HHabits & Hustle
← All episodes
Dr. Will Cole28 March 2023

Episode 227: Dr. Will Cole: How to Heal Shame-flammation

5Frameworks
14Insights

Listen

Frameworks in this episode

Insights & moments

The myth-busts, hot takes, explainers, and tools worth keeping.

Myth Buster· 2

Myth Buster36:00

Leaky Gut May Not Present as an Obvious Digestive Problem

Cole argues that underlying gut issues do not always produce extreme digestive symptoms. He focuses on possible systemic inflammatory effects and discusses a proposed cytokine model connecting inflammation with cognition and mood.

  • Normal bathroom habits do not rule out an underlying gut component
  • The proposed impact can be systemic rather than only digestive
  • Cole highlights inflammation as a possible link to brain function
  • He describes mental-health symptoms as multifactorial

you don't necessarily have to have extreme digestive symptoms that have underlying gut components to it

Dr. Will Cole · 36:30

it's called the cytokine model of cognitive function cytokines are pro-inflammatory cells researchers looking at how does inflammation impact how my brain works

Dr. Will Cole · 37:00
#leaky gut#inflammation#mental health
Myth Buster51:00

More Vitamin D Is Not Always Better

Cole cautions against continual high doses of fat-soluble vitamins, which are stored rather than cleared like water-soluble vitamins. He suggests periodic testing for people taking 5,000 IU of vitamin D and says a dose may not need to remain unchanged forever.

  • Vitamin D is fat soluble
  • High doses can accumulate
  • Cole recommends periodic level testing with a 5,000 IU dose
  • Dosage needs can change over time

if you're going to take 5000 IUS I would get your levels tested pretty periodically every six months or so because you may not have…

Dr. Will Cole · 52:30

more is not always better specifically with fat soluble vitamins like vitamin D3 and vitamin A

Dr. Will Cole · 53:00
#vitamin d#supplements#testing

Hot Take· 1

Hot Take23:30

Why Feeling Well-Rested May Not Match Your Sleep Data

Cole says some patients report sleeping well even when wearable data or laboratory markers suggest poor sleep quality. He presents mouth taping as one possible tool among many for selected patients with a dysregulated sleep-wake cycle, not as a universal intervention.

  • Subjective sleep and measured sleep can diverge
  • Cole looks at wearables and labs in context
  • Mouth taping is presented as one possible tool
  • The discussion centers on selected patients, not everyone

any patient that has um dysregulated sleep wake cycle oh yeah cortisol melatonin on Labs mouth taping can be a great way to optimize sleep

Dr. Will Cole · 23:30

they say oh I sleep fine but you look at their Aura ring or the whoop band or the labs and it's like not good

Dr. Will Cole · 24:00
#sleep#mouth taping#wearables

Explainer· 7

Explainer10:00

How “Shameflammation” Connects Stress, Shame and Physical Health

Cole uses “shameflammation” for the overlap between shame, chronic stress, trauma and inflammation. He argues that prolonged fight-or-flight activation can contribute to a broader physical and emotional health pattern, while emphasizing that it is one part of a bidirectional puzzle.

  • Shame can accompany work, family, body and food stress
  • The term combines shame with inflammation
  • Cole links the pattern to prolonged sympathetic activation
  • He presents physical and emotional health as bidirectional

what I call on the book shame inflammation is really sort of the Confluence of the chronic stress and Trauma piece of How It's playing…

Dr. Will Cole · 10:30

it's the feeling side of that gut feeling puzzle so it's not the only one

Dr. Will Cole · 13:00
#shame#stress#inflammation#trauma
Explainer18:30

What Makes Holotropic Breathwork an Advanced Practice

Cole describes holotropic breathwork as a more advanced, mouth-based breathing practice that can produce an intense somatic or altered experience. He says participants can change the pace, including slowing down with nasal breathing, and that experiences vary.

  • The described method uses breathing in and out through the mouth
  • It may create a stronger somatic experience
  • Cole compares possible experiences with psychedelic-like states
  • Pacing can be adjusted rather than standardized

it's a great way to sort of metabolize storage

Dr. Will Cole · 18:30

you can self-paced this for yourself and not everybody has to have the same experience because there's many types of breath work holotropic is just…

Dr. Will Cole · 25:30
#breathwork#somatic#nervous system
Explainer40:00

SIBO: When Ordinary Bacteria Grow in the Wrong Place

Cole explains small intestinal bacterial overgrowth as bacteria growing where they should not, rather than necessarily involving inherently bad bacteria. He uses a garden analogy and links SIBO with a substantial share of IBS cases, bloating, reflux and other digestive complaints.

  • SIBO stands for small intestinal bacterial overgrowth
  • The issue can be location and overgrowth, not simply bad bacteria
  • Cole compares it to weeds overtaking a garden
  • Bloating and IBS-like symptoms are common presentations

it's quote unquote good bacteria growing where it shouldn't be growing

Dr. Will Cole · 40:30

it's kind of like weeds over growing in this gut Garden where you there's nothing wrong with the weeds they're part of nature but you…

Dr. Will Cole · 41:00
#sibo#ibs#microbiome#bloating
Explainer43:30

Candida and SIFO Are Problems of Overgrowth, Not Mere Presence

Cole distinguishes the normal presence of yeasts and fungi in the human microbiome from fungal overgrowth. He uses SIFO—small intestinal fungal overgrowth—as the fungal counterpart to bacterial overgrowth and stresses that the overgrowth is the concern.

