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

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

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


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


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


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

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

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

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

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


Podcast Highlights

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

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

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

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

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

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


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

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


Podcast Transcripts

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

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

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

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

Dr. Weitz:           Hallelujah!

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

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

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

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

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

Dr. Weitz:         Which one’s on top?

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

Dr. Weitz:         Oh, the right one.

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

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

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

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

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

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

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

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

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

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

Dr. Weiniger:    How about strong posture?

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

Dr. Weiniger:    In our world …

Dr. Weitz:         Yes.

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Weiniger:    Working on it.

Dr. Weitz:         Okay.

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

Dr. Weitz:         Okay. Go ahead.

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

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

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

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

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

Dr. Weitz:         Okay. Hi Harry.

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

Dr. Weitz:         Okay.

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

Dr. Weitz:         That’s okay.

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

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

Dr. Weitz:                            Cool.

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

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

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

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

Dr. Weitz:                          Yeah.

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

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

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

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

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

Dr. Weiniger:                   Okay, same thing.

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

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

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

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

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

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

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

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

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

Dr. Weitz:                          Of course.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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

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


Podcast Highlights

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

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

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

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

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

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

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

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

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

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

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

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



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

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


Podcast Transcripts


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Weitz:            Dr. Vojdani?

Dr. Shade:           Yeah.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Weitz:     Resveratrol.

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Shade:           And what are those called?

Dr. Weitz:            It’s a cytolethal-

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

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

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

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

Dr. Shade:           Cytolethal distending toxin.

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

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

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

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

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

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

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

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

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

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

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

Rational Wellness Podcast 044: Lyme Disease with Dr. William Rawls

Dr. William Rawls talks with Dr. Ben Weitz about Lyme Disease and how to effectively treat it. 

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


Podcast Highlights

3:12  Dr. Rawls explains his journey from OBGYN to chronic Lyme disease patient. He was originally diagnosed with fibromyalgia.

5:58 Testing for Lyme Disease.  “When I see someone, and they have all the symptoms of Lyme Disease, I put them in the category of having Lyme Disease no matter what that testing might show.”

10:10  Dr. Rawls explained that we all have lots of microbes in us, but it is not until our immune system is disrupted that infections with Lyme Disease or Babesia or Mycoplasma cause you to become sick. Dr. Rawls explains that Lyme Disease is really a condition of immune dysfunction.

11:52  Dr. Rawls explains his seven different categories of immune system disruptors: 1. Poor diet, 2. Toxins, 3. Emotional stress, 4. Physical stress, 5. Oxidative stress, 6. Artificial radiation, 7. Microbiome dysbiosis/Leaky gut

15:43  I asked Dr. Rawls, “Do you think there’s an increase in the number of people that are contracting Lyme or is it more the case that our modern lifestyle is leading people to become sick from Lyme disease?” Dr. Rawls explained that while it is true that with global warming there are more ticks, he feels that it is more related to our modern lifestyle.

20:45  Dr. Rawls explains that antibiotics are not particularly effective for chronic infections and they are indiscriminate killers that damage our microbiome and our mitochondria.  Dr. Rawls finds herbal therapy to be more effective for chronic intracellular infections like Lyme Disease and Bartonella. 

30:32  Dr. Rawls mentions that magnesium, esp. at higher dosages, tends to be problematic for patients with Lyme Disease by making symptoms worse. 

32:10 I asked Dr. Rawls if he uses detox protocols in his treatments and he said that rather than including a separate detox phase of the treatment, he regards the whole recovery from Lyme process as a form of detox. 



Dr. William Rawls is available for consultations and speaking and can be contacted at his website where you can find lots of information about Lyme Disease  https://rawlsmd.com/          You can get information about his herbal protocols at https://vitalplan.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 as well as chiropractic work by calling the office 310-395-3111.


Podcast Transcripts

Dr Weitz:             This is Doctor 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. Sign up for my free ebook on my website by going to drweitz.com. Let’s get started on your road to better health.

Dr Weitz:             Hey, Rational Wellness podcasters, thank you so much for joining me again today, and we have such an important topic. We are going to talk about Chronic Lyme Disease. Lyme disease is a very complicated, and confusing disease. It starts with an acute infection from a tick bite, but it can become chronic, and go on for years, and years.  The tick bite results in an infection with a corkscrew-like bacteria, typically known as Borrelia burgdorferi. Since it was first discovered, we’ve learned that there are a number of different variations, and species of Borrelia.  After this initial infection, it can create a chronic condition, and this chronic condition is really what we want to focus on, that’s really the condition that creates the most problems. It’s difficult to detect, it’s difficult to treat. Many of the patients who have Chronic Lyme Disease are not even aware that they were bitten by a tick bite. Or the exposure could’ve been years ago, and it’s not connected up to when they actually got sick.

                                The Centers for Disease Control estimates that there are approximately 300,000 new cases of Lyme disease per year in the US, and it seems to be increasing.

                                Our special guest today is Dr. William Rawls. He was a practicing OB-GYN for 15 years when he found himself dealing with Fibromyalgia and Lyme disease, likely from a tick bite years earlier. He discovered that antibiotics made him worse, and he found that herbs worked better, though his medical training had him very biased against the idea of using herbs. He dug into the literature about Lyme Disease, and he discovered through trial and error how to restore his health. He ended up dedicating himself to treating patients with Lyme Disease, and he wrote three books, including his latest, which is Unlocking Lyme, which is the most informative and well-written book on Lyme Disease that I have ever read. Doctor Rawls, thank you for joining us today.

Dr Rawls:             Thank you very much, it’s my pleasure.

Dr Weitz:             Can you explain what happened when you found yourself not feeling well? How did you figure out that you had Lyme Disease? How did you go about correcting yourself?

