Detoxification with Dr. Bryan Walsh: Rational Wellness Podcast 77

Dr. Bryan Walsh discusses proper detoxification with Dr. Ben Weitz.

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Podcast Highlights

3:04  Dr. Walsh had the typical health care provider’s view that we are all toxic and we should detoxify when we can. But then he heard a detox guru talking about phase three detoxification and it didn’t accord with his understanding of it.  Secondly, he learned that there was a phase zero detoxification. Thirdly, he had read that there was a biphasic response to toxins in that certain nutrients at a low dosage increased detoxification enzyme activity, while at a higher dosage it inhibited the same enzyme for detoxification.  This meant that the amount of some of these nutrients found in food would stimulate detoxification, while the concentrated, isolated forms and the amounts found in supplements such as in detox formulas and powders might actually be inhibiting detoxification.  This led Dr. Walsh into doing a deep dive into the scientific literature and to formulate a detox program that does not include a lot of supplements.

8:24  Which toxins each person gets exposed to has to do with your socioeconomic status, your occupation, where you live, your lifestyle, what kind of cosmetics and cleaning products you use, your water, and your air.  When you look at the data from National Health and Nutrition Examination Survey data from the CDC, we’re excreting all kinds of toxins, including heavy metals like mercury and arsenic, organophosphates, organochlorines, and aflatoxins from mold.  Some toxins exert oxidative stress and others are endocrine disruptors and may disrupt the thyroid, sex hormones or adrenal function.  Toxins may also have a direct cytotoxic effect on our cells.  Some toxins affect the endocrine system, while some have more of an effect on the neurological system and the brain.

13:52  Dr. Walsh doesn’t like most of the serum or urine tests for toxins and prefers using questionaires.  Here are two of the questionaires that he finds helpful to screen for toxic exposure:  http://www.eha-ab.ca/acfp/docs/taking-an-exposure-history.pdf  and  http://familymed.uthscsa.edu/qeesi.pdf

19:22  To properly detox you have to do three things: 1. Mobilize, 2. Optimize the detoxification pathways, and 3. Promote excretion. To mobilize, you want to go on a hypocaloric diet so that you start breaking down fat stores, which will mobilize toxins stored there. You should also use a 6-8 hour time restricted eating period, which means that you should have your two or three meals within an eight hour period of time and have no food the rest of the time. To optimize the detox pathways, this is heavily nutrient dependent, requiring certain vitamins, minerals, amino acids, and other nutrients.  You need methyl groups, you need sulfur groups, you need glutathione, you need certain amino acids, like glycine. To promote excretion, you have to sweat, so Dr. Walsh recommends using a sauna.  You want to drink a lot of water, so that you urinate.  You want to consume enough fiber so that you poop and include some binding agents to insure that the toxins leave the body.

28:18  Detoxification does occur in the liver, but also in the kidneys, the enterocytes, and even in the testes.  The four phases of detoxification include phase zero, which is the entry of these environmental pollutants into the cells. Phase one makes the fat soluble compound water soluble by adding a hydroxyl group. But it also produces a toxic intermediate, so it is important that phase two be sufficiently upregulated so that these toxic intermediates go through conjugation or sulfation or methylation or glucuronidation or glutathione or acetylation.  Then phase three takes that water soluble detox product out of the cell to be excreted through stool, urine or sweat.  You need to be careful to avoid nutritional supplements like curcumin, piperine, and milk thistle, which inhibit phase three of detoxification. For excretion, it is important to include fiber and binding agents, like bentonite clay, charcoal, and chitosan.  And it’s also crucial to sweat, such as by using a sauna, though Dr. Walsh does not like steam rooms, unless you are using purified water.  But overall, Dr. Walsh is not a believer in taking a bunch of nutritional supplements for conducting a detoxification program.  For example, when you take curcumin via food, it enhances phase III detoxification, while curcumin as supplement decreases it: https://www.ncbi.nlm.nih.gov/pubmed/18439772

43:17  Dr. Walsh also recommends as part of his 10 day detox program, 4 days of a modified Fasting Mimicking diet.  He cites the work of Dr. Valter Longo from USC who has published research on the anti-aging benefits of it, though he is not worried about the issue of a low calorie diet mobilizing toxins, which Dr. Walsh is concerned with.  So Dr. Walsh uses the same macronutrient ratio recommended by Dr. Longo, which is basically a low protein, ketogenic program, though Dr. Walsh recommends including foods that facilitate detox.  While Dr. Longo recommends the same amount of low calories to everyone, Dr. Walsh recommends low calories, but with the exact amount of calories based on your weight.



Dr. Bryan Walsh is a board-certified Naturopathic Doctor who sees patients and teaches at the University of the Western States and is an expert at detoxification. Dr. Walsch’s web site is drwalsh.com and he offers a course on detox for patients https://www.metabolicfitnesspro.com/walshdetox/  and also a course on detox for other doctors and practitioners: https://www.metabolicfitnesspro.com/everything-you-wanted-to-know-about-detoxification-2/

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.


Podcast Transcripts

Dr. Weitz:            This is Dr. Ben Weitz with the Rational Wellness Podcast, bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to the Rational Wellness Podcast on iTunes and YouTube and sign up for my free ebook on my website by going to drweitz.com. Let’s get started on your road to better health.

Hello, Rational Wellness podcasters. Thank you so much for joining me, again, today, Dr. Ben Weitz here. For those of you who enjoy the Rational Wellness Podcast, please go to iTunes and leave us a ratings and review. That way, more people can find out about the Rational Wellness Podcast. Today we’re here. We’re going to speak about detoxification, getting rid of toxins from our bodies. We all are probably aware of the fact that we live in an environment in which there are toxins in the air, in the food, pesticides, chemicals in products that we put on our skin, use in our house. We have tons of information that we been exposed to about all these different toxic substances that get into our bodies and, potentially, have negative health affects.

Today we have Dr. Bryan Walsh, who’s a board certified naturopathic doctor, who sees patients, teaches courses in biochemistry and physiology at the University of Western States. He’s also scientific advisor at Lifetime Fitness. He’s devoted a considerable amount of time researching and writing about the concept of detoxification to help us to get rid of some of these toxins. That’s what we’ll be discussing today, his particular approach to detox. Dr. Walsh, thank you for joining me today.

Dr. Walsh:           Thanks for having me. It’s a pleasure to be here.

Dr. Weitz:            How did you get interested in detox as a particular topic?

Dr. Walsh:           Well, that’s a great question. I’ve been steeped in the health world for a long time, well before I became a naturopathic physician. I started out as a fitness professional a long time ago, read up on nutrition as much as I could. I was a massage therapist. I was really into that world and it doesn’t take long being in that world to come across this concept that we’re all toxic and we’re going to die if we don’t detoxify. You’re introduced to all these different ways of supposedly detoxifying your body from foot baths, to colonics, to you can see people online saying, “Drink a little bit of lemon juice in the water. It’s a great way to detoxify the body,” and all these different claims.

My initial, I guess, exposure to this whole concept was that of what everybody else’s is. We’re super toxic. It’s killing us slowly and if we care about out health, we should probably detoxify. And that was it for a really long time. Then, I forget the specific time, but there was a time, recently, I’d say maybe this year or last year. I heard a particular detox guru talking about phase three detoxification. Which most people in this industry have heard of, it’s been around for a little while. I think phase three might have been discovered in the early ’90s. The way that he was describing phase three didn’t entirely jive with what my understanding was. This guy is a guru, I’m not. At least, I don’t consider myself to be. I thought, “That doesn’t really … that’s not right. I don’t think.”

I decided to go into the scientific literature and say, “What is phase three really?” I’ve heard a lot of people say a lot of things about phase three. What it is, what it’s not. I decided, I was like, “I’m not going to listen to anybody else, I’m going to do this myself.” You know how PubMed works. Where you go in and you read a paper. Then it’s cited in other papers and then you go down, the next thing you know, you have 50 tabs open in Firefox or Chrome and you’re reading all these papers. This little mini dive to just trying to figure out what phase three was three things happened.

One was I realized that this guru, who’s teaching people about phase three to sell his supplements, wasn’t entirely accurate. I have a problem with that, as we were just talking about that prior to this interview. In this space, whatever you want to call it, Functional Medicine, nutritional medicine, alternative complimentary medicine. We need to be 100% accurate with what we’re talking about, because we’re so intensely scrutinized by conventional medicine. First of all, the way he was describing phase three to practitioners wasn’t entirely correct.

The second thing that I saw was that there’s a phase zero detoxification. Which, I’ve been in this business for a long time, and I have never heard anybody ever, at any time, utter phase zero. I thought, “Wait a minute, what is this phase zero, that I’ve never heard about?” If we’re talking about detoxifying people, it should be a part of this conversation that we’re having. So, that blew my mind.

Then the third thing, and this may have been one of the things that really sealed the deal for me, was I started reading about what’s called a biphasic response when it comes to certain compounds, or nutrients, or herbs, or minerals, whatever. This biphasic response, specifically in these papers, was talking about how, at a low dose, increases certain detoxification enzyme activity, but, at a high dose, inhibits the very same enzyme for detoxification.  I thought, “Well, wait a minute.”  A low dose would be the kind that you find in food.  So if you were to eat the herb, itself, or to take turmeric, for example, for its curcumin content that, that might stimulate detoxification.  But these papers didn’t explicitly say this, but in a high dose, which I read as, isolated, concentrated, supplement form.  Trying to get as much of the herb, or nutrient, or compound in your body, as possible, might inhibit detoxification.

When those three things happened … All it was, was this guy was talking about phase three. I thought it was wrong. I decided to look it up myself. A, he was a little bit wrong about phase three. B, there was a phase zero that I never heard about. And, C, I really wondered if what we’re doing, as an industry, if we were actually detoxifying people, or not, by giving people these powders, and potions, and supplements in concentrated, isolated forms when the studies were pretty clear that many of the things that we’re using in detoxification formulas might actually be inhibiting detoxification. Then I though, “Oh my gosh, I need to completely get any bias out of my head. Everything that I though I knew about detoxification.” Wiped my brain clean. Wiped my desk clean. And I started from the very top. I said, “All right, what have I heard? That we’re toxic. All right. What does the literature really say? Are we, in fact, toxic or not?”  Two was, are these things stored inside of us? We hear that they are. Is there a synergistic effect of multiple low-dose toxin exposure all at the same time? We hear that, but what does the scientific literature say? Does the dose matter? We hear that the dose makes the poison. And, at the doses that we’re probably exposed to, that it’s not going to cause a problem, so I wanted to look into that.

 Then after answering all these, I guess, basic questions that you and I have heard about for a really long time in this industry. If those are true, if we do have exposure, if it does get stored, if it is causing damage, if there is a synergistic effect, if the dose doesn’t matter, and if a low dose can cause just as much damage as a high dose, what can we do about it? What does the scientific literature say or suggest is the most efficient and safe, I will add, safe, efficient, effective ways of actually detoxifying the body, and assessment. That was a big … How do we test this? You know the labs. There’s labs out there that are supposedly these toxin panels and will … What does the literature suggest about those, as well?  That was the dive. I ended up reading over 300 papers on this topic over the course of months.  That’s my story with this.  So I have come up, now, for air again with a brand new view of what detoxification is.  With really solid answers to those questions that I feel very confident talking about, in fact.

Dr. Weitz:            Okay, maybe we could start by just talking about what are some of the most common toxins that we get exposed to in our environment, and get stored in our bodies. What are some of the health consequences of some of these?

Dr. Walsh:           That’s actually … That’s interesting. That’s a difficult question to answer, because … Well, I just give you an example. There was one specific paper that I found that said that based on one’s socioeconomic status, we are exposed to different toxins.  For example, somebody might have a garden in their backyard, and they’re, therefore, spraying pesticides.  But somebody with a lower socioeconomic status might eat more fast food and, therefore, are more exposed to certain other toxins.  A certain class might use more, what’s it called, sunscreen on themselves, or their kids, or certain cosmetics.  They’re all common.  When you look at the NHANES data, in terms of what people are excreting. We’re excreting everything. We’re excreting everything from elements, so things like arsenic, and the heavy metals, mercury, aluminum. We are exposed to a lot of organo-phosphates and organo-chlorines that persist of organic pollutants. We’re exposed to … Some people might be exposed more to aflatoxins, because they have mold exposure, which other people don’t.

I actually think that’s a really difficult question to answer, because it depends on, well, according to studies, your socioeconomic status, the job that you have, where you live. We’re out in well-water country. I can tell you that we don’t use any pesticides in our yard garden, but I drive down the road, and these farmers around us are spraying who knows what. That’s absolutely getting into our water.

Dr. Weitz:            Absolutely.

Dr. Walsh:           But, on the other hand, and somebody that lives in an urban society and is drinking city water. They’re going to have different exposures. So it depends on your lifestyle. What kind of cosmetics and cleaning products do you use? What kind of food you eat? The water, the air, all these things. I think it’s difficult to say what are the most common ones, because that really will be specific to one’s diet, lifestyle, job, where they live, for example.

The second part of your question is the damage. That was another question I had. We hear these things are so bad. Well, why? Why do they cause problems? And it turns out that depending on the specific, I’ll call it a toxin, they’re really xenobiotics or environmental pollutants. Or the class that they’re in, they really do exert different effects. One of the most common ones, though, that across the board is oxidative stress, surprisingly. I didn’t know that, that was going to be the case, but in many individuals that have multiple chemical sensitivity, they exhibit a tremendous amount of oxidative stress. Other ones, you hear them as endocrine disruptors, but what does that really mean?

It turns out the stuff is so compelling, though, when you look at it. Depending on the environmental pollutant, let’s just talk about thyroid. Just about every single aspect of thyroid hormone physiology can be negatively impacted by an environmental pollutant. So, starting up at the top, the hypothalamus, the pituitary, TCH, thyroid’s ability to bind onto … thyroid binding globulin on the receptor, itself, and conversion on the thyroid’s production of this, every single step. We often think of the sex hormone, that these are all estrogenic. That’s not entirely true. There are some that have been shown to suppress adrenal function, and suppress cortisol, for example.

Then there’s other ones that have direct, what I call cytotoxic effects, on a cell. For example, certain ones might mess up the membrane of the mitochondria. Other ones might negatively impact some of the enzymes involved in the citric acid cycle, or the electron transport chain. Other ones have more indirect effects, like with the immune system, and then that will have system-wide effects. It’s really … There’s so many of these things out there. There’s so many classes of these and they all exert different effects. That it’s hard to say. Some of them exert more neurological symptoms, whereas other ones might impact the endocrine system more. It really depends on the environmental pollutant and what specific effects it causes. But …

Well, here’s another quick one. In the scientific literature, so many chronic conditions have been linked back to xenobiotic or environmental pollutant. Things that you don’t … I mean, of course, the neuro developmental things, like ADD, ADHD, and autism, as well as, things like Alzheimer’s and Parkinson’s. But then there’s things, like obesity, things we never think of, but the studies are really clear, cardiovascular disease, atherosclerosis, hypertension, and even diabetes. Some of these papers say the correlation is so strong that, perhaps, xenobiotic exposure is, not only associated with diabetes, but maybe a significant contributor.  Anyhow, that just speaks to the fact that it depends on what it is, but it can impact virtually any part of a cell, the mitochondria, the pliable membrane, the endoplasmic reticulum, enzymes, transporters, hormones, neurons. You name it, they can cause damage in some way.

Dr. Weitz:            What’s the best way to screen to see what kinds of toxins that we have in our body?

Dr. Walsh:           That was disappointing to me. When I looked into the literature to see what really was the … That’s the big question, of course, because … So, right now, what have we talked about?  Yes, we’re exposed. There’s absolute proof that they’re stored. They do cause damage. Then the next rational question is, all right, well, how toxic am I? When people are talking about how toxic they are, what they’re actually asking is, what’s my total toxic load or total body burden? Which is really to say, “How much do I have stored in my body?” That’s really the question. And the problem is, there’s no way to assess that. There’s no way to evaluate that. I know that people, “Well, what about the hair tissue mineral analysis test?” No. What about the urinary test to show excretion? No. I can go into some of the reasons why too.

One of the gold standards in toxicology, when evaluating this, is a fat biopsy. That’s really what we’re looking at … How much is stored in fat? Well, it turns out that for a variety of reasons, and there’s papers on this too, that suggest that you have different amounts of stored xenobiotics in subcutaneous fat, than you do visceral fat, than you do in different fat depots in different areas of the body. And these papers say that, that doesn’t correlate to serum levels, so you can’t do a blood test and say that, that reflects you and what your storage is, because it may differ.  Then there was one, and this is a rodent study, so you have to take that into consideration. Well, here’s a good example. Let’s say you and I, right now, let’s say we practice in the same area. We live the exact same lifestyle, exact same exposure. You’re following a hypocaloric diet, right now. Intermittent fasting, time restricted feeding, hypocaloric diet. I’m stuffing my face, standard American diet. I’m eating more than my basal metabolic rate. We both go to do a test. Now, because you’re in a hypocaloric state, you’re probably mobilizing more of your stored xenobiotics, and every mammal study says that. That when there’s a hypocaloric, or fasted, state, serum levels of xenobiotics go up every single time, every single mammal, including humans.

Now, I’m in an anabolic state. I’m storing things. When we go to do this toxic panel, you come out sky-high in all these toxins. And you see your practitioner and they’re like, “Oh my gosh, you are so toxic. You must do a detoxification program.” Then, me, because I’m in an anabolic stuffed fed, overfed state. That mine are probably stored. And my levels, on my test, might come back as normal or low. And the practitioner says, “Wow, you’re not toxic, at all.” When, in fact, I might be far more toxic, in terms of my storage, than you are, but you’re in a hypocaloric state. Right there, that totally negates … It’s a severe confounding variable when considering assessments.

Then the last one, that rodent study I was going to say, they showed that when these … They put these rats on a yo-yo diet, poor rats. They would go hypocaloric and their xenobiotic levels would go up in their blood. Then they’d make these rats hypercaloric and guess what happened? These xenobiotics went into different tissues. You might have a certain amount in a certain fat depot in your body that does get mobilized, but then it’s going to go somewhere else depending on your caloric state. In terms of screening, all of this is my opinion. It’s based on the scientific literature, but people can use it how they want. Is there is some pretty good questionnaires that are out there, that are in the … They’re validated questionnaires in the scientific literature that, I personally, think are amongst the best ways of screening if we have toxic exposure or not.

Dr. Weitz:            Can you mention which ones those are?

Dr. Walsh:           There’s a whole bunch of them. One of them is abbreviated and I forget the actual … It’s [Quesy 00:17:59]. If you do links to this in your show notes, we can-

Dr. Weitz:            Yeah, I will. Yeah, maybe you can email me.

Dr. Walsh:           That one’s the most elegant. It’s fairly long. I’ll give you a couple of them that I like for two reasons. One is this one is very comprehensive. It’s not quick, 10 questions, are you toxic or not. It looks at a variety of things from your actual physical exposures and your lifestyle, as well as symptoms across a variety of systems in the body. And I think is really very comprehensive. The benefit of some of these, though, is it forces you, when you ask these, or answer, these questions to jog your memory to see what your exposures might be that you are totally unaware of. Right now, you can say, “What are my exposures? I drink reverse osmosis filter water. I eat organic food. I use coconut oil for my lotion. Apple cider vinegar for my deodorant. I don’t have any exposures.”  But when you go through some of these questionnaires that have these questions, you say, “Oh my gosh, I work in a building that whatever.” They’re really good at helping, not only see if you might have a certain amount of toxicity, if you will, but also what the sources might be.

Dr. Weitz:            Okay. In your concept of detoxification … Actually, you were talking about the phases of detoxification. I’m not sure everybody even knows what phase one and phase two are, and you were talking about phase zero and phase three. Well, actually, your concept of detoxification, you have three basic principles, and then you list the phases in a second one. Maybe we could go through your three main important principles of detoxification that you outline in your program.

Dr. Walsh:           Yeah. And, again, I humbly will say that I think my … I’m a teacher, not by choice, I think I was born into it. When I look past throughout my entire life, everything has been teaching. I say that because when I go through what these three principles are, there’s a feeling you know that being empowered just feels amazing. That you feel like that you know enough information that nobody can pull the wool over your eyes. That you’re an informed individual. So by teaching these three things, these are just … These are principles that must be in place for anything to call itself a detoxification program. I say this so that when people are evaluating, “Well, what about this detoxification?” They can run it past this list of three things.  The first thing that for something to call itself a detoxification, that it absolutely must include is mobilization. You have to get these things out of storage.

Dr. Weitz:            I thought you were going to say it has to come in a box, just kidding.

Dr. Walsh:           No. It can, if it’s a well developed one, it absolutely can, UPS, no.

Dr. Weitz:            Okay.

Dr. Walsh:           You have to mobilize in the first place. The best ways to mobilize, that I’ve seen, and also makes physiological sense, is to go on a hypocaloric diet. Now, i think a calorie restricted diet, I also believe a time-restricted feeding in a window of about six to eight hours, is probably the best. And all that calorie restriction means is less than, essentially, your basal metabolic rate. Exercise. So the technical word is, lipolysis, which is the breakdown of the lipids, or fat cells, but that’s where the majority of these things are stored. When you are in a state, a catabolic state of lipolysis, you do get mobilization of toxics, period. This is not conjecture.

Dr. Weitz:            Right.

Dr. Walsh:           Every mammal study that I’ve looked at, including humans, when people, or mice, or monkeys go hypocaloric, their levels in the blood go up every single time.

Dr. Weitz:            You’ll have to admit that virtually every detox program out there involves some sort of modified fast or fast. They pretty much all involve eating less foods.

Dr. Walsh:           Right.

Dr. Weitz:            So this concept, I think, is incorporated in most of the commercial detoxification-

Dr. Walsh:           Whether they knew it, or not, right. It absolutely involves that.

Dr. Weitz:            Right.

Dr. Walsh:           The second thing, then is, and this speaks to those phases of detoxification. You have to optimize detoxification. Step one is to get them out swimming in your body. All these things, now, are mobilized. They’re going through your blood. You are not going to get rid of them. These are the fat soluble ones that you do not, you cannot … The normal routes of excretion are any water forms of excretion. You can sweat it out. You can urinate it out. There’s a little bit of water in stool, so you can poop it out. You can, technically, salivate it out, or if you cry a lot, you watch a lot of This is Us reruns, then you can cry it out, technically, through tears.

Those are all … I mean, in theory, you could measure any one of those as a form of toxin … Those are all measurable things. We have to take these things that are fat, they like fat, and turn them into things that like water, so we can get rid of them. Those are those four phases of detoxification; phase zero, phase one, phase two, phase three. You have to optimize those. If you’re not, then these things just go in the body and you can’t excrete them, because they’re still fat soluble. Then the third, and last one is, you have to focus on excretion. I’ll just take a step back and say, “Let’s talk about different detox programs to see if they fit those things.”

Mobilization, improved detoxification pathways, and then to really, really facilitate excretion in some ways. Let’s say that somebody were to do a juice fast, some popular juice fast where the juice comes in a box, or maybe they’re just juicing things on their own. Are they in a hypocaloric state? Probably, if all they’re doing is just drinking juices, they’re probably in a hypocaloric state. So they’re probably mobilizing, and that’s fine. Step two is, are they improving detoxification pathways? Now, it depends on what they’re consuming. There are studies that suggest that things commonly juiced, things like carrots and celery-

Dr. Weitz:            We’ve had a technical difficulty, so we’re going to continue this podcast. We’re not exactly sure where we left off, but hopefully we won’t have any lost train of thought. So, go ahead Dr. Walsh tell us more about detox.

Dr. Walsh:           Yeah, no problem. You can tell me if I’m going too far backwards. I was saying the three things that are required in order for somebody to do a detoxification program; mobilization, optimizing detoxification, and then optimizing excretion. Those three things are critical. Then what I said was if you go back, and you start evaluating things that are supposed to be detoxification programs, where they detoxify the body, they have to have those three things. So, just a juice fast, is really common. You mentioned that most juice fasts are hypocaloric, so they probably are increasing mobilization. But then, I think this is the part that we got a little bit glitchy, is depending on what somebody’s consuming, you may, or may not, be either stimulating or inhibiting detoxification pathways. The things that have been shown in the literature to stimulate detoxification pathways, people typically aren’t juicing things like, broccoli, for example, or cabbage, or possibly things like mung beans, which aren’t really juiceable.

Dr. Weitz:            But it is the case that detox is a nutrient dependent process, right?

Dr. Walsh:           Absolutely. Well, yes. I mean, if you want to really get into the biochemistry of it, there are a number of different micro-nutrients, vitamins, and minerals that are even required for these pathways to be taken place in the first place.

Dr. Weitz:            Right.

Dr. Walsh:           In phase two, which I’ll get to, but just really quickly. You need methyl groups, you need sulfur groups, you need glutathione, for example, you need certain amino acids, like glycine. It’s heavily nutrient dependent.

Dr. Weitz:            Hence, the concept of trying to put together a program that has concentrations of these nutrients has some basis in the science, right?

Dr. Walsh:           Totally. Here’s the point. Is a juice fast a detoxification program? From the mobilization standpoint, yes, it probably is. You will be mobilizing. But from optimizing detoxification, I think that, that’s highly skeptical. And it depends on what somebody’s juicing. There’s some evidence in the literature that things that people usually juice, like apples, carrots, and celery may actually inhibit certain detoxification pathways, so then, that’s questionable. Then for excretion, if somebody is just doing a juice fast, they are not doing anything to enhance excretion. In fact, if they’re only consuming juice and, therefore, not fiber, and we can go into great detail on this, or not, but they’re probably urinating, and that’s fine. If they’re not sweating, that’s a huge problem. It’s a huge problem when it comes to detoxification.

Certain things are preferentially excreted via sweat, other ones are preferentially excreted via biliary, in the bile and the gastrointestinal tract. If you’re not sweating, or your not binding things up severely in your gastrointestinal tract, and in the juice fast, you’re not, then you’re not excreting. I, myself, would say that a juice fast is not a detoxification program. Yes, it mobilizes whether, or not, it increases detoxification pathways depends on what you’re consuming. Then the third one, excretion, I’d say a big, no, to that.

Does a colonic, is that a detoxification? Well, if you’re not mobilizing, then, no, all you’re doing is your moving things through your bowels faster. Which is great, that’s excretion, that does nothing for the second step detoxification of the first step, mobilization. That’s what I really want people to do is to be able to look at a detox … something that is allegedly a detoxification program, and say, “Does this increase mobilization?” Check, yes. “Does this increase detoxification pathways?” That’s a big one. That’s questionable with a lot these nutrients that people are using in powders, and supplements, and capsules. And excretion, is just saunaing detoxification? You maybe excreting things that you had swimming around in your interstitial fluid, technically, but not out of your cells, because you might not be in that mobilized state.

Dr. Walsh:           So those three things are critical for something to be called, to truly, truly be called a detoxification.

