Preventing Autoimmune Disease with Dr. Shelly Sethi: Rational Wellness Podcast 97

Dr. Shelly Sethi discusses Preventing Autoimmune Disease with Dr. Ben Weitz.

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Podcast Highlights

4:37  In the Functional Medicine world instead of just treating the overactive or dysregulated immune system that we see in autoimmune diseases, we search for some of the underlying triggers, such as leaky gut, food sensitivities, toxins, infections, nutritional deficiencies.  Dr. Sethi said that the first place we should look for potential triggers for autoimmune diseases is the gut. We now have discovered that there are certain specific bacteria and viruses and parasites that are associated with specific autoimmune diseases.

6:55  Dr. Sethi said that food sensitivities can play an important role as triggers for autoimmune diseases, so she will often start her patients with an elimination diet that eliminates all grains, esp. gluten, dairy, soy and sometimes eggs and nuts, for at least 30 days and then she will test each food back for three days.  Sometimes she will get a patient who has had a food sensitivity test run that shows that they have a lot of different sensitivities, then she will focus on healing the leaky gut.  She will often then look at the gut and do a GI Map stool test from Diagnostic Solutions and an organic acids test from either Great Plains or Genova Labs to look for evidence of bacterial or fungal overgrowth. Dr. Sethi will also look at the secretory IgA on the stool test as an indication of the status of the gut immune system. If the secretory IgA is low, she will support the gut with things like vitamin A, vitamin C, Saccharomyces, and she will sometimes use amla. She may use colostrum or a dairy free colostrum product.  If the secretory IgA is high and she also sees organisms like Citrobacter or Klebsiella, which are highly associated with autoimmune conditions, she may refer to a gastroenterologist to get scoped to look for Inflammatory Bowel Disease.  Once the immune system is supported, if they have a parasite, she will use a product that contains Mimosa pudica.  If there is bacterial overgrowth, she may use an antimicrobial product that contains berberine.  She may use mucilaginous herbs like diglycerized licorice (DGL) and marshmallow to soothe the gut.  Zinc carnosine can also be helpful. She will often used a product with a blend of these. She will often follow an antimicrobial protocol with some liver support such as milk thistle.  She may add some binders like activated charcoal or zeolite clay or fulvic acid for two to three months.  She also will use spore based probiotics.

20:22  Exposure to toxins like heavy metals, plastics, phthalates, BPA can negatively affect the gut microbiome and lead to leaky gut or dysbiosis or SIBO.  Also, if the gut membrane isn’t healthy, then you can become nutrient deficient. This is why Dr. Sethi will include an organic acids test with her initial testing.

22:10  I asked Dr. Sethi to go through a few case studies, starting with a case of Hashimoto’s autoimmune thyroiditis.  She said that often she will get a patient with Hashimoto’s and they have been given Synthroid by their conventional doctor as their only option.  Either nobody has even measured their thyroid antibodies or they only measured after the TSH is elevated. Dr. Sethi mentioned that she has some kids in her practice now who are 10, 11, 12 years old who’s parents or relatives have Hashimoto’s and she finds that their TPO antibodies are already elevated.  She will then look at their lifestyle for triggers like food, stress, toxins, or bacteria or parasites in the gut. Dr. Sethi has a 12 year swimmer who’s in chlorinated water every day of the year, which could be triggering her thyroid problems, since chlorine competes with iodine. Dr. Sethi talked to her patient’s endocrinologist, who disagreed that chlorine could be a problem, but the girl took a break from swimming in the summer and they also got inflammatory foods out of her diet, got her sleeping better, and had her introduce a meditation practice every day. By the end of the summer, the rash that she had had on her skin, which looks to be some sort of scleroderma-type thing, had actually shrunk to half the size. Her dermatologist was shocked.  Dr. Sethi talked about the importance with patients with hypothyroid of replenishing selenium and zinc and magnesium. Also we are starting to see more iodine deficiencies, esp. in vegetarians unless they are eating seaweed. Also people are no longer eating iodized salt and are buying sea salt or Himalayan pink salt in bulk and iodine evaporates when it’s exposed to air. Salt should be kept in a darkened container and you should go through it quickly.  Also much of the public water has both chlorine and flouride added, both of which compete with iodine.  And then there’s the gluten thing, since if your immune system reacts to gluten, it can cross-react and attack the thyroid tissue.

31:34  If a patient wants to prevent autoimmune diseases but does not currently have any symptoms, Dr. Sethi says that autoimmune diseases are really all related and tend to have similar triggers. We should start by looking at the microbiota with GI testing with the pcr stool test and the organic acids urine test. She will look at inflammatory foods that might be in their diet and either eliminate them for a month or do food sensitivity testing. She recommends making sure you are having your drinking water filtered with reverse osmosis or at least a Berkey filter. Make sure that you are not getting exposure to mold. Consider a HEPA filter in your bedroom.  Look at nutritional deficiencies. Everybody should at least be taking a high quality multivitamin. Dr. Sethi cautioned to be careful about doing some of the autoantibody testing, esp. on kids, since there can be some false positives. 


Dr. Shelly Sethi is an integrative, Osteopathic Physician who is board certified in integrative medicine.  She has written a best-selling book, Built To Thrive.  Dr. Sethi’s website is Dr.ShellySethi.com and you can make an appointment to see her by calling 512-215-9984.

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 doing 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. For those of you who enjoy listening to the Rational Wellness podcast, please go to iTunes. Give us a ratings and review. That way, more people can find out about the Rational Wellness podcast.

Our topic for today is the natural treatment for autoimmune diseases, and we’ll be speaking with Dr. Shelly Sethi.  There’s been a significant increase in autoimmune diseases in the last several decades. We also have come to realize that a number of diseases that we didn’t understand the autoimmune origin, that now we’re starting to understand. Now there are approximately 100 different autoimmune diseases. For some reason, 75% of these occur in women. Having two X chromosomes seems to create a lower risk of infection in women, but a higher risk of autoimmune diseases.  According to the American Autoimmune Related Diseases Association, there are approximately 50 million Americans suffering with autoimmune diseases. Some of the more common autoimmune diseases include Alzheimer’s disease, Parkinson’s, asthma, hypothyroid, rheumatoid arthritis, lupus, psoriasis, celiac disease, irritable bowel syndrome, Crohn’s disease, multiple sclerosis, and type 1 diabetes.  

Our immune system is designed to protect us from pathogens, like bacteria, viruses, and parasites, as well as to help us repair our tissues when they’re damaged. But what happens in autoimmune diseases is that our immune system mistakenly attacks our own cells and organs. The conventional medical approach is to treat autoimmune diseases either by controlling the symptoms, such as by providing thyroid medication in the case of Hashimoto’s thyroiditis, or by using medications that suppress the immune system, such as corticosteroids steroids or chemotherapy agents or the newer immune-blocking drugs, like HUMIRA and REMICADE.   These drugs simply block part of our immune system, which is a problem because you do need a properly functioning immune system, and they have potential side effects, like infections and cancer. But functional medicine treats autoimmune diseases by looking at some of the underlying factors that lead to the immune system getting dysregulated, such as leaky gut, food sensitivities, toxins, infections, nutritional deficiencies. This is all very important.

If I have a patient with hypothyroid, and it’s autoimmune in origin, and all this patient is treated with is thyroid medication, it doesn’t do anything for these smoldering fire of the autoimmune disease underlying it. This will continue to attack the thyroid gland. Chances are, it will continue, and the patient will need higher dosages of thyroid medication. Or, they may end up with another autoimmune disease because, statistically, they have a much higher risk of that. So, from a Functional Medicine perspective, not just regulating the thyroid, but also putting out that smoldering fire of autoimmunity is crucial for this patient’s long-term health.  Dr. Shelly Sethi is a board-certified family physician with an emphasis on integrative and functional medicine. She studied integrative medicine with Dr. Andrew Weil and was also certified by the Institute of Functional Medicine. She also practices yoga and meditation and has written a number-one best-selling book, Built to Thrive. Dr. Sethi, thank you so much for joining me today.

Dr. Sethi:             Thank you for having me.

Dr. Weitz:            What do you think are some of the most important triggers for autoimmune diseases?

Dr. Sethi:             Yeah. That’s such a good question and, I think, really under-addressed in the conventional community as you let us know. I feel like one of the first things that we should be looking at, really, is the gut because we know that many of the triggers that are coming to light for a number of these autoimmune diseases really do stem from what our microbiome or microbiota look like. In the advances in research in this field, we’ve really found that there are a number of various bacteria as well as viruses and parasites that have been associated with very specific autoimmune diseases. So, I think we’re really coming to a new era in the diagnosis and treatment and prevention of autoimmune disease.

Dr. Weitz:            Cool. How do we diagnose autoimmune diseases?

Dr. Sethi:             Yeah. In conventional care, the typical way to diagnose is to run a series of blood tests. Typically, what you’re looking at are a number of things like antibodies that are related to various types of proteins that are produced in the blood. For example, looking at an anti-nuclear antibody, an ANA, would be a screening test, an initial test that’s typically run for somebody who might be presenting with things like fatigue and joint pain or inflammation, something to really trigger the doctor to think that maybe there’s something going on that’s autoimmune-related.  Then, from there, that is … Standard conventional care, that’s kind of the screening test. We also typically had been taught in medical school that if somebody presents with symptoms of rheumatoid arthritis that you would also run the RA panel, which also will look at antibodies. Then, from there, typically a patient would be referred to a rheumatologist who would then run a series of additional tests, which are highly specific to certain autoimmune conditions, and there’s a number of those different antibodies.

Dr. Weitz:            Cool. What’s the role of diet and food sensitivities in autoimmune diseases?

Dr. Sethi:             From my training in integrative medicine and Functional Medicine, I can tell you it’s huge.  I will also say that what’s happening now, at least in my practice, is that I’m getting a number of referrals from the conventional rheumatologist into my practice because they are starting to recognize that food and diet and lifestyle have a significant impact. But unfortunately, the training isn’t there. Right?  They’re just not taught in medical school, and I know because I was there myself, what to do about it.  What they’ve been telling their patients is, “You need to change your diet, maybe even anti-inflammatory diet, and maybe reduce stress a little bit,” which isn’t enough information for patients. What I’ve found is that over that last couple years, the number of referrals to me in from rheumatologists into my practice has really increased, which is really exciting-

Dr. Weitz:            That’s great.

Dr. Sethi:             … because we’re able to then really get into it, look specifically at food sensitivities, look at whether or not they’ve been tested for celiac, which, of course, is more specific to gluten sensitivity or gluten allergy. Then, of course, the lifestyle component is huge, and we do a lot of that in my practice. I find that the combination of being able to really work with food sensitivities, dietary changes, lifestyle, medicine, along with what the rheumatologists are doing to help their patients once they’re so far along into the disease process I think is really effective.

Dr. Weitz:            How do you screen for food sensitivities? Do you just tell them to avoid some of the most common food sensitivities, like wheat, dairy, soy? Do you do an elimination diet? Do you do food sensitivity testing?

Dr. Sethi:             I do all of the above. I sort of have an order to that, and it’s because what I’ve found is that, oftentimes patients will come to me because they’ve had a food sensitivity test done by another practitioner or a nutritionist or somebody who is running this panel, and suddenly, they’re allergic to … 50 things show up on their panel, and they’re really stressed because they don’t know what to eat. They’ve lost some weight. They feel really nervous and fearful of eating different foods, and part of my job is to say, “Let’s really look at this from a standpoint of what makes sense.”  I don’t really believe that the body would come to a place where it would be allergic to 100 different food items. I think that in that situation, when you’re seeing that sort of thing turn up on a food sensitivity test, what you’re really looking at is leaky gut. When you begin with the gut-healing process, and you fix leaky gut, and you repeat that food sensitivity test, oftentimes, you find that it just might be a couple of items.  That being said, the gold-standard still is elimination. Right? A full-elimination diet, eliminating each of those foods for at least 30 days and then replacing them one by one over the course of three days is really the only way to truly understand whether or not somebody has a true sensitivity to a food, at least that’s what I’ve found in my practice.

Dr. Weitz:            So, how do you do … Let’s say you do have a patient. They come in. They have this food sensitivity panel, and they have 50 different positives. How do you do an elimination diet? You’re not going to eliminate all of those. What are you going to eliminate in your elimination diet? How many foods are you going to include?

Dr. Sethi:             Yeah. To start with, I would actually probably put that aside for now and begin treatment of leaky gut. Right? I would first say, “Well, let’s fix the gut.” Now, in part of that fixing of the leaky gut, we are going to remove from the diet kind of our top five things that seem to be quite inflammatory regardless, right, so of course, gluten. I typically eliminate dairy, soy, grains from somebody’s diet for at least a time period. I think that if we’re really thinking there’s an egg allergy, nuts, we can do those as well, but I try not to give them a lot of things to do at once. What I find is patients get really overwhelmed. We want to try to meet them where they’re at but also really be kind of strict about the fact that we need to get some of these top items out of their diet, so that’s what I found-

Dr. Weitz:            So, you said gluten, dairy, soy. What else?

Dr. Sethi:             Grains, initially.

Dr. Weitz:            All grains. Okay.

Dr. Sethi:             All grain initially is typically what I do for 30 days.

Dr. Weitz:            Okay.

Dr. Sethi:             If that’s really difficult, then we will focus on the non-gluten grains for them. Then, depending on … Sometimes I also really get a food history and say, “Well, what do you eat a lot of?” If there are a lot of eggs in their diet, like if they’re eating three eggs a day, and they’re presenting with skin rashes, then we might also say, “Let’s eliminate that for 30 days as well and see what happens.” Oftentimes, that gives us a really good idea of what really might be happening in the gut.

Dr. Weitz:            Then, do you test for leaky gut?  Or you just figure they must have leaky gut because of the way they present?

Dr. Sethi:             Yeah, I’ve gone back and forth on that. I have used Zonulin. I haven’t found it to be as helpful, in all honesty, as I wanted it to be. I think we get a lot of information. I typically actually run the PCR stool tests, so I’m usually looking-

Dr. Weitz:            You use a GI Map?

Dr. Sethi:             I use a GI Map. That’s one of the very first things that I do with my patients. I also combine that with an organic acids test so that we can look at small intestine and look to see if there’s bacterial overgrowth or fungal overgrowth, and those two tests together-

Dr. Weitz:            Is that through Great Plains or Genova?

Dr. Sethi:             I use both. It just depends on insurance and cost for the patient, so I’m familiar with both of those and offer either one of those tests, depending.

Dr. Weitz:            Okay.

Dr. Sethi:             Yeah, so we’ll start with that typically. Then, that gives me enough information to get started.  Usually, we’re looking at a number of different organisms that either are imbalanced or an overgrowth.  Or, oftentimes, we’re picking up parasites or C. diff or H. pylori, all of which we know now have been associated with very specific autoimmune conditions, like ankylosing spondylitis, and MS, rheumatoid arthritis.  So, I feel like that’s the best place to start for most patients. We get enough information to move forward.  Then, once we’ve really fixed up the leaky gut situation, then we’ll run a food allergy panel, especially if they’re not getting the results that I would expect.  But if they are getting the results that I expect, I don’t always run those panels.  I still really urge my patients to be gluten-free and dairy-free because I do think that, no matter what, those are two foods that I feel are quite inflammatory in most of our diets these days.

Dr. Weitz:            Let’s say you run those two initial panels. You do the GI Map, and you do the organic acids testing. Say, the organic acid testing has maybe some indication that there might be a little fungal overgrowth and the GI Map shows some bacteria that are overgrown or maybe a protozoan or something like that. What sorts of treatments will you then do?

Dr. Sethi:             Yeah. Usually, I’m also looking at what their immune status looks like in the gut as well. Right?  Secretory IgA is a really good marker for that. If they look like they need a little help there … First, we’ll work on supporting the gut with things like Saccharomyces, vitamin A, vitamin C.  I like to use amla in some of those patients.

Dr. Weitz:            In other words, if their secretory IgA is low, that might indicate that their immune system in their gut is not functioning properly to help them get rid of these pathogens, so then you’re going to try to support the immune system?

Dr. Sethi:             Yes, absolutely. If the secretory IgA is high, it actually gives me another indication that their immune system is really turned on, and it’s trying to fight something.  So, it’s a nice marker.  I also look at the calprotectin and other inflammatory markers in the gut.  I’ve actually diagnosed a number of patients with inflammatory bowel disease just from that GI Map and got them over to the GI and 

Dr. Weitz:            Just because they had a elevated calprotectin?

Dr. Sethi:             Mm-hmm (affirmative), elevated calprotectin. Sometimes, there’s blood in the stool and a particular sort of look to what their dysbiosis looks like as well, so-

Dr. Weitz:            Oh, really? What sort of things do you see in the dysbiosis factor?

Dr. Sethi:             Well, with IBD, oftentimes, I’ve seen organisms like Citrobacter or Klebsiella, which are highly associated with autoimmune conditions. That tends to come up quite a lot, actually, just in my experience working here with patients.  At that point, I say, “Let’s just go a little further and get a colonoscopy and figure out what’s going on.”  Supporting that secretory IgA, the immune system, it really doesn’t take very much.  A lot of it is-

Dr. Weitz:            Do you use-

Dr. Sethi:             … natural foods, like-

Dr. Weitz:            Do you use colostrum as part of that protocol?

Dr. Sethi:             I do if we’re not very concerned about a dairy allergy. I know there’s kind of mixed evidence on whether or not it should be avoided with a dairy allergy or not. I’ve found most people-

Dr. Weitz:            And then use a non-dairy colostrum product as well out there.

Dr. Sethi:             Yes, and so sometimes we’ll use that as well. But I also think Saccharomyces boulardii is one of the best ways to increase and help the immune system of the gut as well.

Dr. Weitz:            Cool.

Dr. Sethi:             Yeah. Vitamin A, vitamin C, those are two other big ones that we usually start our patients out on and get that immune system working.

Dr. Weitz:            Then, once you got the immune system working, what’s the next level of protocol?

Dr. Sethi:             Yeah. Then, it would be really getting rid of what’s there. If they have parasites, I actually really like the parasite protocol from BioCore Cell Sciences or Core Cell Sciences. They use a product that has Mimosa pudica in it, which … In the work that I’ve done trying to work with organisms like Dientamoeba and some of those ones that are a little bit more difficult to get rid of from the gut, this is the one product that works immediately, so that’s my go-to for parasites.

Dr. Weitz:            Interesting. Mimosa, okay. Cool.

Dr. Sethi:             Yeah, it works really well. Then, if they are dealing with a bacterial overgrowth, it really depends if it’s H. Pylori or some of the other ones like Klebsiella or Citrobacter, we’ll start using … Products that contain berberine, that’s a very, very effective antimicrobial. Things that contain mucilaginous-type botanicals as well, like DGL and marshmallow’s one of my favorite- Yeah, all of those. Zinc carnosine is really nice to add in there as well. There’s a number of products, and I typically … In order to reduce the number of supplements that a patient’s taking, I have my mixed blends of products that I like to use to get rid of the overgrowth or the parasites.

Dr. Weitz:            So, you’ll use anti-microbial herbs and also supplements to help strengthen the gut at the same time?

Dr. Sethi:             I do, yeah. I’ll do typically the support for the immune system. Then, it’ll be followed by an antimicrobial-type protocol along with some liver support. Because a lot of times, as there’s die-off from those organisms, we want to make sure that they’re on some milk thistle and other things to support the gut, sorry, the liver. Then, of course, something to sort of bind to those things as they’re dying off as well, so either an activated charcoal or zeolite clay or fulvic acid or something of that nature. That’s usually going on for about two to three months with most patients.

Dr. Weitz:            Okay.

Dr. Sethi:             Then, once we kind of get them through that phase, the killing phase, I’ll retest. Usually, I retest at that point and look to see whether or not we’ve really budged with the balance there and gotten that secretory IgA increased. If so, which in most cases, I would say three months is typically enough, we’ve been able to get rid of C. diff or H. pylori or some of those more aggressive organisms or the fungal overgrowth.   Then from there, we really go into kind of soothing the gut. There I like to use zinc carnosine, marshmallow, chamomile, all of those sorts of things, antioxidants, quercetin, those sorts of things that really do help the gut kind of restore, and, of course, some of the spore-based probiotics as well at that point.

Dr. Weitz:            Cool. L-glutamine as well?

Dr. Sethi:             L-glutamine as well, yes. Yes.

Dr. Weitz:            Okay. What part does toxic exposure play in the etiology of autoimmune diseases?

Dr. Sethi:             Yeah. I think that there’s a lot of different things that we are starting to understand can affect the gut. Right? Heavy metals for one, which can come through the air that we’re breathing. Can also come from exposures through amalgams and things like that. Certainly, plastics, phthalates, BPA, all of those things do affect the microbiome. I think what we’re seeing now is that, as they’re doing more and more research on a lot of these different toxic substances in our environment, we’re really finding that the way in which they actually affect our bodies the most is probably mitigated through the microbiome itself.  I always tell my patients, “You’re only going to be as healthy as your gut is.” So, if the gut’s not healthy because of toxic exposures, poor lifestyle, poor sleep, increased stress, poor nutrition, then you’ve already got a situation where you’re set up for leaky gut or dysbiosis, SIBO, SIFO, all of those various things.

Then, on top of it, you’re really going to become nutrient deficient because if the gut membrane isn’t healthy, you’re not going to be able to absorb the nutrients that you should be absorbing just from your food. So, you could have the cleanest diet, and have all this organic food, but not absorbing all those nutrients, which is why I also include that initial organic acids test so I can really understand what their vitamin deficiencies and nutrient deficiencies look like from the outset. In addition to doing a gut treatment, I will replenish them with nutrients that they’re deficient in so that the cells can really begin to heal with all of those nutrients that they need.

Dr. Weitz:            Cool. Let’s go through a few case studies. I understand you’re not going to have all the details, but just sort of in general, some of the ways you would approach a few patients.

Dr. Sethi:             Sure.

Dr. Weitz:            If you have a patient who comes in, and they have Hashimoto’s autoimmune thyroid, and as far as we could tell, no other blatant symptoms … Obviously, you’re going to do a careful history and find out if there’s anything else going on. But in general, how would you investigate this patient? What direction would you look at? How would you try to find some of the underlying triggers? What tests would you consider running?

Dr. Sethi:             Yeah. That’s a great question. I get a lot of patients with Hashimoto’s because when they see their conventional doctor, they’re typically just given Synthroid. That’s their option. They start to do their own reading. Many of them have been … They’ll come across somebody like Dr. Izabella Wentz’s book or other books out there in the functional medicine community, and they know that there’s more they can do. So, they usually come in with a diagnosis, hopefully fairly early in their diagnosis so we can get them going, and one of the-

Dr. Weitz:            Unfortunately, a lot of times, antibodies aren’t even measured. Or, if they are, they don’t really know what to do with them, so they’re just sort of ignored.

Dr. Sethi:             Absolutely. I am finding that a lot more of the conventional docs are starting to measure the antibodies, but only at the time of when TSH has been found to be elevated, right, which is a little too late. You really want to be measuring your antibodies for thyroid a decade in advance because you can actually start to see that number rising. I mean, I’ve actually got patients in my practice right now who are 10, 11, 12 years old. Their parents have … The mom has Hashimoto’s. The aunt has Hashimoto’s. The moms are concerned, so they’ve brought them into me for testing, and we’re finding those antibodies already.

Dr. Weitz:            Wow.

Dr. Sethi:             Yeah, which is shocking to me. Because when I was in medical school, Hashimoto’s was a funny name for a disease we would never see, and it is one of the more common calls that I get these days is help with Hashimoto’s. So-

Dr. Weitz:            Interesting. I’ve kind of had a little running debate with another prominent Functional Medicine doctor who says, “Wait until the TPO antibodies get over 500, you shouldn’t really worry about it.”

Dr. Sethi:             I disagree with that because I think there’s a lot you can do, so why don’t we talk about that for a minute?  Because I think that’s really, really important. What it does for, I think, patients’ family members and just people in general is give them hope, where they don’t … In conventional practice, we wait till we see the disease to give the patient any hope.  And it’s not even really hope.  It’s really just a pill.  But here we can say, “No, this is … Your body has the capacity to heal itself,” and that is my bottom-line premise of my practice is that the body has the capacity to self-heal. It’s one of the very first osteopathic tenets, which I learned in DO school. I abide by that, and I let my patients know there’s a lot that they can do. Just because you have the genetic predisposition for something does not mean that’s your destiny. There have to be triggers, and the triggers typically come from the environment and your exposome, so all the things that your body is exposed to. That might be food. It might be stress. It might be toxins. It might be neuroendocrine disruptors. It might be bacteria, parasites that live and thrive in the gut. It might be a number of things.

When I see these young kids that are already showing signs of elevated antibodies, it’s telling me that something is triggering that process on to where the body is now attacking the thyroid gland. So, what can we do about that? We begin to look at their lifestyle. This 12-year-old girl that I’m treating right now, she’s a swimmer. She’s in chlorinated water every day of the year. We live in Texas, so that’s a lot of the year. I had to have a talk with her that the skin rashes, the antibodies … She’s already to the point where the TSH is elevated, and so her endocrinologist wants to put her on medications already. We really have to consider taking breaks from the chlorine if not considering what it means in terms of giving that up. So-

Dr. Weitz:            For those of us who are not aware, chlorine is in the same row in the periodic table as fluorine and iodine. So, potentially, chlorine could interfere with iodine, which is an essential nutrient for thyroid function, correct?

Dr. Sethi:             Absolutely. That’s exactly how we think it interferes. I did have her talk to her endocrinologist about it. He was in disagreement with my theory. But I will tell you that, in the summer, I asked her to take a break, and she did. Of course, we did interject a lot of the lifestyle changes. Got inflammatory foods out of her diet. Got her sleeping better. Had her introduce a meditation practice every day. But at the end of the summer, the rash that she had had on her skin, which looks to be some sort of scleroderma-type thing, had actually shrunk to half the size. Her dermatologist was shocked.  Now, I can’t tell you this was a large multi-study, multicenter, randomized, controlled trial, but I think we’re past that point of really considering that to be the gold standard in medicine. Patients, they are individuals, and we have to think of them as an N-of-1. To me, this was a study in what happens when we remove chlorine from her life? What happens to her symptoms? Her mom was in agreement that they really did think it had a lot to do with her not having that chlorine exposure for at least three months. So, there’s a lot that can be done earlier for prevention, which is why I really do advocate for testing our girls early, especially if there is a family history.

Dr. Weitz:            You ever test for halides, like chlorine and fluoride?

Dr. Sethi:             I haven’t really gone down that path… I did with her, but it’s not something I typically do on a routine basis. It’s something I do want to look more into, but I think that we get a lot of benefit just from doing things like replenishing selenium and zinc and magnesium, which so many of these girls are really low in, all of these things being really, really important for the thyroid.  Our vegetarians typically can be iodine deficient. Oftentimes, I’ll test a urine iodine to look for iodine levels because that’s a hugely missed thing now in our society, especially as people have migrated over to using sea salt, which is oftentimes not iodized. There are also vegans, so they’re not eating seaweed. They’re not eating fish. They’re not getting any source of iodine in their diet.  Also, people are buying salt in bulk. Iodine evaporates when it’s exposed to the air, so I oftentimes advise people to buy small amounts of salt. Keep it in a darkened container, and go through it quickly. That’s a huge area where we’ve been able to find that we can do something about as well.

Dr. Weitz:            Yeah, no. In the natural medicine community, a lot more people are using sea salt, Himalayan pink salt, Redmond Sea Salt, so they’re not getting as much iodine as they used to get. Then, so much of the water has chlorine in it and also fluoride, and they may be brushing their teeth with fluoride toothpaste or using fluoride mouthwash.

Dr. Sethi:             Absolutely. Yes, and they do have to look at their city to figure out whether it’s chlorinated or not. We talk about water filters. That’s just another easy way to be able to have a decrease in some of these toxins in the environment. I do think there’s a lot you can do to reduce exposures, which then really do affect whether or not those genes are turned on or not, really.

Dr. Weitz:            Right. Then, of course, foods like gluten can cross-react with thyroid tissue. Right?

Dr. Sethi:             Yeah. There’s always that debate early on with my patients about gluten, so what I ask them to do is I ask them to do 30 days. I think probably 80% of them come back after 30 days and say they feel significantly different. Then, that’s typically enough for them to stay motivated to really stay as gluten-free as possible. There’s a good 10 to 20% that are like, “I’m going to have my pizza.” At least now we have cauliflower pizza options.

Dr. Weitz:            You mentioned a girl whose relatives have hypothyroid. What about somebody who comes to you who’s just concerned about autoimmune diseases because a number of their relatives have had a number of autoimmune diseases? I know that there’s one lab that actually has a multiple autoimmune panel. How would you approach somebody who says, “I don’t know that I have any symptoms of autoimmune disease, but I just want to prevent it. It seems like I have a high family history of it”?

Dr. Sethi:             Yeah. I think there’s a number of steps to really consider. Depending on what the autoimmune condition is, and again, the way I describe this to patients is that if you have a family history, then you do probably have some predisposition to a particular kind of … I think of it like a tree. You have the roots, and then how it branches out may look different in you than somebody else, but all autoimmune conditions are really related. It’s just how it presents itself in your body or maybe what your specific triggers were in the environment.   So, knowing that they’re all related, I think there’s a lot that can be done early. In a patient like that that would present to me, I would absolutely want to really look at the gut. Right? We want to look at the GI mucosa. We want to look at the microbiota. I think there’s a lot we can do there. I typically recommend getting those tests once a year. I do it on my entire family. I’ve got two young kids, six and eight. We all get our GI tests done once a year so we can keep things going and healthy.

I also usually do look at any inflammatory foods that might be in their diet, and we talk about that. Removing those from the diet early on can really have a long effect on chronic disease processes in the later life. Then, we want to look for potential food sensitivities and eliminate those. So, if it seems as though something’s presenting like a food sensitivity, we’ll do removal or maybe even do a food sensitivity test around that.  Some of those are quite easy to tell. They’ll say, “Oh, every time we have nuts, I get a little just itching around my mouth, or I notice stuff when I eat this particular …” I had a guy last week who … He’s been going to an Indian restaurant and eating Saag Paneer every week, and he’s like, “You know, it just occurred to me that every time I eat that, I get this rash.” I was like, “Yeah, I think that’s probably, you probably have a sensitivity to either the dairy or the oil that they’re using, peanut oil or canola or something. Probably want to leave that out of your diet for a month.” He did, and lo and behold, he’s allergic to something.   So, some of these are quite easy and obvious when you really kind of focus in on them. Then, of course, we want to really eradicate any toxins in the environment. So, I’m really big on everybody having their water filtered that does an adequate job. I love the Berkey filter as kind of a quick and easy if you’re not going to do a reverse osmosis in your house. Making sure that if you live in an older home that you’re thinking about things like mold. If you’re living near a road where there’s a lot of traffic, considering a HEPA filter in your bedroom. Thinking about where you’re working if you have a lot of exposure there.

I think that looking at the gut, eliminating toxins from the environment, eliminating inflammatory foods or foods that you might be sensitive to from the diet, and just chronically looking at nutrient deficiency. I’m at the point now in my career where I believe everyone should be on a really high-quality multi-vitamin. I didn’t believe that a decade ago. Like many physicians, I thought that you don’t need vitamins. You can get everything from your food. But knowing what I know now and noticing even in myself how everything changed for me when I started supplementing with high-quality vitamins, I think everybody needs to have that as their foundation.  Our food sources have changed. We just don’t have enough nutrients in our food. We don’t have healthy guts anymore. Many of us have decreased ability to digest, so sometimes digestive enzymes are necessary. There’s a number of reasons why I think that could be really helpful. That’s how I would approach, really, any patient who is concerned about an autoimmune condition because they have a family history.

 Then, as far as … You asked about testing with the autoantibody test. I do think we have to be a little bit careful. I think as a screening, an ANA, an antinuclear antibody, is fine, especially if there’s a family history of autoimmune conditions. I think that doing a rheumatoid arthritis is fine if there’s a family history and maybe some presenting signs or symptoms. Then, of course, the Hashimoto’s antibodies as well.  Other than that, when you’re talking about things like the anti-mitochondrial antibodies and the endomysial DNA, I mean, those are really … You have to understand the sensitivity of the test and also the age of the patient. I’ll just give you a case example. On my son, we had a situation with him where he had presented twice with this acute hip pain. It didn’t look like it was an infection. He wasn’t walking, and presented with these high fevers and had this whole pattern going on that really looked like it might have been some sort of autoimmune condition.  Well, of course, me being a doctor, I’m like, “Let’s run all these tests,” and so I did. He came back with a very high ANA, and he also came back high with a really high anti-centromere antibody, which, if you look it up, can be really scary. It can mean that there is some sort of a autoimmune condition that affects the brain going on. Of course, I got very nervous and pulled some strings and got him in with the one of two pediatric rheumatologists that work here in Austin very quickly because …

Being a doctor and having this information, I was quite nervous and upset. We went in, and he explained to me and showed me the studies and the percentages of children that have positive ANAs and positive autoantibodies that then grow out of it that may not mean anything at all. Right? They have a different presenting percentage of these antibodies, and so they don’t oftentimes test the same tests in pediatrics as they do in adults because it can mean something very different.  Now, being a functional integrative doc, I’m thinking, okay, well, we’re just going to make sure he’s living a clean lifestyle anyway because maybe there’s a potential there, though we don’t have any autoimmunity in our family. But it was really interesting to hear that because I think it does really paint a case for being careful about testing for some of these autoantibody tests and really creating fear in our patients when maybe there doesn’t need to be that situation. So, really focusing on the things that we can do, which there’s a lot we can do preventively and maybe leaving some of those more advanced tests for the people that’ve specialized in that. That’s how I like to approach it.

Dr. Weitz:            That sounds great. I think that’s all the questions I have. I think we covered some good information. Any final words you want to leave the viewers? Then, if you could give us your contact information so we can find out about getting ahold of you, and your book, and any of the programs you have to offer.

Dr. Sethi:             Absolutely. I mean, the final thing I’d like to say is I think it’s … We’re really in a time of change around some of these chronic illnesses, our understanding of them. So, if you’re listening to this, and you’re in a situation where you’re working with a doctor who is not open to believing that lifestyle can make a big difference and even potentially put you into remission with your disease, then please seek out somebody like Dr. Weitz or myself or any of those other integrative functional docs out there doing this work. Because we’ve all seen it with our own eyes how even just holding hope for this can really make a big difference in our patients’ lives, so really kind of trying to change your mindset around that and finding help where you can get help.  Patients can find me at my website, drshellysethi.com. It’s D-R-S-H-E-L-L-Y-S-E-T-H-I dot com. If they go to my site, they can actually download my book, Built to Thrive, for free if they wanted to get a PDF copy of it. I’d love to interact with anybody who has any further questions, but I really appreciate you addressing this and bringing this awareness to your patients and to the public at large.

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

Dr. Sethi:             Thank you.



Al’s Cancer Journey with Dr. Al Danenberg: Rational Wellness Podcast 96

Dr. Al Danenberg talks about his Journey with Cancer 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

3:20  Dr. Danenberg explained that he’s 71 years old and he has been a practicing periodontist for 44 years.  He wasn’t always a really healthy guy, but about 6 years ago he became primal (paleo) in his nutrition and lifestyle and dropped 30 lbs.  He was able to get off all of his medications and he was feeling great and was speaking at conferences about the paleo, primal lifestyle.  He was doing a seminar at a dental group in April 2018 and he was walking through the Atlanta airport and was carrying a heavy bag and felt some pain in his shoulder. Then he started to get some back pain and then he started to get a lot of pain in his chest and rib cage area. He though his pains would just go away but then in September 2018 he went to see his primary care MD and he had some blood work and everything was normal except he had an elevated CRP (3.5 or 4 instead of his normal 0.5).  Then he had an MRI and his doctor told him that he probably had either Lymphoma, Leukemia, or Multiple Myeloma. And there was a soft tissue mass next to his spine, two broken ribs, a cracked vertebra, and a cracked pelvis. He saw an oncologist and on September 19th, 2018 he was diagnosed with IgA Kappa Light chain Multiple Myeloma, which is a very aggressive form of cancer. The radiologist told him he had multiple lytic lesions throughout his entire spine, his ribs, and his pelvis. His bone is literally dissolving away, since the malignant plasma cells are creating a cytokine reaction and Interleukin 6 is destroying the bone. His oncologist recommended that he do a cocktail of chemotherapy and IV bisphosphonates to strengthen the bone and some focused radiation to his sternum for the severe pain he had there.  At some point, a bone marrow transplant would also be recommended, but the oncologist explained that this is not a curable disease. The oncologist explained that he would do better for a little bit but then the Multiple Myeloma would retake over and eventually he would die from the complications of the Multiple Myeloma.  This oncologist also told Dr. Dananberg that if he did not follow this course of treatment, that he would be dead in 3 to 6 months.

Dr. Danenberg decided that since it was almost certain that he would die from this disease, that he didn’t want to put himself through this chemotherapy that would tremendously decrease his quality of life and his family would have to deal with this dread for an extended period of time till he died.  He also didn’t want his wife to be saddled with 100s of thousands of dollars of medical bills after he was dead. He did agree to do some focused radiation to his sternum, which did decrease the sharp pain he was having there.  He decided to follow an integrative, alternative plan using diet and nutritional supplements and so far he feels great and has a good quality of life.  He feels his natural plan is starting to work but he understands that he could die next week.

12:40  Dr. Danenberg addressed the question of why he might have developed this cancer when he was leading such a healthy lifestyle.  He pointed out that when he went to dental school 45 years ago he was exposed to a lot of ionizing radiation from all the x-ray machines and being in the dental office all days for six years. Some research does show that dentists have a higher incidence of multiple myeloma. The other factor is that he was trained, like most dentists are, to put in mercury fillings. when Dr. Danenberg went to school they used to take the liquid mercury and mix it with some powder to make an amalgam. Then they put in a cotton square and squeeze the excess mercury out of it and throw the excess mercury on the floor of the dental clinic.

19:00  Dr. Danenberg’s natural plan changes every few weeks a little but it currently consists of the following: 1. Autoimmune, Paleo eating style, excluding sugars,  carbs from grains or legumes, processed foods, GMOs, and any chemical additives;  2. Intermittent fasting by having his last meal by 8 pm and not eating until 1-2 pm the next day; 3. Pulsed Electromagnetic Field mat that he lays on three times per day to help repair his mitochondria; 4. A variety of nutritional supplements to support his immune and detoxification systems, to help target cancer cells, assist in bone metabolism, and to help repair his gut including: 1. Salvestrol, 2. Fucoidan,  3. Andrographis Complex (Mediherb)–3/day, 4. Catalyn GF (Standard Process)–6/day, 5. CBD powder capsules–2/day, 6. Fermented Cod Liver Oil/Concentrated Butter Oil (Green Pasture)–1 tsp/day, 7. Mega Mucosa (Microbiome Labs)–1 scoop/day, 8. Megaquinone K2-7 (Microbiome Labs) – 4/day , 9. MegaPrebiotic (Microbiome Labs) – 1 scoop/day, 10. Megasporebiotic (Microbiome Labs) – 4/day, 11. Neurotrophin PMG (Standard Process) – 3/day, 12. Ostrophin PMG (Standard Process) – 6/day, 13. Turmeric Forte (MediHerb) – 4/day, 14. Vitamin D–5000 IU/day



Dr. Al Danenberg can be contacted through his website:   https://drdanenberg.com/   Here is the link for his book, Crazy Good Living: Healthy Gums, Healthy Gut, Healthy Life     https://www.amazon.com/Crazy-Good-Living-Healthy-Gums-Life-ebook/dp/B073QD6FWV/ref=sr_1_1?ie=UTF8&qid=1500647091&sr=8-1&keywords=crazy+good+living  

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 Transcript

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 signup 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 listening to the Rational Wellness Podcast, please go to iTunes and give us a rating and review that’ll push us up in the ranks and more will people find out about the Rational Wellness Podcast. Our special guest today is Dr. Al Danenberg. He’s a periodontist and a certified functional medicine practitioner and a certified primal health coach and the author of “Crazy-Good Living: Healthy Gums, Healthy Gut, Healthy Life.”