Dr Rawls:             Like most everyone with a Lyme Disease story, it was convoluted. My health gradually deteriorated, I didn’t have any memory of a tick bite, other than I got bitten by ticks almost continually when I was younger. I chose the profession of OB-GYN because it was a field of medicine that was wellness oriented, it wasn’t drug heavy, which just … it jived well with my personality.  The downside was the call. I went to a small town, and ended up taking call every second to third night. That went on for about 15 years.

Dr Weitz:             By the way, taking call means that you’re on call at a hospital if there’s an emergency.

Dr Rawls:             On call, yeah. If someone is in labor, or in the emergency room, you get called. Most of the time, virtually, every time I was on call, I was at least waking up, and a lot of times I was up all night long. That went on for 15 years. I got to the point that I couldn’t sleep when I wasn’t on call, and my body was just deteriorating.  At first, you go to your local physician, and other physicians in the community, and find that they really don’t know what’s going on. You end up with this diagnosis of fibromyalgia. I considered Lyme Disease, but I did the initial screening test and it was negative.  Because, I had all the symptoms of fibromyalgia, which are basically the same as Chronic Lyme, which are basically the same as the early stages of most Chronic Illnesses.

Dr Weitz:             What were those symptoms?

Dr Rawls:             Fatigue, feeling like you have a flu every day, aches and pains all over, weird neurological symptoms, pins and needles, burning feet, blurry vision, it just went on, and on, and on. Basically, my whole body was collapsing.  It was later after I started taking my health in my own hands that I ultimately discovered that it was, and I did have a positive test for Borrelia, but have come to know Chronic Lyme quite a bit differently than I think most people do.

Dr Weitz:             What do you think is the best way to test for Lyme, or do you think it’s even worth testing for it?

Dr Rawls:             It’s always a loaded question. Our testing right now is fair at best. Something to know about the testing is, all the labs that are doing testing for these microbes that we found to be associated with Chronic Lyme, the standard of testing is for acute infection, in other words, when it’s a brand new infection, the microbe has just entered the body, and the reaction of the immune system is strong, and the microbe levels are high. But, most everybody being tested has chronic infection, where the immune system has these responses been attenuated, and the microbe levels are really, really low.  When you look at the rate of testing an acute infection, which may be a sensitivity, or ability to find the microbe, as high as 95%, it probably drops to around 20% or less with Chronic infection.  Often, the testing is marginally valuable. When I see someone, and they have all the symptoms of Lyme Disease, I put them in the category of having Lyme Disease no matter what that testing might show. But, then you have to come around to defining what exactly is Lyme Disease.

Dr Weitz:             What do you think about Doctor Vojdani’s lab, which does the antibody testing, do you think that’s a little more accurate?

Dr Rawls:             There are two ways to test. One is you can test directly for particles of the microbe, typically DNA from the microbe, or you can test for the reaction of the body to the microbe. But in either case, when you’re looking for a chronic infection, you’re talking about very low levels of microbe, and an immune response that’s been attenuated, pushed down by the microbes themselves.  The testing becomes less, and less valuable. I think we’re going to get better, and as we do, I think what we’re going to find is there are a whole lot more forms of Borrelia than just Borrelia burgdorferi, we already know that there are about 12+ worldwide.

Dr Weitz:             12, wow.

Dr Rawls:             Probably a lot more. Then, there are all the other microbes that are associated with Lyme beyond Borrelia. As we get better testing, what we’re going to find is an awful lot of people are carrying these microbes that aren’t sick. It’s a lot more widespread than most people realize.

Dr Weitz:             Why are there always associated other microbes like babesia, and mycoplasma, why does that exist?

Dr Rawls:             Because we all have them, quite frankly. That goes beyond that basic definition of what Lyme Disease is. When you look at humans, we are wonderful microbe collectors. We start at birth, we pick up the microbiome, the collection of microbes from our mother, and we add to that throughout life.  When you look at insects like ticks, and mosquitoes, and all the other insects, and all the other ways you can get microbes, we’re constantly picking up microbes throughout our lifetime.  A high percentage of people, mycoplasma, 75% of people with Lyme have mycoplasma. Well, if you look at any general population worldwide, somewhere between a third and three quarters of any population, healthy or otherwise, will have mycoplasma.  Same is true with all these other microbes, bartonella, babesia, all of these things. All of us pick these things up, it’s not until your immune system gets disrupted that these things start to become a problem, and that’s what happened in my case. I didn’t get ill until I trashed my immune system.

Dr Weitz:             Interesting. I guess that’s why you write that Lyme Disease is really not so much an infection as a disease of immune dysfunction.

Dr Rawls:             Yeah. When I look at fibromyalgia, and Lyme Disease, and all of the chronic autoimmune type diseases, I see a lot of commonality there. I think, ultimately, we’re going to see more and more associations between most chronic illnesses and these things that I call stealth microbes. The characteristics of all the microbes that are associated with Lyme and so many of these others things are that they live inside cells, and they infect white blood cells, and through doing that, they are able to manipulate the immune system.

                                They are doing a couple of things. They’re pushing the immune system away from being able to take care of inner-cellular microbes. Microbes that have infected cells, they suppress that part of the immune system. But they gear up other parts of the immune system that cause this systemic inflammation, and that helps break down tissues to have access for food sources. Because that’s basically what these microbes want, is they just want nutrients to survive.

Dr Weitz:             You write in your book about seven different categories of immune system disruptors, can you go into those for us?

