb gut. And what happens with the smart gut is you start making smarter behavior changes for a healthier life and you start making them spontaneously. That’s the whole advantage to having a smart gut that’s working for you and not against you.

vpk: Beautiful. And the steps in the program itself are relatively simple, right? Can you tell readers a bit about The Prime?

Kulreet Chaudhary, M.D.: Yes, most of my patients who do the program find the implementation is easy — but extremely profound. They’re also surprised at how dramatic the actual change is, given how simple the interventions are.

The program has four steps, and each step basically prepares your body, particularly the microbiome and your brain, for the next step. In the first step, we are starting to move surface toxins out, not just from your GI tract, but also your kidneys and lymphatic system — which is kind of a trash can for the whole body. The first step is just a mobilization process, so that things are starting to shift in the body. And most detoxes or cleanses actually stop at this first step. But it’s really just a preparatory step; it’s not doing any deep cleaning, it’s just getting you ready for the next step.

In the second step, we’re starting to shift the neuroadaptation that’s already taken place in the brain toward unhealthy foods — and not just unhealthy foods but other unhealthy habits. We’re starting to change the way that the brain is firing so that it’s not as susceptible to bad habits, and it’s not as susceptible to things like sugar, high fat, and all of that. And in addition, we’re starting to build up the body’s reserves for going into deeper detox mode. And this is another really critical part: if you don’t nourish your body before detoxification, it’s actually depleting. You should never do detoxification in a depleted state. The second step also is starting to replenish the body with nutrients.

The third step is kind of the heavy hitter in the program, and this is where a lot of the really deeply-rooted toxins start to get pulled up to the surface. People are oftentimes really surprised at the stuff that comes out. One of the biggest shocks for most people is the emotional stress that comes out, things that people thought they had dealt with. I always explain to them that this is the cellular residue of those experiences, and when you get rid of it, you’ll feel so much lighter — not just physically lighter, but mentally and emotionally lighter.

“Although the main side effect that most people are drawn to is the weight loss that happens, it’s really a program for transforming your life.”

vpk: Sorry to interrupt, but since you’re talking about emotional purification, can you talk just a bit about the topic of “mental ama” and ama in general?

Kulreet Chaudhary, M.D.: Definitely. So in Ayurveda, ama refers to undigested substances, or toxins, in the body. They can be physical toxins, mental toxins, or emotional toxins. All of them fall under the category of ama. So in the third step of The Prime, much of what we’re doing is removing ama.

The way that Ayurvedic medicine looks at the human body is, it’s not just a physical structure. You have a mental body, you have an emotional body, and all of these are interrelated. So an obstruction in any one of these areas — an obstruction, for example, of emotional ama — will cause a physical obstruction, or vice versa. In the third phase, you’re really starting to unplug these channels, physically, mentally, and emotionally. You’re essentially transforming that ama, and by transforming it you’re able to finally process it and remove it. Like I said, I was not expecting this step to be as profound as it has been for patients. Really lifelong issues that they were unable to process were suddenly coming up to the surface and just being released.

Moving on to phase four, that’s where we add all of the habits that help to support the new biochemical state that your body is now in. In most health-based programs, they start with these habits first. But my thesis is that if you don’t have the biochemistry, you can’t sustain these good habits. So I add these new habits at the end, once you’ve had the biochemical shift. For most people, by the time they get to this point they find these habits remarkably easy to implement. And these are the habits that now support the new biochemical state and their new microbiome.

vpk: That seems like a great idea to have the Ayurvedic diet and lifestyle habits at the end — especially for people who are new to Ayurveda — rather than hitting them with a whole new lifestyle regimen right off the bat.

Kulreet Chaudhary, M.D.: Exactly. And the program is very powerful. I have patients who do it once a year and the more you do it, the deeper and deeper you go. Although the main side effect that most people are drawn to is the weight loss that happens, it’s really a program for transforming your life.

vpk: On the topic of weight loss, can slim people do The Prime too?