But today, we’ll be speaking with Dr. Al Danenberg about his own health and his battle with a form of bone marrow cancer known as IgA kappa light chain multiple myeloma. Multiple myeloma is a relatively uncommon cancer of the plasma cells in the bone marrow. Traditional treatment for active myeloma typically involves a combination of chemotherapy drugs. A stem cell transplant is sometimes done following the chemo with stem cells from a donor.  Bisphosphonates may be given to stimulate healing of the damage bones, and radiation may be offered to treat specific areas of bone pain. Dr. Danenberg has chosen to forego traditional chemo therapy and has decided to take a natural integrative approach. I’d like to give listeners one more piece of information that is gonna inform the discussion that we will have, which is that Dr. Danenberg has chosen to be very public about his own health care situation. He’s been publishing a series of blog posts where he’s been very openly and talking about his situation, and very courageously, facing down a terminal illness. I appreciate you talking about your situation, Dr. Danenberg because I think it’s a great glimpse into the human condition and I think it could be very informative and instructful for other patients out there. Al, thank you so much for joining me today.

Dr. Danenberg:                 Hey, Ben. Thank you. This is quite an exciting experience. As you know, you and I have had a conversation before about mundane things like gum disease and gut bacteria and all that great stuff.

Dr. Weitz:                         Yes.

Dr. Danenberg:                 Now we’re talking about a little higher level of a challenge that I’m actually personally experiencing.

Dr. Weitz:                         Why don’t you tell us what were your first symptoms of your cancer and when did you first find out about your diagnosis?

Dr. Danenberg:                 Sure. So, most people who know me, and if you don’t, I’m 71 years old and I have been in practice for 44 years, practicing periodontics. I didn’t start off as a really healthy guy, but about six years ago, I became primal in my nutrition and lifestyle and became amazingly healthy. I’ve dropped 30 some pounds from when I started at the age of 66 through last year. I completely eliminated all medications that were prescribed to me from previous issues that I had. And basically, I was a healthy guy.  So I was doing, and I speak around the country, so I was doing a seminar at a dental group somewhere and I was progressing to one of the airports in Atlanta, which is a very large airport, as you may know, if you have gone.  And when I do that, if I have time between flights, I don’t take the train, I walk the concourses. So, if you know Atlanta airport from A the E concourse or F concourse, it’s a long walk. I had a very heavy bag on my shoulders, it was April last year, 2018, and I just carried that from one flight to the other flight. I started to develop, by the time I got to my connecting flight, some soreness on my shoulder and I thought, well, maybe I pulled a ligament and did something stupid and it would go away like any muscle pain would go away. So, the next day it was still sore. Did my thing, got back to Charleston. It was sore on the rights of my shoulder and then it started to go away, to some extent, went into my back area.

And then, a few weeks later it went away from my back area, went into my chest area and it was starting to get really painful, and I thought this is not a normal muscle issue. So, I went to my physician in, Charleston around September or so, 2018, and he looked at me and press around my rib cage, which was very, very tender. And he said, “Let’s do some blood work.” So, he took some blood, did the conventional type of blood work, everything was pretty normal, and I see him every year. So, it’s basically the way it had been except my CRP, this C reactive protein was elevated.  Generally, my CRP was usually less than 0.5, very healthy, no chronic inflammation, and it was something like 3.5, 4.0. To me, that was an alarm bell. And so, he said, I don’t know what’s going on. Let’s do an MRI. So we do an MRI and he calls me up and says, “Al”, and he’s known me for 30 plus years. He says, “Al, do you want to come into the office, and we’ll discuss it or just talk about it on the phone.” I said, “Great, let’s talk about on the phone.” He said, “If I were you, I’d be very concerned.” He said, “My initial differential diagnosis is either, I think you have lymphoma, leukemia or multiple myeloma.” None of the three doors were the doors that I wanted to open.

He said, “In addition to that, I see a mass, a soft tissue mass on the side of your spine and I also see two broken ribs, a cracked vertebra, and a cracked pelvis. What happened?  Did you get beaten up?  Did you fall down some steps?  What happened?” I said, “I don’t know. I only was carrying this bag when it got sore, and it stayed sore.”  So he called in an oncologist, we did a CT scan, a PET scan, a tissue biopsy of the mass on the side of my spine. A whole bunch of more detailed blood work. And September 19th, 2018, I was diagnosed with IgA kappa light chain multiple myeloma, which is very aggressive. And the radiologist who read the CT scan said in his report there were innumerable lytic lesions throughout the entire spine. That means holes everywhere. That’s the reason why I had cracked ribs and vertebrae and pelvis because it’s almost like severe osteoporosis. Something’s happening and the bone is dissolving away.

What’s happening is malignant plasma cells are setting up a cytokine reaction and IL6 I believe is basically destroying the bone. Well, he said to me, and my family came in at that appointment, so they were all there, and he said to me, “Based on what I see today”, and that is in September 2018, “I’m gonna recommend what I think you should do, but if you don’t do anything, I predict that you have three to six months to live.” Now, here’s a healthy guy, at least I thought I was healthy until now, and I am side struck with this diagnosis that is truly life threatening. What would you do? I thought a little bit about it. We’re sitting there, and I’m telling, my doc’s name is George, and I said, “What do you recommend?”  He said, “Immediately I would recommend we start on a cocktail of chemotherapy drugs and then maybe IV bisphosphonates to strengthen the bone.” And because I had such severe sternal pain from the loss of the bone in that area, do some radiation and, and see what’s going on.” And he said, “But you have to understand this is not a curable disease.” I asked him to explain that, and he basically said what generally happens. You go through chemotherapy, you get remission cause you’re killing all these plasma cells. And in addition, which he didn’t obviously tell me so much, and that is we’re killing everything in the immune system and everything else in your body. And then, you’ll do fine for a little while. And then, the multiple myeloma, the malignant plasma cells were going to a retake it’s itself and we’ll have to use a different chemotherapy cocktail because it will not respond to the original chemotherapy, so it needs to be more aggressive.

And then, maybe even stem cells. Either we get them from you that we can cultivate, or we have to get it from a donor and maybe that will work. But just stem cell therapy, because of what I have, isn’t so successful. Eventually, I will die from the complications of multiple myeloma. I said, “Well, wait a minute. You’re telling me I’m going to die from this disease, and it’s going to be in stages and every time it exacerbates, it’s going to be even more caustic for me to get treatment, and I’m still going to die from this condition. Why do that? Why put myself through the tremendous decrease in quality of life and dignity of life?” And not to mention the practical side.  First of all, my family would have to deal with this dread for an extended period of time until I die. And then, financially, and let’s be realistic here, a lot of these drugs are not covered by medical insurance, and some of them that are just in the investigative stage, if you’re not in a clinical trial, definitely is not covered by medical insurance. So, I could die and my wife could be left with a $500,000 medical bill and then she’ll have to deal with that. It makes no sense to me. And it made no sense to me to treat my disease by killing everything else in it. So, I decided what I needed to do is get rid of the pain in my sternum, which is the mediate radiation treatment for 10 days that was successful, and I investigated an integrative alternative plan, which I’m doing now.  And by the way, it’s more than six months. I am still alive, and I feel fantastic. And my doctor says, “Wait a minute, maybe I made a misdiagnosis, I don’t know.” You didn’t make a misdiagnosis. Maybe my alternative therapy is starting to work. Now, I don’t know that that’s going to happen, and I don’t know that I’m not going to die next week, next month or five years from now. But I have taken a course that is keeping me alive in a way that creates quality of life. I feel great, a little things are bothering me we can talk about, but basically, I feel great and I’m grateful for that.

Dr. Weitz:                         Tell us about your natural plan that you use to help your body fight off and heal from this cancer.

Dr. Danenberg:                 Sure. As you know, diet is everything. And maybe I should go back and first give you an idea of why I think I contracted this because I have some people that read my stuff and they blurted back to me and said, “Well, everything you were doing that you thought was so healthy, doc, obviously didn’t work, doc.” And I’m saying, Oh my God, this is ignorance, but I need to address this. When I was in dental school, and that was a long time ago, 45 plus years ago, I was in undergraduate dental school, four years and then specialty school for periodontal training for two years, so six consecutive years. In the dental clinics, there were x-ray machines everywhere, and we learn how to take x rays on people and whatever.

In those days, I don’t know how well the x-ray was collimated, I certainly don’t remember wearing all the protective clothing that maybe I should have, so I am assuming that I was exposed to excess ionizing radiation, dental x-rays, over the course of six years on a pretty regular basis. Well, one of the actual causes that has been known for multiple myeloma is ionizing radiation, dental-x rays. As a matter of fact, there was a study that was done some years back that showed that dentists, male dentists in my age group have a higher incidence of developing multiple myeloma than the general public. Very interesting. Very interesting.  I had to dig for that research. So, I’m thinking that is a possibility. All you have to have is one malignant cell and then you have a malignancy because that cell doesn’t die naturally, it keeps growing, and it can replace other healthier cells.

Dr. Weitz:                         By the way, I noticed when I’m my dentist’s office, there’s no lead lined walls. There’s not even a complete wall separating one room from the other. There’s just these thin walls sometimes with little windows. So, it doesn’t seem like the x-ray machines in dental offices that there’s really a proper shield. Is there supposed to be …?

Dr. Danenberg:                 Today there is shielding and the walls, theoretically. I don’t think that you can even build a dental office and get it approved by the people to be that tell you everything is okay and you can start seeing patients. But without these lead shields built into the walls or the x-ray is behind some type of a lead device. It’s a scary thing. I mean, the amount of radiation that you can get just yourself in a dental office is not that much, but if you’re there all the time forever and ever, six consecutive years, I’m gonna tell you, I had a lot more radiation than you ever had in your life.

Dr. Weitz:                         Of course.

Dr. Danenberg:                 But you need to ask them questions when you go to doctors. If you had CT scans all the time, you are bombarded with a lot of ionizing radiation. I’ve refused to do more CT scans, for example, at this point because I’m not interested in exacerbating what’s already there.

Dr. Weitz:                         Or getting a secondary cancer somewhere else.

Dr. Danenberg:                 Exactly. Unless it was critical for that type of biomarker or x-ray picture, it’s not going to do my health any good. The other thing that when dental-

Dr. Weitz:                         And you’re opting for MRIs, is that right?

Dr. Danenberg:                 Correct. So, I am doing my next MRI at the end of this month and we’ll see where we are. It’s not completely telling, but it’ll tell a lot and that’s all I need. See if I’m progressing in a positive way. The other thing is, and this will amaze you, dentists have been, and even still are trained in many dental schools to put in mercury fillings. Oh my God, I can’t believe that, but it is true. In those days, here’s how we did this. It’ll blow your head away. We took the liquid mercury, which is a beautiful thing in a little jar, silvery liquidy mercury, and dropped it into a little dish and mixed it with some powder to make what’s called the amalgam. Now, you have this silvery mushy mess and it has a lot of mercury.  So, you put it in a little piece of cotton, like a cotton square, squeeze the excess mercury out of it. And we’re talking about with hands. Squeeze it and throw the excess mercury on the floor, on the clinical floor of the dental school.

Dr. Weitz:                         What?

Dr. Danenberg:                 Everybody did it. 45 years ago, everybody did it. I am sure that the entire dental school was toxic because this mercury vaporizes quickly and it’s everywhere. So, the excess mercury and the ionizing radiation on a continuous basis possibly created what went on in my bodies. But with me being as healthy as I have been, my oncologist who’s a conventional, but fantastic oncologist explained to me probably my lifestyle and diet kept everything under control and it didn’t manifest until it just got out of control. And that’s why I developed multiple myeloma. So, how am I treating it?

One of the things, of course, is a healthy, clean diet, and I don’t want anything that’s gonna interfere with my ability to having an enhanced immune system that I can. So, I am eating basically a Paleo type autoimmune diet, less carbs than normal, but not strictly keto. And I do intermittent fasting. I don’t do multi-day fasting, although I had done that every now and then, but I definitely do intermittent fasting. So, my last evening meal is literally ending by 8:00 PM one night. And then, I won’t have anything to eat until maybe 1:00 even 2:00 PM the next day. So, I have just a small window of eating. I basically am a fat burner. I had no problems with hunger. It’s just not a problem. But you have to develop to get to that point.  You just can’t say, I’m going to do intermittent fasting, have a piece of cheesecake last night, and then all of a sudden, not eat until 2:00 PM and not feel hunger pains. So, you have to get into that state. I’m doing that and I think that’s a critical factor. Another factor that I’m doing …

Dr. Weitz:                            Are you having any trouble keeping your weight up by doing the fasting?

Dr. Danenberg:                 No, because I do eat things like sweet potatoes. So, I got the starchy tubers that take care of my diet and my calories. I am not exercising like I used to because I just physically can’t. I do have some pain and I have a lot of tiredness. So, I know that could have a problem. Generally cancer patients lose weight, but a lot of that is because of chemotherapy, not necessarily the cancer cells are just digesting all this food so fast. So, my diet is critical. I’m working with an integrative physician, not in my town, but in another town. I have conversations basically every three weeks to tweak different supplements. So, I take a variety of supplements, which I’ve never taken before, but I take these supplements to support my bone metabolism, to support my immune system, helped me with antimicrobials that he feels are necessary.  Certainly, good digestion, I take a number of things to really improve my gut microbiome, spore based probiotics basically because they actually do germinate in the gut. They’re not killed by acids.

Dr. Weitz:                         Would you mind going into your whole detailed supplement program?

Dr. Danenberg:                 Actually, it has been like 30 supplements five times a day. It’s kind of crazy. I could send it to you for your perusal by …

Dr. Weitz:                         Would you want to go into some of the highlights?

Dr. Danenberg:                 Yeah, so let me tell you what I think is really core. There is a product called Salvestrol. Salvestrol is a product from well ripened fruits and it is, especially the berries. And it is loaded with the FIDO nutrients. And what that Salvestrol does, which is unique, is that it gets into the blood system and it is attracted to certain enzymes that are dominant in cancer and precancerous cells. These enzymes are part of the Cytochrome P450 process of creating digestion and detoxification in the body naturally. And these enzymes are called CYP1B1 enzymes. They, like I said, are highly concentrated in precancer and cancer cells, very little is in or none is in normal cells.  So, these enzymes attach or bind in some way to the Salvestrols. The Salvestrols and the enzymes react and metabolites are created that literally kill the cell. So, if these Salvestrols were attacked by enzymes in normal cells, it would kill normal cells, but these enzymes are not in normal cells, are just produced by the cancer cells, interestingly enough. And there could be some rationale for the reason why it’s there. These are natural occurring phytonutrients. So, I do take quite a bit of this. There is some great peer reviewed research about Salvestrols. There are a variety of sources of Salvestrol I get from Canada. I know Europe has plenty. There is ongoing research, and I think that this is a major factor.

There is another product from a brown seaweed called Fucoidan, F-U-C-O-I-D-A-N.  Fucoidans have some other interesting properties. They do help cancer cells with apoptosis or self death, but it may be along the lines that it actually ends improving the mitochondria of the cancer cells because cancer for some researchers is basically a result of mitochondrial dysfunction. Every cancer cell has mitochondrial dysfunction, but all chronic disease has mitochondrial dysfunction. But if there are cancer cells that have mitochondrial dysfunction and you can repair the mitochondria, you can help these cells maybe create self death and or prevent them from becoming cancer cells.  So, Fucoidan has the benefit of helping the mitochondria and helping kill cancer cells. So, I do take this brown seaweed in a very concentrated state. Those are the two things. And then, a lot of general supplements to repair or help bone metabolism. I got a few products from MediHerb and …

Dr. Weitz:                         Standard Process.

Dr. Danenberg:                 Standard Process. Thank you. Thank you, my memory’s going away. Standard Process, and then a few other types of supplements that are going to help with digestion and antimicrobial.

Dr. Weitz:                         I noticed you include curcumin in your-

Dr. Danenberg:                 Yes, curcumin definitely. And there’s a lot of great research about curcumin in cancer cells. So, I’m doing certainly curcumin. There’s a MediHerb product that I use, but there are a variety of products. As long as you get a biologically active curcumin, that’s great. It’s not generally bioactive because it has to get absorbed properly, so you have to have a vehicle that’s gonna get absorbed properly.

Dr. Weitz:                         Are you monitoring any lab tests to go along with your supplement program to see if the interventions are …

Dr. Danenberg:                 Yeah, so the lab tests are very specific for multiple myeloma, and I get that every month. Originally, now, I’m only on every two months because my doc says things are more stable. But there are some tests that will determine the degree of the malignant antibodies that are floating around and the ratios of these malignant antibodies that are critical. Right now, I’m so way, way, way high, but it’s not as bad as it used to be. So, yes, I do monitor that. Now, let me tell you another thing that is, in my mind, a very critical element to what I’m doing.

And that is, I just touched upon it, and that is mitochondrial dysfunction in the cancer cells. The mitochondria needs repair and there is a process that actually can repair mitochondria. Let me just mention that one of the destroyers, there are a lot of destroyers of mitochondria, a lot of prescription drugs, certain foods that we’re eating, the chemicals that are in foods, but dirty electromagnetic fields that are generated between you and me right now because of what we’re doing are damaging the mitochondria. What they’re really doing is breaking down the calcium channel passages between cells and it’s also breaking down the protein complexes within the mitochondria that create ATP. And ATP, as you know, is the energy of the cell. If that energy is not there, the cell weakens and eventually dies, theoretically.

 So, what I am doing is using a process, a therapeutic process called pulsed electromagnetic field therapy to help repair the mitochondria in my body. I’m not, and I don’t think there’s any way to be specific to the mitochondrial repair, and I don’t care. I just want my mitochondria to get repaired as fast as possible. So, I lay on a mat from a company, now we can talk about later if you want, but it is a flexible mat, looks like, feels like a very thin, soft pliable yoga mat and it lays underneath my bed cover and we have timers that can go on and off on that mat and during the day I can lay on it and I do it three times a day. And there are different settings and the company that I work with has settings for cancer as well as many other things.

So, I use this mat to help stimulate the mitochondria to repair as well as to improve the calcium channeling within the mitochondria. I believe that this is repairing my body. Now, I do know from reading research, not my personal research, but I do know that NASA has used this type of therapy to help astronauts to prevent osteoporosis because they learned that astronauts being in space for a period of time develop osteoporosis for variety of reasons and pulse electromagnetic field therapy can prevent and cure that kind of problem. So, I’m using this mat that I do three times a day and I think that is a real critical element to my overall protocol to treat my cancer.

Dr. Weitz:                         Awesome. Are you able to exercise right now?

Dr. Danenberg:                 Starting to try that, and actually I got a good bit sore so I have to come back. Zach Bush has a four minute video or a four minute exercise video on YouTube. Easy to Google, “Zach Bush four minute video.” It is a great exercise program. It helps to stimulate and release nitric oxide. He’s a cool guy. Anyhow, brilliant physician. He’s got lots of degrees behind his name. It’s very noninvasive for me. It’s not particularly damaging to my body and I’ve tried to use that. I used to use that on a regular basis as well as other types of exercise, but this I think is the kind of exercise I want to get started with before I move on. My son actually owns a couple of clinics, one in Charlotte and one in Greenville, South Charlotte, North Carolina, one in Greenville, South Carolina, where he works with patients and athletes and does quite a number of therapeutic exercise programs, and he’s going to help me with that.

His company is called Performance Therapy, and he’s really astute in this exercise program. So, he’s going to help me develop a more gentle progressive exercise program as soon as I feel like I can get started.

Dr. Weitz:                         Cool. Maybe swimming might be something you want to integrate.

Dr. Danenberg:                 Swimming would probably be good. It’s not convenient for me. Walking is not a problem. Although walking a distance, I used to walk about five miles a day. Right now, that much walking really puts a lot of pressure on my spine and basically my pelvis and that’s why I have these fractures, so I gotta be careful.

Dr. Weitz:                         Right. Tell us about your latest report when you saw your oncologist.

Dr. Danenberg:                 Yeah, so it’s kind of funny. So, I’m seeing, I guess maybe it’s been three weeks ago or something like that. I see my oncologist, and he is doing his examination, and I’m really feeling quite good. We just did some blood work and most of the results were relatively stable, not progressing in a bad way. And one of the ratios of these unhealthy antibodies has actually significantly dropped, which is great. Still on a very high level. Certainly I’m not cured from this disease, but it had dropped, and he said to me, “Possibly, maybe I made a misdiagnosis, maybe you have not this aggressive form of multiple myeloma, maybe it’s indolent and multiple myeloma.”

He wasn’t really joking at first and then he started to laugh with me, and I said, “Just give my alternative protocol the respect it deserves, maybe what I’m doing is helping me. It’s just that you’ve never seen this before.” He’s a traditional conventional oncologist with a big group working in a major cancer center. So, if he were to tell any of his patients to do what I’m doing, he probably would be kicked out of his group and maybe sued because of malpractice, he’s not following the norm of treating cancer. So, I understand that, but he is interested enough in what I’m doing that he requests me to send to the medical papers that I’m reading, that are supporting and giving me thought as to what I want to integrate with my protocol.

Dr. Weitz:                         Now, how are you supporting your bone health? Because this bone marrow cancer, it leads to damage to bones, and you mentioned that you have several fractures.

Dr. Danenberg:                 Two of the products that I get from Standard Process are bone complex and bios. So, I think maybe bone complex is actually from MediHerb, but MediHerb is sold through standard process. I’m not sure if that’s true or not. And bios, those are two things that are supporting my bone metabolism. That’s the only specific that I’m taking. I definitely do take vitamin D3. I take gobs of vitamin K2 which is so critical.

Dr. Weitz:                         How much vitamin D and vitamin K?

Dr. Danenberg:                 Right now, I’m taking 5,000 international units of D3. Of course, the way you eat, mushrooms or egg yolks, you’re getting vitamin D3 in certain things too, but I am taking an extra supplement of D3. I do take vitamin K2. I use MegaQuinone K2-7 from microbiome labs. It’s 320 micrograms, which is quite a large number. But there’s never been demonstrated any lethal dose to K2 and I think the more the merrier. And recent studies have shown that vitamin K2 actually helps repair and rescue damaged mitochondria, which is brilliant. Actually, this is an aside, but actually I’m doing a double blind study to demonstrate that spore based probiotics and a high dose with vitamin K2 taken orally changes the gut microbiome and eventually changes the oral microbiome to reduce gum disease and improve everything else that’s going on in the mouth. And that is underway right now. It’s been approved by the Institutional Review Board. It’s an exciting area.

Dr. Weitz:                         That’s amazing. Yeah, I think I heard about that.

Dr. Danenberg:                 Yeah, I think maybe we talked about it, but at that time we talked, it wasn’t actually happening yet, but everything has gone through. To do these medical tests is, and they always need to be approved obviously, is a long lengthy process, but once they get approved I can start moving fast as long as you have the participants to do it.

Dr. Weitz:                         And you mentioned supporting your gut health is part of your program.

Dr. Danenberg:                 Yes.

Dr. Weitz:                         Why is that important?

Dr. Danenberg:                 Well, certainly, our immune system is dependent upon the gut microbiome and the intestinal layer which is only one cell layer thick. If I have dysbiosis, I have chronic disease period. And certainly cancer is a form of chronic disease. I need to get that gut as healthy as I can. I think it’s been healthy, but I am doing that much more intensely right now. So, I do take the spore based probiotic. I do take vitamin K2. I use a variety of products that microbiome has. This is not really a commercial. Other than microbiome is funding this study that I’m doing, but they have nothing to do with the independent results. I think they’re on the cutting edge of doing some cross products with lots of research behind them to support, not just the microbiome, which is a very important part, but the mucosal layer in the lumen, which is critical before anything happens to the actual layer of the intestines.  So, these are products that I take to support myself. I think that’s the chronic disease. I wrote a paper called the Big Bang theory of chronic disease a year or so ago that was published in Wellbeing Journal. I believe everything starts in the gut, but there are so many ways things damage the gut. It’s just not the food, but so many things. Well, once that gut is damaged and the immune system is compromised and your host resistance is not where it should be, then other things start to manifest.

Dr. Weitz:                         As a Functional Medicine practitioner, I’m fully in agreement with you that the gut is so crucial for the health of the entire body. I just saw a patient last week who first came to see me because she had seizures that were occurring every few months. She lost her driver’s license and neurologists couldn’t find anything. And then, after talking to her for a while, she had all these gut symptoms that she had just considered normal cause she had them for so long. We did a stool panel and we looked at her gut and her gut was really messed up, and we did some natural protocols to get her gut in order. And now, she’s eight months seizure free and she’s getting her driver’s license back just from fixing her gut.

Dr. Danenberg:                 And that’s amazing. What is not known by the general public is, you don’t have to have gut symptoms that have gut problems. Only 20% of people will have bloating and diarrhea and constipation and issues that are obvious. The other 80%, it’s already systemic. It’s already creating systemic inflammation and chronic in nature and disseminating to other parts of the body. And then, there are the genetic weaknesses in other systems that are breaking down, not related to the gut because of symptoms in the gut, but related to everything else that’s damaged that gut, that damages the rest of the body.

Dr. Weitz:                         Have you done genetic testing on yourself?

Dr. Danenberg:                 No, and here’s the reason why. I understand genetic testing is important for some thought processes. It may be important to give you a heads up as so, “Hey, you really need to be aware.” It’s almost like standing on the train tracks and you let the train slowly get closer to you. Eventually, you should get off those train tracks knowing what’s really coming down. But if I were to know, let’s say I had a snip here or a snip their, or whatever genetic problems I had, I cannot change my genetic code. I cannot change my snips. I cannot do anything therapeutic within reason to do that.

I do know that 80% or so of environment and lifestyle is going to either manifest the disease or not manifested the disease. That I have control over. Stress is a huge factor in health and disease and if I were to put myself under stress, more stress knowing all of these things are inherently wrong with me, and what can I do to correct them, I’m gonna really talk myself into more disease. There are some great papers that prove that placebo effects or not placebo effects, they’re real. And that’s because you have a positive attitude.

Chris Kresser, who I totally recommend. He’s brilliant. He just wrote a paper or an email that he sends to his people today and reviewed a situation where somebody who had all kinds of health issues and he was getting very, very ill. And he said, “Well, if I’m gonna die, I’m gonna be happy and stopped worrying, started eating pizza and coke or whatever it was, beer and pizza.” And he got better, and obviously beer and pizza didn’t get him better. He eliminated his stress. Chris is such a great, great writer. He brings across messages in such an easy to understand way. The point is, stress can be so much more damaging than anything else. If I had a healthy body, but was totally stressed, I wouldn’t have a healthy body.

Dr. Weitz:                         Right. You make a great point and Chris makes a great point, which is, as much as we get caught up into these health promoting practices of healthy eating and everything else, we need to do it in a way that also makes us happy. If it becomes so much of an obsession that creates more stress in our body, then now it’s becoming a negative thing.

Dr. Danenberg:                 You’re absolutely correct. Again, I think this is part of the reason why I feel so good. I’m not going to tell you I look like I’m 30 years old and an Adonis, but I gotta tell you I feel extremely well, and I’ll be 72 years old in a few weeks.

Dr. Weitz:                         How are you maintaining such a positive attitude?

Dr. Danenberg:                 Well, that’s my point. I’m not sure why I’ve maintained this except I’ve accepted it. I have a very strong spiritual sense, but I’m not religious whatsoever. But I have a spiritual sense. I believe in the soul. I believe where I am going to go.  We don’t have to get into that conversation, but it is comforting to me to know that.  And if this time around is the end for my life, I just want to make sure that the quality and the dignity are there until I drop dead. Marxism talks about something like live long, then drop dead. I mean, basically live the life you want to live and then just keel over, and not live a chronically diseased life with all kinds of ailments for 30 or 40 years and then drop dead.  That’s not the way I want it to be.  And if I have any control, it makes my stress level much, much less.  I stress, we all stress, but I have a great attitude and I do feel like I am winning battle more so than general medicine would have suggested. I’ve been told that I needed to sign up for hospice three months ago. I’ve not done that, so I’m okay. I’m good.

Dr. Weitz:                         I applaud you Al.

Dr. Danenberg:                 Thank you.

Dr. Weitz:                         How can our listeners who don’t have access to your blog get on the list and get ahold of it?

Dr. Danenberg:                 Oh, sure. Thanks. So, go to my website, which is drdanenberg.com, which is drdanenberg.com, Or go to my website, click on blogs. You can sign up for email alerts every time I write a post, which is just generally once a week. I talk about all kinds of things, but I certainly am talking about my journey. I’ve got maybe 15 or so posts as to when I was diagnosed and how I’m progressing and doing a variety of other things. So, that’s available. If there’s any comments, you can put them in and there was a contact form if you have questions, you can write a little email to me and I certainly respond to emails.

Dr. Weitz:                         Awesome. Al, thank you so much for sharing with us, and you’re a positive force in the world.

Dr. Danenberg:                  Thank you.



Preventing Heart Disease with Dr. Joel Kahn: Rational Wellness Podcast 95

Dr. Joel Kahn discusses Preventing Heart Disease 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

3:30  Heart disease for our purposes refers to atherosclerosis, narrowing of the arteries, that leads to strokes, heart attacks, erectile dysfunction, chronic kidney disease and even dementia.  According to Dr. Kahn, “…if we could beat this problem, we would add tremendous amount of health to our life, and probably a tremendous amount of life to our life.” 

8:09  Sometimes patients will see a doctor who tells them that they have significant risk or evidence of heart disease and this is caused by genetics and they need to take a statin. End of story. Dr. Kahn explained that this may be because they have seen a conventional cardiologist for their 12 minute follow up visit and the doctor has no time to really talk about diet or lifestyle factors in any meaningful way. Integrative cardiologists like Dr. Kahn take the time to inquire about and make specific recommendations for diet and lifestyle interventions.

9:31  Dr. Kahn wrote in a blog post that erectile dysfunction, going bald, gray hair, diagonal crease in your ear lobe, and calf pain when you walk can all be early warning signs of cardiovascular disease. These are soft signs that you may have atherosclerosis. Unfortunately, there are too many times when people do not have early warning signs and their first symptom is when they have a heart attack or stroke.  These signs should alert you and your doctor to look into whether you have heart disease and besides an advanced lipid panel, you should consider getting a coronary calcium scan, (a CT scan that looks at the arteries of the heart) which is a direct way to see if your arteries are blocked.  Dr. Kahn recommends watching The Widow Maker movie on Netflix.

18:08  Cleveland Heart Lab includes a test for TMAO as a risk factor for heart disease that was developed by Dr. Stanley Hazen. TMAO, trimethylamine N-oxide, is correlated with clogged arteries.  They looked at TMAO in a lab and found that it caused your platelets to clump, which might trigger a clot. It caused your HDL cholesterol not to work well, which is not necessarily good for your arteries. And it caused your LDL cholesterol to get taken up into the wall of the artery more aggressively. So it seemed like in fact, this was now possibly a cause of artherosclerosis. And they went on to show that it seems to be in the blood after a meal that includes a lot of choline from egg yolk, and carnitine from red meat. Vegetables don’t cause it to rise, vegans don’t have it in their blood. Dr. Hazen believes that his research shows that if you eat foods like red meat and eggs that contain choline or carnitine or take supplements of choline or phosphatidylcholine or L-carnitine that you will increase your TMAO levels and increase your risk of heart disease.

But I have several problems with this TMAO test. For one thing, one of the foods that most increases TMAO is eating fish and eating fish has consistently been associated with decreased risk of various chronic diseases, esp. heart disease. Also, while eggs cause your TMAO levels to rise, many studies on eggs show that eating eggs does not increase your risk of heart disease.  Also, taking supplements of choline is very helpful, esp. for brain function, while taking L-carnitine supplements is beneficial for heart health.

25:07  Dr. Steven Gundry is a prominent Functional Medicine doctor who says that grains and legumes and seeds and even certain fruits and vegetables contain lectins, which are harmful to our health.  Dr. Kahn says that Dr. Gundry claims to have lots of published data but he has not published any papers on his diet.  Dr. Kahn claims that many of the references in Dr. Gundry’s book are not really studies that back up what he says, that there are dozens of serious academic errors.  Dr. Kahn said that there are some people with inflammatory diseases who feel better when they avoid foods with lectins and nightshades, like eggplant. But on the other hand, if you look at the blue zones, the areas in the world where people live the longest, the one food they all eat is legumes, so how can legumes be harmful? Here is the video clip of Dr. Kahn debating Dr. Gundry on The Doctor’s Show: https://youtu.be/e61XfKF_NpI

30:10  Some vegans who eat a lot of processed and junky carbs and follow a plant based junk diet are actually more at risk for heart disease than those following the standard American diet.  So if you want to reduce your risk of heart disease with a vegetarian approach you need to make sure your diet is rich in fruits, vegetables, beans, peas, lentils, healthy sources of protein that can include the beans, lentils, organic tofu, tempeh, and such. It’s not a mac and cheese that happens to say vegan on it.  But you should also supplement your diet with high quality fish oil and include 2 tablespoons of ground flax seeds anc chia and hemp seeds eat walnuts leafy greens to get good levels of omega 3 fats. Dr. Kahn also likes his patients to take chlorella and spirulina, and vitamin B12 and vitamin D.

35:16  A Mediterranean diet, which has been shown in many studies to be associated with lowered risk of heart disease, includes plenty of extra virgin olive oil.  But Dr. Kahn is not a big fan of olive oil or of any added oils to the diet.  Here’s a blog post where Dr. Kahn recommends against olive oil: https://drjoelkahn.com/this-doctor-says-olive-coconut-oil-are-bad-for-you-heres-why/  Dr. Kahn feels that a low fat diet is healthier and recommends cooking in water or vegetable broth or wine.  This is especially the case for high risk patients who are especially at risk for a heart attack or stroke.  He cited the work of noted vegetarian nutrition experts Nathan Pritikin, Dr. Dean Ornish, Dr. Esselton, and Dr. Joel Ferman and argued that added oils add extra, unnecessary calories that make it harder to lose weight, esp. since fat contains 9 calories per gram compared to carbohydrates that only contain 4 calories per gram. Dr. Kahn did say that if you were going to use some oil, he would rather have you use extra virgin olive oil than lard or ghee or coconut oil, since it has less saturated fat. 

42:23  Dr. Kahn’ focus in his practice as a cardiologist is the early identification and early reversal of heart disease. He wants to protect his patients from becoming one of the 2,000 people a day who die of a heart attack.  He calls his approach “Prevent not stent”Dr. Kahn says that he did a lot of stenting in his day, but he prefers to practice upstream medicine by going to the root cause and fixing the problem before you’re sick, old, and nearly dead. 



Dr. Joel Kahn is an integrative Cardiologist, internationally known speaker, and best selling author.  He has a weekly podcast, Heart Doc VIP and he’s written 6 books, including Your Whole Heart Solution, Dead Execs Don’t Get Bonuses, The No BS Diet, Vegan Sex, and The Plant Based Solution. Dr. Kahn’s goal is to prevent heart disease by promoting a plant based diet, exercise, and a healthy lifestyle. His website is  DrJoelKahn.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 the Rational Wellness Podcast on iTunes and YouTube, and sign up for my free ebook on my website, by going to Dr. Weitz.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. That way more people will find out about our Rational Wellness Podcast. Today, we are going to talk about the early detection prevention, and reversal of heart disease. With our very special guest, Dr. Joel Kahn.

If a patient has existing heart disease, or has had a heart attack, stroke, shortness of breath, or any other symptom of an existing heart problem, they should see a cardiologist before they do anything else. For patients who don’t have a heart problem, don’t have symptoms of a heart problem, early detection and prevention should start with a careful history, and an advanced lipid profile, such as a cardio metabolic test from SpectraCell, or the Boston Heart Lab that I often run, or the Cleveland Heart Lab, or some of the other great tests that Dr. Kahn uses. Though there are many other tests like this on the market.  Such an advanced lipid profile will look not only at the basic lipids, which are total cholesterol, estimated LDL, HDL, triglycerides. But it will also look at LDL particle number and size, and specific atherogenic particles, like Lp(a), and remnant lipoprotein. It’ll also look at inflammatory factors, like Homocysteine, Omega 3 levels, HsCRP, oxidized LDL, it’s also important to screen for the risk for diabetes by looking at blood sugar factors like glucose, insulin, Hemoglobin A1C, and it can also be helpful to test for some of the genes, such as the APOE gene, and some of the clotting factors.

Dr. Joel Kahn is an integrative cardiologist and internationally known speaker, and best selling author. He has a very popular weekly podcast, Heart Doc VIP, and he’s written six books, including Your Whole Heart Solution, Dead Execs Don’t Get Bonuses, The No BS Diet, Vegan Sex, The Plant Based Solution, which I just read recently, it’s a great read, and Young at Heart By Design. Dr. Kahn’s goal is to prevent heart disease by promoting a plant based diet, exercise, healthy lifestyle. Dr. Kahn, I’m so glad that we met at the anti-aging conference in Vegas in December, and that you’re joining me today.

Dr. Kahn:             Oh, thank you very much, happy to beam out from gray and cloudy Detroit. So I imagine sunny Santa Monica.

Dr. Weitz:            No, no, no, it’s raining like crazy.

Dr. Kahn:             Oh wow, wow, wow, okay. Come to Detroit, bring your bathing suit.

Dr. Weitz:            Yeah, we’ve had an unbelievable amount of rain. So since we’re talking about preventing heart disease, what exactly do we mean by heart disease? What is happening in the body anatomically, metabolically?

Dr. Kahn:             Yeah. So the very broad term that ranges from babies being born with congenital holes, and defects, to irregularities in the heartbeat. But for the purpose of this conversation, really for the purpose of your listeners, the one that should dominate 99% of the combination on heart disease, I just have a little model, is when our arteries, whether they supply our brain, our heart, our legs, our sex organs, our kidneys, become narrowed. Become full of a term, people have heard the term, atherosclerosis, which is basically Latin for gruel, I think a little bit like oatmeal, or porridge. That’s what the word means. It’s appearance on an autopsy.  And that is not something we’re destined to have happen. There are people that are 90 and 100, and don’t have that process. And there are people that sadly are in their mid to late twenties now. In fact, you find teenagers, you can find the earliest trace. And we’ve spent easily 50, 60, 70 years in the scientific world trying to identify why that happens. We know a lot more than we did 50, 60, 70 years ago. I think in the late 1940’s, it was just thought to be aging inevitable consequence of aging. But why does somebody 89 years old not have it if it’s an inevitable consequence?

So the reason that’s important is that’s the substance of strokes. That’s the substance of heart attack. That’s the substance of erectile dysfunction. That’s the substance of progressive kidney weakening, which is no joy at all. And to some degree, that’s the substance of dementia, because there’s a very broad group of people that have what’s called vascular blood vessel dementia. So if we could beat this problem, we would add tremendous amount of health to our life, and probably a tremendous amount of life to our life. And that is the focus of what we’ll talk about, and a whole lot of serious science.

Dr. Weitz:            You know, I’ve increasingly had patients come in and say, “Well, I have some existing heart disease, but genetic, it’s genetic.” And it seems like that’s being thrown out quite a bit. Why do you think that is?

Dr. Kahn:             One, it’s not in any way casting a stone at anybody. It’s a convenient excuse to say, “My weight, my blood sugar, my blood pressure, my heart disease is genetic.” Because until we have crisper 9 technology like an ATM machine, you just go stick your finger in and get your genome changed. Which I wouldn’t be surprised 20 years from now you can’t just dial in what you want, maybe 10 years from now. But right now you can’t. So you’re stuck with the genes mom and dad gave you.

We’ve learned on another layer, that your genes aren’t destiny, because there’s something called epigenetics. And I’m sure your listeners have heard the term. But that’s where lifestyle gets it. Something as simple as air pollution, which is worldwide, in some areas worse than others, can dramatically change which genes are turned on, which genes are turned off. Sleep. Good sleep, bad sleep can turn on, turn off. And then the core of what we’re talking about, fitness, choices in diet, smoking, not smoking, and such.  So we can be handed a genome by our parents at the time of conception. But probably as or more important is what are we bathing our genome in? In some kind of visual there. And what’s actually turned on and turned off. I’m very excited, we’re just breaking into an era, we’re going to be getting reports. I just launched this in my clinic, where I’ll actually be able to know not just somebody’s genome, but which genes are methylated, which aren’t methylated, which are turned on and off.

So we’ll get more into that. And the ultimate conclusion is if you take a disease, very complex disease, like hardening of the arteries. Maybe 80, maybe 85% of the development of the disease is lifestyle and epigenetics, and 15% is just some hardcore genetic risk that you’ve inherited. Genes load the gun, but lifestyle pulls the trigger. So it’s never hopeless in the cardiovascular world, that your genetics will inevitably lead you to have a short life span, or a cardiac event. Just you may have to work much harder than the person who was gifted good genes, and a good epigenetic profile. But you’ve got influence. When there’s influence, there’s hope, you’ve just got to do the hard work.

Dr. Weitz:            I think unfortunately, some patients are in a doctor’s office, there’s some evidence of heart disease, or some risk for heart disease, and some of these doctors don’t really have the time to get into a long discussion of diet and lifestyle. So it’s easy to say, “Hey, it’s genetic, take this statin, and end of discussion.”