Dr. Weitz:            Can we go through those detox pathways? People typically talk about phase one and phase two of detoxification. It’s phase zero and phase three that are the newer ones. Typically, people talk about phase one and phase two as related to the liver, correct?

Dr. Walsh:           Yeah, well, and that’s not true, at all. When people talk about these … I’ll tell you what the phases are, then we’ll talk about why it’s not just a liver. The liver happens to be a huge organ and, yes, it does this, but the kidneys do this very well. The enterocytes of the intestines do this very well. In men, it turns out the testes, actually, do this very well also. Which isn’t surprising, given the role of the testes in terms of, essentially, passing along somebody’s DNA in that xenobiotics. If one couldn’t detoxify well down there, then that could really disrupt somebody’s …

Very simply, if you’re to picture, like a box. I’m trying to look for a prop real quick, but I don’t have one. If a box is a cell or, you’re in a room there. I would say, if somebody’s in a room it’s pretty easy to picture. If this room has two separate doors, this is as simple as it is. Phase zero is quite simply the entry door into your room, which is the cell. Your cell has a nucleus and mitochondria. It has a computer. It has lights and electricity and ATP. That first door is phase zero. That’s the entry of one of these environmental pollutants inside of a cell. You can say a liver cell, but it’s not the only organ that does this. It comes in, now, it’s inside the liver cell. We’ll say it’s a person came through that door.

Then phase one is biochemically not too challenging, but I’ll say what it does biochemically and then I’ll change it back to this metaphor or analogy. Phase one makes that fat soluble compound, first of all, makes it water soluble. It does so, not exclusively, but either by adding what’s called a hydroxyl group or exposing one that was already there. Now, this has this hydroxyl group on it. It’s water soluble. The way that I use this as an analogy. If somebody walked through the door, phase zero. They’re now inside the cell and you, put a sticky note on their forehead, just right on their forehead, or you start berating them, “You suck as a human being. You’re a horrible, miserable, ugly, smelly human being.”

Now, and that’s phase one. Now, this person is really angry. Who wouldn’t be if you start to berate … and they have a sticky note?  So they start trashing your room. They throw your computer across the desk. They start knocking lights over. They start doing all these things.

Dr. Weitz:            Fake news.

Dr. Walsh:           But in a cell, after phase one, and this isn’t across the board, all the time, but it’s actually considered to be more damaging to the body than, in some cases, the original environmental pollutant was, after phase one. You just berated this person, “You’re fat, ugly and your breath stinks.” Now, they’re really, really mad, but that’s phase one. But phase two is collectively called conjugation, and conjugation means, to add something.  Now, in phase two, you’re like, “I’m so sorry. Here’s $100 bill.” Well, the person may have had hurt feelings about what you said, but now you gave them $100 and they’re not angry anymore. After phase two, it’s still water soluble, but it just got $100 bill. It’s not going to damage anything inside of your cell anymore. It’s not going to damage your room. Now it’s a happy person. You made fun of it, it was angry, it started messing things up after phase one. Phase two, you handed it something, now, he’s happy.

Dr. Walsh:           Now-

Dr. Weitz:            Now, let me just stop you for one second. So the story that’s often told about detox, especially from some of the companies that provide these detox programs is, phase one produces a toxic intermediate that’s why if you just do a juice fast you get all these toxic reactions, and headaches, and all these negative things. You have to have the right nutrients that help support phase two, so you take that toxic intermediate, put it into a water soluble form so it can get excreted. Therefore, you support phase one and phase two, and that’s the end of the story.

Dr. Walsh:           Yeah. That’s a good story, but if the intermediate metabolite, after phase one. With that hydroxyl group, it’s technically a free radical. Now, I haven’t seen too many people that get sick from free radicals, if that makes sense?

Dr. Weitz:            But doesn’t that explain when somebody does a juice fast and they have toxic reactions-

Dr. Walsh:           I think that part of it-

Dr. Weitz:            – and the amino acids and the other nutrients for phase two.

Dr. Walsh:           I don’t know. I’m not convinced that, that … It might be because of mobilization, and they’re not excreting things. I don’t know if it’s only because it goes through phase one. Technically, I mean, they’re water soluble, but technically it’s still inside the cell. It hasn’t gone out of the cell yet, so that’s a good story, and it might be true, but I don’t think there’s any proof as to that’s what’s causing this.

Phase two is the conjugation. You hand them $100 bill, or in the case of actual biochemical pathways, sulfation hands to the sulfur group, methylation hands to the methyl group, glucuronidation hands to the glucuronic acid, glutathione gets glutathione glycine, acetylation gets in the acetyl group. That’s the $100 bill. Now, it’s water soluble and happy. Now, it has to get out of the cell to go back into the interstitial fluid, which is water, to be excreted. That’s the other door and that’s phase three. Now, here’s the problem. There’s certain things that can block phase zero, like diesel exhaust has been shown to block food. It’s fairly new. It’s only been discovered in the early 2000s. But phase three, curcumin blocks phase three, piperine from black pepper, which is usually used with curcumin to make it more available, blocks phase three. Milk thistle, honestly, is a mild phase three inhibitor, as well.

And here’s the thing, so now you have this happy person that could leave that third door. Then you’re done with them. You’ll never see them again, because they get excreted. But here’s the problem, you know, beta glucuronidase, which undoes glucuronidation. There are other enzymes that can undo conjugation, which to put it back into the metaphor is, there are things that can take that $100 bill away from that person, whether it was sulfation or methylation. Can take that $100 bill and, now, they’re the intermediate metabolite again. If you block phase three, and that person, metabolite, after phase two stick around inside that cell, now, the conjugation reaction can be undone. Now, it’s back in the intermediate metabolite. That’s why making sure that … This becomes my opinion, at some point here, but I don’t know that we should be taking a lot of supplements when it comes to a detoxification program. Because the reality is, and I can go head-to-head with a lot of people on some of these things, it’s really hard to say whether something actually improves detoxification or not.

Not from enzyme activity, or MRNA expression, for these proteins. There are all these things, but if it actually … What I’ve looked at, which is biphasic response, is that food, and the doses that are found in food, will generally stimulate detox … There was one great paper, by the way, that looked at food-based curcumin and isolated curcumin. Food based stimulated detoxification pathways and isolated absolutely inhibited. In fact, conventional medicine … Think about cancer, think about chemotherapy. What they really want is to keep that chemotherapeutic agent inside of the cell, so that it can fight cancer, correct?

Based on what we’re saying is that best way to do that is to block phase three. If you close that second door, you keep inside that cell whatever is inside that cell. If it’s a chemotherapeutic agent, that’s what you want to be able to exert more of an effect on cancer. What is conventional medicine using as a potential phase three inhibitor to help augment, or improve, chemotherapy? Is curcumin, so should curcumin be in a detoxification program? If it’s truly detox, you want to open up phase zero, have phase one and phase two working very well, and keep that second set of doors wide open, phase three, so that stuff can actually get out. Then, for the third part of the detox, is to be excreted via sweat, via bile and poop, via urine, or, like I said, technically, salivate, saliva, or tears.

I don’t know if that answers the question. But that’s phase zero. Phase zero is entry into the cell. Phase one redox, oxidation, the hydroxyl group is added or exposed, intermediate metabolites, sometimes more toxic, not always. Phase two conjugation gets handed something. Phase three exits the cell and then is excreted, as long as the body is excreting.

Dr. Weitz:            Interesting.  In order to promote excretion, you talk about using particular fibers and binding agents to help get rid of some of these toxins?

Dr. Walsh:           Yeah. What I did, again … Bentonite clay, I’ve been familiar with bentonite clay, as a fitness professional, and different types of fibers, and all these things. But what I wanted to do was look to the literature and say, “Well, what actually shows an improvement in the excretion and, not necessarily, of xenobiotics, but of bile.” So like a bio-acid sequester, like cholestryramine, the old cholesterol lowering drug, bound up bile to excrete it. If we can bind up bile, because so many xenobiotics are found in bile, and is their primary form of excretion, we need to bind up bile. We need to bind up all the stuff in the gastrointestinal tract for a variety of reasons, but I tried to find things that had some scientific basis behind it, so things like charcoal, for example, fiber, soluble, insoluble fiber.

An interesting one is chitosan or ketosan, which is typically used for fat loss, not very well. But there is papers showing that it is, actually, effective at increasing xenobiotic excretion via bowel habits. The other big one is sweat. You have to sweat. In fact, I recently came across a paper that, the short version was and, again, if I come back in a future life as a lab rat doesn’t sound very good. They had two groups of mice or rats and they gave one group a pretty significant burn on their skin, which is unfortunate. They injected both sets of mice with a certain xenobiotic and, not surprisingly, the ones that had a burn had higher levels of this environmental pollutant, because skin is such a major route of excretion. And, in fact, is the preferred route of excretion of some xenobiotics, not all, but some.

So if somebody is not actively sweating, during this hypocaloric phase, then I don’t think we’re getting rid of as much as we need to. To the point then, this is a bold statement. But I have some more papers that I’ll be adding as some bonus content coming down the pike. This stuff just blows your mind, blows your mind. I would not, myself, my family, or any patients, or clients put them on a fat loss program without supporting detoxification pathways, period. If they couldn’t sweat, I would say, “You probably don’t want to do a detoxification program.” If it’s really … I’ll just give you a tip on some of these things. There’s evidence that weight loss actually increases one’s risk for dementia, cardiovascular disease, diabetes and cancer, very strong, and the author cite this as a reason. Weight loss induces mobilization of xenobiotics. They go up and if you’re not getting rid of them, cause damage to cells way down the level.

Now, you look good in sexy jeans, or skinny jeans, but in 20 years might have cancer, or dementia, because of the weight loss. And, in fact, a steady increasing BMI, as one ages, seems to be protective over some of these thing, which is counter to what we want to look like, ourselves, but it’s very compelling stuff. Yeah, this is real, man. I would not do a fat loss program without making sure I was sweating and excreting and supporting detox. I would not. I would not put a patient on one, because I think that the detriments are too strong.

Dr. Weitz:            Sounds good. I know you’re a fan of infrared saunas, or a particular type of infrared sauna, right?

Dr. Walsh:           Well, you know, no, actually. I don’t like steam rooms, because of the water that they’re potentially using. I think that you can have a lot of model organic compounds found in steam. Again, unless it was purified water. But, no, here’s the thing. Again, I try not to have much of an opinion, but base it off of what I’ve read in the literature. Interestingly, in the literature, when they collect the sweat they’ll have a cohort of people to collect their sweat to look at xenobiotic levels. But they don’t tell them how to sweat. So, whether it’s via exercise or in a sauna, it didn’t matter. That when you sweat, you excrete. There’s people out there that might split hairs about a far infrared sauna and a near infrared sauna or the old ones, which are called the radiate heat saunas.  Listen, from what I’ve read, I tend not to like to split hairs over things, just sweat, man. If all you have is an old coal one, and you pour your water on it, and that’s all you have. That’s fantastic, do it. I love near infrared, personally. I think far infrared are interesting. There’s some questions about the electromagnetic frequencies, and stuff, and some of those things. But the goal is to sweat. I don’t care how somebody … In fact, I have people contacting me about my program. They’ll say, “I don’t have access to a sauna, but what if I went up into my attic?” I’m like, “As long as it’s not filled with asbestos or all this toxic stuff up there, then fine. Listen, sweat. It doesn’t matter.”  I like how the near infrared saunas feel and the bright red lights. But, no, I think to say one’s superior is myopic, personally. I think just sweating, according to science, is the most important aspect.

Dr. Weitz:            Interesting. I got that from an interview you did with Mercola. Maybe it was Mercola who liked the near infrared.

Dr. Walsh:           Yeah, he likes near infrared more than far.

Dr. Weitz:            Okay.

Dr. Walsh:           But that’s splitting hairs. To me-

Dr. Weitz:            He didn’t like the EMF thing about it.

Dr. Walsh:           No, just to sweat is the most important aspect.

Dr. Weitz:            Let’s go-

Dr. Walsh:           I would say this … Sorry to interrupt. What’s nice about the sauna, though, is it’s controlled. You can control the temperature and the time, so that, in terms of knowing the quantity that you’re sweating. That’s why I suggest the sauna, but if someone doesn’t have access to it, just sweating is what’s important.

Dr. Weitz:            Let’s go over one more thing. This will be the final question. Is part of your program involves … I know you have a 10-day detox program and part of it includes a four-day version of the Fasting Mimicking Diet that’s been popularized by Dr. Valter Longo, who sells you this box, or his company, and people who are part of this program called, ProLon, sell you this box of pre-packaged foods that you open up and make soup and things like that. You basically have put together a program that involves using real food, but to create the same effects.

Dr. Walsh:           Yeah. The short version is, if someone’s never done a detoxification, just an average person, that maybe has never done one. I recommend doing what I put together, just my view on this, is a 10-day program. The first six days, because of what you talked about, is the very high nutrient … It’s low calorie. It’s hypocaloric, you have to mobilize, but it’s fairly high protein. It’s high protein to ensure that, whoever this average person is, that maybe wasn’t eating perfectly, isn’t particularly healthy, might be protein deficient, or I should say, amino acid deficient. That they have the sulfur groups, and they have the methyl groups, and they have the glycine and all the precursors, the glutathione, in order to really support those phase two detoxification pathways.

That’s why I recommend the 10-day program for somebody who hasn’t done it before. That’s the first six days. Then the last four days, or someone could do five, if they wanted. It is what I refer to as a modified fasting mimicking diet.  Now, I think the work that Longo did is … the papers are brilliant. I think they’re fantastic. The findings of these things are so interesting.  My concern, however, is that every paper that I’ve looked at, where any mammal goes hypocaloric, their xenobiotic levels go up, period. He’s looking at this from diabetes reversal, and autophagy, and mitophagy, and all these health promoting effects, and that’s great.  However, instead of … So the macro-nutrient ratios that he’s come up with are brilliant. The calorie levels, which I won’t get into, but I think that should be based on one’s weight, rather than just having set calorie levels.  So a very hypocaloric diet with very specific macro-nutrient ratios.

Dr. Weitz:            By the way, what are those macro-nutrient ratios?

Dr. Walsh:           It depends if it’s … According to the one paper that I use, that have the specific ratios. Honestly, it’s basically ketogenic.  It’s very low calorie, first of all, but it’s moderate carbohydrates, very, very low protein.  In fact, you can, in what I put together, you can reach your protein levels just by eating vegetables for that are required.  It’s very low protein, which there’s no additional protein that’s actually consumed.  The amount of protein found in the vegetables that I consume, you hit your mark.  Then a little bit of fat.  It’s like carbs, protein, and fat, so that somebody can be in a ketogenic state and not push themselves out. My concern with his work, however, is while really compelling stuff that he’s produced is what about this xenobiotic thing? What about these papers that I’ve seen that show that, if you lose weight, or if you mobilize, and that can cause some other chronic conditions or situations much later in life? Instead of just saying, “Here’s some soup or here’s some avocados and some tofu, or whatever it is to reach the macro-nutrient ratio level that he recommends.” I recommend specific food that, according to the literature, have been shown to support detoxification pathways.

I mean, again, what he’s put together is brilliant. I think it’s genius. I think it’s fantastic. I have no problems with it, other than, if you just eat rice and avocados to meet those macro-nutrient ratios, you’re basically doing nothing to help support detoxification pathways. And these people will have increased environmental pollute levels in their blood, period. I say, instead of eating foods to meet the macro-nutrient ratios, eat specific foods that, according to the literature, have been shown to support detoxification impact. That’s the 10-day.

Now, what I do recommend for someone, like yourself, however, if you’d really wanted to do a good detoxification program over the course of a few months, is not to do … You’re a healthy guy. You eat a healthy diet. You live a lifestyle. I think that you could do two four to five day fasting mimicking diets a month. In week one, you might do four or five of those days. Then, again, in week three do another four or five days. And the next month, do the same thing. So you don’t need to do the full 10 days, because arguably those last four or five days, where it’s really hypocaloric, that’s where you’re going to get the maximum, and it’s time restricted eating, you’re going to get the maximum mobilization. And if you’re eating the right foods … I have some evidence that this absolutely lowers xenobiotic levels.

For someone, like you, that’s already healthy, I don’t think you need to do the 10 days. I think four to five day, modified fasting mimicking diet, a couple times a month would be the most effective way.

Dr. Weitz:            Awesome. It’s been a great interview Dr. Walsh. How can we find out about your fasting programs and the other programs you offer?

Dr. Walsh:           Remember, I don’t agree just with fasting. I think we’re too sick to-

Dr. Weitz:            I’m sorry. I’m meant your detox programs.

Dr. Walsh:           I know.

Dr. Weitz:            How can listeners and viewers-

Dr. Walsh:           Yeah. If you go to drwalsh.com, D-R-W-A-L-S-H dot com, backslash detox, that’s all you have to do. Then there’s a funny little picture of me with two buttons. One says, “Practitioner,” and one, basically, says, “Non-practitioners,” because I created two programs. The practitioner version of this goes into great detail. They both go into the science. I show the studies on the screen. I walk people through the pathways on the whiteboard. Again, I don’t want to tell people what to do without having the reason why the recommendations are there. So that they’re knowledgeable and empowered and understand why they’re doing these things. Why everything is in the program that’s in there. I don’t just say, “Take these potions and detox.” I want them to know. The difference in the programs is the practitioner program is about nine hours. The non-practitioner is about four hours of video. The practitioner program goes in way more detail in the biochemical pathways of phase zero, phase one, phase two, phase three. I go heavier into the science. It’s more technically detailed, but they both have the same output, where it’s, here’s the program, here’s how to do it.

Dr. Walsh:           When I add on some of these additional, bonus, content features, both programs … And the practitioner program, if a practitioner gets the practitioner program, they also get the non-practitioner program for free.

Dr. Weitz:            Great. Any other points of contact you want to give out for people who would like to get hold of you?

Dr. Walsh:           No, that website is the hub.

Dr. Weitz:            Good. Good. Excellent. Well, thank you, Dr. Walsh.

Dr. Walsh:           It was my pleasure. Thanks so much.



How to Fix Your Fatigue with Dr. Evan Hirsch: Rational Wellness Podcast 076

Dr. Evan Hirsch discusses how to fix your fatigue with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Itunes, so more people will find The Rational Wellness Podcast]


Podcast Highlights

2:51  What distinguishes fatigue from chronic fatigue is that fatigue is generally relieved by a good night of sleep and chronic fatigue goes no for an extended period of time, usually longer than 6 months. Dr. Hirsch has found 15 different causes of fatigue: 1. not drinking enough water, 2. not getting enough good sleep, 3. deficiency in adrenals, 4. deficiency in thyroid, 5. deficiencies in sex hormones, 6. nutrient deficiencies like B12, vitamin D, magnesium, 7. heavy metals, 8. chemicals, 9. molds, 10. infections, 11. allergies, 12. negative emotions, 13. EMFs, 14. hidden dental infections, 15. parasites.  One of the founders of Functional Medicine, Dr. David Jones once said that the key to health is finding what we don’t have enough of and providing it and finding what we have too much of getting rid of that.

8:45  Adrenal fatigue or dysfunction can be a common cause of fatigue.  While testing for adrenals can be helpful, you can tell from symptoms if there are adrenal problems. Dr. Hirsch likes to start by using Adrenal Px from Restorative Formulations, which he’ll have patients take every 3 hours until 4 pm and if they need to he will recommend up to 3 capsules per dose.  In addition, make sure they are sleeping well, eating healthy, drinking water, etc. Dr. Hirsch mentioned that one doctor analysed all the studies on cortisol levels and fatigue and there was no correlation at all. If his patients need more support, he’ll recommend Adrenal Px syrup and he may add in some licorice root.  If that hasn’t taken care of the problem, he’ll use a product called Adrenal Para-NS from Byron White formulas. And finally, that hasn’t helped enough, then he will recommend hydrocortisone. 

16:40  Thyroid is another important gland that affects energy levels. Low thyroid is really two conditions: 1. low thyroid prodicution by the thyroid gland and 2. an autoimmune condition in which the immune system is attacking the thyroid. And this is usually because of either heavy metals, chemicals, molds, infections, allergies, emotions, or EMFs. One infection that Dr. Hirsch sometimes finds is involved is Bartonella and getting rid of Bartonella with the Byron White formulas can sometimes completely reverse low thyroid.  To support the thyroid Dr. Hirsch may start with some thyroid glandulars or iodine or kelp, but he generally finds that prescription thyroid is the most effective.  He does not like using Armour or Nature-throid because some patients may bneed more T4 and some may need T3 and we have to figure out the right dose for that individual. You also need to support the thyroid by supporting the adrenals and there’s this beautiful dance between thyroid, adrenals, and the sex hormones.                                               

19:45  Gluten, dairy, soy, and genetically modified corn can all play a role in the causation of thyroid autoimmunity.

24:04  Dr. Hirsch will sometimes use 20,000 IU vitamin D if a patient’s levels are below optimal, since vitamin D will stimulate T regulatory cells, which can help autoimmunity.  Most of his clients take 10,000 IU for maintenance.

27:42  Balancing sex hormones can help with fatigue. He finds that a lot of times when he finds younger men with mold, which results in low testosterone levels and low libido and once we get rid of the mold, their testosterone and libido comes back.  He will test for mold with urine testing from Great Plains or Real Time Labs after taking 500 mg of liposomal glutathione twice per day for seven days. For heavy metals he will use the Doctor’s Data provoked urine test using DMSA and test before provocation for baseline and then test after DMSA provocation.  To screen for other chemicals besides heavy metals he will use the Great Plains Lab GPL-TOX urine test also with glutathione provocation. To get rid of metals and other toxins he will recommend saunas, coffee enemas and cilantro and chlorella and modified citrus pectin. Dr. Hirsch likes to use a combination of products by Byron White that open up the liver and kidney pathways and helps to open the lymph and the neurolymph. He finds that most of his patients require at least 6 months to a year of treatment and sometimes as long as 36 months.

39:45  To support mitochondria, which are the organelles in the cells that produce energy, and they produce 70-80% of our energy.  Our mitochondria can get damaged by heavy metals, chemicals, molds, infections, allergies, emotions, and EMFs.  Not only do we have to remove that crap off of the mitochondria but we also have to inject the mitochondria with some good love in the form of like Acetyl-L-carnitine, L-carnitine and D-Ribose, CoQ10.  Dr. Hirsch likes to recommend a product from Research Nutritionals called ATP Fuel for supporting the mitochondria and he sees a boost in energy from using it.  Dr. Hirsch is on a mission to help a million people resolve their chronic fatigue!



Dr. Evan Hirsch is an MD who is practicing Functional Medicine with a focus on treating patients with chronic fatigue.  His website Fix Your Fatigue  offers a free download of his best selling book, Fix Your Fatigue.

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.


Podcast Transcripts


Dr. Weitz:            This is Dr. Ben Weitz with the Rational Wellness Podcast, bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to the Rational Wellness Podcast on iTunes and YouTube, and sign up for my free e-book on my website by going to drweitz.com. Let’s get started on your road to better health.  Hey Rational Wellness Podcasters. Thank you so much for joining me again today, Dr. Ben Weitz here. For those of you who are enjoying the Rational Wellness Podcast, please go to iTunes and give us a ratings and review, that way more people will find out about the Rational Wellness Podcast. Our topic for today is fatigue and what do we do about fatigue. Today we have Dr. Evan Hirsch, who’s a medical doctor who practices in Olympia, Washington, using a Functional Medicine approach and his practice is really focused on treating patients with various forms of chronic fatigue. He’s written a best-selling book, Fix Your Fatigue. Dr. Hirsch, thank you so much for joining us today.

Dr. Hirsch:           Thank you so much for having me on Dr. Ben.

Dr. Weitz:            So since you’re a conventionally trained MD, how did you veer off the path into functional medicine?

Dr. Hirsch:           So, when I grew up, my mom was really into natural stuff. So, I think I was about 10 when she first started down her path, and she had very high cholesterol genetically, and she was able to reverse it using oat bran. We went on this six months of oat bran muffins, oat bran this, oat bran that. I remember just being really disgusted by oat bran at the end of it, but she brought her cholesterol down significantly and I thought that was very interesting, and then when I went through medical school, I just am very curious, I ask a lot of questions, and I wasn’t happy with the answers that I was getting from all of my professors and doctors-

Dr. Weitz:            Just put people on statins, right?

Dr. Hirsch:           Exactly, and so I was saying, “Well what’s the cause of the cholesterol issue? What’s the cause of the high blood pressure?” And getting to the root, and I didn’t like the answers I was getting so I went off into holistic medicine. I got board-certified in holistic medicine, went into integrative medicine, functional medicine, environmental medicine and that kind of led me down that path and then my wife got chronic fatigue and then a couple of years later I got chronic fatigue, and so it was working through all that that I really became so in tune with what the causes were for fatigue and how to resolve them.

Dr. Weitz:            Great, so what are some of the most common causes of chronic fatigue? And by the way, what distinguishes chronic fatigue from other forms of fatigue?

Dr. Hirsch:           It’s a great question. So fatigue in general just means that you’re tired and it’s not resolved with rest, because theoretically you should be able to work out hard and then you sleep well and then the next day if you’re not well rested you sleep well the next night and then you’re fine, so it may take a couple days to recover depending on whether you ran a marathon or not but you should recover. Fatigue is when you don’t recover and then chronic fatigue is when it’s been going on for a extended period of time. Conventionally it’s usually longer than six months or so but usually if somebody is having an issue after just a couple of weeks I say don’t wait because there’s things that are happening that your body should be recovering and at that point you need to start going after it.

So that’s the answer to your second question there, and then the first one and around the causes, so I have found that there’s 15 different causes of fatigue but to be brief on it, and we can definitely get into those, generally I put them into two categories, one is things that need to be replaced or deficiencies, and so that’s things like not drinking enough water, not getting enough good sleep, deficiencies in hormones, adrenal, thyroids, sex hormones, deficiencies in nutrients like B12, vitamin D, magnesium. And then the second part is excesses, so we’re talking about things that need to be removed, the crap that’s in the body that needs to be removed out that’s causing problems, so we’re talking about heavy metals, chemicals, molds infections, allergies, negative emotions, electromagnetic frequencies, hidden dental infections, parasites, so a bunch of that crap that’s not supposed to be in the body that’s just draining the body and causing all these deficiencies.

Dr. Weitz:            Yeah, a famous Functional Medicine doctor basically said, “It’s pretty simple, what do I not have enough of and add that and what do I have too much of and get rid of some of that.” I think that was Dr. David Jones.

Dr. Hirsch:           Yeah, that’s exactly right. What I find with a lot of docs, they have that theory but they’re not looking enough at molds. They don’t have enough knowledge around mold illness, how to diagnose it in a person, how to diagnose it in a home to make sure they’re not living in a home, what that process looks like and then infections. You really have to dive in there in order to get that knowledge beyond just what Dr. Jones said.