Dr Rawls:             Sure, yeah. That was the initial part of my change in approach. When you look at conventional medicine, we do a great job of treating acute situations. Our whole system is based on acute illness. Most drugs treat things acutely.  It wasn’t until about 1960 that we started focusing on chronic illness, and trying to find drugs that treated chronic illness, but still, if you look at it, we treat chronic illness acutely, in most cases.  It appeared to be a fundamental flaw of through instead of treating the illness, why are we not looking at it and say “Why is the patient sick? What made this person sick?” For a few things, broken leg, heart attack, stroke, that cause is very evident, but when you look at chronic illnesses, it’s less so. It’s usually a combination of things that come together.  They’re pretty obvious, I think most people can pick these things up, if you sit in a group and ask people “What do you think causes illness?” The first thing most people talk about is food. We’re eating an abysmally bad diet for humans, 200,000 years we ate forage food, and now we’re eating all these processed grain products, and it’s just not good for us, it suppresses immune function in a variety of ways.

                                Toxins, we live in a pretty toxic environment. There’s subtle toxins throughout all of our food, and air, and water. Stress, living in the modern world causes stress, really uncomfortable. Just sedentary lifestyle. We’re built to move, and we now sit in front of computers all day, and it’s just not good for us.  One that’s a little harder to define is what the effect these computers, and cellphones, and all the things that are surrounding you right now have. But there’s no doubt that they do disrupt our energy flow, and our normal energy pathways.

                                Free radicals, when we metabolize food, we generate free radicals, but inflammation itself is free radicals. Then, the microbes, we all pick up microbes and some are worse than others. People that don’t pick up Borrelia and some of the things that come with Lyme Disease are less apt to get a chronic illness, but again, I think there are lots of people out there that have these microbes but aren’t ill, because they haven’t had those other factors come together to set the stage for the immune disruption that allows these microbes to flourish.

                                In other words, I had these things in my body for years, and years, and it wasn’t until that I ate bad food, didn’t sleep for years, and years, was under constant stress with a busy, busy practice, that’s when these things started to flourish, and started to compromise my health. It wasn’t one thing.  These things are distributed throughout all the tissues in the body, it’s not like a pneumonia where you have an infection in the lung, it’s throughout your entire body. Everything breaks down. That’s what Chronic Lyme is.

Dr Weitz:             Do you think there’s an increase in the number of people that are contracting Lyme or is it more the case that our modern lifestyle is leading people to become sick from Lyme disease?

Dr Rawls:             Yeah. That’s a difficult question to answer, absolutely. There is no doubt that with global warming, there are more ticks.

Dr Weitz:             Okay, that makes sense.

Dr Rawls:             When I was studying this, I pulled studies that they were looking at well-established tick populations in the arctic that were 10 or 20 years ago, and [crosstalk 00:16:23] the tropics. Everywhere there are warm-blooded animals, there are ticks, and other biting insects.  Maybe there are more ticks, maybe ranges of ticks are changing, but I would say submit that these things have been present for a very, very long time. Looking back, historically, you can pick a lot of people, it’s interesting, I was reading on Darwin recently, and he had all these chronic symptoms throughout his lifetime. He was a guy that was definitely in the forest, in the woods, exposed to a lot of different insects, he had all symptoms of Lyme Disease, it was really interesting.  These things have been going on, it’s just that we haven’t recognized it, and our testing … you know, you look back, there’s no reference point. The testing 20 years ago, or 30 years ago, was terrible, absolutely terrible. It’s getting better, but it’s fair at best. Without a reference point, and without good testing, how do you have any idea whether the incidents of this microbe is increasing?  Plus, people are becoming more aware. People are starting to put together these symptoms, they’re starting to get tested. A lot more people are becoming aware of Lyme Disease, a lot more people are being tested. That increases the incidents artificially, who’s to say that all those people back 40, or 50 years ago didn’t have this? Honestly, my grandfather was an outdoorsman, and he had all the symptoms of Lyme Disease. But, he didn’t he had Lyme Disease back then because nobody knew what Lyme Disease was.  I think that’s, somewhat, at least at this point, an unanswerable question.

Dr Weitz:             Do you think Lyme Disease can be transmitted by anything other than a tick bite? Do you think it can be transmitted by sexual contact, or saliva, or any other vectors?

Dr Rawls:             I think it’s possible, but what you find is microbe specialize. Let’s look at two corkscrew bacteria. One is Borrelia, causes Lyme Disease, the other one is Syphilis. There are a lot of similarities between those two illnesses, and they’re both very similar microbes.  Syphilis is primarily, when that microbe evolved, it found a niche that it could be easily transmitted sexually in human populations. It specialized in that. That isn’t to say that syphilis couldn’t be transmitted by a tick, but it specialized in being concentrated in sperm, and vaginal fluids, so it would be easily transferred between humans. Basically, all these microbes want to do is transfer from one host to another.

                                Borrelia on the other hand chose ticks, there’s very good evidence that it’s been doing that for not thousands of years, but absolutely millions of years. Possibly all the way back to the dinosaurs.  Yes, it is possible that it is transmitted sexually, and it is possible that it is carried in other microbes. It has been found in mosquitoes. I’ve seen too many families that have, whole families Lyme Disease to suggest that it isn’t spread sexually or in utero.  But, it doesn’t particularly specialize in that. You don’t typically find high concentrations of Borrelia in seminal fluid or vaginal fluid. I didn’t say it can’t, it’s just if you gave it a chance, it rather work with a tick. The tick, it has a really cozy relationship that it helps the tick in the tick helps it. It’s predominantly tick borne, no doubt.

Dr Weitz:             You’ve written that you didn’t find, and you don’t find with your patients antibiotics to be particularly helpful, and you’ve found herbal therapies to be much more effective, and other nutritional protocols. Can you talk about why antibiotics are not particularly effective for Lyme? What sorts of herbal protocols you find effective?

