Detoxification and Healing with Dr. Isaac Eliaz: Rational Wellness Podcast 179

Dr. Isaac Eliaz speaks about Detoxification and Healing with Dr. Ben Weitz.

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Podcast Highlights



Dr. Isaac Eliaz is an MD and acupuncturist and he has been a pioneer in the field of integrative medicine since the early 1980’s, with a specific focus on cancer, immune health, detoxification, and mind-body medicine. He is the founder and Medical Director of Amitabha Medical Clinic and Healing Center in Santa Rosa, CA.  He is the developer of PectaSol-C, the only researched form of Modified Citrus Pectin and other nutritional supplements which are available through EcoNugenics.     

Dr. Ben Weitz is available for nutrition consultations, including remote consults via video or phone, specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com. Phone or video consulting with Dr. Weitz is available.



Podcast Transcript

Dr. Weitz:            Hey, this is Dr. Ben Weitz, host of the Rational Wellness podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness podcast for weekly updates. And to learn more, check out my website, drweitz.com. Thanks for joining me. And let’s jump into the podcast.

                                Thank you, everybody for joining. I’m Dr. Ben Weitz in case you didn’t know. And this is the functional medicine discussion group meeting. And we’ve been meeting through Zoom since COVID started. I enjoy these zoom meetings. But it was a lot more fun meeting in person and personal relationships. And so I’m looking forward to the point when we can get back to that. So I hope you’ll consider joining some of our future meetings. In October 22nd, we’re going to get a tutorial on the GI-MAP stool test with Dr. Jeff Ingersoll of Diagnostic Solutions. November 19th, Dr. Steven Sandberg-Lewis will be joining us for some yet to be decided gut related topic. And we’re not going to have a meeting in December. And I haven’t worked out the schedule for 2021 yet, so I guess I better get to work.

                                I encourage everyone to participate tonight. And so type your questions into the chat box. And I’ll either call on you or ask Dr. Eliaz your question when it’s appropriate. And if you’re not aware, we also have a closed Facebook page, The Functional Medicine Discussion Group at Santa Monica that you should join so we can continue to conversation when this evening is over. I’m recording this event and I’ll post it on my YouTube page and I’ll include it in my weekly Rational Wellness podcast. And if you haven’t listened to the podcast, you should really check it out because we have excellent interviews with many of the top doctors in the functional medicine world. And our topic for tonight is detoxification, transformation and healing with Dr. Isaac Eliaz. I want to thank very much, Clinical Synergy, ecoNugenics, which is the proper name for the company.

Dr. Eliaz:               For doctors, the doctor line is Clinical Synergy.

Dr. Weitz:            Okay. And so I want to thank them for sponsoring tonight’s event. So Isaac, can you tell us what the promo is for tonight? There’s a couple of specials for everybody.

Dr. Eliaz:               Yeah. I mean, so I think that companies, there’s going to be an email going out, there are two different codes because of some limitation of the website. So one is the 15% discount on all Clinical Synergy products. This is a professional line. But then I asked them to make a special promo for our liquid probiotics because it’s really on a class of its own compared to any other probiotic. And I’ve been importing it from Europe for years. It wasn’t available in this country. And then we reformulated, we added our POS, pectic oligosaccharides so I asked the company to buy six and get six free so you can really try it yourself. Give it to patients. It’s the kind of products that once you try, you don’t stop using. It’s an amazing, it’s really, I’ll share when I have some section, there are some products that are hard to explain until you try them. It’s like talking what is sugar until you taste sugar. It’s theoretical. It’s really at a class of its own. So I really, so I asked them to do a special code so people can get a great deal on it, you buy six and you get six free.

Dr. Weitz:            Great, everybody’s going to get an email. In fact, you may get one from Dr. Eliaz’ company and from me as well. And in case I wasn’t clear, if you have a question, type it into the chat box, and that way everybody can see it as well. So, Dr. Isaac Eliaz is a medical doctor and acupuncturist, and he’s been a pioneer in the field of integrative medicine since the early 1980s with a specific focus on cancer, immune health, detoxification, and mind body medicine. He’s the founder and medical director of Amitabha Medical Clinic and Healing Center in Santa Rosa, California. He’s a developer of PectaSol-C, the only research form of modified citrus pectin, and many other incredible nutritional supplements which are available through his company, Clinical Synergy. And perhaps most importantly, besides caring for his family, his patients and his business, Isaac cares for humanity and the planet. And he’s such an incredible human being that I’m honored to know him. And thank you for joining our meeting tonight.

Dr. Eliaz:               Thank you. I love the opportunity to come to your group. I’d like it in person better, it’s true. We have some great evenings that are very crowded with people I already know. But Zoom meanwhile is filling in, you know?

Dr. Weitz:            Yeah. So now you’re going to share your screen and you’re going to do a presentation?

Dr. Eliaz:               Yes. So here we go. It’s okay. Can you guys see this?

Dr. Weitz:            Yep. Yep, we can see it.

Dr. Eliaz:               Okay, so good evening, everybody. And we are going, let me see if I can kind of clear the sharing button to the bottom. Good. Okay, so tonight, we’re going to talk about detoxification, transformation and healing and multi system holistic understanding and critical applications. So we’re going to cover a lot of ground today. And I’ll do my best not to get lost in too many details and a certain area that I will go through quickly, because you guys are experts in it, maybe more than me, and you’ve heard a lot about it. But I want to give you both a bigger understanding of what detoxification is and we usually learn and think about, but also give you today, try to be as practical as I can.

                                Okay, here we go. So what we’ll cover today is we’ll about a deeper understanding of detoxification, how to design a balanced and powerful detox program, detoxification, the relationship with the microbiome, which would be very relevant for next month’s lecture, intensive seasonal detoxification. I’ll talk a little bit about the difference between a full detox, which this is a perfect timing from a Chinese medicine point of view. Fall started three days, and compared to spring detoxification, and both in daily detox strategies, and how to avoid detox pitfalls in the healing crisis, which is really something that you really don’t have to see at all.

                                And again, we’ll talk about Galectin-3 and its role specifically today in detoxification and in the microbiome and gut health, and detox challenges as the use of therapeutic services, it’s a lot of my brain’s work. It’s a part, I’m part of the establishment of having NIH grants, publishing with institutes like Harvard, with the leading conventional doctors. So part of my background is that in one level, really I’m kind of out of the bell curve when it comes to my esoteric and holistic understanding kind of growing with this approach, since I was a teenager from being in Korea and meditating and doing yoga, and spending years and years of two months in retreat and learning from great masters in Tibet and treating them and being a creative person and the same time, being a solid researcher that publishes regularly, and works with always dozens of leading research institutes in over 60 different patents and NIH grants, and really collaborating with the people at the top of conventional medicine, with the people in the real top interesting, they’re very creative, the ones that are really there that have gotten there, they’re often very creative, I learned a lot from them.

                                So when we look at a detoxification, we want to really see it as the process. And the process is the preparatory phase, an exposure phase, a binding phase, a discharge and elimination and support and balance and they of course happen together, except for the first stage, the preparatory phase. And this is more when we do a targeted detox, which is very often done in the changing season, the spring and the fall and done before certain disease treatments, let’s say for cancer after, for example, what do you do after chemotherapy? What do you do after radiation? But we won’t talk. My main focus in my medical practice is cancer, but we won’t talk about it in the context of cancer.

                                Today is more about the gut, because also the large intestine, it relates to the lungs, to the fall season, so it’s a good season to talk about the lungs. So when we look in the preparatory phase, we really want to have the body mind scope, we really want to go all over. So for my diet, it’s a good idea to start preparing for the detox so if you’re about to do a detox yourself or recommend to your patients to do it, it’s going to take a few days a week or two, and start shifting to antiinflammatory detox diet, eliminating allergenic foods and reducing exposure to toxins in food, in products, in environment and the idea is one, we are reducing the toxic load in advance. And we are freeing our detoxification enzymes, our detoxification systems, so they can actually help us in the detox process. The GI support is very important because the large intestine, the intestine in general, large intestine specifically, are really our main elimination organs.

                                And we really need our microbiome, we really need our intestinal barrier and elimination to be ready, so when we excrete into the gut, there is no reabsorption. It’s a very important stage that we really want to emphasize. Let me just move the picture of everybody to the bottom, that would be good. And very important, many people detoxify. But not too many people ask themselves, what do we want to detoxify? What do we want to get rid of? So when somebody prepares for a detox, I would ask them, “What would you like to get rid of, on a physical level, on an emotional level, on a psychological level, on a psycho spiritual level?”

                                And in this sense, the fall and the spring are very different. This spring, we’re coming out of the winter, out of less movement, and we are preparing for longer days, more activity during the summer. So detox in the spring is designed to allow us to be more active, to be stronger, and more liver related, muscle related. It’s preparing the body for greater challenges. The fall season prepares more for the dormant stage. It’s interesting to know now we are between Rosh Hashanah and Yom Kippur, and Jewish New Year is a time when we kind of, it’s a season where we weigh what we did good, our deeds, our positive, the negative deeds and we balance it. That’s very much the fall season, the mental season, the judgment season, and we look at it and we ask for forgiveness, we let go. So detox is also a process of forgiveness, of letting go, of discharging. So especially in the context of the fall, it relates more to the past, to letting go. We’re moving into the darkness, we’re moving into the end of life, from a seasonal point of view, from the annual cycle point of view, and this year especially is a year when we ask, “Oh my gosh, what a year. What do you want to really let go of?

                                So this is the detox part. And towards the end, when I summarize, I’ll talk a little bit about the transformation and healing. That’s another power that is not often the event recognizing detoxification. Also the part that I will not be able to cover here, which are how every organ responds to the detox cycle. I talked a little bit about it in my book that I’m finally going to come up out with, which is going to be called The Survival Paradox. It really explains this.

                                That’s not good. Okay, for the moment, let me make sure there’s only one slide here, okay. All right. So, after we prepared, we want to expose the toxin intersections. And here today in the context of the colon, we really want to address biofilms because it’s a key strategy in day to day addressing chronic infection and in detoxification, because biofilms will bind and sequester toxins and metals, interfere with elimination, nutrient absorption, promote and protect coinfections and thrive in an inflammatory environment. And biofilm and inflammation are mediated and rely on sticky cell surface protein Galectin-3. Galectin-3 is the building block of the biofilm. It’s like the structures, it’s like the skeleton of the biofilm. So it’s important to really understand the importance of biofilm and the role of Galectin-3 in this specific context.

                                So when you look at binding, there is a great advantage to using PectaSol, modified citrus pectin, and the reason is because modified citrus pectin not only break the Galectin-3 driven structure of the biofilm but it’s also powerful binder to heavy metals and a powerful prebiotic, and specifically if you want to address more issues like toxins within the gut, not only systemically, then you can combine it with alginates, which have a different profile of binding, which I will get to soon. I just want to mention this so that I often talk for an hour and a half and I forget to be practical. So today I made a point of being practical.

                                So once we have the preparation, once we have the exposure, now we are ready for the discharge and elimination. And I’m not going to talk a lot about this, because you guys are experts in it and this is such a popular topic with different snips and different changes in the liver. But in general, if there’s an imbalance where phase one is overactive in phase two, which is common, we get stuck with a lot of toxic material in the circulation.

Dr. Weitz:            By the way, Isaac, when we have toxins, how often are biofilms involved? Are they involved a lot of the time?

Dr. Eliaz:               In general, from a gut point of view, they’re involved all the time. And the biofilm, we really look at the biofilm as a concept inside the gut. But in the body, the “biofilm” will be atherosclerotic plaque. When you look at people with heart disease, the connection between gum disease and the heart relates to the biofilm in the gums, which are Galectin-3 driven, so you see studies that Galectin-3 promote gum disease and heart disease. So yeah, so this biofilm structure are available in inside us, it’s where different viruses can hide, et cetera, et cetera. So we need to think about it. But I will get into a whole section on biofilm. So we’ll get to it, because we have to look at biofilm as a microenvironment. And what Galectin-3 does, by creating pentamers, it creates microenvironments or what we call in Chinese medicine, book structure, isolated book structures, areas we no longer have control. It’s also a place for us to box and isolate things that are hard for us, toxins, heavy metals, that we don’t want to deal with for a good reason and toxic emotion, toxic traumas.

                                But Galectin-3 for example, gives you an opportunity to open it up and clean it up. So when we look at this, so in many levels, phase one activates a lot of this toxin from a liver point of view, and phase two, get it ready for elimination, for excretion, of water soluble waste. So really, we really have to understand the concept of discharge and elimination. It’s a key, key, key concept bigger than just phase two. Phase one and phase two is just an expression of it. What do I mean? If we look at discharge and eliminations, discharge is making something that is toxic evident to the body, for example, heavy metals. And you can see why I’m a proponent of modified citrus pectin because not only it will break the biofilm in the pentamers of the Galectin-3, and will release some of the inflammatory ligands and neutralize them, it will bind to the heavy metals also, which we published a number of papers on, you get something that addresses both phases.

                                It’s like for example, in Lyme patients, they will feel really good with using modified citrus pectin. They will feel a relief immediately. They don’t get this aggravation, because it addresses both of it. So for my philosophical point of view, you are opening the drawers, and you’re throwing everything into the kitchen flow. That’s discharge. Elimination is cleaning up the mess. So we have to be equipped to do both of them in a balanced way. And then you’ve got the different B vitamins and cofactors, et cetera, that all of you are very, very knowledgeable, but also you want to make sure you’re taking botanicals that helps in elimination, gut, bladder, lungs, skin, all of them.

                                And I’m not talking about this specific formula as it is called detox complete. It’s specifically designed around this philosophy of supporting the different organs that there is. I’m having some… Okay, here we go. Let’s make sure I didn’t skip two slides, I didn’t. Okay, so as we look at the whole process as a movement, we can see the rhythm between preparation, exposure, binding, discharge and elimination, and support and balance. And when it comes to support and balance, we want to also realize that we are bombarded with pesticide and agriculture toxins all the time. We want to make sure we eliminate them as part of the support and balance on a short term and on a long term basis, and we support the microbiome and that’s why I’m talking specifically about this prebiotic and probiotic. Well, okay, cool.

                                Okay. So I want to talk a little bit about the microbiome and its whole movement from survival to harmony. Maybe it’s a great place to look at our body. If we look at our body, we have it in every range… I don’t know why they say 39 trillion cells, I have no idea why. But if you look at the literature, let’s say around 50 trillion cells, trillion, not million, not billion, trillion, which is million times million, or million times 1,000 times 1,000. It’s hard to comprehend the number. Now, you know how many reactions every cell of this 50 trillion has every second? There is argument in the literature between hundreds of thousands and 1 million reactions a second in every cell. Every cell in this amazing body, these 50 trillion cells producing million reactions.

                                I mean, we can’t even comprehend the number. Basically, we are right now, it’s 10 to the minus 18. And if we just wait a little bit longer, we’ll be more than I forgot what number. And so it’s really incomprehensible, and all of these cells are working in harmony. And within it with a microbiome, there is an argument how many creatures are guests in the microbiome, some people say 100 trillion, some people say 1.3 of the amount of cells, like, 50, 70, 60, 70 trillion, a lot of them. And they work in concert with us. We have a symbiotic relationship between our microbiome that have been developed over generations, over evolution, and it’s actually multi generational. And the microbiome serves us really well. Just to give an example, if we take a drug like Adriamycin, which is a very common anti cancer drug for multiple cancers, and we take antibiotics, the drug will not work because we disrupted the microbiome.

                                Our microbiome knows to activate the drug that we’re using for our own to fight diseases outside our bodies. That’s the level of the wisdom of the microbiome. So when the microbiome is in harmony, it serves us well. But it has an ability to become aggressive when it feels threatened. Right? If we look at our survival reaction in reaction to danger, we either survive with fighting or with running away. So the flight response that we have in the running away is controlled by the sympathetic nervous system. It’s immediate as we know, but if we relax, it will go away. If we are constantly under sympathetic pressure, we start getting metabolic changes, increase in cortisol, increase in glucagon, increase, say of course, in epinephrine, adrenaline, norepinephrine. And as a result, insulin spike and everything goes into a mess. Metabolically, our survival protein is Galectin-3. Galectin-3 is in charge, is our alarm and it sets off the alarm. And as such, it allows us to respond to injury very quickly. But the response is devastating. It’s just like there’s something dangerous and you start a fire to burn it and then you get and make a fire, kind of what we’re leaving right now in California, because the injury repair by Galectin-3 uses inflammation and fibrosis.

                                So in infections, Galectin-3 will respond within minutes, respond very, very quickly, before any cytokine or before anything else. Now we have to remember we are not the only one who wants to survive. The microbiome also wants to survive. So the moment the microbiome senses stress, danger, it will activate itself through Galectin-3, right? We know Borellia, Lyme disease, Candida, they know how to do it. The moment they sense suddenly, we feel our rash from Candida in five minutes. It knows, it senses it, it uses Galectin-3. It affects insulin receptors and it starts spiking things like interleukin 1b, interleukin 6. And I will share a study on it a little bit later on it is a mega, mega study that we are about to submit to a high impacting period or journal in sepsis. So when you address a microbiome, you got to understand this movement from survival to harmony.

                                So for example, when we talk about Lyme disease, patients with chronic Lyme, if they got heavy antibiotics before, it’s so much more difficult to handle. I used to treat a lot of Lyme because of family members were in Lyme, but they are all completely 100% back. So I’m back to more cancer, I just take very difficult cases, and all of them turn around, all of them. And I just never use antibiotics, because they understand this movement from survival to harmony. It’s built within our ability to survive with 100 trillion organisms as long as we respect them.

                                So from this point of view, I want to talk about this lecture. So when it comes to the microbiome, there’s another crazy phenomena, which is time and space. What is good for us in the gut is going to kill us if it goes through the gut, right? If we get the same bacteria coming through the gut, into our circulation, we are dead very quickly. It’s called sepsis. And again, it’s enhanced, and it’s created by Galectin-3. Ben, make a point for me to share the study towards the end, okay?

Dr. Weitz:            Okay.

Dr. Eliaz:               Just to give you guys a sense how dramatic it is. It’s really a landmark study that will be published shortly. So who are we? Who is a microbiome? It’s a high complex and diverse and dynamic really community. I like a lot to use bees as an image of the community as a ex beekeeper who is about to start doing it again, about 100 trillion microorganisms, several thousand different organisms with millions of communication links, and includes protozoa, fibroid, bacteria, viruses. It’s not only bacteria we tend to forget. Common core microbiome really is a multi generational, the interpersonal variations are maintained over generations within family. Fascinating.

                                So the structure of the microbiome is weak, really a glycobiome. There’s really highly glycosylated mucus in its epithelial interface. And it’s separated really, it’s a thin layer of host derived glycoproteins and glycolipids around the surface. So for example, from the image of Chinese medicines, if there are any Chinese doctors in the audience, or people interested in Chinese medicine, we really look at the digestive system in Chinese medicine as not being part of the body, because you think you can eat something, it goes through the digestive tract and come through the anus, and we never interacted with it. It’s these boundaries that are so important in creating the separation. So the mucosa associated microbes are important for nutrient exchange. They help us to absorb nutrients, communication with the host, immune system, and pathogen resistance. It’s a delicate balance. And of course, when we have dysbiosis, it’s thrown off. It’s thrown off if we take probiotics and studies in the wrong way in mega dosages. We also have to respect how we address the microbiome when we want to support it. So the glycobiome has evolved with  mucus degrading enzymes and mucus binding extracellular protein such as Galectin-3. And these bacteria in mucus degrading enzymes, they disrupt the [inaudible 00:29:30] junction. So the moment the gut is under stress, we are under stress. We have more aggressive bacteria, they bind very strong to the gut, and they create leaky gut.

                                I mean, a very multiple examples like Staphylococcus aureus, and different other bacteria that use Galectin-3 as their anchoring. As I mentioned to Ben before the lecture, COVID-19 spiking protein, now this is on the COVID itself. It’s not that is uses it, is practically identical to Galectin-3. So it uses a structure practically identical to Galectin-3 to attach to the surface, and in normal tissue, Galectin-3 highest density is in the lungs, so right there. And when we talk about Galectin-3 in a few minutes, you will understand a little bit better what I mean when I talk about this glycosylated mucus because what happened, Galectin-3 is able to bind to carbohydrates, so glycoprotein, glycolipids, all of these structures use Galectin-3 to bind, to create a shield. The pentamer is a biofilm, it’s literally a shield. I mean structurally, it’s not an esoteric thing, we know the structure. And then you bring new blood supply, you create an hypoxic environment, you have sticky molecules like integrase, you have lipopolysaccharides. So galectins will now carry the labor polysaccharide and create a toxic inflammatory response. It’s all happening, really exciting to understand.

                                So the loss of biodiversity is a loss of balance between our self survival cooperating because if you think about it, survival is a basic evolutionary for all of us. If the microbiome realizes that for its survival, it has to support us because when we die, the microbiome dies, it’s going to be synergistic. But if it feels threatened, it’s going to behave differently. We all went through this situation. When we are relaxed and friendly and suddenly we are threatened, boom, we’re ready to fight. So really, so dysbiosis changes the permeability of the gut, but [inaudible 00:32:05] endotoxin translocation LPS, which is specifically carried by Galectin-3, and systemic inflammation.

                                So really maintaining a healthy diverse microbiome can balance, target and avert a toxic biofilm in the gut because of the potential membrane, promoting its integrity and reducing systemic inflammation.

                                Oops, a moment, here we go. So the most important factors in creating balance in [inaudible 00:32:34] from human epigenetics and microbiome, the expression, the stress related to expression, early life conditions, maternal microbiome, nutrition, preterm birth, C-section, breastfeeding versus formula, genetic factors, hygiene, diet, antigenic foods, high fat, high sugar, fiber, different medication like antibiotic, stress, toxic exposures, inflammation, lack of exercise, infection, and issues of the nervous systems, the gut, brain connection, we’re all very aware of it. I know a lot of people are talking about it. And again, lack of exercise is a stressful situation, because mitochondrial function is not functioning well in your gut into one block and you’ll get more anaerobic glycolysis happened in the synthesis, so you can see how different things can end up in the same place.

                                But this process can most of the localized [inaudible 00:33:32] systemic effects. And gut brain connection is one very good example because when we have dysbiosis, we have lack of short chain fatty acid, lactic acid, acetic acid, vitamin biotic factors, getting mutagenic [inaudible 00:33:49] component if they get absorbed in the systemic circulation, because of leakage in the lining, and you’ve got endotoxin that is released into the gut and now actually it’s moving into the system. And it can cause an inconsistent production of neurotransmitters, about 200 billion neurons in the gut. And it causes immunodysregulation both on the localized and the systemic level.

                                And that’s why in functional medicine, naturopathic medicine in the spleen, stomach school in Chinese medicine, we recognize the importance of the gut in digestion. And also it’s hard to really change it. So I want within this to really look a little bit and understand the role and targeting of Galectin-3. Again, the focus today is our lecture about detox and the microbiome. But again, we’re a little bit extended because we don’t have to stick to such to a pinpoint approach.

                                So really, Galectin-3 is startikng alarming from setting the alarm that something is wrong to driver of chronic disease. If you think about what a survival protein does, any [inaudible 00:35:06] in order to survive, our cells have to develop normally. It’s survival, if you look at Darwin’s survival of the fittest, we have to reproduce. So Galectin-3 plays a role in intracellular development, for example, embryogenesis of the kidneys, and it kind of finishes when we are born, [inaudible 00:35:31]. But then extracellularly, and through membrane receptors, cell surface receptors, when we feel that there is a danger, the cell gets a signal, mRNA starts producing Galectin-3, it’s back in vesicles, it’s shipped out of the cells. And we got trouble.

                                Usually it’s done by macrophage, but also cancer cells are able to do it in extracellular matrix and [inaudible 00:36:06] stem cells can do it. So it really will activate the initial immuno response to acute infections. So for example, the study that I mentioned before, we just finished the studies. It is an integration of evaluating patient who are being hospitalized in the ICU with sepsis with no pre existing condition like kidney disease, heart disease, cancer, and they have no signs of kidney damage. And they’re hospitalized in the ICU, and at the same time, we did an animal, a study on the most translated sepsis model, sepsis AKI, acute kidney injury, which is a huge problem that is overlooked in medicine, that is called a cecal ligation puncture, you puncture the cecal, and enema starts getting an infection within a minute. So [inaudible 00:37:10] for this, and my approach was that Galectin-3 will spike before the cytokine, and indeed, Galectin-3 spikes within minutes, it peaks in two hours, two hours, and it’s down in eight hours.

                                If I take these animals, and I give them PectaSol for one week before the injury, even not after, before, I reduce the mortality by three fold. I lower the Galectin-3 level spike after two hours significantly. I lower dramatically the level of interleukin 6, especially at 24 hours. And I prevent kidney injury dramatically. And this study is done as part of my development of developing a Galectin-3 apheresis column that can pull everything out, because it’s what a septic patient is in the hospital. If we look at the septic patients, the level of Galectin-3 at admission within the study will determine one, who will die from sepsis later on in the ICU, and who will get acute kidney injury, highly significant, kind of mind blowing. Remember, clinically no signs of kidney injury. You don’t know. You don’t know who is going to die. Galectin-3 will tell it to you in advance. Why? You understand why people have [inaudible 00:38:43] CP.

                                I mean this is just one example of category we never talked about, sepsis AKI. We always thought it’s a chronic thing, actually it’s an acute thing, because it will instigate recruitment infiltration of immune cells to site of infection. And then you get your mess, your immune response, your cytokine storm. I mean, talking about cytokine storm for years. I mean, you guys know. I lecture about it to you guys. And now suddenly because we can’t treat it, we can’t turn the damn Galectin-3 off, it goes crazy. And it drives systemic inflammation, profibrotic, proliferating [inaudible 00:39:21], echo the inflammatory in molecules, promote biofilm establishment that drives cancer growth. How can it do it and can it do such a different thing? It can do it. I’ll show you in a moment. I’m in the slide now.

Dr. Weitz:            How quickly does modified citrus pectin work? If somebody were in an acute situation and starting to go into a cytokine storm and they were given modified citrus pectin, could it have an effect at that point?

Dr. Eliaz:               It’s a great question. So for us, it’s my other pocket, I have in my medical device. I want to be very dramatic. But MCP will make a difference. For example, we have a very well known environmental, he shared the story. And I forgot his last name in the San Diego, which had a strong infection in his head and was going into sepsis, didn’t respond to antibiotics, and the doctors were ready to amputate it. And he went on high dose, high dose PectaSol with the probiotic, and within 24 hours it resolved. Because this animal study’s showing the power of it. So you just take it, take 20 grams a day, you just load your body. But of course, when somebody is under total storm in the ICU, they can’t take anything already. But that’s really the value of this.

                                And the problem is that we’re not aware that our chronic disease are often small, tiny insults, infectious, emotional toxins on a continuum and each of them does a small damage and we never recover. When I talk about Galectin-3 and maybe I’m going, not really off topic, I mean I talk a lot about it in my book. Really I use a Buddhist concept. It’s like a bird flying in the sky or like riding in water. You want to respond and to have no leftover debris once inflammation goes away. Galectin-3 prevents this from happening. It keeps going and then suddenly, the cytokine that was so necessary in the short term become pro inflammatory and cause all of this damage.

Dr. Weitz:            Will the Galectin-3 be given intravenously?

Dr. Eliaz:               No, MCP. I mean, there’s work on drugs with it. But the much quicker way to do it in such a situation is to pull it out with apheresis. But for right now for ICS, I mean, for me, MCP is my key supplement right now is what’s going on, definitely what I mentioned. Again, this is just for doctors. It’s a limited lecture. So if we look at the Galectin-3 structure, we can see the N terminal structure. When I point with an arrow, you guys can see it right there. Ben, can you see the arrow?

Dr. Weitz:            Yes.

Dr. Eliaz:               There you see the ligands, you see the ligands. That’s the carbohydrate ending, galacturonic acid ending of different proteins, different ligand. People are aware of lectins. Galectin is a galectin binding protein. Lectin in general is a carbohydrate binding protein. So galectin specifically bind to carbohydrate, and then it creates these nasty pentamers, either by a pentamer binding straighter pentamer or by using ligands. So if it can bind to dozens and dozens of different ligands, it can have such diverse effects. That’s why you understand, we do research on one of these ligands on one specific one, let’s say VGF, a VGF receptor that causes VGF. So you take a VGF receptor, it will cause VGF, which will cause new blood growth for cancer.

                                Well, that’s only one ligand out of dozens at MCP, the Galectin-3 can carry. Well guess what, it can carry it anywhere in the body. Crazy, you know. So one thing which is amazing, a paper that was published in October 2019 that kind of made me commit to putting more energy into my medical device and putting it out because I realized, oh my God, I can save millions of lives, even if I just want to meditate now and not work as hard and I’m working hard because raising money is tough is that we realized we there was a study that showed people patients during CABG, during coronary artery bypass graft. But that’s a study, it’s 1,200 patients, 23 ICUs in Europe, no pre existing conditions. Most patient was CABG, just suddenly they find out that for the first time, pressure, they don’t have any and often they’re not sick before and they are rushed into doing a coronary artery bypass.

                                The levels of Galectin-3 before the surgery is that no kidney disease, no heart disease known before will determine who will get kidney injury in the ICU afterwards and who will end up getting cardiac remodeling, cardiac fibrosis and chronic kidney and heart problems and mortality. The level of limit is before the surgery, but then they did a study on mice and they stopped the circulation to the kidneys for a short term. And they stopped the circulation to the arteries, to the legs. Nothing happened when they stopped the circulation to the legs. But when they stopped the circulation to the kidneys, Galectin-3 got excluded. It went to the heart, it mobilized macrophage, and it created heart damage. When they use it on mice or you call knockout mice, it cannot do Galectin-3, or when they gave our MCP to this mice, no damage to the heart. But here was a crazy thing. With the [inaudible 00:45:39] mice, and they injected to them bone marrow that could produce Galectin-3, and they created the damage to the kidney, the signal from the kidney damage, remember when I talk about the alarming, the signal from the kidneys travel to the bone marrow, cause excretion of Galectin-3, the travel to the heart mobilized macrophage into an inflammatory macrophage and caused heart damage, really looked like a landmark study.

                                It was in one of the American Heart Association journals. It was important enough that the editorial board commented on it how important is the study? This is why when I told Ben there’s so many papers now. So Galectin-3 lattice formation promotes establishment of biofilms because it’s a dynamic extracellular J like polymer formed by cross linking with surface glycoprotein, glycolipid. So all of these different glycolipids can attach to the Galectin-3 pentamers, galectins, glycoprotein and glycans, and the references are in the bottom.

                                Okay, so Galectin-3 promote adhesion and invasion of pathogen. Elevated Galectin-3 expression in damaged epithelial gut lining will bind to pathogenic bacteria, viruses, fungi, allowing for tissue adhesion and invasion, and pathogen will exploit Galectin-3 to augment the capacity to colonize and survive. That’s a survival. You can see what I’m trying to convey when I teach. And it’s not something as convenient as giving protocol. I want to think it was the image, the survival image. You can see the pathogens also want to survive. Now, this is part of what’s going on in our country, this divisiveness. It comes from a survival response, from creating different realities, different micro environment. If any of you didn’t see the documentary, The Survival Dilemma, you got to see it. But how’s the social media is creating what is happening now. Why? It creates micro environments of people that have the same thought and have the same belief, that surrounds themselve in isolation. And why they do it? Because they can advertise the same thing to this group.

                                And then this group doesn’t like the other group. And that’s why we are in a losing proposition situation. And that happened between us and the environment, global warming. It’s all the same. It’s a survival reaction. It’s a fighting survival reaction. So if we can recognize it, it becomes very, very important. So Galectin-3 will drive this cycle of dysbiosis because it will affect the leaky gut. It will promote I-1 and interferon alpha, it will promote IL-17 and, IL-6 [inaudible 00:48:42] alpha. All this is well published. And again, it will overburden the liver and will cause multiple toxic effects. The liver is a fascinating organ. It gets both venous blood and arterial blood. And it’s part of its rolling, dealing with past stuff and detoxifying and dealing with the future generation, the only organ that has this kind of behavior.

                                Okay, so what affects citrus peptin, what it does, it binds to Galectin-3. It takes out, it dismantle or blocks in advance like what it did in our study with the mice, this ligand that causes the inflammatory response, and then it breaks down the pentamers into monomers and it breaks their microenvironment. So this is from again, one of American Heart Association journals. So in the context of the biofilm, it will disrupt the biofilm to expose toxin infections. So again, it’s fundamentally different than regular fiber because it has a much lower molecular weight. It has a low level of esterification. And it’s of course, it’s clinically proven so really when it comes to MCP, there’s only one MCP, only PectaSol. I don’t want to go in great detail about the detail of MCP, we don’t have time, but the neutral sugars, the arabinose, xylose and rhamnose are very important for the immune system and for detoxification, and also MCP has 10% of monogalacturonic 2, which is an immune enhancing compound in [inaudible 00:50:32].

                                So, when we combine it with sodium alginates, we get a wider range of detoxification because alginates are powerful in binding to radioactive isotopes as is PectaSol. We published a paper on it, it binds to dioxin like compounds, pesticides, heavy metal, toxic bile and preventing reabsorption. So when you combine them, you get detoxification in the gut with the alginate and you get systemic detoxification with PectaSol. So MCP will inhibit the critical step for biofilm hosted [inaudible 00:51:10] because the Galectin-3 and the ligand, it’s what really promotes biofilm [inaudible 00:51:16] adhesion. I want to go a little bit faster on this so we have time for question. So, we see these are some of the sticky, these are some of the ligands that are bound to Galectin-3, ligands that are synced neuroinflammation, fibronectin and cell surface adhesion integrations and by the way, will affect the thyroid function in different proteoglycan intensive process. How it happens, I don’t go spend a lot of time with it, but initial adhesion, attachment adherence and then the process stopped with EPS, with extra cell polymers that are producing in the whole site.

                                So, biofilm also sequester heavy metals. So biofilm bacteria sequester heavy metals, EPS and polysaccharide bind to heavy metals and bacteria in the biofilm adopt a more toxin resistant phenotype than free swimming bacteria. Very important, the moment we break the biofilm, we reduce the toxicity and the dangers of the bacteria and there are various mechanism to protect against heavy metals such as efflux pumps, where they can kind of throw the heavy metals out of the cell similar to drug resistance in cancer. So in treating biofilm, you need to address release of heavy metals. So the advantage of the binder, remember in the beginning, the advantage of the binders of always using PectaSol, you are binding to heavy metals, it’s well published. I think we have four or five papers that we know high affinity to lead, to mercury, to arsenic or to cesium, to uranium. We published a paper on family with high uranium showing increased excretion from the gut.

Dr. Weitz:            Is there any question about mcps ability to actually bind? Can MCP actually physically bind the metals?

Dr. Eliaz:               Yeah, of course it does. There’s no question about it. We actually proved it, we actually showed it. It’s well known because of its side chains, definitely. But it has to be at lowest esterification. That’s why PectaSol is unique. You have to change the structure to allow room for the metal structure to bind to it because of the hairy sides of the pectin. Like a few slides ago to these ones where RH, AR, AR, AR, these are the areas where the heavy metals but it has to be challenged is if you’re esterified, there is no longer a challenge. So that’s the issue see here with the esterified, like here, here it’s esterified, there’s no more charge. So it combined is neutralized. And this is why it needs to be. That’s why it’s so important, a low esterification, let me just try to move fast enough to where we were.

                                So for example, studies showing that MCP reduced proinflammatory cytokines, so this is in the nervous system and microglia cells treated with LPS, it’s significantly new counts, significantly it reduced compared to control interleukin 1b, interleukin 6, very significant. Again, these are the nastiest cytokines, it will cause problems. And specifically for the microbiome, our MCP was shown in a number of published papers with the USDA. Again, it’s an independent papers. Most of our papers are independent, I mean, I did microbial effects against multiple strains of staphylococcus ROs including MRSA and additive and synergistic, but to say that the effect is combination of MCP and safer toxin, which is very important in Lyme. So this is all published papers.

                                MCP demonstrated enhanced lactobacilli growth. That’s a prebiotic quality of it, in human fecal culture and anti-adhesive effect against Shiga toxin producing e. Coli, inhibiting binding to cell and reduction of the cytotoxicity of the Shiga toxin. So again, the multiple action of pectin inhibits inflammation in fibrosis, protects vital organ and insists and regulates immune function, inhibits adhesion and establishment of biofilms, support healthy microbiome and intestinal integrity and bind systemic toxin heavy metal. It’s more in the context of today. We didn’t touch cancer, autoimmune disease, all that stuff. That’s not the topic today.

                                Okay, so environmental [inaudible 00:56:31] agricultural toxins, we have to be aware of, and one thing that I neglected to be aware of, but in the last few years, is the critical role of pesticide glyphosate. One of the big issues with pesticides is that they will accumulate in the ground. So for example, in Israel, where DDT is a pain since the 60s, you still find high level of DDT in adipose tissues of breasts 50 years later. That’s a problem with pesticide, so many countries now are banning glyphosate. Mexico just joined the list. United States, it’s incredible. It’s like in United States, in 2012, 1.1 billion pounds of pesticides a year. 1.1 billion pounds, which means between three and these days, it’s more so four pounds of pesticide for each of us a year.

                                I mean, just imagine, just put it in grams. Put it in grams, two kilograms. So every day, we have to take six grams of pesticides. That’s how much it’s put in the ground. And it’s going to get to us at some point, because it will accumulate. So again, a lot of political pressure but so now, the WHO is taking, the position is stronger about the danger in non Hodgkins lymphoma and I’m going to go a little bit quick so we can cover everything. A strong correlation with thyroid cancer with increased level of corn and soy that are genetically engineered to be roundup ready. Look at this, you can look at the correlation between this and the thyroid cancer. Kind of crazy, right? And connection with autism in the Central Valley is very, very, very clear.

                                So wait, how did I get here? Oh from here. So glyphosate also can insert itself into protein synthesis. It’s a glycine analog. And it’s a glycine analog, it has an effect on leaky gut, causing celiac like disease. And also, of course, it’s a narrow excitatory effect because glycine is an inhibitory neurotransmitter and it exchanges with it because it’s so similar in structure. And as you can see, and then it will bind to become an excitatory neurotransmitter in the brain. So there’s an argument is how much glycine can really inhibit glyphosate. There’s literature that say that it can exchange with it, but it can definitely prevent the binding of glyphosate to the mucous membranes of the gut.

                                Because glyphosate is water soluble, it’s very well absorbed. Look, how small it is. It’s nested like a tiny, like the smallest amino acid and so you can understand why it’s absorbed so easy. So, glycine will help to prevent the attachment to the gut. And this, so we created a formula with four ingredients that kind of addresses the issue, which we integrate into the detox program and we also integrate into the daily life. And we’re trying to address both pesticides, a lot in the gut because we get them all the time. And we are using a whole kelp that has iodine, and other trace minerals to allow to exchange with bromide, chloride and fluoride. The formula, we really include kelp, which is I mean, is as organic as we can get, and it’s very clean, and it has a standard dynorphin. The amount that we have in a daily dose is about, it’s about 600, 700 micrograms, so it’s really a dose. It’s the right dose. It’s not very high, and then it should take double, it’s 1200.

                                We use regular citrus pectin, which is highly branch, it’s different than MCP, because we wanted to bind to fit soluble toxins and pesticides. Many pesticides are liquid soluble. We use glycine and we use sodium alginate because sodium alginate is a different profile and it works very well with citrus pectin. So it will help, and sodium alginate will help to absorb glyphosate when paired with a positively charged molecule. And in this sense, I will talk about what you can add to it in a moment.

                                So these are some studies showing how kelp enhances intestinal barrier function again and prevent LPS, which is negatively charged and kelp is positively charged. So from a gram negative bacteria, it’s important for us to try to protect it from creating a systemic effect. This is research about glycine links to a higher level of glutathione. So, glycine really increases the production of glutathione in a significant way and also helps survival in patient following [inaudible 01:02:31]. So when you look at, so this is when we look at alginates, when people kind of take [inaudible 01:02:39], which is a herbicide, there is a significant improvement in survival with alginates and alginates is an efficient biopolymer for example, a lot of herbicides like [inaudible 01:02:53]. So it’s really used for toxic swamps.

                                So the combination with high molecular weight kicked in helps to do it in the gut. When you take MCP of course, you have the systemic peeling effect and that’s why we combined the glypho detox together with PectaSol together with probiotic. Citrus pectin is well established, it can bind to DDT, to DDE. All of these are fit solubles. So you can see the difference in the dosages in adipose tissues in the liver, in the kidney and the brain of the different DDE and DDE prospecting, very significant, all of them statistically significant in animal studies.

                                And also in general, fibers enhance the fecal expression of dioxin isomers and specifically peptins do it very well. Now it’s interesting when we combine alginate with chitosan, which is, which is available in the shell of seafood. And the chitosan is positively charged. So when you combine them, you actually can bind to glyphosate and remove it from water. The reason why you don’t just chitosan is because it doesn’t bind to herbicide at all. These are different published papers. So combining them, it’s a good thing. In my next formulation of this product, we’ll be adding this into the formula.

                                So the next, so now I want to talk about specifically about the next generation of symbiotics, prebiotics plus probiotic. This is really my favorite product that I’ve been importing from Denmark for years. And now I reformulated together with using pectic oligosaccharide I showed you all the research right on our POS, take this as the POS so we are adding it to the fermentation process. So why this product in a class of its own, because it’s not like another peel or another, it’s actually live food. The eight different strains of probiotic are fermented on organic molasses. So the molasses is what allows them to grow. There is no more sugars left.

                                It’s fermented on 19 different organic herbs, and it’s fermented on the pectic oligosaccharides. And what you get is you get a live product. Of course, it’s different than kombucha in the power but it’s along the same principle. And you’ll feel the difference in your gut from literally the first dose, the first dose. For the people that makes a difference, it’s something that they say you don’t leave your house without it. So it’s composed of probiotic, prebiotic that create this synergistic effect. And it really is life. It is energy on its own. It’s grown, everything is grown bio dynamically in a bio dynamic farm. And we use organic berry juice, not just flavor, but actually the juice all organic from different berries.

                                So very unusual product and because, so it’s really not about the number of bacteria. There’s the issue of loading the gut with tones of certain bacteria that may not be the right for a person. But it’s about allowing the gut to heal itself. So the different probiotics can be probably it’s a typo, different lactobacillus I’ll show you pectic oligosaccharide in 19 organic herbs in their organic molasses. So during the fermentation process, we produce two types of organic carboxylic acid, lactic and acetic acid, eight strains of life connected probiotic, the herbs and the pectic oligosaccharides. And the lactic and acetic acid lowers the pH below 3.5, where harmful bacteria cannot live. Lactic acid is used as a signal substance to the body to promote our unity and acetic acid promote peristalsis so you get normal bowel movement. It acts as a fuel for muscles and brain and antimicrobial and fungal and the organic acids help to keep the intestine tight and is a source of nutrition for intestinal cells.

                                So these are different bacteria, bifidus, [inaudible 01:07:38] lactase, lactobacillus acidophilus, [inaudible 01:07:40], rhamnose and salivarius and lacteus streptococcus and thermophilus. And these are some of their unique properties and ability to adhere to the intestinal causa, resistance to intestitnal bile, this form LMD is almost exclusively the L active form. So they really offer very, very, very nice synergistic qualities.

                                And these are different herbs that they are growing. So the herbs are there, the herbs are not in the formula, you don’t get herbs but it’s cultured on the herbs. So these are very organic of course. It’s a large selection of different detox in digestive herbs that really support the digestive process. The idea really is to feed the bacteria with a nourishing food similar to my [inaudible 01:08:40], the mushroom box where I grated herbs.

Dr. Weitz:            Some of these herbs like oregano have antimicrobial properties.

Dr. Eliaz:               Yeah, yeah, definitely.

Dr. Weitz:            Won’t it kill the probiotics?

Dr. Eliaz:               No, no, they don’t because they are really just in the fermenting process and you don’t want to look, it’s a good question. Absolutely not. We check this, the spores are active. But it’s really, really got to look at it as a whole formula, not as one is one ingredient or another. This comes really from the digestive schooling in the European herbal from a coffee, it’s different than the Chinese but you can see the licorice, which we had in the the level of the stomach, the pomegranate, which has metabolic function and has warmer qualities but a lot of spices, dill, oregano, parsley, pepper. I mean these are edible herbs that we use, rosemary, and we know just like we know about curcumin, these are digestive herbs, these are the digestive system so we are extracting this active and allowing the bacteria to activate it.

                                And I think about it’s really similar to the concept of renewal of the microphyte, and then the POS prebiotics stimulate the activity of prebiotic. And they also help to produce short chain fatty acids, like acetate, again acetic acid that are present. So these short chain fatty acids are very important as energy sources. And they’re very important for the physiological function of the gut. So we get, so the kind of signature that you take it and you just feel a difference. So this is something about our studies with pectin oligosaccharide, dietary fibers are known to be prebiotic and low molecular weight and esterification enhance the effectivity of the PectaSol. So this is from a published paper, the first report of POS selecting for higher lactobacillus levels during mixed batch fecal fermentation. So when you ferment feces is that POS specifically stimulates the healthy bacteria, very interesting study. It was done on pigs with the USDA.

Dr. Weitz:            Oh, wow.

Dr. Eliaz:               I’m just going to proceed a little bit quickly. These are some other studies showing again, that POS in [inaudible 01:11:33] was additive effect and synergistic in two strains and organic molasses. Again, so this is the product and it can be taken. It could take in a one to two tablespoon twice a day. It’s very good to combine with PectaSol. It’s an ideal combination. I actually put it in my PectaSol. You can put it in different drinks.

Dr. Weitz:            Now since PectaSol is a binder, is it okay to take other nutrients with it?

Dr. Eliaz:               Yes, yes. It’s not a problem because it’s really nutrients, I mean, if you want to take it 10, 15 minutes before food so I won’t take it like if you take a multivitamin, which you take with food, but even 15 minutes before food, it’s enough. It doesn’t interfere with the absorption of calcium or magnesium because of the high affinity for heavy metals. And we’ve published on it. It’s a very good question. So this is again, what we discussed today, the prepare, expose, bind, discharge and elimination. And the system and I know we covered a lot and time went by really quickly.

                                And so now I want to talk to you about something that I specifically specialize with, which is therapeutic apheresis. Therapeutic apheresis is a process, it’s a medical procedure that involves removing whole blood from a patient, separating the blood into individual component, meaning the first thing that we do actually is this is not as good of a description, we separate the cells from the plasma, and then we take out specific components from the plasma, then we put them together, and then we return them.

                                So from a research point of view, I have a company called Eliaz Therapeutics, where I’m trying to develop the Galectin-3, a column just for Galectin-3, which is related to the antibody, because if selectively we can remove it, we can affect AKI sepsis is our primary target, also CKD and NASH, which is a huge problem and enhance immunotherapy and good for lung fibrosis. So it’s a single apheresis. And we are now in the development stage. We’ve been doing it for eight, nine years, seven, eight years. And we are hopefully with the right fundraiser will be in clinical trials in about a year. And one thing that we’ve done to prove our concept so these are the different ligands, some of them that came attached into the Galectin-3. As you can see, lipopolysaccharides will enhance sepsis, collagen, elastin, laminine will enhance fibrosis, here we’re marking one and three and CD-45 where if you block them, you will shut down the immune response covering desmoglein and integrins wherever they are.

                                Maybe we didn’t put the integrins with the sticky molecules and cancer metastasis, et cetera, et cetera. So what we do when you use a blocker, you are exchanging with the ligands. When you use an apheresis model, you are pulling out the whole thing with all the ligands in it. So get rid of everything. And that’s why it’s so powerful and it works so quickly. So for example, we did a study with Harvard when we injected MGH in special pigs that are developed for xenograft transplant. And in this study, we wanted to see if we create inflammation in the skin by injecting something called complete foreign adjuvant similar to BCG, you create very big inflammation. And you can see this as an active group there is no inflammation, look at the tissue compared to the control group. Look at the redness and lack of resolution in ulcers and look at the tissue, very dramatic. This was published, we published this with me being first author and the last author, the other with Harvard in the Journal of Clinical Apheresis, the main apheresis journal, so two different papers we’ve done.

                                In the clinic we use in different way for life. In the clinic, I’ve pioneered the use of LDR apheresis, which is an FDA approved device that is [inaudible 01:16:10] space for hypercholesterolemia. And I use it for inflammatory conditions together with supplement, together with special IVs. In cancer therapies, it helps chemotherapy, radiation immunotherapy. My biggest focus now is chronic kidney disease, degenerative diseases. I’ve now turned about eight out of eight chronic kidney disease patients, some of them on dialysis or pre dialysis, all of them together with MCP. So really, for the people who can afford it, we actually don’t charge a lot but the fee costs thousands of dollars. It really makes a difference and of course, in muscle activation in pandas, in mold exposure, detoxification, amazing results.

                                I myself make sure to actually get this treatment. I got one yesterday. It’s really a proven regenerative treatment. For the people here who use regenerative medicine or use different biologicals in what they call asimilar biologic, tissue biologics, it’s a completely different response when you do the apheresis and then you do the regenerative treatments, and so the apheresis protocols that we do specifically do IVs that we introduced during the apheresis and immediately after. And it also allows drugs and compound to better reach targets before chemotherapy, before immunotherapy.

                                We know now that immunotherapies, checkpoint inhibitors, if the patient Galectin-3 levels are high, for example, they will not work. So here we are moving just a little bit of Galectin-3. We are moving about 70%. But we’re moving a lot of other inflammatory and growth compounds. So that’s an example. So I actually, in most centers, the doctor just prescribed I look at every big, so what I’ve found, it’s called the signature. So you can see like the large intestine, this patient has a tumor in the large intestine used to. You can see the accumulation, crazy, right there.

                                And this is a picture from today. It’s not as good but enough you can see. The bubble, this is just a bubble. But you can see this circle with empty and this kind of line going up. So when I come back, it’s clearly for me, I tend to see this visually, but that’s the esophagus and the stomach. So as the patient, how is the stomach doing, and they say, “It’s my last place where I’m suffering.” So whatever came out, these are all debris. These are all growth factors, inflammatory factors. It’s unreal, I’m going, I now presented in the three last International Society for Apheresis conferences. And now they’re finally realizing this stuff is good for inflammation, but I’m going to present these pictures, like in 2021, I got to start collecting them.

                                It’s unreal, the signature, how you can see the patient problem like the big and people know by me, I will diagnose them just by the way the big looks, you will see a kidney shape, you will see a heart shape. It’s unreal. Anyway, this just came today, I rush to put it in, this [inaudible 01:19:27] because it is just mind blowing for me. So you have to be open, no concepts, just open your mind. And so I also discovered this specific device can cause an anaphylaxis in certain patients that they weren’t able to solve it for 25 years. But now they move to this device. I was able to solve it very simple just by giving high dose magnesium sulfate IV. It moves you from a sympathetic, from a survival mode to a biased mode. The patient no longer responds.

                                So now we just submitted the paper. We got accepted with revision that we just submitted, seven cases in the biggest center in the country for apheresis that could not handle the treatment, even with IV steroids. All got an anaphylactic shock. They use my protocol. Not all of them are tolerating it. So we basically saved the life of seven patients. So this is a presentation. This is a picture when I was teaching meditation retreat in Israel before the COVID about a year ago. And so this is my email for any of you who need my website. And this is for Clinical Synergy. If you need any help, please call us and the company will help you. And I just finished at eight. But if any of you still want to ask me any question, let me just-

Dr. Weitz:            Well, we have some questions here. So I’ll just go ahead and ask. Somebody asked about spore based probiotics versus other probiotics. What do you think about the bacillus strains?

Dr. Eliaz:               You know, I can’t say that I mean, explain the different strains, I must say. I’m a great believer that for probiotic to work, we got to respect and nourish the microbiome. That has been my approach. So that’s really what I presented, and you’re welcome to any other strain. But really, once you try it, usually I don’t see it on a product and push it like this. But I tell you that a patient of mine was so anxious about this SynerGI that they will come and buy supplies for six months, because I have to bring it from Europe in case it runs out. It just changes your gut. And why? Because of this synergistic, and I think with the [inaudible 01:22:02] issues, loading a gut with too many probiotic can be an issue, if it’s not the right profile for the patient. When you give the gut the right food with a little bit of bacteria, which is of different properties, you allow the body to readjust.