Dr. Weitz:            Yeah, absolutely, and the tricky part is that you could spend a lifetime just studying mold, you could spend a lifetime just studying heavy metals, and so each time you get into one of these specific topics as a functional medicine practitioner it’s like jumping down a new hole of a whole new set of things to learn about, and that’s the tricky part. You tend to find what you’re familiar with, so if you’re really comfortable dealing with heavy metals it’s easy to find heavy metals, and most people have heavy metals so you fix those and you’re gonna get some improvement.

Dr. Hirsch:           Right, exactly, and that is a problem with being a clinician is we always have to catch ourselves and make sure that we’re just not leaning on what we enjoy treating or what some of these old patterns are and really trying to be as expansive as possible. And so for me what I have people do when they first come to see me is I have them run a whole bunch of labs because I know my clinical suspicion and I can diagnose some things clinically but neuropathy, fatigue, I mean a lot of these things it could be multiple things. And in fact, with everybody that I see I tell them, “There are 15 potential causes, you have multiple causes of fatigue and the causes that you have are different than the person in the next room.”  So we all have different multiple causes and they’re all different from each other which makes it so hard to treat, so it’s really important to get all of those things assessed, the heavy metals, chemicals, molds and infections, looking inside the body, making sure and seeing whether or not they’re there, putting them together with the symptoms and then coming up with a plan and having the right tools in order to treat them effectively.

Dr. Weitz:            And one of the things that I find challenging in Functional Medicine is when patients come in with the conventional mold, they’re realizing, “Well of course I realize it’s gonna be a little bit different,” but basically they want to take the test, they want to be told it’s this, they want to take those pills and that’s it, I’ll see you, and the problem is these are a lot of times complex cases and there are levels of dysfunction. So if the person has mold but they also have a leaky gut and they also have nutritional deficiencies, and you can’t address all these at one time so you sort of have to prioritize, deal with some of the most significant ones first and it’s a different model than you’re used to going to their medical doctor.

Dr. Hirsch:           Absolutely. I tell people this is a marathon, it’s not a sprint. This is a long-term proposition and it’s gonna require a lot of information or a lot of buy-in from them, and the people who come to see me have already seen 20, 30 doctors and so they’re probably different maybe than the people who come to see you but they’re usually a lot more bought in than when I was just practicing functional medicine now that I’ve ditched myself in this way and people are coming to me for chronic fatigue.

Dr. Weitz:            I see, interesting. I was reading your book which is an excellent read, lots of good information, easy to read and you talk a lot about adrenals in one of the first chapters, can you talk about how important adrenals are to fatigue? And how do we assess adrenals? And what do we do about adrenals if they’re burned out or not functioning optimally?

Dr. Hirsch:           Absolutely, and this is one of the things that I do at the first visit. Generally even without labs I can tell whether or not someone has the symptoms of adrenal dysfunction, and to answer your question-

Dr. Weitz:            Do you ever have patients do a series of labs before they even come in?

Dr. Hirsch:           I don’t.

Dr. Weitz:            Okay.

Dr. Hirsch:           Yeah, they could. A lot of people come with their own labs but I don’t because I want to make the assessment and I want to make sure that I’m ordering the correct labs for them, but the adrenals are really a universal problem. The adrenal gland produces lots and lots of hormones, cortisol is the big one that we talk about a lot that manages stress, it manages the immune system, it manages inflammation, everybody’s heard of prednisolone and cortisone, well guess what? They come from cortisol and that’s our body’s natural anti-inflammatory. So whenever there’s inflammation in the body like from eating gluten or eating dairy or having an infection or having mold, cortisol goes and some of the other adrenal hormones go and try to put out that fire, and as a consequence those hormones coming from the adrenal gland end up going down and people will have low blood pressure, they will crave salty and sweet things.  Generally they’ll say, “I can’t walk past a bag of potato chips without having to stop to eat it.” And then with the low blood pressure they’ll kind of have dizziness when they go from a sitting to a standing position too quickly. They will have low energy throughout the day, but typically they’ll crash usually at around eleven o’clock or at around three o’clock. Three o’clock is the big one where people are like, “Man, between 2:00 and 4:00 I have to take a nap. I have to get some chocolate, pick me up, caffeine, 5-hour energy.” Whatever it is, that’s really when they’re crashing, or they exercise and they have exercise intolerance where they exercise and then they’re crashed out for two days and they’re like, “I thought exercise was supposed to be good for me.” It’s like, “Yeah, but if your adrenals aren’t working well your body can’t manage the stress of that exercise.”

For those of you who don’t know, the adrenal gland is a little triangular gland, sits on top of the kidneys, produces cortisol and some of these other hormones which regulate so many parts of the body, so important and really the sentinel gland. As the adrenal gland goes, so goes the thyroid, so goes the sex hormones, so its really so pivotal, so important. So that’s the anatomy of the adrenal gland, the symptoms that you’ll get with it, and then in terms of testing like I said, I can tell really based off of their symptoms but sometimes you’re looking at a morning cortisol level which is what I do in blood but you can also look at saliva to look at four times a day, but those are kind of the big ones.

Urine can be helpful looking at urine metabolites from the adrenals, so all of those can kind of give you a glance. I do believe that looking at the symptoms are most important. And then in terms of treatment, I’ve tried lots of things over the last 10 years and I’ve dumped all of my protocols into the book, you can read more about this but I found that there’s this one product called Adrenal Px by Restorative Formulations that’s Eleuthero root, Hawthorn root, but mainly the Eleuthero root that’s super smooth and super strong that I have people take every three hours until 4:00 PM and it makes a world of difference in their overall function. It’s really the first thing that I do when you talked about the common causes, one of the most common causes is adrenal dysfunction, maybe it’s cortisol, maybe it’s some other components of the adrenal gland.  But starting to work on that adrenal gland, starting to work on sleep, behavior, food, those are kind of a lot of the big things that I do initially that can make a huge difference in people’s lives.

Dr. Weitz:            Cool, there’s a lot of discussion these days about checking the cortisol within like the first 30 minutes of waking up, it’s called the cortisol wakening response, and so now some saliva tests. You actually spit into a tube before you even get out of bed and apparently you get the most accurate assessment of cortisol apparently using that test now.

Dr. Hirsch:           Interesting. I’ve got a free Facebook group with almost 1,000 people in it and I just did a Facebook live review of some of the work that Ari Whitten did at the Energy Blueprint. He basically looked at all of the research on cortisol and its association with fatigue, and I think most of the research was on blood and on salivary, probably wasn’t on this new technology, but what he found, and time and time again, I mean he went over like, I don’t know, almost 100 different papers and meta analyses and there’s really no correlation between low cortisol levels and fatigue.

Dr. Weitz:            Interesting.

Dr. Hirsch:           Yeah, and so what I really think is happening is that there’s a number of these different components, these different hormones that are being produced by the adrenal gland, epinephrine and norepinephrine which are like the adrenaline hormones, maybe they’re playing a bigger role but utilizing just cortisol to determine someone’s adrenal function really hasn’t been proved and has been disproved in the research to be effective and functional. So we need some better tools but in the meantime I do use it and I combine it with symptoms, making sure that … Because those symptoms can be very specific for the adrenals.

Dr. Weitz:            How often do you actually prescribe cortisol itself?

Dr. Hirsch:           Great question, so like hydrocortisone, Cortef , some of those prescriptive agents?

Dr. Weitz:            Yes.

Dr. Hirsch:           So I have a tiered approach where I’ll start off with giving people Adrenal Px and then if they need I’ll ramp up to three capsules per dose, four capsules per dose. If they need more support I will put them on the Adrenal Px syrup which is a little bit stronger, and then if they need more support beyond that oftentimes and they have low blood pressure I’ll add in a little bit of licorice root and then I’ll move into a product called Adrenal Para-NS by Byron White Formulas, and then I’ll get into hydrocortisone. So there are problems with hydrocortisone, it is a steroid. I mean cortisol is also a steroid, we’re making our natural steroids but it can cause people to put on weight.  They get a little bit of this chipmunk appearance with the jowls and often times they may get a bit of a hump on the back and they do put on the weight and they do start craving a lot more food which causes them put on the weight. So it’s not perfect, there is a book called Safe Uses of Cortisol by William Jeffries where he did use it long term, and I have used it long term with some people but the goal is that it really is just a band-aid, because when we figure out what’s causing stress on the body and that could be a mental, emotional stress or it could be physical stressors like all that crap that’s in the body that I talked about before, once we remove those it allows the adrenal gland to relax. It doesn’t have to produce all these hormones and you shouldn’t need as much of the adrenal support.

Dr. Weitz:            Cool, now another important gland that affects energy levels is thyroid, can you talk about that a little bit? And how often is that playing a role?

Dr. Hirsch:           Absolutely. Thyroid dysfunction is huge and part of that has to do with the fact that low thyroid is really two conditions, it’s low thyroid production by the thyroid gland and then it’s also an autoimmune condition. So the immune system is attacking the thyroid, and usually it’s because one of those crap things, what I call the usual suspects, heavy metals, chemicals, molds, infections, allergies, emotions, EMFs, they’re all in the thyroid and so the immune system is trying to get rid of the stuff in the body that’s not supposed to be there. So it goes on over to the thyroid, calls its friend, starts attacking the thyroid to get at what’s in the thyroid, usually it’s mercury, maybe it’s Bartonella which is this particular kind of infection.

It grabs at it, tries to pull it out, oftentimes not successful because they’re so sinister but that’s kind of the process and in that process you’re destroying the thyroid and you get lower levels of thyroid.  So in order to fix it you have to remove the crap that’s in the thyroid, that’ll slow down the destruction of the thyroid or stop it.  Immune system is no longer gonna react to it and consequently you’re not decreasing your thyroid levels. Now, I do like to use prescription grade thyroid when I am replacing the thyroid.  I’ll start off with some natural things, some thyroid glandular or some iodine or kelp or some of these other things, but generally I find that I get the biggest shifts when I dive into using the prescription agents.

Sometimes people need more T4, sometimes people need more T3.  People who just use Armour or Nature-Throid or Westhroid, they’re missing the boat, that’s basically like a combination of T4 and T3 but everyone’s an individual and most of the time those people who come to me on Nature-Throid or Armour, they need more T4 or they need more T3. We have to figure out the right dose for that individual, and this combination product is not a one-size-fits-all, but thyroid plays a huge role. You also support the thyroid with the adrenals, and there’s this beautiful dance that happens between thyroid, adrenals and sex hormones, and they really all have to be present and accounted for in order for the whole system to work.  So somebody steps out of the dance like when you have stress with the adrenal gland and that’s gonna tax the thyroid and the sex hormones or you get above 50 and all of a sudden the gonads start to shut down and sex hormones start to go down. If the adrenals aren’t robust enough, they’re supposed to take over production of the sex hormones, but if they’re not robust enough, then both the adrenals and the thyroid will start to decrease their function as well, as they try to scramble and compensate for each other.

Dr. Weitz:            Do you find that gluten is sometimes playing a role where the body immune system attacks the gluten and then you get this cross reactivity with the thyroid?

Dr. Hirsch:           Yes, gluten definitely plays a huge role, gluten-

Dr. Weitz:            Soy.

Dr. Hirsch:           … dairy, soy, corn, genetically modified corn, those are kind of the big ones that I see but the only time I’ve ever been able to really reverse thyroid and to get people off of their thyroid medication has been going after infections and heavy metals. There’s one particular infection called Bartonella, this is a funny, serendipitous story where I had a patient who I had just put on a treatment for Bartonella. Now Bartonella is this infection that causes a combination of symptoms usually a combination of headaches, neck pain, problem sleeping, anxiety, depression, pain on the bottom of the feet, muscle cramps in the calves, stretch marks sort of rash on the body and thyroid issues, and so you don’t have to have all those you just have to have some of those. The big ones are like pain on the bottom of the feet usually misdiagnosed as plantar fasciitis and the muscle cramps.

But I put somebody on treatment for Bartonella and she comes back in like the next day and she’s in a thyroid storm. So she was on thyroid medication, I started her on this path and now she’s got too much thyroid, she’s like hyper thyroid. Her heart is beating out of her chest, she’s got tremors, she can’t sleep, she’s anxious, agitated, I said, “I don’t know what’s going on but we got to decrease your thyroid because you’re hyperthyroid.” So we decreased her thyroid and over time as we ramped up on treating her Bartonella we were able to wean her completely off of her thyroid medicine, which I’d never been able to do before.  I never heard of anybody being able to do this before, so it was very exciting.  And so I find that about 50% of people who have thyroid issues who also have Bartonella, I’m able to get them off or wean down off of their thyroid medication, maybe not all the way but a significant way down off of their meds.

Dr. Weitz:            Very cool. What kind of treatment did you use for the Bartonella?

Dr. Hirsch:           So I’m a big fan of Byron White Formulas. He’s just done an amazing job with his herbal complexes, and so A-BART is really one of my favorite formulas which has neem in it and poke root and a number of other things to break up biofilm, to kill the infection, to push it out of its hiding form.  It’s incredibly potent, so even just one drop can send people into a die-off or a Herxheimer reaction where you’re killing the bug and you feel worse, and so sometimes I even start people off topically, just rubbing it into their hands can make a huge difference for folks, but his formulas are really genius and I love to use them.

Dr. Weitz:            Interesting, yeah. I interviewed Darin Ingels who’s an expert on Lyme disease and he mentioned the Byron White Formulas as one of the formulas that he’ll use, and I guess Bartonella is often talked about as a Lyme co-infection.

Dr. Hirsch:           Exactly, yeah. Acutely it’s cat scratch fever, where people get big lymph nodes and they get fevers but chronically, yes it can exist in ticks and fleas and mosquitoes and all these things that transfer Lyme.  And I find that I don’t have to treat Lyme or Borellia as much when I’m going after these co-infections, whether it’s Bartonella, whether it’s Babesia that will cause people spontaneous sweating, shortness of breath, cough, awful panic and anxiety as well as depression and suicidal thoughts. I go after those guys and I don’t have to really go after the Lyme, Borellia as much because then the immune system will come back on board.  I get rid of the molds and the heavy metals that brings the immune system back even more, because you really can’t treat these infections until you get rid of the heavy metals, chemicals and molds that have distracted the immune system. So you got to bring that immune system back in order to bring these bugs back into check.

Dr. Weitz:            Cool, I noticed you were talking about using 20,000 units of vitamin D sometimes for patients with thyroid problems, that’s pretty high dosage, do you find that to be necessary to go that high?

Dr. Hirsch:           Yes, and it really depends on what we’re doing, but when we’re looking at the thyroid and we talked about it being an autoimmune disorder, one of the ways in order to modify the immune system and what’s called the Th1/Th2 balance. One of the aspects of the immune system is causing this autoimmune component, and you can adjust that by dealing with the T regulatory helper cells and you can do that with high dose vitamin D, you can do that with glutathione, you can do that with low dose Naltrexone.  So there’s a number of different strategies that we can use to bring that seesaw back into balance and decrease the amount of autoimmunity that’s happening to the thyroid.  And there’s been lots of studies on vitamin D and I know doctors who try to get people’s levels up to 100 or 150 units on the blood and I’m really looking for more 60 to 100 but people are so deficient that you can give them 20,000 and oftentimes it’s not gonna put them into excess of 100. Most people live at around 10,000 but yeah, 20,000 is also really great for colds, boosting that immune system so that it’s able to function at a higher level.

Dr. Weitz:            Yeah, you probably noticed patients who’ve been to their medical doctor who tested their vitamin D and they said, “Oh yeah, I’m taking plenty of vitamin D. I’m taking 1,000 units a day.

Dr. Hirsch:           Right, yeah it’s almost comical. And the levels when we’re looking at those labs, normal range is not a normal range. It’s not an optimal range, it’s a population-based range, so I’m always telling people … Because a lot of those labs say yeah, less than 20 is low for vitamin D and I’m saying less than 60.

Dr. Weitz:            Yeah, exactly. There was just a study that showed that women who got their vitamin D above 60 had the lowest risk for breast cancer. I noticed you mentioned PEMF which is a kind of electrical machine, right?  And you sometimes use that for patients with thyroid issues.

Dr. Hirsch:           I did. I was experimenting it for a while, probably around that time that I was writing the book. I don’t use it a lot, in part, because some of the ones that I’ve used have just been too strong for a lot of my patients. It opens up the capillaries where you’re able to absorb things a lot better and you’re able to detoxify and I really need more control over detoxification because a lot of my patients were feeling worse. It was also very dehydrating for them and when you have adrenal issues you don’t maintain your salt balance well and so consequently you’re chronically dehydrated, and so it was just a little bit too much. I was using the BEMER technology and some of those and it was just too strong on people.

Dr. Weitz:            You might look into using cold laser. There’s a research group out of Brazil that’s published several studies using cold laser directly over the thyroid, there’s a certain protocol and they’ve actually been able to show changes in the cells and actually reverse Hashimoto’s in some cases.

Dr. Hirsch:           Wow, I’m writing that down right now.

Dr. Weitz:            Yeah, I’ll send you a copy of one of the papers afterwards.

Dr. Hirsch:           Great, thank you.

Dr. Weitz:            So you also talk about trying to balance the sex hormones as something to look at when patients are suffering with chronic fatigue, maybe you could talk about that.

Dr. Hirsch:           Sure, so sex hormones, generally I’m looking at that for people who are over the age of 50, but when mold is introduced it’s incredibly common in any age, especially scratched my head for a while, I’ve had all these men that had low testosterone levels, low libido, stuff like that, turns out that most of those had mold and once we got rid of the mold then the libido came back, the testosterone levels came back up. So it really is about where’s the stress on the organism? How are the adrenal thyroid sex hormones playing a role? Can we do it with herbs? Sometimes I’ll use maca and different forms of maca to boost estrogen, progesterone, testosterone, but sometimes I’ll need to go …

I had a patient today in my office who I needed to give bioidentical hormones. So she’s 47 years old, she’s moving into menopause, she’s got hot flashes and sometimes in the interest of time and in the interest of helping somebody resolve their symptoms I’m like, “Okay, we’re gonna boost your adrenals and while we’re boosting those I’m also going to give you this symptom relief because this is gonna make everything work better as we remove these toxins out of your body.”

Dr. Weitz:            Cool, yeah. One of the problems I think is all these endocrine disrupting substances in the environment.

Dr. Hirsch:           Yeah, we tested her for toxins and we found that there were a bunch of organophosphates, so pesticides that were found in her urine in addition to some mycotoxins or mold toxins that were there too.

Dr. Weitz:            Yeah, I’ve tested hormones on about 20 men in the last several months and like 17 of them were low, especially in their free testosterone, even called up the lab and said, “Is there something wrong?” But I think it’s getting to be really common that these endocrine disrupting substances and potentially mold and heavy metals as well are interfering with testosterone production.

Dr. Hirsch:           You got it right there. Yeah, and they’re all stressing out the hormone system which is really … When it comes to options in the body, I tell people, “Does your body want to survive or does it want to procreate?” And right now it just wants to survive. It’s dealing with all that crap coming at it, it’s stressed out of its gourd and it’s gonna send as many of its resources as possible over to the adrenals, to the thyroid, and it’s not going to worry about the production of testosterone. You can actually see that also when you’re looking at the steroid hormone pathway, that half of it is kind of like adrenals and the other half is sex hormones and you can see how it would be diverted.

Dr. Weitz:            So let’s say you have a patient with chronic fatigue and you’ve looked at the thyroid and adrenal and maybe even addressed the sex hormones, and now you’re starting to think, “Okay, could there be an infection or maybe heavy metals or mold,” and there’s nothing really clear in their history, how do you decide which way to go?

Dr. Hirsch:           So that’s where the labs come into play, because I’ve definitely been proven wrong. And actually another person I had today, I was like, “Well there is no history of known mold exposure.” Now most people don’t ever think that they’ve had mold exposure unless it’s been on the wall, and so I have to ask them, “Okay, have you ever lived in a place that had a leak in the roof or had a flood in the basement or had a broken pipe?” And then people say no and then inevitably they’ll come back the next time and say, “You know what? I think I did.” But it’s so nebulous and it could be that it was a place that they were growing up when they were five and they don’t remember. And so it’s all about the testing, it’s all about having good tests in the urine mycotoxin which is looking at the mold toxins is really the best test out there.  Now you have to propagate it with glutathione so you have to make sure that somebody’s taking glutathione so that they can push all of the micro toxins out and make sure you get a good test.

Dr. Weitz:            Oh, interesting. How much and how long do they have to take the glutathione for before you do the urine test?

Dr. Hirsch:           So seven days, 500 milligrams of liposomal glutathione twice a day, so that’s like a teaspoon twice a day of the ReadiSorb glutathione or the Tri-Fortify liposomal glutathione by Research Nutritionals, and so either one of those should work but seven days or however long. If they can’t take it for seven days because they start to feel like crap because they’re mobilizing all this crap that’s in their body, then just have them take it on that day so that they don’t have to suffer, but generally seven days, twice a day, 500 milligrams and then they do that test but that’s the urine test for the mycotoxins, the urine provocated test for heavy metals utilizing DMSA, really the best ways to get these things out of the body so that you can test them and determine what’s going on.  The PCR tests are basically a DNA test for a lot of these Lyme type infections in the urine through DNA connections is the best test out there. So there are a number of different tests but you got to make sure you’re looking at the right one.

Dr. Weitz:            Which test do you use for the mold? Do you use the Great Plains mycotoxin test?

Dr. Hirsch:           I’ll use both of them, the Great Plains or the RealTime Labs but Great Plains, less expensive, does a great job, I really like what they’re doing. RealTime Labs is covered by Medicare, they also do a great job and they’re expanding their panel a little bit more but I’ll use either one but the Great Plains is less expensive.

Dr. Weitz:            Cool, and then how do you assess for heavy metals?

Dr. Hirsch:           So I’ll use Doctor’s Data, looking at the DMSA provocation test where people take 10 milligrams per pound of body weight, so if they’re 200 pounds or over they’ll take 2,000 milligrams. But I do a pre and a post, so you wake up in the morning and you check your urine and that’s the pretest and that tells you what’s floating around in the bloodstream, and then you take 2,000 milligrams or whatever your weight is of the DMSA and then that’s gonna start pulling out the heavy metals from the tissues, from the organs, because that’s where the heavy metals live. They don’t live in the bloodstream, that’s why when you do a blood test for lead it’s really worthless, blood test for mercury, worthless.

You have to pull it out from the tissues and then you check it in the urine, you collect the urine for the next six hours and then you compare the two and that can give you some really good information as to whether or not someone has a heavy metal. And then there’s a lot of nuances to it because if they’re detoxification pathways are really clogged up with molds or chemicals then they’re not going to have a very positive results or if you detoxify them for a period of time then all of a sudden they’re gonna be releasing a lot more mercury, so they’re going to be like, “Why is my mercury getting worse?” Well it’s not getting worse it’s just that when you were detoxifying initially you could only get rid of up to this amount of mercury, but now that your detoxification pathways are so much open now you’re able to get rid of so much more mercury out of your body. So there’s a lot of nuances to that and I do talk about some of that in my book.

Dr. Weitz:            Interesting. Is there a way to screen for some of the other chemicals besides heavy metals, like the endocrine disrupting substances.

Dr. Hirsch:           So I use the Great Plains Lab, they’re GPL-TOX tests which looks at kind of a hundred different chemicals and that’s a really great test as well, and also should be provocated with the glutathione.

Dr. Weitz:            Okay, great. And then how do you get rid of heavy metals?

Dr. Hirsch:           So that is a great question too, so there are some more aggressive techniques or some more gentle ones. You can use things like saunas and coffee enemas and cilantro and chlorella and modified citrus pectin. I use a combination of products by Byron White. A combination that opens up the liver and kidney pathways, helps open up lymph neurolymph so basically lymph that’s in the brain, and our lymph system is really our garbage can or trash system that really helps to move things through, and then a product that he’s got called Envi-Rad which helps to get the metals out as well as the chemicals.  And in a study that Byron White did on his patients, he found that over a 10-day period when he combined all of these products he saw a 300% increase in excretion of metals in the urine which is pretty darn equivalent to doing it with DMSA which has a lot more side effects and consequences, and you have to make sure that you’re replacing a lot of the minerals and a number of other things. You have to protect the liver and the kidneys while you’re doing that so it has a lot more nuances to it, and so I’ve been very pleased with using this Byron White protocol.

Dr. Weitz:            Cool, how long does that protocol typically take?

Dr. Hirsch:           So it depends on the person, generally the people who are coming to see me need to do it for sometimes six months, sometimes 36 months, so it really depends. I tell people, I say, “I’d like to get you better in a year but depending on the number of causes you have and your ability to tolerate these supplements that I recommend will determine on whether it’s a year or whether it’s three years.”

Dr. Weitz:            Now, do you look at the guy to make sure that they are not constipated, so they’re actually excreting these toxins to make sure they don’t have a leaky gut so they don’t get reabsorbed.

Dr. Hirsch:           That’s a very important point. Nobody should ever be doing any sort of detoxification unless they can get things out of the body, and that means that you’re peeing regularly, you’re pooping regularly, that you’re sweating regularly, that you’re able to exhale. Those are the ways that we detoxify our bodies and so you have to be able to be stooling on a regular basis, once or twice a day. And so I’ll use magnesium to bowel tolerance, but a lot of times when … Constipation has a cause, it could be thyroid and I kind of have a chapter, I’ll dedicate it to this in the book. It could be thyroid, it could be parasites, it could be yeast, it could be a number of these infections that I test.  I really like that GI-Map stool test, really works well.

Dr. Weitz:            Yeah, we’ve been using that a lot too.

Dr. Hirsch:           Yeah, and it gives you a lot of good data and then you can determine whether or not you need to fix it, but everybody that I see has got a leaky gut because they have all these causes of fatigue which also all damage the gut, so there has to be some leaky gut repair. But I found that I’m just wasting time and money to try to heal leaky gut when someone’s got heavy metals, chemicals and molds. I can heal the gut at the same time as going after the fatigue by going after parasites or yeast, but it just doesn’t make a lot of sense for me when I’m treating these really sick people to go after that leaky gut and spending a lot of time there.

Dr. Weitz:            Yeah, especially if their primary symptom is not gut related so you have to prioritize.

Dr. Hirsch:           Exactly.

Dr. Weitz:            Yeah, so the final topic I want to touch on is mitochondria which is that part of the cell that’s truly responsible for producing energy, can you talk about how we think about the mitochondria with respect to fatigue?

Dr. Hirsch:           Absolutely, so the mitochondria like you said is the energy center of every cell in the body except for red blood cells, they don’t have them, but it produces about 70 to 80% of our energy, our ATP as it is. And so the mitochondria comes from a bacterial ancestor, it has this very important mitochondrial membrane which can get damaged by heavy metals, chemicals, molds, infections, allergies, emotions, EMFs, like all these things are going to damage that mitochondria, and so not only do we have to remove that crap off of the mitochondria but we also have to inject the mitochondria with some good love in the form of like Acetyl-L-carnitine, L-carnitine and D-Ribose, CoQ10.