  • SIFO means small intestinal fungal overgrowth
  • Candida can be part of the normal microbiome
  • Presence alone is not the same as pathology
  • The central issue described is overgrowth

just so someone can have bacterial overgrowth it can have fungal overgrowth as well

Dr. Will Cole · 43:30

nothing inherently wrong with it it's the overgrowth of it's the problem

Dr. Will Cole · 44:00
#candida#sifo#microbiome
Explainer49:00

Why the Form of Magnesium Matters

Cole explains that magnesium comes in multiple forms with different tolerability, uses and bioavailability. He contrasts citrate's effect on bowel motility with the goal of achieving adequate cellular magnesium, arguing that the most noticeable effect is not always the same as good storage.

  • Different magnesium forms have different strengths
  • Glycinate is described as well tolerated
  • Citrate can increase gastrointestinal motility
  • A laxative effect does not prove magnesium is well stored

there's actually many types of sub types of magnesium

Dr. Will Cole · 49:00

the problem is those magnesiums like increase the bowel movements like magnesium citrate they tend to not be as well stored in the body

Dr. Will Cole · 50:00
#magnesium#supplements#bioavailability
Explainer54:00

Adaptogens Support Stress Response—They Do Not Fix a Deficiency

Cole describes holy basil, lion's mane and ashwagandha as adaptogenic tools that may support stress response and nervous-system function. He distinguishes them from essential nutrients: people do not have an “adaptogen deficiency,” and not everyone needs daily use or a large blend.

  • Adaptogens are framed as optional herbal tools
  • Cole links them to the brain-adrenal stress response
  • Not everyone needs to take them every day
  • Single ingredients can be tried instead of an entire blend

it's not like if someone has an adaptogen deficiency like Vitamin B or vitamin D but it's an herbal tool to support the nervous system…

Dr. Will Cole · 55:00

let's just try one and see how it works so you don't have to have all of them

Dr. Will Cole · 58:30
#adaptogens#ashwagandha#stress
Explainer1:02:30

Allergy, Sensitivity and Intolerance Are Not Interchangeable

Cole separates three commonly conflated food reactions. He says allergies and sensitivities are immune-mediated, with allergies tending toward immediate reactions and sensitivities tending to be delayed, while intolerances are enzyme deficiencies rather than immune responses.

  • Allergies are immune-mediated and often immediate
  • Sensitivities are immune-mediated and often delayed
  • Intolerances are described as enzyme deficiencies
  • Lactose intolerance involves insufficient lactase

intolerance sensitivity and allergies are all different things actually

Dr. Will Cole · 1:02:30

intolerance is technically aren't actually immune mediated they're an enzyme deficiency

Dr. Will Cole · 1:03:00
#allergy#food sensitivity#intolerance

Tool· 1

Tool47:00

Digestive Enzymes as a Temporary Bridge, Not a Forever Fix

Cole describes digestive enzymes as a possible temporary tool for people who are not breaking down food effectively. He cites low hydrochloric acid, undigested food and bloating as clues, while saying the larger goal is to restore the gut's own function.

  • Digestive enzymes are not presented as necessary for everyone
  • Low hydrochloric acid may impair protein digestion
  • Undigested food and bloating can be clues
  • Cole prefers temporary support while addressing the cause

digestive enzymes can be used in my opinion temporarily while we actually get your gut to do its job

Dr. Will Cole · 48:00

if people see undigested food in their stool if they feel like bloating then yes digestive enzymes can be a tool

Dr. Will Cole · 48:30
#digestive enzymes#malabsorption#digestion

Takeaway· 3

Takeaway27:30

The Thoughts-as-Clouds Reframe for Distracted Meditators

Cole reframes distraction during meditation as material for the practice rather than evidence of failure. The meditator notices thoughts passing like clouds and identifies with the observing awareness—the sky—rather than every thought or emotion.

  • Distraction does not mean meditation failed
  • Thoughts can become objects of awareness
  • The observer is framed as the sky rather than the clouds
  • Lightness and repetition replace perfectionism

we can actually use that distraction thoughts as a meditation too

Dr. Will Cole · 28:00

seeing your thoughts as clouds that pass by and see yourself and realize oh wow I'm this vast Sky not the clouds

Dr. Will Cole · 28:30
#meditation#mindfulness#perfectionism
Takeaway44:00

Why Probiotics Require a Low-and-Slow Approach With SIBO

Cole rejects the idea that every person automatically needs a probiotic supplement. He says fermented foods may be enough for some people, while people with SIBO should introduce probiotics carefully because fermentable fibers and some products may provoke reactions.

  • Not everyone needs a probiotic supplement
  • Fermented foods can provide beneficial bacteria in food form
  • SIBO can change probiotic tolerance
  • Cole advises starting low and slow

some people don't even need to go and buy a probiotic some people can just maybe start judiciously with like some fermented foods

Dr. Will Cole · 44:30

my advice for people that have sibo start off low and slow test these things out

Dr. Will Cole · 46:00
#probiotics#sibo#fermented foods
Takeaway59:00

Food Variety Matters More Than Repeating the Same “Healthy” Meal

Cole says dietary variety supports microbiome diversity, which he associates with healthier aging, lower inflammation and better brain health. The discussion also separates that diversity rationale from the different question of whether repeatedly eaten foods can become inflammatory for a particular person.

  • More varied foods can support a more diverse microbiome
  • Eating the same healthy meal repeatedly may limit variety
  • Food reactions require individualized interpretation
  • A reactive test result can point upstream to gut permeability

the different foods that they eat the more diverse is going to be which is associated with longer healthier life less inflammation better brain health

Dr. Will Cole · 59:30

it could be a source of inflammation it's not that it's causing extreme obvious digestive issues but it's contributing to the larger level of inflammation

Dr. Will Cole · 1:01:00
#food diversity#microbiome#food sensitivity