Dr. Weitz:            Well, just to play devil’s advocate, and one of the arguments for spore based probiotics is because they’re encapsulated in a spore. They get all the way down to the large intestine without getting broken down, whereas other probiotics get killed on their way down.

Dr. Eliaz:               This is why the SynerGI is the probiotic are in a spore form. So when we tested the activity, it takes 24 hours and then they get activated. So they actually don’t get killed in the distance.

Dr. Weitz:            So these are like lactobacillus and conventional strains. How do they end up in a spore?

Dr. Eliaz:               It’s something about the process. We’ve actually analyzed it, and when you give them the active conditions, they get activated and start growing. So we haven’t had an issue. And one of the things that you see with him from a clinical point of view, not like a gut bacteria expert. One thing that I’ve seen more dramatic with this is for example, patient with ulcerative colitis that are bleeding in the rectum. You will see an improvement in the first 24 hours.

                                So it goes all the way to there. It changes the motility, you got to look at this as changing the health of the gut. It’s a difficult concept.

Dr. Weitz:            That’s amazing if you can see positive improvement in somebody with ulcerative colitis in 24 hours. Somebody asked about histamine access and does modified citrus pectin help to reduce histamine?

Dr. Eliaz:               It will indirectly. And the reason is because the histamine reaction is often cytokine storm driven. And it’s going to come through the roof and for example, not only histamine, but for example [inaudible 01:24:34] response with ACE2 receptor with the COVID is Galectin-3 driven. So yes, definitely. So you will see decreasing allergic responses, and I think it’s one of the mechanism why we see improvement in Lyme patients, definitely.

Dr. Weitz:            Somebody asked, can you speak about the role of Chinese medicinal mushrooms and inflammation?

Dr. Eliaz:               Yes, it’s a great topic. So, Chinese mushrooms are very rich in oligosaccharides. And they’re very important in regulating the inflammatory process and the immune response. And that’s why they are so essential especially now. I mean right now is what all we are going, my two main products are MCP and medicinal mushrooms. And specifically, my reason why I use mushroom in ImmuneMax because I grow the mushrooms on herbs that are immune enhancing antiinfectious and antiinflammatory. So it’s very similar concept. So this is the one thing that I never skip.

Dr. Weitz:            Somebody asked how to get PectaSol and mix batter. And David Trader made a suggestion. And he said that he found that by first putting eight ounces of water into a shaker bottle with a nettle ball, and then adding the PectaSol-C. That helps. But do you have any other suggestions?

Dr. Eliaz:               So that’s a great, that’s one way. Remember, it’s a saccharide so it doesn’t get broken with heat. So what I do is I put a tiny bit of regular water. So as I put the PectaSol, and the lime one dissolves better. And I put a tiny bit of regular water and then I put hot water. So it’s not boiling, but it’s hot. And you don’t touch it, because the PectaSol is such small grains, that if you right away shake it, it will clump. Let the water absorb for two or three minutes, and then you can add then a little bit more water, you stir really well and you add more water and it will dissolve perfectly. The trick is not to mix it right away, to let it absorb the water first.

Dr. Weitz:            Interesting.

Dr. Eliaz:               Then once it’s warm, and it’s not too hot, it’s like around like 40 degrees centigrade, that’s when I will add the SynerGI into the mix.

Dr. Weitz:            Great. So I think that about wraps up the questions. So I thank you so much for joining us.

Dr. Eliaz:               Somebody asked me about mixing with applesauce. That’s actually a good idea, not a problem.

Dr. Weitz:            What was that? Mixing with applesauce?

Dr. Eliaz:               It’s not a problem at all. So thank you, everybody, for tolerating me with so many details.

Dr. Weitz:            No, it’s great. We really appreciate it. And thank you, everybody, for joining us, and we’ll see you next month.

Dr. Eliaz:               Take care. Bye bye.

Dr. Weitz:            Thank you.

Speaker 3:           Bye. Thank you.

Dr. Weitz:            Thanks.



Strengthen Bones with Dr. John Jaquish: Rational Wellness Podcast 178

Dr. John Jaquish speaks about Strengthening Bones and Osteogenic Loading with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]


Podcast Highlights

2:39  Dr. Jaquish became interested in improving bone density when his mother was diagnosed with osteoporosis in her mid to late 60s and she was worried about having to give up playing tennis and hiking with no way to reverse her condition.  Dr. Jaquish sought out a group in society that was able to build bone density and he found that gymnasts were most effective at this because of the impact of jumping and then landing on the ground.  Gymnasts sometimes impact the ground with up to 10 times their bodyweight.  Research shows that high impact exercise improves bone density:  Effects of high-impact exercise on bone mineral density: a randomized controlled trial in premenopausal women.

But nobody wants older people to go through high impact exercise, so Dr. Jaquish developed some machines that can provide the benefit of high impact without the risk.  His mother had a T-score of -2.5 and after 18 months of using these machines, she was back to a T-score of just under zero and she has maintained that till now when she is in her mid 80s.  These machines place you in the position you would likely be in to absorb high impact forces, such as the position you would have your arms in if you were to trip and fall forwards, with your arms at a 120 degree angle.

8:40  Those participants who go through the Osteostrong program are holding their arms and legs in one position while pushing or pulling against a load, but Dr. Jaquish says that this is not isometric because there is a range of motion that occurs from the compression of their bones.  Dr. Jaquish pointed out that this compression of the bones will also lead to joint compression and this will lead to fibrocartilage growth, as well as bone growth. 

12:06  The force created in the Osteostrong machines is created by the participant pushing or pulling against the machine, rather than a computer generated force.  The computer system is capturing the output created by the person that compresses its own bone mass and joints.  According to Dr. Jaquish, a force of at least 4.2 times the bodyweight is required to stimulate new bone formation. Here is a study completed by Dr. Jaquish and fellow researchers that shows 24 weeks of going through the Osteostrong Center protocols for 24 weeks improved bone density in the hip by 14.9% and by 16.6% in the spine: Axial Bone Osteogenic Loading-Type Resistance Therapy Showing BMD and Functional Bone Performance Musculoskeletal Adaptation Over 24 Weeks with Postmenopausal Female Subjects. 



Dr. John Jaquish has a PhD in biomedical engineering and he is the inventor of Osteostrong, which are wellness centers utilizing medical devices that can load the bone and reverse osteoporosis. Dr. Jaquish speaks around the world and can be found at JohnJaquish.com. Dr. Jaquish has also developed the X3 bar for muscle strengthening, which you can find information about at JaquishBiomedical.com.  Information about Osteostrong can be found at Osteostrong.me.

Dr. Ben Weitz is available for nutrition consultations, including remote consults via video or phone, specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com. Phone or video consulting with Dr. Weitz is available.



Podcast Transcript

Dr. Weitz:                            Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates. And to learn more, check out my website, drweitz.com. Thanks for joining me, and let’s jump into the podcast. Hello, Rational Wellness Podcasters, thank you so much for joining me again today. For those of you who enjoy listening to our podcast, please give us a rating or review on Apple Podcasts. And for those who’d like to see a video version, please go to my YouTube page.  And if you go to my website, drweitz.com, you can find detailed show notes and a complete transcript.

Today our topic is, how to improve bone density with osteogenic loading with Dr. John Jaquish. We have recently focused on osteoporosis in episode 164 with Dr. Lani Simpson and we explored some of the most effective diet, lifestyle, supplements, and medications for improving bone density and bone health. Osteoporosis is a major health issue affecting 44 million Americans over the age of 50. Osteoporosis can lead to fractures that can be disastrous for our health, especially hip fractures which result in death in 24% within one year of the fracture.

                                                Dr. John Jaquish, our guest today has a PhD in biomedical engineering, and he’s the inventor of OsteoStrong, which are wellness centers utilizing medical devices that can reverse osteoporosis and create more powerful fracture resistant athletes. He’s recently partnered with Tony Robbins to help market his centers. Members go through a four device circuit that takes approximately 10 minutes and done once per week has been shown to significantly increase bone density up to 14% in one year. Most other scientific studies have failed to show a consistent increase in bone density with conventional weight training. In fact, according to Dr. Jaquish, conventional weight lifting is a waste of time as is traditional cardiovascular training like biking or running. Dr. Jaquish is also a research professor at Rushmore University, and he speaks around the world. Dr. Jaquish, thank you so much for joining me today.

Dr. Jaquish:                         Thanks for having me.

Dr. Weitz:                            So maybe you can start by telling us about how your desire to help your mother got you started on this topic of improving bone density.

Dr. Jaquish:                         I did it for my mother, yes. She was diagnosed with osteoporosis, and she was pretty distraught because she was prescribed some medications and she didn’t like the side effects she read about. Neither did I. But she said, “This is just going to totally limit my life.” She felt like she was too young to just sit at home and watch everybody run past the window, because it was going to be something that she believed would change the quality of her life just for fear of fracture.

Dr. Weitz:                            How old was your mom at that time?

Dr. Jaquish:                         She was in her 60s.

Dr. Weitz:                            Okay.

Dr. Jaquish:                         In mid-late 60s, but she was very active. She played tennis, and she hiked a lot. Not just walking around a yard, like 15-mile hikes.

Dr. Weitz:                            Right.

Dr. Jaquish:                         Like a real hiker. So I saw her just having to go through the mental exercise of just giving up on everything she liked and I didn’t like that at all. So I said, maybe there’s a population out there that has figured out how to get their bone to respond. And by getting to bone respond past childhood, being able to really build a serious of amount of bone mass. And so I said, “Let me look into this.” Of course, she had nothing to do, so she was like, “Yeah, sure, go ahead.” And so I did, and I found those super responders is gymnast. They build bone density, very high levels. Now, they also fracture a lot of bones because they’re going through high impact. They hit the ground with sometimes 10 times their body weight.

Dr. Weitz:                            A lot of joint injuries too because my daughter was a gymnast from age four.

Dr. Jaquish:                         Sure, yeah. There’s probably… Some of your patients are probably past gymnast who have all kinds of lifetime injuries that they got when they were teenagers or even younger.

Dr. Weitz:                            Yeah.

Dr. Jaquish:                         Yeah. So there’s an unfortunate part of the sport, but it has allowed us to learn a lot. Unfortunately, the amount of research that has been compiled on high impact is plentiful. It’s in the thousands of studies. It’s very obvious what impact does. But of course, that’s the opposite of what’s recommended by most physicians. Most physicians say, “Well, resistance exercise is good.” It’s a really irresponsible recommendation because there’s no dosage associated with it. So aspirin is good for headaches. Well, how much? Five milligrams or 5,000? Well, five milligrams will do nothing, 5,000 will kill you. But 350, that works for almost everybody.  So having a dosage associated with the recommendations are important. So when looking through all of the data, I thought nobody wants older people to go through high impact type exercise. But what if I were to create a series of medical devices that would give the benefit of high impact without the risks? So for example, being in an isolated position where I’m just in a position I would naturally absorb high impact. So I’m going to trip and fall. I’m not going to try and brace myself like this. I’m going to be about right here, 120 degree angle of inclusion from upper arm or lower arm.  So if I’m in a position and I can brace for that impact, I can handle far more than my body weight, sometimes four or five. If we’re talking about my legs, 10 times my body weight. And as soon as I made that discovery that this was just through trial and error that even untrained athletes could hold five, six times their body weight, I thought, wow. We can build a device that will trigger bone growth in the body based on the process that’s supposed to happen physiologically but doesn’t because of our avoidance of high impact. So I prototyped these devices. I treated my mother with the prototypes. Within 18 months, she had the bones of a 30-year-old and she was back to a T-score of just under zero. She never quite got to zero. She’s hovering around there now and she’s in her mid 80s.

Dr. Weitz:                            Her original T-score was what?

Dr. Jaquish:                         Negative 2.5. I read the diagnosis.

Dr. Weitz:                            Okay.

Dr. Jaquish:                         Yeah. And so within 18 months, it was totally reversed. So like I said, there’s thousands of studies that talk about the force that’s associated with impact, but then the studies conclude, but these forces aren’t practical for anyone other than high performance athlete. Untrue, it’s just the way they’re applied. So that’s what the devices at OsteoStrong do. They are incredibly effective. They’re incredibly quick. It takes just a few minutes to go through the protocol and you can only go through it once a week, because bone has a very different metabolic rate than musculature or your lungs or whatever, from a different kind of exercise. We don’t call it exercise.

Dr. Weitz:                            So are they going through a short range of motion or are they just holding one position?

Dr. Jaquish:                         Well, that’s a great question. A lot of people who don’t really look at the technology thoroughly make a mistake and call it isometrics. It is not, because there is a range of motion, but the range of motion comes from the compression of bone.

Dr. Weitz:                            Aren’t you compressing the joint still?

Dr. Jaquish:                         Yeah, oh yeah, of course. And then the joints adapt also based on what we learn from the Benjamin and Ralphs study in 1996. You put axial compression through a joint, which is where the joint is the most optimized, and you grow… There’s fibrocartilage growth that thickens the tendons and ligaments around the joint capsule, so making the joint stronger, more powerful. And not that even somebody who’s bone on bone, there’s still going to be bone on bone, but they’re going to have a better support of joint and that can cut down on their pain.

Dr. Weitz:                            Now it’s not really physiological in a sense that, normally, you would sit down and you would stand up, or you would push yourself away. You’re normally using your muscles through a range of motion when you’re doing activities and weight training is really designed to duplicate some of those normal activities. But this is-

Dr. Jaquish:                         Not at all. When you move something… If you watch movers, guys who professionally move stuff, they don’t use a full range of motion. They’re trying to be efficient with the way they move their body. They’re not going to squat all the way down when they go to pick up the piano to make sure they get a full range of motion. That is not how we functionally move at all. But if you look at a runner, if you look at a sprinter, you use seven degrees of flection behind your knee where you have 180 degrees available. Why don’t you use 180 when you sprint? Because you wouldn’t go anywhere. That’s why. So it’s a full range. Now, full range has its place for sure.

Dr. Weitz:                            If you were a football player and you were kneeling down. And when you’re coming up to block somebody, you’re going through starting maybe in a deep squat and coming up and pushing.

Dr. Jaquish:                         No.

Dr. Weitz:                            No?

Dr. Jaquish:                         No, you use your strongest range only. I train over 10 NFL players with my other product.  And no, you don’t… Full range of motion is nonsensical to athletes and to functional movement. Now, sometimes we go to a deeper range of motion, like getting off the toilet for activities of daily living for elderly people.

Dr. Weitz:                            Right.

Dr. Jaquish:                         You have that discussion with your patients all day long. Because somebody who has a knee injury, getting off the toilet, it got a little harder.  They’re talking to you about it, how do I improve the joint health?  How do I… Activities of daily living full range of motion.  But if you’re looking at performance movements, not at all

Dr. Weitz:                            Interesting.

Dr. Jaquish:                         No.

Dr. Weitz:                            Now, when patients get loaded on these machines, do you start at a lower level and gradually increase it?

Dr. Jaquish:                         The computer system is actually capturing their output, so it’s whatever force they create. We measure the force that they create. So nothing is being placed on the body. The body’s creating the force and compressing its own bone mass and joints.

Dr. Weitz:                            Uh-huh (affirmative).

Dr. Jaquish:                         That way, we let… Instead of trying to have some software system that’s trying to outsmart your injury potential which has never worked in human history, we use neural inhibition as the limiter. So if something becomes uncomfortable, even unconsciously uncomfortable, your body starts to shut the muscles down. And so you get to the maximum output every time. And as the bone mass adapts week by week, that number goes up and up and up.

Dr. Weitz:                            So can the average 70-year-old person produce four times their body weight in force?

Dr. Jaquish:                         Sometimes they have to build up to it. 70, usually, they’re right around the minimum dose response, because it’s 4.2 actually in the hip joint that it takes to begin growing bone. But they usually see that within two or three weeks.

Dr. Weitz:                            It’s interesting. I’m used to seeing people… Every once in a while, you see somebody at the gym when the gyms were open doing a leg press, and they’re just doing a really short range of motion and it’s funny.  I was like, Oh man, that dude is kidding himself.  He’s not doing anything.

Dr. Jaquish:                         Right.

Dr. Weitz:                            But he’s in that short range of motion, he may actually be increasing his bone density.

Dr. Jaquish:                         Yeah, it’s possible. It takes a lot of weight to do it. Usually, when people are doing that, they’re just fooling themselves into thinking that they’re really strong.

Dr. Weitz:                            Right.

Dr. Jaquish:                         You know what I mean? People are like, “Oh yeah, is that what they’re doing?” And I’m like, “I don’t think they know what they’re doing.” But could they be getting a bone density benefit? Yes, they could be.

Dr. Weitz:                            So for participants who go through your OsteoStrong centers, they do that once a week. What other types of exercise do you recommend for them?

Dr. Jaquish:                         Really nothing.

Dr. Weitz:                            What about, say, balance training, since we know a lot of people fall and break a hip.

Dr. Jaquish:                         The balance training is a part of the OsteoStrong protocol.

Dr. Weitz:                            Oh, it is?

Dr. Jaquish:                         Yeah, because it kind of goes hand in hand. You want to… There’s avoiding fracture by avoiding the fall. So that is part of the protocol.

Dr. Weitz:                            So do they do that at the OsteoStrong Center or they do balance exercises at home?

Dr. Jaquish:                         No, they do it at OsteoStrong.

Dr. Weitz:                            Oh, okay. What kind of balance exercises do you use?

Dr. Jaquish:                         It depends. That protocol changes a little bit. You want them to feel slightly off balance, but you don’t want them to actually fall. So there’s a bar in front of them that they hang on to, and they stand on a vibratory platform, a whole body vibration, by the way.

Dr. Weitz:                            Okay.

Dr. Jaquish:                         Yeah.

Dr. Weitz:                            What do you think about that alone as improving bone density?

Dr. Jaquish:                         Yeah, that’s a falsehood, because… And that’s been disproven many times, There’s actually a great piece of research from a Canadian university that shows that vibration does nothing, basically, for bone density.  It does plenty for balance.  It does plenty for activating musculature especially in the deconditioned.  But what they did when the first vibration platforms came out, I actually know the guy who came up with this scam.  It really irritates me, because this is why when you come up with something new in physical medicine that it’s so scrutinized, because there’s so many scams out there.  Alcohol and water, it was going to cure everything, except it really doesn’t do anything.  So at least as far as any research goes, are we going to discover later that it does something else? Maybe.

                                                But thus far, nothing. What they did was they played a game with some of the mathematics of the acceleration. That’s what they would call it. They would always reference the acceleration, how the thing would go up and down. And it went up and down in whatever, 15 miles an hour and your body having… You put under that impact, you’re getting six times your body weight. But the amplitude is so minimal you’re basically just compressing your skin. It’s less than… I think it’s a millimeter at the most. Most of them are half a millimeter. So it’s not getting into your bone because all of your other tissues are absorbing that force.  So when it comes to your bone, your bone’s not getting anything.  So they basically just lie with math and said, “This is going to increase bone density.” But then whenever it was trialed by somebody other than a company, it didn’t do anything

Dr. Weitz:                            Now, what goes into fracture risk is not just bone density, but we also have bone quality, the ability of bone to flex, for example. Do your machines improve bone quality as well as bone density?

Dr. Jaquish:                         Yes. That’s harder to measure. Now, ours… OsteoStrong focuses mostly on trabecular bone. So you’ll see a bone density change within six months or a year, and then you’ll see an even greater change because, typically a DEXA scan is looking at the outer cortex, not the outer cortex really and the inner. The middle of the bone is where the newer bone cells are, and they’re the ones that are absorbing minerals. So the outer cortex is the old bone. It’s not dead tissue just yet, but it’s right before it’s metabolized.  So it’s compact, and it’s on the outside.  It’s the strongest part of the bone, but that’s not where the growth happens.

Dr. Weitz:                            Yeah. I guess, according to Dr. Simpson, I haven’t performed this test yet, but some of the labs that do the bone density can also give you a trabecular bone score, which is supposed to be a measure of bone quality.

Dr. Jaquish:                         Yes, trabecular is much more in the quality category.

Dr. Weitz:                            Yeah. I guess if they have a certain software, they can compute this.

Dr. Jaquish:                         Yeah.

Dr. Weitz:                            So I looked at some of the literature related to being able to increase bone density. I did see a trial called the LIFTMOR trial in 2017.

Dr. Jaquish:                         Out of Australia?

Dr. Weitz:                            Yeah. It showed that heavy weight training using five rep max, squat, deadlift, overhead press plus they had them jump onto a chin up bar and then drop down, did improve bone density.

Dr. Jaquish:                         Yeah. The only thing that did anything was falling off the chin up bar, because that’s where they’re getting the impact. That’s where they’re getting… They’re hitting the ground. Because no one’s… We already know and it’s been shown in multiple studies of very high quality, and this study was… It was more of a exercise science study, so it was pretty low quality, very low sample size, not a lot of controls. The methods section was not well-documented. Nutrition wasn’t even recorded. So okay, it’s a typical exercise science study.  Because I don’t like holding studies to a standard of what we would see in therapy or what we would see with something you find in the European Journal of Sports Medicine necessarily, because usually it’s a smaller study that stimulates a bigger one. But having said that, we know 4.2 multiples bodyweight is what’s required. We know that from big studies, awesome studies that were published in top journals. And so they added impact in with a bunch of weight lifting and they say, weightlifting works. Well, we could do something health-focused with cocaine users and then say, cocaine makes you healthy. No, it doesn’t. It gives you permanent cardiac damage every time you screw around with it.  So it’s just one of those things where-

Dr. Weitz:                            That’s a bit of a stretch for an analogy.

Dr. Jaquish:                         Everyone will get it.  Everyone who listens to this will be like, Oh, okay.  Yeah, that would be obvious.

Dr. Weitz:                            Right.

Dr. Jaquish:                         There’s a great study that was done for basically comedic purposes for researchers where they determined that jumping out of an airplane with a parachute versus not having a parachute with you does not increase your chances of survival. So parachutes are useless. I’m not kidding, they actually did this. You read the conclusion and it’s just like, you would think people were just jumping out of airplanes and just tumbling while they land. And it’s like, I guess you can just jump off of anything and you won’t get hurt. But when you read the methods section, they did this study while the plane was on the ground. So parachute or no parachute, it didn’t even open. Jump from the airplane to the asphalt, to the tarmac.

                                                The point was, this is how people get misled. This is why when you read something in even like the New York Times, the health reporter isn’t really familiar with what they’re talking about. They read the wrong sentence and misinterpret it and then that becomes the new reality for most people. It’s like, are vegetables good or are vegetables bad?  Well, it’s just not that simple.  Sorry.  How many patients come into your office and they really want health summarized into a meme, a sentence fragment? And it’s like, I’m sorry, it’s just not that simple. You should probably… They still write books for a reason.  It’s because memes don’t tell you the whole story and usually they’re wrong, right?  How many times… I bet you every day you tell somebody, you should read this book or you should read that book. Right?

Dr. Weitz:                            Sure.

Dr. Jaquish:                         It’s not that simple.

Dr. Weitz:                            Yes, and the science changes over time and-

Dr. Jaquish:                         Yeah. So I think the LIFTMOR study, it’s like they proved my point. It’s like, Oh, we’re going to do all this weight training. And then we’re going to do this thing that’s just like osteogenic loading and then say weight training works.

Dr. Weitz:                            So you think if they did the five rep max, squat, deadlift, press, it wouldn’t show an increase in bone density?

Dr. Jaquish:                         I can show you 50 studies that’ll give you exactly that.

Dr. Weitz:                            Where they use the five rep max?

Dr. Jaquish:                         Yeah. Maybe not all of them are five. Maybe some of them were 10 reps, some of them were one rep. It doesn’t matter. You know that 4.2 is a minimum dose response. You know that some of the strongest people in the world don’t squat with 4.2 times their body weight. You also know that a leg sled, you’re only getting 40% of the weight because it’s at an angle and most of the weight is being driven into the floor. So people are like, leg press, a thousand pounds. And I’m like, okay. People push cars when their cars run out of gas.

Dr. Weitz:                            Yeah.

Dr. Jaquish:                         Car weighs 3,500 pounds. It doesn’t mean they can bench press 3,500 pounds.

Dr. Weitz:                            Right.

Dr. Jaquish:                         They just got to break the inertia, and it’ll just go on flat ground. You can do it with 100 pounds, 50 pounds.

Dr. Weitz:                            Right. So you also think cardiovascular exercise is a waste of time?

Dr. Jaquish:                         Yeah. So the title of my book is Weight Lifting Is a Waste of Time: So Is Cardio and There’s a Better Way to Have the Body You Want. Now, there’s a lot of caveats to that and I wanted a title that got attention and it sure did. Yeah. It’s a Wall Street Journal bestseller, USA Today bestseller and also an Amazon bestseller. Not that that really means much.

Dr. Weitz:                            No, I think that’s a big deal these days. It really-

Dr. Jaquish:                         What people do is they’ll write a book and then put it in the category of gardening tool buyers guides 2020, and then it’s like, it’s a best seller. Amazon’s got a lot of categories. But I actually was number one for I think… It’s only been out three weeks. I think we’ve been number one the entire three weeks, including the first hour we put it up on Amazon for the subject of weight training, for the subject of fitness and exercise, or maybe it’s exercise and fitness, however they word it. So it was big everywhere. So I sold tens of thousands of copies.

Dr. Weitz:                            Yeah.

Dr. Jaquish:                         And soon, we may be past 50,000 at this point. So what-

Dr. Weitz:                            Yeah, it certainly got my attention and I’ve been lifting weights for more than 40 years.

Dr. Jaquish:                         Sure. So just very briefly because I don’t want to run us out of time and I know you have a limit.

Dr. Weitz:                            Yeah.

Dr. Jaquish:                         Weightlifting is a waste of time, because what I demonstrated was that what you can hold here and what you hold here is seven times difference. So if you have seven-fold greater the capacity, why would you ever lift with a static weight?

Dr. Weitz:                            But the muscles used change. There’s more pecs at the bottom. You switch over to the front delts and you switch to a lot of tricep at the end.  So if you’re not going all the way down, you’re not fully working your pecs, I would say. Sounds like you disagree with that, but…

Dr. Jaquish:                         All the way down. I know-

Dr. Weitz:                            Whatever range of motion you’re going to have. I usually don’t go below this plane but-

Dr. Jaquish:                         We use a full range of motion. OsteoStrong doesn’t, but in the book, which is mostly about why I departed from weightlifting. I always thought it was inefficient. It just bugged me. Every time I would lift weights, I’d be like, there’s a better way to do this. 

Dr. Weitz:                            I don’t know. I just lifted weight this morning, I felt great after doing it.

Dr. Jaquish:                         You’ll feel even better if you do it right. Physiologically… So I take it you have not read the book?

Dr. Weitz:                            I did.

Dr. Jaquish:                         Oh, you did read the book? Okay.

Dr. Weitz:                            Yeah.

Dr. Jaquish:                         So you know that every time we try or every time scientists try variable resistance, it grows more muscle and builds more strength than standard weightlifting.  That was chapter two.

Dr. Weitz:                            Yeah.

Dr. Jaquish:                         Yeah. So when you have the weight change as you move-

Dr. Weitz:                            Right. You’re saying it gets harder as you go through the range, so you want the resistance to increase as you go through the range?

Dr. Jaquish:                         Well, no, it’s easier when you go through the range of motion, so bench press…

Dr. Weitz:                            You can handle more load. Right. So you want the load to increase? Yeah.

Dr. Jaquish:                         Right, right. So you really want high load where you’re capable of handling a lower load to still exhaust the muscle, but also be easier on the joint because the joint grows based on the force you place on it, close to lockout, back to the Benjamin and Ralphs study in 1996. So the joints don’t need a full range. They need impact range which is very small. The rest of the musculature definitely benefits from a full range of motion. So we do use the full range of motion, and especially when it comes to sarcoplasmic growth. There’s two types of muscle growth, myofibrillar and sarcoplasmic.

Dr. Weitz:                            Yeah. People have toyed with this idea for a number of years.  There were some selectorized machines that had a funny shape cam to try to change the resistance during different ranges. I’ve certainly seen people doing, say, a bench press with chains on. And as they lift more, the chains get heavier as they go towards the lockout and even using bands. So people have been toying with this idea of changing the resistance as you go through the range.

Dr. Jaquish:                         They have been. Typically, they break world records if they do it right. That’s really how Westside Barbell… That’s the secret to their success, is using different methods and they have very complicated apparatus which… It’s one gym, and there’s more than 200 world records broken out of that one gym. One gym, one location.

Dr. Weitz:                            Where is that gym?

Dr. Jaquish:                         It’s a suburb in Ohio, and I always… forget the name of the town. But yeah. So they were doing it and it’s kind of anecdotal information. But I approached it from the data I had where I could demonstrate that somebody’s so much more powerful in the impact of greater range of motion. And so the previous approaches to variance would be like, I got X at the bottom and 1.2X at the top, where I’m like, no, no, no, what we need is X at the bottom and 5X at the top. I think the 13th study I described in the book in the Variable Resistance chapter, in chapter two, they demonstrate how the greater degree of variance that they tested… Now, they didn’t go quite as high as I did because I had the bone density data to know exactly how far to go. They didn’t. So they demonstrated that the more variance and less actual weight you’re lifting… They’d have weights and then they’d add bands on a bar.

Dr. Weitz:                            Right.

Dr. Jaquish:                         But the less weight and the more bands, the more growth, because they had a higher variance curve, because it is a very steep curve what we have. It’s not linear at all. It goes like this, because it’s not X at the bottom. Let’s say we’re using 5X at the top, it’s not 2.5 in the middle. It’s X, 1.5X, 5X at the top. So we’re designed the whole product, X3 product to get as close as possible to those curves with very simple and elegant design.

Dr. Weitz:                            And so you also think cardio is a waste of time as well?

Dr. Jaquish:                         It depends on what your goals are. If your goal is to be a distance runner? No, it’s great.

Dr. Weitz:                            What about overall health?

Dr. Jaquish:                         You get a better cardiovascular benefit from strength training, and there’s more than 100 studies that say that.  And the meta analysis, it references. The 100 studies is referenced in the book as well as a few others, some of the highlights. It really shows you can build as good or better cardiovascular health with strength training. Now, the real reason I say cardio is a waste of time is because most people’s goal is losing weight. And when you do sustained cardio, and this research has been out there for 40 years. When you do you sustained cardio, and what I mean is over 20 minutes at a similar heart rate. So as in 

Dr. Weitz:                            Low-intensity steady-state exercise?

Dr. Jaquish:                         Yeah, that’s right.  You surge cortisol and you keep it high for a long period of time. So cortisol does two things, it gets rid of muscle, and it ensures that you keep body fat longer and don’t metabolize body fat and instead metabolize muscular tissue. So you’re losing muscle and you’re preserving your body fat.  That seems to be the opposite of what people want, is just staying fatter longer, which is why when you look at distance runners, they’re skinny fat. They’re not lean.  You look at sprinters and they’re lean.  I know they might be bigger muscular wise.  That might not be everybody’s goal.  But if you want to be a distance runner, you got to run distance and your body will adapt.  You also have to consider the fact that the body is making decisions based on the environment it’s being placed in, like with all exercise.  So if you’re trying to show your body that you want to go long distances, your central nervous system is like an engineering team.  So it realizes you’re trying to become an economy car.  So what do we know about economy cars; lightweight frame.  So you start losing bone density.  People who do a lot of cardio, they lose bone density and so they have a lighter frame, which makes sense. Cortisol is going to increase the storage, as in preserved body fat.  Because if you want to go long distances, you got to be efficient.  You’ve got to carry a lot of fuel with you.  So that becomes body fat. You don’t see many V12 engines in economy cars. So it’s going to shrink the engine too, so you’re going to lose muscle. So you lose muscle, you keep all your body fat, you lose bone density. That has a tendency of shortening people’s lives. I just think it’s a mess. Don’t do it. I can tell you’re loving this. The myth that strength athletes have for cardiovascular endurance really has to do with what is the test and is it the right test? So for example, have you’ve been to Munich Airport? You got to run up and down the stairs four times and go through immigration, get your checked bag and bring that through an examination stall where they never really examine your bag. They just wave you through. But you’re running up and down stairs four times.  It’s crazy, terrible design of an airport, which is really weird, because the Germans design everything great except for the Munich Airport. So I’m with this guy who probably weighs 100 pounds less than me. I’m 240 pounds. He’s a really slim guy, and we’re running up and down the stairs because we’re trying to get a connecting flight to Moscow. I’m out of breath after running up four flights of stairs. And, “Oh man, your cardio is really not very good.” And I said, “No, my legs are four times bigger than yours. Blood has to pump to my quadriceps, which are tremendous. Yours are not.” So it’s like, does the Lamborghini burn more fuel than the Prius? Yeah, it does. It doesn’t mean that there’s something wrong with the gas, it’s just a different machine. And so that’s kind of where that myth comes from, that a strength athlete won’t have as good a cardio health.

Dr. Weitz:                            Okay.

Dr. Jaquish:                         And like I said, there’s 100 studies to back that up.

Dr. Weitz:                            What nutritional approach did you think are most effective for improving bone mass?

Dr. Jaquish:                         High levels of animal protein, really. I know that there’s a meta analysis-

Dr. Weitz:                            Won’t too much animal protein leach calcium out of the bones?

Dr. Jaquish:                         No, never been shown in a real research study, but it has been… So there’s a meta analysis that compares vegan and vegetarian nutrition to a more what they call balanced diet, which it’s all epidemiology research. So what do people eat, and what do they tell you they eat might not be exactly-

Dr. Weitz:                            Food frequency questionnaires which are often unreliable.

Dr. Jaquish:                         Right. Well, it’s like you have when a patient walks in and you ask them how much they weigh. No, you weigh them, because they won’t tell you. They’ll tell you what they weighed in high school. They do it. It’s wishful thinking. It’s like, well, I’m on a diet. So in two weeks, I’m going to weigh this. Yeah, but that’s not what you’re weighing now.

Dr. Weitz:                            So besides a high animal protein diet, is there a thing else you recommend? Do you recommend green vegetables, vitamin D, vitamin K, calcium, magnesium?

Dr. Jaquish:                         Because of the inflammation… So I look at a lot of vegetable… Did you read the nutrition section of the book?

Dr. Weitz:                            Yeah.

Dr. Jaquish:                         Okay. So you know I prefer carnivore nutrition. Yeah, heavy animal protein. The vitamin K and the vitamin D, you’re getting it. You’re getting a lot of… Now, there’s a difference between grass-fed meats and farm factory raised.

Dr. Weitz:                            Right.

Dr. Jaquish:                         You always get the same… Throwing little organ meats in there pretty much gives you every vitamin and mineral. I usually have liver once a week. I don’t emphasize it as much as Dr. Paul Saladino. He eats organ meats daily. I think that’s… Ultimately, if you look at a cow, it’s got 500 pounds of muscle meat and two pounds of organ meat.

Dr. Weitz:                            Right.

Dr. Jaquish:                         So if you eat in that proportion, it’s a 1:250 pound ratio. That’s not a lot of organ meat. But it’s there. So yeah. The people who do the best to build the most bone mass, they have a lot of animal protein. And like I said, oxalates and vegetables are inflammatory. So we know the lower your inflammation is, the more your bone mass can build. And so I really don’t recommend many vegetables at all. It doesn’t mean people can’t eat them and it’s not like an either/or. The NFL guys and the NBA guys, I talked to them about carnivore nutrition. I talked to their nutritionist about carnivore nutrition. I sent them all copies of the book. A lot of them, I sent advanced copies of the book because I even got the Miami Heat’s endorsement on the back of the book.   They’ve shifted most of these athletes to about 70% animal protein as opposed to… The standard Western diet is 70% plant-based. So it’s really that observation. It’s funny, it’s 70% plant-based right now. We were just laughing about epidemiology, we don’t really know much from it, but we know what people buy. And chances are, if they buy it, they eat it. But 70% of calories [inaudible 00:42:40] purchased are plant-based. Now plant-based is also a Twinkie. That came from plants, which… Oreo cookies. I know vegans will eat three or four sleeves of Oreos right in front of me. And they’re like, “Well, they’re vegan. They don’t have any…”   I’m like, “Yeah, but that’s like poison.” It’s not like they have one, they just eat them in a box. But they think because it’s vegan, it’s healthy. So you got to look at what the building blocks in the body are. I really pushed towards carnivore nutrition when I realized how much protein somebody needs to build muscle, and muscle and bone have a synergistic relationship. So even though I was past my days of bone density development, but I still consult on all the research projects of which there are multiple ones going on at different universities focused on the OsteoStrong devices. Yeah. The ones who respond the best are the ones that have the least inflammation and focus on driving muscle. The forerunner to my chapter on nutrition-

Dr. Weitz:                            Aren’t a lot of phytonutrients found in plant foods anti-inflammatory?

Dr. Jaquish:                         So the antioxidants, let’s start with the antioxidants because we’ve been studying that for a long time. You don’t need an antioxidant if you’re not oxidizing. So the idea that I’m going to poison myself and then take an antidote too.

Dr. Weitz:                            But you’re breathing oxygen, right?

Dr. Jaquish:                         Is what?

Dr. Weitz:                            You’re breathing oxygen. So we have oxygen?

Dr. Jaquish:                         Right.

Dr. Weitz:                            So oxygen-

Dr. Jaquish:                         We do not [crosstalk 00:44:38]-

Dr. Weitz:                            In at least oxidative stress, we know oxidative stress occurs in our system.

Dr. Jaquish:                         Right, but the least amount would be better.

Dr. Weitz:                            Sure.

Dr. Jaquish:                         So yeah, I don’t-

Dr. Weitz:                            [crosstalk 00:44:52] probably the osteoclastic activity probably involves… Because we have the osteoblastic, osteoclastic balance that occurs in bone where bone is being broken down and rebuilt. I’m sure the osteoblastic activity probably involves oxidative stress as part of breaking down the bone, but that’s part of the growth as well, because you want to get rid of the bad bone.

Dr. Jaquish:                         Yeah. A, exercise is inflammatory.

Dr. Weitz:                            Of course, exactly.

Dr. Jaquish:                         You can’t avoid it all, but-

Dr. Weitz:                            Very oxidative, very acidic.

Dr. Jaquish:                         Nutritional inflammatories become chronic, because also people eat all the time. So I also recommend time restricted eating. So I only… Right now, I’m eating five meals in a week. So I do a 72 hour of no food period of time, three days. And then I’ll eat one meal a day the rest of the days. So I go nothing in my system and that’s to take down all the inflammation, allow autophagy to happen. I see my scars disappearing. I got a lot of scars and they’re metabolizing [crosstalk 00:46:15].

Dr. Weitz:                            Why do you have so many scars?

Dr. Jaquish:                         I guess I was part of that generation rode motorcycles without helmets [crosstalk 00:46:27] and got ahold of the farm rifle and maybe got hit with ejecting brass a couple of times and burned myself-

Dr. Weitz:                            Okay.

Dr. Jaquish:                         … [crosstalk 00:46:42] I understand that. Yeah. Fireworks, punched through a car window. When a car rolled over, I was the Terminator thinking that that wouldn’t cause any problems.

Dr. Weitz:                            Okay.

Dr. Jaquish:                         Yeah. Here’s one, you can probably see a little bit of the scarring on my arm. My fraternity letters are branded into my deltoid. So a very serious fraternity, a very good fraternity too. So this is like… You could see when I first started X3, it’s the only time I ever took pictures with my shirt off and then been doing that since then. But you can tell in the last two years that it used to have a [inaudible 00:47:34] on it. It was sticking off of my skin half a millimeter. It’s almost gone, and that’s been there 20 years.

Dr. Weitz:                            [inaudible 00:47:46].

Dr. Jaquish:                         [inaudible 00:47:47].

Dr. Weitz:                            Okay, Dr. Jaquish. Any final thoughts you have for our listeners or viewers?

Dr. Jaquish:                         Well, it depends. You know more about your listeners than I do. So what do you think that I can tell them? Yeah, [crosstalk 00:48:07] vegans or they’re going to be upset with me because I say eat carnivores? Do they look at their nutrition like it’s their religion? Because that’s not how you should look at anything.

Dr. Weitz:                            Yeah, I’m not sure who all my viewers are. So I know we have functional medicine practitioners, but we have educated viewers too. So I’m sure there are vegans. I’m sure there’s people who promote Mediterranean diet. I’m sure there’s people who promote paleo or carnivore.

Dr. Jaquish:                         I like the people who tell me that they’re doing hybrid nutrition between… They’re doing sort of keto and sort of Mediterranean. So they’re told bread is great and so are fats. So they just eat pizza. Yeah.

Dr. Weitz:                            Yeah, that’s good.

Dr. Jaquish:                         One of the sad things about the internet is it’s really shining the light on the fact that people want the news that they want. They don’t want the news that’s actually right. So with nutrition research, there are people who are furious with me because I tell them to stop eating sugar and carbohydrates. You can apply carbohydrates in a very intelligent way when it comes to strength training. And if you really want carbohydrates, the time is, time very carefully around your workout and you can get away with it and actually grow more muscle. I described that in the book, but did you read the hyperplasia section?

Dr. Weitz:                            Yeah.

Dr. Jaquish:                         Yes. I say that and I get just hatred messages by usually chubby people with little baby arms. And it’s like, you should be looking for the right answer not the right answer for your hunger, because you’ve been following that one for a long time and you’re probably going to die a lot younger because of that. So there we are.

Dr. Weitz:                            There you are. I thank you for the time spent with us and providing us with some interesting perspectives on building bone and building muscle.



Sleep Hygiene with Dr. Jose Colon: Rational Wellness Podcast 177

Dr. Jose Colon discusses How to Improve Sleep Hygiene with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]


Podcast Highlights

1:59  We are seeing more sleep problems due to the coronavirus pandemic.  People are losing sleep because of stress, being sedentary, and because of their economic situation.  Working from home makes it harder to turn your brain off.

8:23  While you may not be able to control if you work from home or not, you should start with the things you can control. Keep to a regular sleep and wake schedule and don’t work in your bedroom. Your bedroom should be only for sleep and sex.  Do some form of regular exercise.

11:31  How to analyse sleep.  There are formal sleep studies. There are sleep logs that you can download from the National Sleep Foundation or the American Academy of Sleep Medicine. There’s sleep tracking with devices like Fitbit and the Oura Ring.  Dr. Colon is most familiar with the Fitbit. It’s not monitoring brain activity directly but it tracks heart rate and movement, which are surrogate markers for sleep.  It works best with women in the 30-50 years of age range and not as well for teens or for seniors.

17:44  Ideal sleep pattern.  When you go into the first stage of sleep, your brain slows down and your heart rate slows.  Throughout the night you cycle first into a deep slow wave sleep and then every 90 minutes into REM sleep. During deep sleep is where your lymphatic (glymphatic) system washes away toxins from the brain.  This is also when you release growth hormone and it is the most restorative form of sleep.  During REM sleep (rapid eye movement) your brain is quite active and the heart rate is almost as high as when you are awake.

20:20  When we do yoga breathing or mindfulness meditation, when you become aware of your breath, you’re slowing your respiratory rate down and calming your heart, which sends signals to your brain to calm.

22:59  Nobody sleeps through the night without some minor awakenings. The awakenings typically happen in the second half of the night.  If you’re waking up a lot in the first two hours of sleep, that may be a sign of a sleep disorder, such as a periodic limb movement disorder or obstructive sleep apnea. 

24:50  The benefits of REM sleep are that you are consolidating memories and it is also when you’re secreting testosterone.  Memory issues can be an indication of not getting enough sleep.  If you stop breathing during REM sleep, that can cause cortical arousals.  This indicates sleep apnea and this can be corrected with a CPAP machine that opens your airways while you sleep. Untreated sleep apnea is a cardiovascular risk factor. A CPAP machine is the most common treatment for sleep apnea, but losing weight can sometimes correct the problem.  There are also dental devices that advance the jaw forward to open the airway.




Dr. Jose Colon is an Integrative Medical Doctor who is board certified in sleep medicine and neurology. He teaches for the Institute of Functional Medicine and he is the author of books for women’s sleep, sleep and mindfulness in children, and infant sleep. He is the founder of Paradise Sleep, an organization dedicated to the education of sleep and wellness. He works at Lee Health in Fort Myers, Florida and his website is ParadiseSleep.com

Dr. Ben Weitz is available for nutrition consultations, including remote consults via video or phone, specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com. Phone or video consulting with Dr. Weitz is available.



Podcast Transcript

Dr. Weitz:            Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates, and to learn more, check out my website, drweitz.com. Thanks for joining me, and let’s jump into the podcast.  Hello Rational Wellness podcasters. Thank you so much for joining me again today.

Today our topic is sleep, and, in fact, we’re going to also consider sleep during the pandemic. We’re here with sleep expert, Dr. Jose Colon. Dr. Colon, is that the right way to pronounce your name? Is it Colon or Colon?

Dr. Colon:            Colon.

Dr. Weitz:            Colon. Thank you. Perhaps you can introduce yourself and tell us a little bit about your background.

Dr. Colon:            Thanks for having me, Dr. Jose Colon. I am a sleep disorder specialist, board certified in sleep medicine. I’m also board certified in neurology with special qualifications in child neurology. I’m triple board certified in lifestyle medicine as well through the American Board of Lifestyle Medicine. I’m also certified through the Institute of Functional Medicine, Certified Practitioner. I incorporate all of these aspects with my patients to help improve wellness.

Dr. Weitz:            That’s great. We want to talk about sleep in general and get some updates on some of the latest concepts about how to analyze sleep, the importance of sleep and what to do about it. Maybe you want to talk about some of the sleep problems people are having right now since we’re still in the midst of this COVID-19 Coronavirus pandemic in the United States, in fact, around the world.

Dr. Colon:            I opened up by saying thanks for having me, but actually thanks for having me back. We did talk for quite a bit about sleep and sleep disorders, but you’re right, things have changed now with this COVID-19 pandemic.  There are some things that we are seeing right now and then there’s things that we’re going to see down the road. Some things that we’re seeing right now is we are seeing a lot of insomnia. We are seeing a lot of people losing sleep.  The reason for that is threefold, actually. One is stress. The other is the sedentary effect that quarantine causes and then the other, station, where you’re at. You talk about all three. Stress and sleep, they’re not compatible.

Dr. Weitz:            But some of this stress is not easy to deal with.

Dr. Colon:            It’s not.

Dr. Weitz:            If you’re out of work or you’re making less or you have your own business and your business has been affected or maybe it shut down or partially shut down or you’re worried about getting sick or you’re worried about your kids going to school or you’re having to deal with working from home, now maybe you’ve found out you’re going to be working at home for the next year. Your kids are at home too, and you’re trying to deal with all that. They’re going to school online. A lot of these are things that are real that you can’t change.

Dr. Colon:            If you look at the classic model of insomnia, you have predisposing factors, you have triggering factors and you have perpetuating factors as well, kind of like we do in functional medicine. It’s pretty classic that insomnia, there’s some type of precipitating event, something that is life-altering or life-changing, something that causes some threat that causes insomnia. Threat doesn’t always mean that a lion is going to eat you or …  You just mentioned a bunch of threats. Beyond the threat of getting sick, there is the threat of having less work. There is the threat of just everything that you had mentioned there. The sleep and the stress, that’s something that’s causing some more insomnia.   The other thing that I mentioned is sedentary. During a bit, we were really encouraged not to leave the house and gyms were closed.

Dr. Weitz:            Where we are in Southern California, gyms are still closed. For the most part, the tech industry is all working from home. For the most part, people are staying at home, even now.

Dr. Colon:            Exercise is something that’s really very well-known to help with sleep, and, in particular, exercising 150 minutes per week. Not at one time, 150 minutes per week. I have to clarify that because I once said 150 minutes and people were like, “Oh wow, at once.” No, no, no. 150 minutes per week improves sleep quality and the depth of sleep.  When we’re sedentary, we’re not getting that exercise, we’re not having the same amount of sleep drive in the evening. Luckily, our gyms have been able to be open to partial capacity. It’s funny, when they closed the gyms, I did go to the Play It Again Sports, the youth sports and trying to get gym equipment. It was all gone.

Dr. Weitz:            Oh no. Same thing here. Very, very difficult to get dumbbells and plates and things like that. They’re charging five times what the normal price is supposed to be.

Dr. Colon:            You know what I did, I went to Lowe’s and I bought a rope. I took that rope and hung it over my oak tree. I was doing the TRX bands, the TRX bands, just doing some pull-ups, turning around, push-ups, trying to get biceps in. Sedentary lifestyle does lead to difficulty sleeping as well.  Then the last thing that I mentioned was station, where you’re stationed at. The more time that you spend at home, the harder it is to turn your brain off. The more that you’re working from home, the more work thoughts come into your daytime.   The word dormitory, Latin root dorm is dorme. In Spanish, dorme means to sleep. The word dormitory refers to you go out and about your day and then you come to this place where you live at night to sleep. You have that association with sleep.   Now, we’re working from home, we’re doing stuff at home. The amount of time that we’re spending there, what happens? You can’t shut the brain down. 

Dr. Weitz:            The problem is this may be permanent for a lot of people. I heard Michael Dell on TV this morning. He was saying how a lot of these companies realize that all these employees who are working from home, they’re doing fine, and it’s great for the companies because they can pay for less office space. These tech companies not only have massive amounts of office space, but they pay for lunch and meals and coffee and all these other things for their employees. Now that they’re working from home, these companies are going to be saving tons of money, and this is going to become permanent for a lot of people.

Dr. Colon:            It can. Taking a look at those three things, there are some things that are not in our control, but what are things that are in our control. Start with station, with where you’re at. Do everything that you can to keep regular sleep/wake schedules, and do whatever you can to when you work, try not to work in the bedroom. If you can go out to your porch, do it. If you need to go to the kitchen table, do it. If you have a separate office, but that may be a luxury for some people, but if you have that-

Dr. Weitz:            But if possible, if you could have a designated area where you go, “When I go over here, this is work. When I leave there, I don’t do work anymore.”

Dr. Colon:            That’s basic sleep hygiene rules. They talk about the bed, try to use the bed for sleep and sex only. The more stuff that you do in your bedroom, the more ruminating thoughts that you’re going to have at the time that you go to sleep. You just lose the association with sleep. That’s one thing that you could do.  Another, again, as I mentioned, exercise. Do what you can to incorporate some type of exercise. I couldn’t go to the gym for a period of time. As I said, I bought a rope and I worked out from the tree. I did more running at the time than I normally did. Just find something else that you can do exercise-wise to replace.

Dr. Weitz:            By the way, Peloton Company is booming because that’s one alternative for exercising at home.

Dr. Colon:            What was that?

Dr. Weitz:            Peloton, that company is doing gangbusters. Basically you pay, I don’t know what it is, 30, $50 a month, and you get a bike or a treadmill and they have these videotape workouts and there’s other kinds of workouts that you can do.

Dr. Colon:            I’ve known some people who were doing that beforehand and then they reached out to healthcare professionals, “Hey, you could log on.” Everything’s a business as a capitalist. It’s something that you can do, absolutely.  Stress, of course, is do some type of practice of stress release: meditation, mindfulness. Those are my preferences. I’m certified in hypnosis as well. I work with patients in that. I use it myself as well.

Dr. Weitz:            Can you hypnotize yourself?

Dr. Colon:            All hypnosis is self-hypnosis. I cannot control anybody’s mind. I can guide a patient on how to enter into deeper stages of relaxation, into trance. Yes, all hypnosis is self-hypnosis.

Dr. Weitz:            Interesting. I didn’t know that.

Dr. Colon:            Glad we can contribute.

Dr. Weitz:            How do we analyze sleep?

Dr. Colon:            Analyzing sleep can be done in different ways. There’s formal sleep studies that you can get that take a look at one night. There are sleep logs that you can download from National Sleep Foundation or American Academy of Sleep Medicine. You can log wake times and sleep time. Then there’s also sleep tracking.

Dr. Weitz:            What about all these devices and apps that a lot of people use?

Dr. Colon:            The sleep trackers, I really like them. A lot of medical professionals say, no, don’t do that or go throw it away or don’t use it. I like it. I have one myself.

Dr. Weitz:            Which ones do you think are the two or three best ones out there?