Dr. Kahn:             Right, and that’s … I was in that world where I had 12 minutes for a cardiology follow up appointment. “And Mr. Jones, your blood pressure is 170 over 105, let’s just double your drug du jour. It’s efficient, it often works. Some of these drugs do indeed have rather beneficial long term advantage. But what it doesn’t get at is, “How’s your sleep Mr. Jones? What’s your diet, breakfast, lunch, dinner, snacks? What’s your alcohol intake? What’s your waist line? Now you’re going to the gym.”  Or the advanced labs you just checked. Are you severely deficient in Omega 3 and CoQ10, and vitamin D, and such? And gives you targets to correct, so that maybe on the next visit, you don’t need to double the blood pressure. So I find it like you find it, much more interesting, gratifying. It’s just very hard to do it in 12 minutes, which is why I’ve had to lengthen my office visits, just to accommodate more teaching, result review.

Dr. Weitz:            Right. Great. So what are some of the best ways to detect some of the early signs of heart disease so we can prevent the progression of this condition? In a recent blog post of yours, you mentioned erectile dysfunction, going bald, gray hair, diagonal crease in your ear lobe, and calf pain when you walk can all be early warning signs of cardiovascular disease.

Dr. Kahn:             Right. Well it would be a better world if every time our arteries got 80%, 90% blocked, we had warnings. We felt poorly, we got short of breath, we felt an elephant weight on our chest during exercise. And many people get those, and they should go seek urgent medical attention, emergency room, or cardiology office, see if they can get it quickly. Unfortunately, even that’s not reliable, and people just die. They die, and autopsy shows they’re 95% blocked and they had no warning. And that happens 2,000 times a day in the United States, and that’s largely preventable. So given the nature of heart disease, number one, it doesn’t reliably give symptoms and warning signs, and some of which can be misinterpreted as heartburn, or just fatigue.

Number two, do you really want to pickup this disease when you’re 80 or 90% blocked? We’ve got this crazy medical system that takes care of you when you’re about to die pretty efficiently, but has very little focus … Although, we have other disease models, I mean why do people get a colonoscopy? If you believe in that, at age 50? Or cologuard when you’re perfectly fine? Because we believe early detection is valuable, why do you get a thermogram or a mammogram of the breast? Same thing.

Heart disease, the number one killer of men and women, 2,000 people a day in the United States alone. We don’t share that. So you just mentioned, I’ll go through real quickly, but succinctly, or efficiently. There are some, I’d call them soft signs, never to ignore. Men, it’s as we’re recording this, the day of love, it’s heart month, it’s February. I’m wearing my pink dye, and all that. Men are having difficulty getting an erection, maintaining an erection, performing a sexual act that didn’t used to be a problem, may have clogging of vascular issues. And if the answer isn’t necessarily vague, or zealous, or horny goat weed, the answer is Mr. Smith, let’s know your cholesterol, your blood pressure, your blood sugar, your lipoprotein A. The whole gambit of the blood panels you mentioned.

And let’s make sure that this isn’t a warning sign, not just of sexual difficulties, but of an impending heart attack or they could even be fatal. And the science says that should be performed, but sadly, family doc, nurse practitioner, you get a blue pill, you don’t get blueberries. And a blue lab slip to really dig deep. There is premature gray hair, premature balding, there is this very unusual … You mentioned it, called diagonal earlobe crease. And if you want to just Google Steven Spielberg and take a look at his earlobes. He’s the most famous resident of LA that has a diagonal earlobe crease. I don’t know if he knows about it. I would imagine, because I use him as my example all the time. Somebody by now has gone to his mother’s deli in Los Angeles, and said, “Check Steven’s ears,” or something.

But a physician in New York City 50 years ago identified, a very bright physician, Dr. Frank. That in my patients who have heart disease, I noticed this unusual physical finding. And he said, “I think it’s a sign of silent heart disease.” And in the last 10 years, multiple studies say that was one smart guy in New York. When we actually can study heart arteries much easier now, and that’s the last thing I’m going to talk about. And it’s about 70% accurate.  If you have a deep diagonal earlobe crease. You may have seriously clogged arteries. Take it as a clue, don’t ignore it, just like erectile dysfunction. Take it as a clue, there’s a common and serious disease, you want early clues wherever you can find them. And finally, why even wait? Why wait until your earlobes look funky, and your sex organs don’t go straight?  And all kinds of other further down the road.  We have had a test for more than 15 years that can tell a person very quickly and accurately, and inexpensively, if their heart arteries are clogged.  It’s often called the mammogram of the heart.  But the majority of primary care doctors, not teaching it’s availability or its utility, it’s a heart artery calcium CT scan. CT scan. You make an appointment at your hospital in Los Angeles, Good Sam, Cedar Sinai, UCLA, Torrance Harbor. You go in, you lie down for 15 seconds, you hold your breath, and you go home. No IV, no injection, it’s a CAT scan. There’s a very small amount of radiation when the machine’s on. And you get a report that says your heart artery calcium score is zero, you are golden for five, 10 years in terms of risk. Almost all. And your heart artery calcium score is 642, you’re 95 years old inside, even though your driver’s license says you’re 52 years old. And you need to get to a preventative cardiologist who can dig deep, and help you with the parameters measured in your lifestyle, and your diet, and all the rest. And maybe if we work on reversing that process, that’s been available, and was developed at UCSF and other places. Used to be $1,000, now it’s often $50, $75, $100.

The real breakthrough, November 2018, after years of this being available.  Fantastic documentary called The Widow Maker movie on Netflix, the Widow Maker Movie, everybody should watch it.  American College of Cardiology, the American Heart Association, which previously had said this is a good test, really elevated their recommendation.  Primary care docs managing somebody 45, 46, 47 cholesterol, weight, blood pressure, blood sugar, should consider this test.  Because if it’s a zero, you have really dropped somebody down in terms of risk, and you have time to work with them on diet, fitness, exercise, like that.  Somebody comes back loaded with calcium hardened arteries, you need to intensify your therapy, they’re now high risk.  And the fact that they endorsed it, and actually said, “Primary care docs, you gynecologists, you family docs, you internists, you nurse practitioners, you PA’s, put this in your toolbox as a test.”  So we aren’t yet ready to say everybody at age 50. I would actually say 45, get this like, like they get a colonoscopy. But in my practice, and in my experience, don’t miss out. Almost everybody has some reason to consider doing it once, and maybe 10 years later.

Dr. Weitz:            It’s interesting, there seems to be a push back actually in medicine now.  I’m assuming it’s coming from the insurance companies. Actually, against doing some of these screening tests.  Recently, they’ve been pushing back against mammograms, and PSA testing, and they’re saying you don’t really need it.  It’s not going to change care.

Dr. Kahn:             Yeah, that’s where this heart artery calcium scan is finally finding its niche. Because it is pretty clear, if you’re in this middle risk, you’re 48 years old, you’re tired, your cholesterol is 220, your blood pressure is 142, you’re just not picture perfect. That your physician might run a little calculator and say, “You’re medium risk for heart disease over the next 10 years.” Well that’s where the calcium score, if it’s normal, you’ve just dropped that. It’s called reassignment. You’ve reassigned that patient to a very low risk. No, you don’t recommend french fries and milkshakes. You say, hey, it’s all lifestyle, maybe you can add to your health.  And if it comes back abnormal, you’ve reassigned them to high risk. Where it’s lifestyle, plus depending on your perspective, it could be prescription, it could be referral to exercise lifestyle change programs. So we’re seeing this turnaround. What we’ll never have is a 10,000 patient study where 5,000 got the scan, 5,000 didn’t get the scan. 15 years later, it’s not going to be done. There’s no money in the game. And the tests can be … University hospital in Cleveland just announced they’re doing these tests for free. They got some research grant, so you can go and find out the truth about your heart like you’ve never been able to. The Widow Maker movie, if you want to learn the specifics for free in Cleveland. And in my city, it’s $75. Most people can afford to pay out of pocket $75 once every 10 years.

Dr. Weitz:            Can you talk about this newer TMAO test that’s being offered by Cleveland Heart Lab as a risk factor for heart disease?

Dr. Kahn:             Fascinating topic, controversial as I’m sure you’ll bring up. But you and I both know, I do believe that blood cholesterol is important, and it predicts the development of aging of arteries. But it never was the only predictor, smoking, diabetes, weight, stress, sleep. We’ve known this for years. So that list has expanded a lot. And you mentioned some of them in your introduction. Lipoprotein little A, Homocysteine, inflammatory markers. Well even that list is clearly not complete. We’re going to continue to add, and at the Cleveland Clinic in 2011, Dr. Stanley Hazen, MD and cardiologist, and his team, identified three molecules they felt might be either markers of clogged arteries, or maybe actually cause clogged arteries. Like we believe some versions of cholesterol do.  And they set out to examine yes, no. They developed a blood test for a molecule in the blood called T-M-A-O trimethylamine N-oxide. They found that the more clogged your arteries, the higher was the blood level in a group of more than 4,000 patients. That’s called an association, that doesn’t prove.  But maybe this is a good bio marker. Then they spent a couple years in basic science labs with a whole team, showing this molecule caused three findings.  It caused your platelets to clump, which might trigger a clot. It caused your HDL cholesterol not to work well, which is not necessarily good for your arteries. And it caused your LDL cholesterol to get taken up into the wall of the artery more aggressively. So it seemed like in fact, this was now possibly a cause of artherosclerosis. And they went on to show that it seems to be in the blood after a meal that includes a lot of choline from egg yolk, and carnitine from red meat. Vegetables don’t cause it to rise, vegans don’t have it in their blood.

Then they showed that if you happen to be taking supplements, and they’ve done this mainly with carnitine supplements, it can also lead you to develop TMAO in the blood. And then the whole mechanism of absorbing choline, carnitine, through some enzymes in the wall of the gut called lyases that can birth those precursors to TMA. And the liver converts it to TMAO. It’s a fascinating group of science, that it only eight years, now there’s way more than 1,000 papers.

So what we do know, it is clearly a pretty good marker. If you’re a diabetic, and your TMAO is up, your prognosis is not as good as normal. If you have congestive heart failure, if you have coronary arteries, if you have kidney disease.  And it can predict the risk of brain disease. Does it cause the disease or not?  We don’t have a blocker, we don’t have a trial that we can say, “Here is 500 people that we lowered or blocked TMAO, and their arteries remain healthy, the patient remained healthy.”  We think it’s the case, and I kind of practice that way. I’ve been able to drop TMAO blood levels since 2015 in probably three or 4,000 patients. And if it’s sky high, I want to know their supplements, I want to know their diet. I’m going to see if I can change their diet to at least a Mediterranean diet, which has been described to lower TMAO. And maybe even more of a plant diet than that. And I’ll stop their supplements for a little bit.

Now you and I both know, we need carnitine for proper muscle function, heart function. We need choline. It may be a matter of how much we need, and cutting back rather than cutting out. So there’s much to be learned. I know the Cleveland Clinic wants to find a blocker. Here’s your TMAO blocker prescription drug that becomes a several billion dollar a year drug. They’re going to have to do enormous and long term outcome studies, so we’re a ways away from that. But anybody can get their blood level checked at a Quest Lab, by asking for a TMAO blood level. And if you read the science, if you’re a heavy meat and egg eater, you might want to do that, and ask if your micro biome is producing a lot of this metabolite.

Dr. Weitz:            Yeah. I’m wondering if this is really a marker for an unhealthy microbiome. Some of the problems I have with this test is one, one of the foods that most increases this, is eating fish. And fish has been associated in a ton of studies with decreasing cardiovascular risk-

Dr. Kahn:             Right.

Dr. Weitz:            And other chronic diseases. And likewise, eggs really, we used to think that they were really atherogenic, and it seems like all the studies recently really haven’t shown that eggs increase your risk for heart disease. I know you don’t necessarily agree with that.

Dr. Kahn:             That may be quantity. But yeah, the fish story isn’t clear. And it’s just like there are all only certain fish that are really rich in Omega 3, like salmon, deep cold water fish. There’s only certain fish that intrinsically in their fish have TMAO. And if you eat them, your blood level goes up by a completely different mechanism than meat and egg yolk, because there’s no metabolism. It’s just you’re absorbing TMAO. And I think it’s very deep water fish, like some unusual fish on your plate. They wouldn’t be the bulk of the fish eaten in the Mediterranean based, and where studies suggest it is part of a healthy diet.  So yes, we need to learn more. It would be premature to say never eat meat, never eat bread, egg yolk, never eat fish based on TMAO. You might choose to do that based on other parameters. But I think it’s good that we’re learning new and interesting pathways. We’ve not … Heart disease is still the number one killer of men and women in the United States. I’m not sure if it’s because we haven’t defined all the parameters, or nobody is following a heart healthy lifestyle. There’s so much data that even what’s called the simple seven.

American Heart Association, you can say good group, bad group. They endorsed Fruit Loops in the past as heart healthy. All that stuff is the shameful episode in their history. But yeah, they have a little thing you can go online, do you smoke? Your cholesterol, your blood pressure, your blood sugar. How many servings of fruit and vegetables a day? How many minutes of exercise a day? What’s your weight? Simple seven measures almost everybody knows.  That simple seven calculator correlates to your coronary artery calcium score.  Correlates to whether your coronary artery calcium score is going to go up. Or whether you’re a zero, and you’re going to transition to somebody who has heart disease.  So you can control, do you smoke, what’s your fitness, how many fruit and vegetable servings a day. I mean we need the fancy new bells and whistles, like TMAO.  But God knows we have too many people that smoke, don’t exercise, and eat Tim Horton donuts during the day.  We don’t want to lose sight of simple measures that mean a lot to health and longevity.

Dr. Weitz:            There’s a prominent Functional Medicine doctor, Dr. Steven Gundry, and he’s been out there saying that grains and legumes, and even certain fruits and veggies, and seeds contain lectins, which are harmful to our health.  What do you think about that assertion?

Dr. Kahn:             Yeah I don’t know, I’m not making a promotion for an LA based TV show at Paramount. But I had the pleasure and the heartburn of being on the show, I think it was around September 2017, debating Dr. Gundry. I learned of his book, I had read his previous book, but his book Plant Paradox came out March 2017. I’m actually pretty open minded, I bought the book and I read it, and I thought some of it was interesting, and some of it was somewhat insane. And subsequently, just to fast forward, because it’s really not me versus him.  He is a University of Michigan trained heart surgeon, I’m a University of Michigan trained cardiologist. He likes to call himself a cardiologist, I don’t know why, I don’t call myself a cardiac surgeon. It’s just the first little chip in the otherwise seemingly perfect argument that Dr. Gundry has. He states that he’s published enormous data of his dietary program in patients with auto immune disease. Indeed, he’s published no articles on his diet, it’s just a matter of fact.  He published one paragraph called an abstract, and it has more spelling errors than a third grader trying to write Shakespeare. It’s insane.

And then his book itself, and this is the biggest problem. He has no actual data published. His book is riddled with serious, serious errors. I mean doc, if you write a book, and I write a book, and I say in chapter two, remember, these are books that are recommending health treatment strategies for people with potentially serious disorders. Putting their trust in Dr. Gundry, Dr. Kahn, Dr. Weitz. And he’s saying in chapter two, third paragraph, a little highlight study research number seven. And you go to the back of the book, you wouldn’t believe that it’s actually a real study on the topic that actually was represented appropriately, and fairly, and honestly.  Dr. Gundry’s book doesn’t believe in that rule. Why not just create a piece of fiction that’s called nonfiction?  So I’m not making this up, there are dozens of serious academic errors.  And I challenged him that on national TV, as well as the lack of publication.  I do believe he really is the emperor that wears no clothes.  Now, taking personalities aside, do legumes cause inflammation in one person in 100?  Are there people that have inflammatory diseases that stop eating beans, peas, and lentils, and either feel better, or some bio marker is better?  Maybe.  It’s not reported consistently in the literature.  Of course, Tom Brady will tell you during the season, he avoids lectin rich foods, and deadly nightshades, like eggplant.  Well Tom Brady is not a scientist. But he’s cute, and we all listen to him. The answer is we don’t know, and have I ever recommended a legume free lectin low diet to a patient with a serious auto immune disease? I have if they’ve tried everything else and they’re struggling. You do what you need to do. But it’s way premature to recognize Dr. Gundry as a Nobel Prize winner for fiction and nonfiction. Nor is it … The flip side of course, just to finish, is if you study longevity, which I know your patients are interested in, and my patients are interested in. And you study the areas where people live to age 100 or more in excess, the blue zones. The single food group shared amongst five regions around the world that are very different is legumes.  Beans, peas, and lentils are the central food of the areas where people live long and healthy. Now, their water is better, their air is better. They exercise, their lifestyles are different. But to call these food groups killers, when indeed, the science says the opposite, is just reason number 37 when Dr. Gundry comes on, you throw tomatoes at the screen. Was that subtle?

Dr. Weitz:            Hey, that’s … Yeah. It’s-

Dr. Kahn:             He knows how I feel, I debated him several times in meetings and in the public.

Dr. Weitz:            Yeah.

Dr. Kahn:             But he’s got one big ass vitamin company, and you and I would like to be CEO of that enterprise. You know, the public is looking for quick fixes.

Dr. Weitz:            Right.

Dr. Kahn:             And they’re being misrepresented.

Dr. Weitz:            Yeah. He tells a good story. I think the reality is, is if beans are properly prepared and cooked, that really inactivates most of the lectins.

Dr. Kahn:             Right. Yeah, and it’s like 10 minutes of cooking. So it’s true, don’t eat raw red kidney beans, it’ll upset your stomach. It won’t kill you, but it will upset your stomach.

Dr. Weitz:            Right, and you know, ricin that comes from castor oil beans, and that will kill you. So you know, but anyway. So in my practice, when I had vegans who were overweight, I have found that a lot of people don’t follow a vegan diet properly. It’s very easy to follow a vegan diet, and end up hardly eating any vegetables. You know? They just end up eating a lot of processed and junky carbs.

Dr. Kahn:             It’s a real struggle, and I agree with you, and I’m on your account. There actually is a study from the Harvard School of Public Health looking at cardiovascular disease, heart disease. And if you eat plant based junk, they had a way to analyze your diet, and calculate healthy plant based diet, unhealthy plant based diet. They actually did worse than the average American eating what seemed to be correlated as an unhealthy plant diet. And you did much better if you ate a whole food healthy plant diet than the average American.  So yeah, the word vegan to me is somebody who is into animal rights, and the environment, and is an ethical standpoint. But vegan food, Tyson just announced they’re creating meats and cheeses that will be plant based, Tyson, the biggest producer of chicken products in America. I mean, the grocery store is going to be filled with non animal products that look like former animal product. Doesn’t mean they’re healthy. It’s actually probably ethically and for the environment, a bit of a move forward.  But my heart patients use the word whole food plant based. I mean it’s got to look like the recent Canada food guideline plate. Rich in fruits, vegetables, beans, peas, lentils, healthy sources of protein that can include the beans, lentils, organic tofu, tempeh, and such. It’s not a mac and cheese that happens to say vegan on it. That’s going to move you towards where you want to go.

Dr. Weitz:            How do you get adequate Omega 3 levels with a vegetarian diet? Because the best source of Omega 3’s is from fish, and fish oil, and the type of Omega 3’s that’s found in vegetables and plant foods is linoleic acid, and it has to be converted into the DHA, and EPA, and that’s done very inefficiently.

Dr. Kahn:             Yeah, yeah. Although, it’s been reported on Twitter that I secretly go to Alaska with Dr. Ornish, and Dr. McDougall, and gorge on salmon once a year. And I’m not joking, that is the language of the beautiful world of Twitter that we have our secret meeting. And I haven’t done that.  … Right.

Dr. Weitz:            It’s just fake news.

Dr. Kahn:             Yeah. It’s yeah, it’s a challenge. Like you, because you mentioned those labs, I do actually get blood levels of Omega 3. There’s a lot of data, the higher your blood level, the better your long term brain health. And it maybe the better your overall health span. Dr. Russel Jaffe, you may know of a Perque Labs that makes a big deal about Omega 3 blood level of 8% or higher for long term health and brain health. So it’s a challenge, and the only people in my clinic that routinely have really good Omega 3 levels either eat salmon five nights a week, or they’re taking four grams of a high quality Omega 3 fish oil a day.

And my meat eaters are low, and my plant eaters are low, very often. And yes, it is important to try and get two tablespoons today of ground flax seed, and make some chia pudding, and use some hemp seeds on a salad, and eat walnuts as your preferred nut, because they and Brazil nuts are the only ones really rich in Omega 3. And leafy greens, now, I’m a big fan of chlorella, and spirulina, particularly chlorella. There’s so many benefits to chlorella.  Detoxifying and cholesterol and blood sugar lowering. But because it’s algae based, it actually has EPA and DHA in chlorella. And it’s a wonderful handful that I do every morning, and many of my patients do organic chlorella. And now there are capsules, you may say we’re mimicking the fish oil business. But there are EPA, DHA capsules. And the highest I’ve seen so far is about 600 milligrams of EPA, DHA in a capsule. Getting close to a good quality fish oil capsule, that might have 850 to 1,000 milligrams. So whatever it takes, I try and get my patients’ levels up.   But for the person on a new vegan diet, I’m teaching about chia, hemp, flax, chlorella, walnuts, and I’m probably going to encourage them to take one capsule a day. There’s an interesting couple of startups now that have a spray that has B12, vitamin D, and EPA, DHA. One spray a day, you’re a plant eater, you covered your bases. And there’s a new company out of Australia that has a tiny little capsule for $22 a month that has those three things in a capsule, if you don’t want to do a spray. So I think the solutions are there, but they do apply outside the vegan world, too, if you do the labs.

Dr. Weitz:            I tend to be a big believer in a low glycemic, Mediterranean eating style. And olive oil is a big part of that program. And I know that olive oil is highly recommended by a lot of people in the Functional Medicine community, including your friend, Dr. Mark Houston. And I recently read one of your blog posts, that you are not in favor of olive oil.

Dr. Kahn:             There’s a small niche, with number one. You’re absolutely right, there’s a small niche of patients. I had a guy gentleman in my office this morning who has had previous stinting, he’s having angina every time he walks to the mailbox. It’s what we call chronic, able angina. He just had a stress test, and documents lack of oxygen to the heart. This is not a low risk patient. This man could go on to have a heart attack, could drop dead. He will not go through another procedure. He wants to work on lifestyle reversal of heart disease.  He’s aware of data from the 50s, 60s, 70s with Nathan Pritikin. Dr. Ornish in the 80s, 90s, Dr. Esselton of the Cleveland Clinic, Dr. Joel Ferman. People that have published data that this gentleman might be able to stop having symptoms, and improve his stress testing coronary status. All those data, which are published peer reviewed, and actually government paid for programs, have used whole food plant diets without added oil. It actually goes back into the 40s, and some data from an internist.

If you go, Ben, to the Cedar Sinai cardiology department, the auditorium where I gave grand rounds about a year ago is called the Lester Morrison MD auditorium. Dr. Morrison did studies in 1948 using oil free diets in heart disease patients, and published dramatic benefits. So the problem is, if you’re the rare patient I took care of this morning, I would … with my knowledge of what’s going on, feel obligated to tell them. It is possible to steam, and saute, and cook with water, and cook with wine, but you don’t have to add oil everywhere. It’s a challenge in restaurants for sure. And I feel obligated to tell, so far that’s the only guy we know that can reverse your advanced symptomatic heart.  When we’re talking to people listening that aren’t like that gentleman, is olive oil of a good extra virgin source better than lard?  I mean in my world, much better.  Better than ghee?  I would say yes.  Better than coconut oil?  There is about 15% saturated fat in olive oil, and there’s 85% in some coconut oil versions. I’d rather people use olive oil. But if you’re struggling with your weight at 4,000 calories a pound per olive oil, and a salad is 100 calories a pound, if you don’t put olive oil on it. I mean my patients that are challenged by weight, I do also recommend them that they recognize the calorie density of olive oils is not favorable to their calorie in/calorie out struggle they’re having every day.

Dr. Weitz:            Yeah, on the other hand, fats are a good source of long term energy, and having a person feel satiated, and not craving a lot of carbs is also an important factor.

Dr. Kahn:             It’s a matter of quantity. I mean a half a teaspoon of olive oil versus four tablespoons, or Dr. Gundry talked about 12 tablespoons a day I think, I don’t want to misquote him, in his book. I mean that’s 1,500 calories a day, what else are you going to eat?  Well if you cut all your legumes out, I guess you might just make it on olive oil.  But I think recognizing that the highest calorie density of any food source on our plates is oils, whether they be standard vegetable oils, extra virgin olive oil, it’s just worth being aware how calorie dense they are.

Dr. Weitz:            One more question for you. I wonder if perhaps now the time has come for individualized medicine?  Maybe the time for making any kind of sweeping recommendations for society for the best way to eat, maybe the focus should be on what’s the best way for each person to eat?

Dr. Kahn:             Yeah.

Dr. Weitz:            Look at their parameters, do some testing, see how they’re eating. If that’s not working for them, find a modification that’s going to work for them.

Dr. Kahn:             I’m intrigued by the idea, as you know, there are ways you can send stool specimens, and get advanced microbiome testing. You could get reports back that tell you your microbiome likes arugula, or doesn’t like arugula. We don’t have any long term studies to say that this action makes a difference. But that’s available. You can do certain genomic studies to say if you metabolize Omega 3 rapidly or not. That very caffeine rapid or not. I mean can we guide, we’re going to spend a lot money for individual, but could we guide an individual to their ideal diet? It’s an interesting concept. I think we’re not quite there, or certainly don’t have long term data to say that they’ll feel better, or live longer.

The other just comment is I mean there’s always two people in the room when we’re talking about diet. There’s the patient, and there’s the earth. And we’ve had two very strong statements in the last four weeks. One by a large group that’s spent two years across Europe called Eat Lancet. Looking at a statement, how do we feed 10 billion people in 2050 nutritiously? But also on a planet that isn’t polluted by rain forest destruction, and landfill destruction, the rest. And their conclusion was shifting towards more plant based diets for the planet will also benefit health.  Those are called plant based. Those are called eating more fruits and vegetables, because there is still such an under representation of adequate … attainment of fruit and vegetable consumption. And then the Canadian government, after 12 year absence of the shared food recommendations, very similar frankly, to the USDA, with the food plate that’s half fruits and vegetables, whole grains, healthy proteins. And they brought in the conversation about the planet. So those are the two factors. Do we have to, as individual practitioners, worry about the health of the planet when we’re recommending a diet to an individual patient? Or do we just worry about individual patient? These are long and deep discussions. Largely, there are words out there. Plant predominant, plant flexitarian, plant based. Doesn’t mean you’re committed to not enjoying a nice piece of grass fed beef, or a nice line caught salmon, or a nice free range organic piece of poultry now and then. And I’m not going to yell at you if you’re doing that. But if your Mondays are meatless, or your breakfasts are meatless, or your plate, just like the USDA, Harvard Public School of Health, Eat Lancet, and Canadian Food Guide is largely a plant based plate, with your choice for a quarter of the plate. I think we’re all moving towards a healthier place for the both planet, and the patient.

Dr. Weitz:            Great. Excellent. Thank you for spending the time with us. How can the listeners and viewers get a hold of you, find out about your programs, and tell us about the restaurants that they can visit as well that you own?

Dr. Kahn:             Well first they gotta Google my great debate with Dr. Gundry on the Doctors Show. If the clip is there, I don’t want you to think I’m completely insane. I did go a little Hollywood on him. But it was a TV show. Here it is on YouTube: https://youtu.be/e61XfKF_NpI

Dr. Weitz:            That’s okay, we just had a Functional Medicine meeting a few weeks ago, and Dr. Vojdani, he also critiqued Dr. Gundry.

Dr. Kahn:             Bravo, I love it. Yeah, I’m all over the web on Instagram and Twitter. Dr. Joel Kahn, D-R-J, K-A-H-N. There’s a Dr. Joel Kahn, America’s Healthy Heart Doctor Facebook page. And I’m very active. There’s new postings every day on Twitter, many, many a day. And I have website, Dr.JoelKahn.com. I’m a real cardiologist, I saw patients this morning, I’m seeing patients all afternoon. I see patients, I have a license in California, and Florida, and Georgia.  I see people from all over the world. Really with the orientation, early identification, and early reversal of heart disease. So you’re not a statistic of 2,000 people a day. So go watch that movie, the Widow Maker movie, and get educated on what I call “Prevent not stent”. I did a lot of stenting in my day, and I know the field, but upstream medicine. That’s what you do. Let’s go upstream to the root cause, and fix the problem before you’re sick, old, and nearly dead.

Dr. Weitz:            Excellent, excellent. Thank you so much, we’ll talk-

Dr. Kahn:             Thank you.



Autoimmune Disease with Dr. Holly Lucille: Rational Wellness Podcast 94

Dr. Holly Lucille discusses Autoimmune Diseases 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

5:08  Dr. Lucille explained that she has become more interested in treating autoimmune diseases because more patients with autoimmune diseases have been walking in her office door. And she has found that the simpler, least invasive methods that in the past would really help patients, like simple diet and lifestyle recommendations, are not working as well anymore.  These tend to be more complex patients.

6:45  Dr. Lucille said that women are more affected by autoimmune diseases (75% of patients with autoimmune diseases are women) because the androgenic hormones in men, like testosterone and DHEA, are somewhat protective.

9:18  In the US 90-97% of patients with hypothyroidism have Hashimoto’s (autoimmune) Hypothyroid. Most MDs and endocrinologists do not run the thyroid antibodies (TPO and TGB) to confirm this because they have no ways to treat it, other than putting patients on thyroid medication like synthroid.  If the autoimmune component is not also treated, they are more likely to have autoimmunity against another organ, such as their ovaries. This can lead to premature menopause.  One controversial situation is when you have a patient who has elevated thyroid antibodies and elevated TSH, though normal T3 and T4 and no symptoms of low thyroid. The elevated antibodies is telling us that there is an autoimmune condition that we can try to get under control before too much damage to the thyroid gland occurs and they need thyroid medication. Dr. Lucille mentioned that food sensitivities, infections, medication, poor food quality, poor air quality, and poor water intake are among the triggers for autoimmune thyroid.  You have to take a careful history and probe what potential environmental exposures they might have, such as mold or other toxins. We also have to look at gut health, since leaky gut and bacterial or fungal dysbiosis can be underlying factors. And then you have to do some of the good Functional Medicine testing to confirm your suspicions. 

18:08  With a patient with autoimmune thyroid, if there is nothing suggestive in their history of environmental exposures, Dr. Lucille will look at vitamin D levels. She will also look to see if there is an Iodine deficiency, since Iodine is needed to produce thyroid hormone. And other halogens, like flouride, bromide, and chlorine can all block iodine from working properly, so you need to try to avoid these. If you do give iodine, too much can spur an autoimmune reaction, so she prefers starting with 100-200 mcg and not the higher milligram level advocated by some Functional Medicine practitioners.  You must also make sure that there are sufficient antioxidants, like selenium, since the production of thyroid hormone from L-tyrosine and iodine produces a lot of free radicals. Dr. Lucille also likes to test inflammatory markers like CRP (C reactive protein) and Homocysteine and she has started to use the cytokine panel from Diagnostic Solutions, CytoDx, which measures the TH1:TH2 balance.

23:10  If Dr. Lucille is concerned about a possible food sensitivity in a patient, she may just tell them to eat gluten free for 60 days or follow an Autoimmune Paleo diet. If they are someone who likes to see the data, then she may run some food sensitivity panels. Such test results can help with patient compliance and adherence, which is stronger than compliance. She finds such data helpful, but it is expensive for the patient. She may have them start following a modified blood type diet from Dr. D’Adamo which may help them avoid foods that they are reacting to as well as junk food.

27:07  If you suspect a patient may have exposure to toxins, you need to teach your patients to avoid further toxins. She relies on the EWG.org website from The Environmental Working Group to figure out which skin care, health and beauty aids, and cleaning supplies do not contain toxins. You have to stop exposing yourself to the toxins and then you can start to detox yourself. She likes to start by opening the emunctories by supporting the liver and the detox pathways and also using movement, saunas, steam, and getting hydrated.  The emunctories are the pathways and organs which help us eliminate waste and toxins. You want to make sure the patient is pooping and urinating and sweating and even crying can be good.  You want to support the gut, the liver, and the kidneys nutritionally. 

29:00  When we get exposed to toxins like mercury and other heavy metals, what happens is the immune system reacts to the toxin like the heavy metal, and then it will find a protein in the body that looks similar and then it cross reacts and attacks that organ. This is how autoimmune diseases get started.  Dr. Lucille discussed a case history of a patient who had Hashimoto’s had high mercury from eating fish that came up on a NutrEval panel.  She had the patient avoid sushi and use The Detox Qube from Quicksilver that includes liposomal glutathione, lisosomal vitamin C with Lipoic acid, and silica binders.

33:48  Stress can dysregulate the immune system and play a role in contributing to autoimmune diseases. Dr. Lucille explained that she asks patients to do You Musings in the morning and a daily autopsy at night.

37:07  Dr. Lucille will sometimes recommend the following supplements for patients with autoimmune diseases:  1. Vitamin D, 2. Essential Fatty acids, 3. Curcumin, 4. Resveratrol–200 mg twice per day, and a good gut protocol such as the 4 R protocol.  Here’s an interesting paper on resveratrol for autoimmune diseases: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5748756/  Resveratrol Role in Autoimmune Disease–A Mini-Review.


Dr. Holly Lucille is a Naturopathic Doctor and can be reached through her web site, http://drhollylucille.com/  and she is available to see patients at her office in The Body Well at 7235 Santa Monica Blvd., West Hollywood, CA 90046 by calling 323-658-9151.   

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 signup for my free ebook on my website by going to Dr. Weitz.com. Let’s get started on your road to better health.  Hello Rational Wellness podcasters. Thank you so much for joining me again today. For those of you who enjoy listening to the Rational Wellness podcast, please go to iTunes and give us the ratings everyday. That way more people will find the Rational Wellness podcast. Our topic for today is autoimmune diseases with Dr. Holly Lucille and how to treat them with a functional medicine approach. Auto immune diseases have been on the rise for at least the last four decades and they are between 80 and a hundred different autoimmune diseases and at least 40 other diseases are suspected to have an autoimmune basis.

According to Dr. Thomas O’Brien, if we include diseases that have an autoimmune basis, autoimmune diseases are the third leading cause of death in the United States. Since most of these diseases are chronic and often life threatening and in fact, if we include heart disease as a autoimmune disease, autoimmune disease probably is the number one cause of death. Some of the more common autoimmune diseases include Alzheimer’s disease, Parkinson’s, asthma, Hashimoto’s hypo thyroid, rheumatoid arthritis, Lupus, psoriasis, alopecia, Crohn’s, multiple sclerosis and Type I diabetes.  Our immune system is designed to protect us from bacteria and viruses and parasites and to protect our tissues from damage that occurs on a regular basis. What happens in autoimmune diseases is that our immune system becomes dysregulated and it starts to attack our own cells and organs. The conventional medical approach is to treat autoimmune conditions either by controlling the symptoms, such as providing thyroid medication in the case of Hashimoto’s thyroiditis, or by using medications that suppress the immune system such as corticosteroids, chemotherapy agents, or the newer, injectable TNF Alpha blocking agents like Humira and Remicade, which are in very common usage today.  These drugs simply block part of the immune system and this is a problem because you do need a properly functioning immune system and these drugs have potential side effects like infections and cancer. But Functional Medicine in contrast treats autoimmune diseases by trying to look at the underlying factors that lead to the immune system getting dysregulated. These include leaky gut, food sensitivities, toxins, infections, nutritional deficiencies. This is very important. If I have a patient with Hashimoto’s hypothyroid and most women in the US with hypothyroidism have Hashimoto’s and all this patient is treated with is with thyroid medication, which don’t get me wrong is very helpful.  It doesn’t do anything for the smoldering fire of the autoimmune disease that has been attacking the thyroid gland. And chances are that will continue. The patient may need higher dosages of thyroid medication over time or they may end up with another autoimmune disease. So not just regulating the thyroid but also putting out the smoldering fire of autoimmunity is crucial for this patient’s long term health. And that’s something that we want to discuss today. Dr. Holly Lucille is with us today. I’m very happy that she’s here. She’s a Naturopathic doctor, a registered nurse and a nationally recognized educator, national products consultant and TV and radio host.  She’s the author of several books, including Creating And Maintaining Balance, A Woman’s Guide to Safe Natural Hormone Health and The Healing Power Of Trauma; Comfrey. Dr. Lucille is the host of the popular podcast Mindful Medicine and she’s in private practice in Los Angeles. Dr Lucille thank you so much for joining us Today.

Dr. Lucille:                           It is my pleasure always. I’ve never thought about this as much as I was thinking about this when you were talking about, I love the name of your podcast. It just makes so much sense.

Dr. Weitz:                            Cool. Thank you.

Dr. Lucille:                           Yeah. Rational Wellness.

Dr. Weitz:                            We’ve had a few challenges getting started today and of course just as got started, one of my lights went out, but …

Dr. Lucille:                           I’m sure it will be epic.

Dr. Weitz:                            So how did you become interested in treating autoimmune diseases?

Dr. Lucille:                           You know, Gosh, like I have become interested in treating anything else, if my practice informs me. My patients inform me, I mean like you, I hold a license to practice medicine and I need to have continuing education credits each renewal period and certainly get those and more and always continuing to learn.  But I have to tell you what I have to pay attention to and what gets my attention most is what walks through my door. And then as you said, in the last decade, for me, I have seen it, the increase of people walking in actually diagnosis in hand, right?  So they’ve already been through the conventional, Western, reductionistic process and they’ve been diagnosed with one, two, maybe other autoimmune diseases. Or I’ve got these more complex cases that with the least invasive methods, I’m used to using all throughout at my last 20 years in my career that could really get people far in their wellness and healthcare desires aren’t working anymore. So I’m thinking, “Hey, what’s going on?” And more and more those folks, we’ve ended up diagnosing with one autoimmune disease or another and having to get in there and treat and identify the causes of those. So it’s really been my practice that has informed me to get started down this sort of Naturopathic, Functional Medicine, comprehensive overview of helping people with autoimmune diseases.

Dr. Weitz:                            Why do you think women are so much more affected by these?

Dr. Lucille:                           Yeah, it’s true. I mean more than 80 immune mediated diseases that we looked at and seven in a 100 people aren’t affected. 25% of men, 75% being women. And I don’t think that we know all of those answers. I know that there are some associations with the X chromosome when it comes to sort of a genetic predisposition where a certain excellent gene appears to be critical and then I think on the other side, testosterone, if we look at it, it reduces the number of B cells, which is sort of, that type of lymphocyte that releases those harmful antibodies. So we’re maybe looking at more protection for men because of their higher levels of an androgen like testosterone.

Dr. Weitz:                            Oh, interesting. I was thinking that maybe estrogen was a factor in this.

Dr. Lucille:                           Yeah. Not so much as being protected at all. I think we’re looking more at being able to in treating, looking at optimizing hormones, especially the androgens when we’re looking at DHA and testosterone. That’s what my clinical assessment has been.


Dr. Weitz:                            Interesting. I’ve really been enjoying this discussion, but I’d like to pause for a minute to tell you about our sponsor for this podcast. I’m proud that this episode of the rational wellness podcast is sponsored by integrative therapeutics, which is one of the few lines of professional products that I use in my office. Integrative therapeutics is a top tier manufacturer of clinician design, cutting edge nutritional products with therapeutic dosages of scientifically proven ingredients to help our patients prevent chronic diseases and feel better naturally.

Integrative therapeutics is also the founding sponsor of Tap Integrative. This is a great resource for education for practitioners. I’m a subscriber to Tap Integrative. There’s videos, there’s lots of great information constantly being updated and improved upon by Dr. Lise Alschuler who runs it. One of the things I really enjoy about tap integrative is that it includes a service that provides you with full copies of journal articles and it’s included in the yearly annual fee. And if you use the discount code Weitz ,W-E-I-T-Z, you’ll be able to subscribe for only $99 for the year. And now back to our discussion,


Dr. Weitz:                             Let’s talk about Hashimoto’s hypothyroid and what percentage of patients in the US who have hypothyroid have autoimmune disease and when you’ve seen some of these patients, what do you find in some of the more interesting triggers for this?

Dr. Lucille:                           Yeah, so depending on the reference that you look at from looking at all of the Americans that have hypothyroidism, you’re looking at 90 to 97% of them having an autoimmune related hypothyroid, Hashimoto’s. And it’s interesting and I’m sure you’ve had this conversation and I’ve had this conversation with many esteemed endocrinologist in wondering if those are the stats. “Hey, why don’t you run antibodies TPO, thyroglobulin, why?,” and their answer I think from their scope of practice is quite good. It’s because they wouldn’t change their treatment.