Kulreet Chaudhary, M.D.: Absolutely. Here’s the thing: this was never meant to be a weight-loss program. That’s just what most people tend to use it for, because most people — particularly in the US, because of the traditional US diet — have a tremendous amount of physical ama and that tends to accumulate as excess weight. But originally what The Prime was meant to do is to help improve your digestion and to help reduce mental ama in order to improve the brain.

Mental ama is really the type of ama that causes most neurological conditions. So many people who have no weight to lose do The Primeand what they find is that they’re thinking more clearly, they have stronger digestion, their energy is more stable, they tend not to be as sensitive to changes, meaning if they’re stressed they tend to feel more grounded in those situations. It’s by no means only for people who want to lose weight. If you have weight to lose you’ll lose it; but if you don’t have weight to lose, you won’t lose it. That’s the beauty of Ayurveda. It has an inherent intelligence.

"…many people who have no weight to lose do The Prime and what they find is that they’re thinking more clearly, they have stronger digestion, their energy is more stable…."

vpk: You recommend using some traditional Ayurvedic herbs as part of The Prime, including Triphala (which is our Organic Digest Tone Triphala Plus formula), Ashwagandha, Brahmi, and Guggul. Can you tell us a bit about those herbs and why they’re so special?

Kulreet Chaudhary, M.D.: Triphala is to me one of the most amazing herbal formulations on the planet, and I almost even hesitate to call it herbal because it’s really three berries. Some of these berries are just included in the Indian diet; I grew up eating them as a pickle. But each one of these berries is able to do so much simply on its own. If you take amalaki, for example, it’s getting to be more and more studied now because of its vast ability to heal different conditions, especially reducing inflammation and improving diabetes. The list just goes on and on about what these individual berries can do. But when you combine the three berries together, they have an exponentially more healing impact on the body, and yet they’re unbelievably gentle.

Triphala basically helps to — in a very, very gentle way — remove toxic accumulation, particularly in the GI tract but really throughout the whole body. If the GI tract is not open, then toxins can’t get removed anywhere throughout the body. But Triphala helps to push out water-soluble toxins through the lymphatic system and the kidneys, as well as to remove the accumulated ama that causes an overgrowth of the bad microorganisms in the GI tract. Triphala is considered a rejuvenative formula, so it not only helps to treat diseases, but it actually helps to promote health. It’s called a rasayana, an herbal formulation that helps to promote health long-term.

“Triphala basically helps to — in a very, very gentle way — remove toxic accumulation, particularly in the GI tract but really throughout the whole body.”

Ashwagandha and Brahmi, which are in the second step of The Prime, are two absolutely phenomenal herbs. Brahmi is considered a “brain tonic,” and that’s a classic Ayurvedic description. And when I first started working with it, I wondered, “What does a brain tonic mean?” I’ve learned it’s really something that helps to balance the neurochemistry of the brain globally. So it’s not just for one particular neurotransmitter, although it’s particularly helpful in modulating the release of dopamine in a more balanced way. These two herbs help in conditions where there’s either too much dopamine or too little dopamine. And that’s something that we’re not accustomed to seeing in our Western medications; they either do one or the other. But these herbs help to bring things to a place of homeostasis.

Brahmi is used for a variety of neurological conditions from seizures to Parkinson’s disease to ADHD… the list just goes on. But it’s also used to promote creativity and intelligence. Again, it’s one of these herbs that can be used to treat disease, but Brahmi is oftentimes given to children when they’re younger to help promote their creative intelligence. It’s used to balance mental function and promote the development of higher cognitive function — which is really your natural tendency. It’s just preventing the things that are getting in the way of you accomplishing mentally and intellectually what you are capable of accomplishing.

Ashwagandha is the herb that we use in combination with Brahmi, and it’s considered an adaptogen because it helps your body to adapt to stress. It particularly acts on the HPA Axis — a central axis in the body that coordinates brain function, endocrine function, and how you respond to stress. And the reason why this is so important to balance is particularly in the case of neurological conditions — but also just in general for food addiction — stress plays a huge role. We know that in different neurological conditions, if the person is under stress, the neurological condition will actually get worse. We also know that when it comes to food addictions, people will binge eat or crave certain foods when they are under stress. So modifying this particular axis is really critical to both repair the brain and break out of food addiction cycles.

vpk: And how about Guggul? I read in your book that Guggul is a very powerful herb and you have to use it carefully, right?