Dr. Colon:            What I am most familiar with is Fitbit. I’m most familiar with it for two reasons. Number one, they started it, and then I had so many patients come in with their Fitbit and asking me what it is that they’re seeing, so I got one myself to be able to track my sleep to see what the hell it was about.  Number one, they’ve been around and I’m familiar with it because I personally use the Fitbit. Number two, Fitbit actually has some pretty good data. They presented this data during a technology webinar through the American Academy of Sleep Medicine, and I was very impressed with their data.  That said, the Fitbit gives you a surrogate marker for sleep. It’s not monitoring your brain activity. It does monitor movement and it does monitor heart rate. They have certain algorithms, that based on that, they’re able to track certain sleep.  I’ve found it to be pretty accurate at times. The data says it’s 70% accurate. There’s times that I wake up from a dream and I look and I’m like, “Yup, I was in REM sleep.” I get called by the emergency room in the middle of the night and, yes, I see it, I see what stage of sleep I was in before that and then that I was woken up.  The one thing to know about the sleep tracker is that the data, data is not one size fits all. When I do a sleep study on someone, I’m taking account heart rate norms, if they’re pediatric, if they’re geriatric. The norms are all different from person to person.  Fitbit and all of the sleep trackers have universal data though. That data, those surrogate markers are derived based on who their purchaser is. Their main purchaser are women of middle age, so from 30 to 50 years of age. That’s where the Fitbit gives you the best, most accurate data.  It’s important to know because in a pediatric patient and in a teen, the heart rate is higher. I’ve seen a lot of parents put a Fitbit on a kid, bring the kid in and say, “His sleep is horrible. He’s waking up a lot. He’s never getting into the deep …” It’s because his heart rate is higher and this data was derived based on a different population.

Dr. Weitz:            How about the Oura Ring? Is that more direct data or is that similar to the Fitbit. The Oura Ring seems to have a higher level of detail.

Dr. Colon:            I’ve heard a lot about the Oura Ring. I’m not familiar with it because I don’t have one personally, and I haven’t seen them produce any medical literature data. I think that there’s probably value to it. I’ve seen many people bring many different types of trackers. I’m able to go through it, and I know what I’m looking at. I’m trying to look for sleep cycles, and I make sense of it.  The Fitbit is the one that I’m most familiar with, and I favor that one, but all of these devices have some degree of value to them, and remembering that they’re surrogate markers of sleep, not necessarily a direct measurement of sleep.

Dr. Weitz:            Basically, my understanding, and maybe you can correct me on this, is the main things you get out of one of these devices is: A, the amount of sleep you get, how many times you wake up, and then to what extent you get into REM and/or deep sleep cycles, correct?

Dr. Colon:            Yeah. The data that you get is your heart rate throughout the night, and that heart rate and movement throughout the night extrapolates into everything that you just said.

Dr. Weitz:            Is that the way the Oura Ring works too? It’s all based on heart rate?

Dr. Colon:            I’m not exactly sure because I don’t have an Oura Ring, but I don’t see how else it would work because it’s not connected to your forehead, it’s not connected to your brain activity. There’s no other way that I can see that it works.

Dr. Weitz:            All based on heart rate. Your heart rate gets higher or lower when you’re in REM sleep versus deep sleep versus the other stages of sleep?

Dr. Colon:            Heart rate and movement. There’s a device called actigraphy. That’s a real medical device that looks at movement. When you’re awake, you’re obviously moving more. During periods of quiescent, you’re moving less. It tracks based on movement. These devices, my understanding, it’s the combination of heart rate and movement.

Dr. Weitz:            Basically, could you explain exactly what’s supposed to happen during the night when somebody has an ideal level of sleep?

Dr. Colon:            As you go into the first stage of sleep, your brain slows down. As your brain slows down, your heart rate slows down as well. Your heart and your brain, they’re interconnected, what I call the heart rate and the brain rate.  People have these stages and these cycles of sleep. If we’re not asleep, we are awake. Then we cycle through these. R is REM. People think your REM sleep is your deep sleep but it’s not. It’s actually very active brain time. All throughout the night, you’re cycling first into a deep sleep, then every 90 minutes into a REM period. Every 90 minutes we have another REM period. You have more awakenings in the second half of the night.  Your brain starts to slow down. During this deep sleep, it’s when your brain activity is the slowest. That’s actually exactly what it’s called. It’s called deep slow wave sleep. Heart rates and brain rates are always inter-correlated.

Dr. Weitz:            What’s the benefit of deep sleep?

Dr. Colon:            The benefit of deep sleep, that where your lymphatic systems comes out, and you wash away the toxins into your brain. It’s also the time that you secret growth hormone, and it’s the most restorative part of sleep.  Just like washing machines go through different cycles, your sleep goes through different cycles. Let’s say that you have your washing machine in the deep soak at the beginning, well, that deep sleep is what washes away the toxins and it’s the deepest part of sleep.  Now, in REM, that’s a very active brain period. In fact, the heart rate, the brain rate in REM almost looks the same as that of awake. It’s a little slower, but these two almost look the same. Your heart rate is really elevated during that REM period as well.  These trackers, what they’re doing is that they’re taking a look at both movement but also heart rate fluctuations. When your heart rate is the slowest, it’s saying that you’re in the deepest sleep. Then, all of a sudden, it’ll come up for a moment and it’ll say that you’re in REM. Then it’ll slow down. Even within deep sleep and light sleep, there’s different heart rate fluctuations as well.

                                Let me chime and say something else. Let’s get back to the subject of stress, sleep, meditation, mindfulness. That’s what we’re doing. When we do yoga breathing, when you do an awareness of breath, as you’re slowing your respiratory rate down, you’re calming your heart which sends signals to your brain, and it calms your brain down as well.  Interesting. That’s why people sometimes fall asleep when they’re meditating, or people go to a yoga class, and then at the very end, you get into corpse pose and you do this imagery and you’re breathing slower and people fall asleep.  Interestingly, there’s been times that I’ve woken up and I do a meditation. The Fitbit will tell me that I was asleep. Am I saying it’s wrong, it’s a false? No, I know that I was awake, I was meditating, but that’s the power of meditation that it puts your physiologic body and brain into states of relaxation.



Dr. Weitz:                            I’ve really been enjoying this discussion, but now, I’d like to pause to tell you about the sponsor for this episode of the Rational Wellness Podcast. This episode is sponsored by Pure Encapsulations, which is one of the few lines of professional nutritional supplements that I use in my office. Pure Encapsulations manufactures a complete line of hypoallergenic research-based dietary supplements. Pure products are meticulously formulated using pure scientifically-tested and validated ingredients. They are free from magnesium stearate, gluten, GMOs, hydrogenated fats, artificial colors, sweeteners and preservatives.

Among other things, one of the great things about Pure Encapsulations is not just the quality products but the fact that they often provide a range of different dosages and sizes, which makes it easy to find the right product for the right patient, especially since we do a lot of testing and we figure out exactly what the patients need. For example, with DHEA, they offer five, 10 and 25-milligram dosages in both 60 and 180 capsules per bottle size, which is extremely convenient.

                                                Now, back to our discussion.



Dr. Weitz:            Based on what you showed us about the chart, it looked like the first two, three hours is when you get the most amount of deep sleep. When you have a client who’s having problems with sleep and you find out when they tend to wake up, is that really significant? If they say I wake up in the first hour or two as opposed to I wake up after four hours? Does that have a significance in terms of whether or not it’s more affecting deep sleep versus REM sleep.

Dr. Colon:            You know, that actually has a very big significance. One, nobody sleeps through the night. Everyone has some degree of awakenings that occurs. That’s common to where it’s got a name called NWAK or number of awakenings. If someone actually wakes up four times in an evening, believe it or not, that’s normal. That’s important to know because sometimes people can’t sleep because something is bothering them, and what’s bothering them is that they’re not asleep or that they’ve had an awakening.  Now, typically, you have more awakenings in the second half of the night as you’re transitioning into more of those REM periods. Someone who awakes in the middle of the night or in the early morning, that’s actually a normal phenomenon. We can meditate ourselves back into sleep. If you’re waking up a lot within the first two hours, that may be a sign of a sleep disorder, either periodic limb movement disorder or let’s say obstructive sleep apnea can do that as well.  In obstructive sleep apnea, your airway is being compromised. Remember, in REM sleep, our body is paralyzed so that you don’t act out your dreams. The upper airway has less tone as well. Let me show you something actually.

Dr. Weitz:            By the way, you talked about the benefits of deep sleep. Can you explain what some of the benefits of REM sleep are?

Dr. Colon:            REM sleep, you’re secreting testosterone and in REM sleep, you’re also making memories. In REM sleep, if you remember what you did yesterday it’s because you went into REM sleep and you turned that into a memory. Then there’s some-

Dr. Weitz:            On the opposite end, if you don’t remember what you did yesterday, then that’s an indication that you’re not getting enough REM sleep?

Dr. Colon:            That could be that you’re not getting enough sleep. You’re exactly right. You’re exactly right.  Normally, we breathe. Sometimes we stop breathing. If you stop breathing during the REM sleep, that can cause some cortical arousals. In kids, it’s tonsils and adenoids. In adults, it’s more the upper airway. Here, CPAP opens up the airway. Take a look over here. Look how this person’s going through their sleep cycles. Then look how the heart rate is below 80, and look how it stresses to the hundreds when the oxygen is coming down, and look how it relaxes into the 60s when you start to get the treatment with the CPAP there.  If you look over here, orange are stop breathing events that are a little minor. Green are stop breathing events that are more severe and how it occurs during your REM sleep and that your oxygen is coming down. Untreated sleep apnea is a cardiovascular risk factor.   That said, sometimes, again, regardless of the device, whether it’s Fitbit or I’ve had people come to me with all kinds of devices, and I’m looking at night to night. If I’m constantly seeing awakenings in the REM sleep, that’s not diagnostic for sleep apnea. That’s telling me you’d better get tested for sleep apnea. Many times, indeed, I’ve been correct when I see that.

Dr. Weitz:            Now, a lot of patients hear sleep apnea or obstructive sleep issues, and their first thought is, “I don’t want to wear a CPAP machine. I don’t even want to get tested.” Are there alternatives to wearing a CPAP machine?

Dr. Colon:            Yes, there are alternatives, but let me take a step back. I told you that during the COVID, I’m seeing a lot of insomnia but there’s also going to be a lot of down stream affects. I think it’s pretty well documented that during this whole COVID and the pandemic that weight is increasing. Guess what happens when weight increases? The incidence of sleep apnea is going to increase as well.  If you do have sleep apnea, CPAP is the gold standard. There also are dental devices that are very effective in advancing your jaw forward and treating sleep apnea. These are more for mild to moderate.  There’s these little implantable devices that is like a pacemaker for your upper airway. It’s connected to the phrenic nerve. You go to sleep, you turn it on, it stimulates your upper airway. You wake up, and you turn it off.  There are some surgeries that are available. The surgeries are really not favorable because they don’t really have a high cure rate. What they do is that they make it so that your severity is less and you’re able to tolerate CPAP better.  Even then, there’s other types of CPAP. There’s BIPAP as well. CPAP is continuous positive airway pressure. You breathe in, and the pressure’s eight. You breathe out, and the pressure continues to be eight. Bi means two, so you breathe in and the pressure’s eight, and as you breathe out, the pressure’s four. Bi means two.

Dr. Weitz:            What are some of the symptoms people are going to … I know you covered some of the things in terms of issues with deep sleep and REM sleep, but in general, what are some of the most common symptoms you see when patients are having problems with sleep disorders?

Dr. Colon:            Fatigue is one of the big ones. Sleepiness is another one, concentration, memory, high blood pressure. These are all symptoms that there could be a sleep disorder.

Dr. Weitz:            Now, of course, those are symptoms that are very common. Fatigue could be 20 other things too. We just had a discussion about heavy metals last night. Of course, fatigue and memory issues came up as an issue of heavy metal toxicity as well as fatigue obviously could be a problem with liver problems, adrenal problems, hormones, blood sugar. How do you distinguish that it’s a sleep problem?

Dr. Colon:            How do you find out that you have a problem with metals?

Dr. Weitz:            You’ve got to test.

Dr. Colon:            Yeah.

Dr. Weitz:            You’ve got to [crosstalk 00:29:50].

Dr. Colon:            You do a clinical history. You listen to exposures that a patient may have potentially to metals, whether it’s in the water supply or crappy protein powder or parks.

Dr. Weitz:            I’ve heard about a couple of the protein powders that had lead in them. Is that what you’re referring to?

Dr. Colon:            Yeah. You take a history. In the sleep history, are you snoring? How much are you sleeping? How long does it take for you to get to sleep? It’s part of the core part of the functional medicine matrix there, the lifestyle modifying factors.

Dr. Weitz:            Now, do you find sometimes patients come in with sleep problems and it turns out to be something like heavy metal toxicity?

Dr. Colon:            Yes. I see this because I have the different training.  I’m not thinking only sleep apnea, only sleep apnea, only. No.  There’s times that I treat sleep apnea and they come back and they’re like, “Doc, why am I still tired.” “Let’s take a look at your medication list.” We’ve got a couple of medications that are mitochondrial toxic: Metformin, the statins of which diabetes, having insulin resistant is toxic for the mitochondria as well. You do a history, and then sometimes you do find other things.  I saw a girl the other day that she came to me, she’s got Lupus. We wanted to rule out sleep disorder. It was completely negative. I did a Genova NutrEval on her. Her mitochondria were shot: high oxidative stress, high lipid peroxisomes there, the OOHD was just sky high. You know what else? There was gasoline in … there was some toxicity. She had some gasoline in there probably from the water supply. When things don’t add up, you take a couple steps back, do a further history and you go to it.

Dr. Weitz:            Is that one of your favorite screening tools for toxicities and nutritional deficiencies, a NutrEval?

Dr. Colon:            I like it. I like it. It’s of several that can be done. Genova has some other expanded upon specific toxicity findings. It’s all individualized and basic. What do you use?

Dr. Weitz:            I like the NutrEval. There’s a micronutrient test now that Vibrant Labs has that’s pretty cool. We stopped using SpectraCell because they’re on the verge of bankruptcy and taking months and months to get the results back. We used to use the SpectraCell micronutrient test, but I really like the NutrEval because you’ve got so much data.

Dr. Colon:            I really like SpectraCell a lot and still utilize them. Sometimes the NutrEval gives me more information than I wanted and will confuse a patient. Sometimes it doesn’t give me as much of the nutrient information that I may get from SpectraCell.

Dr. Weitz:            Take a look at the Vibrant version of the micronutrient test.

Dr. Colon:            Okay, I’ll look into that.

Dr. Weitz:            What do we do when we have patients with sleep disorders? What are some of the treatment protocols?

Dr. Colon:            It all depends on the disorder. Number one, you’ve got to identify the disorder. If the disorder is sleep apnea, you get that treated in weight reduction, positional sleeping, CPAP. If the disorder is-

Dr. Weitz:            In terms of weight loss, how much would you say on the average, let’s say you get a patient, a 5’9″ male weighing 260 pounds. Would he have to lose 10 pounds, 20 pounds, 40 pounds before he’d see a significant, just on average, difference?

Dr. Colon:            There is no magic number at all. That doesn’t exist. People are going to lose a certain amount of weight, period. Once they’ve gotten to that, you can retest them.    I had someone who had a sleep apnea that lost seven pounds. When I retested them, they were negative. I’ve had people lose 30 pounds and still have some residual sleep apnea. There is no magic number.

Dr. Weitz:            We’ve got weight loss. What are some of the other treatments?

Dr. Colon:            Let’s say that you have a different disorder. Let’s say you have restless legs or periodic limb movement disorder. There’s medical treatments, there’s pharmacological-

Dr. Weitz:            Maybe you could explain what that is for folks who are not familiar with restless legs.

Dr. Colon:            Restless legs are uncomfortable sensations in your legs. It’s worse at night, relieved by movement. Periodic limb movement disorders are limb movements that occur in your sleep that sometimes are associated with restless legs but not necessarily, and they can cause a lot of sleep fragmentation.  Restless legs, uncomfortable sensations. Limb movements, we move. This person’s moving during the night. This one’s okay. The brain’s all right as opposed to this person, their leg movements are frequent enough and forceful enough to where it is disrupting sleep quality there. There is pharmacol therapy for that, but there’s also some nutritional deficiencies that can cause that. Magnesium deficiencies, iron deficiencies, they can cause restless legs and PLMD. Also, GI issues [crosstalk 00:36:13].

Dr. Weitz:            Magnesium and iron, what are the best tests for magnesium status and iron status?

Dr. Colon:            I’ll go back and say either a micronutrient profile are the best. Serum whole blood testing you can do, but with serum whole blood testing, you get a fluctuation of what you had over the last 24 hours. A micronutrient test is the best way to test for that.

Dr. Weitz:            What about for iron?

Dr. Colon:            Iron is just blood studies. Just flat out iron [crosstalk 00:36:51].

Dr. Weitz:            Do you look at serum iron? Do you look at ferritin? Do you look at-

Dr. Colon:            Ferritin. Ferritin. We actually look at ferritin. Ferritin is supposed to be normal if it’s 30 or 40; however, any ferritin under 70 can give you symptomatic restless legs.

Dr. Weitz:            What other nutritional deficencies are there?

Dr. Colon:            For insomnia, zinc is one. Oleic acid is a big one for insomnia as well. B vitamins-

Dr. Weitz:            For some folks who don’t know what oleic acid is …

Dr. Colon:            Oleic acid is just that.

Dr. Weitz:            Basically it’s Omega-9 olive oil, right?

Dr. Colon:            Yeah, yeah. You need it in order to make neurotransmitters. B vitamins can affect circadian patterns. B-6 helps improve dream recall, so it can affect REM sleep. Zinc I had mentioned as well. There’s a number of different micronutrient deficiencies that [crosstalk 00:38:05].

Dr. Weitz:            What do you like the best marker of B vitamins? Again, you use the NutrEval or do you like homocysteine levels or …

Dr. Colon:            I like micronutrient profiles.

Dr. Weitz:            We got nutritional deficiencies. Are there specific dietary factors that can play a role?

Dr. Colon:            Of course there’s dietary factors that can play a role. If your diet is depleted in something, you’re not going to absorb it, but equally, if your gut is not absorbing nutrients, then you’re going to be depleted. My girl with Lupus there, she had every single micronutrient deficiecy that we can have. She’s like, “But I eat healthy.” I’m like, “Listen, you’re not absorbing it. We’ve got to heal the gut.”

Dr. Weitz:            What did you do for her?

Dr. Colon:            Actually, what I did is first I slapped on, and I didn’t literally do it, but I prescribed multi-vitamin patches. Her gut isn’t absorbing it. We’re working with the micronutrient patch. Then the other thing that we’re going to do is we’re going to [crosstalk 00:39:17].

Dr. Weitz:            Wait, where do you get micronutrient patches from? I’m not familiar with those.

Dr. Colon:            Where do you get anything? You get it on the internet. If you don’t find it on the internet, it doesn’t exist.

Dr. Weitz:            I know, but is there a particular company that you trust for micronutrient patches?

Dr. Colon:            Patch MD multi-nutrient patches.

Dr. Weitz:            Okay.

Dr. Colon:            Patch MD. They also make melatonin patches as well which are good in these kids that can’t swallow pills and won’t take anything. We started with a multi-vitamin patch with her and then we’re going to fiber the gut, a little bit of Inflam-Eze from Nutri-dyn, probiotics, digestive enzymes. A month or two later, after we go through some of this treatment, then we’re going to revitalize the mitochondria and start taking in oral vitamins and Omegas. For right now, we’re just healing the gut and getting the nutrients through the patch.

Dr. Weitz:            I interviewed a dentist at some point who also specializes in sleep apnea. He felt that Vitamin D was potentially a big factor in sleep problems as well.

Dr. Colon:            Yeah, it is. Vitamin D is associated with fatigue but it’s also associated with poor upper airway tone. Vitamin D deficiency can provoke sleep apnea.

Dr. Weitz:            Then, of course, we have blood sugar issues.

Dr. Colon:            Yeah. An untreated sleep apnea can negatively affect blood sugar control.

Dr. Weitz:            And probably [sersa 00:41:05] too, right?  Blood sugar fluctuations can affect sleep. There’s a huge percentage of the population that’s diabetic or pre-diabetic or on their way to it.

Dr. Colon:            The newest evidence shows that high carbohydrate diets really negatively affect sleep.  High glycemic foods before bed likewise. Something [crosstalk 00:41:28].

Dr. Weitz:            Now, you do have some people saying I need the carbohydrates to give me the serotonin release. What’s the reality there?

Dr. Colon:            What happens with alcohol?  Alcohol is sedating but then once the alcohol wears off, you get sympathetic surge. That sympathetic surge disrupts the second half of the evening.  Likewise, high carbohydrate states, they may be sleep-inducing, but once the carbohydrate comes down, it plummets down, guess what comes up? Epinephrin and norepinephrine then comes up. Quality carbohydrates to make your serotonin, yes. Milk and cookies before bed, no.

Dr. Weitz:            Or maybe better some quality fats.

Dr. Colon:            Oleic acid.

Dr. Weitz:            Especially when you have people with blood sugar issues or even type 2 diabetics, they sometimes have trouble maintaining an even blood sugar throughout the night. If their blood sugar drops too much, that can wake them up as well.

Dr. Colon:            Dr. Ben, you know your stuff.

Dr. Weitz:            I think those were the bulk of the questions that come to mind. What other issues would you like to cover, or do you think we pretty much covered it?

Dr. Colon:            No, I appreciate you having me. We’ve covered it. There’s an epidemic of sleep loss during this COVID. Then that epidemic leads downstream to weight gain because of sedentary lifestyle and people being up late eating. That’s something called insomnia-nom-nom-nom-nom-nom-nom-nia.

Dr. Weitz:            By the way, if somebody wakes up in the middle of the night, what is the best thing for them to do? Everybody seems to have something different. One person told me she likes to listen to the radio. Some people turn on the TV. Some people read. Some people get out of bed. Some people feel like if they eat something, it’s going to help them go back to sleep. What do we know about the science, about the best thing to do if you wake up in the middle of the night?

Dr. Colon:            Meditation is great. I’ve been able to put myself [crosstalk 00:44:01].

Dr. Weitz:            Is it better to stay in bed and meditate, or is it better to get out and get back in?

Dr. Colon:            If you’re frustrated, get out of bed. If you’re able to stay calm, just stay in bed and meditate, either an awareness of breath or a body scan meditation. If you’re an anxious person, progressive muscle relaxation. That’s my go-to.  If you want to look at botanicals, I really like L-Theanine. L-Theanine cuts down mind chatter. Athenian is good for reducing anxiety. It’s not sedating. You may say then why are you using it for sleep. You can use L-Theanine during the daytime and not be sedated, but if you wake up in the middle of the night, the last thing that you want is something that’s going to be really sedating because then you’re going to be groggy the next day.  That’s when a liposomal L-Theanine will be helpful. Nutri-dyn makes a good one. Magnesium can be helpful as well. Again, not sedating but there’s things that are calming. Combining that with-

Dr. Weitz:            Quicksilver makes a liposomal L-Theanine as well. In general, in terms of sleep supplements, we have melatonin, 5-HTP, magnesium, L-Theanine, we have these combination products. I think there’s a common thought in the functional medicine community. I’ve heard a lot of people say, and I’ve used this thought process as well, if you have trouble falling asleep, then melatonin is going to be helpful. If you have trouble waking up, then 5-HTP is going to be better. Do you have some thoughts about that or is it better to combine them? Is it useful to add GABA to that mix?

Dr. Colon:            GABA can help reduce anxiety. Everything that you said is correct towards that particular person. Sometimes you can shotgun and try everything. Other times, don’t guess, test. I like doing neurotransmitter profiles. The ZRT neurotransmitter profile with the epinephrin and the melatonin cortisol profiles is money, man. I’ve seen some. It’s been really helpful.  You were mentioning that there were a bunch of different products. Nutri-dyn, again, they make some really good ones. They have this Liposomal Sleep that’s incredible. It’s sublingual, it’s got five milligrams of melatonin, B vitamins, GABA that you mentioned, and then also oleic acid.

Dr. Weitz:            Cool. Okay, Jose, Dr. Colon, how can patients get a hold of you if they want to contact you to get a sleep study or consult with you? You have a number of books available as well, right?

Dr. Colon:            I do. I have some books available. We can go to paradisesleep.com. There, the books can be found. There’s some general inquiries that you can place in there.  Actually, I work for Lee Health in southwest Florida. Essentially, I work for the state of Florida because it’s a government-owned medical system. I have to see my patients from Lee Health, but I do have a website called paradisesleep.com that has a lot of resources for sleep. There’s a place to reach out and ask a question if you need to.

Dr. Weitz:            Do you have any training programs for practitioners?

Dr. Colon:            I don’t have any training programs for practitioners. No, I don’t.

Dr. Weitz:            That’s something you probably should add to your bucket list, do a training program for doctors. That would be something that would be in demand.

Dr. Colon:            I’ll bounce it off of a friend of mine and we’ll see what we can do.

Dr. Weitz:            Sounds good, doc. We’ll talk to you soon.

Dr. Colon:            All right, my pleasure. Thanks for having me.



Parasites and Gut Health with Dr. Ilana Gurevich: Rational Wellness Podcast 176

Dr. Ilana Gurevich speaks about Parasites and Gut Health with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]


Podcast Highlights


3:45   Dr. Gurevich said that she finds that in her speciality GI practice 60-70% of patients that she sees with functional GI disorders also have a protozoa or another form of parasite. 

4:17  If the testing shows multiple problems with the GI tract, such as SIBO, a parasite, fungal overgrowth, and bacterial overgrowth, it can be a diagnostic conundrum which to focus on first.  Dr. Gurevich finds that the patient’s history can help determine if the focus should be on the small bowel or the large bowel. If the patient has had lifelong symptoms, then you should focus on restoring the microbiome in both the small and the large bowel.  If the symptoms came on after a recent onset of food poisoning, it might be small bowel IBS.  If it came on after international travel, then you should suspect parasites. If there is a lot of bloating and abdominal pain, then you might want to focus on the small bowel. We have effective testing for bacteria in the small bowel (SIBO breath testing), but there is no good way to rule out parasites, protozoa, or yeast in the small bowel without doing a small bowel aspirate, which is not commonly done in clinical practice. Dr. Gurevich said that she will prioritize treating worms first, parasites next, protozoa next and microbiome and biofilms next.  It’s interesting what giardia does in the lumen of the intestine, which is that it changes the microbiome. [Here is a paper describing this phenomenon: Barash NR, Maloney JG, Singer SM, Dawson SC.  Giardia Alters Commensal Microbial Diversity throughout the Murine Gut. Infect Immun. 2017;85(6):eoo948-16.]   If the patient has microbiome issues and giardia, then it makes sense to get rid of the giardia, which then may fix the microbiome problems. 

8:09  Some practitioners will also do a second stool test that focuses more on the microbiome, but Dr. Gurevich said that we still don’t know enough about the microbiome to really make too much of a definitive analysis from this.  But if she is looking at a microbiome stool test and she sees pseudomonas, she will suspect that there’s a biofilm, which means that there could be parasites, protozoa, and worms that are hiding in the biofilm.  If staph and strep are present, that will also make her suspect that there is a biofilm present.

11:52  There are certain parasites that can show up on a stool test like blastocystis hominis and dientamoeba fragilis that may or may not be pathological.  [Dr. Hawrelak recently appeared in episode 169 of the Rational Wellness podcast and he feels that these protozoans–blasto and D. fragilis–when found are not usually pathological and do not warrant treatment.]  Dr. Gurevich noted that she tried not treating blasto and D. Fragilis after hearing Dr. Hawrelak speak and she was not getting great results, so she went back to treating such patients and this worked better.  She often uses the antiparasitic drug, Alinia, usually for 21 days.  For the parasite, Giardia, she will use two 10 day courses separated by 10 days. Her treatment protocol will vary depending upon when the full moon and the new moon are.  She will do 10 days of Alinia and then the next 10 day cycle she may start 7 days before or 3 days after the next new moon or full moon.  She might use herbal antimicrobials in between these treatment cycles.  Her favorite antifungal product is Clear Four by Pharmax.  Dr. Gurevich notes that she has not had good success using herbal protocols for treating parasites.  She has tried mahonia, wormwood, black walnut, though she has not tried mimosa pudica.  She tried using Paraguard, a popular herbal combination product for parasites and not had much success.  Dr. Gurevich also finds it helpful to treat Dientamoeba Fragilis, though she is not so sure about endolimax nana, which she thinks may be a normal variant. 

27:35  Calprotectin is a marker for inflammation on the GI Map stool test that I have found does not always correlate with the symptomatology and what would appear to be a lot of inflammation in the gut.  Dr. Gurevich likes to run zonulin on all of her patients because if it’s positive it indicates that her treatment protocols should focus more on the small bowel than the large bowel. 

29:42  Dr. Gurevich noted that quercetin works really well in healing leaky gut. She recommends quercetin at a dosage of 2000 mg three times per day for one month.  She noted that if you used such a high dosage of quercetin, it can interfere with thyroid conversion of T4 to T3.  Quercetin is also a zinc transporter, so it helps in immune protocols and there is on study showing it helps to heal leaky brain barrier, so it is helpful for patients after concussions.



Dr. Ilana Gurevich is a board-certified naturopathic physician and acupuncturist and is currently co-owner of two large integrative medical clinics, one in northwest Portland and one in northeast Portland.  She runs a very busy private practice specializing in treating inflammatory bowel disease as well as IBS/SIBO and functional GI disorders.   She lectures extensively and teaches about both conventional and natural treatments for inflammatory bowel disease as well as SIBO.  She is one of the foremost experts on the intersection of IBD and IBS and how treating one resolves the other. She can be contacted through her website, naturopathicgastro.com

Dr. Ben Weitz is available for nutrition consultations, including remote consults via video or phone, specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com. Phone or video consulting with Dr. Weitz is available.



Podcast Transcript

Dr. Weitz:                            Hey. This is Dr. Ben Weitz, host of The Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to The Rational Wellness Podcast for weekly updates and to learn more check out my website drweitz.com. Thanks for joining me and let’s jump into the podcast.  Hello, Rational Wellness podcasters. Thank you so much for joining us today. For those of you who enjoy the podcast please give us a rating and review on Apple Podcast. There’s a video version on my YouTube page and if you go to my website, drweitz.com you can find complete show notes and a detailed transcript.

Today, we’ll be discussing stool testing interpretation, parasites, and gut health with Dr. Ilana Gurevich. I recently had a fascinating discussion about parasites with Jason Hawrelak and I really wanted to get another perspective on how we should view parasites when they show up on a stool test and how best to treat or not treat them.  Dr. Ilana Gurevich is a board certified naturopathic physician, an acupuncturist, and she currently co-owns two large integrative medical clinics in Portland. She runs a very busy private practice specializing in treating inflammatory bowel disease as well as IBS and SIBO, and other functional GI disorders. Thank you Dr. Gurevich for joining me today.

Dr. Gurevich:                     Thank you Ben for having me again, and I would also just like to say in person your questions, because I listen to a lot of your podcasts, the amount of knowledge that goes into the questions I stop listening and I get so excited. You did an osteoporosis podcast and I swear to God I probably sent it to 10 people.

Dr. Weitz:                          Wow, cool.

Dr. Gurevich:                     It’s like the breadth of knowledge that goes into your questioning I’m sure that you are busting your butt and it is a ton of work doing the podcast-

Dr. Weitz:                          Absolutely.

Dr. Gurevich:                     … so you can get it done.

Dr. Weitz:                          Yeah.

Dr. Gurevich:                     For all the people who are listening get it done.

Dr. Weitz:                          You know what? For me, it’s kind of cool because I always loved school and I feel like I’m always in school because-

Dr. Gurevich:                     That’s funny because what I love about podcast, especially yours, is I feel like I’m going to a webinar, tossing me on my butt and driving somewhere before doing my dishes.

Dr. Weitz:                          Right.

Dr. Gurevich:                     So thank you.

Dr. Weitz:                          You’re welcome. Thank you. Thank you. I thank you for noting that. So as an introductory question how’s your practice doing in the midst of this continuing coronavirus pandemic?

Dr. Gurevich:                     So the positive thing is because since I’m so specialized really my practice very easily transitioned to online. The bummer is what I also do is acupuncture and that does not transfer online. What I have been noticing is a lot of the mental health stuff that people are dealing with in COVID in isolation I was trying to put them on meds, lots of people are suffering from anxiety, through insomnia. I was trying supplementation. I was trying medication. And at some point I was like, can you just come in for some needles, because acupuncture and getting people back in rhythm that fixes a lot of the mental health that suffering people are dealing with right now.

Dr. Weitz:                          Yeah. Yeah, absolutely. All this isolation, especially older people it really makes it difficult.

Dr. Gurevich:                     Yeah, and our clinic I think just like your clinic and every other clinic is taking crazy high end precautions, but sometimes a virtual visit which is totally doable does not replace an in person visit.

Dr. Weitz:                          No, absolutely. I totally agree with that. The chiropractic there’s no way to have a six feet distance giving chiropractic, so we sanitize and we use masks and require everybody else to use masks. So far, we’ve been good, so knock on wood.

Dr. Gurevich:                     Yeah. I’m with you.

Dr. Weitz:                          So how often in practice do you see a parasite on a stool test that may be playing a role in a patient’s health?

Dr. Gurevich:                     Okay, so I’m going to qualify that with my practice is very specialized.

Dr. Weitz:                          Okay.

Dr. Gurevich:                     So by the time somebody waits to see me they’ve probably seen their standard medical GP. They might have even seen another functional medicine provider, so by the time they get to me they’ve been through the ringer, and in my practice for the functional GI disorders 60%, 70% I find is linked to some kind of protozoa or parasite.

Dr. Weitz:                          Wow.

Dr. Gurevich:                     Yeah.

Dr. Weitz:                          So in general, what if you find multiple things, because I know one of my standard protocols a lot of times for gut problems if patients are willing is when they have these sort of IBS type symptoms, gas, or bloating, or diarrhea, or some of the other type symptoms we’ll tend to screen them for SIBO as well as doing a good stool test and it’s not unusual to find several different layers and it’s always a diagnostic conundrum, what do you identify as the primary thing to focus on?

Dr. Gurevich:                     So I actually have a priority. It all comes down to taking a really good history. In that history you want to figure out when their symptoms, has it been lifelong, because if it’s lifelong ever since they’re a kid you’re thinking microbiome. It’s not likely that a newborn baby had some kind of parasite infection, so if it’s lifelong now I’m thinking microbiome. I’m going to think small bowel and large bowel. If it’s some kind of after a recent onset of some kind of foodborne illness that would lead what kind of testing I’m going to do. If it was after some kind of international travel that’s going to lead to the kind of testing I’m going to do. And then, based on also their conglomeration of symptoms, is it really a lot of bloating, distention, pain, small bowel like things?  There is no good way to rule up protozoa, or parasites, or yeast in the small bowel. We have really effective testing for bacteria in the small bowel but that’s it, unless you’re going to do a small bowel aspirate, which no one’s going to do.

Dr. Weitz:                            Right.

Dr. Gurevich:                     If it’s sounding like way more of a large bowel issue then I’m going to think, okay, I want to go down that path and work up the large bowel. When I get results I will always prioritize with treating parasites, protozoa, and worms, and the reason for that is I feel like it’s really well documented that those things change the microbiome. And so, why start anywhere else if sometimes resolving the protozoa or parasitic infection is going to fix the microbiome small bowel issues or the microbiome large bowel issues? And there was a really interesting study and I can get it for you to put in the show notes.

There’s a really interesting study on giardia in particular where they looked at how giardia behaves in the lumen of the intestine. There are parasites that will go and get themselves in the intestine of the human and they’ll be blood, and they’ll be mucus. That’s not what giardia does. What giardia does is it changes the microbiome, right? And so, I’m not going to go after treating a microbiome issue if it’s going to be caused by a parasite that will then correct if you give the body the right enviroment.  And so, I always start there, and worms come first, parasites come next, protozoa come next, microbiome and biofilms come after that, and so that’s my triangle of care.

Dr. Weitz:                          And what’s your preferred stool test or do you use multiple tests?

Dr. Gurevich:                     I really don’t. I really love the GI-MAP.

Dr. Weitz:                          Right.

Dr. Gurevich:                     I love the GI-MAP.  I love it for the money because they have some insurance coverage so like 250 with insurance coverage, 450 without.  I love it because it also gives me functionality and the one thing, I had this ah-ha moment maybe a year ago that I was way under diagnosing exocrine pancreas insufficiency and bile acid malabsorption.  I was missing it and these chronic diarrhea patients were not getting better.  And then, what I always do is I convince somebody to pay me to give them a talk and then I go and do this really deep dive into what do we know about it in the literature, what do we know about it naturopathically, what are our mentors doing empirically with treatments, and when I started realizing this was a huge chunk of my IBS patients and a little bit of my IBD patients it just changed everything, and so the GI-MAP gives me that too.

Dr. Weitz:                          Right. I know some practitioners will do a separate test that’s maybe more specialized on just the microbiome.

Dr. Gurevich:                     I feel like what we are assuming we know about the microbiome is way more than what we actually know about the microbiome.

Dr. Weitz:                          Right, yeah.

Dr. Gurevich:                     But I will also say when I’m looking at the microbiome stool tests there are a couple of things that trigger my thinking. One, is pseudomonas. I feel like with pseudomonas, like I am assuming that if I see pseudomonas on a sample there’s going to be a biofilm there, and then that will shift my thinking to, A, if there’s a biofilm there I could be really missing protozoa, parasites, and worms because they’re hiding, and B, the whole test, like the whole pathology test is a little bit of a question mark because I think things are hiding behind the biofilm.  Strep and staph are the other things that sometimes peak my thought process about biofilm. Pseudomonas always does. Strep and staph if they’re high then that will also inform my thinking.

Dr. Weitz:                          So if staph comes up at all, but maybe it’s still within the reference range do you worry then?

Dr. Gurevich:                     I think it depends. I think it depends on what the rest of the test is looking like.

Dr. Weitz:                          Right. And do you think there’s a problem with false positives with PCR testing for parasites?

Dr. Gurevich:                     I think that there’s a bigger issue with false negatives then there are false positives, but I think there is a likelihood for having false positives as well.

Dr. Weitz:                          Right, because there’s kind of been a debate over the years about what’s the best way to determine parasites and one of the thoughts or criticisms of PCR is there could be potentially evidence, DNA evidence, of a parasite that’s no longer there.

Dr. Gurevich:                     That seems very counterintuitive to me because if they’re segmenting, if they’re taking the DNA segments-

Dr. Weitz:                          Right.

Dr. Gurevich:                     … and I will be honest I have not looked at the literature for this.

Dr. Weitz:                          Right.

Dr. Gurevich:                     But if they’re taking the DNA segments then I feel like if it’s not there what am I seeing. There’s a study that really changed my mind about DNA PCR which was in 2016 that it’s my favorite study. They compared ova and parasite sugar salt stain, immunofluoroscopy, and DNA PCR with known giardia, and it was so gross. The ova and parasite was something like 17 cysts per sample. The sugar salt stain was like 300 something cysts per sample. Immunofluoroscopy found 117,000 segments, and DNA PCR found 300 and something thousand segments.  And so, then I was like, okay, well that’s amazing, and that tells me that’s the best one to use, but they also found that the testing was 64% sensitive, so 56% false negatives.

Dr. Weitz:                          Wow.

Dr. Gurevich:                     Was my math … No. 46% false negatives.

Dr. Weitz:                          False negatives rather than false positives.

Dr. Gurevich:                     False negatives on that particular study, and I looked, I tried to find any literature that I could on comparatives of the different stool testing essays and that was the only study I could find.

Dr. Weitz:                          Yeah.

Dr. Gurevich:                     But I haven’t looked in a couple years.

Dr. Weitz:                            Yeah. No, we’re big fans of the GI-MAP as well, but I know some practitioners like to use two stool tests. I know Ruscio always talks about using-

Dr. Gurevich:                     [crosstalk 00:11:36].

Dr. Weitz:                            … like a PCR test and a culture test.

Dr. Gurevich:                     I mean, I’m thinking it would be amazing and expensive.

Dr. Weitz:                          Right. Yeah, yeah, yeah. That’s always an issue.

Dr. Gurevich:                     Yeah.

Dr. Weitz:                          Okay, so let’s talk about some parasites that show up on a stool test like blastocystis hominis and dientamoeba fragilis that may or may not be pathological depending upon what article you read or who you listen to.

Dr. Gurevich:                     Mm-hmm (affirmative). Mm-hmm (affirmative). So I do generally go after those and treat those. I’ve listened to Jason Hawrelak. I think he’s an amazing amazingly intelligent person. I think he’s been in practice for a long time, and after I started listening to his talk because he’s out now talking a lot about blastocystis hominis and dientamoeba fragilis, and I pulled back on treating them and I tried to do a lot of the other things and I just was not getting a great amount of efficacy and I have been really narrowing into parasites and protozoa for probably the last seven to eight years. I feel like the time they come to me and they have these unresolved symptoms going after the parasites and protozoa it does make a big clinically difference. It really does.  So for blastocystis hominis I usually use a longer course of Alinia. I find that it’s been the most successful.

Dr. Weitz:                          How long a course is that?

Dr. Gurevich:                     21 days.

Dr. Weitz:                          Okay.

Dr. Gurevich:                     I use 21 to 30 days straight. For giardia, I’ll use two 10-day courses.

Dr. Weitz:                          So do you do like 10 days, stop for 10 days, and do another 10 days.

Dr. Gurevich:                     Around the full and new moon because I’m still a naturopath. What I do is I look at the full and the new moon because there is so much empiric evidence and such a history of parasites and the moon, so-

Dr. Weitz:                          So maybe you can explain where this is coming from.

Dr. Gurevich:                     Okay. So there’s a huge amount of empirical information about during the full moon and during the new moon the parasites are going through their cyclical cycle of hatching and laying eggs. I will also say that I come from a long line of psychiatrists and my father happens to be an incredible holistic psychiatrist, and he will always say it’s a full moon. Everybody who’s teeter tottering on that edge of sanity they’re going into the hospital.  And so, I come from this history and then as a naturopathic physician you just see that people feel worse, they get crazier. It feels like the water is boiling a little bit hotter around the full moon. And so, what I’ll do, the way I’ll cycle it out and it’s a little bit confusing is I like to treat for 10 days, so I’ll look at the next full or new moon and start treatments seven days before, and go three days after, right? So a 10-day cycle, and then we give them a break until three days before the next new moon or full moon, start then, and go for 10 days.  And in the interim of that-

Dr. Weitz:                            And by the way, the rational is that the parasites … First, you’re killing the parasites and they may have laid eggs and that the eggs are not going to hatch while you have the antiparasitic drugs in the system, correct?

Dr. Gurevich:                     Right. And then, if they have fungal overgrowth that comes up too, or maybe some kind of microbiome stuff. I might use herbs in the middle of those 10 days just to really try to cover as much because remember parasites and protozoa change the microbiome, and if you’re trying to get much more to a functional microbiome help supporting that with herbal antimicrobials can help.

Dr. Weitz:                            Now, I know a lot of patients are kind of apprehensive about taking antifungal drugs and there are a certain amount of side effects that occur depending on the patient, so what are your favorite herbal protocols?

Dr. Gurevich:                     You know what my favorite, favorite, favorite product is, which I can’t get right now? My favorite herbal fungal product is something called Clear Four. It used to be called Candaclear Four.

Dr. Weitz:                            Oh, okay.

Dr. Gurevich:                     It’s by Pharmax. I swear to God there is some kind of magic in that product. And so, the way that product works is it’s like garlic, cinnamon, oregano, and a probiotic, and there are four tablets, or there’s a tablet and three capsules, and I think maybe it works so effectively because I’m dosing it three times a day. The tablet which is mainly garlic in the morning, the two middle capsules with lunch, and the probiotic for dinner, and it’s a 30-day course, but for fungus I find that there is nothing that I find as effective as that particular product for fungal overgrowth.

Dr. Weitz:                          And what about for the parasites instead of Alinia?

Dr. Gurevich:                     I have never had good success with parasitic treatment and not using drugs, ever.

Dr. Weitz:                          Ever?

Dr. Gurevich:                     Ever. And I tried, but I’m not a herbalist. I think that herbalists are probably going to be more aggressive than I am. How much mahonia can you really have somebody drink before they want to kill you and they’re not compliant?  So I feel like I’ve heard things about Mimosa Pudicas.

Dr. Weitz:                            Right, yeah.

Dr. Gurevich:                     I’ve heard about that. I’ve tried wormwood. I’ve tried black walnut, ParaGuard, it just never. I tried it for years. Sorry.

Dr. Weitz:                            Yeah. No, that’s okay. Everybody has their own experience. We get pretty good results with wormwood and some of the combination products. We use ParaGuard and a concentration-

Dr. Gurevich:                     Yeah.

Dr. Weitz:                            … of wormwood and garlic. I guess some of the data shows garlic can be very effective.

Dr. Gurevich:                     Yeah. I will also cop to the fact that I might be lazy. There is definitely that possibility.

Dr. Weitz:                          Right. Right. And so, if you have a patient who has SIBO and a parasite and you treat the parasite with Alinia do you find that the SIBO resolves, or do you-

Dr. Gurevich:                     At times, for sure.

Dr. Weitz:                          Like what percentage of cases do you have to go ahead and treat the SIBO afterwards?

Dr. Gurevich:                     So that’s a really interesting question because if they come in and they look like they have a large bowel predominant issue I won’t test for SIBO, so sometimes they come in-

Dr. Weitz:                            What does that mean, they look like they have a large bowel predominant problem?

Dr. Gurevich:                     For me to do a small bowel workup I’m looking for bloating. I’m looking for belching. I’m looking for reflux or GERD. I’m looking for some kind of distention. Diarrhea might be there but there’s something that’s telling me that the small bowel is trapping some kind of gas, because I feel like you have air in your stomach you burp, you have air in your large bowel you fart, you have air trapped in your small bowel you bloat, and there is an appropriate amount of bloating that happens to all of us after eating but if it seems excessive, and people are showing me the pregnant abdomen pictures of just bloat, that’s a small bowel workup for sure.  If bloating is not their issue, if it’s more constipation, if it’s more diarrhea but there doesn’t seem to be a big small bowel component I’m going to start by looking at the large bowel.

Dr. Weitz:                            I always have trouble with this whole bloating thing. It’s hard to sometimes correlate when the patients complain about bloating with what we see, and some patients complain about bloating and we sometimes have a tough time figuring out exactly what’s meant by bloating. Sometimes they say they have bloating and it doesn’t appear to be any bloating and they feel it, and then we have some patients that complain about bloating and I think they’re probably just in some cases overweight, not really bloated.

Dr. Gurevich:                     I totally agree with you. Ruscio had this podcast a couple of years ago with this doctor out of the UK.  He was like a tertiary specialist, like to get through the IMH, to get [crosstalk 00:19:49].

Dr. Weitz:                            Oh, yeah. I think I heard that guy.

Dr. Gurevich:                     He was really interesting because he basically was like there are two forms of bloating, and he had this belt that was created called the Bloat-O-Meter. Yeah.

Dr. Weitz:                          The Bloat-O-Meter?

Dr. Gurevich:                     Basically, exactly what you’re saying, there’s the internal pressure that people feel but don’t look distended and then there’s the physical distention that you can see that you can measure with belt loops.

Dr. Weitz:                          Because theoretically the small intestine doesn’t really expand very much and that’s why they feel bloating when there’s gas in the small intestine whereas they don’t feel the bloating when it’s in the large intestine because it’s able to distend, so I always wonder how can it really be that they have this big bloated stomach if it’s coming from the small intestine which really can’t expand very much.

Dr. Gurevich:                     I mean, I think it depends on their morphology. I had a patient who I saw yesterday and she was complaining of bloating. That’s her biggest complaint. She was like this is about average, and I’m looking at her abdomen and I was like, “That looks completely normal.” I think that there’s also that picture of dysmorphia which also plays into some of this.

Dr. Weitz:                          Right.

Dr. Gurevich:                     So I think it is a tricky, tricky thing, but if they’re telling me that that’s one of their symptoms I’m going to start with the small bowel first. If they’re telling me that their symptoms are more defecation related then I’m going to start with the large bowel first and I’m going to start looking at what I can find in there. And then, if we treat and they’re not getting a lot better then I might reflex to a small bowel test. So that’s where it’s tricky for me to give you a percentage because it depends on their history of where I’m going to start a workup.

Dr. Weitz:                          So when you say a small bowel test essentially you’re talking about the SIBO breath test?

Dr. Gurevich:                     Yeah. I’m talking about the SIBO breath test.

Dr. Weitz:                          Okay. Are there any other small bowel tests that you utilize? No?

Dr. Gurevich:                     No. There’s a lactulose mannitol-

Dr. Weitz:                          Okay.

Dr. Gurevich:                     … which I think is a small bowel marker. I don’t use it very much despite the fact that I think it is the gold standard for intestinal permeability.

Dr. Weitz:                          Right. Now, I want to change the topic a little bit. H. pylori is something that shows up on stool tests.

Dr. Gurevich:                     Mm-hmm (affirmative).

Dr. Weitz:                          And the GI-MAP does a good job of having these virulence factors too, but if you get a stool test back with elevated H. pylori and let’s say maybe in patient one there’s no virulence factors do you do additional H. pylori testing? Like some doctors will order the antibody test or … What’s the other test? The breath test for H. pylori. Yeah.

Dr. Gurevich:                     I feel like if I see a virulence factor, if I see the CAGA, or the VACA virulence factor I’m going to move forward with treatments.

Dr. Weitz:                          So only those two?

Dr. Gurevich:                     One those two. One those two, yeah.

Dr. Weitz:                          Really?

Dr. Gurevich:                     Because it has been shown that those two are the ones that are most likely to cause issues. What ended up changing my mind on this was, did you ever read that book Missing Microbes?

Dr. Weitz:                            I know about it but I never read it.

Dr. Gurevich:                     Read it. I mean, he made a really good case for the fact that if they’re not symptomatic H. pylori might really be one of the controllers of the microbiome.

Dr. Weitz:                            Right.

Dr. Gurevich:                     And so, if they’re not symptomatic and I see H. pylori I don’t want to kill anything that I don’t … That’s triple antibiotic therapy. You know what I mean? I’m not going to go after it.

Dr. Weitz:                            Right. I mean, we use herbs, but yeah.

Dr. Gurevich:                     Yeah. I mean, I’m not going to go after it. If they’re symptomatic I think it’s a different conversation.

Dr. Weitz:                            Right.

Dr. Gurevich:                     If they’ve had ulcers in the past I think it’s a different conversation, and if they have those two virulence factors I think it’s a different conversation, but generally speaking if I see it I say I’m not worried.

Dr. Weitz:                            So for people listening to this podcast who might not know H. pylori is generally understood to be the cause of ulcers in a significant percentage of patients and it was something that took a long time to finally be discovered, and the doctor who originally discovered this, Dr. Marshall, had a tough time with the medical community accepting it, and he had himself scoped and he drank H. pylori and then had evidence of an ulcer, and then took this triple antibiotic therapy and had evidence of improvements. H. pylori is now considered a significant potential pathogen, and it usually operates in the stomach rather than in the intestines and it burrows into all of the intestine and leads to acid production and ulceration and stuff.  But maybe it’s a question of degree. Maybe we want a certain amount of H. pylori-

Dr. Gurevich:                     Yeah.

Dr. Weitz:                            … as important for the health of the stomach.

Dr. Gurevich:                     That was his theory, and I feel like symptomatic is very different than a random finding on a test.

Dr. Weitz:                          Have you used the herbal protocols for H. pylori?

Dr. Gurevich:                     I have a couple patients who had. It’s a lot of work but they actually have had success.

Dr. Weitz:                          Right.

Dr. Gurevich:                     I have one in particular she was using mastic gum.

Dr. Weitz:                          Yes. Yeah.

Dr. Gurevich:                     She was using oregano. She was using meadowsweet. Actually, she was one where I was like, “Girl, we had a positive H. pylori with virulence factors.” She was scoped. They found it on scope. She treated it, she was re-scoped, and it was gone, so I think you can totally do it. I think it’s a lot of work, but I think you get a lot less side effects doing it that way than doing it with a drug.