Dr. Weitz:                            Right.

Dr. Lucille:                           So if you’ve got a high TSH, relatively low T-four, which is pretty much all that they’re going to see, you’re going to be diagnosed with hypothyroidism and then given a thyroid replacement therapy, most likely Synthroid or what have you.  And of course our argument is, okay, as you said in your introduction, that’s great. We can get TSH within normal limits again but we’ve got this raging fire of inflammation behind us that I don’t believe the symptoms are going to stop for that patient just because the TSH is within normal limits. And also that autoimmune disease can continue on.  And I’ve seen it way too many times and I’ll tell you where with women, and we don’t really have a test yet for this, but pretty much sure. And I say that clearly, premature menopause because their ovaries end up being affected.  Another gland being attacked by the patient’s own immune system and I’ve seen it over and over and over again in my untreated Hashimoto’s patients.

Dr. Weitz:                            Interesting. Yeah, no, it’s true. The average patient who goes to their medical doctor doesn’t get the thyroid antibodies measured. They basically just look at TSH and that’s all they really focus on.

Dr. Lucille:                           Yeah.

Dr. Weitz:                            I have found a number of patients who had elevated TPO antibodies and actually didn’t have symptoms of thyroid disease and I always find this an interesting phenomenon and I feel as Functional Medicine practitioners, one of the things that we can do is try to prevent some of these autoimmune diseases and if we can see some of these autoimmune markers happening, what it’s telling me is that there is this underlying smoldering fire and maybe now we can put it out before their thyroid gland gets so destroyed that they actually need thyroid medication.

Dr. Lucille:                           Yeah. It’s a tricky thing with, I always say you can’t treat lab tests. You have to treat people. But in this situation, if the patient isn’t really presenting with overt symptoms, you have to look at that lab test and go, “Huh, is this an earlier stage of the disease appearing? Is this something that could be prevented?” And I would say yes, because the other thing too, which I’ve found very interesting in the patients that I could get a hold of their labs all the way back, is that if you think about, if that thyroid starts to get attacked, and of course we remember that at the thyroid level is where the thyroid hormone isn’t made. Okay.  T4 is inactive, we have pro hormone almost.  We haven’t really identified a receptor for it. We have four months of stored T4 in our thyroid. So at first if you catch it early, and I’ve seen this, you got that T4 being released in flush into the bloodstream, converted into T3 in the peripheral tissues of course. And you’ll actually see a hyperthyroid that almost and you catch it early it’s Graves’ disease honestly. But that subsequent attack over and over again, you’re going to start seeing a decline in the hormones being produced. And also, of course, your blood work is going to then start showing. But I think when we look at thyroid as a whole, if a patient is having any abnormalities in their blood work, they are already in dire straits from a tissue perspective.  It’s been going on for quite some time.  So I think the biggest take home is when we’re looking at thyroid health and we think about metabolism, aerobic and anaerobic in every single cell in our body. It’s so important to know that it’s not a numbers game and look at it very comprehensively certainly those lab tests, especially if they’re not presenting with overt symptoms and you still got those antibodies on the rise, that is a great opportunity.  Prevention is always the cure.

Dr. Weitz:                            So what are some of the triggers for autoimmune diseases for thyroid and others?

Dr. Lucille:                           Okay, so just think about it. Certainly, there’s a genetic predisposition I’ve seen for sure, environmental influences, you think all the way through, food sensitivities, infections, medication, poor food quality, poor air quality, poor water intake. There’s so many contributing factors and that’s really the key I think is to help identify what are the contributing factors that are stirring on the body’s ability to attack itself.

Dr. Weitz:                            So when you have a patient that presents in your office and they have some indication or symptom of a autoimmune disease. How do you work that through? How do you decide it, try to figure out whether it might be a food sensitivity or a chemical toxin exposure or an infection, a mold exposure. How do you work that up?

Dr. Lucille:                           Yeah, it’s a lot. I mean it’s tricky, but I think that with Functional Medicine and in Naturopathic medicine, we’ve got all the tools and I do think it first starts with that clinical acumen. I mean here you and I live in the Los Angeles area and we just had four or five days of straight on rain and thankfully because we need it so much, but I have to tell you the buildings that I had been in in the past week or so, a lot of people are exposed to mold and that is an infectious agent. If you do not identify it, it can continue to contribute to a chronic autoimmune disease.  So getting that history from a patient, looking at their environmental exposures, drilling down into that specific part of the case is extremely important because we’ve been … if you’re 30, 40, 50 years old, you’ve been living on a surfer, that time had been beat up a little bit because of our increasingly toxic environment. And so that is just a place where you do that investigation. And of course the way that I played in my practice is my clinical hypothesis is so important and for everybody it’s individualized because everybody comes with not only different genetics, different biochemistry in a sense, but also their different histories.

And then we’ve got these incredible Functional Medicine labs to confirm our clinical suspicion. So as I said before, at least invasive methods to diagnose and treat. And I used to get away with a lot less and it helping people sort of clean up their diet a little bit, get moving a little bit more, open the emunctories and it’d be amazing, right? The outcomes from a clinical perspective, not to work really hard to drill down and understand all of these environmental triggers, but also there’s gut health and we can talk much more about that cause that’s extremely important when we’re talking about the immune system. So the testing I think is really important and also that good clinical acumen taking that case history, especially if you are at all suspicious of an autoimmune condition.

Dr. Weitz:                            Yeah. Alessio Fasano, one of the experts in autoimmune diseases, he talked about having this triad where you have food sensitivities and you have leaky gut is being a major factor. So there’s no doubt that gut health is super important for …

Dr. Lucille:                           Oh, you think about it because I mean you’re looking at 70% of the immune system, the gut associated lymphatic tissue. We’ve got our stomach acids, we’ve got these tight junctions. When there’s any amount of dysbiosis, whether it’d be a bacterial dysbiosis or fungal dysbiosis, you know those tight junctions get a little bit more loose because of those endo toxins that are produced. And then we’ve got larger protein molecules getting into our bloodstream. Our immune system is like, “Hmm, what are you doing there?” And what does it do? It mounts a response, exactly what it’s supposed to do, but if that continues on that it’s gets chronic. And I think that’s a huge underlying cause for autoimmune diseases.

Dr. Weitz:                            So let’s say you have a patient in your office and there’s no obvious cause. You go through their history, they don’t tell you anything suggestive of mold exposure.  Of course it could be they think they’re sort of okay with gluten and there’s nothing obvious. What direction do you go? Do you do a stool panel? Do you do serum lab work?

Dr. Lucille:                           Yeah.

Dr. Weitz:                            Urine testing. What direction do you tend to go to? And I realize there’s intuition and other things that go into this.

Dr. Lucille:                           Yeah. So I look at other common contributing factors like vitamin D deficiency. So I want to make sure I’m checking that out. Iodine is really important because Iodine deficiency I think is a contributing cause to autoimmune disease, especially Hashimoto’s, but very controversial subject because if you have Iodine deficiency, what do you have? You have, because Iodine obviously T4, T3, we’re looking at Tyrosine the T part and the three or four being iodine molecules. And if the iodine deficiency is there, you’ve got these little friends that hang out on the periodic table, the other halogens that are toxic, that can come in and search, create and stimulate this immune response.

Dr. Weitz:                            For example fluorine.

Dr. Lucille:                           Yeah. Bromides, chlorine, all those things. And so I want to understand that I will jump to treatment because I have seen if you give iodine, it can spur on an autoimmune reaction.  But in my clinical experience, the way that I get around that is to make sure that the free radical load is down, the antioxidant status is up, especially with selenium. Once that I’m assured that is happening, I can start successfully putting iodine on board and watch those antibody numbers and they continue to go down. So that’s my quick tip right there.

Dr. Weitz:                            Are you talking about modest dosage, like 100, 200 micrograms or you’re talking about milligram dosages like some practitioners recommend?

Dr. Lucille:                           Well, I definitely start slow because we’d want to watch the antibodies and obviously there’s been some controversy and I do think that dosing iodine, heavy doses of iodine can be more harmful to Hashimoto’s if we’re not doing it in the correct way, which I think is that antioxidant status needs to be preserved first. And so then I start very, very slowly go up and watch the antibodies. But you know the other things too, I’ll run inflammatory markers, certainly C reactive protein, homocysteine. That’ll give me an idea if I should do more genetic testing.  You had mentioned a great lab. It’s fairly new, the test for Cytokines, I think it’s the CytoDX from Diagnostic Solutions. That’s a nifty nifty serum blood test.

Dr. Weitz:                            That tells us about TH one TH two balance, which is an important factor in autoimmune disease. Talk about that.

Dr. Lucille:                           Absolutely. I mean that’s the fun thing about sort of thinking through this and the way that we do is that there’s always a balance and there’s a balance with the immune system. Those pro inflammatory cytokines are important because they’re going to react if we need them to. But I think what happens is once it comes out of balance and those TH1 mediated cytokines which we see all the time, elevated and autoimmune diseases, they just take over. So our goal is to understand that imbalance get things on board that we can actually balance that out and quell that inflammatory response.

Dr. Weitz:                            For those listening who aren’t familiar with the importance of iodine. I just wanted to clarify a few points in sort of the history of hypothyroidism in this country is, we used to have commonly people would have hypothyroidism from iodine deficiency and they would get an enlargement of their thyroid called the corridor. And there were parts of the country in the Midwest called the goiter belt. And then we started adding iodine to the salt. It was a nationwide supplementation program to take care of this. And interestingly rates of hypothyroidism from iodine deficiency plummeted, basically went to super, super low levels, but then autoimmune thyroid took off.  And we’d seen the same phenomenon in countries around the world where they went from having Goiter causing hypothyroid to supplementing with iodine and then autoimmune disease taking off. And so iodine is super important in your body making thyroid hormone and part of the process stow in making thyroid hormone is that it produces a lot of free radicals and those free radicals cam create problems. So you were mentioning taking antioxidants to help quell that if you’re using iodine. Okay, so let’s go back.

Dr. Lucille:                           Nice clarification.

Dr. Weitz:                            Let’s say you’re working up a patient and you think they might have some food sensitivities. What approach will you tend to take? Will you either one, say “Let’s just cut out gluten, dairy, soy, do an elimination diet,” or will you use one of these panels to look at food sensitivities from Cyrex or when these other labs, what do you think is the best way to go about this?

Dr. Lucille:                           Yeah. You know, and I hate to keep coming back to this, but it’s just the gosh darn truth in my practice–is everybody’s so different. There are people that I can say, “Listen, I need 100% gluten free for 60 days, and I’d like you to go on an AIP.” So an autoimmune sort of Paleo type diet. And they’ll do that. They’ll do that sight unseen. They don’t need to see a test. They don’t need to see whether it’s acute allergies that they might have. Even these delayed sensitivities. If I do food allergy testing, I like to do at all just to get that in their IGG, IGA, IGM, all of it. But some people were okay, just let’s clear things out.

If we choose to do, because also and people don’t pay me to mind their pocket book. But when this is a chronic case and there’s a lot of different things to suss out. We’re looking at, I did a talk, Ben, I’m sorry I’m interrupting myself.  But I did a talk a couple of weeks ago in Hawaii called Superpower in your patient self care. And my whole talk was centered around the idea that I end up teaching in my practice all the time, because Docere right? Doctor in Latin means to teach. Here take this, like as you said, Humira.  Here take this is easy, easy medicine when it comes to an autoimmune disease.  You get that prescription, you take it down, pay your copay, open that bottle up.  It’s easy medicine.  What we ask people to do when we’re trying to excavate and identify and treat the cause and have an outcome of being able not to shed this diagnosis and not have this be as chronic or as debilitating and as life threatening and it can be, it’s not easy and it’s not inexpensive sometimes.  And so I’ll also take that in mind.  I mean if money wasn’t an issue, I think I would love all the data in the world because then I’d have it, I let my patients see it.  We could connect the dots together. They could have more of an adherence.  Compliance is like, “Yeah she told me to do this.” Adherence is a faithful attachment to something and I have those patients that just need to see it.  So if they need to see it, I’m going to run it, I’m just going to get that data so we have it, so they know it and they can be more motivated.

Dr. Weitz:                            So what you’re referring to in case there’s some patients who are listening who aren’t familiar with this, is there are a bunch of Functional Medicine oriented labs that are available. And except that they tend to be fairly expensive and they tend to be out of pocket. So it’s not unusual to run a big panel of food sensitivity tests. It’s very comprehensive, but it could cost 1000 bucks and it won’t be covered by your insurance.  And so patients who are used to just paying a $20 copay and getting all your lab tests done might come as a shock. People who are used to the Functional Medicine world would understand though.

Dr. Lucille:                           I have to say this because I’ve been using it clinically. With a certain amount of success, whatever I’m doing to get started. And if we are collecting more data, I will have people sort of just following a modified blood type diet, kind of just really not their food sensitivities by avoiding their avoid foods based on D’Adamo’s work. It gets us started, it gets us started cleaning up the diet, excavating certainly process students because that’s what it does. Gluten for sure. So we’ll get some parameters on board first and wow, we’re getting more data.

Dr. Weitz:                            Yeah. Interesting. So let’s say you have a patient and you suspect maybe they might have some exposure to toxins. How will you try to suss that out?

Dr. Lucille:                           Yeah, so, certainly we want to avoid any other exposure. So a lot of education on all of that. I mean, I always use ewg.org. environmentalworkinggroup.org as a resource as you do for my patients because it’s all right there when it comes to the things that they put on their skin, health and beauty aids when it comes to the cleaning supplies. So that dossier, the education and avoiding exposure is primary. We’ve got to stop at whatever the offending agent is. And then of course you have to an on the way that we talk about it, open the emunctories, we have to get those detoxification pathways really cranking.  That’s extremely important. We’ve got to start helping to get things out that might have accumulated and that are continuing to contribute to this sort of-

Dr. Weitz:                            For those of us who aren’t familiar with the emunctories can you explain?

Dr. Lucille:                           Yeah. So when we think, so among Montreal, this is an old word. It’s where we get things out. So if you think about detoxification and how we get out toxins, it’s your defecation, is through urination, is through perspiration. I mean heck, even a good cry, right is emoting, is can be very detoxifying. So this is where we want to look at the detoxification pathways and of course the gut is involved in that too. Liver, very important and all of the nutrients that drive the cytochrome P 450 pathways in the liver to do that, supporting those and as well then movement, Saunas, steam, like I said, staying hydrated, very important.

Dr. Weitz:                            For those who aren’t familiar with the concept, if we get exposed to toxins, let’s say you have mercury from eating fish or I just heard about a new test from doctor’s data that looks at heavy metals from a metallic implants, which is kind of interesting that a lot of us are as, as we’re getting older or getting knee replacements and other joint replacements and we’re told that they’re using titanium and other substances are totally not a problem with it. Turns out that of these metals are getting into our system and creating problems. What happens is your immune system detects that there’s this toxic near and then there’s just cross reactivity.  So what happens is immune system that’s attacking the metal then recognizes some protein in your body that’s maybe in your thyroid gland or your liver or somewhere else and it starts attacking that organ. So that’s how we end up with these autoimmune diseases from exposure to toxins.

Dr. Lucille:                           Yeah. Then there’s two cases that comes to my mind when you’re talking and this is the art of medicine, right? This is a process that we go through but one of, I mean she loves her heart riddled with them. A couple, she walked in with Scleroderma and as well as Hashimoto’s and I’m thinking, “Whoa, what is going on here when into genetic panel.” Just because we’d had some genetic family history with her, but guess what? Their family own dry cleaners all throughout the Santa Lucia, after school, where would she go? What was her first job? She had solved the exposure. Entire growing up years.

That was huge. Another woman where when you get this down, it’s great because you can start to see people get better and your antibodies come down. Because once again, if we’re looking at Hashimoto’s, you and I are not just looking at the TSH.  My metric is those … Well, my metric is the patient has to start feeling better. That’s number one. Number two, we want to see those antibodies come down because we want to see that the fire is not like raging, that it might just be there still and we can do things to put it out. Let him see those antibiotics come down. When that’s not happening, I always have to say, okay, why? Because the body has an ability to heal itself. That’s sort of one of our biggest tenants. And so what’s in the way we’re obstacles to cure.

And that was another one. This woman was doing everything and I thought, and her mercury, finally we did this testing. It’s her mercury was off the charts. So as soon as we effectively detoxify from mercury and she didn’t have any mercury amalgams, she was only 29 years old. And so hers was mostly her Sushi Habit. And so as soon as we’re able to detox that mercury, her antibodies, everything else she had been doing and having on board starting to drive down. Had my last case and I’ll tell you about, we’re talking-

Dr. Weitz:                            By the way, how did you measure the mercury and then how did you get rid of it?

Dr. Lucille:                           Yeah, so I’m very sensitive. I used a NutraEval for her, which is as a couple as a classroom and just for the patients that are listening or watching if you have the right insurance, we can tuck it under something called Pay Assured. And there are some interesting ways that we can make these sometimes cough rebutted tests and so that’s where that popped up because I had felt like she had done so much, so I really wanted to do the Mac daddy mac just to see what else that was missing. And that’s really a nice test to do that.

Dr. Weitz:                            No, we use that quite a lot. It’s a great nutrition panel that also includes heavy metals through serum.

Dr. Lucille:                           Yeah. And you can see those malabsorption markers, you can see dysbiosis, markers. And for me that’s kind of like a great test to do because it can spin off and make me focus and concentrate on additional testing and additional areas if needed. It will totally red flag a part of my brain to go, okay, this is where we need to start focusing and then for her, I use a detox cube from Quicksilver Scientific which is really, really comprehensive, has the glutathione in there sort of like the catch and release when it comes to pulling mercury out. These heavy metals have such an affinity for our tissues. And so I’ve had great success with that.

Dr. Weitz:                            So for those who aren’t familiar, it uses agents like glutathione, which is designed to help start to pull the mercury out of the tissues and then it has binders to bind to it, things like charcoal, and then make sure that they leave the body through the stool. Right?

Dr. Lucille:                           Yeah.

Dr. Weitz:                            And the urine. What role does stress have on autoimmune diseases?

Dr. Lucille:                           Oh, boy. This is a big one because if you think about it, so stress, obviously we need to quantify, but unhealthy, prolonged stress.

Dr. Weitz:                            Yeah. Chronic stress.

Dr. Lucille:                           Compounded. Those stressors. Because once again, we’ve got this wonderful fight or flight. We’ve got this autonomic nervous system that can help us respond to multiple stressors. When it becomes chronic. You’ve got sort of an over adaptation. You’ve got, we’re supposed to adapt to stressors, but when that hypothalamus, pituitary adrenal access starts to over adapt, one of the things that happens is a dysregulation of the immune response, which you can see in the final stages of sort of this HPA access exhaustion or dysregulation. It becomes blunted. And I think that’s where we start seeing the contribution of chronic stress to these autoimmune diseases.

Dr. Weitz:                            How do you handle that?

Dr. Lucille:                           Wow. Biggest thing. I mean, what do we do? We’ve got to start decreasing and reducing our chronic stressors. What I have people do-

Dr. Weitz:                            Meet the modern world, go live in a shack in the woods.

Dr. Lucille:                           Yeah. Well No, like right. Who will climb up to be a Zen monk. That’s never going to happen for a lot of my patients. There’s a couple things that I have people do and for some reason I’ve seen that adrenaline and meditation have not been effective as far as that way of framing them. So I have people do You Musings in the morning, I just want you to muse about what you want to do. And I have them do it for like three or four minutes, not a lot of time, but before they start getting connected to their devices before they start getting connected to anything else on the outside, I want them to at least to be able to stay connected to themselves.  People just are so disconnected from themselves that when it comes to, as I said, not easy medicine where we’re looking at dietary interventions, we’re looking at lifestyle modifications especially with stress reduction. So I have them do that. And a little other trick I have them do at the end of the day is simply called a daily autopsy because that day is done, of taste. Hey it’s gone. It’s dead. You’re never going to get it back. How did it go? What happened? Was there a piece of bread? Not that bread is evil or anything, but that you unconsciously sort of stuffed in your mouth at dinner after a glass of wine that you promised yourself you weren’t going to have.  And so those two things are really important to just frame the day for folks. Then I just, I have them do it. We share it, we talk about it. That’s really important. But of course, any other thing, meditation, whatever works for that patient, whatever for that patient is gonna create a parasympathetic response, that’s the opposite of fight or flight. That’s why we rest, relax, repair. Some people, it’s spending time with their grandchildren. Some people, it’s not spending time with their grandchildren. Some people it’s like taking a bath, lighting candles, carving out time to just read a book instead of watching television. So all of those things are so important to help. Cortisol is very inflammatory and we’re trying to quell the inflammation, so all those things need to be on board.

Dr. Weitz:                            That’s great. We can talk about autoimmune diseases forever. I’d like to hit on one more topic and recognizing that every patient’s individual in a specific patient in your office, you would have very specific recommendations. But just in general, what are some of the more helpful dietary, nutritional supplements for autoimmune diseases?

Dr. Lucille:                           Yeah, so from a research, and pretty much what I see in my practice, general support, I’m looking at vitamin D, definitely getting them up to optimal levels.  60 to 80, I think you’re not just one click above rickets, which I see a lot of people coming in with their lab test and they’re like, “Oh, your vitamin D is within normal limits.”  Look for optimal. Definitely healing the gut. So we’re looking at that friendly and good bacteria, which is part of the immune system as well as the stomach acid in the gut associated with panic tissue. And we’re looking at the gut.  Essential fatty acids I think are important.  Curcumin, I’ve written a lot about curcumin especially in higher doses. Potent anti-inflammatory, potent antioxidant.  Inhibits the TNF alpha and other interleukins. So that I think is extremely important.  Resveratrol.  This is actually something that folks that I’ve been talking to from a colleague perspective.  It helps to reduce oxidative stress. Yes. But it also inhibits that cell differentiation, which is extremely important. And so I’ve really seen resveratrol, be quite effective in treating Lupus, for sure, Rheumatoid arthritis, Hashimoto’s. So I use that all the time as well.

Dr. Weitz:                            200 or 400 milligrams. How much?

Dr. Lucille:                           What did you say?

Dr. Weitz:                            How many milligrams? 200 milligrams. 400 milligrams.

Dr. Lucille:                           Usually 200 milligrams BID or twice a day.

Dr. Weitz:                            Okay, good.

Dr. Lucille:                           And then you’re always looking at digestive health. The Rs we know the Rs, so removing those microbial the viruses or fungus. Certainly I do, I just want to touch on because they know we’re almost out of time, but Epstein Barr virus has been indicated is especially in a contributing factor to the initiation etiology of Hashimoto’s.  So I am testing for that more and getting on that as soon as possible. Any antimicrobial herbs …

Dr. Weitz:                            Are you testing for that through serum or through stool or?

Dr. Lucille:                           Through serum. Yes. And I mean, and if there are cases that are just ringing in my head once again, why aren’t those antibodies coming down? We’re doing everything that I know to do. That virus was, I mean this one woman bless her heart. I’ve never seen an Epstein Barr, not only just reactivation of a past infection, chronic activation and those titers are so high. So we needed to kind of pull our attention with antiviral support, immune support, really important. So I could go on and on. But those are the big ones that I use.

Dr. Weitz:                            Yeah. Another thing I wanted to point out, GI Map from diagnostic solutions or a stool test, I found that helpful with some autoimmune patients. They actually have a series of potential autoimmune trigger bacteria and sometimes that gives you some hints for things to try to target to clear out, to help reduce that.

Dr. Lucille:                           Yeah, that’s a great point.

Dr. Weitz:                            Okay, good, good, good. So any final thoughts and then how can everybody get hold of you?

Dr. Lucille:                           Sure. My website is always the best to send Dr. HollyLucille.com and for patients, I just want to say that there is hope if we look at this in much more of a comprehensive way and you help get your skin in the game and partner with somebody like Ben, myself, a functional medicine doctor, an hepatic doctor that is going to excavate and identify and treat the cause and ask those questions about why your immune system would start to attack itself. There is hope. So hang in there and then as you said, Ben, I can’t say this enough. Even though my parents both being pharmacists, there are medications out there that are being given every single day, these direct consumer marketing from the commercials.  Because we’ve got more and more autoimmune diseases because of our environment and other contributing factors.  But they do come with toxic side effects that they suppress the immune system.  We’re looking at increased risk of cancer and other devastating things. So if you look at the cost:benefit ratio, there’s a better way. There’s a more comprehensive way. Here, take this is easy, but if you do everything else, when we’re looking at lifestyle dietary, all the things that need to happen, you’ve got a chance for better outcomes and the quality of life that you’re going to soar with.

Dr. Weitz:                            Awesome. Talk to you soon Holly. Thank you so much.

Dr. Lucille:                           All right. Thank you so much.


How to Prevent Alzheimer’s Disease

How to Prevent Alzheimer’s Disease


While we know quite a bit about the pathogenesis of Alzheimer’s Disease, conventional neurology has not found any successful strategies or medications that prevent or reverse or cure the patient suffering with dementia or Alzheimer’s.  The most effective way to prevent and possibly reverse dementia and Alzheimer’s Disease is the Functional Medicine approach taken by Dr; Dale Bredesen in his ReCode protocol.  Dr. Bredesen has written a  popular book, The End of Alzheimer’s, that explains his approach that looks at 36 different metabolic factors that can influence neurological health and result in Alzheimer’s Disease.

We know that a buildup of Amyloid protein around the neurons in the brain, forming plaques, and an accumulation of Tau protein within neurons forming tangles are the physiological processes involved in the Alzheimer disease process.  This much we know. What is not as clear is what causes it and how to prevent these proteins from accumulating. Conventional neurological research has been looking for the one pathway that causes this for a number of years, so they can then develop a drug that blocks that pathway.  But this approach has not yielded any drugs that prevent or reverse the disease process, despite many billions of dollars of research.

Among the factors that Dr. Bredesen recommends looking at or screening for includes genetics (including ApoE), inflammation (HsCRP), food sensitivities, infections, heavy metals and other toxins, Homocysteine, fasting blood sugar and insulin, hormones, nutrient status (omega 3, vit D, vit B12, folate, the zinc copper ratio, etc.), the microbiota, the blood brain barrier, and sleep, among other factors. Amyloid PET scan and brain MRI with volumetrics can help with diagnosis. Dr. Bredesen looks at so many different factors because if your home has 36 holes in the roof and you only patch one, you will still have rain get in.

Dr. Bredesen is essentially taking a comprehensive Functional Medicine approach to Alzheimer’s Disease. It represents the biggest breakthrough in treatment for Alzheimer’s Disease.  Unfortunately it is complicated, since it doesn’t focus on one pathway and one drug that blocks it. And it doesn’t fit neatly into our medical system and a 10 minute office visit concluding with a prescription.  Dr. Weitz is very familiar with these protocols and testing and is available for Functional Medicine consultations for patients with early signs of dementia, like memory problems.

Menopause with Dr. Anna Cabeca: Rational Wellness Podcast 93

Dr. Anna Cabeca discusses Menopause 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

0:57   Menopause is when a woman’s body is shutting off its reproductive capabilities. There’s a sharp decrease in estrogen and progesterone production by the ovaries, resulting in a host of symptoms including hot flashes, night sweats, brain fog, mood swings, depression, weight gain, vaginal dryness, hair loss, and fatigue. There are various long term effects of menopause including increased risk of bone loss and of cardiovascular disease. Testosterone and DHEA hormones also decline, though not as precipitously as estrogen and progesterone.

2:38  Dr. Cabeca said that when she was 38 she went into early menopause, premature ovarian failure. She was told she would not be able to have another child. She traveled around the world looking for answers and found a way through Functional Medicine to reverse her early menopause and at age 41 she conceived a healthy baby girl, her daughter Ava Marie.  All was well until she hit 48 and started to experience menopause again and found that she was gaining weight, which was very disconcerting, since she had previously lost a lot of weight. Dr. Cabeca also started to lose hair. She found that by following a ketogenic, low carb diet and also incorporating a lot of greens into it in order to alkalinize herself, she was able to restore her health and stop the weight gain, which she calls Keto Green.  Keto Green allows women to gain mental clarity, restored physical health, and also spiritual health. 

5:58  In her book The Hormone Fix, Dr. Cabeca talks about three important hormones during menopause being 1. Insulin, 2. Cortisol, and 3. Oxytocin.  Oxytocin is the governing hormone that’s our joy-peace connection.  It’s the hormone that creates the instant bonding that women have for their newborn babies. Oxytocin is also the hormone that leads to uterine contractions and stimulates labor and also is fired up during orgasm. It is the hormone of love, bonding, and connection. When you are chronically stressed, your cortisol levels will rise and then eventually they will fall, along with your oxytocin levels.

9:40  One of the main menopausal symptoms is hot flashes, which we don’t fully understand why they happen, though we know they have to do with the body’s thermo-regulatory center. Hot flashes seem to be increasing today because women seem to be losing their metabolic flexibility. We need to get back in tune with nature, reset your circadian rhythm, and get various temperature exposures from our natural environment.  We also know that insulin resistance is a common trigger for hot flashes, so if women their improve insulin sensitivity with Dr. Cabeca’s Keto-Green diet, many will find that their hot flashes will decrease or go away.

13:35  Elevated cortisol levels from uncontrolled stress can result in reduced levels of other hormones that are further down the hormone pathway, like DHEA, estrogen, and testosterone.  Controlling lifestyle choices like stress, resetting our circadian rhythm, getting good sleep, reducing EMF exposure, and reducing blue light exposure at night would help to with weight loss and other menopausal symptoms. 

16:50  Dr. Cabeca’s Keto-Green diet helps with menopausal symptoms.  Low carbohydrate, dark leafy greens and cruciferous vegetables are essential on our plates every single day. She recommends using her test strips that test your urine for both ketone bodies and for pH.  This tells you whether you are burning ketones for energy and whether you are alkaline from eating enough green vegetables.  Having an alkaline pH of 7 or more will help with bone density and women after menopause tend to have osteopenia or osteoporosis, so this is important. This also decreases your risk of diabetes, heart disease, metabolic syndrome, and other chronic diseases. Getting your body and your brain to burn ketones instead of glucose for fuel is beneficial since when women are going through menopause, as their estrogen levels drop, they tend to get brain fog, memory loss, and they start to fear dementia. But ketones are the optimal fuel source for the brain and it’s not estrogen dependent, so as learn to burn fat for fuel, women get more mental clarity and the brain fog lifts. This keto-green program helps both to diminish hot flashes and with that stubborn weight loss, so women both feel better and look better. Dr. Cabeca also feels that it’s important to practice intermittent fasting and not graze and snack all day long, but snacking causes insulin resistance and worsens symptoms. She says that it is easier for men to skip breakfast, while it is probably better for women to skip dinner. It is better for women to eat by 10 am for hormone stabilization and not to eat after 7 pm, since they will secrete more insulin, which will worsen sleep problems and weight gain.

23:15   Dr. Cabeca believes in using diet and lifestyle changes first for helping women with menopausal symptoms, but she does also believe in bioidentical hormones as well.  She also done research into the use of the androgens like DHEA for women’s sexual health. As women age, they tend to have increasing problems with vaginal atrophy, pelvic floor relxation, and incontinence.  Dr. Cabeca has developed a natural anti-aging cream with DHEA to be used topically for the vulva called Julva that is sold through her website without prescription. Vaginal estrogen helps the mucosal, top layer of the vagina, whereas topical testosterone or DHEA helps with the deeper muscular and fascial layers. Her cream also includes stem cells from the Alpine rose and natural emollients emu oil, coconut oil, shea butter.


Dr. Anna Cabeca is a OB/GYN specializing in Functional Medicine, menopause, and women’s sexual health.  Her new book, The Hormone Fix  will be released Feb 26. Her web site is Dr.AnnaCabeca.comDr. Cabeca is offering a free 7 day trial of her Julva cream for vaginal health:  https://order.julva.com/trial-pack?oprid=41914&ref=223313

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 health.  Hello, Rational Wellness Podcasters. Thank you so much for joining me again today. And for those of you who enjoy listening to the Rational Wellness Podcast, please go to iTunes and give us your ratings and review. That way more people will find out about the Rational Wellness Podcast.

Our topic for today is menopause with Dr. Anna Cabeca. Menopause is when a woman’s body is shutting off its reproductive capabilities. There’s a sharp decrease in estrogen and progesterone production by the ovaries, resulting in a host of symptoms including hot flashes, night sweats, brain fog, mood swings, depression, weight gain, vaginal dryness, hair loss, and fatigue. There are various long term effects of menopause including increased risk of bone loss and of cardiovascular disease. Testosterone and DHEA hormones also decline, though not as precipitously as estrogen and progesterone.

Today, my goal is to bring clarity to some of these issues. I would particularly like to highlight hot flashes and vaginal dryness and atrophy and discuss with Dr. Cabeca some strategies that can help women. Dr. Anna Cabeca is a triple certified OB/GYN in integrative medicine, in anti-aging and regenerative medicine, as well as an expert in Functional Medicine, menopause, and women’s sexual health.  She specializes in bioidentical hormone replacement, natural alternatives, and successful menopause and age management medicine. She has a soon to be published book, which is excellent. I’ve just finished reading it, “The Hormone Fix” which is an excellent look at how to help women deal with the hormonal imbalances and symptoms of menopause.  Hi Anna, thank you so much for joining us today.

Dr. Cabeca:         It is great to be here with you Ben, and for your listeners and viewers. Thank you.

Dr. Weitz:            Great. Maybe you could start by talking about your personal journey and how you found yourself struggling with hormonal issues and what you did to solve them.

Dr. Cabeca:         Yeah. Well, it’s been a long road and at 38, I was diagnosed with early menopause, a premature ovarian failure, early menopause, and I was told the devastating news that I would never be able to have another child. And that was it. Like all hope was erased from me, erased from me. And it’s something we know as gynecologists, I’m a Emory University trained gynecologist and obstetrician and I went to my colleagues. And what we know is that the likelihood of reversing early menopause is dismal.  We had a traumatic incident in our family and a lot of PTSD, and a lot of stress and grieving, and it was all around compiling upon that. That just set me off and I took a journey around the world actually looking for answers then. I looked in my doctor’s bag, I consulted with colleagues, and then I just started traveling. I took my kids, home-schooled them for a year as we went around the world and I looked for answers. So as a result of that and Functional Medicine and integrating that as well into my own life and the life of my family, lo and behold, at age 41 I conceived a healthy baby girl and that’s Ava Marie.

So grateful to God and grateful to medicine and the world of medicine to have healed me on that journey. And pretty much all was well till age 48. So for a decade approximately, I mean, all was well and then I experienced what so many women experience.  And that is my clients would come in and you hear this too, it’s like, “Dr. Anna, I’m gaining 5, 10, 20, pounds and I’m not doing anything different.”  Right?  You hear that all the time.

Dr. Weitz:            Correct.

Dr. Cabeca:         And I was like, “Sure you’re not, you’re more sedentary, not going outside as much, less active, whatever it is.” And lo and behold that happened to me, 5, 10, 20, pounds. And I had already lost 90 pounds in that journey and working to restore my health. And so anyone who’s lost a lot of weight and kept it off, when they see the scale uncontrollably rising, fear grips us. And not only that, I had a tremendous amount of hair loss. I was balding all the way past almost the crown of my head, and it was terrifying.  And that took me on another journey and that’s where I really incorporated the benefits of keto, getting our body into ketosis as well as enforcing the alkalinizing. I call that keto-alkaline or getting keto-green, which is hence what I write in my book about our Keto-Green Way to fix our hormones, because we know that it takes more than hormones to fix our hormones.  So that was my journey. Now I’m 52 with a 10-year-old and I am like just so emphatic on keeping this lifestyle and encouraging other women to embrace it as well because of the clarity, the mental clarity, the physical health, and not just that, the spiritual health that we gain and we can gain in the peri-menopause and post-menopause time period.

Dr. Weitz:            Great.  So when we talk about hormones in menopause, most of the experts talk about estrogen and progesterone and testosterone as the key hormones that drop during menopause.  But you write in your book that you feel that three of the key hormones in menopause are insulin, cortisol and oxytocin.  Can you explain why you say that?

Dr. Cabeca:         Yeah, absolutely. And oxytocin is the crowning hormone. That is absolutely my favorite hormone, and I believe that’s the governing hormone. There’s a spiritual basis to oxytocin, but ultimately that’s our joy-peace connection. And I would like and I’d love to get into more in oxytocin. I put a whole chapter in my book on it, but-

Dr. Weitz:            I don’t think most people know much about it. I mean, I’ve heard of it as the hormone involved in orgasm, but other than that, I didn’t have any clue about it. I’ve never seen it pop up on a lab test, so-

Dr. Cabeca:         No. And it’s really hard. You actually need to have a frozen sample in order to adequately, and it has to be delivered very quickly. It’s very hard to get oxytocin in blood levels. But most women experience oxytocin their first experience with an exogenous form of oxytocin is during labor, pitocin.  So we hear, “Oh my gosh, pitocin, we’re just giving it during labor.” And we’ve felt for so many years that it’s pretty harmless. And I think we’re starting to question some of that research, but pitocin is that hormone, it’s oxytocin and it works to contract our uterus. It works to help us deliver this baby. And the results of it are that instant bonding that defies all explanation. You never understand it until you experience it yourself, between you and that child that you’re looking at. That’s that imprinting that’s done because of oxytocin. You see this baby, look into this baby’s eyes and you’re like, “Wow,” and that’s that feeling. And oxytocin has that benefits.

It’s also a powerful analgesic. So it takes away the pain that we remember from Labor. It’s like, “Ah, I could do this again,” you think like several months later. And like, “What am I thinking?” when you’re in labor again. Right? “What was I thinking?” And the benefits of oxytocin, what it does is take away that pain. And same is true in so many ways. We know that when we orgasm, we’re fired up in the same brain center areas as we are in spiritual ecstasy.  And so there’s powerful connection, powerful spiritual growth that we can experience too with oxytocin. But it is that hormone of love, bonding, and connection. So from hugging, laughing, playing, giving, having pets, healthy, happy, laughter in your life and in your relationships can also stimulate oxytocin.

And that is, and one thing that’s really important to know what I learned from not just the everyday stress of running a family, wearing many hats, like so many women.  I was running a family, running a business, managing a practice, being a wife, all of those things.  So the everyday stresses, let alone post-traumatic stress, create this dysfunctional adrenal rhythm, and we can get into a state from of chronic high cortisol pushing down oxytocin to this chronically low cortisol and chronically low oxytocin.  And that is what we know as burnout or disconnect or divorce.  We can look at the physiology of all those things and look at those hormones and that’s how powerful they are.

Dr. Weitz:            Cool.  So one of the main menopausal symptoms is hot flashes. Can you explain exactly what causes them, is this due to low estrogen or progesterone or fluctuations or what exactly causes hot flashes and why do some women have hot flashes for a short period of time and then they go away, and I have other women in my practice in their 70s or 80s, and some of them still have hot flashes?

Dr. Cabeca:         Yes.  Yeah.  And that’s the conundrum with hot flashes.  And I don’t think I’ve read a really good explanation. I know the physiology of what happens, right? We believe like we have our thermo-regulatory center or internal thermometer, right? And so the hormones are adrenaline hormone, so when we’re getting a hot flash, we’re basically getting an adrenaline rush with vasodilation. It’s like, “Well, here I am just sitting on the couch, not doing anything and I’m getting this like physiologic outpouring of these hormones and hence sweat. What is happening?”  And we all know there’s always some women experience more or less, there are some theories. One very interesting theory that I came across as I kept hearing from my clients as I put them through what I discussed in my book, my “Keto-Green Way”, and they’re like, “My hot flashes are gone.” And that some clients would have hot flashes like every hour, every 20 minutes, and for years and within two weeks their hot flashes were gone.  And so I dug into that. And lo and behold, insulin resistance is a very common cause of hot flashes. So we’re predisposed to more and worse hot flashes with insulin resistance. I’m not clear on the mechanism of action there and I don’t think anyone is, if anyone listening knows, please email me because I have dug into some of the science and I can’t quite understand it.

But there’s that insulin resistant component to hot flashes. So as we control this powerful hormone insulin, which also has effects on progesterone, testosterone, estrogen, right? That’s why it’s the major hormones. And as we get more insulin sensitive, lo and behold, I mean, the hot flashes will go away. But also, hot flashes are worsening in our population now. And I think part of that is we have less metabolic flexibility in so many ways.  We go from a 70 degree home, to a 70 degree car, to a 70 degree office, and back 70 degree gym, when we go work out. Right? And so there’s not that opportunity to really gain this. Also there’s flexibility and this thermo-flexibility, let’s say. So really part of our prescription is to kind of get back in tune with nature, reset your circadian rhythm, get out in the environment, get all the exposures from our natural environment. And that includes the extremes of temperature as much as possible.