Kulreet Chaudhary, M.D.: That’s absolutely right, and this is what surprises me just a little bit: people will kind of start an herb without really understanding the rationale of what it does to the body. Guggul is not something you would just start up front. You really have to prep your body for the introduction of this powerful herb. It’s amazing what it has the capacity to do, but the way that it’s described in the Ayurvedic texts is that it actually scrapes out the ama throughout the body. So, with something that powerful you have to make sure that the channels are actually open so they can handle what’s being pulled out. It also has a very potent effect on the liver and enhances the liver’s ability to be able to remove toxins. It’s something that I won’t prescribe until both the body and the brain are prepped to handle this experience.

vpk: As a pioneer of integrative neurology, where do you see the field going in the future? More in the direction of ancient Ayurvedic knowledge?

Kulreet Chaudhary, M.D.: I think it’s inevitable, really. It’s essentially going back to how we have been built as human beings, and it’s acknowledging the relationship between the brain and other systems. It’s acknowledging that, when somebody comes in with a neurological condition, they’re really not coming in with a brain problem. They’re coming in with a body problem. Neurologists will have to look at all the systems that are involved in the culmination of this so-called brain disorder, whether we call it multiple sclerosis, Parkinson’s disease, or so forth. This is going to be very scary territory for most neurologists, because of the way we have been trained — which is that the brain is operating very independently in this encased little shell. All of a sudden, we’re going to have to have a more unifying approach in understanding how all of the other organ systems, particularly the gut, impact brain health.

It really is inevitable simply because, like I said, this is how we are made. If we are ever going to get to a point as a society where we are acknowledging that these conditions are not only reversible but preventable, then we have to really embrace the story behind each condition. The nice thing is we’re finally at the point where there’s a lot of ancient knowledge that is coming back up and being reexamined and being studied further. It’s becoming the launching point for us to study the microbiome in a completely new way. Eventually there’s simply going to be so much out there that it would be heresy to not include it in your neurological practice.

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Dr. Kulreet Chaudhary’s combined expertise in both modern neurology and the ancient science of health known as Ayurveda has uniquely positioned her as an expert able to pull from the broadest possible base to treat her patients. She is passionate about raising awareness for the need of a paradigm shift in contemporary medicine that focuses on patient empowerment and a health-based (rather than disease-based) medical system. Dr. Chaudhary is a regular guest on the Dr. Oz show, where her teachings about Ayurvedic medicine have been applauded by a national audience.

Dr. Chaudhary was the Director of Wellspring Health in Scripps Memorial Hospital for ten years, and remains a pioneer in the field of Integrative Medicine. Dr. Chaudhary has successfully developed a powerful system to manage chronic neurological disorders such as multiple sclerosis, Parkinson’s disease and migraine headaches, by incorporating fundamental changes in diet, behavior, and stress, in addition to the standard allopathic approach to these issues. This program has been so successful that many patients now use it not just for neurological issues but also for a wider range of health concerns, including weight issues and chronic disease.

Dr. Kulreet Chaudhary is also a neuroscientist. She has participated in over twenty clinical research studies in the areas of multiple sclerosis, Alzheimer’s disease, Parkinson’s disease, ALS, and diabetic peripheral neuropathy. Her research includes groundbreaking work in stem cell therapies for diabetic peripheral neuropathy and drug development for the treatment of ALS.

Disclaimer The sole purpose of these articles is to provide information about the tradition of ayurveda. This information is not intended for use in the diagnosis, treatment, cure or prevention of any disease. If you have any serious acute or chronic health concern, please consult a trained health professional who can fully assess your needs and address them effectively. If you are seeking the medical advice of a trained ayurvedic expert, call or e-mail us for the number of a physician in your area. Check with your doctor before taking herbs or using essential oils when pregnant or nursing.​