Dr. Weitz:                          Right. Yeah. I know in my practice we have a lot of patients who have a history where somewhere along the line they got put on some antibiotics that seemed to play a significant role in their gut health getting much worse.

Dr. Gurevich:                     Worse. Yes.

Dr. Weitz:                          Right. So let’s see, any other parasites we want to talk about?

Dr. Gurevich:                     Dientamoeba fragilis is an interesting one.

Dr. Weitz:                          Okay.

Dr. Gurevich:                     I feel like that also is the one that causes a lot of symptoms.

Dr. Weitz:                          And that’s another one that some people say is… normal to a healthy gut.

Dr. Gurevich:                     Yeah, so that one sometimes responds to Alinia. There’s one study that says that … God, I never remember how to pronounce this medication.  Praziquantel palmitate works a little bit better. I also will offer that one sometimes. I feel like it will change the microbiome and so that’s why I go after it. And then, often times treating it gets improvement.

Dr. Weitz:                          Right. Any other parasites that you see regularly?

Dr. Gurevich:                     Yes. I see endolimax nana as a tricky one-

Dr. Weitz:                          Okay.

Dr. Gurevich:                     … because I’m not sure. I feel like I’m more on Hawrelak’s side with endolimax nana. I feel like I’ve seen it and it doesn’t present how I expected to see, and sometimes I treat it and they don’t get better, so that one I won’t go after with drugs. I might give them some antimicrobial herbs for that one, so that one’s a little bit of a question mark for me. Those are the three that I see more than anything else.

Dr. Weitz:                          Okay. Do you see giardia?

Dr. Gurevich:                     But that’s a parasite. I don’t think anybody’s going to argue with you.

Dr. Weitz:                          Right. Right.

Dr. Gurevich:                     You treat giardia, you treat crypto-

Dr. Weitz:                          Right.

Dr. Gurevich:                     … you treat entamoeba histolytica. I don’t think anybody’s going to argue about that.

Dr. Weitz:                          Right. Right.

Dr. Gurevich:                     That’s not even controversial.

Dr. Weitz:                          Right. Now, one thing I find interesting coming back to the concept of the stool test is there’s at least one marker on the GI-MAP for inflammation, and it’s not unusual for my practice to see patients who have some significant issues in their gut, a lot of symptoms, and you sort of assume they’d have a lot of inflammation, and they may not at all.

Dr. Gurevich:                     Are you talking about the calprotectin or the-

Dr. Weitz:                          Yeah, yeah.

Dr. Gurevich:                     … zonulin?

Dr. Weitz:                          Yeah.

Dr. Gurevich:                     Are you running zonulins also, or no?

Dr. Weitz:                          Do you run zonulin regularly?

Dr. Gurevich:                     I run it on everyone, yeah.

Dr. Weitz:                          So now, that’s a measure of leaky gut, right?

Dr. Gurevich:                     Right. The reason why I find that useful is it’s the only small bowel marker on that entire test, like that is a large bowel test except for the zonulin because zonulin is literally a small bowel marker. The controversy with zonulin, there’s a couple controversies with zonulin, one all the research is coming out of this one particular lab, and so that’s always a question if people can revalidate what that lab has found.

Dr. Weitz:                          Is that Fasano’s lab?

Dr. Gurevich:                     Mm-hmm (affirmative). Yeah. And then, the other controversy with zonulin is there’re a couple of studies that are looking at zonulin and things that you would expect to make improvement in the zonulin doesn’t always, and I’m thinking dietary interventions in particular.

Dr. Weitz:                          Right.

Dr. Gurevich:                     So I feel like that lab’s an asterisk, and I feel like it doesn’t add very much cost, and that is the only that guides me towards … should I be also looking at the small bowel?

Dr. Weitz:                          I guess for me I started running it and it seemed like we didn’t get a lot of positives and I felt like most of these patients must have leaky gut based on their symptoms and history, and yet this test is saying they don’t so I wondered if this is really worth it.

Dr. Gurevich:                     So that’s funny because I had the opposite thinking with it. My thinking was, okay, so if it’s not positive that means that most likely I need to focus all of my attention on the large bowel.

Dr. Weitz:                          I see.

Dr. Gurevich:                     And if it is positive then I need to start thinking about the small bowel. And the other thing that I’ve discovered kind of haphazardly through clinical practice is quercetin works incredibly to heal up zonulin, which is interesting is I feel like-

Dr. Weitz:                          Just by itself, quercetin?

Dr. Gurevich:                     Just by itself. I use it at really high doses for a short amount of time.

Dr. Weitz:                          What’s a high dosage?

Dr. Gurevich:                     2,000 milligrams three times a day.

Dr. Weitz:                          Oh, wow. 2,000 three times a day. Wow.

Dr. Gurevich:                     For one month, because it does interfere with thyroid conversion of T4 to T3.

Dr. Weitz:                          What?

Dr. Gurevich:                     Mm-hmm (affirmative). Yeah, yeah, yeah.

Dr. Weitz:                          Quercetin reduces thyroid conversion?

Dr. Gurevich:                     Especially at those levels. Especially at those levels.

Dr. Weitz:                          Well, I’ve never used those levels but it’s interesting because we’re using quercetin a lot in the immune strengthening protocols.

Dr. Gurevich:                     I’m using it a lot with viral slash COVID.

Dr. Weitz:                          As a zinc transporter, yeah.

Dr. Gurevich:                     Yeah, and it’s phenomenal. It is phenomenal for that [inaudible 00:30:33] viral conglomerate.

Dr. Weitz:                          Right, but what are you usually 250 or 500 two or three times day?

Dr. Gurevich:                     Yeah. What? Ten times more [inaudible 00:30:42].

Dr. Weitz:                          Oh, really. Wow.

Dr. Gurevich:                     I ran 2,000 three times a day, and that’s what I’m using for the acute viral/COVID protocols also, but it works phenomenally. It also works phenomenally. There’s one study that showed that it’s really good for healing up the leaky brain barrier also.

Dr. Weitz:                          Really?

Dr. Gurevich:                     Mm-hmm (affirmative).

Dr. Weitz:                          Interesting.

Dr. Gurevich:                     I mean, for post-concussion syndrome … I have a great doctor I work with, Dr. Laurie [Mengado 00:31:06] who is very, very well versed in post-concussion syndrome where I send all my MCAS concussion people too. Also, I have this one patient that I sent to her, I saw her for GI, but she had a post-concussion history for like five years, and she was like, “Start her on quercetin. It’s amazing to heal up the brain barrier as well.”

Dr. Weitz:                          Wow. Well, you would expect that something that could help heal the leaky gut would also potentially help-

Dr. Gurevich:                     Heal the brain.

Dr. Weitz:                          … a leaky brain. Yeah.

Dr. Gurevich:                     Totally. And so, basically, the way I’ll use that in the format of a GI-MAP test is I will look, if I treat the large bowel I’ll figure out what’s there, and then I’ll do a GI restoration protocol and if zonulin is elevated I’ll really push quercetin in that protocol.

Dr. Weitz:                          You’ll do that after you’re done getting rid of-

Dr. Gurevich:                     Yeah.

Dr. Weitz:                          … the bacteria or parasites.

Dr. Gurevich:                     Because you kind of have to change the terrain to kind of heal everything up in there.

Dr. Weitz:                          Right. So what’s your favorite gut restoration protocol?

Dr. Gurevich:                     Oh, okay, so quercetin is definitely in there.

Dr. Weitz:                          Okay.

Dr. Gurevich:                     I love zinc carnosine. Are you using zinc carnosine?

Dr. Weitz:                          We go back and forth on it. We tend to use a combination formula that had some zinc carnosine in it.

Dr. Gurevich:                     How many milligrams?

Dr. Weitz:                          It has glutamine.

Dr. Gurevich:                     Oh, like Endozin by Klaire? Do you use that one?

Dr. Weitz:                          I haven’t used that one. No. We usually use the … What’s it? GI Effects.

Dr. Gurevich:                     That one’s got a lot of things in it.

Dr. Weitz:                          GI Revive. Right. Designs for Health.

Dr. Gurevich:                     Designs for Health, yeah. That one has a lot of things in there. My only issue with that one is it doesn’t have high enough quercetin. That’s my only issue with it.

Dr. Weitz:                          Interesting. So you said how much of zinc carnosine are you using?

Dr. Gurevich:                     75 once to twice a day.

Dr. Weitz:                          Okay.

Dr. Gurevich:                     If they have a lot of small bowel stuff glutamine’s always on my differential.

Dr. Weitz:                          Now, that zinc carnosine is not going to raise your intracellular zinc levels because it’s acting in the gut, right?

Dr. Gurevich:                     No. Zinc Carnosine, it’s not naturally produced at all. They take a zinc molecule and they bind it with an L-carnosine. It’s made in the lab, and the reason why I like it so much is because they have a couple of studies that basically show that for ulcers that were created because of radiation, so these are esophageal cancer and stomach cancer patients. They use zinc carnosine after treatment and before treatment and it took these radiation induced ulcers from a grade four to a grade two, or it stopped them from producing as actively.   And so, if they’ve shown that with radiation ulcers there’s no way that they [crosstalk 00:33:59].

Dr. Weitz:                          Oh, that’s interesting.

Dr. Gurevich:                     It’s amazing.

Dr. Weitz:                          What about the patients who have like fibrosis from radiation that they had?

Dr. Gurevich:                     I think it could be too late. I’m not sure.

Dr. Weitz:                          Too late, yeah. Yeah.

Dr. Gurevich:                     Yeah.

Dr. Weitz:                          We’ve been using a modified citrus pectin because that supposedly helps with fibrosis.

Dr. Gurevich:                     Is it working?

Dr. Weitz:                          A little bit.

Dr. Gurevich:                     You know what I think about for those people?

Dr. Weitz:                          Yeah.

Dr. Gurevich:                     Is frequency-specific microcurrent.

Dr. Weitz:                          Oh, okay.

Dr. Gurevich:                     Just because I feel like I don’t know if anything I’m going to give them orally, because it’s so scared over.

Dr. Weitz:                          Yeah.

Dr. Gurevich:                     I feel like it’s changing the way the cells work, which is what frequency-specific microcurrent does.

Dr. Weitz:                          Yeah. I wonder about maybe infrared light too.

Dr. Gurevich:                     Yeah, exactly. I’m thinking more like that, so like re-turn on the cells to function.

Dr. Weitz:                          Right, yeah. Yeah. There’s actually some interesting studies using infrared light for hypothyroid, Hasimoto’s.

Dr. Gurevich:                     Oh, really? Like localized over the thyroid?

Dr. Weitz:                          Yeah, exactly. Yeah. There’s some group out of Brazil that did several studies and got really interesting changes in the [inaudible 00:35:01] cells in the thyroid, actually significant reversal of this autoimmune process.

Dr. Gurevich:                     And you know, that’s not a very expensive intervention.

Dr. Weitz:                          No, I know. Exactly.

Dr. Gurevich:                     Wow. That’s really interesting, actually.

Dr. Weitz:                          Yeah.

Dr. Gurevich:                     Huh. That’s really interesting.

Dr. Weitz:                          So what else is part of your gut restoration protocol?

Dr. Gurevich:                     So quercetin, zinc carnosine, glutamine maybe, probiotics are always going to-

Dr. Weitz:                          What do you mean glutamine maybe?

Dr. Gurevich:                     So glutamine if it’s a small bowel. I’m not using glutamine so much for the large bowel because I feel like the enterocytes glutamine is their preferential treatment for food, but the colonocytes it’s something like 10%. Colonocytes really prefer butyric acid for their food. The trick with that is I’ve never seen butyrate ever. I’ve never seen butyrate do anything helpful.

Dr. Weitz:                          Okay. You’re talking about taking short-chain fatty acids like butyrate separately as a supplement.

Dr. Gurevich:                     Exactly. And I mean, maybe rectally, but that’s also expensive and uncomfortable.

Dr. Weitz:                          Right. So then, you’ve got to feed them the right prebiotics to produce-

Dr. Gurevich:                     Right.

Dr. Weitz:                          … the short-chain fatty acids.

Dr. Gurevich:                     And they have to have a microbiome that will accept the prebiotics.

Dr. Weitz:                          Right.

Dr. Gurevich:                     Or the patients to go through the die off that happens when they’re converting their microbiome. But I am loving prebiotics right now. I would agree, yeah.

Dr. Weitz:                          What’s your favorite prebiotic?

Dr. Gurevich:                     So I use two, Life Extension, it’s called Florassist.

Dr. Weitz:                          Okay.

Dr. Gurevich:                     Which is a chewable. I think XOS. And then, I use a lot of Microbiome Labs, they have-

Dr. Weitz:                          Right.

Dr. Gurevich:                     … a prebiotic, but that one people who don’t tolerate dairy won’t tolerate that one.

Dr. Weitz:                          Right. It has FOS, XOS, and-

Dr. Gurevich:                     GOS, I think.

Dr. Weitz:                          … GOS. Yeah.

Dr. Gurevich:                     Yeah.

Dr. Weitz:                          Yeah, yeah, yeah.

Dr. Gurevich:                      So those are the two that I use and it really is if you tolerate dairy or not.

Dr. Weitz:                            Right. And then, do you have problems with patients who have SIBO taking some of these prebiotics?

Dr. Gurevich:                     I don’t start there.

Dr. Weitz:                          Right.

Dr. Gurevich:                     So I’ll go through a treatment round, and then one of the things that I have been really, really playing around with, which is interesting is using all three or four classes or probiotics simultaneously, so I’ll start them in a class, one lactobacillus bifido, at like 75 to 100 billion.

Dr. Weitz:                          This is like Rusio’s class system?

Dr. Gurevich:                     I totally got it from Rusio. I mean, he’s a very smart thinker.

Dr. Weitz:                          The problem I have with that system is when you look at all the data on probiotics so much of the data is strain specific, so to just basically take 90% of probiotics and go lacto bifido.

Dr. Gurevich:                     Okay. Yes, I agree with you. That being said, I feel like the goal is just diversity, right? How do we get any amount of anything? Like when I’m using my class one, the one that I’m using is Probiotic 10 by Protocols for Life Balance, or Super Pro-Bio by Kirkman, right? I like those, and they’ve got like 10 strains. You know what I mean?

Dr. Weitz:                          Right, but the thing is this is getting back to the same concept as there’s actually been really fascinating research done with lactobacillus, NCMF, 1463-

Dr. Gurevich:                     Right.

Dr. Weitz:                          And that particular one has a certain therapeutic value that just having 10 different ones in that category are necessarily going to have.

Dr. Gurevich:                     Absolutely, and there’s also been really interesting studies that take these combination formulas with like stenotrophomonas and a couple of the species lactobaccilus, and some bifido, and maybe some S. boulardii, and those seem to have efficacy too.

Dr. Weitz:                          Right.

Dr. Gurevich:                     I feel like it’s never in the human body which is so complex-

Dr. Weitz:                          Right.

Dr. Gurevich:                     … you’re never going to be able to isolate from one strain of probiotic.

Dr. Weitz:                          Right.

Dr. Gurevich:                     Which is why I’m like, okay, let’s throw it all at you, and then let’s throw in a prebiotic.

Dr. Weitz:                          So when you say three strains you said a combination product, a saccharomyces boulardii, and then a bacillus.

Dr. Gurevich:                     Four.

Dr. Weitz:                          Yes, four-based, yeah.

Dr. Gurevich:                     And then, sometimes E. coli Nissle 1917.

Dr. Weitz:                          Okay.

Dr. Gurevich:                     And so, I’ll do that for a month and then I’ll throw in a prebiotic for a month, right? Because I’m trying to get it to hold because the problem with probiotics, at the end of the day the problem with probiotics is they’re kind of like air conditioning. When you take them you can get people to feel better. When they stop taking them they go back to the diarrhea they were having before. That’s just a waste of money. I don’t want somebody on a pill.

Dr. Weitz:                          Well, it’s also because you’re taking some grass seeds and just throwing them across the ground.

Dr. Gurevich:                     Right.

Dr. Weitz:                          Right? So they’re not necessarily going to take root.

Dr. Gurevich:                     [crosstalk 00:39:41].

Dr. Weitz:                          So you need the prebiotics which is-

Dr. Gurevich:                     Right.

Dr. Weitz:                            … the fertilizer.

Dr. Gurevich:                     Right, and you obviously need the foundation of every kind of functional medicine. You need them to have a good diet. You need them to be eating fermented foods. The more the better. You need them to be eating fiber naturally in the diet so they’re not relying on a pill. All of that goes without saying. You know what’s interesting?

Dr. Weitz:                          It’s really hard to get like 40 grams of fiber a day not taking an additional product.

Dr. Gurevich:                     I would agree, and I think that patients who seek out functional medicine or naturopathic medicine are way more motivated than the standard American patient, and so if anybody’s going to do it, it’s totally going to be them.

Dr. Weitz:                          Right. Right.

Dr. Gurevich:                     And a smoothie can get you … It’s amazing how much you can shove into a smoothie.

Dr. Weitz:                          Yeah. Yeah. What I have in the morning I don’t think you could actually call it a smoothie but-

Dr. Gurevich:                     Exactly.

Dr. Weitz:                          … kind of like just black goopy mess.

Dr. Gurevich:                     But you’ve met all of your dietary needs in one meal.

Dr. Weitz:                          Exactly. Okay. So I think that about wraps it for me. Any final thoughts you want to leave our listeners and viewers?

Dr. Gurevich:                     Yeah. I just really want to say it’s complicated. It’s complicated, and the nice thing, the luxurious thing for me being as specialized as I am-

Dr. Weitz:                          It’s complicated and you’ve got to be patient if you want to restore your gut health, right?

Dr. Gurevich:                     There’s this one clinical case that just kind of blew my mind. There was this patient, she came into see me, and she flew in to see me so I can manage all her meds and all her labs, and all that, and she was on like, I don’t know, 40 supplements, 50 supplements.

Dr. Weitz:                          Wow.

Dr. Gurevich:                     Every supplement under the gun. And then, I was talking to her and I was like, “You’re also having all of these crazy menopausal symptoms. You also are osteoporotic. It’s actually not even safe for you to be with no estrogen.” Right? And so, really I took away, I don’t know, two thirds of the supplements and I started her on bioidentical hormones, and that was the missing link of getting her to poop. You know what I mean?

Dr. Weitz:                          Right.

Dr. Gurevich:                     It’s so complicated, and getting a good history, and working with somebody who actually does this on a regular basis it’s really helpful. It’s really, really helpful.

Dr. Weitz:                          Well, part of this I think is because treatment by Google and the patients start layering, and they start chopping practitioners. I’m sure you’ve had patients that do that to you, and they call you us, and they get a consultation, and you’re now number 17 in a line of practitioners-

Dr. Gurevich:                     [crosstalk 00:42:17].

Dr. Weitz:                            … which is a part of what everyone has put them on, and so they’re layering this group of supplements on top of this one, on top of this one, and they were not meant to be taken simultaneously with that practitioner or that article’s recommendations. This would be your protocol, not to take that plus this one, plus this one, plus this one, and the same thing with diet where you follow this particular diet that takes out these three food groups, and then another diet that takes out four more food groups-

Dr. Gurevich:                     Yeah. Yeah.

Dr. Weitz:                            … and a third diet, and pretty soon there’s no foods to eat.

Dr. Gurevich:                     Right. I mean, you didn’t even mention that they’re paying a mortgage in supplements.

Dr. Weitz:                            Right.

Dr. Gurevich:                     I mean, I think that’s why, granted I’m biased, but I feel like working with a clinician because supplements are not made for, okay, if A then B. You know what I mean? Supplements are made for, this is the whole picture, this is obviously the priority, why would we do anything else if the priority isn’t working because you are literally just pooping money out your butt.

Dr. Weitz:                            Right.

Dr. Gurevich:                     I mean, it’s difficult because the internet is so accessible and not everybody has access to care. I live in Portland, Oregon. I have 13 naturopaths in my practice. You know what I mean? People who live in Florida. They see some functional medicine doctors who run all these tests and then put them on all these supplements based on the tests but not looking at their symptoms. I understand it is not easy, and I also think if you want to try to figure it out yourself I totally respect you trying, and if you’re flattening out I think getting some extra support is really helpful.

Dr. Weitz:                            Absolutely. And I also think if you can find a right clinician who’s giving you a reasonable treatment protocol based on some reasonable amount of tests being done that makes sense you should stick with that practitioner because I think sometimes all these different, you’re talking about 50 different supplements, comes from I did a consultation with this person who put me on these six different things, and then I read this article that said take these, and then I did another one with this one.

Dr. Gurevich:                     Yeah.

Dr. Weitz:                            I think that’s part of the problem.

Dr. Gurevich:                     Yeah. And also, I just want to say we live in this amazing world where information is so accessible, which is amazing. Never in our history have patients been this empowered to take their own care in their own hands and really guide their treatment plan, and we no longer live in the world where doctor is God, and whatever doctor says I’m going to do.

Dr. Weitz:                            Right.

Dr. Gurevich:                     Which by the way I would love for somebody to be like, yeah, you just tell me what to do and we’re done. It would make my job easier, but we don’t live in that paradigm anymore. It’s really important to educate yourself.

Dr. Weitz:                            Right.

Dr. Gurevich:                     And it’s also really important to understand where your education falls short on the internet.

Dr. Weitz:                            Right. Yeah. And I think at this point there’s so much information out there that our job is really to try to streamline and teach the importance of the right information-

Dr. Gurevich:                     Yep.

Dr. Weitz:                            … rather than just provide more information.

Dr. Gurevich:                     Right, which is I feel like what is luxurious about my job specializing.

Dr. Weitz:                            Right.

Dr. Gurevich:                     Because I only need to know about … I’m like an inch wide and a mile deep. I don’t need to know about your kidneys. I know you have kidneys and I know they’re important, but I know what I know, and so I love staying in my lane, doing this thing, and then go.

Dr. Weitz:                            That’s right.

Dr. Gurevich:                     Let’s get you something that’s more of a generalist.

Dr. Weitz:                            So how can patients contact you if they want to utilize your services?

Dr. Gurevich:                     So you can find me on naturopathicgastro.com, and the nice thing about my clinic is I do have residents who work under me, so if it’s cost prohibitive the residents are much cheaper and we will do educational consults, which means that we can talk to you, do a FaceTime visit, or do a Zoom visit, and then get your history and kind of give you our thought process. If you come into see me then I can run your show for a year and do all the labs and all the pharmaceuticals and all that, but we can definitely give you our brain, and when you work with me or the residents you work with a whole team so you’ve got three brains on your case as opposed to one.

Dr. Weitz:                            And do you offer training programs for clinicians?

Dr. Gurevich:                     So I did. I did my first one. I did nine and a half hours on inflammatory bowel disease, standard of care, and naturopathic interventions for inflammatory bowel disease.

Dr. Weitz:                            Is this part of [Nurala’s 00:46:55] program?

Dr. Gurevich:                     No. I did one for Nurala.

Dr. Weitz:                            Okay.

Dr. Gurevich:                     I did four and a half hours for her.

Dr. Weitz:                            Okay.

Dr. Gurevich:                     And then, I bloomed it into nine and a half hours.

Dr. Weitz:                            Okay.

Dr. Gurevich:                     I did a one class specifically on rectal ozone, which might be my favorite, favorite treatment for inflammatory bowel disease. I did a naturopathic protocols. I did drugs for inflammatory bowel disease, and that one is probably my biggest soapbox because one of the things that I feel like naturopaths and functional medicine doctors do wrong is they’re in this big hurry to get patients off their biologics, and that is very, very risky because biologics form antibodies and if they’re well tolerating their biologics and they’re not having any side effects there is no point of taking people off the meds. The meds are not the enemy. The enemy is the bowel deteriorating and wasting away within the human causing pain and symptoms. Go on.

Dr. Weitz:                            No, go ahead.

Dr. Gurevich:                     So that you can find also on my website naturopathicgastro on “Online Teaching” and that is approved for a continuing ed for naturopaths in the whole country through April 2021 I think.

Dr. Weitz:                            Oh, wow. Cool.

Dr. Gurevich:                     [inaudible 00:48:05].

Dr. Weitz:                            That’s great.

Dr. Gurevich:                     I was like God bless you for listening to me talk. I think anybody hears me talk and they immediately become anxious because it’s so fast, so God bless you for listening to me talk.

Dr. Weitz:                          I’m from New York so it’s normal for me.

Dr. Gurevich:                     That’s the problem. That’s the problem. That’s exactly the problem, if I was from South Carolina nobody would be anxious around me. Thank you Ilana.

Dr. Weitz:                          Thank you so much Dr. Weitz. I really appreciate it.

Dr. Gurevich:                     Okay. I’ll talk to you soon.



Environmental Toxins with Dr. Aly Cohen: Rational Wellness Podcast 175

Dr. Aly Cohen speaks about Environmental Toxins with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]


Podcast Highlights

4:22  Toxic chemicals in children.  Children are among the most contaminated because not only do they get exposed in utero, but they may be eating baby food that often has preservatives, chemicals, coloring, glyphosate, and other pesticides. Babies and toddlers spend most of their time on the floor, picking up dusty toys and putting things in their mouths. And their detoxification mechanisms have not fully developed.  If you start getting exposed early in life, you have a long period of time for these chemicals to eventually have damaging effects. Our grandparents had cleaner foods that they cooked, fewer processed foods, fewer chemicals, and they didn’t have lawns sprayed with toxic chemicals. We now have upward of 3,000 toxic chemicals in the food system and their water was much cleaner.

8:27  Chemicals in our food.  To start with, soil has lower nutrient value, which makes it harder for our bodies to defend against the toxic chemicals. Omega 3s, vitamin D, vitamin C, and folic acid are immunologically beneficial and can help block the damaging effects of Bisphenol A and other endocrine disrupting chemicals as well as lead. Having iron deficiency lowers the ability to manage lead toxicity.

Processed foods are overtaking the market. They are cheaper and easier but they are nutrient weak and calorie dense and have lots of chemicals.  A good thing is that the markets now often have frozen organic vegetables, which may even have more nutrient value than fresh, since they are flash frozen, whereas the fresh foods may have been picked and traveled long distances and may be stored in a cooler for up to 6 months.

12:50  The dangers of plastics.  One of the problems with plastics are the chemicals that are used to make plastics either soft or hard. Bisphenol A (BPA) is part of a family of chemicals called phenols that are used to make plastics harder but they are also endocrine disruptors. They act almost like hormones.  But BPA is shown to be harmful at incredibly low dosages, so they take it out and substitute another phenol like BPS or BPFB, which haven’t been studied as much yet.  Pthalates are another class of chemicals used in plastic products from cookware to personal care products and even food ingredients and they make plastic soft and squishy. They may be in the soft grip of cookware. These pthalates are also endocrine disruptors and they can block testosterone and have an estrogenic effect at very low levels.

18:12  Genetically modified crops.  The majority of genetically modified crops are designed to be resistant to an herbicide like glyphosate (the main ingredient in Round Up) that the company that makes the seeds also produces. Mexico just banned glyphosate and it is being banned in every major park due to some landmark lawsuit settlements.This most widely used herbicide, glyphosate, has a multitude of negative health effects, including being a probable carcinogen and being an endocrine disruptor. But there are organic or much less toxic herbicides that can be used.

23:44  The plastic recycling codes on the bottom of plastic bottles in the triangle. There is a number from one to seven. Seven is Bisphenol A or other phenol. Three is polyvinyl chloride.  Six is styrene, like styrofoam.  We should avoid plastic bottles with numbers three, six, and seven.

26:19  Toxins in the water.  We used to use lead pipes and lead would leach into the water. Then we switched to copper and excess levels of copper are also toxic. Now we are using PVC pipes and we know that polyvinyl chloride is not safe either. And our water treatment plants, of which there are about 160,000 are only mandated to test for 91 chemicals under the Safe Drinking Water Act of 1974, while there are 90,000 chemicals on the market.  They don’t have the infrastructure to filter out all of the prescription medications that are found in our sewage. We have coal ash, fracking chemicals, etc. going into our water supplies. The solution is for each of us to filter the water before we drink it and reverse osmosis filers are the most effective ways to clean our water.  Buy a reverse filtration system and have it installed under the sink by a plumber. If you can afford it, get a full house water filtration system.  If you can’t afford either, then use whatever filter system you can afford. 

35:31  Stainless steel bottles and containers are generally safe, though if they are made in China, we should be leery. Nonstick non Teflon cookware that is marketed to be green and safe, such as the porcelein ceramic pans. 




Dr. Aly Cohen is a board certified rheumatologist, integrative medicine specialist, and an environmental health expert in Princeton, New Jersey. She has collaborated with the Environmental Working Group, Cancer Schmanser, and other disease prevention organizations and is co-editor of the textbook, Integrative Environmental Medicine, part of the Oxford University Press Weill Integrative Medicine Library and her new book is Non-Toxic: Guide to living healthy in a chemical world.  Her website is alycohenmd.com     

Dr. Ben Weitz is available for nutrition consultations, including remote consults via video or phone, specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com. Phone or video consulting with Dr. Weitz is available.



Podcast Transcript

Dr. Weitz:            Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates. And to learn more, check out my website, drweitz.com. Thanks for joining me and let’s jump into the podcast.  Hello, Rational Wellness podcasters. Thank you so much for joining me again today. For those of you who enjoy listening to the podcast, please go to Apple podcasts, give us a ratings and review. If you’d like to see a video version, go to my YouTube page. And if you go to my website drweitz.com, you can find detailed show notes and a complete transcript.

                                Today our topic is environmental health and the role that toxins play in our health. As most of us are aware, our modern life is awash in toxic chemicals, in our food, our air, our water, the materials used to build our homes, chemicals that we apply to our lawns, that are contained in our furniture, our cookware, our cleaning products, our personal care products, even chemicals added to your yoga mats. My wife got a new yoga mat from Amazon and there was a warning, “Toxic chemicals.” It’s like you can’t win.  To quote from Dr. Cohen’s book, “Every day the US imports about 45 million pounds of synthetic chemicals. Each year, about 1,000 new chemicals are put into use. 15 new polymers are patented in the us every week, over 1,000 endocrine disrupting chemicals currently exist, but only five chemicals have ever been banned in the United States under the Toxic Substances Control Act passed in 1976. And the revised Toxic Substances Control Act passed in 2016 has failed to improve the regulatory response to toxic chemicals.” And not to quote from Dr. Cohen’s book, whatever controls might have existed with the EPA prior to 2016 have now been effectively dismantled under an administration that is as hostile to environmental regulation that’s ever existed. The current head of the EPA, Andrew Wheeler is a former coal lobbyists, so the fox is now watching the henhouse. And in fact, this morning, September 1st, when we’re recording this, there’s an article from Bloomberg News that’s titled, Trump Relaxes Limits on Toxic Waste From Coal Power Plants. Just what we need.

                                Our special guest today is Dr. Aly Cohen, and she’s a Board Certified rheumatologist, integrative medicine specialist, and an environmental health expert in Princeton, New Jersey. She’s collaborated with the Environmental Working Group, Cancer Schmancer, and other disease prevention organizations. She co-edited the textbook, Integrative Environmental Medicine, part of the Oxford University Press, Weil Integrative Medicine Library, and her new book is Non-Toxic” Guide to Living in a Chemical World. Dr. Cohen, thank you so much for joining me today.

Dr. Cohen:          It’s my pleasure. Thank you for having me, and I’m sure we’re all going to get a drink after this, separately or on the [crosstalk 00:03:30].

Dr. Weitz:            There you go. We’ll have our Zoom cocktail party.

Dr. Cohen:          Yeah. I have to have humor even though this is such a daunting, heavy topic, and it affects everyone, every culture, every religion, every age group, which is kind of why my platform, which is called The Smart Human, is another area by which I push out really important environmental health information because we are all human, and these chemicals are getting into our lives. It’s a heavy topic, but what I try to do is try to get some humor, and the book that’s coming out is all proactive approaches to try to fix it. So, it’s not meant to be such a Debbie Downer, and then you run off and you just get miserable, it’s really about how do you empower people to make some of these healthy changes.

Dr. Weitz:            Right. Yeah. So, I thought maybe we might sort of loosely organize our discussion today around some of the chapters of your book, and I thought maybe we’d start with chapter three, which is Toxic Chemicals and Kids, and maybe you can talk about some of the exposure that kids in particular have to toxic chemicals.

Dr. Cohen:          Yeah. So, I actually don’t even have the copy yet. Believe it or not, it’s supposed to be coming this week. So, if you quote me, I’m going to try to get as much detail as I can, but I literally was hoping to have the book to give you some real good detail.  But here’s the thing. Children are among the most contaminated of all age groups, and just to start with, because not only do they actually get exposed in utero, in the womb, during pregnancy, which is not intentional, of course, moms don’t want their kids to be polluted, but it’s just because they are exposed to the chemicals that their mother and even their fathers are exposed to, from a genetic standpoint, through the air that mother breathes, and the personal care products, lotions, tampons. Well, not during pregnancy, necessarily, but all of the personal care products, food, cooking, cookware, food chemicals, contaminated drinking water, can expose a growing fetus.

                                Then the kid pops out and you have these babies that are getting perhaps baby food that has a lot of preservatives, chemicals, coloring, glyphosate, some of the pesticides that get into even baby food. And also, where do babies and toddlers spend most of their time? On the floor, right? They’re on the floor, picking up dusty toys, and putting things in their mouths. I have two boys, I know they put everything in their mouths. So, the idea is that they’re getting exposed per body mass index at such a greater degree than even an adult who has detoxification mechanisms already matured, like their liver, and their kidney and other processes of the gut.  So, in other words, they are really kind of the worrisome group that we need to think about, of course, all groups, but definitely starting young with exposures over a lifetime, really can add up to a lot of health conditions, which we can go into.

Dr. Weitz:            Yeah, not to mention some of the chronic conditions tend to happen after longer term exposures. So, if you’re starting to get exposed early in life, you’ve got a longer period of time when these chemicals can eventually have that damaging effect.

Dr. Cohen:          Absolutely. I mean, and we think about our grandparents diet, and our grandparents behaviors, they didn’t have toxic lawn chemicals sprayed everywhere, they didn’t have the plethora of pesticides outside in farmland and on their food and all the manufacturing food chemicals. They had cleaner whole foods that they cooked, not as much processed foods, which have upwards of 3,000 chemicals that are now in the food system in terms of just food additives. Their water may have been much cleaner because they didn’t have a lot of the chemicals that end up on surface bodies of water, lakes and streams, end up in aquifers underneath farmlands that travel into wells and into water treatment plants.

                                So, we’re really getting exposed to a whole different level of chemicals, particularly after 1950s when we really had an explosion after World War II with so many chemicals, and they make a lot of our lives easier. I mean, don’t get me wrong, we have canned foods because they make cans, Naugahyde, rayon, nylon, plexiglass, plastic containers that could store food for longer periods of time. There are benefits to what we’ve developed, especially post World War II, but there’s also we never thought about where they would go after we use them. We had a very specific time period in mind to not have to wash dishes, or break dishes, and now we’re finding that all of these chemicals have been in our soil, in our environment for a very, very long period of time, and they get into our bodies and into the bodies of wildlife, of course.

Dr. Weitz:            Right. Right. Right. So, maybe we should start with chemicals in our food and prob maybe start with agriculture and all the chemicals that are sprayed and dumped onto the produce and in the soil.

Dr. Cohen:          Yeah. So, you can start up really upstream by talking about soil quality. I mean, even just soil quality is so diminished in terms of nutrient value. And the reason that actually matters in terms of chemicals, I mean, separate from chemical pesticides and fertilizers that are pretty harmful to human health, many of them, without the nutritional support in the human body, we can’t even defend ourselves against the chemicals. So, in terms of some of the nutritional value of omega 3’s, and vitamin D, which is so immunologically beneficial, and folic acid, which we know can block the effects from Bisphenol A, and BPA and other endocrine disrupters, which we’ll talk about those chemicals, but nutrients actually block lead contamination, especially in children. Vitamin C can do that. Being anemic or iron deficient actually lowers that ability to manage lead toxicity. So, it’s two-pronged. It’s not just what we’re contaminated with but it’s also the nutrients that we’ve evolved to utilize to protect us from environmental chemicals. So, twofold, it’s pretty bad stuff.

Dr. Weitz:            So, you’re saying we’re getting less of these nutrients because the soil is depleted, that the fruits and vegetables are grown in.

Dr. Cohen:          And our choices of food. We all know how processed foods is overtaking the market, much cheaper, nutrient weak and calorie dense. Processed foods. I mean, look, it’s everywhere and it’s hard for all of us to manage. I mean, I have two kids that love junk food or they love processed foods, and it becomes a battle even with people who feel like they know what they’re doing. It’s just too easily available and it’s cost efficient for a lot of people who can’t afford necessarily whole fresh organic fruits and vegetables. There’s been improvements.  We have frozen vegetables and fruits that you can now get in a lot of big box stores, which is great, and I think that’s been a nice change over the last seven to 10 years, making frozen organics available. They’re less costly than fresh, and to be honest with you, they probably have more nutrient value because they’re flash frozen as opposed to being picked and traveling maybe 10 days to get to a supermarket, or even frozen for six months, which a lot of fresh vegetables and produce are actually done. They freeze them at a temperature where they can kind of tee them up for a year from now, in a way.

Dr. Weitz:            Really? So, your fresh fruits and vegetables can be a year old.

Dr. Cohen:          Well, I would say that I’ve heard up to six months for apples, for instance, apples, particularly. A lot of these big chain stores need to have enough surplus to manage their stocks around the country, and so there are processes by which you pick apples, and they stay in a cooler for certain degree of time before they ripen or before they go to market. So yes, there is a process. I don’t know if I’d say a year, but I’ve heard up to six months, particularly with apples as an example.

Dr. Weitz:            So, the bottom line is, in modern life, our fresh fruits and vegetables are not so fresh, even if we’re trying to do the right thing.

Dr. Cohen:          Exactly. And I think when you lift the cover of a lot of these… The people who are trying to do health and wellness and really trying to make all these efforts, really thinking about what they’re eating and how they’re doing it, they’re doing it but they may not get quite to the where they want to even be better in terms of, for instance, having an organic salad with all the great ingredients, you’re all psyched, but then you might be carrying it or cooking something in a plastic container, or all of our organic ketchup for my kids, or organic condiments are in plastic containers, which sort of defeats the purpose in some ways, right?

Dr. Weitz:            Maybe you can talk about the dangers of plastics.

Dr. Cohen:          Yeah. So, plastics, for instance, are part of chemicals that are used to make either plastic soft or hard. So, for instance, Bisphenol A, which many of your audience members may recall, Bisphenol A or BPA is part of a class of chemicals called phenols, and there’s many of them, but BPA is the most well studied. And BPA was actually taken out of baby bottles in 2012… it made a lot of news… out of plastic bottles in the US because of its ability to disrupt the endocrine system. So, hormones in the human body, very, very, very low levels. And this was a breakthrough, because we normally think of chemicals being worse as the dose or exposure gets higher.  Now, what we’ve now found from international research, World Health Organization, American Academy of Pediatrics, Endocrine Society, is that many chemicals can actually do just as much harm at incredibly low doses as they can at very high doses. In other words, they act almost like hormones or mimic hormones in the body, because that’s how the hormones in the body work.   And so Bisphenol A was taken out of baby bottles. My co-author for both the textbook and my upcoming book, Non-Toxic, which is coming out next week, Guide to Living Healthy in a Chemical World, my co-author was largely responsible for helping to get Bisphenol A out of baby bottles in 2012 in the US.

Dr. Weitz:            But what did they substitute for the BPA?

Dr. Cohen:          BPS, BPFB, BPSIP, …

Dr. Weitz:            Right. Which could be just as bad, right?

Dr. Cohen:          Yeah, it’s a whack a mole. So, they take out one thing that has tons of good data from third party reputable researchers and then they just substitute another phenol in. So, it’s been a real uphill battle in those who study chemicals, on I would say, the good side. Not the manufacturers. Manufacturers do not have to prove safety before going to market.  So you asked me about plastic. So, Bisphenol A was designed to actually make plastics hard. It basically if you think of like a clear aspirin bottle, the clear kind of like a bear aspirin bottle, that was the big discovery in the ’50s actually, so that when you linked BPA molecules together, they actually became a real hard epoxy kind of material, hard.

                                Phthalates, which are another class of plastic chemicals used in millions and millions of products, from cookware, to personal care products, even food ingredients, phthalates are everywhere, they actually tend to make plastic soft. So, I think like an iPhone case, or some kind of cell phone case that makes it squishy soft, or cookware that’s got a kind of a soft grip handle. So, that’s kind of how they’re differentiated in terms of structure. But these chemicals actually can, at very low levels, mimic hormones in the human body. And we now have enough data to show that. Especially phthalates can affect male hormones in a growing fetus and can make some reproductive changes in the fetus of a baby boy, can affect or block testosterone, can mimic estrogen at very low levels.

Dr. Weitz:            In fact, it seems like predominantly these endocrine disrupting substances tend to have more of an estrogenic effect.

Dr. Cohen:          Well, they have both an estrogenic and an anti-androgenic effect, and they also have thyroid effects. So, think about all the hormones that our body uses to signal different physiologic functions: growth, development, fertility, managing insulin. We know that these exposures can actually affect blood glucose levels and also utilization of glucose in the muscles, which you know because of your work. But the idea is that we have so many hormones that affect physiologic processes, and these chemicals mimic them, and that’s why they’re called, overall, endocrine disrupting chemicals.


Dr. Weitz:            This podcast episode is sponsored by Quicksilver Scientific. Quicksilver Scientific is a leading manufacturer of nutritional supplements, featuring enhanced nanoparticle delivery systems, specializing in detoxification protocols, fast acting immune formulas, and next generation longevity products. To learn more or to sign up for a professional account, visit quicksilverscientific.com. Listeners of this podcast can receive 15% off their order by using the promo code Weitz, WEITZ2020 at checkout. And I definitely utilize Quicksilver products in our office and some of their products are just absolutely amazing and there’s nothing like it on the market, so thank you to Quicksilver.



Dr. Weitz:         What do you think about genetically modified crops?

Dr. Cohen:          So, genetically modified crops are interesting because it depends on the type of modification where they’re splicing out DNA and inserting different types of DNA into that spot.

Dr. Weitz:            Right. Isn’t it the case that most genetically modified crops currently are designed so that the crop is resistant to roundup or other herbicides, so then they can spray that herbicide on the crops and kill the weed and not kill the crops?

Dr. Cohen:          Absolutely. So, a lot of genetically modified crops, the majority worldwide, are designed specifically by the same makers of those seeds that genetically modified them, such as Monsanto, which was bought by Bayer, they are designed to basically be sprayed with this pesticide that was designed but not die. It would just kill off–it’s an herbicide–and it kills off all the different weeds around it. And what ended up happening, the marketing scheme was that this was going to add food to the world’s food system, and no one was going to starve, and it hasn’t panned out as such. And in fact, it shows that these seeds have shown resistance to the actual pesticides. So now, the weeds are being killed off, and they’re spraying not just once a season, but perhaps even two or three times during a farming season, and they’re sprayed to get the crop ready as a desiccant to dry it, to get it ready to move the farming along in terms of the crop readiness.

                                But the issue with this is that glyphosate, which is the most commonly used worldwide herbicide, we now know has multitude of health effects. Primarily, it’s probably carcinogenic activity, but we also know it has endocrine disruption activities as well. And just to give you a heads up, it’s now what? September… What the date? September 1st right now?

Dr. Weitz:            Yeah, September 1st. Yeah.

Dr. Cohen:          They just banned glyphosate from Mexico very recently, within the last few weeks, they are banning it from every major park, certainly in public parks in Miami, I think they’re looking at it for public parks in New York. Europe is looking at banning glyphosate. I mean, after the million dollar lawsuits that were paid out not that long ago to some of the school lawn keepers who developed cancer, multiple myeloma and some other cancers, I mean, it’s been a windfall. So, so many cases are now coming through the pipeline, and the science is pretty robust showing the pretty terrible harm that comes from Roundup or glyphosate.

Dr. Weitz:            Right. So, glyphosate is the main chemical in Roundup?

Dr. Cohen:          Yeah. Correct. And then there’s also the inert ingredients. So, there’s the active ingredient, which you see on the label, which is Roundup, and then there’s all these what they call inactive chemicals, that actually can be worse than the actual active ingredient, and you’re not privy to know all of those inactive chemicals because they’re proprietary. So, it’s a hot mess, let me tell you.

Dr. Weitz:            Right. Yeah, there’s another sinister aspect to this whole genetically modified crop thing, which is that they also make sure that the seeds can’t reproduce by themselves, so the farmer who buys these seeds has to buy the seeds over and over again, from Monsanto, or whatever company that makes the genetically modified seeds, and then they’re genetically modified to be resistant to a herbicide that they make. So, not only do you have to buy the seeds from them, you have to buy the herbicides from them. And this is especially sinister in the developing world where you have subsistence farmers who normally would harvest the seeds and replant them, and now we can’t do that anymore.

Dr. Cohen:          And I’ll tell you, this is from a very recent personal experience. We live in New Jersey, and New Jersey is the garden state. Okay, that’s just its definition, and every license plate has lots of fruits and vegetables on the license plate. So, we personally live in the corner of a 200 acre preserve farmland area that was bought by a farmer who outsourced it to another farmer that sprays glyphosate 10 feet from my kid’s door, twice a year, once a year. And finally, I worked on this relationship with this farmer and I would drop off articles, and I dropped in chapters off, and I would buy him beers, and I kept break him down. “Just listen to me.”

                                I showed him video of the farm water from the field coming into our driveway. I mean, I don’t know if he thought I was going to sue him, but there’s no lawsuit there. I mean, it’s their land. But the idea was I eventually worked so that he would not spray the season. I even reached out to a wonderful group in Washington, D.C. called Beyond Pesticides, who’s actually in our book, and they’re a wonderful organization that gives lists of all of the herbicides that can be beneficial in farmland, but also even selective ones. So, in other words, what you said where there are selective seeds, there are some herbicides, if you hit them at the right time, these weeds will actually do quite well with these organic or much less toxic sprays. So, there’s a solution to everything, and that’s why we just got to keep working at it.

Dr. Weitz:            Right. So, one of the things in your chapter on food is you talk about the recycled plastic codes on the bottom of the bottles in the triangle. Maybe you could explain what those mean and which ones are the safe ones.

Dr. Cohen:          Yeah. So, I believe it’s in 1988. Again, I have very short term memory because of my children now. So, in 1988, I think it was the Society of Plastics Industry that basically came up with this way of stamping a triangle on the bottom of plastic containers, food storage. I mean, most of us have seen them, maybe now they’ll look even more. Mott’s Applesauce, or my ketchup, or whatever, it’s always on plastic containers. And that triangle actually has value, value to the people who want to use it properly. The Society of Plastics Recycling came up with it just to save money because they wanted to know how they can recoup money from telling people which triangle to put in which trash can for recycling.

                                So, it’s one through seven, in terms of the numbers that go into those triangles, and seven is often Bisphenol A or other, and three is vinyl or polyvinyl chloride, or polyvinyl chloride is essentially what makes up number three triangle. Six is styrene. So, on the bottom of Styrofoam, you’ll see a triangle with six, or take out food. And one and two and five are generally considered less toxic because we water bottles are typically one or two, or five for some foods. So, the idea is that you could literally go on to your Google or Yahoo or whatever and just look up recycling codes, and they’ll tell you the kinds of foods and packaging that’s used for that triangle. And what I would say is avoid three, six and seven. And three is the vinyl, because it’s an endocrine disruptor, PVC, it’s plasticizer, like a phthalate. And six is styrene, because we know styrene is carcinogenic, and seven is usually Bisphenol A or others.

                                So, if you have to choose, try to stay away from three, six and seven. And we go through it in much more detail in the book, but again, the whole book is about practical solutions. It’s about being armed with the stuff to reduce your exposure because we’re all not toxicologists or medical doctors or what have you, we need to have some guidance. That’s all I want to tell you.

Dr. Weitz:            Well, if PVCs are not safe, and pretty much all our plumbing went from lead, which is obviously horrible, and we know about all the issues with lead, then we switch over to copper, and we’ve got issues with copper toxicity, now we’re using PVC. What the hell are we doing?

Dr. Cohen:          Right. Yeah. Which leads me into the next topic, thank you for doing that, that is our water, and the fact that we use PVC piping… And for instance, my company that we use, I think it’s American Water Company in New Jersey, and I visited one of their treatment plants. So, for instance, there are 160,000 water treatment plants in the country in the US, 160,000, which serve about 250 million Americans out of 310 million, right? So, the majority of Americans drink from water treatment plants that are city water. The 20 to 50 million others that are leftover are in wells, they’re usually in wells, and they have their own issues, and they have their own requirements. But the treatment plants, the 160,000, are only mandated to monitor 91 chemicals, 91 nationally, under the Safe Drinking Water Act of 1974.

                                So, what that means is since 1974, they’ve only added… I mean, from then I think it was like 80, now it’s 91. What happens is these folks do their job, and they do it well, but they’re only mandated to calculate how much of those 91 chemicals are over the limit and to remediate it. Now, we have over 90,000 chemicals on the market right now, in everything, even if it gets into the air, the air quality gets into our water, and they all end up going through these water treatment plants. And the water treatment plants aren’t capable, don’t have the infrastructure to manage medications from our sewage.  Yes, sewage does turn into drinking water. It doesn’t have the ability to manage antidepressants, which wouldn’t be so bad, blood pressure medications, oral contraceptives, all of the industrial chemicals, runoff, fertilizer, pesticides, so many chemicals that go through… Microplastics are now-

Dr. Weitz:            To just stop you for a second. So, you’re talking about medication, prescription medications, over the counter that get flushed down the toilet that end up in our water supply. Is there a proper way to dispose of prescription and over the counter drugs?

Dr. Cohen:          That’s a great question. I mean, I guess maybe some of the big box pharmacies probably have some means of doing it, but who knows? I don’t really know where that would go to. It’s not like they just combust into nothing, they have to be somehow destroyed, dissolved. I don’t know. But there’s no great solution for all these chemical… Well, there is a great solution. I’m going to tell you. I mean, worldwide, we have to think about water contamination, but PVC piping takes water from those municipal plants, and ours travels 40 miles to get to our house. I’ve done the drive. I’ve calculated the drive. And so when you’re talking about that much piping, and anything can break the piping, you can get dirt in there, you can get any number of chemicals originally that didn’t get washed out, there’s coal ash, there’s fracking chemicals, I mean the list goes on and on and on, but those chemicals will travel all the way down to your home.

                                And so the solution, which is what we go into in great detail, is to filter the water at the point of us, which is at your sink. So, whether the water comes from below your house at a well, or it comes from a municipal treatment plant 40 miles away, who cares? It had to have chlorine in there to kill off bacteria, it had to have detergents to clean it up, but when it gets to your sink, it’s traveled, it’s done, and you just got to clean it right there before you ingest it or take it with you to work or soccer games or whatever. And then we get into the different types of filtration, how aggressive, the cost.

                                But I’ll tell you the punch line, I think everyone should be filtering no matter what, carbon filter, pitcher, whatever, but RO filters or reverse osmosis are the most aggressive way of cleaning water in this country, and there’s many places you can get reputable RO filters for upwards of 300 bucks max, and they are right under your sink. Not whole house filters.

Dr. Weitz:            And a lot of the big water companies will install it and just charge you a monthly fee like $40 a month or something.

Dr. Cohen:          Well, that’s not how I do it. I say buy the RO filter, have a plumber… We bought ours out of California because we’ve got it off of Consumer Reports, highly certified. You want to make sure it has all the certifications, not outsourced to China, Indonesia. Don’t buy it at a big box store that says Made in America. They often will have parts, especially the filtration portions from other countries. And so you want to research this quite well. I don’t say brands, but I can tell you we do a lot of information to get you to the right product.

Dr. Weitz:            All right. Why not tell us brands?

Dr. Cohen:          Because I’m working to get into Princeton University and all the universities and high schools. My ultimate goal is to have this as a curriculum for high school students. And I’ve been very conscientious of never doing branding, even though I’d love to, but I don’t because my goal is to have a bigger reach than just a one off, and I don’t get paid for any of these remarks, and that’s why I want to keep it so legit and believable.

Dr. Weitz:            Okay.