Dr. Weitz:            Yeah. I’ve heard a lot of people talk about exposing themselves to cold or jumping in a cold plunge or doing a cold shower.

Dr. Cabeca:         Yes. Yeah. To increase metabolic flexibility and burn fat I believe. And so it’s interesting that cold thermogenesis has a tremendous impact on helping our body also in resetting its circadian rhythm. It’s fascinating.

Dr. Weitz:            Seems to be one of the anti-aging strategies also.

Dr. Cabeca:         Yeah. And I just cannot bring myself to do it. Every once in a while I will like totally encourage going from hot to cold in the shower, but like got to get back to hot eventually. But the cold plunges, I’ve done the nitrogen chambers, where there are sub zero and I’ve done that for four minutes and yeah, no, I’m not a fan, but it was worth the experiment.

Dr. Weitz:            You’ve written in your book that elevated cortisol levels result in reduced levels of some of the other hormones like DHEA, estrogen, progesterone, testosterone, what does cortisol have to do with these other hormones?

Dr. Cabeca:         Yeah. Well, one of the things is that cortisol is derived from progesterone and pregnenolone.

Dr. Weitz:            Okay.

Dr. Cabeca:         So again, two of our mother hormones. And when we are producing cortisol, the hormones that are further down on that pathway, such as DHEA and our reproductive hormones, estrogen and testosterone, are diminished. This is just like a traffic jam, right?  All the traffics going in this direction, there’s very little coming down these roads. And that’s what’s happening essentially when we’re under a state of chronic stress and we’re producing cortisol. So we need to be conscientious of that, and resetting our cortisol balance, it has to be done through lifestyle.  And one of the things that I always say, Ben, is that diets fail because it’s a four letter word with the word die in it. So, I don’t love that. And yet 99% of diets fail, and the predominant reason is because it’s probably in my estimate, about only 25% of what we eat. The lifestyle factors, when, how, in what mood, and what else is in our food or in our environment or what other things are stressing us out, that has a greater impact. So controlling those lifestyle factors with simple disciplines and simple strategies can make a huge difference in our success, our quality of life.

Dr. Weitz:            Which lifestyle factors do you feel are most important in that regard?

Dr. Cabeca:         Definitely the part is resetting the circadian rhythm, so getting a good night’s sleep, uninterrupted sleep, removing the EMF exposure from … the EMF exposures, but also blue light exposures that are creating havoc with our own natural melatonin production. And that, again, an important hormone for-

Dr. Weitz:            Blue light is staring at computer screens and phones and things like that. So do you recommend blue light blocking glasses or?

Dr. Cabeca:         I do. When you’re at a computer screen, we should all be wearing blue light blocking glasses. So like typically, I have my glasses here on my counter and I’ll wear them when I’m working at the computer as well as looking at my phone. But definitely also just turning it off and going to good old-fashioned paper after sunset is key. And getting sunrises and sunsets, that inner eyes, not with glasses or contact lenses as a filter in between, but pure sunrises and sunsets to help us reset our rhythm.

Dr. Weitz:            Yeah. I was at an anti-aging conference and Dave Aspery was talking about using red light bulbs in your home at night.

Dr. Cabeca:         Yes. Yeah, to change that or red filtered glasses, which is another strange thing. And I always think of Amsterdam and the red light district when I think that. Yeah.

Dr. Weitz:            There you go. So you write a lot about diet and for help with menopausal symptoms. So specifically you talk about your keto-green diet. Can you talk about that and why that helps with menopausal symptoms?

Dr. Cabeca:         Yeah, it’s really essential. There’s a few things. Definitely we want to improve our urinary pH.  We want to improve the mineral-rich foods. So diet is a component of that and lifestyle is a component of that, hence the greens.  Low carbohydrate, dark leafy greens and cruciferous vegetables are essential on our plates every single day. And it’s not enough to guess, “Okay, I’m getting enough greens.” It’s important to check our urinary pH. And I’m a real big advocate of this and I talk about it in the book, but it’s so simple. It’s so inexpensive. We can buy pH paper at any pharmacy or health food store, and I created urine test strips that have pH and ketones both on them, one less step, right, to make it easy for us and check our urinary pH.  A higher urinary pH above seven is associated with strong bones. And that’s important for us as we get older because women in their 30s are being diagnosed with osteopenia, even osteoporosis. Well, again, we have to get these minerals into our body and we have to nourish our body to be able to detox the harmful chemicals we’re exposed to on a daily basis as well.  So urinary pH, the higher the better, seven or better. And I have clients check that so they can start to discern what works for them. And it’s a very personalized program as you figure out, “Oh, this works for me, this doesn’t work for me.” Or, “This is helping me and this isn’t helping me.” And it sometimes takes time to figure that out but that discovery process is brilliant and enlightening. And now I’ve had thousands of women in my online programs do this and find quite amount of joy doing it and discovery any weight loss and improvement of menopausal symptoms. So that’s key.

That alkalinizing healthy bones decreases our risk of diabetes, heart disease, metabolic syndrome, and the list goes on. The second part, ketosis, as our estrogen levels start to decline, estrogen or so our brain uses glucose for fuel as a rule or ketones for fuel. Well, when women are going through menopause, they’re getting brain fog, memory loss, and the immediate fear is dementia, being unable to take care of themselves, so as they grow older, being a burden to their families.  And so we start to kind of live this fear-based profile, not realizing it’s physiology. So glucose utilization in the brain is an estrogen-dependent process. So naturally as our levels are declining, “Huh, we should have some mental fog or something.” No big surprise. So let’s conquer it. Ketones are the optimal fuel source in the brain. It’s not estrogen-dependent. So as we learn to burn fat for fuel, we get this higher clarity, brain fog gets lifted.

I hear so many patients tell me, “Dr. Anna, my brain fog is gone,” and just that kind of getting your edge back. So getting into ketosis and getting alkaline at the same time, that combination, which I call keto-green is empowering. It helps with diminishing the hot flashes, helping with some stubborn weight gain or difficult weight loss, helps with just the healthy metabolism and feeling healthy.  It’s the one thing, we want to all look good, but it’s even better to feel good at the same time. So that’s what really counts and we see that combination really empower. And a lot of factors in ketosis, there’s components of the ketogenic diet that I like and that I don’t like. So in my program I describe them and we really want to work and getting it to that state of ketosis.  So intermittent fasting, which has been shown to decrease our risk of breast cancer, as well as no more snacking. Women hate it when I say that because they’ve been told to graze and three meals, three snacks. I’m like, “Where in earth did we ever get that?” Right?  So that causes a tremendous amount of insulin resistance and worse symptoms. So we want to eliminate that snacking.

Dr. Weitz:            Yeah, it’s funny how the Functional Medicine world has kind of gone through this major change because for years we were concerned about trying to help people manage their blood sugar, and that’s one of the reasons for this small meals every three hours to try to keep your blood sugar even. The worst thing you could do is skip breakfast, and now the Functional Medicine world has come around and said, “Hey, we just came up with something. The way to be healthy is to skip breakfast and have long periods of time between when you eat.” So it’s kind of funny how we have come complete circle. Everybody’s fat because they miss breakfast and they have too long a period of time between eating.  Now everybody’s too fat because they eat too often and they need to skip breakfast and have long periods of time between eating.

Dr. Cabeca:         Like the pendulum swings, right Ben? It’s like always like where is it swinging next? Well, I think the big thing is that one thing that I recognize is men can skip breakfast. This is one of the differences in the sexes that I found out. Men can do a more carnivorous keto. Women, we can’t and we need to really eat by 10:00 A.M. for hormone stabilization. And I mean, that’s just traditionally how we’ve been designed while the men are out hunting say, right?  So in 10,000 years, supposedly our genes haven’t changed. But I like women to, I prefer we skip dinner or have a lighter dinner.  We definitely want to eat by 7:00 P.M. because we know that if we eat after seven, we secrete 70% more insulin, hence worsening sleep issues, hence worsening weight gain and those issues. So for us, for women, women in my perimenopause, menopause and post-menopause, as they go through my program, I really work to say, “Okay, let’s try to breakfast by 10:00 A.M. and really try to eat by 5:00 or 6:00 P.M.”

Dr. Weitz:            Maybe it’s my feminine side, but I’m with you on that. I feel so good after a good breakfast and I get ready to go. And sometimes if I don’t get a chance to eat, I’ll just skip dinner and I’m fine with that.

Dr. Cabeca:         Perfect.  Yes, no one has died from skipping dinner, I guarantee you.

Dr. Weitz:            So do you recommend bioidentical hormones after menopause?  That seems to be the focus for most people in the functional medicine community. The main strategy is to replace the hormones.  What’s your feeling about that?

Dr. Cabeca:         So nutrition and lifestyle first, right, I really feel strongly about that, something I did in my practice. So since 1999, I really became involved in bioidentical hormones, especially for sexual health because we didn’t really have options for women who’ve had breast cancer.  And as a practicing gynecologist in a small town Georgia, because I was a national health service corps scholar, so I came to a small town from my repayment and I was in this shrimping area called McIntosh county.  And I had to find really industrious ways to help these women because they had no options and they were just told, “Well, you just kind of have to suffer. You’re lucky to be alive. Right?” I’m like, “What?” And so I dug into the research and that’s where I started understanding some of the differences between bioidentical and the synthetic hormones as well as how we can use the androgens such as DHEA and testosterone to help women in sexual health, even if they’ve had a history of breast cancer.

More and more research done, especially by Dr. Rebecca Glaser, a breast cancer surgeon in the Northwest and just fabulous good science around that. And now over the last 10 years with the research doing, looking at DHEA vaginally. So Ben, one of the things is that as we get older, the natural hormone decline, like hot flashes will eventually stop for the most part with few exceptions, but vaginal atrophy changes, pelvic floor relaxation, incontinence issues tend to get worse. And again, incontinence is one of the reasons why care givers put their beloved into a nursing home. And look, I have four daughters, like I’m 52 with a 10-year-old, almost 53 with a 10-year-old, so I’ve got to keep that mental clarity and I definitely don’t want to give any of them an extra excuse to tuck me away in a nursing home.

So the pelvic floor health is a passion of mine and that’s why I really went to create some natural solutions using bioidenticals, and that’s what I teach physicians on when I lecture, writing prescriptions for bioidentical testosterone, DHEA, progesterone, and estrogen when needed as well as a combination either by itself or individually or to use topically or vaginally, preferably in clients as we’re getting older to help that. And that’s one of the reasons I created Julva, which is my natural anti-aging cream for the vulva to help with those changes, the dryness, the accidental leaks when we cough and sneeze and just really improve the quality of the health of that tissue because that’s just compromising.  We stop exercising because of it. We stopped having sex because of it.  We have discomfort, pain, and feel that our body’s betraying us in so many ways because of it. So the first choice is always bioidentical.

Dr. Weitz:            It seems like we’re kind of confused. So since we’re transitioning to the topic of vaginal health and the vaginal dryness and atrophy that occurs after menopause, which makes intercourse uncomfortable or painful and can lead to incontinence. It’s interesting that estrogen can be effective, but testosterone can be effective, DHEA, I mean, there seems to be some confusion about this. What’s the story? I mean, what’s the key for vaginal health? Is it all those hormones? How can testosterone work as well as estrogen or DHEA?  Maybe we just need to know a lot more about it, but-

Dr. Cabeca:         Yeah, so this is the issue that’s come about with the pharmaceuticals, right?  We know that estrogen works to help regain moisture, vaginal moisture, but it works on the top layer.  So we’re talking about vaginal estrogen. All of these, anything inserted vaginally is by prescription.  So vaginal estrogens, for instance, that helps the mucosal layer, the top layer of the vagina. And then to go deeper to the muscular layers and the fascia layers, we really need the androgen, so testosterone. Well, even fascia has progesterone receptors. So, so many women are using progesterone creams, but they don’t think, “Well, let me apply it down my bottom.” And I always tell clients, “From the clitoris to the anus, apply your hormone creams there.” And that’s very beneficial.  But so that’s the difference between vaginal estrogen and vaginal testosterone. Testosterone, DHEA, work all three layers of the vaginal wall to the muscularis layer, so that helps us get this delicate muscle back and functioning and improving. So that’s where the androgens come in. So I think the combination is really ideal. And in fact, in my practice, I would start with the androgens and progesterone first, where typically, I’d use a bioidentical progesterone, pregnenolone topical cream, if they’re cycling on and we’re doing all the other stuff, adaptogens, lifestyle, right? I’m not going to give hormones to someone who’s not embracing a lifestyle of health and wellness because it takes more than hormones to fix her hormones. And we want to improve the entire quality of life, not increase any risk factors. So that’s it. And no bandaids in our care.

Dr. Weitz:            I’m a chiropractor, so we don’t prescribe these things. But I do get into discussions with women about bioidentical hormones. And this seems to be some push back from women who don’t want to apply progesterone and estrogen down there because it’s a hassle. Some of them are worried if they are going to have intercourse with a man, are they going to get exposed to these female hormones? So have you gotten some of that kind of push back from women?

Dr. Cabeca:         I’ve heard those issues for sure, but definitely not in my client population because we’re really working on getting clarity. So hence one of the reasons I created Julva is partly of that. Number one, it contains DHEA, which is safe over-the-counter. Right? It’s been in pills oral form for the last 50 years. We’ve been able to buy that off the shelf essentially.  And DHEA is a precursor and a supportive androgenic or pre-androgenic hormone. And we have a lot of safety. And not only that, it’s about 10 times more in men than it is in women. So you are using this with a combination that I included with plant stem cells, we know stem cell technology is incredibly anti-aging and rejuvenating. So I use plant stem cells from the Alpine rose, which is this rose that grows up and like blossoms in the Swiss Alps.  I mean for me that epitomizes women, right? Women will blossom and will shine in the harshest conditions. And so this plant stem cell of the Alpine rose has been shown to have incredible resilience properties, and that’s why I combined it with other emollients like emu oil, coconut oil, shea butter, into this because again, clitoral health is really important. There’s 9,000 nerve endings in our clitoris. Keeping that tissue healthy and keeping it sensitive is really critical for many reasons, but it’s certainly for pleasure as we get older and to stimulate the pelvic floor sacral nerves.  And so, and all the way to the anus too, we forget about the fissures and hemorrhoids and things that can develop as we get older, that creates so many problems and that causes increased use of over-the-counter creams or topicals that have parabens and synthetics and and petroleum-based products, I mean everything that can cause further hormone disruption and worsening of the skin in general.  So I really had tried to find something and then created my own that was natural without parabens, without synthetics to help women in that area. And yes, use it prior to foreplay. Absolutely. Because he’ll benefit as well. But again, it’s like a drop in the bucket. A little bit goes a long way and we can see that improvement in the skin. It’s anti-aging to the skin for sure.

Dr. Weitz:            So is there a good scientific data or a DHEA play topically to vagina versus testosterone versus estrogen and-

Dr. Cabeca:         Not versus, but we’ve seen a lot of good research with DHEA vaginally.

Dr. Weitz:            Okay.

Dr. Cabeca:         In work done by Ferdinand Libre out of Montreal. And he has been looking at DHEA vaginam and following his research for years. And he’s looked at it even in clients who have had breast cancer. So we can safely prescribe vaginal DHEA progesterone.  It’s just a straight DHEA and a gel suppository vaginally and get really good results as well. And that’s been, there are ongoing studies and clients who had breast cancer, but we’re seeing no increase in recurrence. In fact, we see improvement in morbidity and mortality. I’m really happy to see that research and the safety profiles and the safety studies being done.

Dr. Weitz:            Cool. Would you mind sending me a link to one or several studies that I can throw in the show notes?

Dr. Cabeca:         Yes, I have a white paper too that I’ve written on it,-

Dr. Weitz:            Oh, okay.

Dr. Cabeca:         … so I’ll send that to you as well. Yeah.

Dr. Weitz:            That’d be great. And so that Julva product is available over-the-counter or through your website?

Dr. Cabeca:         Yeah. We’ll give you a link for your listeners to get a free trial. So a free seven night trial of Julva. And I highly recommend it. Give it a try, and also we always give a 60-day money back guarantee when anyone buys a full tube of Julva too.

Dr. Weitz:            That’s great. So I think I’m pretty much done with the question for today. Is there any other issues you’d like to mention?

Dr. Cabeca:         I think that’s it. I just don’t want women to give up hope and I find, because there’s a survey that I just saw the preliminary results on it that are being published, that women in their 30s and 40s are willing to take action, are willing to make changes, but come 56 and older, we’re like giving up on ourselves. And I don’t want anyone who’s listening at any age to give up on themselves. I don’t care what diagnosis you’ve had, how long you’ve been struggling. There is a road to improvement.  And I want to encourage you, I was told again at 38, I’d never had another child. Right? And living proof that can totally reverse many of the physical changes that go on. But even more than that, to keep looking for that trust in your inner calling and your inner voice. And in my book, “The Hormone Fix”, I really strive to give you that power with no barrier to be able to make easy discipline strategic changes that will impact the quality of your life forever. So, I encourage you and I would love to offer your listeners a sneak peek into my book and I’ll give you that link as well.

Dr. Weitz:            That’d be great. Yeah, I think everybody needs to keep in mind that even though your ovaries stop producing estrogen and progesterone, there’s still estrogen and progesterone produced by the adrenals and other organs, in your body throughout the rest of your life. And even though we assume that the androgens like testosterone, DHEA, decrease with age, they don’t necessarily have to. We’re not programmed for that to happen. So I think if you can keep yourself healthy and do some of the things you’ve talk about in your book, there doesn’t have to be this huge drop off in those hormones.

Dr. Cabeca:         So true. Yeah.

Dr. Weitz:            That’s great. Okay, so links to get a hold of you?

Dr. Cabeca:         Dranna.com, so, D-R-A-N-N-A .com, that brings you to my website and on social media, Facebook at Dr. Anna C and @Dr. Anna Cabec on Instagram.

Dr. Weitz:            That’s great. And your book is coming out when?

Dr. Cabeca:         February 26.

Dr. Weitz:            Okay.

Dr. Cabeca:         “The Hormone Fix”, February 26th.

Dr. Weitz:            And can we pre-order it now?

Dr. Cabeca:         Yeah, it’s available on anywhere books are sold. So Barnes & Noble, Amazon, yeah.

Dr. Weitz:            Cool. That’d be great. Excellent. Thank you so much, Anna.

Dr. Cabeca:         Thank you for having me.



Oral Health with Dr. Ryan Nolan: Rational Wellness Podcast 92

Dr. Ryan Nolan discusses Oral Health 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

4:35  In Functional Medicine, the health of the gut is one of the keys to our overall health. Dr. Nolan explained that the gut is the distribution center of the body and it’s also where a lot of bacterial interactions occur, so the gut is going to determine how healthy you are.  If your gut lining is leaky, then bacterial toxins are going to get released into your system. Think of a castle as the gut and the mouth is the moat. If the castle door is open, then you want to make sure that they don’t get past the moat. If the mouth is not very healthy, then the patient is more likely to have heart disease or diabetes. The mouth is the gateway into the gut.

6:42  There is a connection between periodontal disease and Alzheimer’s Disease.  According to Dr. Nolan, periodontal disease is the diabetes of the mouth because periodontal disease can affect every organ system in the body. If you have periodontal disease, you most likely have bone loss. If you have inflamed gums, then you will have bacteria that can easily get into the blood stream, such as spirochetes, which have been proven to cause heart disease. If you have periodontal disease, you are five times more likely to get Alzheimer’s.

11:10  We know that the mouth is the most vascular area of your body and a small infection in your mouth is the equivalent of your whole forearm being completely infected. But patients don’t realize this and sometimes ignore infected teeth for years.

12:53  There is a controversy about whether it is better to get a root canal or an implant?  One of the problems with root canals is that it is not possible with the very complicated canals that the roots and nerves travel in to get all the bacteria out, so some say implants are better. Dr. Nolan said that even though you can’t get every single bit of bacteria out, but that doesn’t mean that it will turn into an infection or that the tooth will fail. He said that if there is enough tooth structure left, he will lean more towards root canal. If there’s not enough tooth structure and we don’t think we’re going to get at least 10 years out of the tooth, then it is better to do an implant.

15:19  Oral DNA is a company that allows us to assess the oral microbiota using PCR DNA analysis.  We can look at periodontal and other oral pathogens.

20.45   A biofilm is an array of bacteria stacked on top of each other that act as a functional unit and dental plaque is such a biofilm.  Brushing and flossing and using a healthy mouthwash with some natural biofilm busting agents can be helpful, though commercial mouthwashes or rinses with antibiotics can be harmful to the healthy bacteria in the mouth.  Also the natural pH of the healthy, commensal bacteria in the mouth are between 7.5 and 8, whereas the pathogenic type bacteria that lead to dental caries are acidogenic and acid tolerating species.  Some of the bacteria in the mouth will adapt to the conditions in the mouth. If you eat a lot of sugar and the pathogenic bacteria start releasing acid, these commensals will also start releasing acid in order to compete with the pathogens, so it is the conditions that make these organisms act in a beneficial or a harmful way.  It’s a bad idea to use mouth rinses that contain antibiotics, since they are ineffective at breaking up biofilms and they lead to antibiotic resistance.  Most commercial rinses are also very acidic, which tends to promote the pathogenic bacteria and leads to the demineralization and breakdown of the teeth and leads to dental caries.  Saliva, which naturally has a pH of 8, naturally helps to break down plaque and allows calcium to penetrate into the plaque and stop the demineralization that is resulting from the acid buildup of the plaque.

32:22   Dr. Ryan has developed a mouth rinse product that is alkaline with a custom engineered nano silver compound in combination with a plant compound that helps to break down the biofilm and allows the calcium in the product to penetrate and alkalinize the plaque.  It also allows saliva to penetrate the plaque, which also helps to alkalinize the area and protect the teeth. It is called NanoSilver Mouth Rinse and is available at Elementa Silver. Here is a link to the paper that Dr. Nolan and his fellow dental researchers published on the effectiveness of using a  Nanosilver mouth rinse to prevent dental caries: Anti-caries Potential of Silver Nanoparticles via Modulation of Free Calcium Activity within the Plaque Fluid of the Oral Biofilm: A Pilot Study.  



Dr. Ryan Nolan is a dentist and researcher in private practice in Orem, Utah.  His research has a focus on the role of biofilms in the oral cavity and his biofilm busting mouth rinse is available at elementasilver.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 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 listening to 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 and please subscribe either an iTunes or YouTube or wherever you get podcasts.

So our topic for today is oral health. And I’m happy, we have dentist Dr. Ryan Noland with us today.  Like in the gut, there are healthy bacteria in the mouth that are beneficial for us. We can refer to this as the oral microbiome or microbiotic, and it’s estimated that there are 500 to 700 different species of bacteria, that’s right, in your mouth that can exist there. And there’s even an online human oral microbiome database. Any of these bacteria are helpful, known as commensal, sometimes we get an overgrowth of some bacteria that throws the oral microbiome out of balance.  We could also get pathogenic bacteria, or viruses, or fungi that can grow there and cause problems. Microorganisms in the oral cavity have been known to cause tooth decay, periodontitis or gum disease, and various other oral infections. It’s also known that most of these oral infections are caused by a group of organisms organized in a biofilm; rather than by a single pathogen. This biofilm on the teeth is generally referred to as dental plaque, I believe. There’s also increasing evidence linking bacteria in the mouth to cardiovascular disease, diabetes, pneumonia, preterm birth and other conditions.

Dr. Ryan Noland is a dentist and researcher located in Orem, Utah, and he’s been focused on the role of biofilms in the oral cavity; and he’s developed a type of specialized mouth rinse product to target these biofilms and raise the pH, and improve the health of the teeth in the mouth.  He’s published a scientific paper focused on this product entitled Anti-caries Potential Of Silver Nano Particles Via Modulation, A Free Calcium Activity Within The Plaque Fluid Of The Oral Biofilm: A Pilot Study.  Dr. Noland also has a podcast, the Biofilm Factor. Dr. Noland, thank you so much for joining me today.

Dr. Nolan:            Oh, hey, thanks again for having me, appreciate it.

Dr. Weitz:            Before we get to the tough questions or before we get to the scientific questions, I’ve got to ask you, is your dad a baseball fan? Because every time I write your name, I go “Noland Ryan, no, no, Ryan Noland.”

Dr. Nolan:            So it’s funny, so we’re Canadian, originally, so I’m American naturalized; so I’m a US citizen, but so we’re all from Canada. Mom and dad didn’t know famous baseball pitcher.

Dr. Weitz:            Okay.

Dr. Nolan:            But, from a strange turn of events, we ended up living in Dallas, Texas, for six years.

Dr. Weitz:            Really?

Dr. Nolan:            So, yeah so when I lived there, everyone called me Noland like it was my first name; so I got used to that. Then I moved back to Chicago and I didn’t … People would say, Ryan, I’d go “Who’s that, that’s not me, I’m Noland.” So, yeah, it ended up affecting my life a little bit more probably than you think. But yeah, no, no, he’s great, I still watch some of the older stuff that everyone follows; but I have no baseball skills, unfortunately, can’t help you there. But no, no he didn’t even know, my parents were clueless as to this famous pitcher, but yeah.

Dr. Weitz:            Okay so in Functional Medicine, which our podcast is really focused on, we often focus on the health of the gut as one of the keys to our overall health-

Dr. Nolan:            Absolutely.

Dr. Weitz:            And the oral cavity is really the first portion of our intestinal tract. So can you talk about the importance of the oral cavity for overall health.

Dr. Nolan:            Absolutely. So, if you consider the body a bunch of windows, I would say that basically the first window that really reflects what’s going on in the body is your mouth. But the reason why that is, is because the second window, which is your gut, is actually the most important part of your entire body.  The reason why is it’s because the distribution center.  It’s where all the energy goes, it’s where everything gets distributed and piled, and it’s also where a lot of bacterial interactions with the body also occur.  So naturally speaking, the gut is really going to determine how healthy you are. If you don’t have a functioning gut, if the lining is leaking, if for some reason there’s a bacterial overgrowth or other kinds of bacteria that are releasing toxins; those are going to get into your system. So it’s essentially like, how would I put this? The mouth is probably the moat, and if the castle door is open, that would be the gut. So you don’t want to let them get past the moat; that would be kind of my thinking about it.

And we see this a lot with patients that come in, they have a horrible mouth, and it’s … I can almost to the “T” tell now, look at someone’s mouth and be like, “Okay, this person probably has a good chance of heart disease, probably has diabetes, probably has this.” And believe it or not, nine out of 10 times, I’m usually right and it’s sad, it’s really sad.  But basically, we look at the mouth as more of a gateway into the gut, and since the gut is such an important feature of how our health functions, especially our immune system, it just ends up being a pretty damning representation of how things are going.

Dr. Weitz:            Yeah, no I totally agree with everything you’re saying. In fact, I was just talking to Dr. Vojdani, who’s going to speak at our Functional Medicine meeting tonight-

Dr. Nolan:            Nice.

Dr. Weitz:            And there’s a connection between periodontal disease and Alzheimer’s disease, because of that gut brain connection, etc.

Dr. Nolan:            Yep. So basically if you look at it, people who have periodontal disease … I always say this and I don’t think I’m alone now in saying that periodontal disease is the diabetes of the mouth. The reason why is periodontal disease affects every organ system in your whole body. It is not an isolated issue to the mouth, these organisms are able to, basically, get through these junctional epithelium. If you notice, anyone whose got periodontal disease, they have bone loss.  But on top of that, they have constantly inflamed gums, and so basically these organisms can easily get into the bloodstream, at that point, because there’s no junction that basically prevent that. Typically, a lot of the organisms that cause these diseases are motile, meaning that they have very good ability to move around.  And one of the organisms, in particular, it’s called a spirochete, it kind of looks like a corkscrew. These things have been directly, not correlated, but actually proven to cause coronary artery disease, so we know that they can increase your risk for a heart attack, among other things. And it’s nuts, because when you really start thinking about it, that’s just one of the issues, people with Periodontal disease-

Dr. Weitz:            For people who aren’t familiar with spirochete, these are a particular type of bacteria and Borrelia burgdorferi, which is the cause of Lyme Disease is a very prominent spirochete.

Dr. Nolan:            Absolutely. And I was just gonna say too, there’s been recent studies coming out linking periodontal disease to … Well, it’s already linked to diabetes, as you know, but it’s also linked to Alzheimer’s. And if I remember correctly, the one study said that if you have periodontal disease, you’re five times more likely to get Alzheimer’s, which is nuts, okay. So some stuff going on in your mouth, you’d think it’s be isolatory, it’s actually affecting your entire body and not just your brain, your heart, or any of these other things.  I think the other thing we should mention too, just real quick is a lot of research has been done as how the gut functions. And one of the things that when periodontal bacteria, they get into a home where they’re really not supposed to be in. So they’re in a foreign home, but they end up having this mechanism whereby they can start controlling how certain gut functions.  So they can actually … Every time you eat, the gut actually tissue opens ups to accept the nutrients to go into your bloodstream. So they can find ways of getting not just through bloodstream, through your mouth, but also once they’re in the gut, it’s like they have free highway ride to wherever organ they want to be in. And that’s really scary because we know that they’re … And if they’re in a home they’re not supposed to be in, they’re going to cause more damage.

Dr. Weitz:            Yeah, I understand. Once in the mouth, there’s actually a route directly to the brain through-

Dr. Nolan:            Yes, yeah so-

Dr. Weitz:            Some of the nerves pass through, right?

Dr. Nolan:            Yeah, so it’s more prevalent, actually, in your front eye teeth, so your canines. There’s been people who have died because they got an abscess, or an infection closer to that area because there is actually a connection to the brain through the blood way path going forward. I don’t remember all the anatomy, I just know that there’s been a lot of cases where people have gotten abscesses in that region are hospitalized and die. And that’s really scary.

Dr. Weitz:            Yeah, I know some Functional Medicine practitioners who, in a hacking sort of way, will sometimes use certain nutrients in the mouth [or the nose] in a certain hacking form because they’ll be taken into the brain and actually help improve brain function also, so.

Dr. Nolan:            Well, you say that, it’s funny because we know that the mouth is the most vascular area of your whole body. So, basically, if you have a small infection in your mouth, now it might only look small, but that would be the equivalent of being your whole forearm covered in essentially being completely infected in terms of surface area. Because if we look at all the blood vessels, that surface area is equivalent to basically your whole arm having an infection. And I don’t know anybody who wouldn’t go to the hospital if their a whole arm was infected, but they don’t see it that way. And so, it ends up causing so much damage, even if you don’t think it. I had this patient and he had waited and waited … He had an infection from one of his wisdom teeth.  He waited and waited and waited; didn’t realize it was an issue. So we took the thing out, and he came back a week later and goes “Doc, I’ve never felt so good in my entire life. I can’t believe what that was doing. I was constantly getting sick, my immune system wasn’t working properly, because I had this infection that I was fighting for 15 years because I didn’t go to the damn dentist.” And so we know these things are happening, and to deny it is just ludicrous, to me.

Dr. Weitz:            So, did you do a root canal or did you do an implant?

Dr. Nolan:            For that one, since it was a wisdom tooth, it was actually, believe it or not, semi impacted and so it actually required removal. So that wasn’t something we had to replace, because wisdom teeth are the spare tires of the mouth. So we never ended up having to do that, it was just lucky that it was where it was and didn’t have to lose a functional tooth.

Dr. Weitz:            What do you think about the whole controversy about when you do a root canal, it’s really hard to get the last bits of bacteria out from the complicated canals and that-

Dr. Nolan:            Oh sure. So, as a dentist, I can tell you just clinically, you’re never, ever, ever going to be able to remove every single little bit [of bacteria]. You have to do the best that you can with the technology that we have. Luckily, things are getting better. I actually started using … The tools are getting better, let’s put it that way. Now nothing’s perfect, just like with what you do, nothing’s perfect. But look, I would say probably about 90, 95% of the root canals that are done, are done to a very high standard, especially in the United States.  I mean, people here are great. I can’t say without a doubt that some of them are not going to fail; however I, in my personal opinion … So I have a root canal, okay, if that gives you an idea. I cracked my tooth chewing on ice.

Dr. Weitz:            So like a root canal versus implant, you come down more into the root canal side?

Dr. Nolan:            If there’s enough tooth structure remaining, I lean towards root canal.

Dr. Weitz:            Okay.

Dr. Nolan:            If there’s not enough tooth structure, and we don’t think we’re going to get at least 10 years out of it, then we that we do an implant because it just makes more sense, at that point, to do it. But no, you’re completely right. Look, some of these canals systems are so complex, that no matter what you do, you’re never going to be able to get it.  However, there is this idea of threshold levels of bacteria.  So even if you miss something even just a little bit, is it going to develop an infection?  It really just depends on how much bacteria were in there or how much didn’t get cleaned out.  So we can still see … I’ve seen these cases with guys that had half done root canals from the 1960s or earlier and the tooth never had any issues. So it’s hard to say, because it’s like, how is the immune system, how is all these, so there’s a bunch of factors. But generally speaking, we just do our best, and we hope that it works out, and if it doesn’t, then the second option is an implant, and usually those are very high success, so.

Dr. Weitz:            How do we assess the bacteria in the mouth? Is there a reliable way to test the oral microbiota?

Dr. Nolan:            There is, there’s a couple of companies that are coming out with more sophisticated methods using PCR which is DNA analysis. So one of those companies is Oral DNA; I’ve used them pretty extensively. And it’s pretty cool because what you can do, is you can actually get an array of periodontal or decay effective causing bacteria, or even fungus and get an idea of exactly what’s going on in that person’s plaque, or saliva, or whatever. Because basically what we’re looking at is we’re looking at threshold levels.  Once you start understanding disease only occurs at a threshold level, that’s where pathogenesis occurs.  So we just only going to start seeing pathogenesis if certain kinds of bacteria are all the above threshold levels.  And they’re ranked in order of individual pathogens in terms of their risk and it’s like you’re saying though planktonic bacteria, which are just bacteria by themselves, and biofilms are completely different animals.  And if you think … I used to think early on, so I’m in my 30s, every bacteria’s bad, get rid of them all, you don’t need them, they’re horrible and, by the way, these are the three that cause disease, end of story, close the book. Now we’re kind of looking at it like, “Wait a second, is that true or is that pathogenesis more complex than that?” And what I mean is when we look at pathogenesis, it’s evolved to be … Okay so there’s commensal bacteria and there’s pathogenic bacteria.

Dr. Weitz:            Commensals are good bacteria-

Dr. Nolan:            Yes.

Dr. Weitz:            And pathogenic are bad bacteria.

Dr. Nolan:            Right. So there’s inherently bad bacteria and there’s inherently good bacteria. I mean some to the extent have even been studied showing that they actually release calcium in the event of a carries attack. Meaning, let’s say you have a lot of sugar, and some of these bad actors start releasing acid, as a result, which we know it dissolves teeth. Some of the good bacteria, say, “Hold on a second, we’re going to release some calcium to help the host because we want to survive with the host.”  And then there’s others that they want us to sequester the calcium out, so there’s a constant battle of titans really going on between these bacteria. What I’ve shifted my focus to is kind of the newest … And I talked to you a little bit yesterday about this, but I’ve kind of shifted to the newest paradigm and this hasn’t been well adopted. So I’m still kind of on the front end of exception, I guess. But I kind of feel like it’s the conditions that set whether or not an organism is going to lean towards being more commensal or being more pathogenic; it’s not a pure, this is commensal and this is pathogenic all the time.

And the reason is because certain organisms adapt to the conditions which you give them; meaning that there’s some commensal bacteria pH of seven, that when you put them in an environment of pH five, all of a sudden they have to compete with a pathogen and they develop more pathogenic features in order to compete.  So they start releasing acid as a response, as well, and that comes from stressors and things like that. So, so we look at it, not just from a purely genetically or originally this is commensal or abnormal conditions, but rather, does the condition to determine whether or not it’s more commensal or more pathogenic?


Dr. Weitz:            We’ve been having a great discussion, but I’d to pause for a minute to tell you about a laboratory that I believe in and that we use their testing in our practice. Many practitioners understand that the gut is central to overall health and wellness; especially Functional Medicine practitioners. The medical literature indicates that an unhealthy microbiome, that’s the gut and our colon and other mucous membranes in our body, is associated with a variety of chronic illnesses; including autoimmune disorders, cognitive function, among others.

That’s why Diagnostic Solutions Lab developed the GI map. The GI map uses the most advanced quantitative PCR based technology to detect microbes that can cause illness and gut problems. This DNA based technology looks at bacteria fungi, viruses and parasites to see why many culture based stool analyses simply can’t fight.

Precise results offer previously unseen window into our gastrointestinal health. And insights allow functional medicine practitioners to personalize our treatment plans to address the underlying causes of illness, rather than merely treating symptoms. When your patients present with GI complaints, don’t just guess, test with the GI map from Diagnostic Solutions. And if you’re a patient, ask your practitioner to run the GI map for you. And now we’ll get back to our discussion.


Dr. Weitz:            So what are some of the most important ways to take care of the mouth and the teeth in terms of brushing, flossing, is water picking good?

Dr. Nolan:            Yes.

Dr. Weitz:            And what is the goal. Do we want a certain … We talked about biofilm a little bit, maybe why don’t you explain what a biofilm is.

Dr. Nolan:            Absolutely. So a biofilm is an array of bacteria, so individually bacteria, which come together and kind of a Tetris stack. So if you ever played Tetris, and you’re trying to get rid of all the blocks, you’re actually just rearranging the blocks in a certain order. And what we’re actually seeing from studies now is that they’re specific orders in which certain bacteria like to attach the tooth, and then they attached to another bacteria, and then they attach to another bacteria.  And depending on what kind of stacking occurs actually can determine pathogenesis, but you got to remember with threshold levels, if there’s more bad actor around, you’re going to have a worse stack. And so you’re more likely to have a more pathogenic stack, if that makes sense. It’s like if you’re playing Tetris and you’re getting behind, and you can’t seem to find the right block, everything just kind of comes together, and you lose the game.  It’s not a fun, but basically it’s a myriad of bacteria that come together and act as a functional, single unit. So together, they’re acting and combining all their features, which is why we have such difficulty dealing with them because now you have bacterial resistance mechanisms from one organism.  But guess what?  It’s being complimented by two or three other organisms, now, and those organisms have the defenses that that one doesn’t have, and so they work together just like a community to kind of prevent things from happening that will affect them and kill them.

Dr. Weitz:            Now biofilms can be helpful or harmful, is that right?

Dr. Nolan:            Yeah.

Dr. Weitz:            I mean, I mean if the good bacteria are forming a biofilm to improve their survival, then that’s a good thing, right?

Dr. Nolan:            Yes, absolutely. So like I said, I think that there’s definitely … You can’t paint them all with the same brush. However, that being said, the second you remove a biofilm, whether that be brushing or through chemical methods, it actually re-establishes within seconds.  It’s not like you have to worry about eliminating everything, I mean, there’s always going to be bacteria; we’ve evolved with bacteria.  So, I don’t think the ultimate goal is entire elimination.  I think the goal is to reduce threshold levels of bad bacteria, compliment the good bacteria, and set up conditions whereby it mimics what your saliva and what the natural human body wants to do; which is to just keep it enough at bay all the time. So it’s more of a maintenance issue, than it is an elimination issue.  And that’s a key distinction that we’re perceiving because it used to be like “Oh, you gotta get rid of.”  You can’t get rid of it, it’s always going to be there, so you just kind of have to accept what you have and set the conditions up for the host.

Dr. Weitz:            So therefore, products that contain antibiotics that might just wipe out a lot of healthy bacteria-

Dr. Nolan:            Sure.

Dr. Weitz:            Are not the way to go, right?

Dr. Nolan:            I would never, ever recommend antibiotics unless you absolutely need them.

Dr. Weitz:            And some of these mouth rinses have them, right?