There’s a number of things that I really like to use but the most important thing I think is also to heal that mitochondrial membrane, because what people forget sometimes is that around that cell, that membrane, is the communication tool for other cells, so there’s these ion channels, there’s these messengers that need to be working, and so one of my favorite products is ATP Fuel by Research Nutritionals which does wonderful things for healing the mitochondria and then repairing that mitochondrial membrane. And they did a study on 58 people, and after the saturation you’ve got to boost it up, taking it twice a day for the first two months but after the first two months they saw a 30% average increase in energy.  So just a really nice bump of one or two points of someone’s energy just from doing that, now imagine if you’re also boosting the adrenals, boosting the thyroid, B12, vitamin D, magnesium and then also removing the crap out of the body, you’re gonna get a lot better energy and a lot better function.

Dr. Weitz:            Cool, I feel more energetic already doc. So thanks for the interview Evan, this is really good. How can listeners get a hold of you?

Dr. Hirsch:           So you can find me at fixyourfatigue.org, F-I-X-Y-O-U-R-F-A-T-I-G-U-E.org. You can also check out my free Facebook group which is Fix Your Fatigue With Dr. Evan, you can find that from my website as well. I do have a free download on my website of my book, so if you want to get it on Kindle or on Amazon as Kindle or paperback you’re more than welcome, but you can also download the PDF for free, and I’ve really dumped all of my protocols into there so you can figure out how to solve your fatigue. And I do have about 10 spots available for one-on-one and group coaching right now, so if people are interested I’ll be filling that up in the next month or so. But otherwise, I’m on a mission to help a million people resolve their chronic fatigue so thanks so much for having me on and helping me with my mission.

Dr. Weitz:            Cool, that’s great, that’s a great mission doc. Talk to you soon.

Dr. Hirsch:           Thanks so much.



Detoxification with Dr. Bob Rakowski: Rational Wellness Podcast 69

Dr. Bob Rakowski talks about how to detoxify your body with Dr. Ben Weitz. 

[If you enjoy this podcast, please give us a rating and review on Itunes, so more people will find The Rational Wellness Podcast] 


Podcast Highlights

3:35  Environmental toxins are so insidious, that we just can’t avoid them.  Dr. Federica Ferrara is a researcher from Columbia University, who’s been studying this for over a decade and she literally took air samples from very sophisticated mechanisms that she had pregnant women wear all over the country and every single woman, every single day, was exposed to these neurotoxins that were known to cause harm to the developing fetus.

4:44  We can start by detoxing our kitchens and don’t buy any unhealthy, processed foods that you shouldn’t be eating, so you remove temptations.  We also need to be concerned about all our exposure to wifi and electromagnetic forces, so unplug your wifi, have a digital sunset, have a day without any electronics, to give our brains a rest.

7:32  In order to detox our bodies, Dr. Bob has been talking about the magnificent seven–You gotta eat right, drink right, think right, move right, sleep right, poop right, talk right, every single day.  So, when we’re gonna eat right, we want to avoid the toxins and yet we want to get the nutrients that help our body to cleanse, so detox is a very nutrient dependent, and believe it or not, protein dependent process. We also want to make sure you are pooping right, since this is how we get rid of toxins. Dr. Rakowski also mentioned one of his favorite quotes, from Jack Lalanne, who happened to be a chiropractor, he said, “If God made it, it’s okay; if man made it, don’t touch it.”  “Move right actually helps to detoxify. There’s no doubt about it that movement, we’re gonna exhale, we’re gonna blow off carbon dioxide, we’re gonna sweat, that’s a pathway.”

12:10  Poop right means that you should go at least once a day and preferably multiple times.  You should have enough fiber so it goes through easy.  What controls bowel function is fiber, water and neurologic tone.

13:20  Talk right–every cell’s in communication with every other, so we gotta make those cells right and flexible and responsive and have the right acid alkaline balance. Acid is the top toxin that we make.

13:30  Sleep right, since we detoxify our brain and body when we sleep, and we go through a liver detoxification in the middle of the night. 

14:12  If we don’t have good digestive function and we are not pooping regularly, then estrogen and toxins that need to be eliminated will get reabsorbed. And if we have leaky gut, as one in two people have, these toxins will pass through the gut wall directly into the blood stream.  Dr. Rakowski says “You are what you eat, and that’s pretty true. You are what you absorb, that’s more true. You are what you don’t eliminate. That’s most true!”

17:58  In order to facilitate liver detoxification, Dr. Bob likes to have his patients do a seven day detox with Medical Foods, like the Ultraclear Renew from Metagenics, and organic, non-starchy vegetables only. If you try detoxing by fasting, within 24 hours of the fast, since the liver is protein and nutrient dependent, liver detoxification will slow down by 50% before you start breaking down your own tissue. Some people try to do liver detox with food and he quotes a study from the Journal of Advances in Therapy that found that food is too weak to replete the depleted cells and bodies, therefore supplementation is advisable for everybody.  Dr. Rakowski has treated hundreds of high level celebrities, professional athletes, and Olympians with his 7 day Medical Food detox and he has found that many of the Olympians set a season or personal best within a week of completing the detox.  He recommends doing this one week intense detox twice per year.

26:58  Too many in our society don’t get enough sleep and Dr. Bob likes to use calming adaptogens and theanine from green tea, which is a GABA facilitator and is very calming. People need a sleep routine and a dark, cool room without wifi.  The best of the best need 8.6 hours of sleep per night.  Dr. Rakowski personally takes 50 mg of timed release melatonin at bed. He mentioned an NIH study in which they administered 50 mg of melatonin and vitamin D and they found that it prolongs survivability and prevented lean tissue breakdown in inoperable cancer patients. Melatonin does not cross the blood brain barrier.  Dr. Rakowski notes that in the last decade his biological aging has been very slight.



Dr. Bob Rakowski is a Doctor of Chiropractic, Certified Clinical Nutritionist, and the director of the Natural Medicine Center in Houston Texas. Dr. Rakowski is available for consultations in person or remote via Skype or Zoom and he can be reached through his website, http://thedrbob.com

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.


Podcast Transcripts

Dr. Weitz:                            This is Dr. Ben Weitz with the Rational Wellness podcast, bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to Rational Wellness podcast on iTunes and YouTube, and sign up for my free ebook on my website, by going to drweitz.com. Let’s get started on your road to better help.  Hey Rational Wellness podcasters, thank you so much for joining me again today. For those of you who enjoy the Rational Wellness podcast, please leave us your ratings and your review on iTunes so more people can find out about the Rational Wellness podcast.

Our topic for today is toxins and how to remove them by conducting a proper detoxification program. Our modern world has many toxic substances in the air, food, water, as well in products … as well as in products that we cook with, clean our homes, apply to our skin, hair, teeth and various other personal care products, products that we use on our lawns, and products that we use in construction and painting our homes.  We often find fluoride, chlorine, and sometimes ammonia that are purposely added to our public drinking water as well as small amounts of prescription medicines. We’ve all heard about the lead in the water in Flint, Michigan, but other … But a recent scientific American report found thousands of cities across America with toxic levels of lead in your drinking water. A recent report from the Environmental Working Group demonstrated that there are toxic levels of PFCs, a certain type of chemical, in the drinking water of 15 million Americans in 27 different states.  These PFCs are chemicals that come from nonstick cookware, such as Teflon coated pans, stain resistant coatings on carpets, upholstery, and clothing such as scotch guard, lining fast food containers, pizza boxes, candy wrappers, and microwave popcorn bags. These are also in paints, sealants, anyway, I could go on and on about toxic chemicals in our modern environment, and these chemicals make our way into our bodies and often, are stored there.  The Environmental Working Group conducted a study in 2009 that found measurable levels of BPA in umbilical cords of nine out of ten infants, as many as 232 chemicals were found in the umbilical cord blood of infants before they even stepped foot in the world. I’m glad that we have Dr. Bob Rakowski with us today to give us some information on how we can start to get some of these toxins out of our bodies.

 Dr. Bob Rakowski is a chiropractor, kinesiologist, certified clinical nutritionist, certified biological terrain instructor, and the clinic director of the Natural Medicine Center in Houston, Texas. In addition to running a busy chiropractic and functional medicine practice, Dr. Rakowski has lectured internationally for over 25 years on various topics in natural and lifestyle medicine. Dr. Bob, thank you so much for joining me today.

Dr. Rakowski:                     You’re welcome. I tend to like to smile whenever I’m on camera, but I probably couldn’t help but have a scowl as you were sharing the grim reality of these toxins that, literally, it’s been said, environmental toxins are on the attack, because they’re so insidious. We just can’t avoid them, and in fact, if you don’t mind me throwing out a little research, there’s a researcher from Columbia University, Dr. Federica Ferrara, who’s been studying this for over a decade and she literally took air samples from very sophisticated mechanisms that she had pregnant women wear all over the country and every single woman, every single day, was exposed to these neurotoxins that were known to cause harm to the developing fetus.  And so, we’ve gotten to the point where, you know what, they’re everywhere, so what do we do about it? I guess that’s the topic for our beautiful conversation today.

Dr. Weitz:                            Exactly, exactly. So, what can we do to … Before we go into detox, what kinds of … What do you think are some of the most important things we can do to try to avoid being exposed to these toxins?

Dr. Rakowski:                     Well, you said a lot of things right there, so the number one rule in toxicology is to separate yourself from the toxic source. So, maybe the first thing you want to detox is your kitchen.  There’s a great mentor out there, his name is Bryan Tracy, he asks a couple of simple questions. What’s the one thing that you can start doing that you haven’t been doing that’ll improve your life the most? And what’s the one thing that you can stop doing?

Well, we can do the same thing with nutrition. Most of us are going to make faster progress by stopping putting garbage in our body and if you’re like me, I can resist almost anything but temptation, so if it’s in my kitchen, there’s a little bit of a challenge. I’m more likely to take it then. So, get your, buy your willpower by either shopping online, sending someone else to the store, stay in the periphery, don’t go down the center aisles with all that packaged garbage.

So detox your kitchen and have strategies there, but we’re taking advantage of this beautiful communication medium and this may be beyond the level of what we’re talking about in terms of chlorine from our body, but we’re exposed to wifi and electromagnetics and things at a level that people have just never been exposed to before, and the data shows that there’s problems. In fact, I’m a little older than you, but Henry Kissinger was Nixon’s Secretary of State-

Dr. Weitz:                            Oh, no. I remember Henry Kissinger.

Dr. Rakowski:                     Yeah, brilliant guy, but basically this guy says, “You know what, the disease of the modern century with all the exposure is actually gonna be insanity because our brain never unplugs from the input and that overstimulated brain is in a very unhealthy state.” So mental illness is happening earlier and faster. So, unplug your wifi, have a digital sunset, have a day without any electronics, clean out your kitchen, and then a lot of times when people think about detoxification, they think, “Well, okay, I’ll do something to enhance my bowel function.”  But you’ve got the liver, the kidneys, the bowel, the skin, and the lungs, all such critical part of detoxification. There’s things we can do for all of them.

Dr. Weitz:                            Oh, absolutely. Everybody should unplug their wifi at night if possible, just hard wire everything, get rid of wifi as much as you can, don’t have your phone in your room. Don’t have your alarm clock next to your bed. There’s a million things we can do. In fact, just consider the fact that if you’re laying there at night on a mattress with metal coils and you’ve got your wifi on, you’re concentrating all those radio waves-

Dr. Rakowski:                     Tell them no thank you. No.

Dr. Weitz:                            So, let’s start talking about what we can do to detox our bodies. How can we really get rid of these toxins?

Dr. Rakowski:                     All right. So for years, I’ve talked about the magnificent seven. You gotta eat right, drink right, think right, move right, sleep right, poop right, talk right, every single day.  And that poop right is kind of the elimination process, but all seven have something to do with it. So, when we’re gonna eat right, we want to avoid the toxins and yet we want to get the nutrients that help our body to cleanse, so detox is a very nutrient dependent, and believe it or not, protein dependent process.

So, if we talk about this wonderful organ called the liver, there is phase one of liver detoxification, which by the way, I like to make the analogy of that’s like burning garbage in your fireplace. So maybe let me take a step back on that. So, partly what I like to tell people is, imagine you have an old time home and you had two ways of getting rid of garbage. You could flush it down the toilet or you could burn it in the fireplace. Well, the toilet, we’re gonna call that the plumbing system, that’d be the bowel and the kidney’s and if that backs ups, guess what? We want to do something about that right away.

But if you burn garbage in the fireplace, now you gotta get the smoke out of the chimney. And so, phase one is actually burning the fire, that is an enzyme dependent process. So the liver has a series of enzymes called cytochrome P450s and there’s more than 75 that are known now, but these are all protein dependent. So sometimes people say, “I’m gonna go on a fast or a juice fast, I’m gonna detox.” Well, if the body doesn’t have the protein from your diet to detox, it’s gonna take the protein from your stores.

It’s gonna breakdown the lean tissue or possibly liver proteins, like albumen and globulin, in extreme cases, even hemoglobin, that can break down. But you don’t want your body breaking down the detox, you want to have it present with the amount of proteins that are needed, and then phase two has a lot of micronutrients. So, as you and I know and have discussed in the past, there’s literally detox formulations by really sophisticated companies where they’ve actually put it to the test. They put it through human clinical trials, exposed people to certain levels of toxins and found out, “Wow, they neutralized them and pass them through when we support them with these nutrients.”

So those are different types of medical foods or functional foods that we can do it, but when we go back to eating right, I have a couple favorite quotes. One is from Jack LaLanne, who happened to be a chiropractor, he said, “If God made it, it’s okay; if man made it, don’t touch it.” Michael Pollan, listed by people as one of the top 100 most influential people on planet Earth said, “Eat food …” Go for it.

Dr. Weitz:                            No, I was gonna say, the guy who wrote Omnivore’s Dilemma and … Yeah.

Dr. Rakowski:                     In Defense of Food, the subtitle is, “Eat food, not too much, mostly plants.” And so we break that down, I wish he’d said, “Eat natural organic food grown in nutritious nutrient dense soil, multiple colors every day, mostly plants.” So why mostly … Why not too much food? Well, we’re overeating as a general rule.  We have more people dying from overeating than starvation now and that’s the first time in the history of the planet that that’s happening. Why mostly plants? Simple enough, data from Bruce Ames Geneticist from the University of California Berkeley, people that eat the most fruits and vegetables get the least cancer. Those that eat the least, get the most cancer. So we want to get all those good plant nutrients in our system.  When it comes to drinking right, we can detoxify with drinking. I’ve got a nice detox tea here in front of me, but there’s plenty of great herbal teas. I have a big propensity towards drinking organic coffee has actually been shown in massive studies to actually increase longevity, and there’s people talking about bullet proof coffee and I actually have a way I believe of making coffee bomb proof instead of bullet proof. That could be another topic-

Dr. Weitz:                            Bomb proof coffee.

Dr. Rakowski:                     Bomb proof coffee, baby. That’s the way to go. We don’t want liquid calories, we want to detox with it, and then think right, guess what? You detoxify your mind through meditation. That’s been described as like a shower for your mind. I was sharing that this weekend at a conference. I had about 70 doctors in attendance, but I said, “Just imagine that the doctor next to you hadn’t showered today. Or maybe, how about they haven’t showered this week? Or maybe this month or maybe this year, or maybe ever?” I said, “That’s our mind. We have to shower our mind with good meditation.”

Move right actually helps the detoxify. There’s no doubt about it that movement, we’re gonna exhale, we’re gonna blow off carbon dioxide, we’re gonna sweat, that’s a pathway. Poop right, guess what, that’s certainly gonna be the bowel function and I was actually lecturing at NASA, and believe it or not, a rocket scientist asked me, he says, “Well, Dr. Bob, how exactly does one poop right?” And believe it or not, people don’t know. You gotta go at least once a day, preferably multiple times. You should have enough fiber that it goes through easy. Bowel function is fiber, water and neurologic tone, and it should have a certain color and consistency. Talk right, every cell in our body is potentially-

Dr. Weitz:            When it comes to poop, I think that digestive problems are so endemic, they’re so common in our society that I think people have forgotten what proper bowel function is. There’s, I mean, you start questioning how many people have either constipation or diarrhea or gas or bloating, abdominal discomfort, reflux, etc., it’s unbelievable.

Dr. Rakowski:                     Well, I’ll give you a stat. This is the American College of Gastroenterology. They say one in two, one in two, that could be me or you on this podcast, thank God it’s neither of us, have chronic digestive disturbance. It’s really a crime against humanity.

Dr. Weitz:                            Yeah.

Dr. Rakowski:                     Talk right, guess what, every cell’s in communication with every other, so we gotta make those cells right and flexible and responsive and have the right acid alkaline balance. Acid is the top toxin that we make and then finally sleep right, and believe it or not, we detoxify our brain and body when we sleep, and actually studies show, and Chinese medicine is known for thousands of years, how they knew I’m not sure, we go through a liver detoxification in the middle of the night.  And so we want to be asleep at that time. So, body’s have good systems. By the way, just on sleep, ’cause I’m kind of a sleep nerd, Anders Erickson, who is probably the world’s leading authority on peak performance wrote a book called Peak, and he said the best of the best of the best in any endeavor, sleep 8.6 hours a night. They nourish, rest, and recover the brain and body, and what a beautiful stat that is. So I’m a big sleep man.

Dr. Weitz:                            Yeah, some of the important things about digestion are that when we do get rid of toxins through our liver, most of those toxins are excreted through our stool and so if you’re constipated, a lot of those toxins are gonna get reabsorbed. So, something like estrogen is just gonna get resorbed and reabsorbed and we’re gonna have problems with all these toxins. So, you gotta be eliminating, so you gotta have good digestive function and then if you have a leaky gut, a lot of these toxins are just gonna cross directly into your blood stream.

Dr. Rakowski:                     And at least one in two people walking around are dealing with that challenge. Just ’cause I like words and little phrases that are memorable, most of us have heard, “You are what you eat,” and that’s pretty true. You are what you absorb, that’s more true. You are what you don’t eliminate. That’s most true. And that probably needs to raise the level of concern in some people. We want to keep those bowels moving, every single day, and preferably multiple times a day.

Dr. Weitz:                            So what are some of your keys to making sure people have a good digestive system?

Dr. Rakowski:                     Well, I’m gonna tell. It’s fiber, water and neurologic tone. And it’s also habit. So we know that bodies have routines and reality is, if people need to use the restroom, they need to know that they need to honor that reflex. So there’s a reflex that’s existent in all of us, but especially in infants, it’s called the gastrocolic reflex, and so when they eat, they poop, when they eat, they poop, when they eat, they poop. So you put something in, something comes out the back end. That seems to work pretty well.  But somehow, someway, we begin to start to suppress that reflex and then it becomes suppressed to the point where it becomes nonfunctional and we see too many people. So if they’re gonna retrain the bowel, they want to increase their fiber, they want to increase their water, and then when it comes to neurologic tone, that’s an interesting term, really muscle balance, but by stretching the colon, the colon has a stretch reflex to eliminate.  So there’s fibers and I like people to rotate their fibers and get most of them from organic fruits and vegetables, but they can certainly supplement. There’s a form of magnesium that I like a lot called magnesium citrate and it’s a very poorly absorbable form of magnesium, so it pulls water into the gut and it helps that bowel function, but people need to honor their bowels.

 I’ll tell a funny story. My kids are now 24, 21, and 20, but when my son was six years old, he already knew the importance of bowel function. So he was shopping at the mall with my wife and he always kept saying, “Mom, I have to go to the bathroom. Mom, I have to go to the bathroom.” He probably likes to shop as much as I did. But Kelly said, “Jacob, you don’t have to go to the bathroom.” He looked at her and said, “Mom, actually I do. I have to poop. Think about all those toxins I’m absorbing.” What a great point, right?  And so Kelly did just what you did, she laughed and she took him to the restroom and said, “Okay, you win. Go. Honor your body.”

Dr. Weitz:                            Did your son become a chiropractor or nutritionist?

Dr. Rakowski:                     You know what, he has a nutrition company that he owns, and actually, super proud of him, proud of all my kids, but he’s basically retired, financially free by the time he was 22 years old.

Dr. Weitz:                            Wow.

Dr. Rakowski:                     But his mother taught him well. But yeah. The picture of health as my kids are, all of them are, solid individuals that honor what they put in their body and honor the functions of their body.

Dr. Weitz:                            That’s great. So, how do we facilitate liver detoxification?

Dr. Rakowski:                     We gotta do it with nutrients. And by the way, that’s my top way of doing it, ’cause it’s nutrient dependent and it’s energy dependent, so we’re gonna start with proteins. We gotta have enough protein and it’s known within 24 hours of fast, that phase one of liver detoxification is gonna slow down by about 50% before you start breaking down your own tissue.

So some people try to do it with food and I’ll quote a study from the Journal of Advances in Therapy, they literally took people that were aged matched, health matched, gave one group an organic diet, the other group organic and supplements, they did tissue biopsies of the nutrient level at the start of the study and end of the study, people that got the best organic diet did not improve their nutrition status one bit. But people that supplemented did, so here was the conclusion. They said food is too weak to replete the depleted cells and bodies, therefore supplementation is advisable for everybody.

So, you could play it simple and go with a multivitamin, Omega 3s and plant nutrients and super foods and vitamin D and things everybody needs, but I’m a big fan of Medical Foods and functional foods. So I consume them myself, let’s say conservatively, 300 days a year. And I recommend that to my patient base as well. My rule of thumb in clinical practice, and I see some pretty amazing patients, high level celebrities and athletes and Olympians, when in doubt, detox.

So we’re gonna put people on an intense seven day detox where they’re only gonna do detox support nutrients and Medical Foods and organic diet, and then a pretty big dose. For a big guy, I might do six or seven servings of the Medical Foods a day. I’ve treated some NFL players that have done really well with that, and then at the end of the week, we see how they’re doing and … I’ve got a, literally, an interview I did with an Olympic coach and he said, “You know what, some people might think this is not a good idea in the hard part of training,” he says, “But all my athletes, and I’ve treated over 50 Olympians,” he said, “set a personal best or season best within a week of doing it.”

I like the idea of nothing but Medical Food shakes and organic vegetables, non starchy for that matter, low glycemic index, ’cause you don’t want to spike blood sugar, and get people to get the right fiber, the right water, the right elimination to help their body through. As I tell people, it’s been published now for well over 20 years in the clinical literature, symptoms of chronic poisoning include fatigue, sleep disturbance, intestinal distress, allergy symptoms, headaches, confusion and anxiety, and guess what? Those things can actually temporarily get worse on a detox, and so people will call me and say, “This ain’t working. I’m sick as a dog.” I say, “No, it’s working. The reason you’re sick as a dog is it is working.”

So we can either, one, tough it out, which believe it or not, a lot of people decide to, ’cause after a few days, this too shall pass; we can buffer it with other nutrients, things that support glutathione or bowel function or kidney function, or they can slow down the process. Stop, slow down, support it, or tough it out.

Dr. Weitz:                            Yeah, a lot of people talk about glutathione, NAC, lipoic acid are really important nutrients for facilitating detoxification. Do you use glutathione in your practice?

Dr. Rakowski:                     Yes, and no. Not to a high level, but certainly I’m going to support it in every different way. It’s a tripeptide, glutamine, glycine and cysteine and so for most people, cysteine, which is a sulfur containing amino acid, is a rate-limiting step, but cysteine, most of it’s derived from something called methionine, I don’t know if we want to get too deep about chemistry, but that requires B vitamins, activated B vitamins and more Bs then to actually help the body convert that all the way down to glutathione.

Another factor is in that pathway, the body can deplete a lot of its cysteine in making something in the body called metallothionein proteins, which by the way is another detox protein, but it clears out heavy metals. You mentioned the lead in the drinking water, but the data shows the modern skeleton contains 500 to 1,000 times the lead of preindustrial humans, so heavy metal detox, guess what, that’s a different thing altogether, and there’s different nutrients that drive that process, as well.

Dr. Weitz:                            Yeah. We do a NutraEval on a lot of our new patients and that includes a heavy metal panel and we see a lot of mercury, a lot of people with elevated metals, very common.

Dr. Rakowski:                     And certainly that’s gonna deplete glutathione along the same path. So pretty tough game. A good comprehensive doc like yourself that knows what to look for and knows how to guide people through. Guess what, people are struggling and they need what they offer, what we offer.

Dr. Weitz:                            Yeah, a lot of people are shocked to see how high their mercury levels are, and a lot of it’s coming from fish.

Dr. Rakowski:                     Yeah, I’ve been in clinical practice 26 years and there was a clinic, basically in the same center as mine, called the Detoxification Centers of Texas, and they would actually infuse substances that were known to pull out heavy metal and capture a 24 hour urine, and they did this for the purpose of documentation, really to get insurance reimbursement. But I asked the clinic director, I said, “Look, how long you been doing this?” And she said, “Well, 12 years.” I said, how many negatives have you seen? In other words, nobody had an excess of heavy metals.” She said, “Bob, zero. Zero. It’s just ubiquitous. We’ve got these metals in our system.” Now, are they harmful to everybody? Probably not. We have different sensitivities, but are they harmful to all people? Yeah, and they don’t know it. So it’s a good thing to find out.

Dr. Weitz:                            Yeah, a lot of times, they have unusual reactions. Some people will have elevated LDL cholesterol levels, some people will have … It’ll affect their digestion. Some people, it’ll affect their concentration and memory and so it really can affect your metabolism a lot of different ways and you don’t know it unless you really just test for it.

Dr. Rakowski:                     Yeah. I think it may be the best kept secret in all of medicine that we can pull these poisons out of the system and like we said, fatigue, sleep disturbance, intestinal distress, allergy symptoms, headaches, confusion, anxiety and other things can all get better with a good detox.

Dr. Weitz:                            So, after doing a one week detox, what can people do on an ongoing basis to continue to detox and so that they’re continuing to remove metals or remove toxins and reduce their burden as they go through their life?

Dr. Rakowski:                     If you don’t mind, I’m gonna answer that just a slightly different way. So I recommend the intense week twice a year, but I’ll often be asked at my seminars, “How long should we detox?” And the way I teach that is by saying, “Let’s do a little experiment. I’ll set my watch and let’s all stop detoxing right now.” Which, by the way, the basic element of detox is to exhale. So the room is dead in five minutes.  We know that we constantly need to support that, and we know with every breath, believe it or not, we’re taking in these toxins, and as our body makes energy, we create toxins, so we need ongoing daily support, and that’s why I said I’m gonna consume these functional food shakes myself, at least 300 days a year and many of those 300 days, I’m gonna take two or more per day. And so, I actually lectured in Orlando, Florida when Barry Sears, who wrote the book The Zone, released it. And he had the USDA food pyramid, which now they have their plate, which is not much better, but they had their pyramid back then with 9 to 11 servings of processed carbohydrates at the base of the pyramid.