Dr. Cohen:          But the RO filters are interesting because it’s almost like a dialysis machine. It’s so aggressive. It has to go through three canisters, it’s not that big, but it goes through three canisters and then has to sit in a waiting tank. And our plumber put it in at $150, I think it was, for one hour of work. It should not be three hours. It should be one hour of work for a plumber who knows how to do an RO filter. It’s super easy. I actually order them as wedding gifts because they cost 300 bucks or 250, nice gift, right? And I’ll send them to their house, with their permission, and then they’ll just pay a plumber to put it in for 150 or $130, and they’re done. And then all they have to do is change out the cartridges for about 40 bucks a year or every nine months, depending on how much they use it. But the tank actually has to hold the water. So, it goes through three filtration systems, sits in a tank, comes with its own faucet, that’s just your drinking and cooking water.

Dr. Weitz:            Yeah, that’s what we have.

Dr. Cohen:          Yeah. And so you don’t have to keep paying anyone for anything. I hate the idea of constantly paying for something when you can do it yourself.

Dr. Weitz:            It’s an American way to just keep overpaying.

Dr. Cohen:          I know. I’m always fascinated when I hear these stories about certain water companies, they come in, they tell your water sucks, and then they tell you to buy the best, most expensive thing they offer because you’re scared out of your mind. Of course, you’re going to buy it and be suckered to a whole house $6,000 filter. But I kind of push away from that. I mean, some patients you have-

Dr. Weitz:            I guess the advantage of the whole house is then the water that you’re bathing in or showering in is filtered as well.

Dr. Cohen:          Well, true, and I agree with you. I think if you can afford that, that’s great. I would love people to afford that over a lot of nonsense things in our lives, right? I do nonsense things too, but the idea is that if you’re taking reasonably short showers, nothing excessive, not too many baths, you’re not otherwise having blood testing that shows heavy metals. I mean, I do that routinely. It’s covered by insurance. I would say, six, $7,000 is a lot of money when you could put that into an RO filter, plenty of food, the clean food, maybe a couple yoga classes. I don’t know. I just look at it as more high yield to just get the water that you’re drinking and cooking set up and then think big later.

Dr. Weitz:            Yeah, we don’t find testing for heavy metals often covered by insurance, but again, we’ve got different insurance in California.

Dr. Cohen:          Yeah. I mean, I don’t do a lot of metals, but they’re covered by Quest and LabCorp in New Jersey, with the right coding and it’s inbursed. I’m always fascinated why regular, non integrative doctors don’t just do them, but it’s not typical that they do screenings of a lot of things.

Dr. Weitz:            Yeah. I’m not sure if the testing done from Quest and LabCorp for metals is as accurate as the better testing.

Dr. Cohen:          I agree with you, but for the vast majority of what I see, based on the symptoms, I try really consciously to keep people’s costs down, because to me, I see enough people where they’re working class, they don’t have money coming out of their ears, and I think to myself, “you know what, if the symptoms match, I’ll do some of these basic testing, and if it’s not resolved over some basic interventions, then we’ll move into deeper testing.” But go with what sprays, is what I say.

Dr. Weitz:            Yeah. Are stainless steel bottles and containers safe?

Dr. Cohen:          Yeah, in general, they are, but I’m always leery of anything that says, made in China. I worry about the recycling of metals. I tend to really try to get people to think about US made pans, pots, containers. There’s stainless steel thermoses that are great made in California. So, there’s some really good companies, and it should say 18/8 underneath on the bottom stamped, because it’s basically the formulation of food grade steel. And we talk about that in the book, and of course, I can’t remember the exact numbers. But the idea is that you want to go with everything that touches your lips, your body, hot coffee, hot tea, you want that material to be strong enough so that the matrix of it doesn’t fall apart and get into your body. Glass and stainless steel is what we’ve got.

Dr. Weitz:            So, nonstick cookware has these polyfluorinated chemicals, these PFAS, PFOAs, and we know those are very toxic. But there’s also nonstick cookware made from ceramic titanium. What do you think about that stuff?  It’s supposed to be safe.

Dr. Cohen:          Yeah. I mean, it’s almost, I guess, like a Le Creuset in a pan form or something.  I don’t know. The idea is that I can’t vouch for companies because I don’t do the third party testing.  So, like many other things that we’re not trained to know, it sounds like we’re going with our best guess or estimate. There was a company online that a woman actually, who her whole job has been to look up pans and safety. I don’t know what her background is, but it’s just not an area I’m so familiar with. So, I just go with the old school stuff.  I mean, to me anything that’s marketed as green clean, I get a little nervous, because remember, there is no testing by the US government on these pans to say that they’re not adding PFOS chemicals, or perfluoroalkyls, which is what you’re describing, and that’s what makes these pans easy to cook with.  So, if they’re made in China, they’re marketed really well to be green pans.  And I’m not saying they’re all a problem, I’m saying I don’t know, and so I stick with what I know.

Dr. Weitz:            Right. Why don’t we talk about those PFOS chemicals right now?  So, these are the chemicals that line these non stick pans, like Teflon, they’re also found in a whole series of other products. They’re what are actually sprayed as fire retardants in California, we have all these fires, and planes are coming by and dumping all these flame retardant chemicals.

Dr. Cohen:          Poor California, man. I [crosstalk 00:38:27].

Dr. Weitz:            I just did see though that there’s a bill in California that was just passed to ban these chemicals. Of course, I think they have eight more years to stop using them, but all this crap is seeping into the groundwater. And I had seen reports where these chemicals are literally in the majority of states throughout the country in much higher levels than are safe.

Dr. Cohen:          Oh, sure. I mean, Hoosick Falls in New York is a big battle. Every military base in this country is pretty much almost a super fun site because of all of the unbelievable number of chemicals, PCE that get in there, perchloroethylene, I think it is, PFOS chemicals, which are the ones that are used, like you said, for fire training in fires. Perfluoroakyls, they’re called perfluoroalkyls, it’s PFOS and PFOA, generally speaking, they’re what’s called forever chemicals.  So, these chemicals, unlike many others… like BPA breaks down in six hours. So, if you give up things with BPA like canned foods, or receipts that you touch, which goes through the skin, you will lower your BPA level in your bloodstream, but the PFOS chemicals happen to be a group of chemicals that are forever. I mean, they don’t break down with sun, wind, rain, they get into the soil. And again, everything will always make its way into water, because soil is like tissue paper, and it absorbs and it transfers chemicals for miles and miles away.

                                If anyone wants to read a really good book called Toms River written by a New York NYU Professor, Dan Fagin, I think his name is, fabulous, fabulous read. True story about chemical pollution. It started in Ohio, the company moved to New Jersey, and then you see these wells that basically contaminated miles of surrounding… I should say, contamination pots that really affected the wells for miles around in the Jersey Shore. It’s a true story and it was beautifully written.   But anyway, I learned from that book just how soluble soil is, and how soil, literally like tissue paper when you drop that little corner in the water, it literally goes right up the tissue paper. It’s similar for almost all soil that we’re in, it literally transfers. So, the PFOS chemicals affect human health as endocrine disruptors, they also lower immune system response to vaccinations. So, we now know it blunts the effect. If you’re going to have a vaccine or vaccination, even as a childhood vaccines, it will blunt those effects, especially with immunocompromised folks, it’ll blunt their immune system process. But they’re a horrible group of chemicals. They’ve been banned but they’re still around and they’re making… It’s kind of like DDT. They’re still finding remnants of some of these chemicals that are 30, 40 years old, and I think we’re going to find the same problem moving forward.

Dr. Weitz:            A thought just came into my head. I always get these weird thoughts, is that we’re in the midst of this coronavirus pandemic, and we’re reading reports about how people who’ve been exposed, who’ve been infected, and it’s assumed that with the majority of viruses, you’re going to develop protective antibodies. And what you’re talking about, vaccines, could it be that if our bodies are loaded with some of these toxic chemicals, maybe our immune system is not going to produce the same amount of protective antibodies that would have happened otherwise?

Dr. Cohen:          Well, what’s interesting, and to make that nice segue into COVID-19 and how chemicals actually really cause more problems for people who are exposed to COVID-19, and the fact that environmental chemicals we now know cause inflammation, okay? They cause inflammation, IL-6, IL-18, IL-17, tumor necrosis factor of natural killer cells. All of these chemicals are shown to be elevated with high exposures to every day chemicals, so we know that.   We know that many of these chemicals contribute to chronic conditions like diabetes, right? Because they affect insulin production and insulin resistance in muscle tissue, heart disease, blood pressure, all affected by BPA, plenty of good studies on that. We know that all these comorbidities that we hear about on the news, five months into this pandemic, we know that the people who do worse once infected… Everyone can get infected, right? Everyone can get it. It’s the people that do worse with it, who respond more severely and require ventilation, oxygenation, and some die, of course, many die, are the people that have one or more comorbidity, okay? And as the comorbidities go up in number, the higher your risk of having an inflammatory response to COVID.

                                So again, the number one way I would say is to eat healthy, eat clean, but to really think about chemicals that affect these chronic conditions and inflammation as one mechanism of preventing that inflammatory response if exposed.  Now, I agree, the vaccine is going to be a whole nother discussion. And as an autoimmune disease specialist, as a rheumatologist, I’m particularly sensitive to this whole topic because my patients are either immunocompromised to begin with, or now exposed to chemicals and may have to be in a position for their jobs or school to get a vaccine. So, it’s going to be very tricky, but yes, it can blunt your immune system response to create antibodies, your B cells creating antibodies, which would be protective to future exposures. So anyway, that’s a long winded answer, but yes.

Dr. Weitz:            Yeah, it’s kind of interesting. It could be that people in the United States are less likely to develop natural immunity, herd immunity, whatever you want to call it, or/and maybe the vaccine might be less effective in the United States because of all these chemicals. I really think this whole crisis is a wake up call for people in the United States to get more healthy, because we’re talking about all these chronic health conditions like diabetes, and hypertension, and obesity, just epidemic, so it should be a wake up for that. Maybe this is a wake up call to start paying attention and getting rid of some of these toxic chemicals or trying to reduce them.

Dr. Cohen:          And you’re absolutely right. And obesity is another one of those big como- in fact, probably the biggest comorbidity, especially in children who have a terrible response to COVID are mostly obese.

Dr. Weitz:            And where do a lot of toxins get stored, but in fat cells, so people who are more obese are storing more fat.

Dr. Cohen:          And also when you talk about environmental justice, and health equity, and you talk about who are getting the sickest, we know that many of the minority groups in this country, major cities, people who are underserved, people who don’t have access to health care, they may have higher access to junk food, right? Because they’re in places where there’s food deserts, or healthy food deserts. And so you can start to pick out why it all connects. Our diet-

Dr. Weitz:            And junk food is cheap.

Dr. Cohen:          And junk food is cheap, and it’s, unfortunately, what a lot of people rely on for feeding their families. So, I think the system is really a mess, it’s really broken. And I think we’re also seeing through the pandemic, just how bad the system is for people who really even want to get healthy. And these are people that just wouldn’t like to be necessarily on junk food, these are people who necessarily want to be healthy like everyone else and have the ability to do so. And it’s not just food, by the way, air quality plays a key role in terms of risk for COVID. And we know this because air pollution actually has been shown over the last five months worldwide and when they measured it, it correlates with a worse inflammatory response to COVID. We have a whole chapter on indoor and outdoor air quality and what to do about it. Because again, it’s not just what you eat, it’s what you drink, it’s what you inhale, it’s what you put on your skin, what you put in your body. These things all add up to a picture of contamination.

Dr. Weitz:            And one of the ways people are trying to be healthier is to reduce their carbs, they might be eating paleo, or keto, or carnivore diet, and they’re eating less carbs, or very little carbs, and they’re eating more fat, and they’re eating the entire animal. And you mentioned in your book how eating the fat and the skin from animal products like fish and poultry are going to concentrate more of the toxic chemicals. Not only are they eating the skin and everything else, but they’re eating liver, and these other organs, which even more are going to concentrate these toxins, right?

Dr. Cohen:          Yeah. Well, you did actually read the book. I can’t believe you know so much detail about the book. I’m so impressed. I’m like, “Oh my god, I did write that.” But it is true. The fish, when we eat fish, the skin is the dirtiest part of the whole fish. Fat holds these chemicals, these endocrine disruptive chemicals.

Dr. Weitz:            But I always thought that’s where the omega 3’s are, right? So you want it.

Dr. Cohen:          Well, it’s become a really sad situation where I tell patients, believe it or not, knowing what I now know about chemicals and seafood, wild or farm raised, I recommend only about two or three servings of fish even a week wild caught. Because I think you start to tip the balance between benefit and risk.  And if you’re going to do supplements, which I do believe in supplements, just evidence based, well thought through and really good brands, because brands matter in this country, because everything is a free for all, I say a good fish oil supplement that’s affordable, that’s cleaned for heavy metals and PCBs, that is concentrated so you don’t have to take 10 of them to get the same amount as another one that’s just one of them, that all plays out into cost, to compliance, consistency. And you need a company that actually cleans and looks for those metals and those PCB contaminants, because quite frankly, I think as we move forward, just those chemicals, it’s actually microplastics are getting into fish. I’m sure you’ve read those articles.

Dr. Weitz:            Oh, yeah.

Dr. Cohen:          Yeah, like I said, it’s a pretty daunting conversation, but what we try to do is just give people really simple, “Here’s what we recommend based on the science.” And it’s not a perfect situation. I color my hair. We all have habits that we love, and we have to work, it’s a journey. So, I call myself out on that, but I think I try to give up everything else so I can still try to be a blonde.

Dr. Weitz:            Absolutely, yeah. It’s not a perfect world. It’s a question of doing our best to reduce our level of these toxic chemicals, and then perhaps maybe doing some sort of detox periodically as well.

Dr. Cohen:          Yeah. I mean, there’s nothing wrong with doing detoxes, I just don’t promote a lot of that. In the book, I have a whole chapter. The last chapter, I think is on detox, and it’s really talking about how exercise works anthropologically. I was an anthropology minor in college, I loved it. I loved it, loved it, loved it, because you can look through the world as an anthropology person and you can see how messed up we are these past 200 years. Really, it’s like 200 years, 300 years. I mean, you could argue further, but in terms of chemicals, pollution, lack of community, spiritual, clean drinking water, sleep, we have really screwed a lot of things up that we’ve been evolving to utilize in our lives for millions of years.  So, I really want people to think about the ways to naturally detox that our bodies were designed, like exercise, how it works, why it works? Sleep. How we detox our brains at night. People don’t realize we actually detox our brains at night.

Dr. Weitz:            The glymphatic system, yeah.

Dr. Cohen:          [crosstalk 00:51:00].

Dr. Weitz:            Which happens during REM sleep, yeah.

Dr. Cohen:          Yeah. Yeah. I mean, it’s so fascinating. That’s new science from 2013. We have all the references in there. But there’s just really interesting stuff that if you just learn about it, you’ll start to realize you don’t need any fancy cleanses, and detoxes, and high colonics, and all these cockamamie things that I hear about, you really just need to be consistent with very reasonable behaviors and lifestyle changes, and that will be enough to do it. And I see this because I test myself, I test my patients, so it supersize me. I’m living and trying to make sure I’m pulling as many studies that show that what you do and how you change matters.

Dr. Weitz:            Yeah, firstly, I don’t find that just exercising and eating clean is enough when you’re loaded with heavy metals and some of these toxins.

Dr. Cohen:          It depends on your occupation too, it depends on where you live, it depends on your water quality. There’s so much. So, what doctors and healthcare professionals don’t often do is do an environmental health assessment. When I see a patient, I see them for an hour, my initial visit, and by the time they leave, I know every aspect of their exposures, their lifestyle, their history. You got to know this stuff because you have to figure out how to intervene. And I think that’s what’s missing, is doctors tend to spend about 15 to 20, maybe half an hour with patients, and mostly it’s dealing with the current issues and not the big picture ideas. But everyone’s different in terms of their exposures, so I don’t go nuts in one direction or another. I try to really hone in on that person.

Dr. Weitz:            Yeah. So, let’s see. We talked a little bit about the water and the problems with the water. We’ve got personal care products. So, there’s so many chemicals in these personal care products, phthalates, and benzoates, and there’s so many chemicals. What are the most toxic ones to avoid?

Dr. Cohen:          Well, they all have their own risks, and of course, over time, exposures add up. So, the idea is that look, when I was a kid and a teenager, did I know any of this? No. Did I go to college and sleep on a nasty mattress? Who knows what I was breathing in. I mean, I look back at all the Cheez Whiz and Oreos I ate. I mean, you cannot change your past, you can only change what you do moving forward. And when it comes to personal care products, we’ve been through all of them. I mean, all of us have been through all of them.

                                The idea is whether one class or one chemical is going to get you is hard to even figure that out. What you want to do is try to think globally about, do I need these products? How many do I need? Since they’re completely unregulated. I mean, personal care products in the US are not regulated at all, meaning they’re not required to have testing for toxicity or health issues before they’re added to products that go on to the shelf. And most people can’t believe that. In fact, products that are on the shelf, like shampoo, conditioner, what have you, body spray, if they cause human health problems and enough people complain, the only ones that can take that off the shelf are the manufacturers. Our government cannot pull products from the shelf. So, it’s absurd, but there are many great ways to check your products. And that’s where we talk about Environmental Working Group has a skin deep database where you type in your products. I even have their app on my phone, and when I go shopping, I can actually use the barcode. And they have a rating system, zero to 10.

                                And so we give all that information as to how to just find your personal care products. For teenagers, it’s usually they use about 17 products per day, 15 to 17, which is crazy, but they use the most. Women, on average, use about 12 personal care products a day, and of course, men use about six. But really, once you get those checked out, you’re done, at least until you recheck them. But the idea is to get clean products that you put in, on, and around your body, tampons, feminine care products, especially. And really, it’s not that complicated once you do it. It’s a journey so you have to do one by one and not stress yourself out.

Dr. Weitz:            Right. Yeah. So, use as few personal care products as you can and shop at Whole Foods and try to get the least toxic ones you can.

Dr. Cohen:          Yeah. I mean, Whole Foods does a nice job. I don’t want to give them so many props that it’s all you have to go shop at. I mean, I think you’ve got to be using your app for EWG skin deep database, and you can buy anywhere. I mean, the idea is that you want to check your products and then you can probably find those products in many places. But you want control.   Now, they do a nice screening process, but again, I can’t vouch for all of their products.

Dr. Weitz:            Right. But I mean you have to go to either health food stores or natural stores, I mean-

Dr. Cohen:          Websites.

Dr. Weitz:            … the main stores websites. Yeah.

Dr. Cohen:          Yeah. But you have to do the work. So, when I teach high school, which I do, and that’s my goal, is to get all of this information into a national curriculum. And if you want to hear that story, actually, it’s a TED talk, TEDx talk on YouTube, if you type my name.

Dr. Weitz:            Yeah, I watched it.

Dr. Cohen:          Did you?

Dr. Weitz:            I did.

Dr. Cohen:          Yeah, that was the hardest thing I’ve ever done. It was really quite hard to do, but I’m proud of it. Anyway, so that’s the story of where this whole thing is hopefully going, is getting information such as in the book and what I do with patients into schools. Because if we can’t teach people young before they get sick, then we’re just chasing after it after they do get sick.

                                So, when I teach high school, I will have everyone in the class download the skin deep database app, or the website, and I come in with a bag of stinky junk from one of the big box stores and I toss the tampons at the jocks, and I’ll throw the body spray at the girls, and lipsticks, nail polish, everything, and their job is to actually take the product, look it up, tell me what the rating system is, tell me what chemicals they are supposedly bad in the product, and choose better products.

Dr. Weitz:            But if I’m a young man in high school, and if I don’t use the Axe products, I’m not going to have all those hype chicks chasing me.

Dr. Cohen:          Guess what? There’s different ratings for the different Axe sprays. So, depending on the flavor, it could be a two, or it could be a 10. It’s fascinating. And again, I’m not here to tell everyone, “Listen, don’t do this, don’t do that.” I don’t want to be that person. I want people to have the tools, the fishing rod, to do this throughout their lives, not just listen to a one off. And you’d be surprised about that body spray. That stuff stinks, man, but these kids love it, and at least I can teach them how to find the safer versions of what they love.

Dr. Weitz:            Right. And then we got these flame retardant chemicals in furniture, in carpets.

Dr. Cohen:          Yeah. And it’s a matter of just working your way through the process. I don’t want this to be overwhelming. Look, I came from a place where I didn’t do any of this stuff, I didn’t know anything about, it’s on the TED talk. I learned, as anyone would learn, and I’m considered to be someone who has a background in science or medicine, or what have you, I didn’t know any of this stuff.

                                So, as I learned and my journey kept continuing, I kept on layering what I would tell other people. And that’s what this is the culmination of, it’s like eight years of trying to figure it out on my own. And instead of people spending eight years to do it, now they can just buy a book and read it. You know what I mean? So, I’m very honest about that. It’s a journey, and I’m not there yet. I mean, I’m still doing things that I wish I could change, but I’m doing it slowly. We changed out our couches. Couches are expensive. And so I would stare at this couch as I walked through the kitchen or the lounge or whatever we have, and I would have like a tick, because I knew that it had flame retardant chemicals, but we needed a couch. So, it was so stressful. And the day I got rid of my couch, I took pictures, I posted, I was like, “This is the way you get good ones.” So, I look at it as a win every time you kind of one out.

Dr. Weitz:            What can you do about your car seat, because car seat all have it, right?

Dr. Cohen:          Car seats have them because they’re covered by the Federal Transportation Association or [crosstalk 00:59:44] Transportation. Anyway, so yeah. Flame retardants are part of car seats and the material in car seats. There’s no way around it at this point. But they’ve gotten rid of flame retardants in baby pillows, and a lot of mattresses. Certain states, like California, are much better at this than others. And the rules are changing, but in car seats, because the car can explode, they have not been able to do that. And quite frankly, I’m not sure I disagree, but you can also do a covering to your car seat that can be non toxic. So, there’s that. You can do that with no problem.

Dr. Weitz:            Yeah. Okay, cool. Well, I think we covered a bunch of really useful information.

Dr. Cohen:          Yeah. I had fun. You got my Jewish [crosstalk 01:00:28] drink.

Dr. Weitz:            There you go. So, how can our listeners, viewers get a hold of you, find out about your book?

Dr. Cohen:          Yeah. Well, my practice is in Princeton. I do telemedicine, I see people from all over the world if they need it. That’s just my website for my practice, which is just A-L-Ycohen, C-O-H-E-NMD.com, so alycohenmd.com.    But my baby is The Smart Human. Thesmarthuman.com, The Smart Human on Facebook, Instagram, Twitter. I post Monday, Wednesday, Friday on Facebook, Instagram, maybe three times a week also. But I’m always posting nuggets, nuggets and pictures, and things I’m learning, and changes in the market, breast cancer prevention tips, Alzheimer’s prevention. So, that’s my educational platform. I’m very proud of it. I don’t sell anything, but I will sell the book. I got that right. But after the book, I really don’t sell anything at all. So, it’s squeaky clean and I hope people will go to follow on those different platforms. And check out the YouTube video, the TED Talk called, How To Keep Your Kids Safe From Toxic Chemicals.

Dr. Weitz:            Great. Excellent. Thank you.

Dr. Cohen:          Yeah, my pleasure. Thanks for having me.




Reversing Type II Diabetes: Rational Wellness Podcast 174

Dr. Candice Hall speaks about Preventing and Reversing Type II Diabetes with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]


Podcast Highlights

2:32  Dr. Hall defines type II diabetes as a condition when people cannot get glucose into their cells, so glucose backs up into the blood. So much glucose leads to a lot of circulating insulin, which leads to the cells resisting any more insulin entering. It will eventually damage the blood vessels and the ability to get oxygen and nutrients to the organs, eventually leading to organ failure. There are a lot of factors that can contribute to causing diabetes, including sugar and anything else that causes inflammation in the body.

3:45  Dr. Hall describes the process of type II diabetes as there being in each of us “a doorway for insulin and the insulin has to open the door, and that’s what lets the glucose in. Well, sometimes there’s so much circulating insulin, it’s kind of like a key when you wear out a lock by using a key over and over and over again, the key doesn’t work anymore.  And so, essentially, that’s what’s happening to the cells with insulin is you just … The insulin can’t open the door because the key doesn’t work anymore. And so, the body is then having to produce more and more insulin.”

5:25  The most commonly prescribed drug for diabetes is metformin, which is touted as increasing the cell sensitivity to insulin, but Dr. Hall says that it is not really clear how metformin works and she believes that it damages the mitochondria, which are the energy producing parts of our cells.

7:11  Diabetes is quite prevalent in the US and is increasing.  The standard American diet plays a role, including the amount of sugar intake. Air pollution can play a role, as can mold illness, biotoxins, and genetic factors that affect the ability to detoxify. Obesity can lead to diabetes, as can anything that increases inflammation in the body.

8:18  During the consultation with a patient with diabetes, Dr. Hall will look for root causes for their condition.  She will explore their environment through their history.  Are they a truck driver sitting in smog every day or commuting a long way on the 405 Freeway?  Is it likely that they have been getting exposed to toxins? Where did they grow up? Did they take a lot of antibiotics growing up?  If they have a thyroid problem, this can lead to diabetes and vica versa.  Dr. Hall said that it’s rare to meet a diabetic patient who’s really eating a good diet, but she noted that she does “But I do meet diabetics that have really cut their calories or tried intermittent fasting and it’s not working for them. And those are the patients that you have to dig deeper on.”



Dr. Candice Hall is Doctor of Chiropractic and a leading Functional Medicine practitioner in Orange County, California. She is the founder of Next Advanced Medicine and Natrueal Products and she has written 2 books, The True Diabetes Solution and The True Thyroid Solution.  Her website is NextAdvancedMedicine.com.  

Dr. Ben Weitz is available for nutrition consultations, including remote consults via video or phone, specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com. Phone or video consulting with Dr. Weitz is available.



Podcast Transcript

Dr. Weitz:            Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest and cutting-edge health information. Subscribe to the Rational Wellness Podcast for weekly updates. And to learn more, check out my website, drweitz.com. Thanks for joining me, and let’s jump into the podcast.  Hello, Rational Wellness Podcasters, thank you so much for joining me again today. For those of you who enjoy the podcast, please give us ratings and review on Apple Podcast. If you’d like to see a video version, go to my YouTube page. And if you go to my website, you can see detailed show notes and a complete transcript. That’s drweitz.com.

                                Today, our topic is how to prevent and reverse type 2 diabetes with Dr. Candice Hall. Diabetes and pre-diabetes are epidemic and increasing in the United States and around the world. According to the CDC 2020 statistics, 34.2 million Americans or 10.5% of US population are diabetic and 88 million folks have pre-diabetes or 34.5% of the population, which means that 45% of Americans have either diabetes or pre-diabetes. And I suspect with the coronavirus pandemic that this rate is increasing.  I heard the CEO of Kellogg’s on CNBC at the end of April bragging about how increasing numbers of Americans are eating cereals like Frosted Flakes and Fruit Loops for dinner as well as breakfast. Isn’t that great? Diabetes is associated with serious complications including heart disease, stroke, blindness, kidney failure and lower leg amputations. Diabetes is now the seventh leading cause of death in the United States.

                                Dr. Candice Hall is a leading functional medicine practitioner in Orange County, California. She’s a founder of Next Advanced Medicine and Natrueal Products.  She’s written two books, The True Diabetes Solution and The True Thyroid Solution. Thank you so much for joining me, Dr. Hall.

Dr. Hall:               Thanks for having me, Dr. Weitz. I’m really impressed with what you’re doing. So, I feel privileged to be here.

Dr. Weitz:            Very good. Why don’t you explain what is type 2 diabetes?

Dr. Hall:               Type 2 diabetes essentially is when people cannot get glucose into their cells. And so as a result, the glucose backs up into the blood … its like glass on the blood vessels and eventually destroys them and destroys the ability for oxygen and nutrients to get to the organs. And so, organs slowly fail. It’s just not a good way to die.

Dr. Weitz:            Now, a lot of people define diabetes as a state of insulin resistance. Is that how you see it?

Dr. Hall:               No.

Dr. Weitz:            No?

Dr. Hall:               A resistant to insulin for sure, but their answer and I shouldn’t say no. Certainly, the cells are resistant to insulin. So an insulin, for those of your listeners who don’t quite understand, I know that you have a large functional medicine population-

Dr. Weitz:            Perhaps you could explain the process by which somebody ends up with type 2 diabetes.

Dr. Hall:               I think they might find interesting is there’s quite a lot of different things that lead to type 2 diabetes, but essentially, think of yourselves as having a doorway for insulin and the insulin has to open the door, and that’s what lets the glucose in. Well, sometimes there’s so much circulating insulin, it’s kind of like a key when you wear out a lock by using a key over and over and over again, the key doesn’t work anymore.  And so, essentially, that’s what’s happening to the cells with insulin is you just … The insulin can’t open the door because the key doesn’t work anymore. And so, the body is then having to produce more and more insulin-

Dr. Weitz:            Well, isn’t that what’s commonly meant by insulin resistance?

Dr. Hall:               Yes. When I hear people understand that my patients say things like, “Well, my doctor says I don’t make enough insulin.” The lay person commonly hears insulin resistance in the same manner that they hear, “I don’t make enough insulin,” which those are very different things.

Dr. Weitz:            “I don’t make enough insulin” is late stage, after years of having too much insulin circulating around?

Dr. Hall:               Yes. So what most type 2 diabetics don’t realize is they’re making so much more insulin than someone like you or I who does not have that problem. So much insulin that eventually, they can actually wear out their pancreas and even become a type 1 although that’s not common. The other thing that happens is by the time they start injecting insulin, as you know when you put hormones into the body and then your body can stop producing its own and that can be problematic as well.

Dr. Weitz:            Of course, that’s why the most common drug for type 2 diabetes is metformin, because it’s a drug that increases the cell sensitivity to insulin.

Dr. Hall:               Supposedly.

Dr. Weitz:            Supposedly? You don’t think it does that?

Dr. Hall:               Well, there’s a lot of studies out about insulin and the consensus seems to be they don’t really know how metformin really works, which is a little disturbing.

Dr. Weitz:            That it’s touted as an anti-aging drug too as well as the most popular medication for diabetes.

Dr. Hall:               It is.  But there is also research that it damages the mitochondria, because I have patients who are not diabetic and want to take it as anti-aging and they asked me if I give them that.  I do not.  I like mitochondria.

Dr. Weitz:            Personally, I take Berberine, which is this sort of natural form of metformin for anti-aging purposes.

Dr. Hall:               Very much so.

Dr. Weitz:            So what is pre-diabetes?

Dr. Hall:               Pre-diabetes is essentially the same thing. The numbers are not just as high. There’s really not much difference between pre-diabetes and diabetes.  What that means is that you’ve turned on the problem.  I mean oftentimes, if they really put in some habit-changing, change the way they’re eating, they can get those numbers down.  What we seem to see is once you turn on that disease, there are deeper things at play than just diet. It’s always diet-exercise, diet-exercise, but we’ve had patients, hundreds of them, who’ve dieted, exercised, lost a 100 pounds and the A1c goes up two points. It’s a very frustrating disease. There’s a lot more underneath diabetes than just diet and exercise.

Dr. Weitz:            Why is diabetes so prevalent today? Why is it increasing?

Dr. Hall:               Well-

Dr. Weitz:            Especially in the US.

Dr. Hall:               A loaded question. So certainly the standard of American diet, what we call the SAD diet plays a role.  There’s a lot of sugar and so, too much sugar in the body can create insulin resistance.  But there’s lots of studies showing that air pollution is very connected with type 2 diabetes.  Mold illness, biotoxin illness, there are genetic factors when someone cannot detoxify the body well that lead to diabetes. So there’s a lot of different reasons why the numbers are going up.

Dr. Weitz:            Does obesity lead to diabetes?

Dr. Hall:               It certainly can, yes.

Dr. Weitz:            Do you think saturated fat plays a role in diabetes?

Dr. Hall:               I think anything that creates inflammation that … Remember diabetes happens at the cellular level. If your cells are inflamed, then the receptors on them don’t work very well.

Dr. Weitz:            When you get a patient who comes into your office with pre-diabetes or diabetes, what are you thinking about as you’re doing the consultation with them, what their root causes of their diabetes might be?

Dr. Hall:               Well, I start by just asking them when did they get it. I do like to see if there’s a family history of the disease, but that’s not nearly as important to me as their environment and their habits.  Are they a truck driver?  Are they sitting in smog every day? Are they commuting on the 405 or the 5 Freeway? Are they working in a carpet factory? What is their environment and what kind of toxins are they around? That’s one of my first questions.  I always like to see where they grew up, if they grew up somewhere on a farm where there was a lot of pesticides.  Did they have a lot of antibiotic use?  Those are areas where I start. I like to see if they have a thyroid problem. Thyroid problems can lead to diabetes and vice versa.  So those are the types of questions I like to start with.

Dr. Weitz:            As well as their history, you’ll look at what their eating and their lifestyle, their exercise?

Dr. Hall:               Yeah. But we always assumed that the diet has to be improved. It’s rare that I’ll meet a diabetic who’s really eating a good diet. But I do meet diabetics that have really cut their calories or tried intermittent fasting and it’s not working for them. And those are the patients that you have to dig deeper on.

Dr. Weitz:            What is a good diet for a diabetic? Is there a good diet?

Dr. Hall:               It’s funny that you ask me that because you see-

Dr. Weitz:            Does it depend on a person?

Dr. Hall:               It does actually depend on the person. We got to take out inflammatory foods like sugar, dairy. We’ll look at taking out those types of foods, grains, if needed but we always test the patient because there’s a lot of research around the fact that when you eat certain foods that your immune system doesn’t like that you make antibodies, blood sugars will go up anywhere from three days to 12 weeks from one exposure to that food.  The immune system plays a large role in the elevation of blood sugar as well.

Dr. Weitz:            It sounds like you’re placing an equal importance on toxins as you do for blood sugar?

Dr. Hall:                Well, when you’re looking at the-

Dr. Weitz:            Most people when they talk about diet for diabetes are saying, they’re advocating a ketogenic diet or super low carb diet or some specific diet that it has a direct effect on glucose regulation or insulin sensitivity.

Dr. Hall:                That’s a good comment. What I would say is there are patients who do really well on a ketogenic diet and there are patients that don’t do well at all. If I have a biotoxin patient, meaning they have been exposed to a toxin and they carry a particular gene where they can’t rid the body of the toxin. Now, these are living toxins, things like mold, Lyme, certain types of bacteria.  Then I put that patient on a keto diet. They’re already not processing their fats correctly. And so, the cholesterol just goes up and the blood sugar does not come down. It depends on the patient. There’s not a single one of our patients who’s on the same diet. I have to look deeper at the patient and find out which diet we’re going to put them on.

Dr. Weitz:            What’s your workup? Somebody comes in your office with diabetes or pre-diabetes, how do you decide what tests you’re going to run?

Dr. Hall:                Let’s say, obviously, you’re not diabetic. You look very healthy. But let’s say you were diabetic and you come in. I get your history and based on that history, I would determine which tests to do. So let’s pretend that you’re someone who’s … Well, give me a scenario. That’d be a fun way to play it. Give me a hint of diabetic.

Dr. Weitz:            I’m a 50-year-old guy who’s been eating standard American diet, really haven’t had a lot of time for exercise. I was exercising a little bit but I stopped during the pandemic. I work in the tech industry, but yet I’m having rising hemoglobin A1c and my doctor wants to put me on hemoglobin. He wants to put me on metformin and my blood sugar is like 98, my fasting blood sugar. What would you do?

Dr. Hall:               You mean like 198? That person’s blood sugar is at least 198 if they’ve been eating through COVID especially Frosted Flakes. Well, that’s an easy workup. That’s really easy. And then when you say you work in the tech industry, are you in front of a computer all day?

Dr. Weitz:            Yeah.

Dr. Hall:               And then I’d be asking you how do you sleep? Do you sleep well at night?

Dr. Weitz:            Yeah, I get a full four hours.

Dr. Hall:               Four hours. So do you wake up in the middle of the night or you only sleep four hours every night and then you get up and go to work?

Dr. Weitz:            Yeah. But I don’t have time for any more sleep.

Dr. Hall:               Okay, so you’ve been sleeping four hours. There’s no helping you and I would just stop.

Dr. Weitz:            We’ve had a lobotomy.

Dr. Hall:               So certainly it’d be very difficult. People who work nights have a massively increased risk for diabetes because how it switches their hormones, the hormones that regulate Circadian rhythm play a huge role in regulating blood sugar. If someone is only sleeping four hours a night, I’m going to go in on that first.  And then I’m going to look at their hormones especially even though you’re male, you make estrogen. We’d look at testosterone levels. We’d look at all these-

Dr. Weitz:            Let’s say my testosterone is low, my estrogen is high, my sex hormone binding globulin is elevated.

Dr. Hall:               Then I would you know you’re a diabetic. Yeah, male diabetics, they can be very estrogen-dominant which is what increases their risk for prostate and colon cancer. So when a male diabetic’s sugars are high, they’re literally converting their testosterone into estrogen. And we have to look at that pattern. It’s also what causes the erectile dysfunction that most male diabetics end up going through.  But we’re looking more at cause at this point. So we’re looking at the hormone-

Dr. Weitz:            At that point, do you try to fix the hormones or do you try to fix the sugar?

Dr. Hall:                Well, the hormones are part of what’s dysregulating the sugar. So we have to hit it from all angles. So I’m going to test this patient’s hormones. I’m going to test their stool. I’m going to test their blood. I’m going to-

Dr. Weitz:            Tell me what tests you’re going to run. How are you going to test my hormones? You’re going to do serum hormone testing?

Dr. Hall:                I do serum and I do saliva because you’re only sleeping four hours a night. So it would depend on your symptoms. I do serum and saliva.

Dr. Weitz:            You’re going to do saliva testing? What, you’re talking about for cortisol?

Dr. Hall:                I want to do cortisol and also it’s a good way to look at the free fraction. It’s a good way for us to kind of see … It gives us two different windows. Some people prefer saliva and some people prefer blood but it really kind of depends on what I’m looking at. But I do like to look at cortisol through saliva. And then sometimes too we’ll do, depending on the patient, we’ll do four times a day-

Dr. Weitz:            Yeah, that’s pretty much the standard or now, it’s six times a day with the first morning, the cortisol … What’s it called the cortisol … The first [crosstalk 00:16:32] which one?

Dr. Hall:                The cortisol rhythm?

Dr. Weitz:            No. You take the first test before they get out of bed. I forgot what it’s called. It’s six. You do one before they get out of bed. Then you do one 30 minutes out of bed. Then you do one morning, hit noon, afternoon, and evening.

Dr. Hall:                I’m not sure what word you mean-

Dr. Weitz:            Anyway. Well, let’s-

Dr. Hall:                The DUTCH test, it’s a urine test but it’s a really good way to look at cortisol. And then we see [crosstalk 00:17:07]. Cortisol plays a large role in regulating blood sugar as well. We’ll do those tests and then we’ll do the blood test. We’re looking at about 60 different markers.

Dr. Weitz:            So are you using a specific lab you can talk about or have you just set up your own panel?

Dr. Hall:                No, I don’t use my own lab. I used LabCorp most of the time for blood. I used Doctor’s Data for stool at times and then I also use the [inaudible 00:17:38] out of-

Dr. Weitz:            Yeah, diagnostic solutions.

Dr. Hall:                … diagnostics, yeah, diagnostic solutions. And then I’ll use for the stool tests, again, it depends on symptoms which company I’m going to use. For saliva, I use Diagnostics and I use Lorisian for the food intolerance testing. That’s a company out of UK that I really like the way that they perform their test.



Dr. Weitz:                            I’ve really been enjoying this discussion, but now, I’d like to pause to tell you about the sponsor for this episode of the Rational Wellness Podcast. This episode is sponsored by Pure Encapsulations, which is one of the few lines of professional nutritional supplements that I use in my office. Pure Encapsulations manufactures a complete line of hypoallergenic research-based dietary supplements. Pure products are meticulously formulated using pure scientifically-tested and validated ingredients. They are free from magnesium stearate, gluten, GMOs, hydrogenated fats, artificial colors, sweeteners and preservatives.

Among other things, one of the great things about Pure Encapsulations is not just the quality products but the fact that they often provide a range of different dosages and sizes, which makes it easy to find the right product for the right patient, especially since we do a lot of testing and we figure out exactly what the patients need. For example, with DHEA, they offer five, 10 and 25-milligram dosages in both 60 and 180 capsules per bottle size, which is extremely convenient.

                                                Now, back to our discussion.



Dr. Weitz:            On a blood sugar on a serum testing, what are the key factors you look at?

Dr. Hall:                Well, certainly A1c and fasting blood sugar but we want to look at … Like a lot of our patients, the ones on insulin anyway, we’re always going to look at the antibodies to the pancreas. A lot of patients are what we call a 1.5 diabetic. They’re not even a type 2. They’ve been misdiagnosed. And so they’re being treated as a type 2 and as a result, they’re getting worse.  I have patients who make antibodies to insulin that are taking insulin and that’s obviously very bad for them. So we’re trying to … Those patients, we want to get off the insulin right away. Those blood markers, looking to see if they’re making antibodies to their own insulin, to the islet cells, to the pancreas itself. We want to see their C-peptide, how much are they actually able to produce. We’re looking at homocysteine because obviously, diabetes can inflame the brain and cause problems with the heart.  We’re looking at C-reactive protein. We’re doing a CBC to see if there’s an underlying infection, if the eosinophils are elevated. And commonly the gut infections are part of what’s driving the inflammation created by the immune system that’s been causing problem with the cells.  You can see it’s quite a bit deeper than just putting them on a diet. The diet makes up about 30% of reversing a patient. What we’re doing is getting in and saying, “What is really driving all of these?” Think of how many people are obese and eat a terrible diet but are not diabetic? Looking deeper and finding out what’s driving it is really the goal.

Dr. Weitz:            And then you mentioned toxins. How do you screen for toxins?

Dr. Hall:                Well, biotoxin illness is really one of the … When a patient is getting stuck, let’s say you have a patient that you do the normal stuff and their numbers aren’t with me or you plateau. Often, underneath that is something called biotoxin illness.

Dr. Weitz:            Which is mold, right?

Dr. Hall:                Which is what?

Dr. Weitz:            Mold.

Dr. Hall:                It can be … So if the patient is what we call a multi-susceptible, sometimes it’s not mold at all. But mold would be a common cause of biotoxin illness. But we have Lyme patients. We have patients who have what’s called resistant MARCoNS. So then we’ll look for those toxins. Also, we have people who are … No, I had one patient, her job was to count the amount of product in someone’s truck. So they back up the truck, keep the truck on and then she’d go look and see what was in the truck and she did that all day.

Dr. Weitz:            Breathing in all that diesel?

Dr. Hall:                Yeah, she was one of the sickest patient. Through Great Plains Laboratory, they have some really good test for environmental toxins, the GPL-TOX is good. We’ll do a MycoTOX on patients with biotoxin illness. But it’s amazing how many patients have that as their underlying driver and they just can’t get it all out. Their environment has gotten so much worse.

Dr. Weitz:            Your testing is going to be pretty extensive and pretty expensive too, huh?

Dr. Hall:                I mean, we get discounts on certain labs. I get a $1,700 blood test for $149 because we order so many of them. LabCorp gives me a great reduction. Certainly the testing, understand that when I’m seeing a patient, it is their history that determines the testing. And so I have a patient who spent $300 in testing. I have a patient who’s spending $900 in testing.

Dr. Weitz:            Let’s say, you got a patient. This patient is pre-diabetic, and they have some evidence of biotoxins. What’s your next step? Are you putting them on a diet and working on the biotoxins? Do you try to clear out the biotoxins first? What’s your procedure?

Dr. Hall:                Good question. We’ll start with the VCS test to see if their brain is actually inflamed because that will determine how we’re going to treat them.

Dr. Weitz:            Maybe you could explain what that is real quick.

Dr. Hall:                Sure. A VCS test is the visual contrast study. So when someone has biotoxin illness, the posterior portion of the eye can begin to swell. And if it does, then the person will lose the ability to see lines as they get closer together, they’ll lose that contrast, not that they can’t see the difference between gray and white but these lines as they get smaller, they’ll have trouble distinguishing them. That along with certain symptoms indicate about with 98% accuracy whether the person has biotoxin illness or not.

                                So let’s say that’s what’s happening. Then we’ll go through to do the genetic testing to see what specific toxins they are unable to detoxify. One of my patients for instance, he can detoxify mold but he cannot detoxify Lyme. So then we did the co-infections for Lyme and Lyme, and he does have Lyme disease. So, we have to start treating that. We’ll also determine what diet he should be on or do …

                                We can help determine that through the blood test. What do the inflammatory markers of like? What does the cholesterol look like? We’ll fractionate out the lipids, see what that looks like. And then put them on a customized diet. And then we will start working with their habits.

Dr. Weitz:            As far as diet, is pretty much everybody on some version of a lower carb diet or some people on a high carb diet?

Dr. Hall:                I would say all of our patients are not eating grains. They’re not eating grain. They’re not eating sugar. As we get into patients who have autoimmunity and things, we’re taking out inflammatory foods. So, it is definitely not a high carb diet. Yeah, we have certain patients that can tolerate specific grains. So when we test them of their specific grains and we let them know how much they can have. But for the most part, I think patients do better off of grains.

Dr. Weitz:            So, as far as grains, you’re talking about food sensitivity testing? Is that what you’re talking about?

Dr. Hall:                We do food sensitivity testing. I had one patient, she had an A1c when she started at 7.4. When we got her by month four of her program, she was down to a 5.4. She was off all six of her medications. Her blood sugars have been under 100 for three weeks. She was doing really well, off all her meds. On Sunday night, her blood sugars spiked to 196. So, there’s two things that will do that. Either she has an infection or she ate something she makes an antibody to. Those are the two things.

                                So, we start digging in and find out her husband had marinated her steak in vinegar and oil dressing, which is fine. She can have vinegar and oil dressing but the one he used was full of soybean oil and she makes antibodies to soy. So now, we have to work with her immune system or we’re not going to get her blood sugars down. So, she did not have any sugar at all, and that’s what happened.

                                So, the antibody testing I think makes a really big difference in how it is that we customize someone’s diet.

Dr. Weitz:            Another thing I found is stress. They can get a spike in cortisol. And by the way, the test I was trying to think of is a cortisol awakening response, the CAR.

Dr. Hall:                Oh, okay.

Dr. Weitz:            Let’s say somebody has Lyme. How are you going to deal with that? You’re going to use the herbal botanical protocols?

Dr. Hall:                We use a lot of ozone in our practice. If it’s in the beginning, we are going to have the doctor prescribed antibiotics obviously or a good defense in the very beginning if they have the bull’s-eye rash.

Dr. Weitz:            But that’s pretty rare that you see him at that phase?

Dr. Hall:                It’s funny to say this because I just had a patient two days ago. Friday, sorry, it was Friday. She had the bull’s-eye rash and everything. I’m like, “Perfect, this is so much easier.” And I have to tell you, so I am actually a Lyme expert but one of the doctors in my clinic is very good at it. So we just refer them to that doctor.

Dr. Weitz:            We just had Darin Ingels at the meeting speak on the last podcast about Lyme.

Dr. Hall:                Yeah, I tuned into that. That was pretty cool.

Dr. Weitz:            He gave a great presentation. So, Lyme could take a long time, it seems, to treat. He said three months to a year.

Dr. Hall:                Yeah. And if it’s intracellular, man, those patients can really struggle.

Dr. Weitz:            I want to ask you a few more questions about diet. Is it better for patients to have a small meal? And this is in general, is it better for patients to have a small meal every three hours to keep their blood sugar even which by the way we preach for years because I’ve been doing this for 32 years. I’m older than I look, and so when I first started, the big thing about why everybody was overweight was because everybody skipped breakfast and then they ended up eating too much at dinner and that’s why everybody was fat. They went too long without eating so then they would have this blood sugar spike. It would drop and then they would eat too many carbs.

                                So the answer was that they had to eat within an hour of waking up. You have to eat every two to three hours with a small meal or snack to keep your blood sugar stable and that’s going to be the key to losing weight. And of course now, the most popular trend is to skip breakfast and do intermittent fasting. Anyway, so from your perspective for diet, is it better to have small snacks or is it better to have gaps in eating throughout the day?

Dr. Hall:                I feel bad. I feel like every time I answer you, I’m not giving you a direct answer because I know that’s what your listeners want to hear.

Dr. Weitz:            No, if it depends on the person, that’s a completely valid answer.

Dr. Hall:                Yeah, it does depend on the person. So let’s say for instance that … Let’s say you’re somebody who’s having high blood sugar and low blood sugar. So, when someone is diabetic, there’s a couple of things that can happen. When someone starts getting low blood sugar, that can be a sign that diabetes is coming later because they’re having trouble regulating hormones that regulate their blood sugar.

                                Most of the time when people get diabetes, they just have high blood sugar. They don’t get lows because if they’re getting lows, they’re getting sicker. If somebody is getting highs and lows, we are going to feed them more often because the lows are really very bad for the body. It’s bad for the heart. It’s bad for the brain. So, we don’t them having low, so we’ll feed them more often and smaller meals.

                                With our patients, we don’t really regulate how much they eat typically. We just tell them as long as their plate is about … We really want them moving towards about a good 60% to 70% of their plate is vegetables. We’ll push them, depending on the patient, even up to 80% vegetables. But typically, it’s a 70-30 split between protein and vegetables on their plate. And then we determine the amount of fat depending on the labs.

                                But for those patients, we won’t really limit how much they eat.

Dr. Weitz:            How do labs determine how much fat they should have?

Dr. Hall:                I don’t want to be misleading. If the cholesterol is high, we only absorb about 6% to 8% of the cholesterol we eat. But if you’ve got somebody who’s really inflamed, cholesterol obviously is still an inflammatory marker as well. But if they’re not processing their fats well which you can see on just by looking at just even the LDL and cholesterol, and again with the diabetic, if they can’t get glucose into the cell, then part of what happens is they’re converting it into cholesterol.  And so, you have to take that into account too. But when the lipids are high like that, we generally will not put them on keto.

Dr. Weitz:            And is that because saturated fat causes heart disease?

Dr. Hall:                No. But that’s what they want us to believe. No, it’s because when the people are ingesting fat-

Dr. Weitz:            They’re not processing it.

Dr. Hall:                … those lipids correctly. And so it’s creating more problems. So we don’t put them on a high fat diet.

Dr. Weitz:            Right. So, you mentioned snacking or eating certain foods to maintain the blood sugar. One of the issues for diabetics can be that their blood sugar can drop at night and that can create a real problem. Have you had patients like that? And do you have a strategy for something they can eat at night?

Dr. Hall:                I do. So, it’s interesting, when the blood sugar is dropping … I mean everyone’s blood sugar drops when we sleep but we don’t drop to 40 and think we’re going to die. But by the time that’s actually … So when someone is waking up in the middle of the night, even somebody who is not a diabetic, it is generally most often a blood sugar problem. So, what’s happening is they’re not making … Let’s say you’re somebody who is just really stressed, or you’re diabetic that’s really stressed … That’s even worse … and you’re just pumping out cortisol all day to try to regulate your blood sugar and your stress.

                                Then come nighttime, cortisol was the hormone that regulates your blood sugar when you sleep. But if you’re just kind of maxed out and you can’t make anymore, then what will happen is the person will just, come 2:00, 3:00 a.m. depending on when they ate dinner, boing, they’ll just wake up and they can’t go back to sleep. Well, that’s because the body is now secreting adrenalin because you don’t have enough cortisol to bring your blood sugar up.

                                So, when that’s happening, that is very damaging to the brain. So, it’s one of the precursors to Alzheimer’s, so we want to get that person sleeping through the night. What we’ll do, let’s say they’re waking up at 3:00 a.m. As crazy as it sounds, we’ll have them set an alarm for 2:30 and eat four grapes. Just get up, eat something with a little bit of sugar in it and go right back to sleep. And as we do that, as we start eventually within a short period of time, they stop waking up at night. But that’s only because during the day, we’re also regulating the blood sugar.

Dr. Weitz:            What about intermittent fasting?

Dr. Hall:                I love it. It just, again, depends on the patient. Some patients do better with intermittent fasting at night, dropping out that six o’clock meal. Most patients prefer to skip breakfast but that’s not always the best meal to skip. And if patients are on insulin, intermittent fasting can be great but it can also be dangerous. So you’ve really got to watch them. With the patient on insulin, we’ll usually do a smaller window, for sure.