Dr. Nolan:            Yeah, so this is kind of how I’d put this. Let’s say you have a sniper rifle, and you know exactly which person in the crowd that you need to kill; to make sure that things don’t go awry, because we’re looking out for the guy on the podium. And instead, what we do is we just basically hack and slash at every single person in the crowd; we save the guy. It’s the most archaic way of dealing with the biofilm; and not only that, antibiotics are one of the least effective ways of dealing with biofilms, because biofilms or about 1,000 times more resistant to antibiotics.  So there are companies which have come out with antibiotic rinses. Gosh way to give yourself antibiotic resistance without actually taking the antibiotics orally; what a mistake. I mean, I actually just made a post about this the other day; there’s an image floating around online, and it says … I’m sure you’ve seen this 10 year challenge thing where everyone’s showing them their pictures for 10 years ago, and they’re showing their pictures today.  So someone got a picture of a Petri dish with three or four different types antibiotics and showed that in 2009, there’s actually a clear border where the bacteria won’t grow. And then they showed a picture in 2019 and there’s no border; they’ve literally all become resistant to all four different antibiotics in the span of 10 years sitting on a dish. So the point is that antibiotic resistance is scary.

We know that these organisms, especially in a biofilm are much better at getting co-evolutionary mechanisms like sharing DNA, sharing resistance features. So why would we want to limit the things that’s currently working for systemic infections and things like that?  Why would we expose bacteria and give them a free shot at getting resistance because of a mouth rinse, when there’s other solutions out there?  It’s just, to me, that was my mind. That’s so archaic; are we trying to reinvent the wheel here like at putting spikes on it? The point is, it’s just to me that’s very, very not prudent and stupid, really, to be honest.

Dr. Weitz:            Right. So what you’re saying essentially is, don’t use some of these commercial mouthwashes that claim to kill all the bacteria because they have antibiotics in them and they’re really, ultimately, going to be harmful for your oral health?

Dr. Nolan:            Yeah, additionally, I should say-

Dr. Weitz:            Likewise, toothpaste that happens to have it as well.

Dr. Nolan:            Oh yeah, you wouldn’t want any antibiotics in your oral care regimen. The other thing is to say about these commercial products. One of the things that we really looked at, when we were looking at commercial products, is they are so acidic. And it wouldn’t seem like it’s an issue because a lot of these things, even though they’re acidic, they do kill bacteria. But they don’t do so in a fashion that really sets you up for a win after. So what do I mean by that? A lot of the organisms that cause disease in your mouth love acidic conditions.  So you’re giving … So let’s say you use something and not could it dissolve your teeth because it’s acidic, let’s say it does kill some bacteria and then just leaves the acid behind as it slowly deletes away. Now we’re setting up a condition where every organism got a free pass to an environment they love. So they’re going to multiply and come back even stronger and happier; it just doesn’t make sense. So, I looked into this and I really, really put a lot of thought into it. And what I ended up finding is the part of the reason why this is is because they don’t have preservative mechanisms that work in the alkaline range. Meaning that they, literally, have no choice but to use preservation and techniques and antibacterials, because they only work in acidic conditions; which blew my mind a little bit.  Because if you’re thinking about it, now we’re using archaic systems that only kind of work, we’re giving some of the bad bacteria some advantages, were dissolving teeth in the process; and on top of it, there’s nothing that seems to be being commercially made in the alkaline range. Which is where, by the way, your human saliva if simulated, is close to a pH of eight.  So why the heck are we not mimicking what your body’s naturally trying to do?

Dr. Weitz:            So the natural mouth pH is eight, you said?

Dr. Nolan:            So there’s something called unstimulated saliva and stimulated saliva. Stimulated saliva is basically where your body starts releasing saliva; it happens throughout the day, but let’s say you’re chewing gum or you have something you’re eating. The pH of your saliva actually goes up when that happens. So yeah, so your saliva likes to be in a probably about a pH range of seven and a half to eight; that’s the ideal range for-

Dr. Weitz:            Is that … And I know bacteria, some, in the gut, acidophilus, are acid loving bacteria.

Dr. Nolan:            Correct.

Dr. Weitz:            Got more alkaline. So when you’re talking about a pH of above seven, you’re talking about a pH that’s alkaline.

Dr. Nolan:            Correct.

Dr. Weitz:            Being a bacteria is the mouth, the healthy ones generally prefer more alkaline environment?

Dr. Nolan:            Yes, so commensal bacteria are seven or above. And it’s funny because even some of the bad actors stop releasing acid when the biofilms’s at a pH of seven, seven and a half or eight. They don’t seem to be able to function properly, and it reduces their threshold levels as a result to low enough levels that they essentially act as a pseudo commensals.  Meaning they’re providing competition, but they’re not exerting pathogenesis.  And so we’ve actually determined that this is the primary reason why.  So if you set the playing field in the host’s advantage, which is us, you’re going to have a better chance of not exhibiting disease, perhaps.  The other thing I should mention too, real quick, and it’s a little more advanced but there have been studies on calcium and fluoride penetration into the plaque. Obviously, these things are helpful, once they get into the plaque. The question is, do they actually get there? And the answer is no. So one of the big issues and what saliva actually does for us is it actually not only kind of breaks down the plaque, it actually releases calcium into the plaque, but it sometimes can take up to an hour or two.  So we know that’s the mechanism of how things work. So there’s been studies done on how much of these agents can actually get into the actual plaque where the interface between the tooth is where all this de-mineralization and acid build up is occurring.

Dr. Weitz:            So just let me stop for a second.

Dr. Nolan:            Sure.

Dr. Weitz:            So one of the things you’re talking about is the plaque on the teeth, which is hopefully what you’re getting rid of with brushing and flossing, and when you go to get your teeth cleaned, that that plaque can lead to a breakdown of the calcium and de-mineralization of the teeth?

Dr. Nolan:            Yes, sir-That’s correct. So, um, what we’re finding is that the penetration ratio of neutralizing agents is only about one to two percent; that is abysmal. And not only that, at a low pH, even … So at a low pH, these things enter at half the rate of a higher pH.  So it’s kind of really counterintuitive now to use something that’s acidic, because not only is it not going to be able to deliver what we want, but on top of it, it’s going to cause all these other potential issues.  So it’s funny because the more and more I get into it, the more I realize just how bad of an idea it is; and hopefully that makes sense to you. But essentially, it’s just we want to mimic what saliva does.  And in order to mimic what saliva does, we have to have something that’s able to deliver neutralizing agents better than two percent.  I don’t know about you, but two percent is, that’s a joke.  I mean, it may as well not even happen; it’s not enough, so.

Dr. Weitz:            When you’re talking about a neutralizing agent something like calcium, which is alkaline can help to neutralize an acidic plaque-

Dr. Nolan:            Correct.

Dr. Weitz:            And it can’t penetrate and now you have developed a mouth rinse product that can help with that?

Dr. Nolan:            Yes, correct. So one of the things that we really, really looked at is we looked at all the existing agents on the market. And I pretty much couldn’t find an anti-bacterial agent that was basically above six. Almost exclusively about 95 percent of them are pH of five and a half or below. And a pH of five and a half is actually called the critical Ph. The reason why it’s called the critical pH, is because that’s when demineralization and decay actually occurs.  So the tooth starts dissolving pretty heavily at a pH of less than five point five.  So now we have all these agents commercially available that literally can dissolve your teeth, and they’re supporting an environment that’s not great.  So what we did, is we looked at the most recent technology available.  So my background’s actually nanotechnology; I’ve worked on carbon nanotubes, in college, and so I actually met up with a good colleague of mine in school, his name is Matt Hollister; really, really bright guys.  So he knew that I worked on nanotechnology applications, and I actually was, at that time, actually still kind of endeavoring in that and researching that. And he goes, “Brian, what if we could do something where we could use some of these nano compounds to effectively enhance the remineralization cycle?” So, we kind of got our heads together and started kind of hypothesizing some of these things really early on, even in dental school. And basically what we ended up doing is we spent three years and we actually custom engineered a nano silver compound, among others, but a nano silver compound that we found can actually increase the amount of neutralizing agents that get into the plaque.

And we did a clinical study on it, and found that when you add nano silver to a solution … And we’re talking only about 10 parts per million; it’s very dismal the amount that you have to use. It increased the amount of calcium that got into plaque over the control by 4.6 times; it is nuts; the results that we got were insane. So it basically is a perfect delivery system for getting into the biofilm. On top of that, when we engineered these, one of the major issues we had was how do we ensure that these actually are kind of more selectively targeting the biofilm, and how do we basically make sure the stuff’s alkaline and, on top of that, we want to make it non toxic?  So we actually ended up going the route of using plant compounds to synthesize these nano particles. And if you already know, I mean, a lot of plant compounds are very biocompatible. So, basically, the outer surface of the nano particles is actually covered in a plant based compound, and it’s actually is able to pretty selectively attach to biofilms.  So now we have something that acts like a cactus spine, gets on the biofilm, gets in the biofilm penetrates it, and opens up channels for calcium, saliva, and other things to get in. So it’s kind of an ingenious system, because not only is it alkaline-

Dr. Weitz:            Is it the plant compound, or the silver that breaks the biofilm?

Dr. Nolan:            So the plant compound allows it to approach the biofilm and attach to the biofilm and enter.

Dr. Weitz:            And what compound is this?

Dr. Nolan:            I can’t actually tell you because we have our patent pending. But I can say it’s from a plant, and it’s from a pretty cool plant at that.  But that information will probably be more available probably towards the end of the year. But, the silver nano particles are essentially … How would I put this? Silver nano particles that are like carriers. So basically, what they do is they’re able to get kind of close enough and enter the biofilm, kind of rip it into pieces, if you will, put a bunch of holes in it.  And silver ions are actually what ends up getting released after from the nano particle over time. That enhances its anti-bacterial capacity, but also keeps things … It targets the areas which are going to be caused … Which are building up the acid, which is the deeper layers of plaque. And so that’s kind of the way it works; it basically acts as a delivery system for other neutralizing agents. So instead of two percent, we’re seeing maybe 20 or 25 percent, which is a huge deal because it also helps saliva do its job.  So what we’re doing really is we’re mimicking what natural saliva is going to do in a much faster time period. So instead of saliva after … Let’s say you eat a bunch of sugar, saliva might take an hour to neutralize that plaque acid that’s already started building up. We’ve seen the neutralization effects within a couple minutes; I mean it’s pretty astounding. So, it pretty much works instantly, and so we’re basically just mimicking what the body wants to do. And we’re helping it out, so.

Dr. Weitz:            That’s great. I know you mentioned fluoride also I’m a big fan of calcium, but not such a big fan of fluoride.

Dr. Nolan:            Totally understand.  So here’s the thing. I mean, I’m not anti-fluoride, but I will say this I am pro-progress. I’ve tested along the fluoride stuff, and I just haven’t seen the same level of efficacy. So when people asked me am I anti-fluoride, I mean, you guys don’t put fluoride in your product. Yeah, but I also didn’t see when we were doing all these tests, I just didn’t see the same level of efficacy. And to me, I care more about what the end result is.  And it just so happens that it just didn’t end up with my product because of that. So, to me that matters more than the politics behind fluoride. I know a lot of people aren’t a big fan, but it’s great, because there are people like yourself who were like, “Look, I just want something that’s going to work that doesn’t have fluoride in it because I’m concerned. I’m not concerned, I use it all the time, but I can understand that. And so it’s great because then you have an alternative instead of everybody else using it, and then you don’t have an option. It kind of feels he got shut out of the market is anyone looking out for me?

Dr. Weitz:            Just to go into it for a second. Fluoride is a toxin in some levels, and it’s given off by the fertilizer industry and things like that. And the type of fluoride that’s in the water; even if we decided that fluoride was a good thing, it would be nice if we agreed on that. And then we decided to put a super purified form of fluoride in, but instead we’re putting this industrial waste product into the water. I forgot the exact name of it-

Dr. Nolan:            Fluorosilicates, instead of sodium fluoride, I think that’s what you’re saying, right?

Dr. Weitz:            Is that what it is?

Dr. Nolan:            Yeah.

Dr. Weitz:            I know it’s a-

Dr. Nolan:            It’s a green looking-

Dr. Weitz:            Byproduct of the fertilizer industry and basically it’s a way for them to dispose of this waste product. And then in the bone, it’s replacing the calcium and so just because it gets incorporated into the bone, I’m not convinced that it’s a healthy thing; we’d be much better off with calcium in there.

Dr. Nolan:            Yeah, so here’s my thoughts. Definitely some things that I would say is that there is always a level where something’s going to be a toxin, no matter what. However, I think one of the things you really should focus on is how much benefit do we get from it being in the drinking water? As you know, the United States is one of the few countries that still mandates fluoride in water. One of the things that we’ve looked at is basically outside of developmental, meaning if you’re a kid and you’re drinking the fluoridated water, adults don’t really benefit very much from drinking fluoridated water. So the reason is is because the concentration’s usually 1.7 parts per million.  So topically, that’s not going to do anything because it’s not really going to penetrate your plaque. So the only thing that’s going to do is basically just accumulate in your body, it usually enters the bone. But it doesn’t really offer you really much benefit past the age of eight, in my humble opinion.  So it just makes sense that … So then you have to ask yourself “Okay what’s happening in other countries, what does their decay rate look like, the ones that have taken fluoride out of their system?” So a study in 2015 actually compared a bunch of different countries that haven’t had fluoridated water in some time. And the decay rate approaches the same decay rate that we have in the United States. So the question becomes, “Okay, is orally ingesting fluoride helpful?” And the data doesn’t look as promising as what we originally thought in the 70s and 80s; and there could be a number of reasons for that.

It could be that more people are using topical agents, it could be a number of people care more about their oral health, it could be a number of different things. But the one issue I have with some of these studies done in the 70s, is they just don’t have very good controls. And anytime you look at a study, you have to have a pretty good control, and you also have a pretty good idea of all the variables that you should control for. So I’m not so hot, necessarily, on removing it from the water, but I’m also … I’m able to come in with an unbiased opinion and say, “But is it really helping to the extent we thought it was?” And the answer is probably not.  The other thing is, is I still use topical fluoride agents; luckily you’re not digesting them or anything like that. But I can understand why someone … There seems to be a fair amount of people concerned about it. I mean fluoride is the most reactive element on the table, I mean, we know that it reacts pretty readily. And one of the things it reacts with this is organic compounds, and we’re an organic compound, essentially. So, I mean, look, having concerns about it is okay, I think people need to be okay with that.

Dr. Weitz:            By the way, throw in one more thing. And I know we can go on and on about this. But one of the concerns about fluoride is it can replace iodine, because it’s a very similar compound; it’s in the same row in the periodic table, and so therefore it can impair thyroid function. And that’s one of many concerns I have about fluoride.

Dr. Nolan:            Yeah. So the other thing too, as you mentioned, is we started seeing a lot of something called fluorosis and I’ve seen it a lot in my clinical career. But basically what happens is, if you have too much fluoride, you can actually develop these pit and fissures that are actually more likely to break down and get decay. I’m sure you’ve seen-

Dr. Weitz:            I understand it’s fairly common, yeah.

Dr. Nolan:            Yeah, it’s very, very common, So the question becomes, is there a point where there’s too much fluoride and I would say yes.

Dr. Weitz:            Especially if you’re consuming fluoride in the water, and they decided “Okay, if you have this much water.” But what if you’re cooking in the water, drinking the water, then you using a fluoride toothpaste-

Dr. Nolan:            Showering with it.

Dr. Weitz:            And you’re doing a fluoride mouth wash, so the compound total amount of fluoride, yeah.

Dr. Nolan:            So you’re exactly right. So there’s many routes of exposure. I think it becomes a question of how much good versus how much possible harm.

Dr. Weitz:            And plus, if we wanted diabetics to have Metformin, we want them to have a specific dosage-

Dr. Nolan:            Sure.

Dr. Weitz:            We wouldn’t put it in their tooth paste, their mouthwash, water, they’re getting a completely uncontrolled dosage, and you have no idea how much you’re actually getting.

Dr. Nolan:            Right, so you’re-

Dr. Weitz:            So it’s a very inefficient way to, basically, give a chemical, a drug to the population.

Dr. Nolan:            Right, so I say this from a clinical perspective, I like flouride and I like topical fluoride the most. I don’t know, like I said, I’m still kind of debating whether or not having it in the water makes a ton of sense. I’m going to need some more studies to have a official opinion on that. However, you’re right in saying that everybody’s dosages seem to be very different. And that seems to be a concern, because you get people have too much, you get people that maybe aren’t getting any.  And so you have a wide array of people that don’t seem to be getting consistently dosed and so that’s a problem, and we live in the United States, which is 75 percent fluoridated water, and we’re comparing against these other countries that don’t, seem very similar and points in the decay rate.  So, you know what? You wouldn’t be a good scientist unless you actually questioned it. You got to understand why things happen and you can’t just say, “Oh, well, it’s good, so, therefore, we have to have it.”  I think I lean in the opinion of people should have a choice; they should always have a choice.

Dr. Weitz:            Right, I mean you’ve being-

Dr. Nolan:            I can’t-

Dr. Weitz:            Given a prescription drug without your consent, essentially.

Dr. Nolan:            I can’t go and just say “Hey, look you know what? Silver is great because it cleanses the water, let’s put it in the water.” I can’t go do that, okay, even if I knew it was a beneficial compound. I just told 330 million people they don’t have a choice; not that’s not fair, in my opinion.  So I’m with you on that, I think mandating that it’s in the water; I think people should have the choice.  Now, obviously, there’s been a lot of push back and forth between the dental community as well as, people who fluoridate the water, and things that.  I just think, at the end of the day, the citizens should have the choice, really.  I don’t think it comes, it doesn’t come to me; I don’t get that decision.  So, yeah, so I’m still kind of on a fence there, but I’m willing to question the limitations.  I think that that is okay and if that makes me a black sheep, it makes me a black sheep.  But look, if you’re looking at the data, the data’s going to tell you what you really want to know. And even though we do need more studies; it’s definitely raised an eyebrow for me because I’m like, “Well, how does that really… What kind of picture are we painting here? And the picture right now is not enough studies to confirm fluoridation in the water. Is it really working?  I don’t …. Maybe, maybe not.  I mean, so we have to question, and we have to at least pop that tomb open; we don’t really know where that rabbit hole’s going to go.  But yeah, so for now I’m okay with the topical fluoride; I still have some reservations about fluoridating.

Dr. Weitz:            Great. So there’s a lot more stuff we could talk about, but I think we provided some good information about oral health to our listeners. So how can everybody get a hold of you, and is your mouth rinse product commercially available now?

Dr. Nolan:            Yeah. So we launched it in September, we’re doing a rebrand now. So we’re going to be able to have all the new bottles and a lot more new product coming out probably in February.  So basically the website is elementasilver.com. And we do sell on Amazon, if you Google Amazon and then throw in Nanosilver rinse, our product will come up. And my Instagram handle is @ryannolandmd. I’m very interactive on my Instagram, I try and always post thoughtful stories and things to kind of … I don’t know if I’d be a podster, I don’t know if that’s the word for me, I’m not lurking, but I like to question things. So if you like someone who’s kind of questioning the existing paradigms, I’m probably a good person to follow. Because I do make a lot of posts about “Hey, what do you think about this?” And we do get a lot of people who say “Yay or Nay”, but they at least agree. “Hey look, this guy’s questioning a paradigm, he’s got some evidence. Let’s think about it.”  That’s a problem, so we have to think about things and address them as a society, not just as a dental community. So yeah, those are my handle.

Dr. Weitz:            I think that’s one of the keys to wisdom is always questioning our paradigms.

Dr. Nolan:            Absolutely. Oh, I should mention this, we do have an Instagram account for our product it’s at @elementaoralcare. So you can find us there and like you’re saying, we have a product that I think a lot of people are going like specifically because it’s a different way of approaching the same problem and we do have a fluoride free product. So if fluoride bothers you, it’s not really a concern.

Dr. Weitz:            Great. Awesome.  Thank you for joining us.

Dr. Nolan:            Hey, I appreciate your time. Thanks so much for having me. I had a really great discussion.

Dr. Weitz:            Excellent. I’ll talk to you soon.



The Truth About Fish with Randy Hartnell of Vital Choice Seafood: Rational Wellness Podcast 91

Randy Hartnell of Vital Choice Seafood discusses The Truth about Seafood 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

3:12  Randy Hartnell became a commercial fisherman while going to college to help finance his school and fell in love with commercial fishing. He did commercial fishing for over 20 years till farmed salmon came in and in 2000 they had a large catch of Alaskan wild salmon and they couldn’t sell them because everybody was buying the farmed salmon for less money.  He had to give up the business, so he transitioned from catching fish to marketing fish and started Vital Choice Seafood, and his mission was to educate people about the difference between wild salmon and farmed salmon and provide them with access to wild salmon.  

7:30  Vital Choice sells a Ventresca tuna that comes from the smaller tuna and it is lower in mercury than most canned tuna sold.  The younger tuna not only have lower mercury levels, but they also have higher omega 3 levels.

10:15  Fish is sometimes mislabeled by some less scrupulous people who sell fish. Randy talked about filming a segment with Dr. Andrew Weill where they went to the Fulton Fish Market in New York City where they went into one stall by Slavin and Sons in November, which is not wild salmon season and they had all these pallets of boxes marked wild king salmon. He asked them where they got all this wild king salmon this time of year and they said, “Why those are farmed wild king salmon.”  Then the New York Times did an investigative report on this bait and switch practice. Then a year or two ago there was a big study done in California showing half the fish in sushi bars is mislabeled.  There was one species like an Asian Carp that was labeled as more than a dozen different types of fish.

12:10   Less scrupulous restaurants sometimes sell farmed salmon and call it wild salmon.  Farmed salmon don’t eat krill and phytoplankton, so their skin is not pink and they have lower levels of omega 3s, so they have to be fed dye so their flesh is pink.  And farmed salmon is increasingly being fed grains, which are the cheapest form of food.  But this gives the farmed salmon higher levels of omega 6 fats and lower levels of omega 3 fats than wild salmon.  Another problem is that farmed fish tend to have higher levels of toxins since they are also fed rendered fish feed made of tons of anchovies and sardines rendered down into pellets. While the individual sardines and anchovies have miniscule amounts of contaminants, when you render them down and concentrate the the toxins. 

34:25  Unlike what I thought, which is that most of the mercury in the fish is from coal-fired power plants that spew mercury into the air, which then drops into the oceans, Randy explained that at least half of the methyl mercury in the oceans is from natural sources, eroded from the land masses. They did hair analysis of Inuit Eskimos 10,000 years old and found that they had substantial levels of mercury. There has been mercury in the oceans since the beginning of human existence and we have evolved living off fish from the oceans with no ill effects.  Consider how healthy and long-lived the Japanese are and they eat seafood many times per week, including while Japanese women are pregnant. And the Japanese have among the lowest rates of infant mortality.  One hypothesis is that seafood is also one of the richest sources of selenium and selenium binds with methylmercury and renders it harmless. This is in contrast with mercury from industrial accidents like Minamata disease from severe levels of mercury found in fish resulting from the Chisso Minamata factory that was producing acetaldehyde using mercury sulfate as a catalyst.  This led to massive levels of mercury in the fish far above the levels that would occur naturally and this level did create a severe neurological disease.  While we may want to avoid shark and swordfish and the other big bill fish, for most common seafood, the relatively low levels of mercury is just not really a health issue and the health promoting benefits of eating fish far outweigh the potential downside, such as the levels of omega 3 fats.


Randy Hartnell is the founder and president of Vital Choice Seafood.  They offer exceptional quality, wild seafood, both frozen and canned, fish bone broth, as well as a range of other products at VitalChoice.com or by calling 800-608-4825. 

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 e-book 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 listening to 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 health fish. We’ll be speaking to Randy Hartnell, the Founder and President of Vital Choice Wild Seafood and Organics. A company dedicated to bringing to the public top quality seafood that has lower levels of hazardous contaminants like mercury. There are many questions today about whether it’s healthy to eat fish and seafood.  On the one hand, many, many scientific studies have shown that eating fish and seafood promotes better health. Even more studies demonstrate the health benefits of omega 3 fats from fish and seafood. We know that seafood, especially certain types like wild salmon, not only contain quality protein but many vitamins and minerals including fats, soluble, vitamins D, A, B vitamins, and are the absolute best source for omega 3 fats that promote cardiovascular health, reduce inflammation, and have so many other health promoting benefits. This is why I eat seafood at least several times per week, and I recommend it for my patients.

 On the other hand, we have many concerns about eating fish today for a number of reasons. Toxic chemicals that humans have been dumping into the oceans for decades like mining waste, agricultural runoff, industrial waste, mercury, et cetera. Oil spills, nuclear radiation from Fukushima, we’ve probably all seen the reports about the Great Pacific garbage patch of floating plastic. Recent reports about microparticles of plastic found in fish. There’s questions about the sustainability of fish in the oceans. Farm fish versus wild fish. There’s an issue with the genetically modified salmon that’s on the market now. Also reports that when you go to buy seafood, many of it is mislabeled. It’s farmed and it’s labeled as wild, or labeled as the wrong species.

So Randy, thank you so much for joining us today. Maybe you can start by telling us a little bit about your background and how you came to start this seafood company, Vital Choice.

Randy Hartnell:                 Well, thank you Dr. Weitz. I really appreciate the opportunity to be here today to address some of these many questions.  There’s a lot of confusion around seafood, so I always appreciate the opportunity to bring some clarity to it.  Well, I started as a commercial fisherman back in my college days.  My dad worked up in Alaska as a court engineer, and he got me a job in a cannery, and he got me a job on a boat.  So I financed my way through college as a fisherman in Alaska.  I had planned to go onto grad school, but basically I fell in love with fishing, and took that up as a full time profession and ended up doing that for over 20 years.

Then about late 1990’s, early 2000’s, something disrupted our industry and I basically had to move on and do something else. That something was farmed, industrial salmon. Basically took over the world markets for salmon. I got to the end of the 2000 season I think, and we had caught a lot of fish, but nobody wanted to buy them. It was the first time in all my years as a fisherman I couldn’t afford to pay my crew. I couldn’t pay my bills, so I moved on.  I ended up transitioning from catching fish into marketing fish.  I started a company called Vital Choice, and my mission was to, one one hand, educate people about the differences between wild and farmed salmon. Also to provide them with a preferable alternative, provide them with access to wild salmon.  So, that’s what we’ve been doing ever since, almost 18 years now.

Dr. Weitz:                          Cool. So let’s talk about, maybe we can talk about some of the health benefits of eating fish on a regular basis?

Randy Hartnell:                 One of the interesting things that happened when I started this company was I was selling direct to consumers.  So I had a one on one relationship with my customers, and they had lots of questions. All those years that I was a fisherman, I didn’t know an omega 3 from anything.  I just had never heard of omega 3’s.  So I needed to do a lot of studying and basically that continues until the day I read just about every book on omega 3’s, and there are a lot of them out there, and all the health benefits of them as you know.  Seafood is probably one of the few foods out there that pretty much everybody agrees is healthy.  If you get the right versions of it.

Dr. Weitz:                          Right.

Randy Hartnell:                 So, seafood has been in the human diet from the very beginning. Our bodies are constructed of these marine omega 3 molecules, and we still need them, they’re still essential.  Seafood is really the only place you can get them, or products from the marine food web.

Dr. Weitz:                          Can you explain why the fish that you’re offering is healthier than what a lot of other’s are selling? Such as the canned baby salmon that’s lower in mercury?

Randy Hartnell:                 Well, I think there’s some confusion there. I don’t know of anybody that’s selling canned baby salmon.

Dr. Weitz:                          Oh, okay.

Randy Hartnell:                 Salmon are relatively short lived species. So even if you get a grown up salmon, it’s going to be only four years old. It’s going to have relatively low mercury levels. Where the younger fish come in is with the longer lived species. So like a halibut, or a tuna. They can over many years, they can get huge. So if you’re going to the market to buy fish for your family, and you’re aware of this contaminant issue, you’re going to choose the smaller fish.  So that’s what we do. We just buy the kinds of fish that we want to feed our families and we know that our customers appreciate it. When it comes to those longer lived fish, that means that you want the smaller ones.

Dr. Weitz:                          Oh, okay. I thought that you had some sort of salmon that had less mercury in it?

Randy Hartnell:                 No, I think what you’re thinking about is … because we have a lot of fans for our product called our Ventresca.

Dr. Weitz:                          Oh, okay, yeah.

Randy Hartnell:                 Which are smaller tuna.

Dr. Weitz:                          Oh, tuna, okay.

Randy Hartnell:                 Albacore tuna. A lot of-

Dr. Weitz:                          That’s what I meant. Yes, yes, yeah, yeah, yeah.

Randy Hartnell:                 A lot of people, health experts tell people just to avoid tuna.

Dr. Weitz:                          Exactly.

Randy Hartnell:                 It’s an unfair generalization because there are 800 pound tuna that have sky high mercury levels, and there are three pound, five pound skipjack tuna that are two or three years old that have relatively low levels, and relatively high omega 3 levels. So it’s not fair to the fishery, to the industry, to the community out there just to tell people to avoid all tuna. It really is based on a lack of knowledge about that type of fish.

Dr. Weitz:                          Right. So you’re using the younger tuna and those are much lower in mercury, right?

Randy Hartnell:                 That’s right. The University of Oregon, I believe, did a study on albacore caught off the coast of Oregon, Northwest Washington. Where they drew a correlation between tuna size, or age, and mercury levels. Now generally the smaller fish have lower mercury levels. The interesting thing is they also have higher omega 3 levels in our experience. Just remarkably high fat levels in these younger tuna.  When I first went down to the dock to meet our fisherman, his name is Paul Hill and he’s been a … he’s a second generation tuna fisherman and when I told him we only wanted to buy his small fish and he just couldn’t wrap his brain around that. He said, “My whole life, my dad’s whole career the buyers told us that the small fish were trash, and they wouldn’t pay us anything for them. And you’re telling me that’s all you want?” That’s all we’ve doing now for probably 16 years.

Dr. Weitz:                          Oh, interesting.

Randy Hartnell:                 That’s great for him because you know, the big buyers, they want the bigger fish. The yields are higher, they’re less costly to process. Our customers are more focused on the purity and the health benefits and those are both delivered in a superior way by the younger fish.

Dr. Weitz:                          Oh, okay.

Randy Hartnell:                 The one thing I want to clarify is we’re not out there … he’s not out there targeting little fish, right? He’s just catching fish and they’re part of every load. So when he comes in, he size grades-

Dr. Weitz:                          Oh okay.

Randy Hartnell:                 … and we take the small ones. So it’s-

Dr. Weitz:                          You’re not going after the tuna nursery schools?

Randy Hartnell:                 No. That’s right.

Dr. Weitz:                          I figured you’d just wait until the tuna come across the border and then you separate the mothers from the baby … no, I’m kidding. So what about some of the reports that some of the seafood is mislabeled when you go to buy it?

Randy Hartnell:                 You know, that’s been going on forever because it’s really easy to bait and switch people. I like to tell this story of many years ago I was back … and like I said, things haven’t changed that much, so it’s still applicable. I was back in New York City at the Fulton Fish Market, and I met Dr. Andrew Weil. I was going to show him around the fish market.

Dr. Weitz:                          Oh cool.

Randy Hartnell:                 We had a video crew with us. We walked into this one stall, Slavin and Sons, I believe it was. I noticed … this was in November, which is not wild salmon season. I noticed all these pallets of boxes piled high and on the end of the box it said wild king salmon. So I asked him … I think it was the grandson of the founder … I said, “Where in the world are you getting all these fresh wild king salmon this time of the year?” And he goes, “Why those are farmed wild king salmon.” People don’t want to pay for real wild king salmon.  I went back and wrote an article in our newsletter about it. Marianne Burrows at the New York Times somehow got that, and she called me up and she said, “Well, we want to do an investigative report about this.” So sure enough a few weeks later, the front page of the Sunday New York Times was a big story about the bait and switch.  Fast forward to just last year or two, there was a big study done in California basically showing half the fish in sushi bars is mislabeled. There was one species like an Asian carp or something that was labeled as more than a dozen different types of other fish.

Dr. Weitz:                          Wow.

Randy Hartnell:                 Then of course one of the most common examples that I run into is in restaurants. As more and more consumers become educated and they’re requesting wild salmon and they understand the differences, the less scrupulous restaurants are just calling their farmed salmon, wild. I can’t tell you the number of times I’ve gone in and it said wild salmon on the menu and it’s clearly not been wild salmon.  So it’s just something people have to be aware of and-

Dr. Weitz:                          Now, can you tell just by looking at it? Are there things that the consumers can detect?

Randy Hartnell:                 I probably eat more salmon than just about anybody on the planet and caught millions of pounds of salmon and I can’t always tell.

Dr. Weitz:                          The color seems to be different right?

Randy Hartnell:                 Well, the aquaculture industry has done a good job of mimicking wild salmon color. The farmed salmon, they’re not eating what wild salmon are eating. They’re not getting the krill and the phytoplankton.

Dr. Weitz:                          Right. That’s one of the main issues right?  The fish are getting the omega 3’s because of what they’re eating, and then-

Randy Hartnell:                 So their diet … the farmed salmon diet is supplemented with a synthetic version of that compound that will turn the fish flesh the color that resembles wild salmon.

Dr. Weitz:                          Yeah, essentially they’re dying the fish pink?

Randy Hartnell:                 Yeah, I guess you could say that, right, right.

Dr. Weitz:                          So those farmed fish are being fed a much less healthy sources of nutrition, isn’t that right?

Randy Hartnell:                 In the early days when we first started, the primary criticism against farmed salmon was that it had much higher levels of contaminants. A lot more PCP’s and-

Dr. Weitz:                          Right.

Randy Hartnell:                 … and that was because they were being fed predominantly rendered fish feed. So they’d go out and catch tons of anchovies and sardines. They would render them down into pellets. While those individual sardines and anchovies just had minuscule levels of contaminants, when you render them down and concentrate them into pellets, you’re concentrating all those contaminants. Then you start feeding basically livestock fish it’s entire life, it accumulates.  Also fish feed like that is very expensive, relatively expensive. So there were two challenges, it was expensive and it was giving their farmed salmon the high contaminant levels. So, how do you address that? Well, you find cheaper feed that doesn’t have contaminants in it. That, just like every other livestock turns out to be grains. So farmed salmon now have been fed increasing amounts of grain products.

I’m sure the aquaculture and scientists are trying to figure out how they could get away feeding pretty much all. Because it’s the cheapest possible thing you can feed them. Consequently the farmed salmon are fat. The profile no longer mimics the wild salmon. It has much higher levels of omega 6’s from the grains. I’m speaking generally here that there may be exceptions. I’m sure there are salmon farmers out there that are trying to do the right thing. Trying to-

Dr. Weitz:                          Yeah, but for those of us in the Functional Medicine world, many of us are trying to stay away from grains, and advising our patients to stay away from grains. Then we go eat fish and to find out that the fish actually contain inflammatory omega 6’s because they ate grains. Potentially we may be exposed to some of the same immune issues that some of us have when we react to gluten.

Randy Hartnell:                 Wild salmon, say a wild sockeye salmon has roughly nine omega 3’s for every omega 6. King salmon might be six to one. Basically, wild salmon you’re getting a lot more omega 3’s than you are 6’s. A farmed salmon is, last I heard, roughly one to one. So if you’re trying to improve that ration, it’s pretty hard to do with farmed salmon.

Dr. Weitz:                          Absolutely, absolutely. How about being able to detect other fish … one species from the other? Are there any hints that we can use if we go to a fish market?

Randy Hartnell:                 You know Ben, the best way to protect yourself is just find a good fish monger that you can trust. Or find a good restaurant that the person running it really knows what he’s doing. The problem is people are often driven by price. When you want the cheapest anything, you go to places that generally don’t hire the most knowledgeable people. They’re just trying to move product and they don’t know what they’re selling. I’m talking about a fish counter, or restaurant.

Dr. Weitz:                          Yeah.

Randy Hartnell:                 That’s really, I think, the safest way. I figure out which restaurants in know that I can trust that care about their reputation and would never bait and switch a customer and that’s who we try to be for our customers. As far as … you go into a sushi bar and they tell you it’s some white fish, how in the heck are you going to know unless you do a DNA test on it?

Dr. Weitz:                          Yeah.

Randy Hartnell:                 As for your original question, it’s really difficult for people. That’s why it’s so common. That’s why so many people get away with it. Because there are very few penalties for people who get caught. Other than their reputation.

Dr. Weitz:                          So we can order fish frozen through your company?

Randy Hartnell:                 Yeah, we have a broad line of premium Alaskan frozen seafood and then we also have canned, and pouched seafood. Our product line has really expanded over the years. We’ve also got other proteins, but seafood is still our passion in what we do.  Now we just … to put it as simply as possible, we just … my wife and I started the company. My brother and sister still work in the company, we’ve grown quite a bit. But really we’re just buying products that we want to eat ourselves.  That we can trust and we apply that standard to everything that we buy.

Dr. Weitz:                          What about some of the reports of the plastics. There recently have been a bunch of reports about micro particles of plastic in fish?

Randy Hartnell:                 It’s definitely concerning. It’s a horrible problem, how it impacts salmon in Alaska. I haven’t seen any evidence that it’s impacting them, although of course all of our oceans, none of them are pristine anymore. One of our big missions from the start is what can we do to protect the seafood resource? To protect the oceans?  Most of our charitable efforts over the years have gone toward environmental organizations working to protect the ocean.  One personal mission I have is just by educating people like you do about how incredibly important seafood is.  Hopefully people will start to make the connection if we don’t have healthy oceans, we’re not going to have seafood. If we don’t have seafood, we’re not going to be as healthy or have it to enjoy.  It’s already happening in many parts of the world.

Dr. Weitz:                          Yeah. You know, I hear these discussions sometimes where you get these really smart people like Elon Musk and even Steven Hawkings before he died recently, talking about how we need to explore Mars because we’ll probably have to leave the planet, because we’re destroying it. It’s just insane to think “Why don’t we just protect it?” That would make a lot more sense.

Randy Hartnell:                 And Mars once we get there too, right?

Dr. Weitz:                          Right.

Randy Hartnell:                 Well, there won’t be any oceans to mess up. I think there’s room for both, and I do see some encouraging signs that … there are more and more people becoming aware of these problems. And more and more people working on solutions. So hopefully they will be successful.

Dr. Weitz:                          What do you think about this new genetically modified salmon? What’s it called? The AquaBounty or something like that?

Randy Hartnell:                 Well, that’s sort of been on our radar for more than 10 years. What to say about it?

Dr. Weitz:                          It grows twice as fast as other salmon.

Randy Hartnell:                 It’s not available in American markets now that I’m aware. There’s been such a push back from the consumer that to my knowledge, it’s not available.

Dr. Weitz:                          I mean, once a species is out in the public, in the wild … I know they say they’re going to keep it contained. But my worry is it’s going to take over. You know?

Randy Hartnell:                 I maybe have some good news there. Because these are Atlantic salmon, Salmo salar is the species. I live in the Pacific northwest. So we have five different wild salmon species that populate this region.  Years ago, somebody thought it was a good idea. “Let’s bring in some Atlantic salmon and plant them. See if we can get them going. Then we’ll have six species in the wild.” They tried multiple times to bring in healthy, truly wild Atlantic salmon and they just would not take. They’ve never been able to survive.  So I think that’s one fear that’s probably not serious.  I’m sure if they escape … and sometimes the Atlantic salmon farms will have escapes. Just last year, here in Washington state, hundreds of thousands of farmed salmon got out. There’s no evidence that they’re displacing the wild salmon. They’re finding them with empty bellies. They’ve been fed their whole lives. For generations they’ve been hand fed, machine fed, whatever it is. I’m not an expert, but I do pay attention and I have never seen any evidence that they are displacing the wild salmon.  There are a lot of other concerns, habitat destruction, but I don’t think GMO salmon present that much of a risk to the wild salmon.

Dr. Weitz:                          What about some of the issues about over fishing and sustainability?

Randy Hartnell:                 You know, that’s a huge problem around the world. There’s good news there on several fronts. Over the last 10 years there’s been an increased consumer focus on that issue. There’s one organization … there’s probably 30 different organizations focused on sustainable seafood and it’s growing all the time. It’s confusing for consumers because there are so many different ones. Some of them sort of have maybe less than noble agendas.  There’s one that’s sort of the gold standard, and we were one of their first licensee’s way back in 2002. That’s the Marine Stewardship Council. Basically what they do is they will go in and assess a fishery and look at the impact of a particular fishery on other species. It’s very rigorous, it could take years to get a fishery certified as being sustainably managed. So, Alaska was the first fishery state wide, all their salmon were certified by the Marine Stewardship Council. There’s a little blue logo you can find. If you go to msc.org you can learn a lot more about it.