And Barry Sears said this, he said, “If ever there was a terrorist like plot designed to take the health of the world down, this would be it.” But so I created a life pyramid where I have love at the base and purpose and discipline, but I also have a food pyramid. And so the base is gonna be food, organic food, not too much, mostly plants. The next one is gonna be super foods, so there’s tons of those. My favorite is ganoderma, which is also known as reishi. There’s aloe and there’s spirulina and there’s goji berries and acai berries.  Lots of berries are actually super foods in and of themselves. And then we move up and I think everybody should take a nice bioabsorbable multivitamin and then they should take omega 3s and probiotics and now we know instead of D, there should be a D3 K2 combo, and those are actually if you’re counting seven. So I like sevens, the magnificent seven. And the seven things we need in our nutrition pyramid.  Accompany that with seven good nights of sleep a week and at least seven good bowel movements, and we’re gonna be in pretty good shape.

Dr. Weitz:                            There you go. As far as sleep goes, there are many in our society that don’t get adequate amounts of sleep.

Dr. Rakowski:                     Too many, too many, and so there’s a lot of calming adaptogens for the central nervous system. Green tea has an amino acid in it called theanine, and theanine’s very calming, so it buffers the caffeine in green tea. I like straight theanine, which is a known, if your listeners are familiar with the term GABA facilitator, very, very calming.

Melatonin, we now know that melatonin is, believe it or not, even in single cell organisms, it’s a mitochondrial specific antioxidant, enhances human energy production. The gut makes 400 times the amount of melatonin as the brain and melatonin puts the brakes on our stress drive in our body. So since the gut has so much, it likely doesn’t cross the blood brain barrier, but by calming our stress response, that’s often calming enough to put people to sleep. But people need a routine, they need a dark, quiet, calm, cool, peaceful room without wifi, and whatever their routine is, wind down an hour before bed, don’t get hyped up watching sports, ’cause that’ll keep you up for hours, or something that rivals you in any other way.

Have a wind down routine on your body, honor that routine, and figure out what you need for your sweet spot. The best of the best need 8.6 hours a night. Sleep is a little bit like a shoe size, but our military actually did a study and they found out if they gave soldiers less than six hours of sleep for six straight days, they actually functioned as if they were legally drunk.

Dr. Weitz:                            Wow.

Dr. Rakowski:                     So imagine those guys walking around with high powered weapons. Sleep deprivation is the norm. So, a good sleep routine and enough hours to have you wake up refreshed.

Dr. Weitz:                            How much melatonin do you like?

Dr. Rakowski:                     Well, now you’re asking me. I’m a big melatonin guy, so I actually like to use 50 milligrams of time release … 10 milligrams time released capsules, I take five at bedtime, but the NIH did a study, by the way I’m-healthy, right-

Dr. Weitz:                            That’s a very high dosage, 50 milligrams.

Dr. Rakowski:                     It is. They did 50 milligrams at bedtime, not even timed release, just straight up 50 milligrams with a dose of D3 and they found out that it prolongs survivability and prevented lean tissue breakdown of non-operable cancer patients. And remember, it’s not gonna cross the blood brain barrier, and it’s pretty fascinating. I do it myself. I can’t say I do it all the time, and there’s plenty of times when I’m on the road, “Oh, I forgot my melatonin.”  Guess what?  I still sleep.  But someone posted something on the internet how everybody and their brother these days wants to be a bio hacker, doing different things to try to increase longevity, but it’s a mitochondrial specific antioxidant that’s present in single cell organisms that it buffers the stress response and now I’ve been doing that for about a decade, since I saw that study in the NIH.   I can tell you that in the last decade, my biologic aging has been very slight. So, I think it’s a complete program, but that’s one factor there.

Dr. Weitz:                            Wow. Very interesting. Yeah, we usually use 20 milligrams for patients with cancer. Some of the studies seem to indicate, and I’ve had some patients who get nightmares when they go up to 20 milligrams.

Dr. Rakowski:                     There is another further downstream metabolite of melatonin, which is profoundly hallucinogenic and what’s fascinating about that is there’s a plant in South American, and shaman they use something called Ayahuasca-

Dr. Weitz:                            Oh, yeah.

Dr. Rakowski:                     … it’s a downstream metabolite of melatonin-

Dr. Weitz:                            Interesting.

Dr. Rakowski:                     Yeah, the shaman actually believe that it increases a higher level of consciousness, and for many it does, but for others, it can cause these profound responses. So I’ll share with you, I was teaching a seminar like I do, many, many times a year, literally taught over 10,000 hours to help professionals around the globe, and I had a 30-year pharmacist in one of my classes that said, “You know what, I love melatonin, I’ve been experimenting with it for a long time,” and here’s what they said, they said they believe the people that have the really most profound responses, in their experience, actually need more and it’s something that they can get through over time.  Now, I’m of the mindset that there’s gotta be, possibly, a pathway that needs to be supported in another way, nutritionally, to make it happen. And so, that might be activated B vitamins, it might be some of the minerals, and we know our general population, well, here’s the stats, 99% are deficient of one or more of those things. So when we do a comprehensive program, I think we can help a lot of people with that.

Dr. Weitz:                            Cool. Cool. Very interesting. Yeah, they use Ayahuasca for patients with PTSD. Apparently, it’s one of the more effective treatments for that.

Dr. Rakowski:                     Since I’m in a community of such naturally minded people with a lot of means, I literally know dozens, including myself, that have gone with shamans with organic product and realized, “There’s something to this plant.” But part of what I like to say is, “Don’t try this at home. Let’s go with people that have dedicated their lifetime to studying the plants and the rain forest and helping people to understand their body and work through the process.”

Dr. Weitz:                            What about using high dose melatonin with patients with PTSD? That would be a kind of interesting study.

Dr. Rakowski:                     I haven’t seen that study. I’m a big fan of thiamine as the GABA facilitator. I don’t know that I want to take the chance on those folks and nightmares, but if we know they handle it right, that might be a titrated up dose.  God bless those people. They’ve had more challenges than I wish on any person.

Dr. Weitz:                            Yeah. Great. So, thanks for providing us some great information, Dr. Rakowski. This has been a fun podcast. For listeners who want to get a hold of you, what’s the best way for them to contact you?

Dr. Rakowski:                     I’ve got a website called thedoctorbob.com, and that’s a good way. There’s a “contact us” tab, and that’s a great way to do it. if you did contact me because of this podcast, let me know, and I certainly want to send our friend Dr. Ben a thank-you note, and one of my favorite things is to share information and I appreciate the opportunity to do it with you and your incredible group.

Dr. Weitz:                            That’s great, and you’re available for consultations via phone or Skype?

Dr. Rakowski:                     All the above, yeah. We kind of shifted now away from Skype to Zoom-

Dr. Weitz:                            Zoom, okay.

Dr. Rakowski:                     … for whatever reason, but it’s probably been a couple years since I’ve done Skype, but I’ve Zoomed halfway around the world and most of the things I’m going to recommend, I do have connections halfway around the world, ’cause I’ve taught halfway around the world, and we can make recommendations and connect you with a great source for nutrition, poor nutrition, to help you with whatever you’re challenged with.

Dr. Weitz:                            That’s great. Thank you so much, Bob.

Dr. Rakowski:                     You’re welcome.




Optimum Hydration with Dr. Dana Cohen: Rational Wellness Podcast 68

Dr. Dana Cohen explains how to optimize hydration by eating foods with water in the gel state with Dr. Ben Weitz. 

[If you enjoy this podcast, please give us a rating and review on Itunes, so more people will find The Rational Wellness Podcast] 


Podcast Highlights

2:48  Dr. Cohen explains that being in a state of sub-clinical, low grade dehydration can lead to fatigue, brain fog, dry skin, constipation, but them, even more important things, it puts you at risk for certain cancers like bladder cancer and colon cancer. It also can put you at risk for Type II diabetes and Alzheimer’s disease.

5:25  Dr. Cohen explains that we know that water exists as liquid, ice, and vapor. We now know that there’s another phase of water called gel water or structured water, which is the type of water that’s in our cells and this exists in plants, in fruits and vegetables.  So by eating more fruits and vegetables we can get better hydrated than by just drinking water, which she talks about in her new book, Quench: Beat Fatigue, Drop Weight, and Heal Your Body Through the New Science of Optimum Hydration. Now we have science to back up why we should have a green smoothie and eat more hydrated foods.

7:15  Dr. Cohen recommends drinking 16 oz of water with some sea salt and a squeeze of lemon to start your day and then drink 8 oz of water before every meal. They’ll feel better and they’ll also lose a few pounds.

9:35  Dr. Cohen said that common table salt is just sodium and is dehydrating, while natural sea salt or Himalyan pink salt have other minerals besides sodium, so they are hydrating for the body. 

11:48  Dr. Cohen wrote that we should eat fruits and vegetables that are in season because research shows that the microbiome changes seasonally.

13:53  Dana noted that chia seeds are one of the more hydrating foods and she highlighted the gel that forms when you wet them.

16:19  Lychee fruit is great for skin, has antioxidants, helps with blood sugar and protects against sun damage and is a very hydrating food. Since it has a short growing season, she will often use a nutritional supplement, Oligonol, and she will open two capsules into a smoothie. 

18:35  Prickly pear from cactus is another very hydrating plant food.

19:33  Aloe vera has water in the gel state, so it is also very hydrating.



Dr. Dana Cohen is a nationally renowned internal and integrative medicine specialist, based in New York City. Her new book is Quench: Beat Fatigue, Drop Weight, and Heal Your Body Through the New Science of Optimum Hydration. Her website is www.drdanacohen.com and her coathor’s website if HydrationFoundation.org.

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.


Podcast Transcripts

Dr. Weitz:            This is Dr. Ben Weitz with, The Rational Wellness Podcast, bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field.  Please subscribe to The Rational Wellness Podcast on iTunes and YouTube and sign up for my free eBook on my website by going to drweitz.com. Let’s get started on your road to better health.  Hello Rational Wellness Podcasters. Thank you so much for joining me again today and, for those of you who enjoy The Rational Wellness Podcast, please go to iTunes and give us a ratings and review.

So our topic for today is water and what is the best way to get hydrated. It’s often stated that Americans do not drink enough water, and many doctors believe that as many as 75% of Americans are under-hydrated. I personally test all of my patients with bioimpedance analysis for their body composition, and we find very few who are optimally hydrated.  I often encourage my patients to drink more water and so do many functional medicine doctors, nutritionists and health coaches. Its typically recommended that patients drink eight to 12 glasses of water per day or at least half of their body weight in ounces of water. However, new research has discovered that water, which has been thought to exist in one of three states, liquid, gas or, solid actually exists in a fourth gel like state that has the potential to hydrate the body more effectively and efficiently than just plain water.

This new state of structured water is also more organized, making it more effective for healing at the cellular level. Dr. Dana Cohen is our special guest today and, she’s a nationally renowned internal and integrative medicine specialist based in New York City. She trained under the late Dr. Robert Atkins and also under Donald Ronald Hoffman, two of the pioneers of functional medicine.

Dr. Cohen says that new research shows that hydration may not be as simple as drinking more water, it’s a premise of her new book, Quench: Beat Fatigue, Drop Weight, and Heal Your Body Through the New Science of Optimum Hydration. And in fact, she says, drinking too much water can actually cause harm to your body by flushing out vital nutrients and electrolytes from your cells.  Dr. Cohen, thank you so much for taking time out of your schedule to join us today.

Dr. Cohen:          Thank you for having me.

Dr. Weitz:            So, how dangerous is it to be under-hydrated and what concerns can arise from not being properly hydrated?

Dr. Cohen:          Okay so, I want to clarify first that we’re not talking about overt dehydration where you’re in the hospital needing IV fluids and you have heatstroke, and those are, can be life threatening. We’re talking about this sort of sub-clinical, low grade dehydration which we give evidence that shows basic things, fatigue, brain fog, dry skin, constipation, but then, even more important things, it puts you at risk for certain cancers like bladder cancer or colon cancer. It also can put you at risk for Type II diabetes and even Alzheimer’s disease. So it is, I think, a very real problem.

Dr. Weitz:            How do you know if you’re under-hydrated?

Dr. Cohen:          So, okay, good question. Everybody, the first thing people think about is thirst. The truth is, thirst is not a great measure because we’ve learned to override our thirst or ignore our thirst so, some ways that you can know, once again, fatigue. We actually, I really believe that fatigue is your first sign of dehydration and instead of maybe going for some coffee or sugar in the afternoon, think about hydrating better when you get that slump.  So fatigue, brain fog. Other things that we can think about. So, we’re meant to urinate every two or three hours and, if you’re not doing that, you may be dehydrated. A good rule of thumb and at home test that we can do is, look at the color of your urine, we want it to be pale yellow. If it’s dark orange or darker, you’re dehydrated, with one caveat that us as integrative practitioners know, if you’re taking B vitamins, that rule doesn’t hold because it turns your urine bright yellow.

Dr. Weitz:            Yeah, my urine is very dark, I take so many supplements.

Dr. Cohen:          Yeah so, that’s not the best thing for you to do.  Another good at home thing is, you could pinch the top of your hand, the skin on the top of your hand, if it stays up there, if it tents up for longer than a millisecond, you’re dehydrated or, can be dehydrated.  So, that’s a little at home test you can do as well.

Dr. Weitz:            So, what’s the best way to get properly hydrated?

Dr. Cohen:          Great question.

Dr. Weitz:           We kind of teased that in the intro.

Dr. Cohen:          So, what we talk about well, lets just get right into it. Let’s talk about the new, the new discovery that we’re all, that you sort of alluded to earlier.  We know that water exists as liquid, ice and vapor. Now we know that there’s another phase of water and, this phase of water we call gel water or structured water in the book is, it’s different, it has different properties than regular bulk water.  What we’ve discovered is that this is the type of water that’s in our cells and also happens to be the type of water that’s in plants.  And so, by eating your water, by having more plants and vegetables and that can kind of thing, it’s a much more effective way of getting better hydrated.  So, that’s what we tell you.  A lot of it is instinctual but now we have real science to back up why we should have a smoothie every day and why we should eat our greens in concentrated forms and eat more hydrating foods.

Dr. Weitz:            Are there products on the market now, structured water? And, if they’re not, I’m sure there will be.

Dr. Cohen:          They do exist. There are machines that can structure your water. We don’t talk, I don’t know any of them, I don’t, what’s the word? Recommend any of them because I haven’t done the research on them, I don’t know about them. The book is for the masses, this is for every person how you can get this water by eating better, eating more fresh fruits and vegetables, eating your water and following some simple rules.  We lay out a very easy five day plan in the book where you just follow them. So, I’ll give you a couple of them right now. A first rule is, we want to wake up and front load your water so, 16 ounces of a big glass of water with a little bit of sea salt to get some good electrolytes in there and a squeeze of lemon, start your day that way, that’s one rule.

Another rule I can give you is, you want to drink eight ounces before every meal. So that’s a way of getting water in right before your meal and there’s some research behind that that it also can help lose a few pounds if you just do that and do nothing else.

Dr. Weitz:            Now, now, you know, I like to have some of my clients do that but I know a number of people in the nutritional world who feel that drinking water prior to your meal is going to dilute your enzymes.

Dr. Cohen:          Yeah, I’ve had no problems with it and I’ve been researching this book for three and a half years, I’ve been giving the program to patients and, in fact, their digestion is improving, they do lose a little bit of weight, their brain fog goes away, their fatigue, if you’re hydrating better.

Dr. Weitz:            It doesn’t matter if the water is cold or room water, does it matter if it’s carbonated?

Dr. Cohen:          It’s a good question, I don’t know, I really don’t know. I know in Chinese medicine there’s something to, depending on what type of whether you’re damp or a hot person, I don’t know, and there’s something to that. I’m not a Chinese medicine practitioner so I don’t know. I definitely think there’s something to it but, I honestly don’t know. As far as carbonation, I don’t have a problem with carbonation, I actually drink a lot of Pellegrino, a natural carbonated spring water but I think the jury is out on that one, I don’t think there’s evidence either way.

Dr. Weitz:            Yeah, even acupuncturists in my office, we kind of still having a battle. I’ll put ice on a patient and she’ll say, “No, don’t put ice, we have to use heat.”

Dr. Cohen:          I know and I think the truth is, whatever gets you to drink better, I think is important.

Dr. Weitz:            So I was reading your book, Quench, this morning while walking on the treadmill and drinking some water.

Dr. Cohen:          Love it. Excellent.

Dr. Weitz:            I want to ask a couple of questions that are a little bit off track and then we’ll get back to the foods is, you talked about how some foods like pizza have the wrong kind of salt that’s dehydrating while natural salt is hydrating. Can you explain that?

Dr. Cohen:          Yeah so, like the store bought table salt, I don’t think I should mention any names but, the one with the girl with the umbrella on it and the galoshes, I mean its sodium, it’s just sodium, there’s no minerals, there’s no other minerals in there.

Dr. Weitz:            Yeah, there is iodine in it. Sodium iodine.

Dr. Cohen:          Sodium is iodized salt, yes, yeah, if it’s iodized but, you can get sea salt iodized as well and that’s a whole conversation on its own and I do think almost everybody is deficient in iodine as well. Unfortunately, we don’t have great ways of measuring that but yes, the iodine is a separate issue.  But, the table salt is just sodium, real salt has an abundance of other minerals and electrolytes that we need that is and, there’s a lot of research behind it too that’s been shown, it’s not going to affect your blood pressure in a way that we at least thought salt was such a bad thing for us.  So that’s the difference.

Dr. Weitz:            Yeah so, in fact, you say that having sea salt and natural forms of salt like Himalayan Pink Salt actually helps with blood pressure.

Dr. Cohen:          Well, I think there’s something to that, I’m not sure if it actually helps with blood pressure but, I don’t think it harms.

Dr. Weitz:            Yeah.

Dr. Cohen:          You know so, I think and, there may be a select few that have very salt sensitive hypertension that they do need to worry about it so, its hard for me to say, I still want people to be careful, who have high blood pressure and even using real salt, you just need to monitor and look at it but, I don’t think it’s the foe that we’ve made it to be at all.

Dr. Weitz:            Yeah, no, I read that book by James DiNicolantonio about salt (The Salt Fix) and it was really sort of a shock that, everything we thought about salt, kind of like, everything we thought about saturated fat isn’t quite true.

Dr. Cohen:          Right. Exactly.

Dr. Weitz:            One more thing that I was reading about in your book was, you talk about eating seasonally, eating fruits and vegetables that are in season and you also mention that our microbiome, which is the bacteria in our colon, actually changes according to the season and I thought that was really fascinating and I don’t think that’s information that people commonly talk about.

Dr. Cohen:          Yeah, we touch upon it lightly in the book and, we’ve looked at the research, I think his name is Julliard, John Julliard, I think his name is. There’s some very interesting research that how the microbiome does change seasonally and that’s one of the reasons that we should eat what’s available to us. I have a feeling that that’s probably the key of why eating seasonally is really good and important for us. And there’s some research to back that up as well.

Dr. Weitz:            Yeah, interesting.  So, can you tell us about why it’s so important to eat certain fruits and vegetables and seeds that can help to hydrate us?

Dr. Cohen:          Suer so, I would love to, I picked out four things today to specifically talk about so, they’re a little bit unusual but they’re sort of fun to talk about.

Dr. Weitz:            By the way, these are examples, right? And, most, my understanding from reading your book is, most fruits and vegetables and also nuts and seeds in general are very hydrating?

Dr. Cohen:          Exactly, exactly and we lay out many, many examples in the book. We have over 50 recipes. I love to just bring up the example of even iceberg lettuce. Iceberg lettuce, you know, we always thought has no nutritional value. As it turns out, it’s probably one of the most hydrating vegetables you can eat because it’s just loaded with that structured water and that alone makes it worth it’s weight in gold.  So iceberg lettuce, there’s a reason for. So, let’s talk about chia seeds first.

Dr. Weitz:            Okay.

Dr. Cohen:          Chia seeds …

Dr. Weitz:            And by the way, I wouldn’t normally think of dried seeds as being moisturizing.

Dr. Cohen:          Yes. So, if you’ve ever seen or made a recipe for chia pudding, you know that when you add liquid to chia it forms that gel, it makes a very gelatinous, a mucilaginous surrounding the seed so that is that gel water, it’s going to hold onto and absorb water better than regular water.   And, there’s actually this Mexican tribe of people, the Tarahumara tribe who, anthropologically would run 50 mile marathons on water and chia seeds. So chia has, they are really the star of the show, they are a super food, they’re loaded with Omega 3 fatty acids, they’re really good for endurance, they’re great for blood sugar and, I just think, I love to throw them in my smoothies, make chia pudding, throw them on your salads. They’re a very hydrating food.

Dr. Weitz:            Okay.

Dr. Cohen:          Second one I want to talk about, another sort of fun and unusual one …

Dr. Weitz:            Now, do you just eat the chia seeds raw or do you grind them up first?

Dr. Cohen:          I love to grind them because you’re creating more surface area when you grind them. I’ll do both but, I think grinding them, you’re probably getting more gel water because you’re creating more surface area. So I think ground chia seeds are a better way to do it.  In fact we tell a story in the book from my co-author. She is an anthropologist, her mother was in a nursing home with Alzheimer’s and she was suffering from dehydration, like literally overt dehydration and, her mother would never ask for more water or, you know, she was very proper and she decided to tell the nurses to put some chia in her water every morning and that cured the problem, she never had another UTI after that, urinary tract infection. So, yeah, chia seeds are really important and great for us and inexpensive. Anybody can find them everywhere, it’s a great thing to do and to start putting in your water.

So let’s talk about the second one, speaking of seasonal fruits and vegetables, I want to talk about Lychee (aka, litchi) fruit. Lychee, have you ever had a litchi? Do you know what it is?

Dr. Weitz:            Not really. I was at some wedding that had like every exotic fruit known to mankind and I’m sure I ate it but I don’t remember which one it was.

Dr. Cohen:          I think lychee, you’re going to start to hear about lychee’s like, I think it’s going to be the next super food.

Dr. Weitz:            Next super food?

Dr. Cohen:          Yeah.  They are delicious, they’re from South-East Asia in fact, you know, I love anthropological information, these ancient Chinese princesses used to have their servants get them litchi fruit to keep their skin youthful so, lychee is great for skin, youthful skin, it’s a very powerful antioxidant, it helps with blood sugar, it helps protect against UV radiation, ultraviolet radiation from sun damage, that kind of thing.  Couple of problems with litchi is, they, and by the way, they taste incredible, they’re delicious. I’ll often just sort of throw them in water and it’s a tiny little fruit, I actually have some here, I’m going to show you. Can you see that?

Dr. Weitz:            Okay.

Dr. Cohen:          So they look like little eyeballs, these are seeded, there’s a pit in the middle and, so when you pop open a litchi you can see the gel just sort of coming out very, very gel like. The one problem is, they’re seasonal so they’re hard to get, only short period of season we can get them and, they’re high in sugar.  So, what I’ll often do is recommend a supplement because I do recommend a lot of supplements. There’s a supplement called Oligonol, there’s over 30 human clinical trials, it’s made from lychee fruit. I’ll pop open the capsules in the winter and throw it in my smoothie, two capsules a day and that supplement has been shown to help with decreased belly fat, decreased brown spots from skin aging, really great supplement made from lychee.  And, other than that, a couple one or two lychee in a glass of water will help structure that water a little bit better than without it.

The third thing I want to talk about is, and you may have played a little bit more with this is, prickly pear which is a cactus fruit. I do have one here. I love prickly pear. Basically what I’ll do is I’ll cut off both ends, peel it off, it’s bright red. This is water infused with prickly pear. Can you see how red it is?

Dr. Weitz:            Okay, yeah.

Dr. Cohen:          Also, really delicious but, it does have seeds in it so you have to put it through a strainer before you do anything with it.  Prickly pear is great for blood sugar also, helps with cholesterol, what else is it good for? Known as a hangover remedy. So, if you’ve imbibed too much, have some prickly pear. Prickly pear and lime is a really wonderful water infuser. There’s jam’s and jellies you can make with that but, maybe a little too much sugar also.

And then last I want to talk about is, aloe. All these cactus fruits. Aloe, I grew up in South Florida, originally from Long Island but, we moved to South Florida when I was little and, we always had aloe plants outside. So, everybody knows if you get a burn, you go outside, cut an aloe leaf and put it on top of your burn, it really helps your skin. But taken internally, aloe can help with digestion, it can help with constipation, also maybe help with blood sugar so, basically just open an aloe leaf, take that gel inside of it, throw it in your smoothie, or just eat it. There’s aloe juice you can buy now, great for all of those things, for digestion, heart burn, constipation.  So a couple of fruits, sort of fun and unusual, easy, play around with them and, they’re ally delicious.

Dr. Weitz:            Sounds good, yeah. We use aloe a lot for all sorts of issues, it seems to be really good for the skin and it’s good for the gut as well so, we use some supplements that have aloe in it as one of the ingredients.

Dr. Cohen:          Yeah, the one thing I’d be a little careful about is too much, even natural aloe can lead to diarrhea so you just got to find your perfect sort of dose.

Dr. Weitz:            Yep, yep.  Great. So, how can listeners or viewers get hold of you and get a hold of your book? I’m assuming its available from Amazon, Barnes and Noble.

Dr. Cohen:          Everywhere books are sold. My website is, www. drdanacohen.com and my coauthors website, there’s a lot of information, it’s the hydrationfoundation.org. Tons of information up there about water and all the new research that’s coming out with new water.  And by the way, water is way more complicated than I ever thought before I embarked on this journey and every day there’s something new coming out about it so, yeah.

Dr. Weitz:            Yeah. Good, good, good and, I’m assuming you still see patients in your office and remote. Do you do consultations?

Dr. Cohen:          I don’t see people remotely unless, you have to see me one time in person because I still am an old timely doctor, I like to put my hands on patients but I do see people in New York City, my office is called completewellnessnyc.com.

Dr. Weitz:            Great. Thank you so much for joining us.

Dr. Cohen:          Thank you Ben.


No Single Mechanism Drug has Provided a Cure for Alzheimer’s Disease, which is why a Functional Medicine Approach is Best

Johnson and Johnson has recently announced that they have pulled the plug on another drug–atabecestat–designed to block amyloid plaque buildup because it didn’t work and had significant side effects. This drug was designed to block Beta-secretase 1 (BACE1), which is an enzyme involved in beta-amyloid production.  Drugs to block this enzyme (BACE inhibitors) in theory would prevent the buildup of beta-amyloid and (per the Amyloid hypothesis) may help slow or stop Alzheimers disease. 

One of the problems with this hypothesis is that the laying down of beta-amyloid protein is not the real causative factor in Alzheimer’s disease. The body lays down the beta-amyloid protein in response to heavy metals or pathogens–viruses or bacteria–that create inflammation in the brain that the body is attempting to protect against. The amyloid protein is a protective coating for the brain.