Dr. Weitz:            What about fiber?

Dr. Hall:                Fiber is great for the gut as long as you don’t have SIBO.

Dr. Weitz:            What about fiber for blood sugar regulation?

Dr. Hall:                I think it’s great. I think the more fiber there is, the better your blood sugar is going to do.

Dr. Weitz:            Let’s see. I think we pretty much covered diet. Perhaps you can talk about supplements for diabetes.

Dr. Hall:                Well, you mentioned one, berberine. Apex makes a product I like a lot called Glysen. And then Biogenetix makes one called Glucostatic Balance. And that has a really nice mixture of supplements that are helpful for blood sugar.  When we’re using supplements … Every patient is on different supplements, again based [inaudible 00:36:46]. In our practice, every single patient we accept is going to be put through about a four-week de-inflammatory cycle. It’s all really focused on giving them things to open up their methyl pathways to dump as much inflammation as possible. And then we’ll start customizing what supplements they’re going to be on.

Dr. Weitz:            You’re kind of doing sort of a detox. Is that …?

Dr. Hall:                Mm-hmm (affirmative).

Dr. Weitz:            And what does that consist of?

Dr. Hall:                I use a lot of Apex, and I use a lot of Biogenetix. So, Biogenetix has a product called … Isn’t it funny you use something so much?

Dr. Weitz:            I know.

Dr. Hall:                So, they have a detox, it’s pretty great.

Dr. Weitz:            Like a powder?

Dr. Hall:                It’s a powder, and then there’s supplements that go with it. The ClearVite through Apex is very similar and coming with that is like a BileMin. We’ll use that to help clear the toxins from the lymph to the gallbladder. We’ll use Adaptocrine to help the adrenal glands. We use Methyl-SP to help open up the methyl pathways and then we use the ClearVite shake to start really pushing the toxins out and the inflammation. And the hormones, my goodness, a female with diabetes has so many excess hormones.

Dr. Weitz:            And so, how many times a day will you have them use the ClearVite or other detox shakes?

Dr. Hall:                We have them start with one time a day, then we’ll go up to two times a day, then we’ll go to three times a day and then we start backing down from there.

Dr. Weitz:            And this is over a four-week period?

Dr. Hall:                Yeah.

Dr. Weitz:            Basically, you start everybody on essentially 28-day detox?

Dr. Hall:                Yes.

Dr. Weitz:            And that’s a way to start to clear out toxins?

Dr. Hall:                Yes. And then the next thing we’ll do is we really prioritize based on the labs. What are we going to go after first? Is the gut the major problem, or toxin is the major problem? Is the hormones the major problem? We’ll prioritize from there and we’ll manage it [inaudible 00:38:54]. If the hormones seem to be the biggest problem, we’ll try and manage those first. If it’s gut, then we’ll manage that.

Dr. Weitz:            So, you see a patient. You put them on this one-month detox. You haven’t got labs. It come back in a month and then you start basing your protocols on their history and labs at that point?

Dr. Hall:                Yes. That’s exactly right.

Dr. Weitz:            Okay. Let’s say they have some other sort of … Let’s say they have mycotoxins. How do you deal with that?

Dr. Hall:                Well, we have them take an ERMI test and see where the mold is coming from. It’s really hard to get the patient well if-

Dr. Weitz:            He’s got mold in their residence-

Dr. Hall:                The first thing we’ll do is test their genetics and see what they cannot detoxify. We suspect the molds, certainly we want to rule that out. Once we’ve ruled out mold, then we’ll dig deeper and see what other toxins are sitting in there or whatever.

Dr. Weitz:            Is that part of your screen, heavy metals?

Dr. Hall:                If they are biotoxin, yes, then we will. Or if they’re showing signs of cognitive decline, we will certainly test metals.

Dr. Weitz:            How do you test for metals, with serum?

Dr. Hall:                I like Quicksilver because it’s doing three. So it’s doing serum, hair and blood.

Dr. Weitz:            You mean for the tri mercury one?

Dr. Hall:                Well, yes and also when you’re looking at how much … It gives us an idea of how much the person is actually able to get rid of in the urine. So, a lot of people don’t do that test. They just look and see how loaded they are. But what we found is that it doesn’t … Unless we’re doing like a glutathione challenge or something, it could be so stuck in there that you’re not really seeing a real picture of how much is in there and how much they’re able to shed.

Dr. Weitz:            Right. You’re talking about doing a glutathione challenge before you do a urine test for metals?

Dr. Hall:                Before we do any of the testing for metals, we’ll do a glutathione challenge first to really try and push it out and see what we’re dealing with.

Dr. Weitz:            And then you’ll do a Quicksilver, a Doctor’s Data or something?

Dr. Hall:                I like Quicksilver. I like them best.

Dr. Weitz:            We got Chris Shade speaking at our meeting this month. We’re going to talk about heavy metals.

Dr. Hall:                Chris is brilliant. He’s really brilliant.

Dr. Weitz:            He is. He really is, absolutely. Okay, great, I think I’m pretty much done with the questions I had. Is there any other topics or things you’d like to tell our audience?

Dr. Hall:               I would say from years-

Dr. Weitz:            How about this, what do you think a lot of practitioners often miss when they’re dealing with patients with diabetes?

Dr. Hall:                I think they missed the underlying causes. I think they assumed it’s diet and don’t go digging deeper to find out what’s really wrong with the cells.

Dr. Weitz:            They go straight to low carb diet and that’s the end of it?

Dr. Hall:                Because it typically works, but I mean these patients when they eat any carbs, their blood sugar still just go up. So they’re still not really managing their blood sugar great. But what I would say after, I’ve been doing this a really long time and I got into functional medicine because I became very, very ill at one point in my life and functional medicine is how I found my way out of it.

Dr. Weitz:            What were you ill with?

Dr. Hall:                First, I had what I thought was a bladder infection which went on for about three years. I was a competitive swimmer in college and I just thought it was from being in the pool all the time. And then I ended up … I had an autoimmune disease called interstitial cystitis and I had done a tremendous amount of antibiotic use at my doctor’s orders. At that time I was young. I was just in college and then, you know how that messes the immune system.

                                And then shortly after, I was diagnosed with Hashimoto’s and then shortly after that, diagnosed with multiple sclerosis. So, functional medicine, it’s a long story but I believe I had mold illness way back then. It’s really what helped me find my way out and I know a lot of people suffer with that disease and don’t find their way out. So, I feel very fortunate there.

                                But after years of working with patients, I would say one of the things that patients should do … People in general should be doing regularly, is some level of a binder. Chris Shade makes a great one called Ultra-Binder. And there are good ones out there but with the amount of toxins that are in our environment now, I mean 50 years ago, we were not dealing with anything like this. I mean it is really causing some serious health problems.

                                So, being on a binder regularly and making sure you’re not getting constipated from the binder, like making sure you’re getting enough magnesium, et cetera, to keep your bowel movement, I think that would be … That’s something I think every doctors should be looking at with their patients. And most people don’t know. You can’t have a binder like charcoal or something like that around your food or your supplements. So, I’ll meet people, “Oh, yeah, I do that all the time with breakfast.” I’m like, “That’s not good. Don’t you [inaudible 00:44:28] breakfast.”

Dr. Weitz:            By the way, charcoal now is being found increasingly in foods, in toothpaste, in consumer products.

Dr. Hall:                Yeah. It’s funny you said that, I just brushed my teeth with charcoal before I did this.

Dr. Weitz:            There you go.

Dr. Hall:                Hey, thanks for having me on, Dr. Weitz. This is really fun.

Dr. Weitz:            Absolutely. So, how can folks get a hold of you if they want to get in touch with you and work with you?

Dr. Hall:                They can either just go to nextadvancedmedicine.com, or they can just call our office. Our number is 949-786-5050.

Dr. Weitz:            Sounds great, Dr. Hall. Thanks for joining me.




The Science of Chiropractic with Dr. Leonard Faye: Rational Wellness Podcast 173

Dr. Leonard J. Faye speaks about the Science of Chiropractic with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]


Podcast Highlights

2:59   The type of chiropractic technique that I practice is Motion Palpation, which I learned from Dr. Faye and other doctors he had trained who worked with the Motion Palpation Institute, which he founded. Motion palpation is a repeatable, scientific way to analyze the spine and other joints and it gives you a direction to perform your chiropractic adjustments at a specific location and in a specific direction. Then after the adjustments you could repeat the motion palpation procedure to see if you had accomplished what you were trying to do, which was to restore better motion to the joints.   It didn’t require taking a bunch of X-rays or having the patients come in five times a week for months on end and it fit better with my active life in motion perspective. 

5:30  Dr. Faye, who was born in Canada, contracted rheumatic fever when he was 16 years old and he had such severe polyarthritis that he was in bed for three months.  Today this condition can be cured with antibiotics, but at the time they placed him on 3 aspirin every 4 hours and he couldn’t digest any food and all he could eat was soup. He was down to 100 lbs after having been a very competitive hockey player and tennis player.  Dr. Fayes SED rate was at 47 and the Medical Doctor told Dr. Faye’s dad, “You know, Leonard isn’t doing very good and 42% of the kids that have this die and 85% of the survivors have serious heart trouble.”   Dr. Faye’s dad called a chiropractor who came with a portable table and adjusted him from T1 to T7 while he was lying face down.They lifted him back into bed and the next morning when he awoke his joints were half as swollen and half as painful.  Three days later he walked to the bathroom and he was on the path to recovery.  He recovered fully without any heart problems and he is now 82 and only finished playing hockey at 76. He was so impressed with chiropractic that he enrolled in chiropractic college after grade 13. 

8:47  Chiropractic manipulation serves a lot of functions, including reversing post traumatic restrictions of motion in joints in the body, not only in the spine.  Chiropractic manipulation puts a demand on the tissues to become more mobile and stimulates the mechanoreceptors in the joints to improve the range of motion and to reset normal muscle function.  Chronic inflammation in the body is often driven by over stimulation of the sympathetic nervous system and this can result from spinal dysfunction that affects the sympathetic ganglion chain along the cervical spine.  If you adjust the cervical spine to restore flexion and anterior to posterior rotation you can reduce sympathetic facilitation and this will allow many inflammatory conditions to heal. 

15:42  There was an article in the Los Angeles Times on July 7th by David Lazarus entitled “No, A Chiropractor Can’t Cure COVID-19 or Diabetes For That Matter” that criticized a few chiropractors who had claimed that getting regular chiropractic adjustments might protect patients from getting COVID-19 or from having a severe infection and I agree that there is no research to prove that this is the case and I think his criticism is appropriate. Unfortunately, Mr. Lazarus went on to quote from D.D. Palmer, the person credited with starting the chiropractic profession in the 1890s, who described chiropractic treatment as a religious system.  Then, Mr. Lazarus attacked chiropractors who help patients to modify their diet and lifestyle using a Functional Medicine approach to help patients with Type II Diabetes, which is essentially a disease caused by poor diet and lifestyle.  This is an entirely reasonable way to approach patients with diabetes. Mr. Lazarus says that chiropractors are not endocrinologists, which is true, but endocrinologists are not nutrition experts and just giving prescriptions for Metformin and other insulin and glucose regulating medications for a diet and lifestyle condition without also making a serious attempt to get such patients to modify their diet and lifestyle is also reckless and irresponsible medicine. 

Dr. Faye points out that D.D. Palmer was practicing chiropractic in 1895 and medicine was not in a good place at that time either. Surgeons were barbers and really didn’t know what they were doing. In fact, it took 100 years to get surgeons to wash their hands before they did surgery. It wasn’t until Flexner came along in 1935 and cleaned up medicine and closed about 50% of the medical schools because they were just teaching nonsense.  Unfortunately D.D. Palmer made up a story and his son, B.J. Palmer propagated that story into the late 30s and opened a chiropractic college based on those stories. [Palmer Chiropractic College]  It became the busiest chiropractic college in the United States. They were espousing a concept of universal intelligence, which was God, which expressed itself in the body and this was referred to as innate intelligence.  It was said that spinal misalignments were blocking innate from its life force being spread around the body.  Dr. Faye points out that we know that it’s just complete nonsense and hopefully today since we have chiropractic colleges all over the world, usually in a university setting, all that dogma has been dropped and we’re starting to find out more and more science evidence for what can explain the results. Fortunately chiropractic is slowly going through this paradigm shift. There is absolutely no evidence that chiropractic can help an acute condition like COVID-19.  Some chiropractors have claimed that chiropractic helped patients with the Spanish Influenza of 1918 survive. In Canada at the time, some chiropractors were making housecalls to patients that had the Spanish flu three and four times per day and they survived. But we don’t really have ac curate statistics and we don’t know how many would have survived withut any treatment at all. But the interesting thing is that after this experience that chiropractors in Ontario, Canada got their licenses. The people who survived the Spanish Flu who received chiropractic adjustments demanded that parliament license chiropractors, so they passed the Drugless Practitioner’s Act.

28:17  With respect to helping patients with Type II diabetes, it is clear that it is a condition related to diet and lifestyle factors and there is no reason why we could not help patients with changing their diet and lifestyle and adding exercise and losing weight.

35:05  The use of nutrition in Chiropractic practice.  When Dr. Faye went to chiropractic college CMCC was a naturopathic college as well and he learned the principles of naturopathy Royal Lee, who started Standard Process Labs used to come and speak at his school. Royal Lee was a dentist and he had done a bunch of experiments with cats.  He took a family of cats and he gave half the offspring a really good cat diet with lots of animal protein. Then he gave the other brothers and sisters a really bad diet. By the second generation of those cats, their jaws in the poorly fed were smaller, their teeth were overcrowded.  The cats fed the healthy diet, these cats looked all the same all the way down the generations. Their jaws and facial bone structure, everything was the same. Their builds, their looks. So, he showed through this research in 1957 that nutrition could actually affect our genetics. When it comes to vitamins and minerals, while there is a minimal daily requirement, which is amount of vitamin C to prevent scurvy, etc.  But why would you want to take the minimal if you want to function optimally?  But to this day, there is no optimum daily requirement.




Dr. Weitz:            Absolutely. That whole concept is ridiculous. You could say, “Why don’t we just figure out how much we urinate and stop drinking water so that we don’t urinate because we’re just wasting all that water?”

Dr. Faye:              Oh I know. These were basic principles I learned. So, I try and function off that as opposed to specific supplements and things like that. But I do supply patients with certain supplements. I know for a fact we’re all Vitamin D deficient because the skin cancers and whatnot. They’ve stopped us from going in the sun. We used to all lie in the sun. Now nobody does. So now we’re all D deficient.

Dr. Weitz:            [crosstalk 00:40:44] out of the sun. We use sunscreen.

Dr. Faye:              Then I found out Vitamin K about four years ago was really essential to get that calcium into the bones. I used to wonder why patients I put on good calcium magnesium tablets, they just kept getting osteoporotic. Well, I was missing the K2. I found out about that and different things. I’m trying to think of the mineral that people get overweight if they don’t have enough of it.

Dr. Weitz:            A mineral that [inaudible 00:41:29]

Dr. Faye:              I had a patient that was a nutritionist at UCLA and she came in one day and she said, “You know, we found out all our obese patients are zinc deficient and they also have this other” … I can’t remember the name of the mineral. But this other mineral that’s …

Dr. Weitz:            Iron, selenium.

Dr. Faye:              Selenium. Yeah. They’re deficient in zinc and selenium. When they put people on those minerals, they started losing weight. So, I’ve been doing that ever since. That happened about 30 years ago.

Dr. Weitz:            Yeah well check chromium levels for patients who have trouble with blood sugar regulation. That’s another super important one.

Dr. Faye:              Yeah. Chromium is another one. Yeah. So, I put people on a multiple mineral tablet that are having weight issues. I don’t know if you can send blood off and find out if they’re deficient in those three, but I just clinically apply it.



Dr. Leonard J. Faye is a Doctor of Chiropractic and he is a legend in the chiropractic world. He revolutionized the thinking in chiropractic by developing the concept of motion palpation and he created an institute to teach this method to thousands of chiropractors around the world. Dr. Faye has given over 350 seminars around the world, has published hundreds of articles, and he wrote Good Bye Back Pain and he co-wrote Motion Palpation and Chiropractic Technic and he continues to mentor chiropractic doctors. His next book, Chiropractic Odyssey–A Journey of Practice, Observation and Reading Research and will be available in October 2020.  Dr. Faye’s website is chiropracticmentor.com.

Dr. Ben Weitz is available for nutrition consultations, including remote consults via video or phone, specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com. Phone or video consulting with Dr. Weitz is available.



Podcast Transcript

Dr. Weitz:            Hey this is Dr. Ben Weitz, host of the Rational Wellness podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness podcast for weekly updates and to learn more, check out my website, drweitz.com. Thanks for joining me and let’s jump into the podcast.  Hello Rational Wellness podcasters. Thank you so much for joining me again today. For those of you who have joined the podcast, please go to Apple podcasts and give us ratings and review. If you’d like to see a video version, you can go to my YouTube page and if you go to my website, drweitz.com, you can find detailed show notes and a complete transcript.

                                So, today we’re going to talk about chiropractic which is a, even though I’m a chiropractor, I actually haven’t had too many discussions about chiropractic and we’ll also it will involve nutrition as well with one of the most famous chiropractors of all time, Dr. Leonard Faye. So, Dr. Faye is one of my mentors so I’m very proud that he’s here joining us today. I recall when I first went to chiropractic college and I was in my first chiropractic technique class.  The instructor started going on about DNA and chiropractic philosophy and in my mind, he was describing the basis of chiropractic in almost religious terms. I challenged him and he told me that I could not be a chiropractor without that philosophical belief system. So, I pushed back and told him that I was interested in the scientific basis of chiropractic and had no interest in such religious or spiritual beliefs.

                                I did become very proficient in performing chiropractic adjustments despite him and merely shut my ears when discussions of the innate came up. I found my way to a version of chiropractic known as chiropractic biophysics which is a very scientific way of understanding chiropractic based on the shape of the ideal spine and then trying to draw lines on carefully taken X-rays, patients who have been carefully positioned and then using a combination of very specific adjustments, forms of traction and exercises, we would try to reshape their spines to these ideal shapes.  This form of chiropractic had a scientific rigor that appealed to me. But it was really too rigid and it really didn’t account for individual variations in form and function.

Then I learned about motion palpation and a motion palpation institute which taught the principles of how to analyze the motion or lack of motion of joints in the various directions of motion that occur. Not only in the spine, but all the joints of the body.  I took a bunch of these motion palpation classes. It was a repeatable, reasonably scientific way to analyze the spine and the other joints. It then gave you a direction to perform your chiropractic adjustments at a specific location and in a specific direction. Then after the adjustments you could repeat the motion palpation procedure to see if you had accomplished what you were trying to do which was to restore better motion to the joints.   It didn’t require taking a bunch of X-rays or having the patients come in five times a week for months on end and it fit better with my active life in motion perspective. For teaching me this and for creating the Motion Palpation Institute, Dr. Faye, I will always be indebted to you.

Dr. Faye:              Thank you.

Dr. Weitz:            Dr. Leonard John Faye. Graduated from Canadian Memorial Chiropractic College in 1960 and he practiced in England for 14 years, in Canada for 12 years and in Los Angeles for the last 34 years. Dr. Faye is a legend in the chiropractic world. He revolutionized our thinking by developing this concept of motion palpation and created an institute to teach this method to thousands of chiropractors around the world. Dr. Faye has delivered hundreds of seminars, he’s published hundreds of articles and he wrote Goodbye Back Pain and he also co-wrote the book, Motion Palpation and Chiropractic TechniqueHe continues to mentor chiropractors around the world and he will soon be publishing his next book. Dr. Faye, thank you so much for joining me today.

Dr. Faye:              It’s a real pleasure and it’s so much fun for me to hear somebody that’s done so well and has become such an expert doctor.  Forget chiropractor and hopefully I’ve started a lot of people down that path and they more than surpassed my knowledge that it’s terrific.

Dr. Weitz:            That’s great. So, perhaps you can tell us how you came to decided to become a chiropractor.

Dr. Faye:              Yes. As a 16 year old, nearly finished grade 12, I contracted rheumatic fever and had the polyarthritis that put me in bed for three months. The treatment in those days, it wasn’t antibiotics which has wiped out that condition, but I was on three aspirin every four hours around the clock for three months. So needless to say, I couldn’t digest any food. I was drinking consume soup. I was down to 100 pounds having been a really good hockey player and tennis player.  So, I was quite an athlete and the doctor said who had taken my sed rate the week before and it was still 47.

Dr. Weitz:            Wow.

Dr. Faye:              On the scale at the time, 8 to 12 was normal and he then said to my dad, “You know, Leonard isn’t doing very good and 42% of the kids that have this die and 85% of the survivors have serious heart trouble.” So when he left, my dad called a chiropractor and he came in with a portable table and adjusted me from T1 to T7 and I was lying face down so some of my neck moved as well. They lifted me back in bed and the next morning, I woke up, my joints were half as swollen, half as painful.  Three days later, I walked to the bathroom and on recovery. I’m now 82 and I only finished playing hockey at 76 so my heart wasn’t involved and that really impressed me. I thought, “My God, I got to learn to do this. The people should know about this.”  So, I entered chiropractic college after I got grade 13 which is what’s called matriculation.

Dr. Weitz:            Wow.

Dr. Faye:              Yeah. It went on from there. When I got to chiropractic college, I had the same experience you had. It was just religious concepts. God was doing this and that and every other damn thing. Because he had no hands, we were using our hands were the hands of God, right? It was unbelievable what was being told to us. But the manipulation I knew there must be some scientific evidence for this. If there wasn’t I dedicated myself to trying to figure out what the heck was going on and support research and to try and help people get into research which did happen over the years.   A lot of our top researchers that bumped into me when they were in chiropractic college and decided hey, we got to find out what this is all about.

Dr. Weitz:            So maybe you can tell us for a lot of people, they don’t really understand much about chiropractic. What is chiropractic? What does chiropractic manipulation do?

Dr. Faye:              Well, it has a lot of different functions. If there’s just post traumatic changes in the joints, that’s producing restriction of ranges of motion, the manipulation puts a demand on the tissues to start reversing and becoming elastic and mobile. The mechanoreceptors around those joints start to talk to the brain so that the muscles can be recruited that move the joints that the body has been ignoring and setting up adaptive changes.  So, if you couldn’t raise your shoulder to put a bottle of milk in the refrigerator, you’re automatically would lean over and your hand would go up and the bottle wouldn’t get to the right height and you could put it on … You didn’t have to think about doing that. That was just adaptive mechanisms for the loss of mechanoreceptors coming from your shoulder and in that kind of a condition, we increased by manipulation the shoulder movement and the whole shoulder girdle and deal with the soft tissue changes and eventually with time and increased ranges of motion, the inflammation clears up, the mechanoreceptors and proprioceptors become active.

                                Your body learns to recruit properly and the whole thing reverses. However, there’s also a effect of the areas of the spine where the sympathetic ganglion chain is and it turns out that the ganglion chains can be irritated mechanically from dysfunction in the spine and this causes a facilitation of the sympathetics and two guys named Basbaum and Levine up at San Francisco discovered that chronic inflammation is often driven by the release of norepinephrine from the end of the sympathetic nerves.  In their experiments, they took dogs and cut the sympathetics to an arthritic knee and lo and behold, the arthritis started to heal because it was no longer getting this norepinephrine. Then they discovered the norepinephrine caused the mass cells to release PG2 and PG2 was driving the inflammatory response. So, we had known for a long time that if you adjusted the cervical spine to restore flexion and A to P rotation, anterior to posterior rotation, these were the limitations that would irritate the superior sympathetic ganglion chain and cause chronic inflammatory conditions in the shoulder or levator scapulae tendinitis, tennis elbow, carpel tunnel.  All these chronic inflammatory conditions down that extremity on the side where the sympathetics were facilitated, then manipulation and other soft tissue procedures would lessen that and remove that sympathetic facilitation and then those tissues would heal and of course, patients would take Advil which is a PG2 blocker or surgeons would go in and then put people on an NSAID and it would heal up and so there’s other ways of doing the same thing, but nothing nonsurgical, nondrug like our chiropractic procedures.  [Here is one reference I found to one of their papers:  The contribution of neurogenic inflammation in experimental arthritis.  JD LevineMA Moskowitz and AI Basbaum. 

                                The trouble is that a lot of chiropractors don’t know how to do that and don’t even know that the sympathetics can be facilitated and if they’re in the old paradigm, then they’re cracking away and quite often, they’re not doing flexion and A to P rotation from the lower cervical spine. The same thing can go on in the lumbar spine or the lumbar sympathetic chain and a chronic tendinitis of the knee can often be improved by adjusting the cervical lumbar junction.  It’s not always the way it is because there are direct traumas that cause inflammatory conditions, but it’s sad that we haven’t penetrated into the whole diagnostic world as to what it is that we are actually doing because unfortunately, we haven’t standardized our education so that all chiropractors know about sympathetic facilitation. If you hear my phone ring, I won’t be answering it. I’m at the front desk. So sorry about that. So that’s kind of a … There we go. Yeah. So, then in the modern chiropractor is not only changing the function of the joints, but is then going into rehabilitation facilities, getting patients to use the muscles into so that they do recruit in the normal order and weakened muscles become stronger.  It’s become now a whole process rather than just cracking the spine.

Dr. Weitz:            So, the next couple of questions are going to take a few minutes for me to set up because I want to describe some statements that were made in a recent LA Times article on chiropractic and ask you to comment on a few of the claims. So, I think some of the public gets confused about who and what chiropractors do. In fact, it sounds like a number of chiropractors are confused as well. We’ve recently seen articles attacking claims by chiropractors that they can prevent COVID 19.

Dr. Faye:              You were cutting in and out. Do you want to repeat that?

Dr. Weitz:            Oh okay. So, let me start again. So, Dr. Faye, the next few questions are going to take a few minutes to set up. I’m going to describe some statements made in recent LA Times article on chiropractic and ask you to comment on a few of these claims that were made. Some of the public is confused about what chiropractors do and who we are and there was recently an article that appeared in the LA Times on July 7th by David Lazarus that was titled, “No, A Chiropractor Can’t Cure COVID 19 or Diabetes For That Matter.”  In this article, Mr. Lazarus made some reasonable critiques of some claims by chiropractors that getting chiropractic adjustments regularly might protect patients from getting COVID 19 or from having a severe infection. Mr. Lazarus goes on to explain that the person credited with starting the chiropractic profession, D. D. Palmer claimed in a memoir that the basic principle from 1914 that the basic principles of chiropractic were passed to him during a seance by a long dead doctor.  Palmer described chiropractic treatment as a religious system that imparts instruction relating both to this world and the one to come. Then Mr. Lazarus conflated this attack complaint about chiropractic to chiropractors who advertised to be able to help patients with conditions like Type II Diabetes.

                                So, on the one hand, he’s criticizing chiropractors who are claiming that they can prevent patients from getting COVID 19 or ensure that they’ll have a better outcome if they get regular adjustments. He also threw into the article that chiropractors who are offering diet, lifestyle and a nutritional approach to helping patients with diseases that are like diabetes that are essentially caused by poor diet and lifestyle and I think it was very unfair to throw both of those critiques in together as though they were along the same lines.  So, he attacks doctors of chiropractic saying that they are not endocrinologists. Well, that’s true. Chiropractors are not endocrinologists. But endocrinologists are not nutrition experts and just giving prescription for Metformin and other insulin and glucose regulating medications for a diet and lifestyle condition without also making a serious attempt to get such patients to modify their diet and lifestyle is also reckless and irresponsible medicine.

                                I know that was a long setup Dr. Faye, but perhaps you could comment about chiropractic and you’ve already given us a little information about how chiropractic can affect the body as a whole, but perhaps you can comment about both of these and then maybe also talk a little bit about how nutrition can be a part of a chiropractic practice.

Dr. Faye:              Right.

Dr. Weitz:            So, take that where you’d like.

Dr. Faye:              Well, first of all, D. D. Palmer was 1895.

Dr. Weitz:            Okay.

Dr. Faye:              At that time, surgeons were barbers and medicine was in a mess. It wasn’t any wonder that he didn’t know what he was doing because nobody really knew what they were doing. It wasn’t until Flexner came along in 1935 that cleaned up medicine and they closed about 50% of the medical schools because they were just teaching nonsense and he managed to get a couple of results. So, he [D.D. Palmer] made up a story and unfortunately, his son [B.J. Palmer] propagated that story into the late 30s and opened a chiropractic college based on those stories. [Palmer Chiropractic College]  It became the busiest and put out the most chiropractors in the United States. They were still espousing all those universal intelligence which was God and expressing itself in the body is innate and these little misalignments were blocking innate from its life force being spread around the body. It’s just complete nonsense and hopefully today since we have chiropractic colleges all over the world, usually in a university setting, all that dogma has been dropped and we’re starting to find out more and more science evidence for what can explain the results.  

                                They used to get good results with certain conditions. They just had a ridiculous religious explanation. Right? Today, we still have two colleges. Sherman and Life that espouse to these old concepts and old dogmas. Unfortunately, that’s the way it is until we get it cleaned up completely. We’re probably 85% scientific and rational and only maybe 15% in the old paradigm. I’ve been connected with this paradigm shift since 1962 so I know how slow paradigms shift.   One doctor said to me, “Well, you know it took surgeons 100 years to wash their hands before they did surgery.” That was 100 years just to get them to wash their hands. God, the English sailors were eating limes and lemons to stop getting scurvy. In the rest of the world, the sailors were coming down with scurvy right, left and center because nobody would look into the vitamin C in limes and lemons. That’s why Englishmen are called limies. I don’t know if you know that.

                                But anyways, then he went on about COVID 19. It’s absolutely ridiculous that we could be dealing with a crisis that the COVID 19 causes in the body where we’re asking the body to make a healing response but it’s going too fast and it’s an irreversible pathology for some people. I was taught at CMCC that we’re a drugless and surgeryless therapy only for conditions that are irreversible. Not reversible conditions. Lifestyle conditions are reversible if you catch them early on.  But once the pathology becomes irreversible, then we’re stuck where we can’t … My philosophy is that we should be seen up front and once it becomes a disease pathological process, then medicine has really good expertise in managing diseases. They manage diseases really well. Let’s face it. If you had a heart attack, you wouldn’t run to a chiropractor. You’d run to the hospital. Right? So, we have to decide just where we are in this society as a healing profession, but because we still have 15% saying we can help COVID and there’s no evidence that we can help COVID.  We should all be evidence influenced if not evidence based in our practice. It’s just we have to stop these people from making these statements. In Canada, you would lose your license for doing that. In Denmark, you would lose your license. In Norway and Sweden, you would lose your license. Until we get those kind of laws that stop these people, it’s just unbelievable what they’re saying and what they advertise. Some of them don’t take any exam. They just crack people three times a week for life at so much a month fee.  In Canada, that guy would lose his license in a heartbeat. You can’t not examine patients to see what you’re treating and then declare that everything that happened is due to your manipulation. Now, the virus thing is confusing because in 1918, with the huge flu epidemic, the chiropractors-

Dr. Weitz:            You talking about the Spanish Influenza of 1918

Dr. Faye:              Spanish Flu.

Dr. Weitz:            Yeah.

Dr. Faye:              The chiropractors in Toronto did house calls three and four times a day to patients that had Spanish flu and they survived. Now, we don’t know how many they treated. We don’t know how many survived because people survived without any treatment. So, there’s no statistics about it. The only thing that happened was that because there were enough survivors from chiropractic, they demanded at parliament that there become a licensing for chiropractors. It was through that Spanish flu that chiropractors in Ontario, Canada got their licenses. It was called the Drugless Practitioners Act.  It wasn’t even for chiropractors. It was for naturopaths and everybody. Drugless practitioners. But we don’t know how many they treated. We don’t know how many survived and how many didn’t survive that were treated. There was no evidence really. So, you can’t say because some chiropractors in Toronto treated some people that survived that it was their chiropractic that made them survive. So, we have no evidence but that’s what you occasionally hear that story and people are saying, “Well, there you go. See? We cured people in the Spanish flu.” Well, we didn’t. So, that’s where that all comes from.

Dr. Weitz:            Yeah. I have heard that.

Dr. Faye:              As far as diabetes II, I’ve helped patients with their diet, exercise, getting their weight down, doing a lot of things that improved their diabetes II. I also did manipulation. Whether the manipulation, we don’t have a study where we changed people’s diets, get them exercising, lose weight and don’t manipulate them and then have a group that we do manipulate that get all those things. Then we have a group that don’t get any of that and start comparing and see what happens.   So, we have no evidence. Who’s fault is that? It’s our fault. Right? We keep on doing research on low back pain. It drives me crazy. There’s 52 studies on low back pain. There’s not one study on a whole lot of other things that we can help. So, I don’t know when the research is going to catch up to the practices, but as clinicians, we can be evidence influenced and then we have to go by our experience.

Dr. Weitz:            Right. Because there isn’t enough research.

Dr. Faye:              No. There’s not enough. What a lot of the researchers believe, until we get a place at the table for back pain, we don’t have the right to come to the table for headaches and paresthesias down the arm and things like that. Discs. They reckon in Switzerland that 95% of discal surgeries could have been helped by a chiropractor in three to five months without surgery. The chiropractic college there is in a university in a hospital setting. So, they’ve done studies on patients with major MRI proven discal budges, herniations, and submitted them to chiropractic care and 95% never went to surgery. It was a good study and it was done properly.  So, that’s hard news to bring to orthopedics. They don’t want to hear that. It’s unfortunate, but that’s the way it is. It’s just like stints. They’ve shown stints aren’t much good, but they still use stints and bypass surgery.  So, we’re not the only ones but I know that that becomes a straw man argument.  So, straw man arguments aren’t worth a damn, but let’s face it.  We’re all in this fish bowl together.  So, we have to be looked at in the same light.

Dr. Weitz:            Yeah. No, I think what you’re hinting at is most people don’t realize this, but even though drugs are subject to randomized control trials, the majority of procedures that are performed in any physicians office have not been subject to randomized clinical trials.

Dr. Faye:              That’s right. I was once approached to go into the cancer ward at Cedar Sinai to help with pain control because somebody there read a paper that manipulation has a down regulating of pain.  So, I was being interviewed and then an orthopedic.  An old guy. He started on about chiropractic. I said, “Well, could you quote one paper about surgery, one that has a control group, a nontreated group and a surgical group?”  He didn’t know one.  It’s what you just said. Their procedures are not put through the same rigor that drugs are put through.  There’s a reason for that. It would be unethical to take somebody that needed a surgery and then let them be the control group with no treatment.  So, ethics do come into it.

Dr. Weitz:            Right. Essentially what you’re saying and I don’t think people realize this is a perspective randomized clinical trial that is the type of trial that’s done to show efficacy and safety for pharmaceutical interventions, that type of study was designed to test drugs. Applying that to things other than drugs like chiropractic manipulation but equally trying to apply that to surgery or other procedures performed within medicine, it’s very difficult or impossible to do.  So, really we need to think about scientific efficacy for procedures. It can’t be based on the type of study that’s designed to test pharmaceuticals.

Dr. Faye:              Yes. Rand has been doing studies on chiropractic for about the past 15 years. They’ve tried that old formula. They have now gone to pragmatic studies. So, they look at the outcome. The outcome where you had manipulation or you didn’t have manipulation. The outcome where you had manipulation plus exercise or you didn’t have manipulation with exercise. Then see what the results are. Then after that, you can start figuring out what caused what. But to start with, we need to show do we have an effect on sciatica?  It needs to be a pragmatic study. So, that’ll come.

Dr. Weitz:            Right. Yeah. Good. So, how about the use of nutrition? How does nutrition play a role in a chiropractic practice, in your practice?

Dr. Faye:              I was very lucky. CMCC at the time I went there was a naturopathic college as well. So, I had four hours every week for four years on naturopathic principles. Nutrition was one of the things that was looked into. We were lucky enough to hear Royal Lee speak who started Standard Process Labs. He had done experiments with cats. He took a family of cats and he gave half the offspring a really good cat diet with lots of animal protein. Then he gave the other brothers and sisters a really bad diet. By the second generation of those cats, their jaws in the poorly fed were smaller and the teeth were overcrowding.  Because Royal Lee was a dentist and the facial structures were such that you couldn’t recognize these cats were related to the grandparents. But on the good nutrition side, these cats looked all the same all the way down the generations. Their jaws and facial bone structure, everything was the same. Their builds, their looks. So, he showed through this research that nutrition could actually affect our genetics.  Now that in 1957 was a huge breakthrough. You couldn’t read that anywhere.

Dr. Weitz:            I know. That’s amazing [crosstalk 00:37:10]

Dr. Faye:              But we saw the pictures of these cats and what he’d fed them and whatnot. It was really interesting. We all went, “Holy mackerels. We are what we eat.” Right? It can actually change our genes. Everybody knew it could make you fat or skinny or it could be energetic or not energetic, but nobody knew that it could affect the genetic structure in us and actually affect our offspring. So, we were all going by a formula. Eat 50% raw, right? At least 50% raw. We weren’t vegetarians, we weren’t vegans. But we knew that we had to eat a lot of vegetables and fruits and nuts and everything raw.  That’s the diet I’ve followed. I’ve eaten a lot of meat, but I also have eaten a lot of raw fruits and vegetables and nuts. So, that was kind of the basics they put in. Then they went through all the conditions that were recognized in pathology texts. Pellagra, scurvy. One nutritional element missing could make the body be a complete mess. Right? Completely destroy the human body with vitamin C missing.  So, then the question was well, what else? Then the concept that we got was that if we know what the body needs and we do, why don’t we supply it? That’s got to be logic number one. I don’t know why that’s missed. So, with these basic understandings and then we discussed minimum daily requirement. Well, why would you want the minimum to function optimally?

Dr. Weitz:            Right.

Dr. Faye:              Right? There must be an optimum daily requirement. Well, you can’t find it anywhere. [crosstalk 00:39:24] It doesn’t exist to this day.

Dr. Weitz:            This is true.

Dr. Faye:              So, you have to overdose and make sure your body kicks out what it doesn’t need. Oh, well that got ridiculed as producing expensive urine. Well, I’d rather produce expensive urine than have a minimum daily requirement that makes me function less than optimally.

Dr. Weitz:            Absolutely. That whole concept is ridiculous. You could say, “Why don’t we just figure out how much we urinate and stop drinking water so that we don’t urinate because we’re just wasting all that water?”

Dr. Faye:              Oh I know. These were basic principles I learned. So, I try and function off that as opposed to specific supplements and things like that. But I do supply patients with certain supplements. I know for a fact we’re all Vitamin D deficient because the skin cancers and whatnot. They’ve stopped us from going in the sun. We used to all lie in the sun. Now nobody does. So now we’re all D deficient.

Dr. Weitz:            [crosstalk 00:40:44] out of the sun. We use sunscreen.

Dr. Faye:              Then I found out Vitamin K about four years ago was really essential to get that calcium into the bones. I used to wonder why patients I put on good calcium magnesium tablets, they just kept getting osteoporotic. Well, I was missing the K2. I found out about that and different things. I’m trying to think of the mineral that people get overweight if they don’t have enough of it.

Dr. Weitz:            A mineral that [inaudible 00:41:29]

Dr. Faye:              I had a patient that was a nutritionist at UCLA and she came in one day and she said, “You know, we found out all our obese patients are zinc deficient and they also have this other” … I can’t remember the name of the mineral. But this other mineral that’s …

Dr. Weitz:            Iron, selenium.

Dr. Faye:              Selenium. Yeah. They’re deficient in zinc and selenium. When they put people on those minerals, they started losing weight.  So, I’ve been doing that ever since. That happened about 30 years ago.

Dr. Weitz:            Yeah well check chromium levels for patients who have trouble with blood sugar regulation. That’s another super important one.

Dr. Faye:              Yeah. Chromium is another one. Yeah. So, I put people on a multiple mineral tablet that are having weight issues. I don’t know if you can send blood off and find out if they’re deficient in those three, but I just clinically apply it.

Dr. Weitz:            Yeah you can. We do a lot of those nutrition panels as part of our practice.

Dr. Faye:              Yeah I think obviously that’s the way to go.

Dr. Weitz:            Yeah.  One of the founders of functional medicine, Dr. Sidney Baker, he said a long time ago, medicine is basically the principle to make people healthy is find out what they don’t have enough of and give it to them.  Find out what they have too much of and let’s remove some of that.

Dr. Faye:              Yeah. Yeah.

Dr. Weitz:            So, if they have too many toxins or too much et cetera.

Dr. Faye:              I know.

Dr. Weitz:            Poor diet, sugar, et cetera. Yep.

Dr. Faye:              So, you can’t treat patients without looking at their nutrition. It’s impossible. Even a dentist should be doing that. Let alone medical doctors and chiropractors.

Dr. Weitz:            Absolutely. You got people coming in with cavities and gum disease and we know that nutrition is a major factor. If you don’t clear that up, you’re never really going to help them.

Dr. Faye:              That’s right. That’s right. I’ve always given patients stretches and had them walking or if they’re athletic going to the gym and getting themselves fit. So many patients are unfit it’s ridiculous.

Dr. Weitz:            Yeah. Sedentary lifestyle is one of the big killers today for sure.

Dr. Faye:              Yeah. 70% of patients in hospital are there because of lifestyle conditions. Now admittedly, they do get to a pathology status where they do need medical care.

Dr. Weitz:            Sure.

Dr. Faye:              Right. Just because that’s what put them in there doesn’t mean that you can just take them out and start their nutrition going. It’s too late.

Dr. Weitz:            No. Absolutely. In fact, there are people in nursing homes who can’t get out of bed and the only thing wrong with them is that they are too weak. They have sarcopenia. They’ve lost all their muscle from lack of activity.

Dr. Faye:              Yeah.

Dr. Weitz:            That’s sad.

Dr. Faye:              Yeah. I read a study last year, even 90 year olds can build muscle.

Dr. Weitz:            Oh absolutely.

Dr. Faye:              If they do exercise. It’s never too late to increase your strength.

Dr. Weitz:            Absolutely. Everybody should be doing regular exercise and one component that exercise should be some sort of strength training, cardiovascular training, flexibility training and balance. All four of those should be included in everybody’s regular exercise program.

Dr. Faye:              Yeah. I don’t know why medical doctors can’t tell patients that. But they just don’t.

Dr. Weitz:            Well, unfortunately our healthcare system is largely controlled by insurance companies who are pressuring medical doctors to spend no more than 10 minutes with a patient and they simply don’t have the time. They’re stuck in this system. Patients don’t realize [crosstalk 00:46:04] it’s the insurance companies in the United States that are making the rules.

Dr. Faye:              Right. In Australia, my wife had to go to a gynecologist and the sign on his desk was my fee is based on 15 minutes. If you go over 15 minutes, you’ll be charged a second fee. So, maybe that’s what should happen for people that [crosstalk 00:46:30]

Dr. Weitz:            Well, you don’t get 15 minutes in the United States. That’s a long office visit.

Dr. Faye:              Right. It’s terrible. Anyways, I’ve got a new book coming out.

Dr. Weitz:            Good.

Dr. Faye:              Chiropractic Odyssey A Journey of Practice, Observation and Reading Science.

Dr. Weitz:            Awesome.

Dr. Faye:              I go through all the books and papers that I read that changed my behavior from 1960 onward. So, I think it’ll be an interesting read.

Dr. Weitz:            That’s great. I’m looking forward to it. When is it going to be out and where-

Dr. Faye:              September 15th.

Dr. Weitz:            Okay.

Dr. Faye:              The pre-publication is on offer now at www.chiropracticmentor.com.

Dr. Weitz:            Okay.

Dr. Faye:              So, it’s a reduced price and it’ll be a hard cover. When the real book comes out, it’ll be soft cover for $20 more. So, there’s a benefit from buying it up front.

Dr. Weitz:            Oh. I’ll be heading over there and getting it [crosstalk 00:47:41].

Dr. Faye:              I’m always selling something. You know me.

Dr. Weitz:            I’ll be sure to give you a review, doc. So, is it going to be self published or do you have a publisher? Is it self published?

Dr. Faye:              Yeah. I’m self publishing it because I don’t want it to go to the public. It’s all about the paradigm shift.

Dr. Weitz:            So, it’s for the chiropractic profession mostly?

Dr. Faye:              Yeah and students I hope. Students I hope will read it and understand why they have to become evidence influenced and not listen to the bullshit, but the references … Have you heard of Davis law?

Dr. Weitz:            No.

Dr. Faye:              No. Davis’s law is a [inaudible 00:48:36] of the law that states that bones grow according to the stresses-

Dr. Weitz:            Oh. Yeah, yeah, yeah. Yes. Yes. Yes. Yeah.

Dr. Faye:              Right. So, soft tissues can change according to the stresses of movement.

Dr. Weitz:            Yes.

Dr. Faye:              I quote the literature that people have done those experiments. Drilled holes in rabbits knees and put some in a cast and some in a treadmill and some in a mobilized cast and the healing changes were dramatic and the motion of the continuous passive motion of cast caused a complete recovery of the highland cartilage in a joint. Those experiments and those facts are not mentioned in the modern chiropractic education. So, how can you expect a chiropractor to want to deal with developing increased ranges of motion in a joint that’s paining and degenerating and doing all kinds of pathological pathogenesis of the lack of motion that is reversible? They don’t understand it. So, it doesn’t give them the need for learning to do really specific manipulation into the directions of loss of motion.

                                That’s just one example. There’s so much old literature that was well done that isn’t unfortunately read today. Barry Wyke-

Dr. Weitz:            Cool. cool.

Dr. Faye:              Barry Wyke discovered that mechanicoreceptors override nociceptors. So, once the joint starts to move, it feels a whole lot less painful. He did all that work. You ask the modern chiropractor who Barry Wyke is-

Dr. Weitz:            That was the famous white and [inaudible 00:50:48].

Dr. Faye:              Yeah. No. Wyke. W-Y-K-E.

Dr. Weitz:            Oh okay. Yeah. Yeah. Yeah.

Dr. Faye:              Barry Wyke. He was an English joint neurologist.

Dr. Weitz:            Okay.

Dr. Faye:              Amazing.

Dr. Weitz:            Cool.

Dr. Faye:              These were not old studies to be thrown away. They back up a lot of what we do. If you don’t know that, then you won’t think that manipulation is worth a damn because the modern research, these controlled studies do three adjustments on somebody that I would treat 30 times. How did [inaudible 00:51:30] migraine headaches relieved in three visits? It’s impossible.

Dr. Weitz:            Right.

Dr. Faye:              How do you get it if you don’t even know if chocolate, red wine and old cheese is one of the trigger factors?

Dr. Weitz:            Right.

Dr. Faye:              They don’t even ask anymore. They just think, “Oh, we can’t help migraines.” Well, we can help a lot of migraines. It’s just you have to know the references. So, this book is full of them.

Dr. Weitz:            Awesome. Great. So, what’s the website they go to for that?

Dr. Faye:              Www.chiropracticmentor.com.

Dr. Weitz:            Okay. Awesome. Thank you so much Dr. Faye.




Heavy Metal Detoxification with Dr. Chris Shade: Rational Wellness Podcast 172

Dr. Chris Shade speaks about Heavy Metal Detoxification with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]


Podcast Highlights

5:19  Dr. Shade talked about his experience as a farmer and how he studied mercury while earning his PhD in Environmental Science.  He developed a patented a way to separate out and test for different forms of mercury, including inorganic mercury found in amalgam tooth fillings from organic mercury found in fish.  The key is that mercury never exists as a free ion but is always bound to something, such as cysteine or glutathione.  Also, he realized that the body has an innate system for detoxification, the glutathione system and also the methionine system and rather than using chelators, you can upregulate your natural system.  When Dr. Shade was going to school for his PhD and he had 17 mercury amalgams in his mouth and he could feel the effects and he used chelators to reduce the mercury and they made him sicker. This inspired him to develop a better way to get rid of heavy metals in the body.

11:10  Testing for Heavy Metals.  Since metals can be stored in our bones and organs, doesn’t it make the most sense to take an oral chelator like DMSA to liberate those metals and then measure urine before and after the challenge?  Dr. Shade explained that even though there may be more metals in the tissues than in the blood, there’s a dynamic equilibrium between what’s stored in the tissues and what’s in the blood. Further, these chelators like DMSA do not go into the tissues and the cells, but they simply go into the blood and plasma and they make the kidneys more filterable.  And no matter who you are, when you take a chelator, your urine levels go up, so it becomes this excuse to chelate everybody, not a look at where everybody really is with their metals levels.  But you can get the same results from just measuring the blood as long as you use the correct reference ranges, though mercury is an exception.

13:16  Nuclear factor erythroid 2-related factor 2 (NRF2) is a protein that regulates the expression of antioxidant proteins that protect against oxidative damage triggered by injury and inflammation.  When you turn NrF2 up, that’s a key pathway and a trigger in the body to dump toxins into the blood.  It also triggers the genes for glutathione synthesis, glutathione s-transferases, and transporters for removing toxins from the body. Turning up NRF2 is needed to get toxins out of the cells into the blood and then you need to turn up the filters, which are the liver, the kidneys, the GI tract, and the skin that take toxins out of the blood for excretion out of the body.

14:48  It doesn’t work well to just do serum metals testing through Quest or Labcorp even though it may be less expensive and it may be covered by the patient’s insurance, because they don’t speciate out the different forms of mercury into inorganic (from tooth amalgams) and methylmercury (from fish).  It is only measuring methylmercury, which is really a measure of how much fish you eat.  If you have inorganic mercury from dental amalgams you would only show a very small amount in the blood and the 95th percentile for inorganic mercury is below the detection limits for Quest and LabCorp.  The best way to test for mercury is with the Mercury Tritest from Quicksilver that measures blood, urine, and hair and compares the ratios.  Blood is the best way to measure organic mercury, while urine is a better measure of inorganic mercury and the urine:blood ratio provides information about the excretion of inorganic mercury. The excretion of methylmercury is seen in hair and the hair:blood ratio provides information about the excretion of methylmercury.

22:18  The most common symptoms of heavy metal toxicity include fatigue and anxiety.  Fatigue occurs because the metals diminish the antioxidant pool in the mitochondria. They suck down the glutathione and the thioredoxin in the mitochondria.  Metals also work at the thyroid level, which creates further fatigue. If you have normal or high T4 but low T3 that can be caused by mercury, cadmium, arsenic, or other metals. Metals can also affect the adrenals. And metals can accumulate in the kidneys and burn them out. Most metals are also glutamate receptor agonists, so they drive you into a neuroinflammatory state and this can lead to brain fog and depression and anxiety. You go into a state of hypersympathetic autonomic nervous system, which shuts down detoxification through prioritization pathways.  What engages with the mercury are endotoxins from leaky gut, chronic jaw infections, chronic UTIs, gingivitis, and periodontitis.

26:15  It would be great if our body just naturally got rid of all of our toxins or if we could simply do a juice fast, but it’s not true. Perhaps it would be true if “we were living in the mountains, and we were all chill, and we’re eating wild food and getting all the phytonutrients, yeah, we wouldn’t really have a problem, but we’re not.” We’re chronically in sympathetic mode, which downregulates detoxification.  We eat inflammatory foods, rather than phytonutrient rich foods.  We need to take specific nutrients to activate transcription factors like Nrf2 and activate cardiometabolic factors like AMPK and take things like glutathione to liberate metals from the cells to put them into the blood, so the liver will dump them into the bile and then into the GI tract.  And you need binders into the GI tract to make sure toxins don’t get reabsorbed.

27:57  At the cellular level the metals are conjugated onto glutathione and then transported out of the cells into the blood.  Then we want to pull from the blood into the liver, dump the liver into the bile, get it to the GI and then stick it on a binder.  If there are metals in a cell, the metals are always bound to some some protein. You have to take the metal off the protein its bound to and link it on to glutathione. This conjugation reaction occurs through an enzyme known as glutathione s-transferase, which is synthesized by the cell and if Nrf2 is upregulated, you will synthesize more glutathione s-transferase. Then there are transporters that escort the metal/glutathione conjugate out of the cell. This is phase three of detoxification.  These transporters use ATP and magnesium. 