The result is more and more consumers are looking for sustainable seafood. It’s kind of like what we talked about earlier, if you go to stores and restaurants that have made their business about sourcing only sustainable seafood then you can pretty much trust that you’re getting fish that are coming from responsibly managed fisheries. We only source fisheries from healthy, sustainable, sources.  Alaska is really a model for the world. A lot of people are unaware of this, but Alaska pursued statehood in part to take control of their fisheries back from a federal government, which was mismanaging them, imagine that. They wrote right into their founding constitution that all the fishery sources would be managed on a sustainable yield basis.  Basically what that means is scientists, biologists, are in charge of those salmon runs. They’re isolated from the market. No matter how much the market demand is for wild salmon, the scientists are going to dictate how many are caught. Then they’ll take those that are caught and they’ll go out into the market.  Just this year, or the last couple of years in Crystal Bay Alaska, where I used to fish, they’ve had the biggest runs they’ve ever seen since they’ve been keeping track.

Dr. Weitz:                          Oh wow, cool.

Randy Hartnell:                 … 50, 60 million salmon coming back. It’s just an amazing story.

Dr. Weitz:                          Is there any increasing demand for wild salmon now that people are more educated about it’s benefits?

Randy Hartnell:                 Huge. Because back when I was a fisherman, if we had a big run like this, our price would collapse. Then farmed salmon came along and people just buy farmed salmon. But now a lot of people are a lot more knowledgeable about farmed salmon, they want wild and they’ll pay more to get wild.  So now the fisherman are doing really well. Even though that was the biggest run they’ve had in 50 years, the price was almost as high as it’s ever been.  So the fisherman are doing a good job and being well rewarded for it.  That was another part of our mission was to educate people about the differences so that they would create demand, drive the price up.  Because the whole fishing industry is really the most vocal, political advocate for the salmon resource.  There are all kinds of competing industries that want to come in and destroy the Alaska salmon habitat, just like they have in the rest of the country.

Dr. Weitz:                          Yeah, we keep reading reports about how they’re opening up more mining and more oil drilling off the coast of Alaska, it’s kind of scary.

Randy Hartnell:                 We have a saying, if you want to save wild salmon, you need to eat wild salmon. Stay wild, eat wild. Because a healthy salmon industry is the last line of defense for these wild salmon. If your livelihood depends on catching these fish, then you’re going to do everything you can to make sure they’re managed responsibly, that the habitat is protected.  So far, they’ve been successful of fending off this trillion dollar mine. This mine that they want to put in, it’s called the Pebble Mine up in Bristol Bay.

Dr. Weitz:                          I heard about that. Wasn’t that just approved again, or something?

Randy Hartnell:                 Well, with the current administration they’re not big defenders of the environment … Yes they did, but I don’t think … as long as you’ve got a trillion dollars worth of minerals sitting in the ground, the fight is never going to be over, right?  If was those fisherman, the native communities along there that just made passionate pleas and reached out, and got help from a lot of the bigger environmental organizations. Politicians and commerce. Tiffany said, “We will never buy gold from those mines up there.” They’re just one example of many. It was a fisherman that really … the heart and soul of that fight, and continue to be.

Dr. Weitz:                          Well, that’s good. Good to get some positive thoughts about that. Everybody get out there and eat your wild salmon.

Randy Hartnell:                 The one last thing I want to say about the sustainability issue. There’s a book called ‘Perfect Protein’ by Andy Sharpless who is the CEO of Oceana.

Dr. Weitz:                          Okay.

Randy Hartnell:                 He points out the sustainability movement that’s been underfoot is really having a positive impact. Fisheries around the world are stabilizing. If you’re out there harvesting fish that, in an unsustainable way, you’re over catching or whatever. The market doesn’t want those, so that’s going to force you to clean up your act. That’s basically what’s been happening. There’s still bad actors out there of course. There’s still some little black holes and we don’t really know what’s going on.  By and large there have been a lot of fisheries that have recovered and are doing a lot better. Now we just need to focus on cleaning up the ocean.

Dr. Weitz:                          When it comes to sourcing omega 3’s, some of the companies go, “Oh, our omega 3’s are from more sustainable sources. Some of them are from krill and some are from Norwegian fish. Some are from squid and things like that.  From the standpoint of sustainability, what’s the truth about the best place to source your omega 3’s?

Randy Hartnell:                 Well you know more about this than I do, probably. I don’t think that anybody will tell you that … the best form of omega 3’s is in food.

Dr. Weitz:                          No, I know but if you are going to say use fish oil capsules, is krill a problem because that’s what the whales eat? Or is it better-

Randy Hartnell:                 That’s a great question, that’s a really great question. The thing about krill oil is it’s all the rage in the nutrition and health world.

Dr. Weitz:                          Right.

Randy Hartnell:                 The consumption of krill oil is relatively minuscule compared to the population of krill. There’s a massive krill biomass in the antarctic. The total allowable catch is like a thing slice of that pie. The amount that’s actually caught is a super thin slice of that pie. So they’re not even approaching the total amount that they’re allowed to catch, conservative guidelines. So the Marine Stewardship Council as a result has looked at that and from a scientific perspective, and they have certified krill oil, we were the very first krill oil, actually.  I happened to be in the offices of the Marine Stewardship Council in London, the day the approval came through. I said, “Wow, this is great. We can add MSC certified krill oil.” Because Whole Foods had stopped selling krill oil because of the concerns that you mentioned. It’s one of those things where it was a PR, it was kind of a green washing PR move. Or at least they were holding off until they were convinced that it was a sustainable product.

Dr. Weitz:                          What about fish oil from say squid versus fish? Is there an issue of sustainability there? Does it make a difference, you think?

Randy Hartnell:                 Depends on where the fish are coming from. A lot of the fish oil comes from the big anchovy fisheries in Peru. It’s one of the biggest fisheries in the world.

Dr. Weitz:                          Right.

Randy Hartnell:                 It’s a regional type of … a certain type of fish in a certain region. I’ve listened to a woman from Peru who manages their fisheries down there, talk about how it would be so much better if we consumed these fish, these incredible omega 3 rich fish as food rather than rendering it down and feeding it to salmon. Right? Which is where a lot of it goes. Or turning it into to fish oil for humans. You’re just better off eating a can of sardines than eating the fish oil.  We have supplements. We have fish oil, sockeye salmon oil, but I just eat fish almost every day, or several times a week like you do. Because that’s the best source of omega 3’s. If you’re eating a sustainable fish than that addresses your question.  As far as the quality of omega 3’s from squid versus green lip mussels, versus salmon, or whatever, sardines. I don’t know, my sense is that I’ve talked to a lot of scientists and lipid scientists. Their opinion is essentially an EPA or DHA omega 3 molecule doesn’t really matter where you get it from a nutritional standpoint.

Dr. Weitz:                          Yeah.

Randy Hartnell:                 Although the krill oil in is phospholipid form, so there’s some case that’s more bio available. Nothing is more bio available than the omega 3’s you get in the fish itself.

Dr. Weitz:                          Right. So the conclusion really is to just eat more fish.

Randy Hartnell:                 Eat more sustainable fish.

Dr. Weitz:                          Sustainable.

Randy Hartnell:                 Alaskan salmon and sardines, and what not.

Dr. Weitz:                          Yeah, yeah. Those are the fish that I tend to eat the most as well. Okay, great. So how can our listeners and viewers find out more about your products? Order your products?

Randy Hartnell:                 Go to Vitalchoice.com and we have tons of information. We’re really passionate about education. We have a news letter that … we do some science based articles about the environment. A lot of these things we’ve talked about. There’s also specials for the products. We have absolutely fantastic customer service. So you can call us 24/7 and talk to knowledgeable customer reps about these products. We have 100% money back guarantee, if you don’t like … we have a lot of pressure on us to make sure what we send people is good. I think we’re close to 11,000 reviews on our website now.

Dr. Weitz:                          That’s great. What’s the low mercury tuna called again?

Randy Hartnell:                 Well, I’ll tell you but it’s probably not going to be in stock. We can’t keep it in stock.

Dr. Weitz:                          Oh, is that right? Wow.

Randy Hartnell:                 We call it Ventresca.

Dr. Weitz:                          Yes.

Randy Hartnell:                 That’s the belly of the young tuna. But just all of our canned albacore tuna is fantastic. It’s a superb, good source of omega 3’s. It’s coming from those smaller fish so it’s going to be the best risk reward ratio there.  I’m not sure how much time we have left, but I didn’t want to go without giving an opportunity to discuss the whole mercury radiation.

Dr. Weitz:                          Oh, okay, yeah, sure. Yeah, absolutely, let’s go into it. So why don’t we start with the mercury? My understanding is most of the mercury is being dumped into the ocean from coal fire powered plants, right?

Randy Hartnell:                 One thing that’s interesting is that a lot of the … at least half of the methyl mercury that’s in the oceans is from natural sources. It’s eroded … the land masses over the eons have eroded down. They found remains of Inuit Eskimos 10,000 years old. They do hair analysis and they find mercury in their hair.

Dr. Weitz:                          Oh really?

Randy Hartnell:                 So it’s not like mercury is a new thing. In fact it’s always been there in the marine environment and life evolved in the ocean.

Dr. Weitz:                          Oh, because people are always talking about coal fired power plants spewing hundreds of tons of mercury into the atmosphere. Which then falls down into the ocean.

Randy Hartnell:                 I’m not saying that’s not a factor. That is a factor and it also makes for a great copy if you’re trying to raise funds for your environmental organization. You know, follow the money right? So it is a legitimate concern, but honestly we are burning less coal and that’s a good thing.

Dr. Weitz:                          Right.

Randy Hartnell:                 … than other parts of the world are. Anyway, the main takeaway here is if you look at people who eat the most seafood in the world, take Japan for example. 80 plus million people that eat seafood many, many times a week.  Pregnant women eat seafood many times a week.  They’re not the sickest people on the planet.  You don’t find mercury toxicity. You find that they’re some of the healthiest, longest living … and it’s complex.  It’s not only the fact that they’re eating a lot of seafood.  There are other things maybe they’re not doing. They’re not eating an American diet.  We are exporting our bad food over there too I guess.

Dr. Weitz:                          Oh yeah, we’re exporting our rates of diabetes and heart disease, and cancer as well.

Randy Hartnell:                 The bottom line is they have some of the lowest infant mortality. They live the longest. The lowest amount of different types of common diseases that we have. If you go to a place like the Seychelle Islands where seafood is pretty much their primary protein, they’re eating 15, 16 times as much seafood as most Americans. There’s been a study run by the University of Rochester, I think, close to 30 years they’ve been looking at these people and they tested the mothers when they were pregnant for mercury levels. Yes, some of them have higher mercury levels that correlated higher fish consumption.

They fully assumed that as these kids got older … were born and got older that the kids born to the mom’s with the highest mercury levels would have the most developmental problems. They found no correlation. They did a study with 14,000 mother child pairs in the UK, same thing. It turned out that the kids born to mom’s who ate the most fish had the least developmental problems. The mom’s have the higher mercury problems, but the kids have the least developmental problems.  Those are two very rigorous studies showing that these trace levels of mercury that people freak out about are … at least for most people, not an issue.

Dr. Weitz:                            Are you suggesting that’s because the levels are just not high enough to really cause problems?

Randy Hartnell:                 Well, there’s one hypothesis is that life evolved in the oceans, amid a background of methylmercury. So we developed a way to deal with it. The way that deals with it is selenium. Selenium binds with methylmercury and basically renders it harmless. Seafood is one of the richest sources of selenium. So in a sense you’re getting … We’ve got a lot about this on our website. If you just go to our website and type in selenium, or methylmercury there’s just a lot of information there, videos. But basically that’s one hypothesis that when you get methylmercury from seafood the concentrations are so low that the selenium basically is the anecdote to that.

As opposed to if you get mercury toxicity from industrial accidents … a lot of people like to talk about Minamata and the horrendous birth defects that came from the Minamata industrial accident in Minamata, Japan. Just horrible birth defects in the kids. But the levels of mercury that was in those fish in that area, they’re just orders of magnitude higher than anything you’d get in common seafood.  So one of my closest friends at the NIH has studied this. He’s one of the authors in this study in the UK, his name is Dr. Joe Hibbeln. He said mercury is just not an issue in most common seafood. You want to avoid the shark and the big bill fish, the long lived high on the food chain-

Dr. Weitz:                            The swordfish and-

Randy Hartnell:                 Right. The sardines and the salmon and the kind of fish you find in most supermarkets, the benefits just so vastly outweigh the risks. He even concluded in his paper that was published in the Lancet that advice. Especially to pregnant and nursing women to avoid seafood risks causing the harm are trying to prevent. So you’re telling women … I had a friend his name is Barton Seaver, he’s written a bunch of books on seafood on the east coast. They just had a child here a year or two ago. They went to the OBGYN and they looked for the best OBGYN in the Boston area.  They went in and she told his wife don’t eat any seafood while you’re pregnant. This still is going on out there. So they’re conclusion based on 14,000 mother child pairs was when you give that mother than advice, you risk causing cognitive deficits that you’re trying to avoid. So they’re well intended, but they’re just not up to speed on where the science is.

Dr. Weitz:                          Okay. What about some of the other toxins?

Randy Hartnell:                 So the PCP … it kind of applies … we used to do a lot of testing on our Alaskan seafood. We just saw the same basically low results every time. we never had a spike. Pink salmon is only out in the ocean for two years, that’s it’s life cycle, two years. A sockeye salmon, four years. Maybe a king salmon will live six years, but they’re not like these longer lived fish like the Chilean sea bass or a halibut or whatever.

Dr. Weitz:                          Chilean sea bass is on the list of fish that are among the highest in mercury now.

Randy Hartnell:                 Well I was just looking at that yesterday, because there is no an MSC certified Chilean sea bass and we’ve had a lot of requests for it. Again, it lives a long time. So if you look at the studies it has super high mercury levels if you get the bigger ones. That’s typically what industry wants, they want the bigger ones because they’re cheaper to process. If you get the little ones, they’re comparable to an albacore tuna or something. So not that bad.  The big takeaway is just risk versus reward. These nutrients … like a wild salmon is … I never heard anybody make a case that there’s any other food on the planet that’s more nutrient dense than a wild salmon. We’ve got all the fats, the proteins, the micronutrients. It’s just incredibly nutrient dense type of food.  The other is there are going to be trace levels of mercury and maybe some other contaminants, but we’ve got to eat something, you know

Dr. Weitz:                          What about all these plastics? Some of these reports on the plastic stuff is pretty scary.

Randy Hartnell:                 You know, I talked to Dr. Ray Hilborn at the University of Washington, he’s a fisheries expert, he’s written a lot of books. He’s one of the leading scientists in fisheries, about this. From a nutritional standpoint, he wasn’t aware of any evidence that there’s harm.  I think also it’s a matter of choosing species that are coming from the cleanest areas. I think if the fish is ingesting the plastic, typically it’s going to pass through the gut and not make it’s way into the flesh. I haven’t seen any evidence that it is.

Dr. Weitz:                          Well, these new articles about the microparticles, you know?

Randy Hartnell:                 Yeah. It’s concerning. I’m not trying to-

Dr. Weitz:                          We’ve got to do something about these just floating patches of plastic. It’s just incredible. I can’t believe we’re not concerned about it.

Randy Hartnell:                 Well I think there are a lot of people that are concerned about it. They just hauled a bunch of big … I don’t know if you’ve seen the story about the young guy that came up with this idea about how to collect it and-

Dr. Weitz:                          Oh, I saw the commercials where these two guys are like diving under the water and picking up plastic and stuff.

Randy Hartnell:                 Yeah, there’s an organization that we support called Plastic Bank. In fact I just saw an American Express commercial that featured them, which is pretty cool. They’re just based up in Vancouver, an hour from us.  They’ve come up with this model where they go to a lot of areas around the world where plastic accumulates on the beach. It’s pretty horrendous in a lot of places like Bali. We think of these tropical paradise and they’ve just been destroyed by all this.  Well they go in and they basically create an economy around the plastic. So they pay people to go out and pick up plastic on the beaches, then they haul it back to these recycling centers that they set up. That’s Plastic Bank, I don’t know if it’s dot org or dot com. There are just more and more of those kinds of efforts springing up. I look at is as … when they say all progress starts with the truth and we have to start acknowledging what we’re doing to the oceans. And also realize how vitally important the oceans are to our own well being. You can’t have a healthy planet, healthy population without healthy oceans. So we’re working to educate people and do what we can to support that.

Dr. Weitz:                          Excellent. I think that’s a good note to end on. We need to have healthy oceans to have a healthy planet. We need a healthy planet to have healthy human beings.

Randy Hartnell:                 That’s right, that’s right. That’s why we called our company Vital Choice. It’s a vital choice to choose the right seafood from the right fisheries.

Dr. Weitz:                          Well sounds like you’re on a good mission and I know you have a great product. So thank you for bringing some information about fish and seafood to us, Randy.

Randy Hartnell:                 Thank you Ben, really a pleasure.



Emotional Eating with Tricia Nelson: Rational Wellness Podcast 90

Tricia Nelson discusses Emotional Eating 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

2:00  Tricia is an emotional eater and she tends to gain weight really easily. Her weight used to fluctuate up and down a lot. She would gain and lose so much weight that she had four different sized pants in her closet.  She tried many weight loss and exercise programs and even went to an eating disorders therapist, but nothing worked long term.  Eventually she found someone who could help her really get to the underlying problem and heal herself.  This is the basis of the system she has developed and she has been using for the past 30 years to help others overcome emotional eating.

5:13  To determine if you are an emotional eater, you can take this quiz: https://www.healyourhunger.com/are-you-an-emotional-eater-or-food-addict/.  People who are  emotional eaters are people who are using food for emotional reasons to really avoid feelings. They’re using food so they can escape themselves and escape experiences they don’t want to feel.

8:50  Most people who are emotional eaters are physically addicted to sugar and carbohydrates. This physical craving makes it incredibly hard for them to control how much they eat.  It’s physical, emotional, mental, and spiritual all in one.  They usually do better on a lower carb, paleo type of eating plan.

10:59  Emotional eaters typically have neurotransmitters, like dopamine and serotonin, that are depleted and out of balance.  Emotional eaters are prone to anxiety and tend to be worriers and over-thinkers and carbs tend to calm them down. It is helpful for emotional eaters to have their hormones and neurotransmitters checked and have them balanced. Sugar excites the opiate receptors and that’s how its so addictive. If they stop eating sugar for even a few days, they’ll go through withdrawal. They have to be detoxed off of sugar.  The best way is abstinence and avoid sugar completely. But it’s hard to find foods without sugar. Tricia does feel that stevia is the best sweetener if you are going to have one–it’s God’s gift to emotional eaters.

17:02  Emotional eaters are typically medicating themselves. There are 3 primary reasons why people over eat, which she calls the PEP test. The P stands for painkiller, which means they are eating over emotional pain. The E stands for escape, which means the emotional eater uses food as an escape. The P stands for punishment, which means that the emotional eater is prone to guilt and they are constantly beating themselves up over things they have done or not done. They tend to graze all day long, so to break the cycle it is important to have 3 meals and not snack. Intermittent fasting where you skip meals and purposely go 14 or 16 hours without eating is probably not a good idea for emotional eaters.

24:47  To stop being an emotional eater, you need to have a community, and Tricia notes that her Heal Your Hunger program gives people a lot of community. Tricia has a program called 10 Weeks to Freedom From Emotional Eating, that contains modules to teach people learn about emotional eating.  They learn about the emotions underneath, but there’s also a big element of community where they have live phone calls weekly together. People all around the world who have the same problem. There’s such healing in being with other emotional eaters. This is such, as I said before, such an isolating condition. We think we’re the only ones. Emotional eaters tend to be givers and bad at taking care of themselves, so Tricia teaches them self care habits and to put themselves first.

27:51  You also have to know what your real underlying problem is and change the way you interact with the world. Even if you lose the weight, if you don’t address the underlying emotions that are the causes, you’ll gain the weight back.  Emotional eaters, who are generally women, tend to be people pleasers and they tend to get their self esteem from outside of themselves, from doing extra at their job and from trying to please others.  Emotional eaters are always doing and giving and neglecting themselves. They have to value themselves and take care of themselves and put themselves first. They have to speak up and put boundaries on their time.  Emotional eating is not really about the food.  Emotional eaters reach for food to clam them down. You have to do the inner work and this inner journey of healing your emotional self. Meditation is the number one thing you can do to calm your inner mind. Prayer can also be very helpful and reading spiritual literature. Writing in a journal can also help to get your thoughts and feelings out and release some of your anger.



Tricia Nelson is an Emotional Eating Expert and the author of Heal Your Hunger, 7 Simple Steps to End Emotional Eating Now and is also the host of the Heal Your Hunger podcast. She can be contacted through her web site, HealYourHunger.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 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. Dr. Ben Weitz here, thank you so much for joining me again today for another episode of the Rational Wellness Podcast. For those of you who enjoy listening to it please go to iTunes and give us a rating or review so more people can find out about the Rational Wellness Podcast.

Today I’ll be speaking with Tricia Nelson about emotional eating, the reason why so many conventional nutrition weight loss program fail for so many clients. Including, I’m sure, some of mine.  As a functional medicine practitioner I find myself often getting caught up in intellectual left brain discussions and even arguments about which diet plans are most effective for promoting weight loss and also for health, but seldom do I spend a lot of time thinking about the various emotional reasons why people eat. Tricia Nelson lost 50 pounds by identifying and healing the underlying causes of her emotional eating. Tricia’s an emotional eating expert and author of the number one best selling book Heal Your Hunger: Seven Simple Steps to End Emotional Eating Now. She’s also the host of the popular podcast, The Heal Your Hunger Show. Tricia, thank you so much for joining me today.

Tricia Nelson:                    It’s so awesome to be here. Thank you, Ben, for having me.

Dr. Weitz:                         Great, great. So can you tell us a little bit about your own personal journey with emotional eating?

Tricia Nelson:                    You bet. Yeah, all my work comes really from my experience having first been an emotional eater and then I spent 30 years helping other emotional eaters. It started out I think as far back as I can remember. I was obsessed with food and loved to eat, so food was like a big deal to me. It’s important to everybody, but to me it was super important. So I love to cook, I love to eat, I love to serve food to others. It was all I thought about. Unfortunately, I was one of those people that gain weight really easily so I would have this roll on my tummy that I’d scrunch up in my hands and have these terrible thoughts like cutting it off like you’d cut the fat off a side of a steak. I’m like, “I wonder if I could do this, it’s just fat, right?” Thank God I didn’t try that. I thought about getting a disease, like some crazy disease where I’d automatically lose weight and I wouldn’t have to try.

Dr. Weitz:                          Start eating parasites.

Tricia Nelson:                    Oh, God, no. And then I even thought about joining the Army where I’d be forced to go through bootcamp because I hated to exercise. So I was out there, I was thinking some pretty crazy thoughts just because I was that out of control with food. I couldn’t control my weight and really the amounts that I ate, so I was frustrated. And I tried a lot of different things. I tried pills, and potions, and lotions, and of course weight loss programs and exercise programs, and 12 step programs. I even went to an eating disorders therapist. I put in a really good college try in doing something about my weight and my eating and nothing I tried worked for any length of time.

I would always … I knew to lose weight, I would lose weight, but I’d always gain the weight back. I had like four different sized pants in my closet because I never knew what size I was gonna be. It was really a painful and very private struggle for me. It was obvious that I was overweight, but people didn’t know … I carried it well and I was happy generally on the outside, so people didn’t know what an internal struggle it was for me. And it is very … For most people it’s a very isolating thing, so I didn’t know what to do about it and what happened was I found someone who could really help me. What I began to learn is that my problem had nothing to do with food and everything to do with emotional eating. Really those underlying causes is what was driving me to crave the ooey gooey chewy foods and to crave unhealthy amounts.

When I started really going to the heart of the matter that’s when I began to lose weight and keep it off. It’s really about … And my business is called Heal Your Hunger because it’s really that deeper hunger that people … If they’re emotional eaters they really need to heal. As I said, for 30 years now I’ve been blessed to be able to share my system for overcoming emotional eating with people around the globe.

Dr. Weitz:                          How does someone know if they’re an emotional eater? And as a doctor, how do you determine that someone is an emotional eater?

Tricia Nelson:                    That’s a great question. I think as a doctor it’s really important to listen for people who are complaining about being out of control around certain foods, they can’t stop eating certain foods. I actually have a quiz that I give to doctors if they use my program in their practice, which gives their patients emotional support to go through my program, which helps them follow through with the doctor’s protocols. I have a quiz, and I also have it on my website, and it’s are you an emotional eater or a food addict. Basically my feeling is most … I think as a population or as a species we are emotional eaters. We have an emotional attachment to food, which makes us want to eat. It feels good, it’s comforting, it’s a nice experience.

But the people who are actually emotional eaters in a more dangerous level, they are people who are using food for emotional reasons to really avoid feelings. They’re using food so they can escape themselves and escape experiences they don’t want to feel. So that’s when it becomes a habit and really gets out of control. So I always say it’s a spectrum. Everybody’s an emotional eater. On the lower end is emotional eating, and then it basically depends on the consequences. Whether somebody can’t stop it, they feel out of control regularly, they’re chronically overweight no matter what they do. And then on the high end of the spectrum is really food addiction, and I was a food addict for sure where I would literally binge and I could pack away 4000 calories in a sitting. I’d get a bunch of carbs, and ice cream, and brownies, candy, whatever and sit in front of my favorite TV show and just go to town. That’s serious addictive habit where then I don’t want to go out and be with friends, I don’t want to be seen at the beach, forget about it.

So it really starts to effect your life and your choices. People can lose their jobs because of their weight. Either they’re being discriminated against because of their weight or they’re not showing up for their job. They’re hungover. Literally, you can have a sugar hangover, a binge hangover. You don’t want to go to your job, you’re depressed. So many … I feel like so many people who complain of depression are emotional eaters and they’re just … They’re in that terrible cycle of overeating where they hate themselves. They hate themselves and they hate their lives because of what they’re doing with food. It’s so shameful and so dark. It can get really dark, just like an alcoholic with alcohol. So that’s really where it’s in the addiction category or placed on the spectrum.

So my quiz, to answer your question, that’s a great place to start in finding out where are you on the spectrum? And where you are is gonna determine what actions you need to take.

Dr. Weitz:                          So that quiz will tell you whether you’re an emotional eater or a food addict?

Tricia Nelson:                    Absolutely, yeah.

Dr. Weitz:                          Okay, great. And can you send me that link?

Tricia Nelson:                    Yes, I’d be happy to.

Dr. Weitz:                          Okay. So what does it mean physiologically if somebody’s addicted to food? What exactly is happening inside their … Is it in their nervous system, or in their …

Tricia Nelson:                    Yeah, my experience is most people who are emotional eaters are having a physical reaction usually to sugar. So most emotional eaters, not all emotional eaters. There are some that binge on protein, on big slices of meat, but most emotional eaters in my experience definitely have a carb addiction. A carb and sugar addiction, which is essentially a sugar addiction, right?

Dr. Weitz:                         Yeah.

Tricia Nelson:                   And they just can’t leave it alone. They swear off of sugar, and then they … All it takes is one bite to set off that cycle of craving. And it is a physical thing, and I’ve been through it where if I eat sugar, if there’s even sugar in a salad dressing or something it makes me more prone to want more or crave more because it’s definitely a physical reaction. If people are more sensitive to sugar than the average person, and I know for myself I’m very sensitive to alcohol as well. I cannot drink alcohol without over drinking alcohol. I feel like it’s the same … It’s really the same reason I can’t eat sugar is because alcohol is the most refined form of sugar anyway. So it’s definitely a physical thing where it sets up a craving that makes it incredibly hard for somebody to control how much they eat.  So it’s physical, and emotional, and mental, and spiritual all in one. But definitely the physical aspect is something to definitely pay attention to because I find that if I eat more of a paleo type diet and not eating-

Dr. Weitz:                          Lower carb approach?

Tricia Nelson:                    Yes.

Dr. Weitz:                          Yeah.

Tricia Nelson:                    Lower carbs is gonna make it so much easier to stay on a healthy plan because I’m not teasing my body with carbs and sugars that make it harder to say no.

Dr. Weitz:                          Interesting. I was reading one of your blog posts where you talk about some of the neurotransmitters like dopamine, and serotonin, and glutamate. Can you explain how these effect emotional eating?

Tricia Nelson:                    Probably not as well as you could. But definitely people who are emotional eaters typically do have neurotransmitters that are off. They’re depleted and they are seeking, that’s where that carb craving will come in, needing the serotonin effect. Plus, I find that emotional eaters are very prone to anxiety and so we tend to be worriers and over thinkers, and that’s where that carb element can help as well is it calms us down, it gives us that sedative effect that we really need. There are better ways to get it, like through meditation, and prayer, and walking and things. But that quick fix of that carb craving often is on account of some depletion in neurotransmitters.

Dr. Weitz:                          Do you ever test or try to evaluate neurotransmitters to see if that’s part of the mix?

Tricia Nelson:                    I definitely recommend it to people, but that’s not my forte.

Dr. Weitz:                          Right, okay.

Tricia Nelson:                    So I’m not a doctor, I’m really an emotional eating expert, and I know that can be part of it. I think it’s really important for people to get their hormones checked, their neurotransmitters checked, because that can definitely support somebody in healing. But my experience is if somebody’s chronically overweight or chronically struggles with their weight that’s not gonna fix them. Getting that stuff in line is not the full picture. If they do that and they get the support for emotional eating then you’ve got a much more complete healing package.

Dr. Weitz:                          Right. Can you explain how some foods excite the opiate receptors in our brains in the same ways that pain medications do?

Tricia Nelson:                    Well, I just know from experience, like I was talking about with sugar, definitely it effects the reward center in our brain where literally it’s been proven that sugar is as addictive as heroin. For the very same reason where you feed that reward center, it gets all lit up, and then you need to keep doing it to the get that same level of happiness or sense of fulfillment and excitement. And just like heroin or another drug in the effect on your brain you need more of it in order to get that same hit, that same effect, which is why it’s a progressive condition just like it is with alcohol, just like it is with drugs. Where you need more of that sugar, you need more of that carb effect in order to achieve the same thing. And you can get withdrawal symptoms just like you would a drug as well. You take it away from the mouse … They’ve proven, you take sugar from mice and their teeth chatter, their hearts are racing. They’ve got the same withdrawal effect that drugs have on the body as well.  So I’ve experienced all of that. Not my teeth chattering, but I’m just saying that sense of withdrawal. Definitely headaches, lethargy, things where if I’m detoxing off of sugar it’s not pretty for a few days. There’s four days of hell of detoxing off of sugar because I was addicted, no question about it.

Dr. Weitz:                          How do you detox off of sugar?

Tricia Nelson:                    Well, my experience is abstinence. The only way to do it, you don’t want to really titrate it, you just stop eating it. But know that … Maybe some people go through more serious withdrawal symptoms. For me it’s always been a headache and needing to drink lots of water, so that’s what I recommend to people. But definitely supplementation as well is super, super helpful. It’s the hard way. That’s the best way is doing it the hard way and just quitting cold turkey. But I really teach people about looking at their labels, checking their labels and making sure they’re not getting sugar that they don’t even really … When people are trying to be good and there’s sugar or corn syrup in their salad dressing or their spaghetti sauce it’s so depressing because here they are with all full intention wanting to be sugar free but there’s so much sugar and so many hidden sugars in the foods that we eat that they’re shooting themselves in the foot and they don’t even know it. It’s like, jeez, you know? Here I am trying to be good and I’m still getting screwed by even-

Dr. Weitz:                          It’s so hard to find foods without sugar like you’re talking about. Salad dressings and sauces. I was just looking for some … My wife wanted some hemp protein powder and almost every product on the market had some sort of sugar, even if it was just a little bit of stevia. She said, “Just get me hemp protein powder.” It was hard to find one that didn’t have any sweetener.

Tricia Nelson:                    It is so true. I do love stevia. I always say stevia at least is not triggering physically, generally speaking. But it isn’t easy to find anything that’s unsweetened. But for an emotional eater who loves sweet, and I am one, I always say stevia is God’s gift to emotional eaters because at least there’s something that doesn’t have an adverse side effect but you still get the sweet taste.

Dr. Weitz:                          Right, yeah. Yeah, no, I don’t really have a problem with moderate amount of stevia. It seems to work fine for me and most of my clients. So how do you differentiate between emotional and physical hunger? When does it become emotional? How do you know?

Tricia Nelson:                    Well, I think it’s really important that … First of all, emotional eaters are typically medicating themselves. I’ll go into that a little bit and then I’ll answer your question more directly. There are three primary reasons why people really eat, or over eat, or the three primary emotions that they eat over. One, I call it the PEP test. So the P stands for painkiller, so they’re eating over pain, and that’s emotional pain. It doesn’t have to be pain like, “Ah, I’m dying.” But uncomfortable feelings, like you’re in a job that’s not really the right fit for you so you’re kind of miserable every day that you go to work. Or you’re in a relationship that’s really trying, like really hard and stressful. So that creates an emotional pain, and that’s what people medicate over. They’re just not happy, they’re not fulfilled, and they’re very uncomfortable over some situation. Perhaps they have a death in the family or something, so there’s some emotional pain that people are anesthetizing with food.

The E is the PEP test stands for escape. So sometimes emotional eaters, it’s like … Emotional eaters are typically super responsible, so if you’re an alcoholic … Wherever there’s an alcoholic there’s usually an emotional eater. So you have an alcoholic who’s totally irresponsible and blowing off appointments, just messing up the family structure, or rhythm, or whatever. But then you have the emotional eater who’s always there picking up the pieces, super responsible, always on time to work. That’s how emotional eaters typically are, but it gets tiring because we’re always do gooders. We’re always doing the right thing and we get so tired. Eating is like our escape. It’s like I want to shut the world out, I need me time, right? So we got our TV, we get our favorite goodies, and we want to the world to go away. Often times that’s on account of fear too. Emotional eaters have a lot of fear, so a lot of times we’re eating to escape fear as well. It’s like life is overwhelming to us.

The last letter P in the PEP test stands for punishment. Emotional eaters typically are very guilt prone. Because we’re emotional eaters we’re very emotional, so we typically feel things at a deeper level than your average person, so we typically feel guilty over things. We’re constantly beating the crap out of ourselves for things we’ve said, things we’ve done, things we haven’t done. Often times food is a way for us to punish ourselves. It’s like we want to escape just the self flagellation that goes on in our head, but we also want to punish ourselves as well. So these are the three primary drivers is I would say pain, fear, and guilt.

So back to your question about how do you know if you’re emotionally hungry or physically hungry? People are typically grazing. Emotional eaters are good grazers where we’re eating throughout the day because wherever there’s food it’s like we’re totally drawn to it. So if we’re at work, work places are the unhealthiest places for emotional eaters because everybody’s bringing in their leftover from the party to the kitchen, right? That’s all in the kitchen. Or there’s candy jars throughout the office. All day long we’re grazing, we’re eating, our hands are in the candy jar all the time. So we’re eating all the time, and what I say is one of the best ways to know whether you’re physically hungry or emotionally hungry is to not graze but eat three meals with nothing in between. I call it three meal magic.

What’s important about this is it’s not as a diet, it’s not a food plan. I tell my clients this, I’m like, “Do it as a way for you to get in touch with your emotions, because if you’re grazing all day, anesthetizing that pain, fear, and guilt, you don’t know what you’re feeling and you don’t know whether it’s physical or emotional. I will say, emotional hunger feels a lot like physical hunger. It’s incredible to me sometimes. But because I eat three meals and I don’t eat in between what it looks like then is that around 10 o’clock in the morning if I’m sitting there having this conversation with myself saying, “I’m so hungry.” All of a sudden I’m like, “I got to go to the refrigerator, there’s got to be something in there for me.” I have this conversation with myself and say, “Gee, Tricia, it’s 10:00 in the morning. You had breakfast a few hours ago, maybe three hours ago. You’re probably not starving like you’re telling yourself you are, in which case let’s do a little sleuthing and see what pain, fear, and guilt is coming up for you. Where are you feeling uncomfortable? What are you trying to anesthetize?”

But, see, if I didn’t have that space between my meals I wouldn’t be able to do that sleuthing work. I wouldn’t be able to know what emotions I was feeling. I would just totally convince myself I’m physically hungry, and that’s why it’s so important to put space between the meals. Not only because it’s good for your digestion, but it really does inform you about what’s going on emotionally. So I know that was a long answer, but it’s just really important that emotional eaters do put some boundaries around their meals so they can start getting in touch with themselves and their true emotions.

Dr. Weitz:                          Well, if eating three meals without snacks is good for emotional eaters would eating two meals be even better? Because now intermittent fasting is so popular and now a lot of people are skipping breakfast, and that seems to be the key to longevity.

Tricia Nelson:                    Yeah, but I say no to that if you’re an emotional eater. So the science says, “Great.” But you can still get that intermittent effect with three meals with nothing in between. I eat dinner around 5:00, 5:30 and I’m not eating breakfast till 6:30 or 7:00. There you’ve got 13 plus hours. I’ve gotten some good intermittent fasting in there.  But two meals is really a set up for an emotional eater because you got to understand, emotional eaters are great at skipping meals. We take the cake on this, pardon the pun. But emotional eaters are always trying to skip meals to try to hack their weight loss, hack the system. It’s totally a set up, and that’s why emotional eaters who skip meals are typically larger in weight than people who don’t skip meals. It’s counter intuitive. You think, “Oh, I’m gonna skip breakfast.” I’m telling you, I’ve been doing this for 30 years and I still have that little bugger in my head that’s like, “Oh, maybe I’ll lose some weight if I skip this meal.” But my body is not gonna stand for it, and neither will my mental capacity. Because what happens is we get hungry and then we’re dysregulated because we’re over hungry and we end up overeating. You don’t beat the system that way. You actually beat the system when you have your three meals, when the meals are pretty much the same amount each meal. Then you can get an idea of what full means if you’re having the same amounts in each of your three meals. But I rarely see somebody win by just eating two or one meal. It’s just getting to over hungry is not good for an emotional eater.

Dr. Weitz:                          So how do you stop being an emotional eater? What are some concrete tools that can help?

Tricia Nelson:                    I think it’s really important, first of all, to get support. I don’t find that anybody can really successfully do this alone. This is why I do what I do with Heal Your Hunger is I give people a lot of community. In my program, I have a program called 10 Weeks to Freedom From Emotional Eating, and it’s modules that people learn about emotional eating. They learn about the emotions underneath, but there’s also a big element of community where we have live calls weekly together. People all around the world who have the same problem. There’s such healing in being with other emotional eaters. This is such, as I said before, such an isolating condition. We think we’re the only ones.

Ben, in the worst, in my worst state I would literally take food that I’d thrown out and eat it. There’s some bummer things that we do that are so shameful. Let me explain that a little bit more for those who are listening that might identify. What would happen is I’d be binging, be eating all this food, and then I’d get stuffed. I’m not a puker, so I never was bulimic. I tried, trust me, but I didn’t. I just packed it on and got fat. So after a binge I can’t eat all the foods that I bought, and I’m feeling totally disgusted with myself eating to that terrible place of being completely stuffed. Then I would say to myself, “I’m never eating that again. That is disgusting. I’m never having whatever X was.” I throw X out, convinced I will never eat it again, but that’s on a full stomach, right? So little while later and I get a little bit of hunger going on I’m like, “Let me reconsider that decision.” And I go retrieve what I threw out.

That, I did that so many times. I even did a video, I reenacted that whole thing on YouTube like 10 years ago and I got over … I think at this point it’s 30 or 40 thousand hits of people, and people commenting, “Oh my God, I’ve done that too.” So, so many people are living in this shame and guilt of their food habits, which are really bizarre and shameful, but you think you’re the only one. You beat the crap out of yourself and feel so bad, it affects your self esteem, it affects everything in your life. It affects your relationships, your sex life, your work life. If you think about it, it reverberates throughout every part of your life. So when you get to be on a call with people who have done the same things where we can almost laugh about it, it’s kind of funny if it weren’t so sad, you know? And it’s like it heals something inside of somebody to realize they’re not alone.

So that community is so, so important and that’s a big part of my program. The bottom line is don’t try to do it alone. You won’t be able to. You’ve got to have that community effect, but you also have to know what your real problem is. The problem with people struggling with food and weight is they’re always doing the dieting thing. It’s proven that 98% of all diets fail. 98% of all diets fail. That’s an astounding number. If you consider-

Dr. Weitz:                          And you mean especially long term, ’cause people lose weight but then they gain it back.

Tricia Nelson:                    Right, so did it work? You know.

Dr. Weitz:                          Right.

Tricia Nelson:                    And that’s the point is people always gain the weight back. If they don’t address the underlying emotions, the underlying causes. If they don’t start changing the way they interact with the world, in my book and in my program I talk about something called the anatomy of the emotional eater. These are personality traits that the emotional eater has. We have this composite of personality traits that really is the crux of the problem. It has nothing to do with food. That’s why treating it at the food level is so silly because that in and of itself is not a complete picture. That’s not gonna do it. But if somebody starts addressing these emotional qualities, qualities like people pleasing. Emotional eaters are consummate people pleasers. We get our self esteem from outside of us and from the kudos we get when we do extra at our job, or taking on an extra load.