A Functional Medicine approach, such as the one outlined out by Dr. Dale Bredesen in his paper, Reversal of cognitive decline in Alzheimer’s disease(2), and his book, The End of Alzheimer’s(3), is liable to be more effective because it attempts to modify the underlying causes of Alzheimer’s.  The medical approach that targets one particular pathway has not proven effective after many failed attempts at drug development. The Functional Medicine approach is more complicated, looking at multiple pathways, mechanisms, and triggers, but this is needed for a complex condition. Dr. Weitz has studied Dr. Bredesen’s ReCODE approach and can provide a Functional Medicine approach to investigate some of the many possible underlying factors that can result in dementia and the pathological processes that result in autoimmune conditions like Alzheimer’s or Parkinson’s disease.

Vitamin D Helps Protect Women Against Breast Cancer

We have known for a while that vitamin D is potentially protective against various chronic diseases, like cancer.  And we know that raising your vitamin D levels above 20 or 30 ng/mL, which most labs say is normal, is beneficial.  We also been told to be careful not to take too much vitamin D because it can be toxic at high levels.  But what is the optimal range for your best overall health?  Is it better to be on the higher end or the lower end?   
It has been common for Functional Medicine practitioners to recommend an optimal level of vitamin D of 40-60 or 50-70 ng/mL or even more for patients with cancer, while conventional MDs often consider vitamin D levels of 20-30 ng/mL to be sufficient.  This is partially because for years we were warned not to take too much of the oil soluble vitamins, like vitamin A and vitamin D, since unlike the water soluble vitamins, the oil soluble ones can build up in your body and become toxic at a certain levels.  However, in recent years we have learned that the upper limits  of vitamin D are much higher than previously thought.  And while some Functional Medicine doctors have been recommending fairly high levels, I have not been confident that there was enough rigorous data to support making an aggressive recommendation for the higher ranges of vitamin D, such as 50-70 ng/mL.       
This new review paper found that women who had vitamin D levels above 60 ng/mL had the most protection against breast cancer.  In fact women who had vit D levels above 60 had a 82% lower risk of breast cancer than women who had vitamin D levels below 20 ng/mL.  There was a clear linear relationship between higher levels of vitamin D and lower rates of breast cancer, with more protection at progressively higher levels of vitamin D.  
The authors of this paper provide the following explanation for how vitamin D reduces breast cancer risk: “The biologically active form of vitamin D, 1,25(OH)2D3, binds to the vitamin D receptor (VDR) in normal breast epithelium and this complex regulates the cell cycle, promotes differentiation, increases cell-to-cell adhesion, protects cells from DNA damage, regulates cytokines, activates immune cells, and suppresses inflammation, all of which may act to reduce malignant transformations.  In breast cancer cells, this complex also activates apoptosis and other mechanisms to suppress tumor growth”.  


Dr. Ben Weitz is a Sports Chiropractor and Functional Medicine practitioner and he is available for both chiropractic care and for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss by calling his Santa Monica office 310-395-3111 or going to www.drweitz.com. 

If You Have Type II Diabetes, What Target for Lowering Your HbA1c Should You Have?

If You Have Type II Diabetes, What Target for Lowering Your HbA1c Should You Have?

There is a debate among experts what target level of Hemoglobin A1C should be your goal.(1)  Hemoglobin A1C, which stands for glycated hemoglobin, is believed to reflect your average blood sugar readings over a 3 month period.  The American College of Physicians just released new guidelines recommending that the new goal for HbA1C  should be between 7 and 8 but the American Diabetes Association disagrees, feeling that the goal should be to lower HbA1C below 7.(2) The American College of Physicians (ACP) made this recommendation based on some studies showing that when you aggressively try to lower blood sugar levels with using more and more medications at a certain point, you end up with too many side effects.  These negative effects include the blood sugar dropping too low–hypoglycemia–but also increased risk of heart disease. But elevated levels of glycated hemoglobin means that you increase the risk of the vascular complications of diabetes such as heart disease, strokeheart failurekidney failureblindnesserectile dysfunctionneuropathy, poor wound healing, gangrene, and gastroparesis (slowed emptying of the stomach).


The ACP based their recommendations on several clinical trials, including the ACCORD Trial, which was ended early due to a 22% increase in all-cause mortality, a 35% increase in cardiovascular-related deaths, and a 3-fold increase in risk for severe hypoglycemia in those who received intensive therapy.(3) What this tells me is not that it is a bad idea to lower your HbA1C below 6.5 but that when you do it by using an increased amount of drugs, you increase the potential side effects, which is not surprising. This is especially the case with using insulin and sulfonureas, as opposed to the newer categories of drugs, like GLP-1 analogues & SGLT-2 inhibitors. Each of these older drugs have more potential side effects, including increased heart disease, and when you combine multiple drugs, you are compounding this effect. This is quite a bit different than using diet, exercise, and lifestyle changes to lower HbA1C levels, which is the approach that we take at Weitz Sports Chiropractic and Nutrition.


Another trial that the ACP based their recommendations on is the ADVANCE trial which did achieve HbA1C levels of 6.5 and did not see an increase in the risk of death but it did result in a lower risk of kidney problems.(4) The risk associated with this trial was increased incidence of severe hypoglycemic events, meaning that at times the blood sugar dropped too much, which risks falling into a diabetic coma and dying. Once again, if you can accomplish this with diet and lifestyle changes, the risk of hypoglycemia is less, provided that the program is not too severe in limiting all carbohydrate foods.


Type II Diabetes is a disease directly related to diet and lifestyle and if you don’t significantly change your diet and lifestyle, it will only get worse. Medication only manages your downhill ride. The only way to change direction is to eat a low carbohydrate healthy diet such as Paleo or Keto or low glycemic Mediterranean, exercise regularly, and lose weight (if overweight). However, if you use a very carb approach, like keto, be very careful not to let your blood sugar drop too low and it would be best to work with a practitioner, like myself rather than doing it on your own. Make an appointment today to see Dr. Weitz for a nutritional consultation and hire him be your health coach till you reach your health goals. But expect this journey to take a number of months and perhaps a few years, but the benefits are worth it.

2.  Qaseem A, Wilt TJ, Kansagara D, et al. Hemoglobin A1c Targets for Glycemic Control With Pharmacologic Therapy for Nonpregnant Adults With Type 2 Diabetes Mellitus: A Guidance Statement Update From the American College of Physicians. Ann Intern Med. 2018;168:569-576.
3. Gerstein HC, Miller ME, Byington RP, et al.  Action to Control Cardiovascular Risk in Diabetes Study Group Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008; 358:2545-59
4. Patel A, MacMahon S, Chalmers J, et al. ADVANCE Collaborative Group Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008; 358: 2560-72.

Improving Posture for Anti-Aging with Dr. Steven Weiniger: Rational Wellness Podcast 055

Improving your posture is an anti-aging strategy with Dr. Steven Weiniger, who is interviewed by Dr. Ben Weitz. 

[If you enjoy this podcast, please give us a rating and review on Itunes, so more people will find The Rational Wellness Podcast] 


Podcast Highlights

3:49  Dr. Weiniger talks about some of the negative consequences of poor or weak posture, including neck and back pain.

8:32  The key to posture is taking a picture of yourself and drawing lines and measuring how you stack up. Then make some changes and next year take another picture and see if you have changed. 

9:22  The invention of the smart phone on top of the computer now has led to about 90% of people in the US having weak, folded posture being bent over with rounded shoulders and forwards head.  This is an epidemic in our society that is getting worse. 

10:22  I pointed out that the more time people spend on social media, the more lonely they get, which increases their risk of chronic diseases and early death. 

13:00  We talked about Dr. Weiniger’s PostureZone app that allows you to take a picture and measure where their head, torso and pelvis is in space over where they are standing. Those are the four posture zones and the Posturezone app lets you measure the degrees of deviation from vertical of the poor posture zone.  This app both lets people become aware of their posture and allows professionals to measure posture and generate reports showing changes over time before and after treatment. 

23:20 Dr. Weiniger explained how we go about constructing an exercise program to improve posture with his strong posture protocols. He also mentioned that chiropractic manipulation is very important in helping to improve posture, as is proper nutrition.


Dr. Steven Weiniger is a Doctor of Chiropractic with a specialty in posture analysis and correction. Dr. Weiniger is an author, speaker, and internationally recognized posture expert  https://www.bodyzone.com/posture-expert/  Dr. Weiniger has written Stand Taller Live Longer: An Anti-Aging Strategy available through Barnes and Noble  https://www.barnesandnoble.com/w/stand-taller-live-longer-steven-weiniger/1009154991?ean=9780979713606  and Posture Principles-–5 Principles of Posture. 

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.


Podcast Transcripts

Dr. Weitz:            This is Dr. Ben Weitz, with the Rational Wellness Podcast, bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to Rational Wellness podcast on iTunes and YouTube, and sign up for my free ebook on my website by going to drweitz.com. Let’s get started on your road to better health.

                           Hey Rational Wellness podcasters, thank you so much for joining me again today. We’re going to talk about posture again and it’s such an important topic because it affects so many factors in our overall health. And as a chiropractor, I constantly see patients every day who come into the office and they say, “Doc, why does my back hurt? Why does my neck hurt? I didn’t lift anything, I didn’t do anything.” And so, in so many of these cases, posture is the unthought of, underlying cause and as somebody who’s into functional medicine, I always believe in trying to get to the root cause of problems. And the same thing for chiropractic, we can’t just correct your neck and back pain with a drug that’s gonna relieve the pain, we’ve gotta try to get to the underlying cause. And I personally have found that poor, bad, inefficient posture is a major factor, in not only the cause of their pain but also in your inability to heal properly from the pain. And the fact that, the pain is likely to come back.

                            By the way, all of you who enjoy the Rational Wellness podcast, please go to iTunes, or wherever you get your podcast and leave us a rating and a review. That will allow more people to find the Rational Wellness podcast. And so, our special guest for today is Dr. Steven Weiniger. Steve is a posture expert, he’s the author of Stand Taller, Live Longer, a tremendous book, the creator of the CPEP training program for professionals, helping people check their own posture with his PostureZone app that you can get on your phone, and he’s the chief posture evangelist of May. And May is posture month, and he’s the head of the posture month organization. Anyways, Steve, thanks so much for joining me today.

Dr. Weiniger:      Ben, thanks. Thanks for having me, I appreciate it. And the chief posture evangelist label came when we decided to do a public health initiative for a CPEP, Certified Posture Expert Professionals, and the label …

Dr. Weitz:           Hallelujah!

Dr. Weiniger:      Because basically, I’m going around and I’m talking to media. It was just a really cool thing that came out on CBS yesterday. We’ve been with them talking about posturing. I feel like I’m evangelizing. I’m cured. I’ve not been doing evangelical work, but it’s true because people … It’s something everyone knows about, but people don’t stop and really look at. And my job becomes making people talk about it and that’s why we’ve expanded posture month to not just CPEPS, but to anyone that’s worked with posture to be able to take a picture or to offer the public a picture of their posture to create awareness of what their posture looks like, because it affects your health in a tremendous way.

Dr. Weitz:           Cool. Can you tell us, what are some of the negative consequences of somebody having poor posture or inefficient posture?

Dr. Weiniger:     Well, there’s two sides to it. One is the health consequences and the other is the personal consequences. Beginning with the health that is one that’s most important even though it may not be the one that’s the most emphasized. It effects back pain and neck pain tremendously. A recent study found that 89 percent of primary care physicians, considered posture to be one of the primary causes of back and neck pain, which is not surprising because your body is not aligned, it puts more mechanical stress on your joints. Especially if you’re living on that all the time. But there’s other issues as well, because when your body is folded, it can affect how well you can breathe. It affects how different organs’ work and things like this don’t occur quickly, but especially if you want to get to the root core of the problems, if someone’s living with their body folded and they can’t take a deep breath … There’s been a lot of research that shows that breathing is really important for your health. If you don’t breathe, bad things happen.

Dr. Weitz:          And it’s important to breathe that way as I’ve learned, because I was always a mouth breather and recently, in the last six months, learned how to breathe through my nose with a help of a breathing professional. It makes a huge difference.

Dr. Weiniger:    And there are breathing professionals that work with posture as well, because it’s not just a reflex thing, when your head goes forward of your torso, it changes the muscle relationship in the front of your neck going to the mandible, the jaw bone. That effects the opening for the air coming down into the lungs. It’s easier to breathe with the chest than it is to breathe with the abdomen or the diaphragm. And once you’ve developed that habit, it becomes like any habit. It’s easier to move that way. Try this. Press your fingers like this. Look at which fingers are on top, the left one or the right one?

Dr. Weitz:         Which one’s on top?

Dr. Weiniger:    Yeah, when you’re looking at your thumb, which thumb is on top?

Dr. Weitz:         Oh, the right one.

Dr. Weiniger:    Okay, cross it the other way. Put the left one on top. If I asked you to cross your hands, things like this, a thousand times, how often would you do it this way?                                               Most people … If you worked with it your good. Most people I would do this, would find that …

Dr. Weitz:         Well, you see I play golf. So, actually this is my normal golf grip.

Dr. Weiniger:    In that case you’re not using it. But most people that do that, find that …

Dr. Weitz:         My wife is always reminding me that I’m not normal.

Dr. Weiniger:    No, you’re better than normal. You pay attention to your body. That’s the point. Once your body learns to move in a pattern, you keep on moving that way without thinking about it. And that stresses some muscles, stresses other ligaments and your body literally folds into that pattern. You think your moving one way, but a camera proves that you’re not moving that way and that’s why taking a picture so that you can see how you’re standing when you think you’re standing tall is one of the first ques to building posture awareness.

Dr. Weitz:         So, since you brought that up, how do people become aware that they have bad posture. Is it simply because they have neck pain and they go to a chiropractor and that chiropractor tells them they have bad posture?

Dr. Weiniger:    I really don’t like the phrase bad posture. Because no one’s posture … Unless someone’s body is perfect, their posture is not gonna be perfect. Your posture is bad if you’re having some symptoms from it and that’s for certain. But even if you might have symptoms …

Dr. Weitz:         How about if we call it inefficient posture? ‘Cause isn’t the key to posture, resisting gravity, and we can’t resist efficiently if we have a certain posture?

Dr. Weiniger:    Inefficient is a good way to look at it, especially from a sports point of view. The way that we talk about it would be what is weak posture. Because if your posture is inefficient your body is gonna be weak and it’s not about as being as strong as the strongest person in the world, or as tall as the tallest person in the world because that’s probably not most of our genetics. It’s about being as tall as your body should be, as strong as your body should be for what you’re doing. If you’re working your body inefficiently, your body is gonna get better movement inefficiently and that makes problems. So, the key to posture is just taking a picture of yourself and measuring. Not making a pathology of it, not making it bad, not making it a problem, but it make it just, when I’m trying to stand tall, this is what I look like. And looking at it, and then coming back next year and comparing it again and measuring your body as something your aware of. If you see your body folding from your one to two to three, if you look more and more like an old person, you’re gonna start feeling like an old person and having pains like an old person before you should be.

Dr. Weitz:         So Let’s say we call good posture optimal posture. Right?

Dr. Weiniger:    How about strong posture?

Dr. Weitz:         Okay, so, let’s say we call it strong posture. Can you say approximately what percentage of the population has weak posture?

Dr. Weiniger:    In our world …

Dr. Weitz:         Yes.

Dr. Weiniger:    There’s been this great invention that I don’t know that it was made by chiropractors, but if you wanted to invent something to have a device that you could put in front of people and then have them spend half their day hunched over with this over rounded forward typing on something, you’d have a hard time advising that business model, but it’s been great for chiropractors because we end up seeing and helping so many people walking around in pain. In our society, I’d say 90 percent are walking around with posture problems. One thing that I’ve noticed is when I travel, I’ll see families with kids, and sometimes the little girl looks like mom and the boy looks like dad, and usually when I used to see people like this, the kids had good upright erect posture and the parents were a bit more slumped forward in general. Now, the kids look worse than the parents. This is an epidemic going on in our society, and it’s getting worse.

Dr. Weitz:         So, this is negative health consequence of cellphones, on top of so many other health consequences. I was just listening to another podcast on my way in here and they were talking about how loneliness is a parameter that increases your risk of early death and chronic diseases.  The more people spend on social media, the more lonely they get. So you spend all this time interacting with other people, but not in a real way so, you end up decreasing your health as a result of that.

Dr. Weiniger:    And that’s a … I completely agree with that perspective. One of the things of that is, people spend a lot of time trying to curate the perfect image on social media so that they look really good. And when they then compare themselves to other people that look better, it becomes a competition of how well can I artificially make myself look good and if they compare themselves to other people. And it’s like a world full of barbies of people shaped in ways that no human being is shaped. Whereas if you and I are sitting together and we’re being comfortable and we’re opening up to each other, that’s a different kind of friendship than occurs online.

Dr. Weitz:        Yeah. That creates this unrealistic body image that people have when they see these people on Instagram and Facebook and Twitter and stuff, having these ridiculous looking bodies and they feel all worse about their own because they know nobody can look like that and those are not real images, unfortunately.

Dr. Weiniger:   And one thing that I’ve become more aware of personally is the old custom of breaking bread with people, we don’t talk about that, but when you sit down and you eat with somebody, it’s a more intimate thing where … People don’t show videos of themselves eating, they show videos of the meal because I can curate it, I can make it look right. I can put the glass to the left of it. I can arrange the silverware so it looks like the food they get are perfection. Whereas a video of somebody chomping away at something, that doesn’t look so good because that’s a more openness of how people truly are. And when you sit down and have a meal with someone, if you like them, that’s when you come away and you say, “We can have breakfast together. We can have dinner together.” The saying a long time ago was people breaking bread.

Dr. Weitz:        Yeah, interesting. So, how’s … Tell me about your app that lets people be able to take a picture and get a better since of how good or how strong or weak their posture is.

Dr. Weiniger:   Posturezone app is a free app that’s on iPhone, iPad, and Android. And it’s a way for everybody to take a picture of themselves and measure where their head, where their torso, and where their pelvis is in space over where they’re standing. Those are the four posture zones. And it’s not about trying to pathologies something with this is normal and this is not normal. I mean, if somebody is five foot five for male, and the normal population is 5’7 to six feet, does that mean that person that is 5 foot five is abnormal? Of course not. It means that’s the way that person is and there’s a population demographic. Normal means different things. You don’t want to confuse a normal population demographic with normal for that individual.

If someone’s 5’5, if they’re standing tall, they can have strong posture. If someone’s six feet and they’re slumped over down to five foot ten, they’ve got horrible posture. So it’s not about being tall, it’s about standing taller. So that’s the direction of that is aligning your head over your torso, over your pelvis, over where you’re standing. The more those four posture zones are vertically aligned, in a line, the taller the whole system is. The taller the person is. The more the person is flexing forward, the shorter they are, and what the Posturezone app does lets you measure the degrees of deviation from vertical of the poor posture zone.

Dr. Weitz:         Do you have it on your phone right now? Can you show us real quick how that works?

Dr. Weiniger:    Sure. I can show you on my phone. If this …

Dr. Weitz:         So this is an app. It starts out as a free app and then there’s advanced features that you can purchase on … You can put it on your phone, your iPad.

Dr. Weiniger:    You can put it on your phone, iPad. It’s 29 dollars for the pro version, which is for professionals. If you’re a professional watching this, you want the pro version ’cause it will let you take a comparison picture of somebody and compare it in a report over time. If you’re a regular user, the app will let you take pictures over time and compare them. You can just flip back and forth and look at your pictures and you can see the number, but you can’t create a report and you can’t keep things in tables to work with people. [inaudible 00:15:52] designed to give the consumer or the health enthusiast the ability to check their own posture and posture of friends, but if you’re doing it professionally, it cost 29 bucks, but it’s a one time thing. It’s not an all the time thing. The reporting is again, of the angles of deviation. It’s not saying this is normal, this is not normal. That’s like a fear based marketing thing that I don’t care for.

Dr. Weitz:         Hey … You ever done a study to validate this? Maybe with patients after whiplash?

Dr. Weiniger:    Working on it.

Dr. Weitz:         Okay.

Dr. Weiniger:    There’s a couple that are working on things that are working on exactly and there’s been other studies that have been done that point to the lack of validation of some other things that a lot of people talk about and that the most promising way of recepting posture is the head, torso, and pelvis over the gravity line, which is exactly what we do. Dolphins did a really nice study of that and that was the only thing that correlated with back pain. There are things like high shoulder or a high hip, really didn’t correlate though, it’s just … Over mechanical, as you put inefficiently, the more everything expands out, the more efficient mechanical advantage there’s gonna be but less energy is spilling, the less strain there is on muscles and joints.

Dr. Weitz:         Okay. Go ahead.

Dr. Weiniger:    So if you wanted to take a look at it, this is … My office is a mess, but if you … Don’t look at …

Dr. Weitz:         You gotta hold it … Right there, good. Okay.

Dr. Weiniger:    So basically … Oh, I’ve got a great idea. Don’t go away.

Dr. Weitz:         Okay, you gonna bring somebody in to help demonstrate it?

Dr. Weiniger:    I’m gonna bring Harry in.

Dr. Weitz:         Okay. Hi Harry.

Dr. Weiniger:    Harry is my posture [inaudible 00:17:38]. Okay we’re gonna see if we can do this. So basically, you want to take a picture and notice when I rotate this back and forth, the line turns green.

Dr. Weitz:         Okay.

Dr. Weiniger:    In the middle. When the lines green, it’s level. Since my screen is not level, this is gonna be a weird picture, but if I put Harry between those two lines, I can bracket him between those two lines and I’ve got a grid in the background that if I were smart, I’d have it setup where I could show you that grid, but that’s not today. That’s not gonna happen today.

Dr. Weitz:         That’s okay.

Dr. Weiniger:    Professionals will need the grid and if I took a picture of Harry, and this is not gonna be nearly level ’cause I’m not that coordinated, but if I can take a picture of Harry. Did we get it? I got it. Good, this is far from perfect, but I can then take … You don’t need to see this, but I need to set it up for side view or front view, I can take a side view. I can then move the brackets to bracket the head over the torso over the pelvis over where the feet are standing. And this is not well placed cause I can’t do this sideways very well, but I can then check that and it will measure the degrees of deviation the head over the feet, the torso over the feet, and the pelvis over the feet.

So just measuring how the body is balancing and what the body is going to be vertical. And this is what the free version does. If I wanted to add other lines, and let’s say that I’m a pitcher or a golfer, you can add another line. I can call that a golf line. And then I’d be able to make a line between my shoulder and my front foot for example if I wanted to add that measurement to see how my body aligns. When I think my shoulder’s right over my foot, if it’s really two degrees off, and I start working on it and then it’s one degree off, it’s going in that direction. It’s a way of bench marking the accuracy of your perception and of the way your body is to the truth of where your body is.

Dr. Weitz:                            Cool.

Dr. Weiniger:                     And you can then if you want to save it and I’ll just put it into a case, and hopefully this is nobody that I don’t want to show you.  Within that case, I can look at an image and compare Harry today to Harry yesterday. Or in the pro version, I can generate a report to compare that to prior images. No. Sorry, I can add that to prior images and move backwards. There we go. Where I can do a checkoff. You can see that and get a report and then I can generate that report … And the report disappeared. I can’t do this backwards very well. There it is. I can generate that report and that report that has those images as well as the deviations of where the body is in space. And the cool part for consumers, if you’re looking for a professional near you, on the bottom there’s a locator for CPEP so they can find somebody that’s in their area and now you know where I live, but where there’s a CPEP near them. And that is someone that if they want to work with a posture professional that can take a picture of their posture and help them to do exercises to strengthen their posture.

                    And that’s the idea behind posture month. People have to become aware of their posture ACE, A is awareness. Next part is C, control. Do exercise to strengthen your posture and professionals work with people from a clinical point of view, especially, really strong posture exercises to strengthen how people move. Other things like yoga, Pilates, are also what I call controlled motion exercises and they can help posture, but the external posture exercise have the advantage of being able to be very, very targeted to help someone’s weaknesses and strengthen their weaknesses especially when there’s been a problem that needs any kind of rehab.

Dr. Weitz:                            You know, another thought about using this and I just started to incorporate this app, is insurers, third party payers, want to see objective measurements of the improvement that we achieve with our treatments and we know our patients feel better, but simply having a patient who says, “I’m in pain.” And then saying, “Now I feel better.” That’s not very objective, of course, we use these zero to ten pain scales that the patients fill out and that’s a little bit of objectivity, but it’d be nice to have something like this that we can include in a report to either an insurer or on a personal injury case to show some objective improvement. So, I think this is pretty cool for that idea.

Dr. Weiniger:                     I’ve personally had adjusters that we’ve worked with and they said, “You know what, when you showed me the picture of what the person looked like the first time they came in and what they looked like a few weeks later after that, it makes it very real. People unlike online texts, that’s not real. A picture of you in eye when you see somebody talking that’s much more real.

Dr. Weitz:                          Yeah.

Dr. Weiniger:                     And then you have someone standing against an objective, that’s more real.

Dr. Weitz:                          Okay, so once somebody identifies that they have poor posture or once a practitioner whose maybe has gone through your program identifies somebody with postural issues, how do you go about correcting those?

Dr. Weiniger:                     The first thing you do is you take a picture so you benchmark where you’re starting from because it’s not necessarily correcting, it’s strengthening. My best review of this is almost certainly gonna be different because we have different genetics and we treat our bodies differently along the way. And your body is not gonna be balancing the exact same as somebody else’s, but having an awareness of how you’re balancing at the beginning. To strengthen balance you want to strengthen each of what are called the three elements of balance. How your body is aligning, how your body is balancing, and how your body is moving. And basically those words balance, alignment, motion or BAM, are what we talk about in my book Stand Tall and Live Longer and the posture exercises are what CPEPs and other professionals teach their patients and teach people and it’s often trainers and massage therapists that teach people how to do postural exercises.

For posture month, there’s a number of balance exercises we’re putting out every day and for each week, we’re going to be focusing people on one exercise. So week one, we’re focusing people on an alignment exercise, it’s really easy. Go to the wall, walk til your back’s against the wall. Remember when you were in school they told you that you should be able to line up your shoulders, your feet with shoulders, your feet, your butt, your shoulders and your head against the wall and be straight. Did they have that when you were in school?

Dr. Weitz:                         Well I remember doing that after the air raid drills.

Dr. Weiniger:                   Okay, same thing.

Dr. Weitz:                         Like that will really protect you if a nuclear bomb strikes near your school.

Dr. Weiniger:                   In my school, they had us hiding under the desk.

Dr. Weitz:                        Oh, okay. Like that’s gonna help you.