29:57  Many of us are familiar with phase one, phase two, and phase three of liver detoxification. But these phases of detox occur in all the cells in all the organs of the body and not just in the liver.  Yes, detoxification occurs more in the liver, but if you’re a thyroid cell and you have a toxin in there, you can’t wait for the liver to walk into your thyroid, because it’s not going to happen.  So all three phases of detoxification occur in all cells.  Dr. Shade points out that when it comes to metals, there is no need for phase one detoxification, since metals are already reactive.  Phase one involves taking a toxin like PCB or a flame retardant chemical like a polybrominated diphenyl ether, to take you from being a nonreactive thing to being a reactive thing, and phase one chops into that molecule and makes it more reactive, so that phase two, you can link a glutathione onto it.  Most toxins start with phase one but metals pick up at phase two. 

32:01  After we attach glutathione to the metal, then it is in the blood and it ends up in the liver.  The liver transporters move both bile and toxins together, so you get this flow from the blood to the hepatocyte to the bile.  If your bile is not flowing smoothly (cholestatic), then you will have toxin buildup as well. Once the toxin, such as mercury, ends up in the GI tract, the glutathione will fall apart and you’ll be left with methylmercury bound to cysteine that will get reabsorbed in the gut unless you can stick it into a binder so it doesn’t reabsorb.  If there is endotoxin or fatty liver leading to inflammation, that can block the bile flow out of the liver.  Endotoxin is an inflammagen in that it generates inflammation.  Being stressed, being in sympathetic dominance can block the flow of bile and deprioritizes detoxification and digestion. Estrogen dominance, high estrogen levels, can also block bile flow via stimulating glutamate receptors in the brain.  Progesterone and herbal bitters open up the liver and facilitate bile flow.  There are a number of Nrf2 upregulators that are also AMPK activators, including quercetin, luteolin, berberine, resveratrol, green tea, and lipoic acid.  Lipoic acid is probably our best Nrf2 upregulator and it is also an AMPK activator.  Fatty and fibrotic liver can lead to leaky liver and AMPK can reverse this.  If you consistently eat a lot of carbohydrates, you will be building up fatty deposits in the liver and these fatty deposits are generators of inflammatory cytokines like NF Kappa beta and TNF alpha, which eventually activate hepatic stellate cells, which end up being myofibroblasts, resulting in fibrotic liver and blocking detoxification.

40:31  The best way to stimulate bile flow is with herbal bitters like gentium, dandelion, solidago, and myrrh, which are all contained in a formula from Quicksilver Scientific called Liver Sauce.  It also contains phospholipids, milk thistle, lipoic acid, DIM, quercetin, and luteolin. Milk thistle supports the liver and supports detoxification.  Most people think of DIM for estrogen metabolism, but DIM is an Nrf2 upregulator and its a Nrf2 epigenetic modifier. Mold can block your liver function and DIM can work against that.  DIM can also reverse immunological reactivity to food.  Quercetin and luteolin are included as mast cell stabilizers. 

47:05  CBD can be helpful if there is a lot of inflammation since CBD blocks inflammation at a brain level first and then cascades down. It helps reduce sympathetic dominance.  CBD stabilizes the glutamate receptors and stabilizes the activated microglia. It also helps with kids with autism.

48:23  Oral chelators can be a useful add on once you make sure the cells and liver are working well, the bile is flowing and glutatione system is upregulated using these protocols.  Once you have done all this, then you can add in a little DMPS or DMSA or EDTA in small doses to increase the amount of metal toxins being pushed from the blood into the urine and out through the kidneys.

49:28  One of the best binders for heavy metals is the IMD that Quicksilver developed, which is like putting DMPS on a little silica grain.  It has sulfhydryl groups, like you find on DMPS or glutathione, and they’re covalently bound on to a tiny silica gel particle with tons of surface area.  It is most specific for mercury, cadmium, arsenic, but also helps with lead and nickel. Oral EDTA can be added to help with lead because it is not absorbed in the GI tract.  Zeolite and charcoal are good for mold toxins and chitosan, which is a molecular mimic for wellchol, which is part of the Richie Shoemaker protocols for mold.  Acacia gum and aloe are added to the Ultrabinder to help with healing the GI tract. The best time to take binders is about 30-60 minutes after taking the Liver Sauce or glutathione.  Binders should be taken at least 30 minutes before or 2 hours after meals.



Dr. Chris Shade is a PhD researcher working in the field of nutritional supplements. He is the founder and CEO of Quicksilver Scientific, which is known for its heavy metal testing and detoxification products and its unique liposomal supplement delivery systems.   

Dr. Ben Weitz is available for nutrition consultations, including remote consults via video or phone, specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com. Phone or video consulting with Dr. Weitz is available.



Podcast Transcript

Dr. Weitz:    Hello again. Dr. Ben Weitz here and I’m so excited to be able to speak to you today and I’m so happy that you decided to spend a little bit of your listening or viewing time with me to learn about another important topic in the world of Functional Medicine, in this case, what to do about heavy metals. How to test for them, how to get them out of our bodies with Dr. Chris Shade of Quicksilver Scientific. And today is going to be a broadcast of a Functional Medicine meeting that we did online with Functional Medicine practitioners and they were able to ask questions online, so I asked Dr. Shade their questions as well as my questions, but it is very similar to our regular podcast. I just wanted to point out to those of you listening today education people is a passion of mine, but the way I earn my living is by consulting with patients both in person and virtually Functional Medicine, Functional Nutrition, any sort of health care conditions that they want to address with a root cause approach. And I also see patients in my chiropractic office in my office in Santa Monica for chiropractic care. Anybody interested you can call my office at 310-395-3111. And for those of you who enjoy listening to the Rational Wellness podcast, it would be helpful if you went to Apple Podcasts and gave me a ratings and review. And I also wanted to remind everybody who’s perhaps listening on their phone through Apple Podcasts or Spotify or all the other areas that it is on that there is also a video version if you go to my YouTube page, weitzchiro. And if you go to my website, drweitz.com you can find detailed show notes and a complete transcript. So, let’s get into the podcast with Dr. Chris Shade about heavy metal detoxification.         

                                I want to thank very much, Quicksilver Scientific for sponsoring tonight’s event. For all of you listening in tonight, you will get 15% off your next order of Quicksilver Scientific products, if you use the discount code, Weitz, my last name, WEITZ 15 for products ordered from now until September 4th. If you are a practitioner, and you and you do not have a professional account with Quicksilver, you can email Katherine Sumner at Katherine, K-A-T-H-E-R-I-N-E.S-U-M-N-E-R@quicksilverscientific.com, and she can set you up with an account, so you can receive the discount. If you’re not aware, Quicksilver is Dr. Shade’s company that makes some of the most amazing products for detoxification that are widely used in functional medicine world.

                                Our topic for tonight is heavy metal detoxification with Dr. Chris Shade. We will cover how best to test for heavy metals. What are some of the most effective and safest ways to detoxify metals from our body? We all know that we live in a very toxic world, and many of us are exposed to various heavy metals in our everyday lives, including mercury, lead, arsenic, nickel, aluminum, and cadmium, which are pretty much always toxic. Then there are other metals that, in small quantities, are essential nutrients, but are toxic if at higher levels, like chromium, copper, zinc, and selenium. Now, there’s a lot of controversy over how to test these heavy metals, and even more controversy over how to reduce metals in our bodies. We’re going to try to clear up some of those controversies tonight.  For example, does it require doing intravenous curation to get rid of metals? Or can I just place my feet in an ionic foot bath? Or can I just brush my teeth with charcoal toothpaste? There are many products marketed to detox heavy metals, some of which have no proven effectiveness. We really need to hone in on what products have been scientifically proven to be effective, and what particular protocols are going to work for us and our patients.

Dr. Chris Shade is one of the most brilliant Ph.D. researchers working in the field of nutritional supplements. Dr. Chris Shade is the founder and CEO of Quicksilver Scientific. Quicksilver Scientific is known especially for it’s heavy metal testing and detoxification products, and its unique liposomal supplement delivery systems, among other things. Dr. Shade, thank you so much for joining us tonight.

Dr. Shade:           Ben, I’m happy to be here. Love to talk about this stuff. It’s second nature now.

Dr. Weitz:            I know you’ve been talking about heavy metal detox and other forms of detox for a very long time, but for those of us who are not familiar with your story, maybe you could tell us a little bit about your background in farming and how you became interested in heavy metals.

Dr. Shade:           Yeah. It’s really a story about how you get interested, not just in here’s why I detox metals. It’s a lot of people’s stories, like, “I was just shattered by metals, and then all I thought about was getting out from under metals.” When you do that, you get a little like … If it’s mercury, you get a little mercurial centric. But really, it was an education in becoming a holistic thinker. How does nature deal with things? How do people deal with things? How do fish, how do birds deal with things? I was in environmental chemistry as an undergraduate and I remembered learning these stories. Environmental chemistry, you just tend to test where the polluters are, and then you pollute some groundwater, you try to pump it out.  You never really get it out.  It’s just this kind of futility thing of running after industrial pollution and pretending you’re cleaning it up.  But then there’s a deeper understanding called biogeochemistry, which is about how elements cycle in the earth.  How they go into the atmosphere, down into the water. How they move through the food chain.  What happens in the sediments.  How they go into phytoplankton, zooplankton, fish and move on through.  That’s really where you understand the dynamics of elements cycling and the dynamics that we were studying with those of mercury.  At the time, all the money had gone out of studying mercury in people.  This is sort of post the first scare around vaccines and mercury.  All the money moved from the NIH and CDC, and moved over to the EPA.

                                All the studying was on mercury moving through the food chain and how it infected biota. We have very complex models of transitions of mercury forms in the atmosphere, in the rain, in the water, how they partition into different things that bind them in the cells. Key to that is that things like mercury are never present like sodium is in the water as a free ion. They’re always bound to something. It depends what kind of ions are present there, or what molecules are present to bind it. It was very sophisticated, and you know how much is bound on cysteine, how much is bound on glutathione in a cell, in the blood. When I came in over into … Well, I had developed this testing because to really test biomagnification, we had to separate different forms of mercury. That being nepo mercury from fish and inorganic mercury, the sort of primal form of mercury.

                                When I came over into looking at clinical, I realized nobody was respecting the different forms. Nobody was respecting how the metal is complexed, how it moves. Nobody was respecting the fact that the body has an innate system for detoxification, the glutathione system, and also the methionine system. I brought across these ideas and I said, “Look, you don’t need to just use chelators to do this. You can upregulate your natural system.” First, we should test better and separate the different forms of mercury, and look at how they excrete, and then we should up regulate aspects of our biochemistry, because they’re not only the ones that depurate it, meaning take it out of the system, get it out into excretion patterns, urine, fecal, sweat.  They’re also the ones, at the same time, that are making the cells resistant to whatever residual mercury is there. Let’s change the language from this one of, what’s your body burden and how does the chelator get it out, to what is your resistance to metals versus your susceptibility, versus how much is in there? We can work on these different things. We can turn up your resistance, and at the same time, turn up your depuration, how much comes out. In doing that, we found that we got people better, faster. There was less of this, “The chelator made me worse,” and much more of this, “My god, I started feeling better right away and then kept getting better, better, better. At the same time, my blood levels went down,” because we’re working to make the cell more resistant and get this stuff out at the same time. That doesn’t mean that there’s not a place where the two can play together, but the underlying thing is you must upregulate the glutathione system, the underlying detoxification system.

                                Then if you want to speed up depuration by putting some chelator in to get you to pee it out faster, you can do that, but only once you’ve corrected the system. I developed the testing. I moved in to starting Quicksilver Scientific, first doing environmental testing, and then moving on to doing clinical testing, and then moving on to developing the tools to detoxify. That was really my story of how I did that. Along the way, halfway through my PhD, I had 17 freaking amalgams in my mouth. I had come from Bethlehem, this hell place of Bethlehem Steel, the second biggest steel plant in the world. I was stinking full of metals, and I saw it. I felt it. Then when I went to get the stuff out, I used chelators and they got me sicker. That was really how I knew I was going the wrong way. Then when I went to fixing the system, I fixed myself and developed everything that we do now at Quicksilver Scientific.

Dr. Weitz:            Cool. Let’s start with testing. What’s the best way to test for heavy metals? The first part of that question I want to ask is if … I know the answer to this, and this gets asked a lot, but if metals are stored in our bones and organs, wouldn’t it make the most sense to take an oral chelator like DMSA to liberate those metals, and then measure urine before and after? If we’re just measuring the levels in the blood, then we’re not really going to get the levels in the tissues.

Dr. Shade:           Well, if that was true, it would be the best way, but it’s not true. It’s not that they’re not stored more in the tissue. There’s a dynamic equilibrium between what’s in the tissues and what’s in the blood, and there’s more in the tissues than is in the blood. But the lie is the idea that the chelators go and liberate this stuff from the tissue. They don’t. They don’t get into cellular. All they do is go into the blood, little plasma and get a little bit of the kidney burden, liver … well, they make that more kidney filterable and then you pee it out. You’re still working from the blood. Why not just measure the blood? Then that whole … and this has been all proved out, but the whole mythology around the chelation challenge was that these things go into the blood, and they go into the cells and give you a representative example of everything, but they don’t do that.   You’re working with what’s in the blood. You’re going to strip that off into the urine, and hopefully, you’re going to have a reference range in urine that’s from chelated urine, but it’s not. The reference range is from non chelated urine. No matter who you are, when you take a chelator, your urine levels go up. It becomes this excuse to chelate everybody, not a look at where everybody really is with their metals levels. Urine after chelation, if the kidneys are working, is a measure of what was in the blood. What’s in the blood is a measure of what was in the tissues. Fact, when you go and you turn up Nrf2, that’s a trigger in the body to dump things into the blood. When you turn that up, the blood levels will actually rise for a little bit and then come down. It’s showing you what you need to pump things out of the cells, into the blood. But the measurement [crosstalk 00:12:27]-

Dr. Weitz:            Now, can I stop you for a second?  I’ve heard you talk a lot about Nrf2 as being a key pathway.  Why is Nrf2 so important?

Dr. Shade:           Nrf2 is a trigger outside of the nucleus, in the cell, that is a stress response switch. It’s looking at chemical and oxidative stressors in the cell. If those oxidative stressors go up, or electrophilic stressors, that means something that pulls electrons out and oxidizes things like metals do, then this Nrf2 goes into the nucleus and it turns up the expression of the genes for all of the chemo protective system. That’s the genes for all of the glutathione synthesis, Glutathione S-transferases and transporters, all the defense mechanisms against those toxins. That’s what you need to elevate in order to throw things out of the cell, into the blood. Then once you’re out of the cell, into the blood, you need to turn up the filters. That’s the liver, the kidneys, the GI, the skin, even, that take it out of the blood into excretion.

Dr. Weitz:            Is it sufficient to just send out to Quest or LabCorp for heavy metal serum testing because this is, say, covered by the patient’s insurance and less costly?

Dr. Shade:           Good question. Quest and LabCorp are looking at whole blood mercury, and whole blood mercury, not speciated, not separated into inorganic and methylmercury, is really a measure of methylmercury.  If I took you, Ben, and I injected equal amounts.  Say you had no mercury, and we injected equal amounts of methyl from fish and inorganic mercury from amalgam, we fill up your blood, and then that would fill into the tissues.  Then, after a couple of days, it would come to this equilibrium, and we would see a small amount of inorganic mercury and a large amount of methylmercury, or maybe 10, 15 times more methylmercury.   It doesn’t mean it’s because you had more. It’s because of this equilibrium between the tissues and the blood, so it’s more to the tissues for inorganic, less to the tissues for methylmercury.  Then that means when you go and do blood mercury, whole mercury, it’s really a measure of how much methylmercury you have, which is a measure of how much fish you eat.  Inorganic mercury, if all your mercury was from dental amalgam, then you would … and you had no fish mercury, you’d have a very, very small amount in the blood.  In fact, the 95th percentile for inorganic mercury is below the detection limits for Quest and LabCorp.

                                If you don’t eat any fish, you have a ton of amalgams and you send in a blood sample, you’re not going to see anything.  You go, “But why don’t I have any mercury?” Then a good occupational toxicologist would say, “Inorganic mercury, that’s in the urine.  You have to run your urine.”  Your urine may be high, if your kidneys are working, but if they’re not working, then your urine will be low.  That’s a transport system in the proximal tubules that brings mercury from the blood into the urine.  If it’s not working, you’ll show low urine.  You can have high blood, low urine, that’s called retention toxicity.

Dr. Weitz:            Okay, so what’s the best way to test for mercury?

Dr. Shade:           Well, you got to send it to me.

Dr. Weitz:            I know that.

Dr. Shade:           The mercury TriTest. The blood, we will show you methyl and inorganic mercury independently with independent reference ranges. Then we’ll show the urine. Then we’ll take your blood inorganic mercury and compare it to the urine on a graph, which will show you as your blood goes up, your urine should go up.  Are you on that equilibrium line, or are you off?  If you’re not on the equilibrium line, and you’re below it, that means you’re retaining it.  The kidneys aren’t excreting it and it’s building up in your blood.  Hair to blood ratio, hair is all methylmercury.  Blood has both.  You compare hair mercury to blood methylmercury, it’s more of a liver proxy for how you mobilize methylmercury. There you’re getting excretion patterns and the relative ratios of methyl and inorganic mercury.

Dr. Weitz:            Now, why is hair a measure of how your liver mobilizes mercury?

Dr. Shade:           Yeah, I know. The urine, the blood is really, really direct. The hair in the blood, we did that based on some studies that were done by Boyd Haley looking at metals, and these are metals that are mostly detoxified by the liver.  They were looking at copper, mercury and I think cadmium, and they saw that in autistic kids, they knew relatively how much mercury should be in their body based on … they were pretty young, based on what their mother’s exposure was. They saw that the more of the sphere of the autism, the lower the mercury levels in the hair. They saw a dysfunction in the transport system going into the hair, so that’s where we picked that up.  The reason we relate it to liver, is liver is where all the methylmercury goes out.  It doesn’t go out through the kidneys.  You don’t get any methylmercury in the urine.  You only get inorganic mercury in the urine, and then through the bile, you get methylmercury and inorganic mercury.

Dr. Weitz:            What about using hair analysis for other metals as a general screen? Because it’s a easy to do and …

Dr. Shade:           There’s this whole cult movement around that and … Yeah, maybe I diminished it by saying cult movement, but all the data, if you look to Natural Resource Council, these big scientific groups, the relationship between mercury in the hair, and fish consumption is just well studied, really well studied. A lot of the others are just all over the map. They’re like, “It’s high. You’re screaming it.” “It’s low. You’re not excreting it.” The basic research on whether that’s relevant to the body is not really there. They’d like to call it hair tissue mineral analysis, and it’s as if it’s the same as taking a biopsy, but that’s not really true. It’s never really been proven out. Now, it doesn’t mean that there isn’t a relationship to it, and these guys haven’t built out systems that show things. It’s just not a direct way to do these.

Dr. Weitz:            Since we’re talking about the metals, I just want to make a suggestion. You might consider including additional metals besides the ones you include. For example, today I had a patient who had symptoms of metal toxicity, and we’re thinking it might have to do with this metal on metal hip plant implant he had, which is cobalt and chromium.

Dr. Shade:           Yeah, we actually have cobalt and chromium in our blood metals analysis, so those are in there.

Dr. Weitz:            Those are included? Okay.

Dr. Shade:           But really, we’ve got to change the reference ranges a lot. When the cobalt chromium comes up, it comes up really, really high, and then sometimes it’s localized. It’s a little bit difficult to track, but they’re both on the … so we have the Mercury Tri-Test, and then we have the blood metals panel, and the blood metals panel, in the nutrients, says chromium, but you just look for when it goes off the nutrient scale into too much. You got manganese. Do you have the right amount of manganese, or do you have this ridiculously high amount of manganese?

Dr. Weitz:            Right.

Dr. Shade:           Or copper. High copper is a real problem and it makes synergistic toxicities with all the rest of the metals.

Dr. Weitz:            Right. What are some-

Dr. Shade:           But there are some we do need to add, but they’re hard to do in blood, so we’re developing a urine panel, too, and that would be nickel, uranium, and one that’s a rat poison and the one that’s a radiotracer.

Dr. Weitz:            There’s beryllium. You’re going to add that one?

Dr. Shade:           Beryllium, not really. Beryllium, it’s not really toxic unless you get tons, and then you got ones that are toxic when they’re radioactive, but you can’t really tell the difference between the radioactive and the non radioactive ones-

Dr. Weitz:            I see.

Dr. Shade:           … like cesium. People want that.

Dr. Weitz:            Right. Okay, so what symptoms should alert us to the fact that somebody might have heavy metal toxicity?

Dr. Shade:           Well, the fatigue and anxiety are the most quintessential symptom. Fatigue, because all the metals are working at a mitochondrial level to diminish the antioxidant pool in the mitochondria. They’re sucking down all the glutathione and the thioredoxin in the mitochondria, and they’re creating free radical damage, which damages the membranes. Then the mitochondria can’t make ATP. They also work at a thyroid level. If you’re looking at thyroid labs, you look at the TH4, TH3 ratios, and what they do is they damage the ability of the deiodinase to take T4 to T3. You’ll have normal or high T4, but low T3. That’s usually a metal thing and it’s mercury, cadmium and arsenic dominantly, and also, to a second degree, the others. Then it works in an adrenal level.

                                I mean, the metals really accumulate in the kidneys, all aspects of the kidneys, and they burn those out. Plus the adrenals are trying to keep up with things all the time. Another thing that metals do, which is not … it’s sort of an unsung problem, is a disordered inflammatory response. When you have an inflammatory response, you have a little infection. You have a secretion of both inflammatory and pro inflammatory, and anti inflammatory cytokines. You’re trying to create a fire somewhere and a wall around it, so you’re not burning everything up. Metals are shown at physiological levels, the higher physiological levels, to block the secretion of the counter inflammatory cytokines, so you just have a pro inflammatory storm.

                                I mean, that’s what’s going on right now, that people get sick, have pro inflammatory and not counter inflammatory, and so the metals do that as well. They’re sucking down, then your adrenals are burned out trying to put out glucocorticosteroids all the time, trying to counter this inflammatory storm that’s coming out of the immune cells at a cytokine level. That’s the way that they burn out your adrenals. You’re burning out all your energy supply, then most of them, and the most notable of which is mercury are glutamate receptor agonists. They wind up the hyperfunctioning of the glutamate receptors, which of course, gets you anxiety, and eventually will drive you into a deeper neuro inflammatory state called neuro inflammation. That’s where you engage also the immune side of the brain, as well as the glutamate receptors, and when those really start going, you don’t just get anxiety.  Then you get these deeper brain fog, and these cycles of depression and anxiety, and your whole autonomics switch into a dysautonomia in which they are hyper sympathetic, all right?  Sympathetic autonomic nervous system tone shuts down detoxification through prioritization pathways.  Prioritization, meaning how are we going to use ATP? Now, if we’re parasympathetic, our ATP is going to be driven towards rest, digest, repair, regenerate, detoxify, all the rebuilding stuff, but if you’re in sympathetic, it’s just fight or flight. You’re going to deprioritize all the regenerative medicine. What really engages with the mercury to drive you into the deep neuro inflammation is endotoxin, which you’re getting from leaky gut, chronic jaw infections, chronic UTIs, gingivitis, and periodontitis, all drive endotoxin …

Dr. Weitz:            SIBO.

Dr. Shade:           Yeah, I mean SIBO for sure, but then we think it’s all in the gut, but your freaking mouth generates a ton of endotoxin, too.

Dr. Weitz:            Absolutely. What’s the best way to detox? Can I just do a juice fast? Or can I just do a water only fast? Can’t my body detoxify itself?

Dr. Shade:           You’re laying up these softballs for me, Ben. It would be nice, if only it were true. If everything else was good, and we were living in the mountains, and we were all chill, and we’re eating wild food and getting all the phytonutrients, yeah, we wouldn’t really have a problem, but we’re not. We’re chronically, sympathetically activated, meaning we’re chronically downregulating detoxification. We’re chronically eating inflammatory foods. We’re eating not enough real intense phytonutrient foods.   What we need to do is take all this stuff that activates all these nuclear transcription factors like Nrf2, activates cardio metabolic factors like AMPK, to liberate, to end taking things like glutathione, which are the necessary cofactors. That will liberate the metals from the cells, put them into the blood, the liver will jump them into the bile, into the GI. The kidneys of dumping into the urinary flow, and you’ll get them out. Then you just have to assist the process by putting binders into the GI tract that take the things that come out through the bile and make sure that they don’t get reabsorbed…

Dr. Weitz:            Well, hang on, hang on one second. I was trying to mute people and somehow … here, let me do this. Let me mute everybody, and then where are you?

Dr. Shade:           There we go.

Dr. Weitz:            Okay.

Dr. Shade:           Just to throw out this framework for detox, you’ve got a cellular level, I call the microcosmic level, and that’s the conjugation of the metals onto glutathione, and the transport out of the cell and into the blood.

Dr. Weitz:            Okay. Let me stop you there. What do we mean by conjugation of metals onto glutathione?

Dr. Shade:           All right. Well, let me give the framework. We want to push from the cells into the blood. We want to pull from the blood into the liver, dump from the liver into the bile, get it to the GI and stick it on a binder. Now, how do we get it out of the cell?  That’s back to the conjugation thing.  If there’s a metal in the cell … remember, the metals are never just free ions.  They’re always bound to something, and so you have to take it off of a protein it’s bound to, a membrane it’s bound to, and you want to link it on to glutathione.  You need this intermediary.  It’s called a phase two transferase.  It’s called glutathione S-transferase.  It’s going to kind of grab the edge of the metal and the edge of the glutathione, bring them close together, whisper sweet nothings in their ear, and boom, they’re a pair.  All right? They let go of the previous one and they go with the new one. All right?

Dr. Weitz:            Now, where does this glutathione S-transferase come from?

Dr. Shade:           Well, it’s synthesized. You’ve got genes to turn that on.  You’ve always got a little bit around.  Then when you have Nrf2 upregulation, you’ll synthesize more of it.  Then it’ll float around in the cell, and it’s sensing when there is a metal in a bad place. It’ll get the glutathione and it’ll pull those two together, and boom, then you have the conjugation reaction, and you have a metal glutathione conjugate in the cell. That’s floating around in the cell, but it doesn’t passively diffuse across the cell membranes. You have to get it out of the cell into the extracellular space, and then in the blood, and that’s the transporters. That’s phase three. Phase three is transmembrane transporters that use ATP and magnesium to push these things out of the cell.

Dr. Weitz:            Hang on one second. You’re referring to, we have phase one, phase two and phase three of liver detoxification, right?

Dr. Shade:           Yeah. Well, of all detoxification.

Dr. Weitz:            Of all detoxification.

Dr. Shade:           Well you call that liver detoxification, but what if you’re a thyroid cell and you have a toxin in there, and you need phase one, two and three. What are you going to do, wait for the liver to walk into your thyroid? It’s not going to happen.

Dr. Weitz:            But do you have a cytochrome P450 system in the thyroid?

Dr. Shade:           Yep.

Dr. Weitz:            Okay.

Dr. Shade:           You’ve got all that everywhere. You’ve got multiple copies of it in the liver because the liver has to handle so much. Maybe you got 10x more in the liver than you do in the thyroid, but the thyroid has to be able to do this.

Dr. Weitz:            Okay.

Dr. Shade:           Now we got to clear up the difference between glutathione … Well, I never talked about phase one with the metals, because metals don’t need phase one. All right? Really, if you’re a PCB or a flame retardant like a polybrominated diphenyl ether, you need a phase one to take you from being a nonreactive thing to being a reactive thing, and phase one chops into that molecule and makes it more reactive, so that phase two, you can link a glutathione onto it. Then phase three can move it out, but metals don’t need that because they’re already reactive.   We talk about, well, you need the glutathione, then you need to transferase, phase two, then you need to transport, phase three. Metals pick up at phase two, but most other molecules start at phase one, but not all. They all come into the pathways at different places, like a polyphenol. We don’t often think about, “Well, how am I going to detoxify resveratrol?” But you have to detoxify resveratrol, and you start also at phase two, so it’s more rapid than things that need phase one, two, and three.

Dr. Weitz:            Okay, so we attach glutathione to the metals, and then we have the transporters to get it out of the organ. Then what’s the next step?

Dr. Shade:           Then they’re in the blood. When they’re in the blood, then they got to get out, right? So, you have another transporter at the liver, at the basal lateral side of the liver. This is the blood side of the liver. Now you got to think about, make a little rectangular liver cell, a hepatocyte. You’ve got the basal lateral side that harvests toxins from the blood. Then on the other side, you got the canaliculi side. That’s the side that’s on the bile flow, on the bile canaliculus. Bile canaliculus is like … The bile tree is like an upside down root ball going down to a tree trunk, and the little rootlets, the little tiny hairs of roots are called the canaliculi, and they come together into bigger ducts. The bile canaliculus, your secreting bile salts out of your hepatocyte into the bile.  Same transport system that moves the bile salts moves the toxins. You’re moving toxins and bile together, and there’s two transporters that are sisters that live together in that membrane. They upregulate, down regulate together. Right there, you’re like, “Wait. What if I’m Cholestatic?” Well, then you’re toxostatic. You have to move bile and toxins together. They got to go together, or they don’t go. You’re setting up this flow from the blood to the hepatocyte, to the bile. The blood, you have transporters, phase three transporters called organic anion transport peptide, OATP, and it’ll pull that mercury glutathione conjugate into the hepatocyte. It’ll go over to the canaliculi membrane, and it’ll dump through MRP2 into the bile flow, and go into the GI tract.  Now, that’s all well and good.  It’s methylmercury, the kind from fish, the glutathione will fall apart and you’ll be left with methylmercury bound to cysteine, the amino acid with the sulfur on it from the glutathione.   That’s actually the same form that you absorbed from the fish, so you reabsorb it in the gut. When that gets down to the gut, you want to stick it onto a binder so it doesn’t come back in.  There’s a lot of toxins that have this reabsorption phenomenon, especially biotoxins like mold toxins, but then in the metals, it’s methylmercury and cadmium are the primary ones. We want to kick out from the cell, go to the blood, pull into the liver, dump into the bile, get to the GI and get a binder.  There’s all these ways that we can fuck up.  The cell might not be doing it, the liver might not be pulling in, the liver might not be dumping out, or you might be reabsorbing.  All that I call the directionality.  The baton race needs to be hand off one to one to one, to get all the way down there, stuck onto a binder and then you poop it out.

Dr. Weitz:            What are some of the sticking points in the liver that are going to keep us from being able to handle this?

Dr. Shade:           Inflammation. There’s a couple main ones. I want to hit inflammation and the prime inflammagen something that generates inflammation being endotoxin. Same thing we just talked about a second ago it stops at cellular level and it stops at the liver level.

Dr. Weitz:            What about in NAFLD, which is getting to be really common?

Dr. Shade:           Yes, we’ll wind that in, in just one second. Inflammation in the liver, and the inflammation can be from endotoxin, or the inflammation can be secondary to a fatty buildup in the liver, and we’ll talk about AMPK and how that winds into this whole thing. But then stress, just being sympathetically dominant, locks up that bile flow. That’s why when you’re parasympathetic, you get hungry. Why? Because your liver opens up and you secrete bile down into the GI, and you secrete other digestive enzymes. But one of the things that block all that, so I want to set up a connection between the glutamate receptors and sympathetic dominance, and the bile flow.  The other thing that can block the flow of the toxins out of the liver is estrogen dominance.  High estrogen, whether you’re just estrogen dominant, or whether it’s during pregnancy and it’s temporary, are going to block that bile flow. Now, what does estrogen do in the brain?  It makes you glutamate receptor hyperactive, which gives you glutamate dominance, which gives you what?  Irritability and anxiety, which is what estrogen dominance gives you, and what does that do on an autonomic level?  It puts you into a sympathetic autonomic tone, which is further deprioritizing detoxification, so that whole stress axis just locks you up.

                                We want to calm things down now on a hormone level.  What unlocks all that?  Progesterone, because progesterone is a GABA receptor agonist, or at least the metabolites are.  Progesterone, if you taste it, is hyper bitter, and bitters all open up the liver.  That’s why we use a lot of bitters in opening up the liver.  All that is open, close.  Fatty liver then, when ever we … That’s more of a AMPK switch. AMPK is what’s activated when you’re carb restricted and when you’re fasting, when you’re on a keto diet, when you exercise really heavily. All that draws down ATP temporarily, and activates the AMPK kinase, which activates burning of fuel.  What fuel do you burn?  You burn your stored glycogen, you burn your stored fat.  If you’re always carb loading, you’re always building up fatty deposits.  Fatty deposits are the generators of chronic inflammatory cytokines, like NF Kappa beta, and they build up in the liver, and they generate NF Kappa beta and TNF alpha highly in the liver, which eventually result in activating these hepatic stellate cells, which end up being myofibroblasts, which then start making fibrotic liver. All that is activating all these inflammatory processes which are blocking detoxification. Fatty liver brings with it toxicosis, or toxostasis. Then going the opposite way opens it all up. Now, it turns out, a lot of the things that I thought I was using as Nrf2 upregulators are also very strong AMPK activators. All your polyphenols, like quercetin and luteolin, berberine and resveratrol also do that. EGCG does that. They’re all very good for that. Turns out, lipoic acid is, too.

                                Now, lipoic acid is probably our best Nrf2 upregulator, and also an AMPK activator. We’ll use that … if we’re going more after clearing out liver, we’re going to use a different blend of things than if we’re going for cardio metabolic strength. We have a product called AMPK Charge. Used to be called Keto Before 6. Puts you right into ketosis. In like an hour, you’re making blood ketones, like nutritional ketosis from eating fries and drinking beer the night before, because it’s such a strong AMPK activator. Now, if we just want AMPK, we get more with the polyphenols.  If we want more Nrf2, then we’ll put in the lipoic acid as well, so that we can get the cellular response to detox. AMPK also brings with it a big amount of cytoskeletal organization around the liver.  I mean, people talk about leaky gut all the time. Who talks about leaky liver?  There is leaky liver.

Dr. Weitz:            Of course.

Dr. Shade:           There’s leaky liver, there’s leaky blood brain barrier, and as Grace Lou likes to talk about, there’s also leaky vagina.  There’s leaky everything, and adds all the integrity of the adherence in the tight junction. What brings them up?  AMPK activation.  In fatty liver and fibrotic liver, you have leaky liver. AMPK restores that cytoskeletal organization, and it’s also restoring the canalicular membrane, and the transport of the bile and the toxins out of the hepatocyte. It just brings all of that together, and including bringing up cell membrane polarization.

Dr. Weitz:            What’s the best way to get the bile stimulated?

Dr. Shade:           We use this stuff called liver sauce, and liver sauce, as the name implies, is something that is like A1 for your liver. It does everything. We use bitter compounds, classical bitters like gentium and dandelion, solidago, and then we use myrrh. We have all that in there and then we have phospholipids…

Dr. Weitz:            Let me stop you for a second. Those bitters have been a sort of naturopathic-

Dr. Shade:           Go to.

Dr. Weitz:            … go to for long period of time, but have they really been shown scientifically, to significantly affect bile flow?

Dr. Shade:           Yeah. I mean A4M made me put a bunch of slides in my presentation, and yeah, they’re cholagogues, they help regulate bile flow. Every one of them has been studied independently. The last 10, 15 years are ridiculous for how much primary research has come out of the universities looking at all these specific compounds and herbal extracts. They mostly like pure compounds, but they’ll do herbal extracts and stuff. All that shit works and … every part in the chain, sometimes we just know that it brings it up. We got bitters and then PC is part of the MDR, which is a transporter that keeps the bile flowing, that uses all phosphatidylcholine. We got all that in there. Then we got milk thistle and lipoic acid for Nrf2 and AMPK.  Milk thistle anchors … This is part of why it’s hepatoprotective, is it anchors those transport proteins in the canalicular membrane, so when the oxidative or chemical stress comes up, they don’t give up on their job, because you’ll see, often they just turn all that transport off.  Then what do they do?  When there’s too much free radical damage and toxin damage in the cell because you can’t get it up through the bile, it dumps all that stuff out of the cell back into the blood.  It’s the backwash of the liver, back into the blood when the liver can’t process. Because say it’s under too much autonomic sympathetic stress, hormone stress, inflammatory stress, it dumps it all back into the blood. That’s all the negative effects people get from detoxification, when they’re, “I’m herxing.”  You’re not herxing.  Herxing is a specific immunological reaction.   What you’re doing is dumping all these toxins from your liver back into your blood. They’re going to your kidneys. You have that lower back pain. They’re going to your skin and you’ve got rashes and itching and they’re going to your brain, and you feel like crap. All that’s because that anchoring through the liver into the bile isn’t happening.  Milk thistle helps anchor that as well as bring up phase one and phase two. It’s helping with all the different phases, and then we have an immunologic program in there that’s an AMPK activator, and a mast cell stabilizer, and that’s quercetin and luteolin, and DIM. Now, DIM, why do people use DIM? People use DIM for estrogen metabolites, but they miss the whole bigger picture of DIM. It’s an Nrf2 upregulator.  Good, it brings up all this detoxification stuff.  More importantly, it’s an Nrf2 epigenetic modifier.  When epigenetics block either Nrf2 or some of the mechanisms, some of the … well, just say when epigenetic processes block Nrf2, DIM can release them, and we see that mostly from mold. Mold isn’t always epigenetic. It’s what’s called post translational blockage, but DIM reverses all that. Mold blocks your liver function, and DIM can reverse that. DIM also reverses a lot of the immunological reactivity to foods.  The TH cells, you’ve got TH one polarization, then TH2, TH17. TH2 and TH17 are this runaway allergic inflammation, and then there’s T regulatory dominance, which is immuno passivity.  DIM pulls you into T regulatory dominance, and takes you away from TH2 to TH17, which are sort of autoimmune runaway reactions.  DIM is bringing down inflammation because inflammation blocks detox.  It’s unleashing Nrf2 from post translational and epigenetic effects-

Dr. Weitz:            You’re saying …

Dr. Shade:           … add it’s an AMPK activator and an Nrf2 activator. You want ingredients that hit a lot of targets all at once.

Dr. Weitz:            So DIM is something we could use if we have a patient who has a lot of food sensitivities?

Dr. Shade:           Yeah. I started using it because I was getting into hormones and I made a nano DIM. I just started taking it, like I do with everything. I’m like, “Oh my god, my food reactivities are going away.” Then all these different changes, I took it for like three months and it was like every week was like a new week. It was like, the sun is shining.

Dr. Weitz:            Wow.

Dr. Shade:           Then I gave it to other people and a lot of their food reactivities have gone away. It’s one of these unknown-

Dr. Weitz:            a clinical pearl.

Dr. Shade:           What’s that?

Dr. Weitz:            That’s a great clinical pearl right there.

Dr. Shade:           Wow. It’s a huge one.

Dr. Weitz:            Obviously, gut health is super important because what’s going to happen to the bile if you’re constipated and your gut’s not working right?

Dr. Shade:           Yeah. When the bile is not flowing, that will get you constipated. When you’re constipated, it’ll stop the bile from flowing. Those both are feeding against each other. SIBO, you have small intestinal bacterial overgrowth because your bile is not flowing enough, and bile is a detergent and an antimicrobial in the upper GI. The upper GI isn’t supposed to have all the probiotics. That’s the lower GI. Upper GI is pretty sterile.  It’s a chemical reactor.  When that stuff crawls up there, it’s because the bile is not pushing it down.  Whenever you’re trying to do a SIBO protocol, you should be encouraging bile flow.

Dr. Weitz:            It’s interesting because Dr. Rahbar, who I think is listening to this call tonight, he’s a integrative gastroenterologist, and he was telling me how he gets SIBO patients, and a lot of times they’ll have bile that flows backwards. He’ll see it in the upper intestine. He’ll see it in the stomach.

Dr. Shade:           Flows backwards. You mean, like they throw it up?

Dr. Weitz:            Yeah, exactly.

Dr. Shade:           Yeah. That’s a problem with the sphincter there, going into the GI and it’s coming back up there. That’s a directionality problem, and that needs to be corrected, and I don’t know necessarily how that’s done.

Dr. Weitz:            Right. Okay. I’ve heard you talk about using CBD as an important factor in this process.

Dr. Shade:           Yeah. Inflammation and detoxification are fundamental opposites. Inflammation blocks detoxification at a cellular level, at a liver level. It’s just doing it all over the place, and at a brain level. The inflammation is making you sympathetic dominant. CBD blocks inflammation at a brain level first, and then cascading down. It’s taking you from sympathetic dominance to a parasympathetic sympathetic balance. It’s cleaving the cycles of neuro inflammation by stabilizing glutamate receptors and stabilizing activated microglia.  I first saw this use in autism. The autistic kids, god, you’d have to … For the first two years, you just talk to them about detoxification. For the next three years, you show them the bottle, and the next 10 years, you start one year, every year you give them a drop more than you used to give them. It was a painfully slow process. Then you give them some CBD and you’re like, “Okay, here’s the adult dose.” I mean, it just created this beautiful window for detox. You do the CBD, you push in the liver sauce, you give them the binder and you’re like, “Whoa, you’re detoxifying like a pro.”

Dr. Weitz:            Now, is there a role for using chelators in this process?

Dr. Shade:           Yeah. First, restore the whole damn thing and make sure the cells are working, the liver’s working, everything else. Then if you want to poke in a little bit of DMPS or DMSA, I like DMPS, better, or EDTA for sure, and then just do small doses, and that’ll take more out of the blood and put it through the kidneys into the urine.  Now, first you want to do that testing, make sure that’s all right.  Then you can speed up the process. I remember Huggins used to use five to 25 milligrams of DMSA a day, along with using our metal binder and some glutathione, and a lot of the guys over at Ultra Wellness, Mark Hyman’s group, Todd Lapine  does this. He blends it, too. You’re going to do Chris’s glutathione system upregulation. I’m going to do DMPS. You don’t do the chelators without the other. When in doubt, you’re always going to do glutathione system upregulation. If they’re pretty stable and impatient, then you can put in some chelator, too.

Dr. Weitz:            Now, which are the best binders and does it depend on each metal? Is there an ideal binder for each metal?

Dr. Shade:           Well, we made IMD, which is like putting DMPS on a little silica grain.  That one’s super good for all metals.

Dr. Weitz:            What is that made out of?

Dr. Shade:           These are sulfhydryl groups, like you find on DMPS or glutathione, and they’re covalently bound on to a tiny silica gel particle with tons of surface area. It’s like a little particle with a million hairs that all have sulfhydryls, and any metal that gets near it just getting trapped into these hairs and get taken out the GI tract. Those are most specific for mercury, cadmium, arsenic, but those still do lead and nickel.  It’s interesting, oral EDTA is a binder for lead because EDTA is not absorbed through the GI tract, but I think you could just use IMD for all of the metals there.  Now, we added zeolite and charcoals, because zeolite and charcoals are going to work on your mold toxins and a lot of the … all the other environmental things, the pesticides, herbicides, the volatile organic chemicals.  We actually use a cocktail.  We use charcoal, zeolite, chitosan, which is a molecular mimic for wellchol, that’s using the Richie Shoemaker protocols for mold, and then we use IMD.  Then we put in some GI candy. It’s a acacia gum and aloe.

Dr. Weitz:            This is all included in your Ultra Binder product.

Dr. Shade:           Yeah, the Ultra Binder.

Dr. Weitz:            And then there’s-

Dr. Shade:           We do this combo, pair, push catch liver detox. You do the liver sauce, and then the Ultra Binder a half hour later. Push the toxins, catch them. Then you got all the add-ons. I got neuroinflammation, I add on CBD. I got metals, I’m going to add on glutathione, I got lead. I’m going to add on Liposomal EDTA. You take them all with all the liposoms at once and then go to the binder.

Dr. Weitz:            In terms of the binders, when’s the best time to take them?  You said a half an hour after you take the liver sauce or the glutathione?

Dr. Shade:           Yeah. A half hour’s a nice simple timing. It can be anywhere from a half hour to 45 minutes up to an hour. 45 might even be better but a half hour you feel it. You take this stuff and then a half hour later if you’re toxic you’re like, “There’s something happening.” You take the binder and you’re like, “Oh, perfect.” Binder then anytime you get into a detox and you feel funny, more binder almost always blocks the reaction.

Dr. Weitz:            Now of course binders will block all these nutrients from having any role either potentially, right?

Dr. Shade:           Yeah, if you take your nutrients and your binders at the same time, but that’s pretty stupid so why would you do that. Remember your GI is a tube, one thing in, then the next thing, then the next thing and they all go. It’s funny, they don’t actually mix, they actually go in a line.

Dr. Weitz:            They don’t exactly go that quick. Yeah.

Dr. Shade:           You take your binder in your wait a half hour, 45 minutes until you eat, and then the binder sooth, and then you can eat. You can take your supplements and stuff. If you want to be really careful, then your wait till lunch for your supplements. If you’re doing something like a serious medication, say you’re doing your thyroid or heart medication, give it an hour, two hours afterward, just to make sure that the binder wasn’t, didn’t have delayed gastric emptying, because it will bind that kind of stuff.

Dr. Weitz:            Right. Okay. Who wants to ask questions? We’ve got a few questions. I think I’ve been trying to blend them in. Somebody asked about at the beginning, you were mentioning about resistance and susceptibility. I guess some people can get exposed to toxins and not have any effect, and other people are super sensitive.

Dr. Shade:           Yeah, and that is how upregulated your cellular detoxification systems are and your systemic ones. It’s really more, how good is the cell. Because I’ve seen … If the cell’s pushing away really at a fast rate, the blood levels will actually be higher, but the cellular levels are lower, and so it comes down to that coding for those. When that is up, you’re keeping your cellular machinery free of the metals. When you keep inflammation down and you keep Nrf2 and AMPK up, you’ll have higher resistance.

Dr. Weitz:            In terms of when you get a complex patient, and this seems to be something that I see fairly commonly. You have a complex patient and maybe you do a bunch of testing and you find out, maybe they have some mycotoxins and they have some metals, and maybe they have a few gut issues. Where do we put metals in importance? Or do we try to … Let’s say you had a patient who had mycotoxins and metals, would you prioritize one and try to remove it, or would you try to do both of them at the same time?

Dr. Shade:           I do those both at the same time. The only really question … You might modify some of the things that you’re giving them. But you really want to get all the toxins at the same time, and you can’t pretend like you’re going to kick one out and not the other. Now, maybe Glutathione S-transferases is more important for metals, and make me glucuronosyltransferase is more important for molds. You can either do them both at the same time, or you can go back and forth but there’s no separating the two. You can’t activate one without activating the other, you can favor one, so that’s not really a big question. The big question is the infection versus the toxin.

Dr. Weitz:            Okay.

Dr. Shade:           Infections block detoxification. There was some schools that said well you … All right, infections block detox, but toxins diminish your immune system. A lot of people said, just get the toxins out, your immune system will pop back up. It’s not been my experience with a lot of other people have been like, “No, you got to clear an infection first.” But it doesn’t mean you do just one or just the other. We’re such a binary brain we think we do one or the other. It’s just relative importance. You’re going to be holding up detoxification but at a lower level, because as you kill things more toxins come out. You’ve got that going on, maybe you got that running at 30% out of 100. And you’re going to run antimicrobials at 70 to 100%.   Then as you get a little further into it and you’re wiping out the infections more, you’re going to switch and you’re always going to have both going on, so you don’t get a resurgence of the infection. I start antimicrobial dominant switch to detox dominant. When you know there’s creatures in there, you got to clear out.

Dr. Weitz:            I’ve heard some practitioners saying, “Look, you got to fix the gut first, because they’ve got a bunch of gut problems and leaky gut, and you were talking about endotoxins, that’s just going to make the process more difficult.

Dr. Shade:           Yeah, but sometimes the got problems or from the toxins, and so the toxins are locking the gut problems in place. You can never just do one damn thing. I mean, that’s just fricking psycho. You’ve got to be blending things. Yeah, you’re working … But when you’re using Ultra Binder you’re working on gut. So to me you’d be doing push, catch, maybe not hitting it so hard, but you got gut problems, so you’re going to put a lot of other gut things in there. You’ll be using the programs just for the gut, you’ll be fasting them more, you’ll be keeping them away from bad foods, but you can’t just ignore detoxification.

Dr. Weitz:            One of the questions came in, if you’re using your liver push catch protocol, does drinking coffee affect it?

Dr. Shade:           It helps it.

Dr. Weitz:            Okay.

Dr. Shade:           At least in my espresso centric lifestyle. Yeah, I mean, coffee actually has AMPK activating activity, it has niacin in it. It’s got a lot of different things. People are like, “Oh, caffeine, it’s a toxin.” If you do too much coffee, you’re going to make yourself sympathetically … If you’re wired, you’re going to be sympathetically dominant and you’re not going to do that. But a little bit of coffee … What was the what was the Arrested Development song? Coffee makes you go to the bathroom. I don’t have a cafe but my cousin does. It was in a song. Everybody knows it makes you go to the bathroom, which means it’s a bioflow stimulant. You can do an enema of it, and everybody knows that works, but just a little bit of coffee does that too.   The right amount of coffee, good. Too much coffee, you’ll lock up the system.

Dr. Weitz:            Right. Somebody asked if you have a really high viral burden and metal toxicity at the same time, but I think we just covered that.

Dr. Shade:           Well, yeah. But what do you want to use for that? There’s a lot of different things, but I want to do that always at the same time. Low glutathione makes high viral burden, and so you’ve got to bring glutathione into the system, and the metals are draining out the glutathione. A cat’s claw was the thing that I use the best for high viral burden. A cat’s claw along with push catch and glutathione was how I dealt with high viral burden. But sometimes [crosstalk 00:58:17].

Dr. Weitz:            How does cat’s claw-

Dr. Shade:           … the other ones that are better.

Dr. Weitz:            How does cat’s claw work? That’s an immune stimulant?

Dr. Shade:           Yeah, it’s poorly researched, but clinically people show it. It’s an immune stimulant, and it’s immune modulators, so the immune system doesn’t get so hijacked by the viruses. Things like Epstein–Barr and cytomegalovirus I’ve seen the best results with. They have things that block your ability to take the virus and digest it through autophagy, and then mountain immune response to it. The best I can see it’s blocking the blocking of the digestion of the virus to mount the immune attack, but that one’s worked really well for us in the past.

Dr. Weitz:            It’s interesting how some of these pathways like the AMPK pathway and Nrf2, are some of the same pathways that are really beneficial for antiaging as well.

Dr. Shade:           Oh, yeah, totally. Because, if there’s anything we know longer live people have higher glutathione. I did a glutathione study for LifeWay patches we were trying to … Way back before it was even making glutathione. We’re measuring serum glutathione in people are whole blood glutathione in people and seeing if this product raised the glutathione. But the thing that was so obvious is these people who came in and look super good for their age, all had the highest glutathione. The people that look very dry and [inaudible 00:59:53] burned out for their age, they’re the lowest glutathione. Glutathione, why is that? Because it controls telomerase activity for one.  Goes into the nucleus and controls cell division, controls the immune system, it controls detox. It does all these different things. Glutathione is a major antioxidant thing, and so Nrf2 activation as part of that. It just turns up all the antioxidant system. The only down with it is in cancer that system gets hijacked for immortalization of the cell. Everything that’s good for antiaging people worry about for cancer.

Dr. Weitz:            Serum glutathione, is that a good measure of glutathione levels?

Dr. Shade:           Whole blood.

Dr. Weitz:            Whole blood glutathione?

Dr. Shade:           Yeah.

Dr. Weitz:            Okay. [crosstalk 01:00:40].

Dr. Shade:           If the lab can match it right. It’s very tricky, it’s very labile, it breaks down a lot.

Dr. Weitz:            I see. It’s interesting. I wonder if anybody’s looked at whether whole blood glutathione levels are a marker for outcome with SARS-CoV-2.

Dr. Shade:           Well, there’s all these anecdotal responses of giving people glutathione and blocking the runaway inflammation of SARS. All the anecdotes we got from people using … As soon as they went on liposomal glutathione, it was like, “ah.” It went from being really bad to being, “Oh, this isn’t so bad.” That’s a definite one.

Dr. Weitz:            That was after they had breathing problems or what’s [crosstalk 01:01:31]?