Well, guess what? When we’re taking on an extra load of work so that people will be pleased with us we end up overworked, over tired, and then what’s gonna happen? We’re gonna end up overeating. So that’s a typical example of how we’re showing up in the world and how that’s directly effecting our eating, but it has nothing to do with eating. There’s so many, I have actually 24 personality traits that make up the emotional eater. So that’s really what we focus on is treating ourselves at a deeper level, and also really implementing self care habits. Emotional eaters are the worst at taking care of their self care needs because we’re always doing, doing, doing, giving, giving, and neglecting ourselves. So a lot of the work I do is teaching people, primarily women, those are the people usually respond most to my methods. But teaching women to take care of themselves and put themselves first. People don’t get that message, so that’s so, so important. It directly affects how much they eat and their food choices.

Dr. Weitz:                          How much is this at the root about self esteem and how you feel about yourself?

Tricia Nelson:                    It’s huge. If we don’t take care of ourselves it’s really because we don’t value ourselves. It’s like … I say to clients all the time, “Would you treat your little sweet daughter the way you treat yourself?” And the answer is, “Hell no.” Would you have your kid skip two meals hoping she’d lose some weight, you know? No, but that’s what we do to ourselves. We beat ourselves up constantly. It’s so much about self esteem, it’s so much about those core issues, because if we’re not taking care of ourselves it’s because we don’t see the value in self care because we are in that process, that cycle of self denial. Putting other people first, thinking we don’t matter.

So the upshot of people who take my programs is they start to feel better, they find their voice. One whole part of my program is about speaking up with self confidence. Emotional eaters don’t speak up. They don’t say what’s on their mind. They’re passive aggressive, they’re hoping people will read their minds. Then they’re pissed off, and resentful. And resentment is a great way to justify a binge. Like, “Screw them, I’m gonna eat myself to death.” So it’s really important that people start having better communication, and speaking up, and putting boundaries on their time, and not letting everybody come visit them where they’re slaving away for weeks on end for their guests. So many examples of life really affecting our eating habits when it has nothing to do with food.

Dr. Weitz:                          And do you find a lot of the emotional eaters end up turning to things like plastic surgery as part of this self esteem issue instead of just really liking themselves or trying to change these things?

Tricia Nelson:                    It’s an obsession with the superficial and with a symptom. The symptom of overeating is overweight. I was 50 pounds overweight. I hated my body. And when you’re overweight you are desperate to do something. And you do, you throw money at it, you’re hoping some doctor has the magic pill, or some doctor can fix you from the outside. It’s obviously a farce, because it is an inside job. As trite as that is, it absolutely is an inside job. People get weight loss surgery, and how sad that makes-

Dr. Weitz:                         Yeah, they get liposuction when they need to lose weight, and it doesn’t make sense.

Tricia Nelson:                   Yeah, it doesn’t, because it’s not gonna do anything for your cravings. It’s not gonna do anything for that hole in your soul that you’re filling with food. So it’s so, so important to know that there’s no quick fixes and if you really do go to the heart of the matter, if you go inside and do this inner journey of healing emotional eating … If somebody stops emotional eating they’re gonna lose weight automatically. I don’t even focus on weight loss because I know if somebody starts to address what’s driving them to eat and they’re no longer overeating then they naturally lose weight and it’s not their focus. To me, that’s really the most holistic way obviously to heal this problem and it’s the long lasting way. You’ve got to have that self care, you have to have that community, and you have to do the inner work.

Dr. Weitz:                         What are some of the forms of self care that you’re thinking about?

Tricia Nelson:                   I have something called the six self care success secrets that are vital for emotional eaters and I teach them in my programs. Again, it’s hard to do this alone because even though you know these are … These things are not gonna be earth shattering, okay? They’re things everybody’s heard before, but when you’re in community with other people who are doing them it makes it so much easier because you’re getting reinforced.

The number one thing is meditation. The thing we all know we should do, right? Well, for emotional eaters it’s actually vital because we overeat because we’re stressed so much of the time, we’re natural born worried. Emotional eaters or over thinkers. Overeater or over thinkers. So meditation just takes it down several notches. I couldn’t … I wouldn’t be the size I am if I didn’t meditate twice a day, because i just helps calm me down. It basically does for me what I was looking for food to do for me. We reach for food not just because we love food but because it calms us down, it gives us that serotonin hit. It helps us even out emotionally. Well, guess what? Meditation can do that. Prayer can do that. Writing in a journal, getting your thoughts and feelings out, getting that anger out. So, so important. And speaking up for ourselves, so, so important. I always say, “Say it or stuff it.”

Other things like reading spiritual literature. Talking is an important one. We can’t stay bottled up with our emotions. We’ve got to talk and share. I also find walking to be super important. I do something called a walk-pray. It’s my own coined term, but every day I walk and I pray. I put my ear buds in my ears and I go for a walk so it looks like I’m talking to a friend, which I am, but not the friend everybody thinks I’m talking to. But basically the rhythm of walking and prayer helps calm me down. It brings me down several notches. It helps me not have to worry, and it gives me exercise at the same time. But not exercise where I’m beating my body up hoping to force it to lose weight, it’s really more meditational, just meditative and calming. So that’s an important tool as well.  So those are my six self care success secrets, and they make a huge difference for people who are nervous, and anxious, and reaching for food constantly to calm themselves down. They’re probably not even aware of it. They think they just like food like I did, but once somebody starts on this journey, they start to become aware of how emotional their food choices are.

Dr. Weitz:                         Great. Excellent, Tricia. For those listening or watching who’d like to get a hold of you what’s the best way for them to contact you?

Tricia Nelson:                    HealYourHunger.com. H-E-A-L, healyourhunger.com.

Dr. Weitz:                          That’s great.

Tricia Nelson:                    Yeah, and my quiz is on there so they can take that emotional eating quiz.

Dr. Weitz:                          Okay.

Tricia Nelson:                    Find out where they are on the spectrum.

Dr. Weitz:                          Great. I’ll throw that in the show notes on my website as well.

Tricia Nelson:                    Great. Thank you so much.

Dr. Weitz:                          Okay, yeah, enjoyed this talk. I’ll talk to you soon, Tricia. Thank you.

Tricia Nelson:                    Take good care.



Epigenetics and Skin with Dr. Anne Marie Fine: Rational Wellness Podcast 089

Dr. Anne Marie Fine discusses Epigenetics and Skin 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

7:09   Some of the most important factors that lead to aging of the skin include sun exposure, air pollution, inflammatory skin care products, our diet, our stress levels, toxins, and sleep. Personal care products that are inflammatory will ironically plump up your skin and make your wrinkles look better but on a long term basis they will prematurely age your skin.

10:25  Genetics probably dictates no more than 25% of your aging, which means that epigenetics and environment are much more important, which should be hopeful for people.  You can take the HomeDNA test to look at some of the gene SNPs that relate specifically to our skin.

13:10   Epigenetics is the software that instructs the body which genes will be expressed or not expressed.  It is the future of medicine.

14:57   Methylation is putting a methyl group on the DNA and it is one of the main roots of epigenetic marks. It is important to be properly methylated by taking methyl B vitamins but it is not good to be overmethylated, since that can turn off tumor suppressor genes and result in cancer.

17:41  Environmental toxins found in skin care and other personal care products can be endocrine disruptors and can disrupt our hormones, such as phthalates.  They can also adversely affect our blood sugar and lead to diabetes.

29:56  To find out if products are nontoxic, we can use The Environmental Working Group as a source.  We can also go to madesafe.org, which certifies products as safe. There is also a free app known as Think Dirty, which will allow you to scan the UPC codes and get a score as to how clean or toxic a product is.  Dr. Fine also has great resources on her website, Dr.AnneMarieFine.com and she offers an online class on this topic.

33:07  In order to get rid of toxins, the first step to stop using these toxic products. It can be helpful to test for toxins to see what toxins are being stored in your body. Dr. Fine will often do urinary testing for toxins and the Toxic Core test from Genova, which is very comprehensive.  We should also test for heavy metals.

36:05  To learn about what is the best type of diet for healthy skin, Dr. Fine’s book, Cracking the Beauty Code: How to Program your DHA for Health, Vitality, and Younger-looking Skin, is a great resource.  You want to follow a Mediterranean, anti-inflammatory diet, which includes olive oil, fruits and vegetables, legumes, some meat, and red wine.  Inflammation will increase matrix metalloproteinases, which are enzymes that cut up your collagen., and this will result in more wrinkles.  You want to consume foods with antioxidants and that push Nrf2, which turns on your own, endogenous antioxidant system.  You turn on your genes that make antioxidants. Green tea is the number one beverage for good skin and shown to help with inflammation, elasticity, microcirculation.  Fish oil also helps with the elasticity of the skin. Blueberries are anti-inflammatory and pomegranate is also helpful. Sulforaphane from broccoli and other cruciferous vegetables help with detoxifying. Dr. Fine recommends avoiding glycation, such as the browning of the skin of chicken or other meats when grilling or barbecuing.

40:05  Dr. Fine’s favorite nutritional supplements for skin include vitamin C, proline, astaxanthin, carotenoids, lycopene, and collagen products, some of which are better than others. 42:27  Sleep is also very important for skin health and one night of sleep interruption has been shown to epigenetically alter your skin health genes. During sleep your body rests and repairs the glymphatic system of the brain helps the brain to detoxify. Your skin also regenerates and heals overnight.



Dr. Anne Marie Fine is a Naturopathic Doctor who focuses on Environmental and Functional Medicine.  She is the Founder and CEO of IAmFine, a line of safe, non-toxic, vegan, and sustainable anti-aging skin care products.  She wrote the bestselling book, Cracking the Beauty Code: How to Program your DHA for Health, Vitality, and Younger-looking Skin. You can find more information about Dr. Fine through her website Dr.AnneMarieFine.com  and she is available for a free 30 minute consultation by calling 480-510-3448.

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. For those of you who enjoy the Rational Wellness Podcast, please go to iTunes and give us ratings and reviews so more people can find out about the Rational Wellness Podcast.  Our topic for today is Epigenetics and Skin Health with Dr. Anne Marie Fine.

Most of the time when the average person thinks about the health of our skin, we think about the exposure of our skin to sun and other environmental factors, and about various products that we apply to our skin. But our skin is clearly also a reflection of our overall health, including health of our digestive tract and our other organs, our metabolism. Our skin health is a reflection of everything we put in our bodies, how we treat our bodies, how we lead our lives. Our skin health is also a reflection of our epigenetics.

For those of you who are not familiar with that term, what that means is genetics, I think most of us understand, is the set of genes that we are born with. These definitely have some influence over what happens with us during our life. But what’s even more important are a set of switches that determines which of our genes get turned on or turned off, or another way to put it, which of our genes get expressed or which of our genes get suppressed, which we’ve referred to as the epigenome. Dr. Fine, who will be our guest today, describes this as the control panel to our genes. We are going to focus on how we can flip these switches to the correct position to have healthy, glowing skin well into our later years in this discussion.

Dr. Anne Marie Fine is a practicing naturopathic doctor. She focuses on environmental and functional medicine. She’s also an award-winning researcher, internationally recognized speaker, and a Founder and CEO of IAMFINE, a line of safe, non-toxic, vegan, and sustainable anti-aging skin care products. Dr. Fine also wrote the bestselling book Cracking the Beauty Code: How to Program Your DNA for Health, Vitality, and Younger-Looking Skin. Dr. Fine, thank you so much for joining me today.

Dr. Fine:    Well, thank you, Dr. Weitz, for the introduction. I’m really excited to be here on your podcast because I want to talk about epigenetics and beauty. You’ve already said it so beautifully. Your skin is basically just a reflection of your health on the inside. Even though the title of my book is epigenetics and beauty and really speaking more conceptually about epigenetics and our health, our aging process, our disease processes, which all show up on our skin.

I’m also going to talk about today some of the toxins found in personal care products and the latest advancements of how to address them in ourselves and our patient population, because I feel this is a missing link in how we evaluate and treat patients today. I’m also going to take the opportunity to talk about where I’m taking my practice in 2019, where, to my knowledge, very few practitioners have done yet. I’ve already started taking this to the next level in a personalized way to help patients get better faster. This is my main focus for 2019, engaging my patients in a whole new way, in an ongoing platform that’s palatable and cutting-edge.

Why am I doing this? How did I even get started? More than likely, many of you, and I can put myself in this category, too, is we really overlooked personal care products as a source of toxicants in our patient population. This is a mistake. There’s so much emphasis on the heavy metals and some of the more egregious of the toxins that are in our environment, but the whole topic of personal care products has not received the attention that it really deserves.  We have to think about the fact that ourselves and our patients, we basically are just slathering on these products, our shampoos, our conditioners, our body wash, and our face wash and our makeup and perfume and everything. I mean it’s ongoing. Washing our hands. What are we washing our hands with and brushing our teeth? There’s just so many opportunities for exposure during the day that I really wanted to bring more focus to this. Then I also wanted to talk about the epigenetic environment and how it impacts the skin.

At the end of the call, I want to offer a surprise for Dr. Weitz’s listeners. Then with all of that being said, I just want to start with a question. Are you sick of all the toxins out there? Have you had trouble breathing from the wildfires? Have you or your patients been impacted by autoimmune disease or other chronic diseases of aging? That’s where we’re going to go today. We’re going to talk about understanding the relationship between those questions and our health and our patients.

Dr. Weitz:  Yeah, absolutely. Lots of patients have been complaining for several months now about the aftermath of the fires and breathing all that crap in. Unfortunately, I guess that’s becoming a regular thing every year in California, with the wildfires.

Dr. Fine:    Do you know that in many parts of the global world, that wildfire emissions, PM 2.5 in wildfire emissions, now exceeds anthropomorphic emissions from car exhaust and coal-powered fire plants, coal-fired plants?

Dr. Weitz:  Is that right? Wow!

Dr. Fine:    Yeah.

Dr. Weitz:  Well, it’s equally probably related to what we’re doing, but a little more long term. But we certainly need to do something about it. Dr. Fine, what are some of the main factors that lead to the aging of our skin?

Dr. Fine:    Everyone always wants to talk about the sun, sun damage, as being the primary skin ager. It does have a pretty good effect on the skin, but it doesn’t end there. Sun exposure is considered an extrinsic cause of aging, but you know what else?  Studies are now showing that the particulate matter in air pollution is now being found to prematurely age the skin in terms of loss of elasticity and also in terms of age spots and wrinkling.  That’s what I just mentioned before. It’s like air pollution. Who would have thought?  But now studies are actually backing this up. They started the studies in places like China, which everyone’s like, “Well, they’re so polluted. Of course.”  But they’re now finding it in other places that are not so polluted.  We have the air pollution.

We also have, well, the personal care products that you use on your face. Some of them are … They’re inflammatory. They are so cheaply made that these products are inflammatory, which ironically will plump up your skin a little and make you look like your wrinkles maybe look better, but on a long-term basis, if you look in my book, I’ve got a chart on the molecular basis of skin aging, and inflammation is right at the top.  We have skincare products, we have the foods that we eat, what we drink. Our stress levels are very impactful on an epigenetic level. We see that in twin studies where the twins don’t age the same. You can look that up on the internet. There are some pictures that are really quite striking at the difference in these twins.  One twin had a lot more stress than the other, or smoked.  Of course, smoking is bad for your skin, too.  Stress levels, food, how you sleep.  Basically, it’s stress, toxins, and food are the three main epigenetic modifiers in your body.  It’s going to be the same for the skin.

Dr. Weitz:  What about smoking marijuana? That’s becoming a new health food. I just came back from the American Academy of Anti-Aging Medicine, and they were talking about CBD and marijuana. Isn’t marijuana smoke probably fairly bad for your skin, too?

Dr. Fine:    I actually don’t know, but that’s a good question, isn’t it?

Dr. Weitz:  Yeah.

Dr. Fine:    I really don’t know. Didn’t they talk about that at all?

Dr. Weitz:  No.

Dr. Fine:    No, they didn’t.

Dr. Weitz:  Everybody’s talking about all the benefits of it right now its enjoying it’s heyday.

Dr. Fine:    Right. Well, I’m sure part of it has to do with the fact that cigarette smoke has so many toxins in it that you’re creating a lot of oxidative stress and damage, and that’s creating DNA adducts and inflammation. I really can’t answer that question, but that’s-

Dr. Weitz:  What part does genetics play in as far as your skin health?  Maybe you can talk about genetics and epigenetics a little bit.

Dr. Fine:    Yeah. It’s so interesting that when I was doing the research for this book, I wanted to see globally how much of your skin aging is genetics and how much of it is something else, because I noticed that years ago, when I started speaking on aging, healthy aging, and people would say, “Well, the reason why you look so young is because of your genetics,” and I’m like, “Seriously? Do you know how well I take care of myself?” I started looking into it, and really it’s only about 25% of your aging can be dictated by your genes, which means the bulk of it is epigenetic, it’s your environment, which I think can be very hopeful for people.  The other thing I want to say is I have tested my skin genes because I wanted to see on me, am I a really good ager or am I really a bad ager? But I do so many other things. I’m really helping my-

Dr. Weitz:  So how do you test your skin genes?

Dr. Fine:    You know what? It was a special gene test just for skin. It’s called HomeDNA. They have one for skin. I tested it, and you know what I discovered?

Dr. Weitz:  What?

Dr. Fine:    They don’t do that many … Okay, they don’t. I’m sure there’s more skin genes, but what they did, like half of mine were pretty good, like green light, yes. Then half of it were pretty bad, red light. That’s all the Irish skin. It’s like I burn easily and the sun damaging aspect of my genes are very bad because I’m so light and Irish. I feel like, maybe in totality, I’m average in terms of skin aging on the genes. But I thought that was interesting to just see what came up for that.

Dr. Weitz:  They picked out particular genes that seemed to relate to skin, or SNPs?

Dr. Fine:    Yeah. I don’t have that report in front of me, but it’s HomeDNA. They have different panels. You can do it yourself. It’s very easily available over the internet. You can see what your skin looks like.

Dr. Weitz:  Cool, yeah. I mentioned a little bit about epigenetics, but maybe you can talk a little bit more about exactly what epigenetics is and maybe give some examples of some epigenetic effect.

Dr. Fine:    Yeah, I’ll do that. Epigenetics means above your genes. It’s like the genes are the hardware and your environment is the software telling the hardware what to do. Your hardware doesn’t really do anything by itself. You’ve got to have software to tell it what to do. Your environment in which you are bathed 24/7 basically is providing information continuously to your hardwired DNA on what to express and what not to express. We are very much in tune with our environment and we can change it moment-to-moment, day-to-day, hour-to-hour based on what we’re doing.

It’s so different than last century’s dogma of your genes are your destiny. This gives us power to change our genetic destiny and to be healthier, but you have to know what to do. You have to know which foods turn on your healthy genes and which foods are turning on inflammation, which foods turn them off. You do have to know how it all works. Epigenetics is very, very exciting. I think this is where the future of medicine is going to be, in epigenetics.

Dr. Weitz:  You mentioned in your book a little bit about methylation. Can you explain that and how that can relate to this topic?

Dr. Fine:    Well, so methylation is one of the main roots of epigenetic marks. Histone modification is another one and the microRNA would be another one. Methylation is just putting a methyl group on the DNA. Methylation, it’s tricky because if you have too much methylation on a particular gene area, you may turn that particular gene expression off. Overmethylation can produce cancer by turning off tumor suppressor genes. Too much methylation is not good, but too little methylation is not good as well.  You can see that in my book. I talk about the rats, with the fat rats with the yellow coats, and their brothers had the same DNA but they were sleek and lean and they had brown coats. It was the same strain and the same genetic makeup. In the lean brown rats, the mothers, while they were pregnant, were fed methyl donors. They came out healthy-

Dr. Weitz:  Randy Girdle and the agouti mouse model.

Dr. Fine:    Yes, the agouti genes and then the other ones turned out to be overweight and prone to chronic diseases. That chat, in a nutshell, gives you an idea of how important the maternal-fetal environment is for the fetus.

Dr. Weitz:  In order to stimulate methylation, we have to take, say, B vitamins in a methyl form, like 5-hydrotetramethylfolate and methylcobalamin for B12, et cetera, right?

Dr. Fine:    Right, exactly. That brings up the whole concept of prenatal vitamins and do they have the right forms, the active forms, of the B vitamins that can methylate properly. But MTHFR gene defect, you may not be able to utilize the B vitamins as well, so that’s a consideration, too.

Dr. Weitz:  Right. Let’s talk about toxins. What kind of toxins are in the environment and what we can do about some of these toxins?

Dr. Fine:    Okay. We’re not going to talk about heavy metals. We’re going to talk more about the ones I talked about, which a lot of them are endocrine disruptors. The endocrine disruptors are something that are going to disrupt the hormone system. They may do so in many different ways. One of the ways that … This is fascinating to me because type 2 diabetes is like the Black Plague of the 21st Century. Yet when we ask our patients are they eating Snickers bars for breakfast with Krispy Kreme donuts, they’re not. They’re not dumping sugar in their system.  Typically their diets could use improvement, but what’s not known is there are environmental chemicals that are pushing the diabetes pathway. That would be fantastic for us to know and to recognize and to test for in our patients, because I don’t know about you, but have you noticed your patients’ blood sugars are rising over the years?

Dr. Fine:    I’ve noticed it.

Dr. Weitz:  Blood sugar levels are rising, hormones are getting lower, and cortisol-

Dr. Fine:    Testosterone is in the toilet.

Dr. Weitz:  Yeah.

Dr. Fine:    I just wrote an article for Thrive Global on The Handmaid’s Tale Becomes A Reality. Are you familiar with that show, that TV show?

Dr. Weitz:  Wasn’t that one of the Chaucer’s tales? Handmaid’s-

Dr. Fine:    No.

Dr. Weitz:  No.

Dr. Fine:    It was a Margaret Atwood book that came out in the ’80s.

Dr. Weitz:  No, I’m not familiar with it. 

Dr. Fine:    The premise is that the environment, the world got so polluted that the men became infertile. Then they took a special group of young, fertile women to be the breeders for this whole new society. Then they made a TV show out of it, which is very interesting. Decades later, they made a TV show out of it. It’s kind of scary. I think it’s an Emmy Award-winning show.

Dr. Weitz:  Oh, really?

Dr. Fine:    But people are acting like it’s entertainment. The reason I wrote my article is that it’s true. It’s already starting to happen. I wrote this article called The Handmaid’s Tale Becomes A Reality. It was published on Thrive Global, which is Arianna Huffington’s new platform. It talks about the toxins in the environment contributing to infertility and really tanking testosterone, sperm counts, sperm motility. I mean the sperm, they swim like crazy, drunken sailors. I mean they can’t really even deliver the goods anymore. I talk about this, and one of the main instigators of the effect on male hormones is this class called phthalates. You’ve heard of phthalates?

Dr. Weitz:  Oh, absolutely. Yeah. They’re used as fragrances in personal care products as well as in plastics. They’re really common.

Dr. Fine:    The phthalates

Dr. Weitz:  Estrogenic ingredients, of course.

Dr. Fine:    It’s like they’re in everybody and they’re really hard to get away from, but what they’re finding in the male babies is that they’re being born … They can correlate this to the higher tertials of phthalates in the moms, correlate to smaller penises and testicular dysfunction and a shorter anogenital distance, which that distance, that is your marker for virility. As that becomes smaller, that is, these babies are being born more feminized.  That’s a big one. They’re finding that in adult males that the phthalates are being linked to lower testosterone and all the sperm things I talked about before. The average man today has about half the testosterone that his father had.  You can basically look at any adult man today and say, “Yeah, you’re like half the man your dad was.” Right?

Dr. Weitz:  Yeah, I know. There have been documentaries. I think one of them was called The Shrinking Male. There’s no doubt. We measure hormones on a lot of the men, and especially free testosterone, almost every man is low.

Dr. Fine:    Yeah. It’s true.

Dr. Weitz:  Some of these endocrine substances are estrogenic, so they’re really inhibitory for testosterone.

Dr. Fine:    Yeah. Pthalates are a big one. Then you’ve got … This is crazy, but these products being marketed to these teenage boys by Axe … You know that company?

Dr. Weitz:  Oh, yeah. Yeah, it’s horrible. All those products.

Dr. Fine:    They have extra fragrance in them. Their whole marketing platform is you’re going to be so sexy that you’re going to get not just one girl, you’re going to get two girls. [inaudible 00:23:18] taking their testosterone. They may get a girl, but they’re not going to know what to do with them, right?

Dr. Weitz:  Yeah, I know. I’ve seen the commercials with the guy and all the women on the beach, and they’re all chasing them.

Dr. Fine:    Yeah. That’s crazy. It’s interesting, I was in Europe over 10 years ago attending a show, a business platform for personal care product development. This is kind of like my entree into this becoming an expert in this area. I started with my global travels to get the information.  Anyway, it was a market research talk and it was my first market research talk on personal care ingredients. I was skeptical that anybody could have advanced information on how this was really going to go and I really wasn’t sure I wanted to spend my time in this lecture, but I was totally closed off, “Oh, what are you going to tell me here?”  The first thing they’ve said was … And they were really excited, “We’ve got some good information.” They were like, “In the United States, the young male grooming category is going to explode with these Axe products.” I was like, “Oh, should I leave now? Because no self-respecting mother is going to let her teenage boy talk her into buying these terrible fragrance products.” I’m just thinking to myself, “That can’t be right. This is a stupid lecture.”  At the time, I had a teenage boy. I went home and two weeks later, he walks in with this bag from the grocery store and I’m like, “What did you get?” Axe products. I’m like, “I buy your stuff for your shower. What are you doing?” I do not approve of those products. I’m like, in two weeks, their marketing research was spot on. Oh, yeah. It’s like you can smell those boys … They’re 10 rooms away and you can smell them.

Dr. Weitz:  Now one of the things I’ve noticed, because I only use natural products for myself and my wife, and I recommend for my kids as well, but my kids are kind of on their own now, but I do think they tend to use what I recommend. But you use these natural products and they don’t have, say, sodium lauryl sulfate, but they have some other ingredient that sounds sort of like it, like calcium laureth something else. You wonder is this just another version of this toxic product that’s not on the list yet, but probably will be in a few years? Like we’ll take the BPA out and we’re going to put BPS in, which is probably just as bad, it’s not just not on the list yet. Right?

Dr. Fine:    Yeah, worse. Yeah, this is called greenwashing. Well, actually, this is called the case of regrettable substitutions, where they say, “Oh, my gosh. This thing, BPS is bad and worse. The consumers know it’s bad. We can’t sell this anymore.” Then they put in BPS and then BPF and then BPAO. It’s like it’s all from the bisphenol family. I mean you would think that chemists that are involved in this would say, “Well, maybe it’s the chemical family that … ”  What they’re finding is that those new BPA substitutes are as bad, just as bad, or even worse in terms of effects than just the BPA, but the consumer hasn’t made that leap, and now they’re like, “Oh, BPA’s back.” Then they see a product, BPA-free, and they’re like, “That’s it. That’s the product I’m going to get,” and you don’t want it. You really don’t want it.  That’s why I’m changing the way I practice is because people think they get it. They get it a little bit, they’re starting to get concerned, but they still don’t have the right idea on what actually is good. The greenwashing, your question about the ingredients sounding the same but being a little bit different, is that I … And I also consult with companies who manufacture personal care products and I also lecture to companies in the personal care industry, like CEOs of these companies, and they don’t even know a lot of times what’s truly non-toxic.

There’s a lot of education that has to happen in this arena. They’re slipping in other things that maybe it’s not really any better, and sometimes it’s better. Or this drives me crazy, too. They’re like, “Oh, here’s our blockbuster product for 80 years,” like Johnson & Johnson’s baby shampoo. They finally took out the formaldehyde-releasing preservative system, which nobody even knows that it had it in there.  But I know.  It’s interesting. When I had babies, I put it on them, and they screamed and shrieked. There were lots of tears. I’m just like, “This is not truth in advertising. My babies are crying.” I went to the health food store and I got something else. But recently, like two or three years ago, they reformulated it. Wasn’t that nice? They took out the preservative-releasing system that dumped formaldehyde into your product.  Of course, they knew at the time they did it that you can’t just put formaldehyde in a product.  Everybody knows formaldehyde is a good preservative, because we had to work on cadavers, and they were all preserved with formalin, which is formaldehyde. We know it worked. But they were savvy enough to know you couldn’t put formaldehyde on the label, so they put in formaldehyde-releasing preservative systems that had different names altogether.  But if you knew … Like this is what I teach people to recognize. These chemical systems, they get into the product and then the product sits in the warehouse for who knows how long. Then it’s on the truck and it’s on a boat and then it’s at another warehouse. Then it’s on the shelf. Then you buy it two for one. Then you bring it home. I mean years later, the whole time it’s releasing formaldehyde slowly because that product is old. You took it out of the Johnson and Johnson’s baby shampoo, but it’s like it’s still not a great-

Dr. Weitz:  So how do we know how to get healthy products? Is the Environmental Working Group a good resource to look up products?

Dr. Fine:    Yeah, they have a really big database on ingredients, so that’s a good resource. There’s also madesafe.org is another certifying organization that will actually certify something made safe. I’m actually on the scientific advisory board for them, so I know what their criteria are.  It’s very solid.  There’s an app called Think Dirty. It’s a provocative name, but it’s free. Do you know about this one?  You put it on your phone-

Dr. Weitz:  No, no.

Dr. Fine:    Okay, I’ll tell you. It’s a free app on your phone.

Dr. Weitz:  What’s it called again?

Dr. Fine:    Think Dirty.

Dr. Weitz:  Okay.

Dr. Fine:    Then I hope that’s right. But, anyway, you put it on your phone, it’s free. When I first got it on my phone, I went into the department store-

Dr. Weitz:  You go to download it, you find out it’s some porn site or something.

Dr. Fine:    I know. I hope it’s not. I know. But, anyway, you put it on. I went into a department store and I went to the cosmetic counters, which are all toxic, and I started … You scan the UPC codes with this cool thing. It does its thing and then it comes up with a score. It explains which ingredients are causing the bad score. It’s pretty easy.  The problem is it’s fairly new, and so it doesn’t have every single product in there. It has some of the more obvious ones in there, but you take it into a health food store or something and with smaller companies, smaller brands, and it’s like, “We don’t have this product.” But if you take it into a grocery store or you take it into Nordstrom’s and you’re at the counter, yeah, you get really terrible scores on all that stuff, including the ones that claim that they’re not allergenic or clean. That one’s fun. Then I have some resources on my website. I have a class. I have a digital class, online class, that I teach-

Dr. Weitz:  Hang on. Hang on just one second. I’m sorry. We’ll clip and paste this. One of the other doctors was having a loud conversation in the room right next door.

Dr. Fine:    Oh, wow! Are they even good?

Dr. Weitz:  Okay. I’m sorry. We have all these toxins. How do we get rid of these toxins from our body? How can we detox them?

Dr. Fine:    Yeah. Well, that’s part of what I work with on my patients. But I will say the first rule of environmental medicine is avoidance. The first thing is recognizing that you have a bad product if you need to get rid of it. Then you just have to know what are the ingredients in there. Is it a persistent toxin? Usually not.  Usually things like phthalates, they’ve done studies and they’ve taken away the bad products in, say, teenage girls. Within three to five days, their levels start to drop pretty dramatically. Same thing with parabens. But it’s interesting how they never go to zero because they’re not getting them all. That’s the thing that I take away from that. I would say you just have to do a beauty detox. Read my book, look on my website for the resources I have on these bad products. But it does take some-

Dr. Weitz:  Let’s say we eliminate these products. How do we get the toxins out of our body? Do you recommend some sort of liver detoxification program?

Dr. Fine:    Well, because my focus is on environmental medicine, what I do is I really evaluate patients in the office with a very detailed environmental health history. Then I look at their symptoms and then I test them for certain toxins, so I’ve really got a good picture.

Dr. Weitz:  Cool.

Dr. Fine:    Because, for example, I worked with a patient who was a natural aesthetician. She told me she didn’t use phthalates or parabens anymore, and I could have said, “Okay, cool. That’s not your problem,” but instead I tested her for phthalates and parabens. What did I find? Phthalates and parabens, because it’s not as easy as you think to get them all out of your life. I do tests, I’m a big believer in testing, and then I design for-

Dr. Weitz:  What kind of testing do you do? The urinary testing?

Dr. Fine:    I like that. There’s also the Toxic CORE test from Genova, which is very comprehensive. There’s other ones that are not quite as comprehensive.

Dr. Weitz:  Okay, cool.

Dr. Fine:    That’s an addition, too. Everybody tests for heavy metals. Heavy metals are important still, but I like to know some of these other things because the effects are so insidious. I mean look at testosterone. I mean you’ve got to have your testosterone, right?

Dr. Weitz:  Absolutely.

Dr. Fine:    Especially if you’re a man.

Dr. Weitz:  Let’s talk about what’s the best diet for healthy skin.

Dr. Fine:    Oh, the best diet. This is my book. In terms of diet, you want to make sure that you’re having an anti-inflammatory diet, because if you look at my flow chart on how your skin ages, it’s like inflammation is pretty much at the top. You’re basically going to go through and you’re going to increase matrix metalloproteinases, which are enzymes that cut up your collagen. As you get older, you don’t make as much new collagen to make up for the collagen you’re losing. That’s a problem. You increase your NF-kappaB.  Anyway, you’re going down the wrinkle pathway starting with inflammation. We want to have … Basically a Mediterranean diet has been the best diet for skin. It’s not vegan, it’s not keto, it’s not Paleo, it’s not vegetarian, but it’s got olive oil, it’s got some red wine, it’s got vegetables, it’s got legumes. It does have some meat, but you want to push the anti-inflammatory foods.

Then the other thing you want to do is you want to consume things that turn on your own endogenous antioxidant system, as oxidative stress is also at the top of that wrinkle pathway. These are foods that push Nrf2, for example, which turns on your own antioxidants and also your detoxifying enzymes in your body.  Even though the fruits and the vegetables do have antioxidants in them, the antioxidants, the half-life of those, not very long at all. You probably can’t even eat enough of them all day long. But by consuming foods that push your Nrf2 pathway, you’re telling, you’re turning on your own genes to make your own darn antioxidants and detoxifying enzymes, which are so important. Those are things like olive oil and green tea. Green tea is the number one beverage for good skin and shown to help with inflammation, elasticity, microcirculation.  I mean the skin on your face, the stuff right on the top is old, dead skin. Old, dead skin. It’s hard to get blood flow into those levels, and so microcirculation for skin is very, very important to keep it oxygenated and nourished. Green tea has been shown to do that. Fish oil is another one that’s been shown to help with elasticity of the skin. The amount they used in the study that I referenced in my book was only one gram per day. I don’t remember the length of the study, but one gram, as you know, is not much.

Dr. Weitz:  Not very much, no.

Dr. Fine:    It’s not very much. I mean we typically do more, don’t we?

Dr. Weitz:  Oh, absolutely.

Dr. Fine:    Yeah, and so things like that. Blueberries are very anti-inflammatory. Your berries are very important. Pomegranate is very important, the pomegranate juice, the sulforaphane, the detoxifying enzymes that…

Dr. Weitz:  Which is from broccoli and cruciferous vegetables, right?

Dr. Fine:    Yeah. You’re pushing the Nrf2. You want your anti-inflammatory foods to knock down NF-kappaB. Then you want to push up your Nrf2 system. This is how you’re manipulating, I guess, your genes to support good health and good skin.

Dr. Weitz:  What are your favorite nutritional supplements for skin health?

Dr. Fine:    The supplements that I like for skin health are … I do like vitamin C for the skin because it helps make collagen. Then I have the collagen and-

Dr. Weitz:  Do you like collagen supplements?

Dr. Fine:    Collagen supplements, I think, are … I’m a little mixed on that because you’re just digesting them in the gut. It’s protein. You’re just digesting it. But it is collagen and it is protein, and protein is good for the skin. I like it from that standpoint, too. I think there’s some newer products that are coming out that have different digestibility and different qualities that can make it better. I do like proline. I do like astaxanthin for the skin. It’s got some really good research behind it and-

Dr. Weitz:  It’s an important carotenoid, right?

Dr. Fine:    The carotenoids are really crazy good for your skin.

Dr. Weitz:  Yeah.

Dr. Fine:    Lycopene is very good for your skin. I’ve seen that available as supplements as well. But, gosh, there’s so many that I could say. The other thing that I didn’t mention in diet, but I’ve been mentioned in my book, which is very important, is you’d want to watch your glycation and your food. You don’t want the browning on your chicken breast. You don’t want the grilled meats. You don’t want the glycation because glycation is an irreversible process. That is also aging your skin, and I talk about that at length. I have a great chart-

Dr. Weitz:  You want to be careful about barbecuing or avoid barbecuing, right?

Dr. Fine:    Yeah, barbecuing is not so great.  In my chart, it talks about a fried egg, how many glycating units it has, versus a poached egg.  If you poach things, proteins in water, you can see on my chart how much less glycating it is for your skin.  Very interesting research.

Dr. Weitz:  Interesting.

Dr. Fine:    Yeah.

Dr. Weitz:  Maybe let’s do one more topic. How about sleep for your skin?  How important is sleep?

Dr. Fine:    Yeah. One night of sleep interruption has been shown to epigenetically alter your skin health genes. One night of interrupted sleep. I could do several of those in a week.

Dr. Weitz:  Yeah, of course.

Dr. Fine:    Yeah. I was shocked. I was like, “Wow!” because I was really hoping to find research that said if you have to miss an entire night of sleep, you knock off a little bit. No, it’s just like one interrupted night, that’s it. That was very discouraging, I thought.  Sleep is very important. I mean it’s true, there is no beauty without beauty sleep. Your body rests and repairs the brain. Now we know the brain has a glymphatic system and it’s detoxing overnight. Your skin is also … Everything is just regenerating and healing overnight. You do have to sleep.

I want to talk about tai chi for a minute. Actually, I do tai chi. I have a story about it. I have a friend and she said … I was talking to her about my book, tai chi, “Oh,” she said, “I had a client come in once. This woman looked like she was in her 60s, but I asked her she was. She was like 93. I asked her, ‘What do you do?’ She said, ‘In my 60s, I took up a new job of teaching,'” I don’t know, “‘women.'” I don’t know if they were pregnant women or … She was teaching some group of women tai chi. She started doing that in her 60s, and she just looked so youthful. She lived into her 100s.  I looked into tai chi and it’s like tai chi, in the study that … There’s more than one study, but in a particular study, they looked at six different gene regions that affected aging. Six. That’s what I looked at, six. Tai chi positively affected all six. Not one of six, not two of six, not three. All six. Six out of six, which makes you think, “I wish [inaudible 00:44:45] more”, right? Well, it affected all six. What’s interesting is that those particular gene regions were mostly involved with DNA repair. That’s something that’s really important. Our DNA, as we get older, it’s crumbling.

Dr. Weitz:  Absolutely. Physical activity is so important.

Dr. Fine:    That’s a medical term, crumbling.

Dr. Weitz:  There you go. Okay. Why don’t you tell us how listeners can find out about your programs and get a hold of you? I know you said you have a special offer.

Dr. Fine:    Yeah, I do. I do have a website. It’s drannemariefine.com. My online programs are on there. I’ve got a newsletter and different things like that. Anyway, if you would like to book a complimentary 30-minute consultation with me, we can explore how we might work together outside of the podcast to implement some of these things into your life or in the lives of your patients for all the doctors out there. You can contact me at my email, which is info@drannemariefine.com, or you can give me a ring on my phone. Do you want to just put that in your show notes or should I say it to you?

Dr. Weitz:  It’s up to you.

Dr. Fine:    Okay. You can call me at 480-510-3448.

Dr. Weitz:  Great. Your office is located where?

Dr. Fine:    It’s in Corona del Mar, California.

Dr. Weitz:  Okay. Your book is available on Amazon and Barnes & Noble, right?

Dr. Fine:    Yes. Well, not Barnes & Noble. It’s available at Amazon.

Dr. Weitz:  On Amazon, great. Cool. The name of the book again is?

Dr. Fine:    It’s Cracking the Beauty Code: How to Program Your DNA for Health, Vitality, and Younger-Looking Skin.

Dr. Weitz:  Great. Thank you so much, Dr. Fine.

Dr. Fine:    Thank you, Dr. Weitz. Thanks for having me on your podcast.

Dr. Weitz:  Yes. I very much enjoyed it. We’ll talk to you soon.