Dr. Weiniger:                   What does help you is connecting your perception of your body with how it really is. Going to the wall, stepping one foot away from the wall with your feet parallel, leaning your butt against the wall and your shoulders against the wall, and then really lock in. Look straight ahead. Keep your head level. And try to keep your head level, that’s the must. And move it back towards the wall. If your head can’t touch the wall, and keep it level then that’s saying that you’ve got some distortion where your head, torso, and pelvis aren’t lining up ’cause if you take your feet away, you should be able to align head, torso and pelvis unless there’s something holding something forward. The strong posture exercise all use what’s called the must versus try killing. The must in this exercise, keep your head level. If someone says, “Yeah, I can touch the wall.” But the head’s not level, they’re not doing the must. And if you can’t touch the wall, the exercise is quite simple, go as far back as you can, but keep it level. Keep your head level as you pull it back.

It’s similar to the turtleneck that some people teach from an exercise point of view, but it’s more effective because if you take your feet away from the wall, you’re reducing some of the impact of the solace on the upper lumbar and lower thoracic spine and it makes easier to isolate the real cause for that particular posture distortion.  And so practicing keeping your head level, pushing it back and doing that with your breaths. So, doing it for what we call five slow breaths. Breathing in, letting your head come forward, breathing out, pushing it back to the wall. And you’ll notice by the third or fourth, you can get a little bit more play if you’re doing it right when you’re stretching the tight link of the chain. Doing that twice a day for a couple of days, you may find that you start to find it easier to keep your head level, which is what we’re trying to do, to open the body up, which opens up the second week of posture month, which is the first balance exercise.

And the first balance exercise is holding your best strong posture and balancing by lifting one leg up so your thigh’s parallel to the ground and holding it for five slow breaths, and then repeating it on the other side. And doing that just three times a day, just dialing in to standing tall and you can’t see me now, but I’m lifting leg up because if I lift my leg up, and my body is going like this and I’m twisting, I’m not strengthening the muscles of my posture. You want to first do alignment so you have an awareness of what standing tall feels like and then hold that feeling, lock that awareness in, and then challenge it by lifting one leg up. And as you know from a rehab exercise point of view, the way you strengthen something is by challenging it. That’s the second week. Do that a couple times a day, second week.

The third week of posture month, we’re coming out with the first motion exercise, sitting on a ball and just like you would sit at work, sitting really tall and trying to only move your pelvis. So instead having to focus the head, torso posture zone, we’re moving the focus back to the torso, pelvis posture zone. The key is moving the ball making three circles to the right, three circles to the left, but there’s two musts here. One must is don’t move your knees. The second must is don’t move your torso. So you’re sitting tall, you’re not moving your knees or torso, the only thing left to move is your pelvis. It sounds really easy, but it’s way harder than it looks, especially when you try to make a circle to the right, many people that have any kind of an issue will quickly notice that their circle isn’t round, but there’s a lack spot in their motion where they’re not able to control something actively in that arc. And what they’ll also find that if they make three circles to the right and three circles to the left, the inaccuracies of motion, the kinks, the things that are locked, that they didn’t know that were not moving, are not the same on both sides.  And it’s been not able to be recruited and used when you’re really focusing on it when you’re not focusing on it, when you’re doing a bunch of other things at the same time, you’re not gonna be using it and that’s why there’s this prior protocols that become so powerful that isolate and strengthen the weak link in each individual’s movement connect chain.

Dr. Weitz:                          What do you say to patients who say, “You know, why do I need to do these dorky exercises? I’m already going to the gym and I’m doing squats and deadlifts. I’m doing one of these other exercise programs where I’m lifting all these free weights. Why do I need to sit on a ball?”

Dr. Weiniger:                     Because exercise is good, but exercising effectively is far more important. If someone … I remember going to the gym and seeing guys that were bench pressing 250 pounds and they were doing it by lifting their head up, rolling their shoulders in, and bouncing it off their chest. And just saying, “I’m benching 250.” And especially, those guys, if you try to go over to them and say, “Try doing this with tight form.” Their response is, “I can’t lift as much, and the only thing that’s important is how much I can lift.”

Dr. Weitz:                          Of course.

Dr. Weiniger:                     And that’s not good. If actually, you’re a chiropractor and you want to take care of patients, it’s great for business, but it’s lousy for people’s bodies. All motion begins with your posture. All motion ends with your posture, and that’s why the awareness part becomes so important. If in your awareness, you think standing tall is standing like this, when you exercise all of your exercises is gonna be like that. If you’re a golfer, if you golf, golf begins with the address position where you’re getting set up, standing tall and then you’re … That’s what every pro that I’ve ever spoken to tells you to do. It’s when you think you’re standing tall in an address position, you really adapted in some subtle way like those silly ball things that we just talked about that you said, then you’re going to be taking those in asymmetries into whatever that larger motion is.  The only way you can strengthen the subtltees is to focus on only them. When you’re doing big macro motions, you can’t be aware of the small subtltees. Your body thinks in whole motions, not individual muscles. Start focusing on the subtltees and such incredible power, both from a pain point of view as well as from a performance point of view, as well as how other people see it.  Because the other part we need to talk about is when your training well, people look at you better.

Dr. Weitz:                         Are people actually making themselves worse by exercising in poor posture, and reinforcing that posture?

Dr. Weiniger:                    I’ll go back to what you said at the beginning. When a patient comes into you and they say, “Doc, why am I hurting? I’ve been going to the gym, I’m doing all this stuff, but this happened. What happened?” Because what you think you’re doing may not be what you’re really doing and everything that you do always begins with the posture. That’s why if you want to exercise effectively, you want to begin with effective posture.  And there’s been number of studies that have demonstrated that training bodies to move towards greater symmetry with greater accuracy makes a big difference in back pain. In fact, if you recall, last years guidelines both care of both acute and chronic lower back pain from the American College of Physicians said that surgery a lot of times is not good, opioids, not good, and they said things like Advil are not as highly recommended as they used to be and there should be alternatives like spinal manipulation, which chiropractors have been saying thank you very much, but also motor control exercises. That’s exercise really looking at the starting piece of motion. That’s precisely what the strength type exercise I designed to do.

Dr. Weitz:                          Okay, so do you tell somebody … Let’s say somebody comes in, and their posture is pretty bad. Do you tell them to stop all their other exercise until they can correct their posture or do you tell them maybe while they do their exercises, try as much as you can to get into a better posture?

Dr. Weiniger:                     And the better posture is what they’re learning to feel when they’re doing the strength posture exercises. Especially, if they’re working with a CPEP. But because if they’re coming in clinically, you want to be not creating more pain, not creating more tissue damage. So, you may possibly pull back from some of the exercise, and you may increase other exercises depending upon the person’s clinical story, the person’s exercise and their functional ability. That’s why we have the must versus try protocol becomes so powerful because we let you tailor it to their functional ability. The exercise is a test of what they can do functionally, which is then teaching them how to do in a way to strengthen the weak in their mechanic chain. So, in general, if you’re exercising, you want to work out quickly how to get the most benefit out of your exercising. That’s what a professional can help you do.

Dr. Weitz:                          Now, you talk about strengthening and balance, but what about stretching? So Let’s say you have this sort of rounded shoulder, forward head posture that you see in a lot of people and certainly strengthening the romboids and the middle and lower trapezius and some of the intrinsic neck muscles are important, but don’t you need to stretch out some of these shortened muscles in the front as well?

Dr. Weiniger:                     Absolutely, and that comes back to the point at the beginning. It’s not one thing, it’s everything. It’s like which tire on the car is most important? The left front, or the back rear? You’re going 60 miles an hour on the highway, you don’t want any of them to blow out. And if one blows out, the whole system doesn’t work the way its supposed to. In terms of correction, very very commonly someone’s gonna have a short pectoralis, more likely a short pectoralis minor, coracobrachialis, which the muscle underneath that is another really, really common shortness that’s missed because if you think about it, if there’re different layers of muscles, which there are, if the superficial muscles are tight, then other parts are gonna move differently. If the short muscles are tight, the muscles closer to the center of action of rotation of each joint, then nothing around that is gonna be able to move and you can stretch the superficial mussels out all day long, but you’ve gotta also get the deep ones. That’s why the pattern can be really different for different people.

And it’s what you just did, it’s not just open up what’s on front, it’s simultaneously strengthening what’s in back, but it’s not just the front and the back because when we did this, we also unfold the torso pelvis a little bit. We lean towards the back. So, if there’s an imbalance between torso and pelvis, that’s gonna keep on pushing it forward and you can try to open this up, but you’re gonna have to do something else to compensate. Posture is a whole body phenomenon. It’s not just your head, it’s not just your back, it’s literally how you balance your body. And that’s why the balance exercises are so key to strengthening posture.

Dr. Weitz:                            And what’s the role of chiropractic in this?

Dr. Weiniger:                     Tremendous. Chiropractic’s main goal of focus began with spinal manipulation, which is working on the segments of the spine, the vertebrae of the spine to restore motion and to allow more normal neurologic function because the spine houses the spinal column and that connects the brain to the muscles and then the nerves. And if those are not moving well, if there’s not accurate information coming to the brain, it means the way that you think you’re moving is even less likely how you’re moving. From a biomechanics perspective, if there’s a locked link in the chain, so my hands should be moving like this, and my fingers are not moving, it’s gonna move like that. That’s gonna put more stress on one joint, more exercise on one joint, and less on others. The same thing happens in the spine where one spinal segment is working more, breaking down more, getting more exercise at one level, and less at others and that imbalance then drives how everything else is moved. So the combination of chiropractic spinal manipulation with strong posture exercise is like this.

Dr. Weitz:                            Right. For those in the audience who aren’t really familiar with what chiropractic does is, one of the core factors treatments of chiropractic that really no other professional really does effectively is the manipulation or adjustment and it sounds like your understanding is similar to mine, is we’re trying to find those particular joints in the body, whether they be spinal, or extra spinal, in the shoulders or elbows or knees or wherever, and making sure all those joints are moving freely in all those different directions that they’re supposed to move in. For example, your spinal joints are supposed to bend forwards and backwards and side to side and rotate and we’ve gotta make sure they’re doing all those motions so that you actually can attain the type of posture and maintain that type of posture.

Dr. Weiniger:                     Exactly, and I talked about the spine, because you said where chiropractic began, but from a perspective of postural rehab perspective, we also want to be … A good chiropractor to me addresses all of the links in the kinetic chain because if you’ve got a problem with your big toe. I drop a cinder block on your big toe, your posture when you walk is gonna go to heck ’cause it’s gonna hurt and you’re gonna adapt to it. So a good chiropractor should be able to address all the links in what we call the kinetic chain. It’s the body how to move symmetry, how to move with greater symmetry. In other words, a chiropractor unlocks motion, stimulates neurology to function more accurately, but if you don’t retrain the body to move more accurately, it’s gonna keep ongoing back to the old patterns. The chiropractor unlocks and restores motion, strong posture exerciser retrains that motion. They both fit together.

Dr. Weitz:                          One more question. Is there a role for nutrition in promoting posture?

Dr. Weiniger:                     Oh, absolutely. If your body doesn’t have the materials that you need from a biochemical basis to function, it’s gonna function adaptively. Everything from enough water, which is something that is one of the underrated issues with a lot of people with lower back pain, to enough calcium, to other things like functional medicine that you can use to stimulate or to decrease how different things are functioning to address it. Our bodies are not just biomechanical, it’s not just nutritional, it’s both working together.  As well as, biopsychosocial or attitudinal or mind or emotional, however you want to phrase it. Your head space, your attitude, will affect your posture and effect your health, and effect your biochemistry. They’re all together as mind, body, and spirit, which is kind of how chiropractic began once upon a time and it’s cool seeing more things go in that direction now.

Dr. Weitz:                          There you go. That’s kind of a evangelical saying from the posture evangelist. With a prayer here.

Dr. Weiniger:                     It’s funny because as you’ve noticed, I’ve got … I wear a number of different hats, and I’ve been at different boards and I didn’t want it to sound stuffy. I wanted to make it more of a fun thing to engage people and that was literally put out there as a kidding around and some people started banting it around and it became kind of what it is, but it’s true. Posture can make a big difference in your life. The posture month. Be aware of your posture, take control, engineer for a strong posture environment and next year recheck and see how you’re doing. And all the time, do basic posture exercises. You have a problem, see someone that can help. And the Posturezone app lets you check it and will help you find somebody.

Dr. Weitz:                          Cool. And so for listeners who want to get a hold of you, what’s the best way for them to contact you or get ahold of your book and learn about your programs?

Dr. Weiniger:                     From a public point of view, Stand Taller Live Longer, is the website for the book because that’s the name of the book. From the public point of view, Bodyzone.com, is where public information is. In the professional point of view, Posture Practice is where we teach people how to be CPEPs to strengthen people’s posture and from everyone’s point of view, download the Posturezone app. And all of those sites have ways to contact us that they can get a hold of me.

Dr. Weitz:                          Sounds great. Thanks, Steve. Keep spreading the word.

Dr. Weiniger:                     I appreciate it. I very much enjoyed it. Thank you.

Dr. Weitz:                          Okay, I did too. Talk to you soon.


Heavy Metal Detox with Dr. Christopher Shade: Rational Wellness Podcast 054

Dr. Christopher Shade discusses how to test for and remove heavy metals from the body with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Itunes, so more people will find The Rational Wellness Podcast] 


Podcast Highlights

2:25  Dr. Shade talked about how he got interested in studying mercury and developed a way to separate different forms of mercury as part of getting his PhD. 

3:35  Dr. Shade explained that he tried heavy metal chelaters like DMSA and DMPS and these made him much sicker, which led him to design better supplements for detoxification.   

5:45  I asked Dr. Shade to explain why his tests for heavy metals are more accurate than other tests on the market?  I then asked how serum testing can be that accurate, since it only reflects recent exposure and not metals that have been stored in the tissues for months and years?  This is why we do oral chelation challenge and collect urine for six hours to detect metals that have been stored in the tissues and are now being released through the urine.  Dr. Shade challenged that view and explained that chelaters like DMSA do not go into the cells and cause metals to dump into the urine.  What they actually do is pull metals from the lymph and the red blood cells and bind it out into a form that’s easily filtered out through the kidneys.  And serum reflects the body burden. And urine also is somewhat reflective of body burden and urine has a baseline level of metals, in contradiction to the assumption that there is no baseline of metals until the chelation challenge. Also, after the serum levels rise due to a recent exposure, such as eating some fish, it takes 45 to 60 days for the serum levels to go back to the previous level in a healthy person and up to 300 days in an unhealthy person.   

10:51  Dr. Shade described how organic methylmercury from fish is represented very well in the blood, while inorganic mercury from dental amalgams doesn’t represent itself very well in the serum.  But inorganic mercury is seen much better in the urine, provided that the kidneys are functioning properly and the kidneys can become damaged by mercury.  Quicksilver Scientific offers the Mercury Tri-Test, which separates out the inorganic from the organic mercury and measures mercury in blood, hair, and urine.  Hair is only reflective of organic (from fish) mercury and you can have a mouth full of almagams and it will not show up in the hair.  Quicksilver also offers the blood metals panel.  Here is a link to Quicksilver’s website with more information on their testing, including why urine challenge testing with oral chelators is problematic: https://www.quicksilverscientific.com/testing/clinical-metals-testing 

20:19  I asked if Dr. Shade ever measures antibodies to metals and he said that he is interested in looking at that and thinks that it may show patients who become symptomatic with metal exposure. 

22:18  Dr. Shade said that undiagnosed Lyme Disease may become symptomatic when treating the metals because raising the glutathione levels reboots the immune system. If you then send them out for more Lyme Testing they may then test positive when they were negative before. So you need to focus on controlling the infection with antimicrobials before you can effectively complete your metal detox program. 

22:58  Dr. Shade explains his approach to removing toxic metals from the body.  You can use the same approach for mercury, cadmium and arsenic, while the approach for lead is a little different.  Mercury is detoxified well by glutathione, but you also need glutathione S-transferase and transmembrane transporters and also magnesium. So if we want to build a system of detoxification, we need to build glutathione levels. We need to turn up the activity of the transferase, and we need to turn up and support the activity of the the transport proteins. And when it gets down to the GI tract, we need to grab it before it gets reabsorbed.

25:40  Liposomal glutathione is better absorbed and someone with mold toxicity or Lyme disease are sick and will have a tough time making glutathione from NAC. Taking liposomal glutathione is better than taking NAC in a diseased person.  Dr. Shade mentioned a study showing that 600 mg liposomal glutathione produced a 30% increase in glutathione levels in six hours while 600 mg IV glutathione only produced a 15% increase in six hours. 

30:15  Dr. Shade explains what a liposomal formula is and how it works.  You are creating a fat soluble bubble with phosphatidylcholine and tucking the glutathione in it, so it gets absorbed like a fat would and it passively absorbs into the upper GI tract.  Dr. Shade also explained that by making his liposomal products small enough, some of them will pass through the oral mucosa and directly into the capillaries, so you should hold the liposomal products directly in your mouth for 30 seconds before swallowing. He explained that all of his products are between 20 and 80 nanometers since below 100 they get much better absorbed but you also don’t want them to be too small or you have problems with nano particles toxicity. 

33:15  Once you get glutathione into the cells, then you need to up-regulate the transferase and get those membrane transporters working by invoking NRF2 by using Lipoic acid and polyphenols. You can also use sulfurophanes from crucifers and garlic oil.  The best polyphenols to use are green tea extract, pine bark extract, red wine extract, grape seed extract and haritaki. 

34:55  Dr. Shade explains that to get the transporter proteins working well, you need to stimulate the liver-gall bladder system and promote the flow of bile. The transport of toxins into the bile tree is synonymous with and linked intimately with bile transport. The two transporters that move bile from the hepatocyte into the bile tree are the bile salt export pump and MRP2, the multidrug resistance pump number 2. The MRP2 is the is also the toxin transport and thus it moves both toxins and bile salts.  These transporter proteins get up-regulated and down-regulated together, so cholestasis is toxostasis.  Thus, if you move bile, you move toxins.  If you don’t move the toxins from the liver into the bile, they get dumped into the brain and you get inflammation in the brain, the kidneys, you get lower back pain, skin rashes.  He likes to use herbal bitters to get bile and toxins flowing and also phosphatidylcholine to help solubilize the bile to keep it flowing. Then, when the toxins are moving through the GI tract, you want to use binders like thiol-functionalized silica, charcoal, clay, zeolites, and chitosan, so these toxins don’t get reabsorbed.

39:28  Dr. Shade explains why modified citrus pectin is not a good binder for toxins, though it helps remove toxins by reducing inflammation.



Dr. Christopher Shade is a PhD researcher and a recognized expert on mercury and liposomal delivery systems. He has lectured and trained doctors in the U.S. and internationally on the subject of mercury, heavy metals, and the human detoxification system. He founded Quicksilver Scientific and Quicksilver is an industry leader in blood metals testing and the development and production of superior liposomal delivery systems. Quicksilver Scientific is the only company to offer advanced mercury speciation testing (the Mercury Tri-Test), which comprehensively assesses for the body burden of mercury. Here is more information about the metals testing: https://www.quicksilverscientific.com/testing/clinical-metals-testing  Quicksilver Scientific is dedicated to producing superior nutraceutical products tailored at supporting the human detoxification system for the optimization of health. https://www.quicksilverscientific.com/home

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure as well as chiropractic work by calling his Santa Monica office 310-395-3111.


Podcast Transcripts


Dr. Weitz:          This is Dr. Ben Weitz with the Rational Wellness Podcast, bringing you the cutting edge information on health and nutrition. From the latest scientific research, and by interviewing the top experts in the field.  Please subscribe to the Rational Wellness Podcast on iTunes and YouTube, and sign up for my free ebook on my website by going to drweitz.com.        Let’s get started on your road to better health.

                          Hey Rational Wellness Podcasters. Thank you so much for joining us again today. For those of you who enjoy this podcast, please give us a ratings and review on iTunes.

                          Our topic for today is heavy metal toxins. This is a very important topic. We recently had Dr. Joe Pizzorno on talking about toxins, and now we’re going to focus in on heavy metals, mercury, lead, all the other heavy metals. And these are incredible important, can have all kinds of effects for our health, can play a role in various chronic diseases. And I’m very excited that I’ll be speaking with Dr. Christopher Shade, who is a PHD researcher and the founder and CEO of Quicksilver Scientific, a heavy metal testing and nutritional supplement company. Quicksilver Scientific is known especially for its detoxification products and its unique supplement delivery systems, and it’s patented mercury speciation test. Christopher, thank you for joining me today.

Dr. Shade:         Thanks, Ben, it’s a pleasure to be here.

Dr. Weitz:          Good, good, good. So can you tell me a little bit about your background and how you became interested in mercury and heavy metal testing?

Dr. Shade:         Oh, sure thing. I’ve a very circuitous background to get here. Grew up a scientist in an academic family. Got a little disillusion with reductionist science, went out into the woods, I was an organic farmer for a long time, sort of a Thoreau summer starting farms and stuff. And then one thing or another led me back into getting a graduate degree around pollution in the environment. I was looking at agricultural pollution and I got a masters in that.

Dr. Shade:         Then when I went to do my PHD, I didn’t really find the research that was going on there that interesting, but I found this guy who was specializing in global cycling of mercury as a toxin in the environment. And I ended up working with him. And they needed new analytical developed, new systems for separating different forms of mercury, which is really crucial to understanding their movement through the environment and movement through the body. And so I developed that, patented that, and graduated and started a company around that testing, originally doing environmental testing and then switching over into health and wellness. Because I wanted to get back to this human focused look at toxins in the environment and health in the environment, and cycle it back into looking at personal health.

                         And I brought this testing in, showed it to people like Hal Huggins and Dietrich Klinghardt, original pioneers in mercury toxicity. And they really liked that, but you know you bring up a problem, you gotta bring up a solution. And at the time, everybody was working with chemical chelators for getting rid of mercury and other heavy metals. And I thought I would do testing in conjunction with people using chelators, and so I tried all those chelators on myself and I got myself really into a hole. I really blew out my adrenals, I blew out my neurological balance, my immune system.  And while I was in the middle of just being in this dark night of my biochemical soul, I was watching these functional medicine meeting lectures here in Boulder County.  I was watching Bob Roundtree and Nigel Plummer from Pharmax, and they were talking about GI health and the GI system calling the shots in so much stuff. And I realized that a lot of amalgam toxicity was having so many metals in the GI tract.  And I was trying to push things through the kidney, but I should clear out liver GI functioning first.

                          And that led me to make my first detox supplement, which was kind of a chelator for the GI tract. It was like taking a clay or an activated charcoal and making it specific for metals. And as I did that and cleared everything out of my GI tract, I just opened up all my problems, I just cleared everything away. And introduced that product, which is now known as IMD, or Intestinal Metals Detox.  I introduced that to Huggins and Klinghardt and it filled a big void in everybody’s tool chest and it led me to research why it worked, and that led me to understand all the processes of the glutathione system and how the body’s naturally supposed to get rid of these metals. And that metal toxicity is not a deficiency of chelators, it is a deficiency of your own chemo defense system. And then when we optimize that, we can get rid of all these metals and at the same time make us resilient or resistant to other toxic insults. And so my whole life work became developing systems for optimizing all of that in people.

Dr. Weitz:            Cool. So can you explain about your heavy metal testing and why it ends up being more accurate than so many other testing?  And I keep coming back to whenever I look at serum testing I always think, you know, that’s only going to give us current levels of metals and so that’s why we’ve tended to do the oral challenge and then collect urine for six hours afterwards, with the idea that we’re going to liberate some of these metals, mercury, that’s been stored in the body, sometimes for months, years, maybe decades at a time. So how can you get a sense from testing of stored metals as well as what’s circulating and has come into the body recently?

Dr. Shade:           Right. But this is all … What did you just say to me? You said, “Well I think that this is only what’s circulating.”  Why do you think that? Did you do the primary research? Did you figure out why you think that?  Or are you just parroting what the guys who did chelation testing told you? Answer the question.

Dr. Weitz:            I have always been told that certain testing is only-

Dr. Shade:           Exactly.  Always been told is the problem there.

Dr. Weitz:            Including by the way some of the companies that do certain testing will tell you that as well.

Dr. Shade:           This is just what became the dogma of what’s going on. And the reality is that 20, 30 years ago we didn’t have really good testing to look at baseline levels. Like in urine, if you extended your discussion you’d say, but in urine there’s no metals in urine so I challenge it. That’s not true at all. There’s always a baseline of metals that are going on in the urine. And they are a filtrate of what’s happening in the whole blood, which is the plasma and the red blood cell. And the plasma and the red blood cell are in a steady state with what’s in the tissues.

                           Now for that whole argument that you brought up to be correct, that would mean that the chelators would go into all the cells and take a representative amount out into the serum and then make it go into the urine. But if you look at DMPS and DMSA, all the data around that says that they don’t do that. All the data around it says that they never cross the blood brain barrier, they don’t go into the cells. What they do is take what’s in the lymph and the red blood cells and bind it out into a form that’s easily filtered out through the kidneys.

                           And in a very famous paper that was done in Sweden in the mid-’90s, they were trying to look at DMPS and if it really reflects long term body burden, or if it’s just amplifying what you can already find in the body.  And they took acutely exposed workers who work with mercury directly, they took dentists with a long term burden, and then they took people with amalgams and people without amalgams.  And they looked at inorganic mercury in the plasma, and inorganic mercury in the urine before and after taking DMPS, 300 milligrams IV.  And what they found was that the mercury in the urine is linearly correlated with mercury in the plasma, and mercury in the urine after the challenge was linearly correlated with mercury in the urine before the challenge, and with mercury in the plasma before the challenge.

                          You’ve got these compartments and there’s a back and forth between them all. It’s not that the mercury comes in and goes into the tissues and sticks there and then leaves the blood. What happens, like if we went out for dinner tonight and we eat swordfish, a high mercury meal, we’re going to absorb that mercury in there and it’s going to peak between 12 and 18 hours after we eat. And it’s going to be much higher than our baseline is. So from our baseline let’s call it, let’s just give it a number. Say I’m at 5. I’m going to eat this meal, my peak is going to go up through maybe even 10 or 15, and then over 2 to 3 days it’s going back to this next baseline. And let’s call that 6.  And from the time to get from 6 back to 5, the original baseline, how long is that? It’s 60 days, 45 to 60 days in a healthy individual. As many as 300 days in an unhealthy individual. It’s not 2 to 3 days. The 2 to 3 days story was about a bolus that goes in, it goes up and peaks and comes back to a new baseline, and then it comes back.  But where people were kind of throwing their hands up with what’s urine mean, what’s blood mean? What’s going on here?  Methylmercury represents itself very well in the blood and will give you high levels.  Inorganic mercury from dental amalgam doesn’t represent itself very well.  It works on a lower scale.