Dr Rawls:             Sure. Yeah, we could talk about this for an hour, but I’ll condense it here. Antibiotics like most drugs, are designed for acute infections. You have someone with pneumonia, they have an extra cellular microbe, that doesn’t live inside cells, it’s consolidated in one area of the body, it’s growing very rapidly, it’s turning over generations very rapidly. That’s what antibiotics are built for. You put that person in the hospital, and they’re going to turn the corner in a day or two, and be well in a couple of weeks. 

The problem with antibiotics is that they’re indiscriminate. When you’re going to hit the fastest growing microbes the most, but the longer you use them, the more you’re going to affect all of the microbes in the body. What tends to happen is you suppress your normal, friendly flora, and you grow out pathogens in the gut.  I always look at antibiotic therapy as being a race. Are you going to kill the offending microbes before you disrupt the entire microbiome and suppress immune system functions even more?

                                Other things with antibiotics is they actually, they destroy our mitochondria, mitochondria are ancient bacteria that we incorporated into our cells eons ago. They disrupt biofilms in the colon. When we talk about biofilms, everybody’s worried about biofilms. Your immune system deals with biofilms quite well, and actually, you want to protect some biofilms. You have a biofilm in your colon that is protective, and it’s very important. Antibiotics disrupt that biofilm.

                                There’s a whole list of reasons why when you apply these things to a chronic, intra-cellular infection, it just doesn’t work as well. Because when you look at these microbes, Borrelia, mycoplasma, bartonella, all of these things, they’re intracellular, they’re growing very slowly, they’re distributed throughout tissues in the whole body.  When you hit them with antibiotics, you end up hitting your normal flora harder than you hit these microbes. Typically, the solution that most people follow is “Well, we’re not going to get them in days or weeks like with pneumonia. You’re going to have to hit them for months, or years.” You lose the race almost every time. Not to say that there aren’t people that do recover with antibiotic therapy, but I’ve seen all too many people that had squandered their life savings on expensive, intravenous antibiotic therapy just to be much, much worse than when they started.

                                The advantage of herbal therapy is that you’re talking about a whole different thing. Plant medicine, you’re talking about a spectrum of substances that the plant is producing to protect itself. The plant has to figure out the friend versus foe problem also. Plants have to deal with these threatening kinds of microbes, but they have to protect their normal flora.  One of the interesting things that I’ve found about herbs is they typically don’t disrupt the gut. But they are more suppressive. I wouldn’t use herbs to treat an acute pneumonia, but for the stealth microbes you have the suppressive effect without disrupting your normal flora, and you’re enhancing immune, you’re rebalancing immune system function at the same time. You can literally use these things for months and years.  I’ve been taking herbs almost continually for 10 years, and things just keep getting better every year. It’s a gradual thing, you do have to create long-term, but herbs, because they suppress the stealth microbes, they don’t disrupt the normal flora, and they restore normal immune function, are just a really nice choice.  

Dr Weitz:             Now, can you talk about some of your favorite herbs for Lyme Disease?

Dr Rawls:             Fortunately, there are a lot of them. Early on I happen to read a book by a guy named Stephen Buhner, who wrote Healing Lyme, it was a well-known book. I used that core protocol starting out, but then I built out beyond that.  What you find is, virtually, all herbs has some anti-microbial and immune enhancing properties. His initial protocol, the top of the list, was Andrographis, which is a really nice herb, has some really nice antiviral properties too, especially for flu, it’s probably one of the best things out there for flu.  Cat’s claw, which is from the Amazon, another great herb that was used for syphilis, so we know it has some activity against Borrelia, which is really important.  Then, we have so many other, the Japanese knotweed, sarsaparilla, but the list goes on and on. Neem is a good antimicrobial, has some really nice properties. One I’m looking at now is mimosa pudica, which is an excellent herb. The list just goes on and on.

Dr Weitz:             Is that from the mimosa tree?

Dr Rawls:             Pardon?

Dr Weitz:             Is that from the mimosa tree? Right? There’s a tree.

Dr Rawls:             Right. No, this is a mimosa plant, the leaf looks like mimosa, but it’s a ground cover. But it’s the touch-me-not plant, if you touch it, it folds its leaves up. It’s a really cool plant. Turns out that it just has some fantastic medicinal properties, a wide range of properties. There are just unlimited number of things that we can use.

Dr Weitz:             Japanese knotweed resveratrol is interesting. We use that as part of an antiaging protocol for its polyphenol properties. I never knew that it had antimicrobial effects as well.

Dr Rawls:             Well, yeah, no doubt about it. There are other places you can get resveratrol, grapes, the muscadine grape we have in North Carolina has some really nice properties. But when you look at the whole herb, Japanese knotweed, or all of the other chemicals that come in grape seed, or in grapes in general, you’re not talking about just resveratrol.

Dr Weitz:             I agree.

Dr Rawls:             Resveratrol by itself does have antimicrobial properties that has some really nice antiaging properties, but the herbs also have a full spectrum of other components that are really important. But when you talk about anti-aging, those system disruptors that I talked about, those are the things that are causing us to age.  When you look at herbs, they’re counteracting all of those things. They’re loaded with antioxidants. They balance the immune system. They balance the microbiome and suppress the stealth microbes that I think are part of all of aging and illness, in a chronic illness.   All the herbs, if you’re looking at an anti-aging protocol, it matches what we would do for Chronic Lyme almost to the tee, it’s really interesting.

Dr Weitz:             One thing I find interesting is, I deal a lot with patients with SIBO, Small Intestinal Bacterial Overgrowth, and there’s a series of herbs, antimicrobials, that we typically use for those patients, and it includes berberine, oregano and thyme oil, garlic, and those don’t seem to be effective against Lyme, I guess, because I don’t see those in the list of herbs recommended for Lyme, typically.

Dr Rawls:             Berberine and your berberine containing herbs, goldenseal, coptis, so many others. Berberine is the predominant one that I find to be top of the list for SIBO. The others that you mentioned are also excellent. But they’re not absorbed systemically as well. That’s the thing about berberine, it gets absorbed into the urinary tract, you get it into your GI tract, so it’s good for urinary things, it’s good for GI things. It’s not as good for systemic infections. But it is just exceedingly good for so many things.  Really great for balancing the gut, I think it’s better than a probiotic for balancing the microbiome in the gut.

Dr Weitz:             Interesting. You write in your book that magnesium can make Lyme symptoms worse, I thought that was kind of an interesting … I often recommend magnesium, we find a lot of patients are low in magnesium. How can magnesium be a negative for Lyme?

Dr Rawls:             That one it’s hard to answer. I’ve heard it theorized, the microbe use magnesium, and therefore if fuels the infection. I’m not sure whether I buy that or not, I’m not sure whether it causes micro imbalances in our minerals in the body, but I have noted it personally, and noted it with other people.  When I took high doses of magnesium, after a while, after I used it, my symptoms just got worse and worse until I stop the magnesium. That is really common. I’m choosy, I think a lot of people can take magnesium, probably a lot of people need magnesium, but it’s still you have to be careful with.

Dr Weitz:             Interesting. Do you ever use IV vitamins?

Dr Rawls:             I don’t personally, and I haven’t in my practice, but for somebody who’s really ill, I think there can be some benefit to get you there a little bit faster, which I think is a fairly reasonable thing to do. But glutathione and vitamin C, especially, seem to be beneficial.

Dr Weitz:             Do you use detox protocols in your treatments? We had Melanie Gisler speak at one of our meetings about Lyme Disease. She likes to include detox into her protocols.

Dr Rawls:             Yeah, I just did a webinar pretty recently on detox, and really did a deep dive on what we’re doing. My conclusion was when you look at Lyme recovery, it is detox, the whole thing. This concept of just doing this protocol, and I’m done with that, and I’ll move on to other parts of recovery, nah, it’s an initiation.  But the whole recovery process is detoxing. When you look at detox, it’s really clean food, it’s lots and lots of vegetables. But if you look for one thing that detoxes the body better than anything on the face of the earth, it’s vegetables. Lots, and lots of fresh vegetables.

                                No matter what diet you choose, I think that the golden rule for any healthy diet is it needs to be at least half vegetables, or more. Eat more vegetables than anything else. Because the vegetables are binding the toxins, pulling them out of the body, and vegetables are going to be lower in toxins than a lot of other kinds of processed foods. That’s really important.  The vegetables help enhance liver function. Then you throw in the herbs on top of that, you know, we’re talking about berberine, berberine is a really nice bile-stimulant, you got to get your liver moving. You throw some andrographis in there, which is another bile-stimulant, and really enhances liver function, and protects the liver. Throw in some milk thistle too if you like.

                                So many of our herbs are doing the things that we want to do with detoxification. Then, cleaning up air. I’m spending a lot of time studying research that I can find on negative ions, and negative ion generators, and essential oils for just cleaning up the air, making our air better, filtering water.  I don’t see detox as a thing that’s done, I think detox is something you embrace for a lifetime. A detox protocol is a way to get initiated in that, but it becomes “This is how you live your life.” You live a clean life, and that’s what enhances immune function. That is not only what’s going to help you recover from chronic illness, but it’s also going to help you slow down the processes of aging in general.

Dr Weitz:             Cool. What do you think about ozone? That’s very popular in LA for Lyme protocols, is using some form of ozone.

Dr Rawls:             Yeah, I think if you have asked me five years ago, I would say “That’s crazy. Ozone is just really toxic.” But, I’ve since come around, there has been enough literature out there, and I have been to enough lectures and really studied it enough to recognize that I think it does have value. All of these microbes are very oxygen sensitive, basically, we’re infusing high reactivity oxygen species that are free radicals. They do have a pretty strong effect on the microbes.  Of the types, you can either inject ozone, or you can run someone’s blood to a hyperbaric chamber with ozone that pushes ozone into the blood, and then back in the body, and that circulates over and over. I think it does have an effect.  Are you going to eradicate all the microbes? No, because they’re so deep in the tissues, and they’re inner-cellular, you’re not. But I think it has value.  

Here’s the thing; I think it’s important to put in perspective. If I have someone that is doing all the things that they need to do to rebuild their immune system, they’ve cleaned up their diet, they’ve cleaned up their lifestyle, they’re living a clean lifestyle, they’re embracing the herbs, and they’re not quite getting there, or they want to get there a little faster. You know, their immune system is on the rebound. Then ozone can be beneficial. It might be what I call a heroic therapy that might get them there a little bit quicker.

                                Whereas, I’ve met all too many people that aren’t doing those things, and are going for ozone, and they might feel better for a week or two, or a month. But, then they’re right back where they started. Then, they’re doing it again, and again.  It’s expensive, and every time you use it, every time you use it, you’re going to do more damage to your blood vessels. There’s a certain amount of toxicity with it. You’ve got to be really frugal in that use.  The message with ozone is do all the things that you need to do first to rebuild your immune system, then if you want to get there quicker, or if it’s not quite getting all the way there, then I think ozone is a consideration. But, as a stand alone therapy, I don’t think that’s a good choice.

Dr Weitz:             Great. Great. This was really good information Doctor Rawls. Is there any final thoughts you’d like to tell our listeners and viewers?

Dr Rawls:             Let’s see. The big thing is, when you look at Chronic Lyme Disease, I think you’re fundamentally looking at a model of all chronic illness. More and more, as I searched the literature, I find that we’ve lost connections to our ancient past. The food we’re eating is abnormal, our world is full of toxins, our microbiome is less diverse, and it contains more pathogens than it ever has. Herbs are part of the missing link.