                       Now why is that? It’s because of the distribution between the blood and the tissues. There’s always more in the tissues, which the prevailing wisdom is right about. There’s more in the tissues than the blood. But there’s a ratio between the two. And maybe it’s 10 fold more in the tissues for methylmercury and 30 to 50 fold more for inorganic mercury. And so dental amalgams and blood levels didn’t seem to correlate very well. But fish and blood levels did correlate well. But dental amalgams correlated pretty well with urine, and fish didn’t so well. That’s because methylmercury you find a lot in the blood, inorganic mercury, small amount in the blood. In the urine it’s all inorganic mercury. And so it’s reflective of the inorganic mercury levels in the serum, if the kidneys are transporting correctly.  And this comes down when we talk about detox we’re going to talk about pathways in the liver, you have the same pathways in the kidney. And when they get damaged, and they’re easily damaged, then that urinary representation of the blood blows out and you have low urine, high blood. Alright, but if it is working, then urinary mercury’s an inorganic mercury exposure.  Hair, you have Naturopaths going through all these soups to explain what hair meant compared to blood or intake. Hair is only fish. You can have a mouth made out of dental amalgam, if you eat no fish you have no mercury in your hair.

                     So there was all this improper, imprecise understanding of the pools of mercury, the compartments, and the interactions between them all. And so we just said, we’ll take the chelator, boom, a bunch comes out through the urine and we can compare people that way. And you can, but it’s not a very sophisticated way to go. And humans always do this, in order to justify that, they create this whole story that the mercury’s never in the blood except for like the last two days, and it’s all in the cells and the challenge pulls it all out of the cells and gives you this long term mercury number. But I pulled five or six different papers out of the literature where they examine that, and none of it worked.

                    Get this, one paper on DMSA, they took a grouping of people who had worked in the Chlor-Alkali factory, you sit there with a pool of mercury and stir it, and it’s an electrolysis cell, to split sodium chloride into sodium and chlorine. It’s the highest exposure you can ever get. So they all worked there and then they stopped working there for either one year or three years, but that’s the highest level of burden you can take into your body there is.  And then they took the general population and they measured urine before and after DSMA chelation.  Before DMSA chelation the guys who worked with the pools of mercury before were higher than the mainstream. But after chelation, the differences leveled out totally. There was no statistical difference between the two and there’s a reason for that. Because DMSA is really no good on inorganic mercury, which is what you get for that vapor form. But it’s pretty good on methylmercury. So this is a measure of how much fish these two groups ate. And it’s the same, because they were just a cross section of the population for methylmercury exposure, but one of them had significant inorganic mercury exposure.  So there’s all these papers showing the failure of the challenges to show long term burden. The exception being EDTA challenge and bone lead versus blood.  EDTA challenge is better correlated with bone lead than blood is, but blood’s still not bad.  You just have to take these scales, you’re looking for these huge, big scales, you’ve focused them down, and key for us for mercury, you separate methyl and inorganic mercury.  Give them their own reference ranges in the blood. Then once you have that inorganic mercury separated away from the fish-based methylmercury, that’s supposed to correlate perfectly with urine. And when it doesn’t, then you see it building up in the blood and you know where the damage is. It’s to transporters in the proximal tubules. It’s not even related to glomerular filtration. And you know when you treat them you have to focus on that. So there’s the whole story.

Dr. Weitz:      Yeah, so to sort of highlight a couple of points that you’re making is number one, the oral chelators like DMSA, they’re not effective at removing mercury and heavy metals from the tissues like we think they are.

Dr. Shade:     No, they remove from the blood plasma, maybe a little bit of soft tissue, lymph, and then the metals redistribute from the cells into the blood. And that’s when it’s important to have things that up regulate the chemistry that dumps out of the cells into the blood. Like lipoic acid. If you go to the Cutler theory, Cutler thought that DMSA was clearing the body and lipoic acid was clearing the brain. And he would start with DMSA and then he would move to DMSA and lipoic acid. DMSA clears from the blood and then lipoic acid gets the cells that dump into the blood. And then the DMSA can take it.

Dr. Weitz:      Interesting. So the first point is the oral chelators are not effective at removing the metals from the tissues. And two, the serum testing is actually effective for measuring mercury that’s in the body for up to 300 days.

Dr. Shade:     Yeah. And as long as you have the right testing. If you go to Labcorp, they’re not measuring low levels, and they’re not separating the two forms of mercury. So once you separate the two forms and you can measure really, really low, then everything’s good.  For instance, if say we’re measuring you and you have a lot of dental amalgams, but you never eat fish. Your total mercury in the blood might be say 0.5 parts per billion. Now the limit of detection for Quest is 1 part per billion. And some labs it’s 0.5. And so you’ll like less than the detection limit, less than 1. And they’ll say you have no mercury. But all of it is inorganic mercury. If you look at our reference ranges once you separate methyl and inorganic mercury, 0.5 parts per billion if inorganic mercury is the 95th percentile. It’s a very, very high amount.

                      And if your urine to blood ratio is good and your kidneys are working well and if you measured your urine, your urine would actually be fairly high. And so it was just, oh, we’ll measure serum. It only shows a little bit of one story. We’re measuring urine, only shows a little bit of story. You gotta put all this stuff together with the right technology. And there’s a beautiful story about the disposition of the metals and your excretion ability all in that one test.

Dr. Weitz:            So your company offers this tri-metals test that measures mercury through serum, urine, and hair.

Dr. Shade:           Yeah, that’s called the Mercury Tri-Test. Those three, blood, hair, urine.

Dr. Weitz:            And then there’s another test that measures multiple metals, and that’s a serum test.

Dr. Shade:           Yeah, that’s our blood metals panel, where you’re looking at nutrient metals and toxic metals. So the nutrients, you’ve got classic calcium, magnesium, copper, zinc. Most are really important because they have to be in a certain ratio. When you have high copper and low zinc, you’re synergistically toxic with all your other metals and it’s a marker of a serious dysfunction. So is calcium:magnesium.  Then you’ve got co factor detoxification metals like selenium, molybdenum, which is crucial for sulfur cycling, and you’re taking a lot of sulfur compounds when you’re detoxing. And lithium, which is a big one for B vitamin cycling.  And then in your toxics you’ve got the major four, arsenic, cadmium, lead and you have mercury but just as total mercury. If you’re just looking at somebody who’s a big fish eater and you want to know is it high, is it low, it’s sort of a good first cut.  A lot of people think, well if it’s high there then I’ll go do the Tri-Test. But if you have a patient who has dental amalgams but doesn’t eat fish, you’re not going to see anything in the total mercury blood. You need to go to the test that separates the two and looks at inorganic separate from methyl. It’s like they’re two totally different metals.

Dr. Weitz:            So ideally, if you have somebody that you suspect has serious metal issues, you really need to do both tests.

Dr. Shade:           You do both and you have a map of everything then. Both functional excretion capacity, sourcing, and your whole metals map, nutrient and toxic all together.

Dr. Weitz:            You ever measure the antibodies to metals?

Dr. Shade:           No, but every time I hang out with-

Dr. Weitz:            Dr. Vojdani?

Dr. Shade:           Yeah.

Dr. Weitz:            He spoke at our meeting last month so I got to hang out with him, it was great.

Dr. Shade:           Yeah. And so hopefully I hired guys to be in charge of a clinical research program here, and we’re starting to really crank out a lot of stuff. And so that’s on our list is to reach out to Dr. Vojdani and get a bunch of patients. Because he had said to me, “Well I think when you see the levels are high you’re going to see antibody response.” My take is very different.  When you see an antibody response, that’s going to mean that a certain level of metals is infinitely worse than maybe a higher level with no antibodies. So the antibody and the levels together will correlate with symptomology. And we’ll see, because you’re going to find a lot of people who are super symptomatic at low levels, and it’s this diffused whole immune dysregulation and neurological dysregulation. And the amount of mercury is really hard to justify that that’s doing it alone. But if they’re allergic to that mercury, then that can give those symptoms.

Dr. Weitz:            Yeah, boy, those can be some of the toughest patients, some of these chronic patients, and you’ve been doing mercury protocols and years later they’re still sick. Those are the toughest patients.

Dr. Shade:           Yeah, they’re very difficult. It’s very multifactorial, why did the immune system turn on it. There’s usually layers and layers of stuff going on.

Dr. Weitz:            Yeah, in one of the discussions you were having with somebody else, you were talking about how when you’re trying to get rid of metals or mercury, at a certain point sometimes that will increase some of the infections and you’ll have to stop and fight that off, like SIBO will recur.

Dr. Shade:           One of the things that we see a lot is that with lyme, undiagnosed lyme, when we start treating the metals we bring the glutathione levels up, it reboots the immune system and it starts reacting to the lyme and they feel horrible. And then you send them out for more lyme testing and then they show positive on their Western blots, and then they have to take a side road and get some antimicrobial therapy before they can come back and just do the metals. Although there’s still detoxification support for that. So in the complex cases I would say there’s a sort of pendulum between microbial focusing and toxin focusing.

Dr. Weitz:          So can you talk about your strategy for helping to remove metals, and how much does it change depending upon the metal?

Dr. Shade:         Oh, good, good question. And I’ve gone to a more broadly focused detoxification strategy, but let’s just look at mercury now. And mercury, cadmium and arsenic are playing by basically the same rules, and lead plays by a different set of rules. And then cadmium a little bit straddles the fence between the two. So mercury is the classic glutathione dependent detoxification. So if we’re in a cell, say there’s a cell here and we got a protein and there’s a mercury stuck to it, we gotta get the mercury off of the protein because mercury’s blocking the function of the protein. So you’re going to have glutathione floating around in the cell. But it doesn’t just go and grab the mercury on its own. You need glutathione S-transferase. Glutathione S-transferase is part of the phase two detoxification proteins called transferases, where they link something you make, like glutathione, onto something you want to get rid of, like mercury. And so that transferase would be me, and it changes the bond structure on the mercury so it can come off the protein and go with the mercury. 

Dr. Shade:         So then we got a mercury glutathione complex in the cell, we gotta get it out. Now it doesn’t just passably diffuse out. There is a series of transmembrane transporters that depend on magnesium and ATP, meaning you need to energy to turn them over and you need magnesium. And they actively push that complex out of the cell.  Okay, so the cell’s free, but it’s out in the body. And it’s in the extracellular environment and then that’ll join in to the blood flow and then how do we get it out from there? In the liver you got another transmembrane transporter that’s feeling around for these things, grabs it, pulls it into the hepatocyte, and another one that’s another one in these family of transporters that dumps it into the bioflow. And then from the bioflow goes down to the GI tract and out to fecal excretion. That’s when everything’s working well.

                        So if we want to build a system of detoxification, we need to build glutathione levels. We need to turn up the activity of the transferase, and we need to turn up and support the activity of the the transport proteins. And when it gets down to the GI tract, we need to grab it before it gets reabsorbed.  So we like to bring in liposomal glutathione for building glutathione.

Dr. Weitz:        Now how much is glutathione actually absorbed? Those of us in a Functional Medicine world have it in our heads, we’ve been told glutathione’s not absorbed, you gotta take NAC, that’s the only way to do it. If you end up in the emergency room with acetominophen toxicity, they’re going to give you IV NAC, so NAC’s the way to go. But now that we have these better forms of glutathione, like liposomal, how much is actually absorbed?

Dr. Shade:       Right, and so in … These total amounts absorbed in kind of vary and we’re doing a lot of research to show how much goes in and how these different approaches compare. But first, why would we do … Let’s just assume we get the liposome in and then we’ll come back to how well liposomes are absorbed, and what’s required for a liposome to be absorbed, because all liposomes aren’t the same. It’s like all cars are not the same, all wines are not the same. There’s a vast range of quality.

                       But first just assume that it gets in there. Why would you use that instead of NAC? Now in the cases of really compromised individuals who are very sick, people with lyme disease, mold toxicity, things where there’s actually blockages of the enzymes that are synthesizing glutathione.  For instance, there was a paper done using ready liposomal glutathione in cell cultures and they took immune cells from HIV patients, which are notoriously poor at making glutathione, and they’re getting all these infections because of the low glutathione. And that’s one thing that people miss about glutathione is it’s an essential factor for proper immune response, it’s not just about detoxification.  So they found in these cells, they were challenging them with the tuberculosis culture, they culture the white blood cells, the put tuberculosis in, and for the cells to be able to handle the tuberculosis, they needed to raise the reduced glutathione levels. And then the cells could deal with this. And they tried two ways to do it.  One was NAC, and the other one was liposomal glutathione into the cell cultures. And they needed 5,000 times more NAC to raise the glutathione levels up the way that the liposomal glutathione did. 5,000 times. Because those enzymes are epigenetically being blocked by disease states. So when you’re sick, just pouring NAC in, it’s hard to get the levels up. You’re healthy, that’s a good way to go. If you have snips for poor glutathione production, then you want to think about both as differing strategies.

                      Then liposomes, what gets in, what doesn’t. We’re actually in the middle of a study right now where we’re measuring all the different liposomes on the market and the factors that go in to getting these into absorption. And we just got a study back from our Japanese partners, we’ve got a bunch of Japanese doctors who use our stuff, they wanted data on glutathione, I didn’t have it yet, so they went and got Doctors’ Data, blood glutathione test. They took 10 people, measured baseline, gave 5 of them IV and 5 of them liposomes, 500 milligrams each. And then they measured them six hours later. To see not right away, if you do an IV you spike up, but often you spike right back down. So they said six hours later, what’s the effect on this system?  IV six hours later there was a 15% jump above baseline. Liposome, a 30% jump. Anything that gets you a 30% jump is awesome. But the fact that we just beat the IV, because the IV has no mechanism for really interacting with cells. Glutathione’s not really good at getting in the cells. But the liposome showed its ability to raise the levels for an extended period of time. It was a beautiful piece of work. But in all the other data that we’ve got on liposomes, the membranes have to be right and the size has to be right.

Dr. Weitz:       And by the way, liposomal basically means putting it in a fat soluble form, right? Essentially combining it with phosphatidylcholine.

Dr. Shade:      Well what you’re doing is using phosphorylcholine to make a little bubble that’s sort of watery on the outside, fatty on the inside. And you’re making like a little cell and you’re tucking the glutathione in there. And so it absorbs like a fat would. It passably diffuses across the upper GI. So that’s why they say it’s like it’s like fat soluble, because it absorbs like a fat.

                       But if you make them small enough, they pass right through the oral mucosa into the capillaries in the oral mucosa. In fact in the blood uptake studies that we did with vitamin B12, we had a very significant bump in the blood levels in two minutes after holding it in the mouth. That’s why with our liposomes you take them orally, you swish them around your mouth, you let them hold in there 30 to 60 seconds and you swallow. The uptake begins there. Even if … You get to the stomach acid and the bile salts, you’re starting to beat on those liposomes. So the faster you start that journey, the better.  And that journey only begins that far up in the GI tract when they’re really small. We call them nano liposomes because they’re below 100 nanometers. And all of our products are between 20 and 80 nanometers. This is not a threat, don’t worry about nano tech. Because when you’re absorbing fats in your diet, you make something called a chylomicron. It’s triglycerides surrounded by phosphatidylcholine with a couple of apolipoproteins that you use as delivery vehicles to bring the fatty acids to the cells to use them. And those range down to 70 nanometers in size. So those are lipidnanoparticles, and you have a whole enzyme system for dealing with phospholipid based nano particles to take them apart, use the phospholipids in your cells, in your membranes. You can use them as fatty acids for energy, you can make acetylcholine.

                    So this delivery system is really good but it only worked when we got it below 100 nanometers. And all this other stuff on the market is selling you the dream of the liposome but they’re 2, 3, 400 nanometers, and I just don’t see any evidence that they’re working. So we’re really spending a lot of money and a lot of time working out exactly what works and what doesn’t work. Alright, so that’s the glutathione story.

Dr. Weitz:     What about the idea of spraying some in your nose, because Dr. Vojdani was talking about how there’s a route of entry from the nose for bacteria directly into the brain.

Dr. Shade:     No, that’s a great idea but it’s not a dietary supplement, then it’s a compound pharmacy product. Because a dietary supplement has to go through the GI tract.  Don’t think I don’t have a couple of nasal applicators here in my office. I did that, but I can’t do it on the market. So there’s the story there.

                     So back to our detox story, we got glutathione in, and now we need to up-regulate the transferase and get all those transporters working. So now we want to invoke NRF2, which is the little switch, the protein inside the cytoplasm that when you activate it, it goes into the nucleus and turns on all the chemo protective genes. It’s like the light switch for all the protection genes. So you want an NRF2 up regulator. So the things that do that, lipoic acid is probably my favorite. There’s a number of compounds from crucifers, like sulforaphane is very well known but there’s some drawbacks with those. There’s things from garlic that work very well. And don’t get deodorized garlic because it’s actually the stink of the garlic that works, it’s garlic oil that does it.  Then polyphenols, I love polyphenols.

Dr. Weitz:     Resveratrol.

Dr. Shade:    Well resveratrol’s not a great NRF2. It’s more in the SIRT 1 activation, so mitochondrial up regulation. But it is a polyphenol. And then people say curcumin, and that’s not the best either. The good ones are green tea extract, pine bark extract, red wine extract, grape seed extract. The Ayrevedic polyphenols from haritaki is one I use a lot. So all of those are really good NRF2 up-regulators.

                     And with that comes glutathione S-transferase. There’s also a bump to glutathione synthesis in there. So that’s working, and there’s also a bump to the transport proteins. But to really get the transport system working well, I like to work from the GI–gallbladder–intestinal axis here. Why am I talking about that? Because the biggest transport system that’s happening here is from the hepatocyte into the bile ducts. And that transport of toxins into the bile tree is synonymous with and linked intimately with bile transport.  There are two transporters that move bile from the hepatocyte into the bile tree. And it’s the bile salt export pump and MRP2, the multidrug resistance pump number 2. The MRP2 is the toxin transport, it moves toxins and it moves bile salts, and obviously the bile salt pump moves bile salts. These guys get up-regulated and down-regulated in unison. So cholestasis is toxostasis. If you move bile, you can’t move -toxins.

                   So what happens to the toxins that are in the liver when you can’t move them into the bile? There’s another door out of the liver back into the blood. It’s a pressure release valve. When you wind up a bunch of toxins in the hepatocyte, and the hepatocyte can’t deal, it can’t move them out fast enough, it dumps them back into the blood.  Where do they go from there? Brain, neuroinflamation. Kidneys. Lower back pain. Skin, rashes and things coming out through the skin. These are all the classic detox reactions, and they’re all caused from a failure to continue to move bile. So we’re taking our cues here from the early 1900s and the prohibition time when bitters was the medicine for everybody because it was the only way to drink, but it also cured half of what ails you, because stuck liver was what was going on. And when you open up liver, bitters activate those transporters, and when you open that up and you dump bile, you dump toxins and you start feeling better. So we use a lot of bitters.  We use a lot of phosphatidylcholine just on its own, not even in liposomes, because PC is always being donated from the hepatocyte cell membranes into the bile flow because it helps fluidize the bile flow. People talk about thick bile, PC is what’s solubilizes it. And it actually forms little mixed micelles with the bile salts so that the bile salts, which are a detergent, don’t dissolve the bile tree.  And the reason you have pressure release valves from the hepatocyte is when bile salts build up in there, they dissolve the hepatocyte. And so you’re dumping those back into the blood and then bringing them up when you can use them. So when you’re always moving out, you’re always moving toxins out of the system.

                 But what else are you doing? You’re cleaning the upper GI tract. Everybody’s talking about SIBO and SIFO, like it’s a new infection. Do you really believe that you have an infection in the small intestine that has to be treated? Why do you have an infection? It’s not like a creature came in and is living there in a classical infection sense. It’s crawling it’s way … It’s just bacteria in your lower GI tract crawling their way into the upper GI tract. Because the upper GI tract is supposed to be washed by bile. The antimicrobial detergent that washes the upper GI tract and acutely brings glutathione along with PC into the upper GI tract as part of the metabolism in the upper GI.  Upper GI is doing mostly chemical reactions. Detoxing things in food, and pulling things out of blood and dumping them into that GI tract, and then the microbes start growing further on down. And in fact, in people with congenital intrahepatic cholestasis, meaning you’re not able to move bile salts from the hepatocyte into the bile tree, those people are statistically higher cases of SIBO, and when you treat them, it keeps coming back.

                 So this bile flow, this keeping things moving out, is a crucial part of keeping the transport chain open, keeping the liver open, and then coming in with binders to bind these toxins in the GI tract so you don’t absorb them. And that’s binders like our IMD, which is thiol-functionalized silica for metal, or charcoal. Clays and zeolites, Chitosan, those are all grabbing different parts of the toxin pool and we blend those all together-

Dr. Weitz:            What about pectins, like modified citrus pectin?

Dr. Shade:           Now modified citrus pectin, I don’t buy into that at all. So remember my … No, I buy into it’s use therapeutically, I don’t buy into the idea that it can bind toxins. Because remember my PHD is in mercury chemistry. I designed the whole analytical system we use to model out what molecules bound mercury as it moved from the sky to the rain to the bacteria to the plankton to the fish to the people. We know this stuff really, really well. And there ain’t nothing in modified citrus pectin that’s going to be a good toxin binder.

          But remember this, inflammation blocks detoxification. When inflammation is down, detoxification gets blocked because detoxification’s part of the antioxidant system and inflammation is pro oxidant. So they just go like this. And modified citrus pectin is a very nice immune modulator, especially in the GI tract, and it turns down inflammation in the GI tract. When you turn down inflammation in the GI tract, you release a stuck immune system and allow it to detox more. And I believe that that’s why modified citrus pectin has a therapeutic value in detoxification. And it probably does bind a lot of other toxins that are made, maybe it binds an endotoxin, maybe it binds some of the other dysbiotic toxins, maybe it gets a little bit of mold toxin. It does have a therapeutic thing but arguing for it mechanistically as a mercury binder is not a good path for the argument.

Dr. Weitz:            It’s interesting because it’s in a lot of products that are designed for removing heavy metals.

Dr. Shade:           Yeah. And again, I think therapeutically it works but not in the way that they’re describing. And my whole goal, my whole path here has been one of shedding light on the path, and the light is on the light of the mechanism that things are working. I am big into empirical medicine and knowing what’s worked and what hasn’t. But until you reduce that to mechanism, you can’t take the next step of effectively bringing together the best players for a different problem, and designing a higher order of natural medicine.

Dr. Weitz:            Right. Just a word on the SIBO. You know part of the theory about one of the reasons for SIBO, apart from decreased bile secretion, is that you get decreased motility and you get a blockage of the migrating motor complex which causes these peristaltic waves to happen in between eating that helps to clear out the small intestine.

Dr. Shade:           Flush, clean, flush, clean, flush, clean. You’re right. And so it has two sides to it. How do they get blocked, are they poisoned, is it a microbe, is it a toxin? But somehow they get locked down.

Dr. Weitz:            Well there’s that whole cytolethal toxin theory of Dr. Pimentel’s, and they even have a blood test for it.

Dr. Shade:           And what are those called?

Dr. Weitz:            It’s a cytolethal-

Dr. Shade:           [crosstalk 00:42:43] toxin?

Dr. Weitz:            It’s an endotoxin secreted by a campylobacter jejune or some form of food poisoning that secretes a toxin that then damages the nervous system of the small intestine.

Dr. Shade:           Yeah. And when you go into the body and you look at what really amplifies toxins-

Dr. Weitz:            It secretes a cytolethal toxin distending toxin.

Dr. Shade:           Cytolethal distending toxin.

Dr. Weitz:            Yeah, Dr. Pimentel has a test for it, I think it’s called the IBS check test.

Dr. Shade:           Okay, cool, I’m going to look more into that. Because things like endotoxin amplifies all the toxicity through the body because it’s pro inflammatory. And there’s papers looking at the damage of mercury alone and mercury plus endotoxin and it’s synergistically higher. And I was talking about those transporters that are moving the bile salts and the toxins. Well what blocks them the best? Endotoxin. And it actually causes the transporters to be pulled out of their membrane and internalized into a little vesicle in the hepatocyte. And you really want to damp the inflammation, get those transporters back in there to drain everything out.  And it was great, we put a paper, Carrie Decker and I wrote a paper in Townsend Letter about all these pathways and nutraceuticals work on these things. And one of the interesting things about milk thistle is that it actually preserved the transporter’s ability to stay in the membrane during the stress of high toxicity.

                           But another thing that blocks that is excess estrogen. And something that opens it up is progesterone. So there’s estrogen progesterone balance, estrogen dominance actually locks up your gallbladder. And in the brain estrogen dominant winds up the glutamate system which gives you anxiety, it makes you sympathetic dominant. But the gallbladder’s also para sympathetically innervated, so it’s working against you on so many different levels. So stress, estrogen dominance, leaky gut and endotoxin, all this is blocking your ability to detoxify.

Dr. Weitz:            And Dr. Vojdani at Cyrex Labs has a test, it measures anticytolethal distending toxin and also vinculin. That’s the part of the small intestine that gets damaged and they have a test for that.

Dr. Shade:           See me writing all this down. Distending toxin, I like that. Alright.  See, this goes back to understanding mechanism. The more we understand mechanism, the more we can reach out to other people that are working in different fields and say let’s bring this together and really let’s lock this down. And it’s an amazing time in the whole history of natural medicine where you go into PubMed and you see that there’s research being done all over the world on all the different natural compounds and the genes they hit, the proteins the express, interactions between the two. We’re getting all of the mechanism of all these transporters all down. This is a brilliant time where we can design the most powerful natural medicine systems.

Dr. Weitz:            That’s great. This has been an awesome discussion, Dr. Shade. So for listeners and practitioners who are interested in getting some of this testing done, or getting a hold of your products, are the testing and products available to laypersons or should they just go through functional medicine practitioners like myself? How does it work?

Dr. Shade:           Yeah, so Quicksilver Scientific is dominantly a professional company. We’re offering the testing to the practitioners, they pass it through. You guys buy the supplemental through wholesale, you pass them through. You use our protocols or individual products. But there’s such a world of hyper informed self medicators out there, and they’re dying for this stuff and I gotta give it to them because that’s me, too. And so we do sell direct to consumer all but some. Like there’s some real pro-grade stuff, like the EDTA, that’s practitioner only. But most of the other stuff is available. Even the testing, but but that’s state by state, about half the states allow direct access testing where you can buy a kit from us, go to to a clinic, get the blood draw done and send it back.  But it’s always good to go through a practitioner, because they’re going to bring a wealth of experience of all the other things that they’ve seen. And they’re going to button up the whole protocol and they’re going to put the little extra things you need in there. There’s “Oh no, did you think about doing this and this?”  So both are available, but we’d like people to work with practitioners.

Dr. Weitz:            That’s great. And for those who want get more information, where should they go?  

Dr. Shade:           Quicksilverscientific.com. And we have a whole new website being launched in about two weeks. Right now Quicksilver Scientific, if you’re buying as an individual, it will move you over to Quicksilver Life, our second website, which is a retail website. But they’ll all be merged together as Quicksilver Scientific in about two to three weeks. And there’s different things, it’ll be one site with different things available to you depending upon your journey in there, there’ll be more stuff available to the practitioner.

Dr. Weitz:            That’s great. Thank you, Dr. Shade.

Dr. Shade:           Great, thank you so much, it’s been great hanging out here with you, Ben.