                                I’ve been thinking about it, it was very differently as of late. I’ve just rewrote our diet guide, and you study, and humans ate foraged food for 200,000 years. It wasn’t until about 10,000 years ago that we started adopting grains. Really, most intensely 100 years ago.  That foraged food was roots, and leaves, and stems, and bark off of trees, it was anything that might have some calories. Humans ate a lot of it. It was very bitter. When you look at the concept of digestion, bitter is really, that’s what initiates our digestion, because all the food was bitter for several hundred thousand years.  But all of that food was loaded with phytochemicals, these substances that we find in herbs. Those things are typically very bitter, they don’t taste good. We selectively bred all of those things out of our food now.  Our food tastes better, it’s higher in carbohydrate, it doesn’t have the bitterness typically, and we like it better. But it’s missing that spectrum of phytochemicals. The only way you can really get it back now is herbs, because herbs have been cultivated to actually enhance the presence of those things.  I’m starting to see herbs not as something you do therapeutically, but as a true deficiency, something that is really, really missing. When you look at paleo diets, and other things, people are eating a paleo diet because they’re not foraging food out in the woods, and they’re still missing those ancient phytochemicals that are so important for our health.  Whether you’re talking about treating Lyme disease, or antiaging, or virtually anything else, I see herbs as really an essential component of what people should be doing.

Dr Weitz:             That’s a great clinical pearl. How can viewers get a hold of you?

Dr Rawls:             We’ve got an informational website called rawlsmd.com, I got a lot of information about Lyme disease, connections to the book, and that sort of thing. Then, we also have a website called Vital Plan, that we do carry some products and things on that. Either way, they can find lots of other information, and yeah, it’s important.

Dr Weitz:             Are you available for consultations?

Dr Rawls:             I am. I do do consultations. I’m spending more of my time just writing, though, at this point, because I can reach so many more people writing, and doing webinars, and doing shows like this. We can connect, and I can get this information out there in a bigger way.

Dr Weitz:             That’s great. Thank you, Doctor Rawls.

Dr Rawls:             Thank you very much for having me, it was a real pleasure.

Dr Weitz:             Excellent, I enjoyed it too.


Improve Your Thyroid Function With Proper Nutritional Supplementation


Improve Your Thyroid Function With Proper Nutritional Supplementation 
Approximately .4% of people in the United States have hypothyroidism, an under-functioning thyroid gland, and an additional 4-8% of people in the US have a mild form of hypothyroidism known as subclinical hypothyroidism, meaning that they have an elevated Thyroid Stimulating Hormone but don’t have significant symptoms of low thyroid. The most common symptoms of hypothyroidism are fatigue, hair loss, dry skin, feeling cold, poor memory, brain fog, constipation, and weight gain. When screening for thyroid, the Thyroid Stimulating Hormone (TSH) is most commonly tested, however, we find it helpful to also run free T3, free T4, and the thyroid antibodies, TPO and TG. Over 90% of patients in the US with hypothyroid have autoimmune hypothyroid, referred to as Hashimoto’s Thyroiditis, so we find it helpful to run the thyroid antibodies to see what level of autoimmune disease is present. If autoimmune disease is present, it is important to try to discover some of the triggers and causes of of it and not just take thyroid hormone and forget about the cause of the problem.

Studies show that there are a group of nutrients that are important for the proper functioning of the thyroid gland, including iodine, selenium, zinc, iron, vitamin D, magnesium, and Coenzyme Q10. Some of these nutrients are important for the production of thyroid hormone as well as for the conversion of the inactive T4 thyroid hormone produced by the thyroid into the active T3 form mostly in the peripheral tissues, especially in the liver, gut, skeletal muscle, and the brain, but also in the thyroid gland itself. There are a number of triggers that can set off or exacerbate autoimmune disease, including the nutrient deficiencies just mentioned. There are other factors that are important for thyroid health and which can be triggers for thyroid autoimmune disease (Hashimoto’s), including adrenal status (esp. if cortisol levels are too low or too high), chronic infections, leaky or unhealthy  gut, heavy metals and other toxins, including flouride, chlorine, and bromide, estrogen fluctuations, PCOS, imbalances of the TH1/TH2 immune system, as well as a number of prescription drugs. Medications that can interfere with thyroid function and T4 to T3 conversion include the following:

               1.  antibiotics & antifungals (i.e. sulfonamides, rifampin, keoconazole),
               2.  anti-diabetics (Orinase, Diabinese),
               3.  diuretics (Lasix),
               4.  stimulants (amphetamines),
               5.  cholesterol lowering medications (Colestid, Atromid, LoCholest, Questran, etc.),
               6.  anti-arrhythmia medications (Cordarone, Inderal, Propanolol, Regitine, etc.),
               7.  hormone replacement (Premarin, anabolic steroids, growth hormone, etc.),
               8.  pain medication (morphine, Kadian, MS Contin, etc.),
               9.  antacids (aluminum hydroxides like Mylanta, etc.) and
               10. psychoactive medications (Lithium, Thorazine, etc.).

You can see Dr. Weitz for a comprehensive nutrition consultation and after going through a detailed history with him, he can prescribe recommended laboratory testing to try to help determine some of the underlying triggers for your autoimmune thyroid disorder. These could include functional stool analysis, other gastrointestinal testing, such as SIBO breath testing and/or testing for H. pylori, provocative urine or serum testing for heavy metals or other toxins, testing for chronic viral infections, nutrition testing, hormone testing, or organic acid urine testing.

Low Vitamin B6 Status in Kidney Transplant Patients is Associated with Increased Mortality

When functional levels of Vitamin B6 are measured to be lower in kidney transplant patients, they have a higher rate of dying (mortality), particularly due to cancer or infection.  This correlates with other research associating low B6 levels with increased risk of mortality, cancer, and infection. 

Vitamin B6 deficiency is common in renal transplant patients. Functional B6 status is measured by looking at levels of pyridoxal 5′-phosphate, the biologically active form of vitamin B6. and the ratio of plasma 3-hydroxykynurenine and xanthurenic acid. Such functional measurements of vitamin B6 status are a more accurate assessment of vitamin B6 status than trying to measure direct B6 levels in the blood.  

This goes to show that such functional vitamin deficiencies or insufficiencies can be a factor that increases your risk of chronic diseases like cancer and heart disease and for longevity.  Consider seeing Dr. Weitz for a nutritional consultation and having him run a full functional vitamin, mineral, antioxidant, amino acid, and fatty acid analysis through Genova or Spectracell.  You need to know that the blood panels run by your MD for annual physical do not assess the functional status of vitamins and other nutrients, other than perhaps iron if an iron panel is included or vitamin D if this optional test is included.  Optimize your intake of nutrients to reduce the likelihood of or to help control chronic diseases, like heart disease, cancer, and autoimmune diseases. 
Minovic I, Van Der Veen A, Van Faassen M, et al. Functional vitamin B-6 status and long-term mortality in renal transplant recipients. Am J Clin Nutr. December 2017. vol. 106 (6):1366-1374

Rational Wellness Podcast 034: Maximizing Fitness with Nutrition with James LaValle

Pharmacist James LaValle discusses how to maximize your fitness levels by following the optimal nutrition program with Dr. Ben Weitz.

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Podcast Details

I started the discussion by asking James LaValle to comment about high intensity forms of exercise, such as Tabatas, which might involve doing high intensity exercise, such as sprinting for 30 seconds to one minute, followed by a 1 minute or longer rest, and the whole workout may take 5 or 10 minutes.  I asked Jim if this is enough exercise to get someone into shape?  James said that while he likes high intensity exercise like Tabatas, it is not enough, esp. not for a type II diabetic or someone who is really overweight. They have to burn it off over a period of time to affect their blood sugar and their cortisol levels. One of the problems is that we need to be careful not to say that everyone should train one way. For people’s different metabolic demands, they will need different programs. James explained that the football player’s nutrition program should be different than the hockey player’s and may have different metabolic demands than the baseball player or the gymnast. But for the average person, you just have to get them moving. They are too sedentary.

3:59 I asked isn’t it the case that just getting them to get up and move around at work and not just sit all day is beneficial. James answered that it’s not ok to just go the gym for 30 minutes per day and be sedentary the other 23 1/2 hours.  We need to be active and move and keep our bodies in the shape that we need to be able to exercise and train.

4:40 I asked if he likes any of these wearable devices that help you track your steps? James said that anything that brings awareness is great, but people tend to burn out using them after a while. He said that the device he likes the most for sleep is the Oura Ring, but some of the other devices are less accurate for tracking sleep. Tracking can be helpful when you are trying to create a new habit.

5:35 I asked what he thinks about monitoring heart rate variability, such as for measuring overtraining in athletes? James explained that heart rate variability is incredibly important because when you lose heart rate variability, you lose vagal tone, which is the balance between your sympathetic and parasympathetic nervous systems. When you lose that balance, your blood vessels stay stiff and you don’t get compensatory relaxation when you need it and you get dizzy upon standing and in the worst case you get POTTS, Postural Orthostatic Tachycardia. For monitoring heart rate variability, he recommends an app called Inner Balance for his patients. Also, if you are sympathetic dominance, then you are catabolic, and muscle is the currency for aging.

7:05 I pointed out that with respect to heart rate variability, you want more heart rate variability, which signals health. James explained that there is a rhythm between the brain and the heart and there is a built in variability in it. When the variability shrinks, that means that the nervous system is miscommunicating with the heart and the neurovascular network. There are strong correlations between performance and also with what you eat and your heart rate variability. 

8:21 I asked if any of the wearables are accurate for heart rate variability?  James explained that if you are going industrial, a lot of the sports teams are using the omega wave. If not, then Interbalance from HeartWave has a real simple device using an ear clip on that’s a medical device and can be helpful.

9:20 I said that I read that James was not a fan of sports drinks. Don’t they help with replenishing electrolytes? James responded that the typical sports drink has a lot of sugar with very little electrolytes. And 


James LaValle can be contacted through his website, http://jimlavalle.com/ where you can order his latest book, Cracking the Metabolic Code.       

Dr. Ben Weitz is available for nutrition consultations. Dr. Weitz specializes in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and he also specializes in helping you to reduce Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure as well as chiropractic work by calling the office 310-395-3111.

Roasted Carrot and Red Quinoa Salad

  • 2 teaspoons sweet paprika
  • 1 teaspoon ground turmeric
  • 1 teaspoon ground cumin
  • 1 teaspoon ground ginger
  • 1 teaspoon ground coriander
  • 1 teaspoon ground cinnamon
  • 1/2 teaspoon cayenne pepper
  • 1/4 teaspoon ground cardamom
  • Salt
  • Freshly ground black pepper
  • 4 large carrots, thinly sliced lengthwise
  • 1 small red onion, thinly sliced
  • 7 tablespoons extra-virgin olive oil
  • 1/2 cup walnuts
  • 1 cup red quinoa
  • 2 cups water
  • 2 tablespoons fresh lemon juice
  • 5 ounces mixed salad greens
  • 1/2 teaspoon finely grated lemon zest
  • 1 teaspoon Dijon mustard
  • 1/2 cup dried cranberries
  • 2 tablespoons chopped flat-leaf parsley
How to Make It

Step 1
Preheat the oven to 400°. In a small bowl, whisk the paprika with the turmeric, cumin, ginger, coriander, cinnamon, cayenne, cardamom and 1 teaspoon each of salt and black pepper. In a medium bowl, toss the carrots with the onion and 2 tablespoons of the oil. Add 1 tablespoon of the spice mix and toss to coat. Spread the vegetables on a rimmed baking sheet and roast for 20 to 25 minutes, stirring once or twice, until tender.
Step 2
Meanwhile, spread the walnuts in a pie plate and bake for about 7 minutes, until golden. Let cool, then coarsely chop.
Step 3
In a medium saucepan, combine the quinoa with 2 teaspoons of the spice mix and the water and bring to a boil. Cover and simmer over low heat until the water is absorbed and the quinoa is tender, about 17 minutes. Uncover, fluff with a fork and let cool slightly.
Step 4
In a large bowl, whisk 2 tablespoons of the oil with 1 tablespoon of the lemon juice and season with salt and black pepper. Add the salad greens and toss to coat. Spread the greens on a large platter. In the same bowl, whisk the remaining 3 tablespoons of oil with the remaining 1 tablespoon of lemon juice and the zest, mustard and 1 teaspoon of the spice mix; season with salt. Add the quinoa, walnuts, cranberries, parsley and roasted vegetables and toss well. Spoon the quinoa salad on the greens and serve.

Irritable Bowel Syndrome is Treatable


For many years, Irritable Bowel Syndrome (IBS) has been thought of as a condition that is stress related and can only be managed with drugs that reduce symptoms. But most cases of IBS are caused by an infection in your small intestine, known as Small Intestinal Bacterial Overgrowth (SIBO). This can be diagnosed with a Glucose or a Lactulose Hydrogen/Methane Breath Test that we can prescribe for you. Up to 84% of patients with IBS have been shown to test positive for SIBO with a lactulose breath test.(1)


However, IBS is usually treated as a condition with no known cause that can only be treated with drugs that reduce symptoms, like constipation or diarrhea.  Medications for constipation are many and can include magnesium, MiraLax, stimulant laxatives like Senokot, and other medications like Linzess and Amatiza. Medications for diarrhea include calcium, charcoal, Imodium, Lomotil, bile acid binding agents like cholestyramine, and also Lotronex, among others. But these medications do not attempt to correct the underlying causes of the symptoms.

After carefully going through your health history and doing a breath test and a stool sample, we can hopefully find the underlying cause of your symptoms and correct that. Occasionally other testing, such as food sensitivity testing can be very helpful. If you test positive for SIBO/IBS, this can be effectively treated in many patients with a special dietary regimen, natural, herbal anti-microbials and a few other nutritional strategies, including specific probiotics. There are certain prescription antibiotics that can also be very effective, but some of the herbal anti-microbials that have been shown in studies to be as effective as the antibiotics, and these are usually safer.(2)  If you choose to go with antibiotics, I will refer you to a gastroenterologist.  For an effective treatment, we must also restore proper intestinal motility, which can be accomplished nutritionally as well, as long as there are no structural barriers. Unfortunately, not everyone is better after the first month of care. An additional round may be necessary, perhaps with a different choice of herbs. We may need to change the dietary approach as well. Sometimes another type of diet is necessary, such as a few weeks of the elemental diet.

After phase one of our treatment, which is to Remove the overgrown bacteria and restore the intestinal motility, we then need to Rebuild our intestinal health using certain other nutritional strategies. This Rebuild is the second phase and is necessary in reducing the likelihood that it will return. We also need to broaden our nutrition out from the specialized diet we have been following while trying to eradicate the SIBO. This should be done in a gradual manner, checking to see if any of these foods create a reaction.  A percentage of patients continue to have some symptoms and may want to repeat the breath test and possibly repeat a cycle of care every so many months or may do well with a low dose of herbs on a daily basis. But there is a good chance that we will be able to identify the underlying cause of your discomfort and correct that, rather than just treating your symptoms.


Fish Oil Supplements Help Stabilize Chronic Kidney Disease

Patients with both diabetes and coronary artery disease often develop chronic kidney disease. Increasing levels of a protein, albumin, in the urine is one of the key indicators of the development and progression of chronic kidney disease. This is referred to as albuminuria. Normal, healthy kidneys filter out large protein molecules and do not allow them to pass into the urine. The presence of albumin in the urine is an indicator of improperly functioning kidneys. This is best measured by looking at the albumin to creatinine ratio (ACR) in the urine. 

72.3% of patients with diabetes and coronary artery disease saw an increase in their ACR over a one year period, meaning that they had a decline in their kidney function. Only 63.3% of those patients who were treated with either an angiotensin-converting enzyme-inhibitor (ACE) or angiotensin-receptor blocker (ARB) (both types of blood pressure medications) experienced an increase in their albumin to creatinine ratio.  However, those patients with both diabetes and coronary heart disease who took fish oil (2.3 gm of EPA and DHA) had no change in their ACR.  In fact, not only did these patients not see a decline in their kidney function, some of the patients who took fish oil saw an improvement in their kidney function via a decrease in their ACR, whereas none of the patients who took ACEs or ARBs saw such a reversal.  

My interpretation of this paper is that fish oil essentially reduced to zero the likelihood that patients with both coronary artery disease and diabetes would progress to chronic kidney disease, at least over a one year period, which patients taking the drugs that are the current standard of care–ACEs or ARBs did not experience. In fact, some of these patients saw an improvement of kidney function, which the blood pressure meds were unable to accomplish.  If this is not enough to demonstrate a significant benefit of fish oil supplementation, then I don’t know what is.  If fish oil was a prescription drug, it would become a billion dollar drug.


Elajami TKAlfaddagh ALakshminarayan D, et al..  Eicosapentaenoic and docosahexaenoic acids attenuate progression of albuminuria in patients with Type 2 Diabetes Mellitus and Coronary Artery Disease.