Dr. Shade:           They were already sick. These were going through some of the doctors that work for us, so I wasn’t direct on all of them. But they had that whole hyper fluishness, and yeah, there was breathing problems. They weren’t in ICU, but they were having problems. Then over in New York, there were some cases where people were hyper sick and they took glutathione and started getting better right away.

Dr. Weitz:            Somebody asked can you measure pyroglutamate, which is a glutathione metabolite instead of whole blood glutathione?

Dr. Shade:           Yeah, I can’t really speak to that, whether that’s a good measure.

Dr. Weitz:            Right. Okay. I think people are still coming, but I think those are the questions. I have any final thoughts you want to leave us with Chris? [crosstalk 01:02:20] you want to talk about?

Dr. Shade:           No, we’ve said a lot there. I think the importance of the of the autonomic system is the thing that’s missed the most often, and how do you get yourself to an autonomic balance, meaning you’ve got good parasympathetic balance. It’s not just things like CBD, GABA also works for that. But it’s getting into breathing, getting into mindfulness. Taking more time for your time for yourself. Yoga, tai chi is my favorite. All of those lifestyle factors are going to be a big X Factor [crosstalk 01:02:50] from getting you into proper detoxification.

Dr. Weitz:            Do you recommend sauna and things like that to stimulate detox as well?

Dr. Shade:           Sauna is excellent. That’ll take out some of the excess burden while you’re moving a lot of toxins around, the sauna will relieve some out through the skin make that a little bit easier. Foot baths are actually not taking toxins to the skin. They’re an autonomic measure. I’ve had people do foot baths and measured their blood metals before and after the foot bath 30 minute thing, their blood metals go up. That means the tissues dumped into the blood, but the next day they’re back down. The foot baths are relieving the autonomic block. Saunas are working on autonomics if they’re nice, calm saunas, and they’re also relieving toxic burden through the sweat.

Dr. Weitz:            What about any these electrical modalities like PEMF?

Dr. Shade:           Those all definitely work on autonomic levels. I haven’t measured them. I felt them. I know they do work. You have to set the biochemistry in place, and then what are your different technical modalities, and what are your life’s style modalities. These are all things that add into it.

Dr. Weitz:            You recommend infrared sauna for sauna?

Dr. Shade:           Infrared is the best yeah.

Dr. Weitz:            Okay. Well, thank you, Chris. Thank you for-

Dr. Shade:           Thank you.

Dr. Weitz:            … spending this time with us. It was fascinating. We all learned a lot, great clinical pearls. Just want to remind everybody that everybody who listened in on this call, get a 15% discount on your next order if they order before September 4th I think, and use the code Weitz W-E-I-T-Z, my last name 15. Thank you, everybody, and we’ll see you next month.

Dr. Shade:           Great. Thank you so much Ben. Take care.

Dr. Weitz:            Okay.



Autoimmune Disease with Palmer Kippola: Rational Wellness Podcast 171

Palmer Kippola speaks about Autoimmune Diseases with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on YouTube at https://www.youtube.com/user/weitzchiro/]


Podcast Highlights

4:28  Palmer reports that when she was 19 years old she woke up one day and had tingling in the soles of her feet. This tingling progressed and crept up her legs like a vine. Her parents took her to a neurologist who did a cursory exam and then told her that she has multiple sclerosis and there is nothing that she can do except go home and wait and eventually she would be destined for a life in a wheelchair.  She essentially laid on the couch for 6 weeks since it was difficult to walk, but eventually, with the encouragement of her father, who told her “Honey you’re going to beat this thing,” so she decided to fight it and overcome her health challenge.  But her Dad was also verbally abusive to both her and her mom and she recalls her dad yelling at her mom when they were age 3 or 4 for being overweight. She developed insomnia at around age 11 or 12.  So she lived with chronic stress and this may have been the trigger for her autoimmune disease.  The Adverse Childhood Experiences (ACE) Study shows that traumatic events in childhood can trigger autoimmune diseases later in life. Palmer considers herself cured of her multiple sclerosis and she pointed out that in the dictionary, the word cure means to restore to balance. She recognizes that she still has the genes for MS but she has altered the epigenetic expression of those genes.

13:52  Some of the keys to Palmer improving were developing a yoga and a meditation practice that enabled her to deal with stress better. Prior to that she would get symptoms whenever she felt stress building up. She tried following a low fat, vegetarian diet since this is part of the Roy Swank diet that was recommended for multiple sclerosis, but it did not work for her. She found that she did not do well eating gluten and she also found that it was important for her to include some humanely raised, grass fed, grass finished beef and wild fish and that such animal proteins and amino acids were helpful in her body being able to repair and heal.

19:12  Most patients with autoimmune diseases should give up eating gluten since Dr. Alessio Fasano in 2015 discovered that gluten creates leaky gut and leaky gut (aka intestinal hyperpermeability) is the pathway to autoimmune disorders.  And 70% of the people sensitive to gluten are also sensitive to dairy.  The casein protein in diary is inflammatory, esp. from A1 cows. Palmer recommends her clients do a 30 or 60 or 90 day food elimination diet in which they avoid gluten and all grains, dairy except for ghee, sugar, eggs, soy, corn, night shades (tomatoes, white potatoes, peppers, eggplant, goji berries), legumes, nuts and seeds, coffee, and alcohol. They essentially do an autoimmune paleo diet until their symptoms resolve and then they test these foods back in one at a time to see if they create a reaction or are tolerated.   

29:25  Gut health is a big factor in autoimmune diseases and if you have leaky gut then large protein molecules like gluten and casein will more likely get into your bloodstream and get attacked by the immune system.  If you have leaky gut, you have genes that predispose you for it, and you have environmental toxins and other factors that create inflammation and cause the immune system to overreact, then you are more likely to end up with an autoimmune disease. In order to stop an autoimmune attack we need to remove the stuff that is breeching the lining of our gut, heal it, and seal it, so that we can arrest that process. Palmer said she likes look at a good stool test like GI Map or a stool test from Genova or Doctor’s Data to assess the gut health and then she will use the 4 R program (Remove, Replace, Reinoculate, and Repair) first pioneered by Dr. Jeffrey Bland, the Father of Functional Medicine, in her treatment approach.



Palmer Kippola is a Functional Medicine Certified Health Coach who specializes in helping people prevent and reverse autoimmune conditions.  Palmer is the author of the best selling book, Beat Autoimmune: The 6 Keys to Reverse Your Condition and Reclaim Your Health. Her website is PalmerKippola.com.

Dr. Ben Weitz is available for nutrition consultations, including remote consults via video or phone, specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com. Phone or video consulting with Dr. Weitz is available.



Podcast Transcript

Dr. Weitz:           Hey this is Dr. Ben Weitz host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates and to learn more, check out my website drweitz.com. Thanks for joining me and let’s jump into the podcast.

                                Hello Rational Wellness podcasters. Today our topic is autoimmune diseases with Palmer Kippola. Autoimmune diseases are increasingly common causes of sickness and death in the United States. Autoimmune diseases have been on the rise for at least the last four decades. The immune system which we’ve all been learning a lot more about in recent times, it’s designed to protect us from viruses, sure. Bacteria and parasites and to repair our tissues from damage. Autoimmune diseases are diseases when the immune system, instead of attacking those pathogens, attack our own cells and organs and what this means is that the immune system is out of balance. This is often referred to as immune dysregulation. So there are at least 100 different autoimmune diseases and the list is growing and quite a number of other diseases that are suspected to have an autoimmune base. So if we include diseases that have an autoimmune basis, then autoimmune diseases are now the third leading cause of death in the United States, since most of these diseases are chronic and are often life threatening. So a little more common autoimmune diseases include Alzheimer’s Disease, Parkinson’s, Rheumatoid, Hashimoto’s Hypothyroid, Celiac Disease, Type one diabetes, multiple sclerosis, Crohn’s Disease and what we have recently learned from Dr. Pimentel that Irritable Bowel Disease, the most common GI condition, also has an autoimmune origin in many patients. Conventional medical doctors treat autoimmune diseases either by controlling the symptoms, such as providing thyroid hormone in the case of Hashimoto’s Hypothyroid or by using medications that suppress the immune system such as corticosteroid, chemotherapeutic agents or the newer injectable TNF alpha blocking agents like Humira and Remicade. These drugs block the immune system and unfortunately this is a problem because we do need a properly functioning immune system and they have potential side effects like infections and cancer.

                                But functional medicine treats autoimmune diseases by looking at some of the underlying factors that lead to this immune system getting dysregulated such as leaky gut, food sensitivities, toxins, mold, heavy metals, infections, nutritional deficiency, stress, et cetera. This is very important. If I have a patient with Hashimoto’s Hyperthyroid and most women in the U.S. with Hypothyroid have autoimmune Hashimoto’s and all this patient is treated with is thyroid medication, it doesn’t do anything for the smoldering fire of the autoimmune disease that’s been attacking the thyroid gland and chances are will continue. So this patient may need higher dosages of thyroid or they may end up with another autoimmune disease. So not just regulating the thyroid, but also putting out that smoldering fire of autoimmunity is crucial for this patient’s long term health.

                                Palmer Kippola wrote an awesome book, “Beat Autoimmune The Six Keys to Reverse Your Condition And Reclaim Your Health.” She is a functional medicine certified health coach and she specializes in helping patients reverse and prevent autoimmune diseases and she’s here to bring some clarity to this topic and give us some more detailed ideas about what we can do about preventing and reversing autoimmune diseases. Palmer thank you so much for joining me today.

Palmer:                It’s an honor and a pleasure Dr. Weitz. Thank you so much for having me.

Dr. Weitz:            Absolutely. So, maybe we can start by introducing you to our audience by having you tell us a little bit about your life story, beginning when you were diagnosed with MS at age 19.

Palmer:                Yeah, well I have to take you back a few years in time for that. In fact, I grew up in where you’re practicing right now in Southern California and I was home for the summer after my freshman year of college. I was your average 19 year old hardworking, hard playing young woman. I was home from school and I didn’t have any of the precursor symptoms. So this hit me quite out of the blue. I was working a summer job and one morning I woke up and the soles of my feet were all tingling. That feeling, that pins and needles feeling like when you sit on a limb too long. I shook my feet, but as hard as I shook my feet I couldn’t get the blood flow back to my feet. I headed off to work thinking this will just pass.   But over the course of the morning the tingling progressed and it crept up my legs like a vine. By the time it got to my knees I knew something was wrong. So, I called my parents who called the family doctor who said, “Get her over to the neurologist at UCLA today.” So that afternoon we sat in the neurologist office and it was a woman who had me do the cursory exam which you know heel toe, heel toe. Touch your finger to your nose. That was really about it. Tested my reflexes and after about five minutes she said with what I consider to be a spectacular lack of sensitivity, “I am 99% certain that you have MS, multiple sclerosis.” My family and I had never heard of this. So this is in the mid-80s. I have to take you back a little bit. We didn’t have an internet, but like you said in the introduction, these are on the rise. These autoimmune conditions and when I was growing up and in the mid-80s nobody had heard of MS or multiple sclerosis.    So the doctor continued if I’m right, “There’s nothing you can do except go home and wait. We have these immunosuppressive drugs. These steroids, which you could take and we have something called an NMR, a nuclear magnetic resonance image machine” which was the precursor to the MRI. “But other than that there’s nothing you can do.” So later I would learn that she actually pulled my parents aside and said, “You better get ready because she destined for her life in a wheelchair.”

Dr. Weitz:            Wow.

Palmer:                “So you need to really prepare for that.” I’m telling you like a mack truck just simply quite out of the blue and that day we went home just devastated. We had no idea what to expect. That feeling of uncertainty and the earth has shifted beneath your feet. That was what we felt and that night we got into bed, my mom crawled in with me and all the areas that had been tingling had crept up right underneath my chin, but now every part of my body had gone numb. My body would stay completely numb for a full six weeks that summer, 1984.

Dr. Weitz:            Wow.

Palmer:                A terrifying time. Yeah, so I’ll leap into, I won’t leave you hanging here. We started when I wasn’t despairing about the future, my parents were really rocks. They were really there for me and my dad, who really encouraged my can do attitude, would say to me, “Honey you’re going to beat this thing” which is how I got the title of the book was my dad’s encouragement, “You can beat this thing.”  My mom started to plan for my future in a wheelchair.  Could I got to school? Could I attend UCLA in a wheelchair for example?

Dr. Weitz:            Wow.

Palmer:                That was what we were feeling. So I lay on the couch because there was nothing else I could do that summer. When you’re numb, you can walk, but you don’t have any of that proprioception where you can feel your limbs in space. So it’s this really gangli walk. I would install myself on the couch everyday for six weeks. Friends who weren’t too scared off by this mysterious disease, would come and visit and some friends brought, what do 19 year old friends bring you? Cookies, books, movies, they hand out with you. This one family friend came to visit. She was into things metaphysical. She said, “Palmer why do you think you got this MS? Why do you think you got this?” I was literally stunned. I was really taken aback. I got mad. “Are you insinuating that I brought this on? Do you think that I did something to do this or deserve this?”   She left, but the question wouldn’t leave me. So I sat there on the couch chewing on that question like a dog with a bone. I just lay there, “How did I bring this on?” So I need to take you back a little bit more in time. So I had been adopted as a baby and my parents were very loving. But my dad had been a fighter pilot and his way was invariably the right way. We used to butt heads quite a bit. It was this dichotomy because on the one hand super motivational, encourage my can do attitude all the time. But on the other hand, he was a yeller and he was really judgmental and really critical and he verbally abused my mom and me.

Dr. Weitz:            Wow.

Palmer:                I have to tell you Dr. Weitz that my earliest memory and this is unfortunate, but true.  I’m maybe age three, maybe four my dad’s yelling at my mom who is overweight.  She struggled with her weight perpetually.  So she shut herself behind the bedroom door and she’s crying and my dad is yelling at her.  I am standing up to my dad in the hallway with my little dukes up, “You call my mom names? I’ll sock your lights out” or some words to that effect, right?  I had become a child warrior.  I was going to protect my mom no matter what.  I had become hyper vigilant.  I developed insomnia maybe around age 11 or 12.  I was always scanning my environment for safety, right?  In that moment as I’m lying on the couch at age 19 I had no idea how this came to me.  But I figured that if I didn’t have a real battle to fight my immune system, the concept of Don Quixote?  I came up with that idea years later.  But he didn’t really have a battle.  He was fighting windmills. He was lunging at windmills right?

Dr. Weitz:            Right. Yes.

Palmer:                So there was nothing really to fight. But if I didn’t have a real battle to wage, I would turn those warriors, that immune system, that attack on myself. So that hypothesis, that initial hypothesis at age 19 that it was chronic stress from growing up in that environment where I didn’t feel safe. That still rings true for me today even though I know there’s vastly more to the story. But that was my initial hypothesis and now we have tons of research from the ACES study, the Adverse Childhood Experiences Studies powerful connecting what happens in childhood does not stay in childhood, but is profoundly linked to the advent of autoimmunity even decades later. So just to put a nice period on the story, I had the type of MS which is called relapsing, remitting. Meaning symptoms come and symptoms go.   So that summer just in the nick of time for me to go back to college for my sophomore year, the numbness started to retreat. That would take a full two years for the numbness to completely dissipate, but I got off the couch and went back to school for my sophomore year and there I went off on my 26 year course of relapsing, remitting MS.

Dr. Weitz:            So along this journey what have been some of the biggest keys to helping put your condition in, would you say it’s in remission now?

Palmer:                I don’t like to use that word because remission makes you think that something is lurking in the background, ready to pounce forth.

Dr. Weitz:            Okay.

Palmer:                Okay. So let me step out boldly here and say that the word cure if you look it up in the dictionary, means to restore to balance.

Dr. Weitz:            Okay.

Palmer:                Okay, I believe that the larger forces like the pharmaceutical industry and I’m not a doctor so I’m not constrained by some of those American Medical Association rules that say you cannot say cure. So I believe that I am cured and I will say very, very clearly that I will always have the genes for MS. That’s not what we’re talking about here. We’re talking about the expression of our genes and that is some of the most profound science that I discovered was the science of epigenetics which allows us to control the expression of our genes. That is what’s super empowering and ultimately how I healed.

Dr. Weitz:            So what were some of the real keys that allowed you to overcome the expression of your genes?

Palmer:                So, it just follows that because I intuited that chronic stress was my big root cause, then I needed to address stress head on.

Dr. Weitz:            Right.

Palmer:                I didn’t immediately do this. In fact, I went back to college and I was in denial for quite some time. Let’s call it for the next couple of years and probably for the next three or four years I just went on with my life. When I started having symptoms again I started to realize maybe there was something in fact, that I could do about this. Maybe my dad was right, I could beat this thing. So I noticed that when I was stressed out when I had exams at school or something that I was particularly stressed out about, I would develop symptoms, almost immediately within a day or a week of that stressful event. Conversely, when I started to relax more I noticed a dissipating of symptoms. I mean it really became clear. So in 1987 I started doing yoga and I found that that was a practice that I could actually do and become present. I wasn’t focused on the past. I wasn’t worrying about the future. I was just on the mat and I learned how to breathe in through my nose and man that shavasana of just lying there and letting things go, that was huge for me.  So that practice was the first thing I did and subsequent to that I discovered meditation in the early to mid-90s and as long as I did those practices I noticed a reduction in symptoms. I mean it really became this little experiment that I was doing, not realizing that I was really doing it. But I could tell this cause and effect pretty early on that stress equals symptoms, relaxation equals a diminishment of symptoms. That was certainly number one and that is still true today. That was one of the biggies.

Dr. Weitz:            Great. So if that’s number one, what were number two and three on your journey to health?

Palmer:                So there was a lot of experimentation that went on. Since I had more than two decades with MS and I was really trying to do this and remember there was no internet at the time. So I was just doing things by going to the public library in Santa Monica or intuiting things and following that intuition. I tried diet for awhile. I just want to touch on this because I think it’s also important to pay attention. We try things, right? Our life is a series of experiments. Not all of them are going to work.

Dr. Weitz:            Yeah, so let’s talk about diet. What’s the best diet for somebody with an autoimmune disease?

Palmer:                Yeah, well-

Dr. Weitz:            Or does it depend on the person?

Palmer:                I think it depends. I will say what didn’t work for me was a low fat veterinarian diet. So it became very clear there was this book that was in the mid-80s called the Roy Swank Diet. Multiple sclerosis diet, something like that.

Dr. Weitz:            Yes.

Palmer:                He professed that you got to get rid of fat, that’s your enemy. So we were a super low fat house. Tried that. The advent of the inclusion of more healthy whole grains in my diet, not only didn’t make the MS symptoms better, it actually made things worse and I started experiencing more tummy troubles.  So that for me was a failed experiment and it wasn’t until much later until 2010 that I discovered my biggest root cause or I would call it the linchpin root cause for me happened to be gluten.  So, I have what’s considered to be non-celiac gluten sensitivity meaning I don’t have Celiac Disease, but I am sensitive to the protein in wheat called gluten.

Dr. Weitz:            By the way do you think that that’s the case for most people? Can some people get positive results following a vegetarian diet with an autoimmune disease?

Palmer:                It’s an interesting question and again I need to just convey not only my personal experience, but I’ve done a lot of research since as you’ve seen I have a very large book.

Dr. Weitz:            Right and what have you found?

Palmer:                I have found that not a single person that I have found or interviewed including Dr. Terry Walls, including Linda Clark who is a health educator, including lots of people that I include in my book, Michelle Corey, people who had been vegetarian or vegan could not heal from autoimmune disorders until they began to incorporate meat. We’re not talking about tons of meat, but I found from my studies that what I’ll call a paleo template diet appears to be the best for people with autoimmune disorders. Now that’s not to say that a short term vegetarian or vegan diet is not powerful in helping you to detoxify from things. I think as a cancer healing mechanism that can be helpful for a short term. But when it comes to building and repairing the proteins that we have in our bodies every single cell, we need those amino acids from animal based protein. I would certainly only advise and advocate for humanely raised, grass fed, grass finished, so 100% grass fed animals and wild fish.

Dr. Weitz:            So, in terms of you mentioned gluten, so gluten is a food that you said you were sensitive with. You didn’t necessarily have Celiac Disease and so are there a set of foods that all patients with autoimmune disease should avoid, or should we be testing for food sensitivities or doing an elimination diet? How should we approach that?

Palmer:                So this is huge and I didn’t answer one of your questions which was does everybody need to give up gluten? I want to really address this.

Dr. Weitz:            Okay, yes.

Palmer:                Because this is the elephant in the room. In 2015 Dr. Alessio Fasano who is now at Harvard Medical School, he and his team of researchers discovered that gluten creates a leaky gut in anyone who eats it. I want to be really clear because that sounds like a really big and bold statement and it is. Because we’ve also discovered that a leaky gut that is intestinal hyperpermeability is the pathway to autoimmune disorders. So if you are doing something that is causing your gut to be leaky and you’re continuing to do that thing and you have the proclivity, the genetic predisposition to autoimmune disorders, then you are setting yourself up for a bad path. So, I would say from my research, from the science, if you have an autoimmune condition or if you have the proclivity because you have the genes in your family which we know genes are a part of it. May only be five to 10% of the equation. Your lifestyle matters way more. But gluten happens to be the biggest baddie that I have seen in my practice, in my experience, in my research.

                                To add to that, it turns out that people who are sensitive to gluten, it turns out 70% of the people sensitive to gluten are also sensitive to dairy. So that goes hand in hand. We see a lot of people sensitive to gluten have the same sensitivity to dairy and it’s not the lactose. It’s the casein, especially in these inflammatory cows like A1 cows, these Holsteins. So there are varying degrees of this, but in my research and experience and work with people, the gold standard as they say in functional medicine and in my experience is to do that elimination diet. I call it a 30 day food vacation to make it a little more palatable in the book. But it’s really the same thing. Take the usual suspect foods out for a period of time and when we remove those inflammatory proteins it gives our immune system a chance to calm down so that when you add them back in slowly and one at a time you can really tell if you are reacting to something. That’s super empowering because my-

Dr. Weitz:            So you’re saying essentially anybody with autoimmune disease, you should automatically give up all gluten and all dairy?

Palmer:                I am saying that gluten needs to go for good and I’m saying that dairy most people need to get rid of it, now with the exception of ghee.

Dr. Weitz:            Right, what if they say what about this one form of dairy? What about just yogurt? What about just non-A1 casein?

Palmer:                That might be just fine.

Dr. Weitz:            Right.

Palmer:                So this is where experimentation comes in. I’m not dogmatic about my approach.  You’re asking me for … I’m giving you the 80-20 rule.

Dr. Weitz:            I know. These are some of the controversial areas.

Palmer:                Right, right, right. But gluten isn’t controversial.

Dr. Weitz:            We get really clear about it, you know?

Palmer:                Right, people want clarity. But nothing tastes as good as feeling healthy feels. I like to say that to remind people that look, I can do this. I have been completely gluten free since 2010. So just about 10 years. I have not experienced a single MS symptom, not a tingling baby toe, not anything and we didn’t get into all of the ups and downs that I had over the years. But I had searing pain of optic neuritis. I really felt terrible MS symptoms for a very, very long period of time. So by removing some of these things, it can be a eureka moment for some people, but it’s not the only thing. That’s why I go into a great bit of detail about what the other categories are that we have to address.

Dr. Weitz:            Okay, so when you put somebody on an elimination diet, what are the six, eight or 10 foods that you have them eliminate?

Palmer:                Yeah, so we take out grains. I mean that’s really a starting point. Gluten is a grain, but many grains contain a form of gluten that is highly inflammatory. So we take out all grains. We take out all dairy with the exception with organic, grass fed ghee. We take out sugar. We take out soy. We take out corn, which happens to be a grain. We take out for a period of time night shade vegetables. People with pain or aches often are sensitive to night shades which include tomatoes, white potatoes, eggplants, even goji berries. So those have to go for a period of time. Let’s see what else is on that list? I don’t have them all.

Dr. Weitz:            You take out nuts and seeds?

Palmer:                Take out nuts and seeds and coffee and alcohol.

Dr. Weitz:            You take out legumes?

Palmer:                Yes.

Dr. Weitz:            So essentially you’re saying follow an autoimmune paleo diet?

Palmer:                That’s right. That’s right.

Dr. Weitz:            Okay.

Palmer:                I would say it sounds so restrictive and people are like, “What do I eat? What’s left?” I have that optimal food guide which we can share with people. They can go to my website and get this free download because I really want people to know there is a ton of stuff that you can eat. But the best you can do for this period of time, it might be 30 days, could be 60, might be 90. Some people never want to go back to eating these things. Eggs, oh, we forgot eggs. That’s a big one. It might actually be number three on the list and what people will notice across all of these foods, it’s the protein. These are protein molecules that can often be inflammatory in people with autoimmune susceptibilities, but not everybody is intolerant to eggs for example. So that’s why we call it a paleo template because sometimes there’s variability. You asked about dairy. Could you come back to goat yogurt for example or sheep cheese. I mean there is a world of things that you could try to experiment with. But we know enough now. There is enough data, there is enough research, you don’t have to go and do all this research on your own. I did it because it wasn’t out there. There was no Terry Walls when I was healing from MS, right?

Dr. Weitz:            So they follow this autoimmune paleo very strict diet.

Palmer:                Yep.

Dr. Weitz:            How do you determine if it’s 30 days or 60 days? You’re waiting for a [inaudible 00:26:09] of symptoms?

Palmer:                That’s right. that’s right. So people typically and I see and other practitioners and integrative and functional doctors agree that people can reverse symptoms of autoimmune conditions between 60 and 100% just by addressing food which is why it’s chapter one in my book, start with food because it’s such a high leverage category.

Dr. Weitz:            Okay so you do that. Let’s say you do it for 30 days, your symptoms go away. Now they start putting foods back in one at a time. What if they put all the foods back in and they don’t notice any difference?

Palmer:                Oh. I have to share with you that this was a story of one practitioner who is a friend of mine who overcame, completely reversed lupus and hashimoto thyroiditis. She had a hefty dose of traumatic stress in childhood. She had a ton of food sensitivities. She developed these autoimmune conditions. She finally discovered that food might be the path out. So she did this elimination phase, but she was so eager to go back to her favorite foods, guess what she had for her first meal after all this? She had a burrito. A burrito. So it’s got flour, there’s gluten in the tortilla. There’s cheese, so we’ve got dairy. There’s beans, so there’s beans and legumes, right? There’s tomatoes for the night shades or other people. Then she developed the symptoms, they came flooding back. So she had lost all this weight, that inflammatory water weight when she was doing the elimination phase, she had the burrito and everything swelled back up again. So she had to go through the whole process again.

                                So that’s one thing that can happen if you decide to introduce things, like you’re going to go have a pizza as your first meal. One at a time. There are other people that try this elimination, they go through it, they put things back in slowly. They do everything right and they still can’t tell their symptoms. This is when as you mentioned, doing food sensitivity testing can be helpful, although I’ve seen it go both ways in my own personal experience and with clients who get these tests done and it turns out that they’re sensitive to cooked pineapple and red dye number 32. Crazy things that they don’t even eat. So it’s less empowering when you get a test done and you don’t resonate with what I find.

Dr. Weitz:            Or the test comes back and says they have no food sensitivities and they spend 800 bucks for it.

Palmer:                That’s right. That’s right. So there’s more than just food and we need to talk about that because there are a number of root causes. I mean even stress can create a leaky gut. So I’m not sure that people are really aware of that. But, you can do everything right. You can get your pristine diet, you can exercise. You can get up in the morning and meditate. But if you’re still wrangling with a lot of stress, I would submit that you can have a really hard time healing or if you decide you’re not going to address that traumatic stressful childhood, it’s a tough road to get fully better.

Dr. Weitz:            So let’s go into gut health next. Gut health is one of the chapters in your book. It’s obviously one of the big factors in autoimmune diseases and you mentioned leaky gut and there’s the term gut dysbiosis. How do we figure out what’s going on and how do we figure out how do address these issues?

Palmer:                Great question. So we know that and I don’t know what your experience is in working with autoimmune patients, but I can say that if you have symptoms, mysterious symptoms or an autoimmune condition, there is almost a one for one correlation with a leaky gut. We can assume that your gut is leaking these large protein particles.  Why?  Because if you have symptoms that means that your immune system is attacking something in your body and it could be dysregulated.  Sometimes it’s called molecular mimicry or mistaken identity.  That gluten fragment if we want to use that inflames the lining of the gut, actually breeches the cut barrier, gets into the bloodstream where it doesn’t belong and that’s what sets off the immune system.  So let’s start there, right? So it gets through the lining of the gut. Then your immune system doing what it does, what it’s supposed to do develops antibodies which are missiles. They’re actually bullets you can think of them to attack the invaders. That’s what the immune system is supposed to do. So it views gluten or that protein, that casing from dairy as an invader. Tags them, begins to shoot at them, right? But it develops so many antibodies in the process of trying to destroy that invader that it’s going around the bloodstream looking for a fight. Your human tissue and I don’t know how in the world this is possible, but our human tissue at a molecular level can resemble that gluten fragment. That gluten molecule looks like the thyroid tissue or in the case of MS, as the myelin sheath, okay? So that’s where the bullets are mistaken. They’re doing their job, but your thyroid or your mile in chief just gets in the way.  So it’s not that your immune system has turned on you in some evil or malicious way. It’s just doing its job. So, in order to stop that autoimmune attack, we therefore need to remove the stuff that is breeching the lining of our gut, heal it and seal it, so that we can arrest that process.  That’s central to the autoimmune equation that Dr. Fasano and his team discovered.  We have an autoimmune equation which are, you have to have the genes for it, right?  So it turns out that my birth father has MS.  So I know that there’s a genetic connection.  Number two, we have to have these inflammatory environmental factors that are either coming from the environment or within us that are toxic and causing our immune system to overreact and then we have the advent of this leaky gut.  So the exciting thing about this autoimmune equation is that if you flip the equation, we can reverse the condition.  Meaning, you find and remove your environmental triggers, remove them and heal and seal the lining of your gut and that is central to arresting that process.  So, I wanted to share that mechanism of how autoimmunity happens so that people can really visualize every time you’re putting something into your gut that is irritating it, inflaming it, there’s a possibility that that autoimmune attack could start or it could be perpetuated until you stop that process of introducing those proteins.

Dr. Weitz:            So how do we assess that’s going on in the gut? Do we assume they have leaky gut? Do we test for leaky gut? Do we do a stool sample? Do we do a SIBO breath test. What is your normal procedure with a patient to figure out what’s going on in the gut?

Palmer:                So typically we can assume that leaky gut is going on and so people don’t necessarily need to spend money to figure this out. They can just do their own experimentation of just taking stuff out. We know what the biggest baddy culprits are for harming our guts and we’ve talked about food.  I will also add that part of the food problem is how it has grown and how it is sprayed with lyphosate and that is one of and commonly known as RoundUp. This is something we know harms the lining of the gut. So people can take this stuff out and do their own experimentation. We know that antibiotics-

Dr. Weitz:            But the container of RoundUp at the store has nice pictures of animals and butterflies and plants.

Palmer:                Don’t be fooled people. Don’t be fooled. This is where it is incumbent upon us as consumers to really become the CEO of our own health and wellbeing. We have to do our job, our research to protect ourselves. The Europeans have or follow what’s called the precautionary principle and in their I forget the name of the body that tests for chemicals and whatnot. But they won’t let chemicals get introduced into the environment until they’re proven safe. Whereas in this country, we release the chemicals and then they’re only taken off the shelf when they’re proven guilty.

Dr. Weitz:            Well because the goal is protection of the profits of big corporations. People’s health? Oh, well.

Palmer:                Right. So I’m somebody, I’m a product of cheerios. I ate gluten with every meal, okay? I have peanut butter and jelly sandwiches for every day of my life growing up. I had pasta or pizza or beer throughout my life. I did not realize, I did not put this together that I was inflaming and harming my gut and perpetuating the MS for more than two decades until I did that experimentation and removed it and voila. Again not to say that that’s going to be the standard that happens for people, you take one thing out and your good. No, no, no there’s a lot more than that. But-

Dr. Weitz:            Okay, assume they have leaky gut. We assume they’ve gotten exposed to pesticides and other chemicals. Do you do a stool analysis? Do you put them through a gut healing protocol 4R, 5R, what’s your normal protocol?

Palmer:                Yes. Yes, I’m a big fan of getting the data. We’ve got fantastic modern lab work that’s getting better all the time and even though nothing is perfect, we do have some good tests that we do and a couple of the tests that I like are the GI map test is fantastic. GI Effects from Genova has been around it’s probably the gold standard gut test. Doctor’s Data, all of these labs have comprehensive stool tests and we can tell not only what’s the state of somebody’s microbiome, but are there any infections present? Because it’s not just foods, they’re infections that could be at play here. They offer I think it’s called a zonulin add on. Zonulin is the marker.

Dr. Weitz:            That’s for leaky gut, yeah.

Palmer:                For the leaky gut, right? So, when you have that it monitors and manages the tight junctions in our gut in that lining. So our gut is supposed to be selectively leaky to let in nutrients, right? But when the doors are left open, that means there’s excess zonulin at play and zonulin gets into the blood stream and so forth. So we can test for leaky gut and I think that’s now considered to be more of a gold standard than the former-

Dr. Weitz:            Lactulose mannitol test.

Palmer:                Yeah, yeah, yeah.

Dr. Weitz:            Yeah. Okay. So, what protocol do you put everybody on besides you’ve already put them through a diet program, right?

Palmer:                Right.

Dr. Weitz:            Do you change their diet again? do you put them on a specialized diet? Do you put everybody on probiotics? Do you use the four or 5R program?

Palmer:                I really like that 5R program. I mean this has been around for decades now.

Dr. Weitz:            Since Dr. Jeffrey Bland.

Palmer:                Yes, yes. There were a lot of people-

Dr. Weitz:            The father of functional medicine.

Palmer:                Right, right. There were a lot of people involved with that and you’ll have to remind me of all the R’s, but the biggest one in a 5R program is the remove. A lot of people are they get a little miffed that, “Well why aren’t we talking about putting more stuff in? I just want to take probiotics and heal.” Well, the best thing, the biggest bang for your buck is taking the stuff out that’s harming you. So the first R of remove is what we’re already doing when we’re in the food phase. So these are often overlapping categories right? The next thing we want to do is maybe oh, my goodness. It’s not replenish, reinoculate. A lot of us are missing digestive enzymes.

Dr. Weitz:            Replace, yeah.

Palmer:                Replace. Thank you. So, we need to replace our digestive secretions and often people feel like if they have an acid tummy or acid reflux that they are experiencing too much acid when in fact it’s often a sign that they’re not producing enough acid. So by supplementing with hydrochloric acid when eating meals can be a game changer for people to be able to actually digest and absorb their food better. Maybe their enzymes that we want to include and a lot of people don’t have a gallbladder. A lot of people are having sluggish bile. So whatever you can do to improve your bile flow by maybe taking digestive bitters before eating, we definitely start to add those. So people can digest and absorb what they’re already eating and that is that phase, replacing those digestive secretions.

Dr. Weitz:            Okay.

Palmer:                Then and only when we address if there’s an infection present, like candida, we want to get rid of it, right? So we’re going to work to get rid of that with as natural a process as possible and other infections that might be present, H. Pylori and so forth.

Dr. Weitz:            So you’re going to use natural antimicrobials in that case?

Palmer:                Exactly. Exactly.

Dr. Weitz:            Okay.

Palmer:                And there are some helpful anti-yeast and anti-mold things that people can do.

Dr. Weitz:            Right, combinations.

Palmer:                Combination therapy is often very, very helpful and-

Dr. Weitz:            How long does that usually take? Two weeks? A month? A few months? Many months?

Palmer:                It can take three to four weeks. Excuse me, three to four months.

Dr. Weitz:            Okay.

Palmer:                I’m doing wishful thinking there. Because sometimes we find parasites too and if people find that on their stool test that parasites are present, there’s actually another test that I really like from Parawellness Research that can be much more specific about the types of parasites that are in there. So oftentimes we got to get that stuff out. I mean this is … We were designed to cohabitate with a lot of these critters that are in us. But I think what happens is that when we have all of these inflammatory foods and the sugar we’re eating and the simple diet, we start to feed those microbes of the pathogenic stuff and it starts to overgrow like the candida, like the parasites. So when we start with a diet, remove stuff, we address those parasites in yeast. It might take three to four months. People need to be patient with the process, right?

Dr. Weitz:            Yep.

Palmer:                And it’s only when we remove all of those pathogens that we want to start replacing with the, and reseeding with probiotics and prebiotics because we don’t want to be feeding the microbes that are out of balance. We want to be introducing probiotics at the right time.

Dr. Weitz:            Right. So, the next chapter in your book is infections and so this is not somebody who currently has a cold or a fever. These are stealth, chronic infections that they often don’t know they have.

Palmer:                That’s right. That’s right. Again, you’ll see the overlap here because a lot of the gut infections that I just talked about are the infections that are driving autoimmune conditions. But people here about Epstein-Barr and they want to point every finger at Epstein-Barr at being the problem. Well I’ll tell you, 96% of us in the United States have Esptein-Barr. So, we have coexisted with viruses for I don’t know how long. As long as we’ve been on earth. It’s when things get reactivated and when things get way out of balance that these things become problematic. So, infections could include viruses. It could include bacteria. We’re seeing much more Lyme Disease. What’s now called Persistent Lyme, I found out only in 2017 that I have Persistent Lyme and in fact, I might have gotten it when I was age 18 when I was romping around in the hills of Vermont. That may have preceded the MS. But I only learned about it recently. So, getting tested for Lyme and there are more and more good tests for Lyme Disease.

Dr. Weitz:            Yeah, yeah.

Palmer:                And many more doctors are recognizing that. I don’t know if you see Lyme frequently in your practice.

Dr. Weitz:            There is a fair amount of Lyme. It’s not necessarily one of my specialties, but we’re learning how common it is. In fact, we have Dr. Darin Ingels speaking at our functional medicine meeting on Thursday who is a Lyme expert. He feels like a large percentage of patients with MS actually are undiscovered Lyme patients.

Palmer:                That’s right. That’s right and not just MS. I mean this is why I didn’t call the book, “Beat MS” because what we’re talking about these healing principles-

Dr. Weitz:            Goes to all autoimmune.

Palmer:                All of them. It’s wholistic. Mind, body, spirit, but you got to look at food. You got to look at infections. You got to fix your gut health. You got to look at toxins in your environment. And you got to balance your hormones and last, but not least is that S for stress that we are all facing and that makes everything worse.

Dr. Weitz:            Right.

Palmer:                So all of it is part in partial of what we do. I’m not collaborating with a naturopathy doctor who specializes in infections and toxins. The other thing that we’re seeing much more of is mold. Mold and mycotoxins are just amplifying the problem. So it’s not just one thing. It’s I call it a toxin bucket. We all have one, right? We carry a certain amount of toxins and if we’re not excreting properly, if we’re not able to handle and let go of the toxins that come into us and it’s all of those things, then things start to build up until finally the leaky gut spills over and you start to have symptoms. Because autoimmunity happens on a spectrum. It goes from silent where you start to build those antibodies, right? That’s happening silently. So when I was 19 and the MS struck, I had been silently building antibodies to my own tissue and the gluten and other things. Not even knowing it and then the next phase is autoimmune expression where you start to feel symptoms. That is exactly where you want to … Well you want, ideally you want to prevent things. But most people are going to pay attention when they start having symptoms.

                                What you don’t want to do is get to the next phase of things which is full blown autoimmune disease where tissue damage starts to happen, right? So you have this window of it could be decades from the first silent autoimmunity all the way to full blown autoimmune disease. But the opportunity to address it is now. It is now.

Dr. Weitz:            So for practitioners who are listening and maybe even patients who are trying to sort through some of this stuff themselves and they are saying to themselves, “Wow, look at all the things that could be affecting my potential autoimmune disease or the autoimmune disease of this patient sitting here in front of me and we could have food. We could have stress. We could have nutritional deficiencies. We talked about infections. We’re talking about gut problems. There’s hormonal problems. Oh, my God where do I start? Then where do I go next and how do I decide what to do?”

Palmer:                Yeah I think the first thing to do is take a big, deep breath. I mean I really do and I’m not being facetious. I mean in through the nose, in the belly a big deep breath. Autoimmune problems did not happen overnight and they’re not going to go away overnight. This is a process and a practice. But now we have people that have gone through this that have a framework or a protocol. Follow people who have healed themselves or who have cured themselves. I mean that would be a really good place to start. There are books out there, not just mine. There are a lot of really good books on the subject. Educate yourself. Empower yourself. I would submit that the very first thing to do is to understand that these are reversible conditions. This is not a death sentence. This is not something that you should take what a conventional doctor tells you that all you can do is manage your disease. That is simply false. There is so much hope and it’s real, find people who have reversed their condition. I profiled 12 of them in my book. I didn’t want to write a memoir, because people would just pat me on the head, “Oh, look at you. You had a spontaneous remission.”

                                No, no, no. This is not a spontaneous remission. This is learning to control what we can control and you let go of the rest. But the people that I profile in there, Dr. Mark Hyman, Terry Walls, Susan Bloom, I mean there are a wealth of practitioners who used to be medical doctors who themselves had some debilitating autoimmune disease or condition. They did the work and then the wounded healer themselves, now they’re helping hundreds, thousands of people. So this is an exponential good news story. It’s not just my story. So my aim is to really help people to know this is possible. So the first step, understand that it’s possible, decide you’re going to reverse your condition and reclaim your life because you can. Then the next step is to get whatever book you’re going to get and then educate yourself. There’s lots of … My website is palmerkippola.com. I have got lots of free information on there. I’ve got this book which is about ten bucks on Amazon. People ask me, “I need more help than a book. I want help implementing this.” Because there’s a lot. As you said, it’s not just one thing, it’s wholistic. So I created this membership called Beat Autoimmune Academy. I’ve got a bunch of people in there who we’re taking step by step because it can be overwhelming. People get overwhelmed.

Dr. Weitz:            I would say to the practitioner out there, the first thing you want to do is take a detailed history like they teach in the Institute of Functional Medicine courses and then you’ll start once you really go deep into someone’s history from birth and find out about their life story, you can start to figure out what direction, “Oh, this person had a lot of early life stress. This person took lots of antibiotics and had multiple ear infections and maybe more liable to have gut and chronic infections.” You’ll get a sense of what direction to go first. If nothing jumps out at you, always consider starting with the gut and then also doing some testing can give you an idea of what direction to go to as well.

Palmer:                Perfectly said. That was beautiful. That history when you’re sitting with somebody and they’re sharing with you how they grew up. Were they breastfed? Were they delivered as a C-section. What kind of home life did they have growing up? What was that like? If they started to develop let’s call it juvenile rheumatoid arthritis, what happened before age seven that you developed rheumatoid arthritis at age eight? What happened when you were 11 years old and you developed lupus when you were 15? We really need to have other people tell us the story so that they can see how powerful it is that when I was asked that question, “Why do you think you got the MS?” I took it as an affront, right? But that question has become my north star for me and for the people that I work with. We always want to find out why. If you haven’t healed, if you’re still experiencing symptoms, those are just messages from your body letting you know that you haven’t dug deeply enough into root causes. You need to keep going.

Dr. Weitz:            That’s great. So, any … I think we should wrap because we both have appointments coming up. Obviously there’s a lot more stuff we could talk about. We really didn’t get to toxins or hormones, but this is a huge topic and we could spend hours talking about it. So for now do you have any final thoughts for our audience?

Palmer:                I do. I do. I want to help you shortcut the suffering because there’s an expression that pain is real, but suffering is optional. I think the faster that you can view what’s happening in your life as a gift, the faster that you can realize that this is happening for you and not happening to you. You move from a victim mode to an empowered mode. The faster you can get to the other side of this. So when I was 19 I didn’t have a crystal ball into the future. I don’t know that I would have had the where with all to think, “Oh, thank goodness this is happening to me.” I’m not trying to be [inaudible 00:52:01]. Of course you’re going to have grief and there’s going to be stress and so forth. But the faster you can realize that these things are actually happening for you to take a more close look at your life mind, body, spirit, the faster you’re going to get to the other side of this. I find it such a privilege to work with people when I do my one on one consulting and they tell me, “I want to get to that side too. I want to work with people who have autoimmune conditions. I want to help people. I know I can reverse my condition and I’m still working on it, but I can see that I’m going to view this as an opportunity and as a gift.”

                                So that’s what I would invite people to consider this as happening for you and not to you.

Dr. Weitz:            That’s a great message, absolutely. It’s easy to play the victim or feel the victim and not see it as an opportunity.

Palmer:                Yeah. I think every moment of every day we all have an opportunity. Health is not static. So I didn’t just beat an autoimmune condition and everything is roses. It takes daily work and practice. That’s why health is a practice. But when we view it in a certain way it can take a lot of that angst and deep level of stress away and when we remove the stress and we get into that relaxation response that’s where healing happens. So, it’s powerful.

Dr. Weitz:            That’s great and you have a special gift for our listeners?

Palmer:                Yes. So I mentioned when we were talking about food that it can be very, very frustrating and difficult to figure this out. So I have a gift. If you go to my website palmerkippola.com/gift, I have created an optimal food guide E-book and you can find out what your optimal foods are by following this process of what I call a 30 day food vacation and that’s just a little 12 page E-book that can be very helpful for people to see that there are a lot of things that you can eat. It’s not just, “Oh, I can’t have any of the foods I love.” No there’s a world of foods for you to explore and maybe many vegetables that you’ve never heard of or tried. So I invite people to take that step.

Dr. Weitz:            And what’s the best place for people to get ahold of you?

Palmer:                Palmerkippola.com is my blog and website and so I have a lot of information there. That would be a great first place to start. I lead people in Beat Autoimmune Academy, so it’s on website beatautoimmuneacademy. People can check out what’s in there. Those are two great places to find me and so thank you.

Dr. Weitz:            That’s great, excellent. Thank you Palmer.

Palmer:                It’s been a pleasure. Thank you so much for having me Dr. Weitz.



Reducing Food Cravings with Dr. Elena Zinkov: Rational Wellness Podcast 170

Dr. Elena Zinkov speaks about Reducing Food Cravings with Dr. Ben Weitz.

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Podcast Highlights

3:47  Many of us, esp. women, have food cravings such as for sugar or chocolate or for salty, crunchy foods and they can be overpowering.  There are numerous reasons why they may exist, including genetic predisposition, skipping meals, hormones, etc.  If a woman is nearing her cycle and her progesterone is tanked that can trigger food cravings.

5:20  There are various genetic variations including if there is a MTHFR mutation, which controls how our body utilizes vitamin B12 and folate.  This can trigger neurochemical imbalances and mood disorders that can lead to food cravings.  We often need to prescribe methylated B12 and methyl folate to such patients but if you see skin breakouts or feeling a bit more irritable than you were before are signs that you could be over-methylating.

15:28  There is a dopamine receptor gene that can play a role in neurotransmitter balance and in food cravings.  If you are genetically programmed to have fewer dopamine receptors, you need more stimulus to gain the same effect and you may be reaching for more pleasurable things and you need dopamine to reinforce that behavior.  It can be helpful to do urinary neurotransmitter testing.  It can be beneficial to use amino acids therapeutically, like 5-HTP or L-Tyrosine or to use some adrenal support or thyroid support or some B vitamins. GABA, pregnenolone, or progesterone supplementation can also be helpful for the right patient to help with issues with the GABA receptors.

19:45  Dr. Zinkow has found that some patients do really well with pregnenolone, which is one of the main precursors for all of the other female hormones, like estrogen and progesterone and it can have a positive effect on the GABA receptors and can be very soothing to the nervous system.  Similarly, for some women giving DHEA may work better than prescribing testosterone, since it is like a back door way of boosting both estrogen and testosterone levels.

22:58  Diet can be very helpful in controlling food cravings but we should be cautious if we have been eating the standard American diet that if can be too drastic to just jump into intermittent fasting right away and this can trigger more food cravings and they may get irritable, angry, and fall off the track completely.  It is probably better for them to clean up the diet first, get your emotions under control, and then later jump into some time restricted eating. Start by cutting out the crap and processed foods and find healthier ways to satisfy food cravings like having a couple of dates with some almond butter instead of a candy bar.  Getting enough protein and healthy fats is important and getting carbs from starchy vegetables or sweet potato and limiting fruits to one or two per day rather than eating pastas and breads.

27:32  Nutritional deficiencies can promote food cravings, such as a lack of magnesium can lead to more chocolate cravings.  A lack of iron can lead to carving more red meat.  A lack of B vitamins can stimulate sugar cravings.  Or we may have an inability for our mitochondria to produce enough ATP, so we may need mitochondrial support, like CoQ10, L-Carnitine, B vitamins, and magnesium.

29:48  The microbiome can play a role in food cravings.  For example, if you eat more sugar, you are more likely to grow more yeast and then you’re going to crave more sugar, which is going to cause more yeast overgrowth.

31:44  If we eat a higher fat, higher protein diet it is still important to get enough fiber to feed the microbiome, but we just need to avoid foods that we have sensitivities to. Dr. Zinkow said that she tends to stay away from food allergy testing because she does not find it to be very accurate and the gold standard is to do an elimination diet.




Dr. Elena Zinkow is a Naturopathic Doctor in Seattle, Washington who specializes in women’s health, hormones, and gut health utilizing a Functional Medicine approach.  She is also the best selling author of Crave Reset: A breakthrough guide for mastering the psychology and physiology of carvings.  Her website is ProactiveHealthND.com.

Dr. Ben Weitz is available for nutrition consultations, including remote consults via video or phone, specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com. Phone or video consulting with Dr. Weitz is available.



Podcast Transcript

Dr. Weitz:            Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the rational wellness podcast for weekly updates, and to learn more, check out my website, drweitz.com. Thanks for joining me, and let’s jump into the podcast. Hello, Rational Wellness podcasters. Those of you who enjoy listening to the Rational Wellness Podcast, please go to Apple Podcasts and give us a ratings and review. If you’d like to see a video version of this podcast, go to my YouTube page, and if you’d like to see detailed show notes and a complete transcript, go to my website, drweitz.com.

                                Today, we will be discussing how to reduce food cravings, which we all have, with Dr. Elena Zincov. How do we reduce food cravings? Is it just by not giving into them? Is it by learning to stop hating our father? No. Food cravings actually have some physiological relationship to various things going on in our physiology, our genetics, our hormones, our microbiome, et cetera, and today we have Dr. Elena Zincov here to discuss those with us. She is a naturopathic doctor in Seattle, Washington. She specializes in women’s health, hormones, and gut health utilizing a functional medicine integrative approach, and she’s also the bestselling author of Crave Reset, a breakthrough guide for mastering the psychology and physiology of cravings. Dr. Zincov, thank you so much for joining me today.

Dr. Zincov:           Hey, thanks for having me. It’s a pleasure.

Dr. Weitz:            Good. So, we can get to know you a little bit. Perhaps you can tell us how you decided to become a naturopathic physician, and for the few who are new to this podcast, what exactly is a naturopathic physician?

Dr. Zincov:           That’s a great question. So, I grew up as a competitive athlete. I played competitive tennis for many years, I played in Voluntary Academy down in Florida, and I got exposed to a healthy lifestyle early on as a teenager, and so having struggled with my own cravings and acne and bloating and gut issues and hormone imbalances, I found my way to naturopathic medicine, and in fact, my mom was actually a medical doctor and I was exposed to naturopathic medicine when I was about 16 years old and I felt great, and so after competitive sports, I wanted to help others, I wanted to help myself, and I found myself at the Steer University applying for the naturopathic doctorate program, and naturopathic medicine, it looks at the whole person.

                                We don’t want to just treat the symptoms, we want to see how all things are interconnected and how they’re working synergistically, and even nowadays when patients come see me and they want to know what’s at the root cause, I always say there could be multiple root causes, right? We sometimes don’t know what came first, the chicken or the egg, and it ends up being this orchestra of things. It’s hormones, it’s gut, it’s brain, it’s inflammation, it’s immunity. So, naturopathic medicine really looks at the whole person, and not just the person, at the the environment, at mental state, at the work situation. So, it’s a total mind-body approach.

Dr. Weitz:            Cool. So, what are food cravings and how should we think about them? It’s a general thought.

Dr. Zincov:           Yeah. Yeah, we need to willpower away through food cravings, no. Food cravings are really interesting. I personally struggle with food cravings, sugar in particular, I’m sure a lot of people-

Dr. Weitz:            Does everybody have food cravings?

Dr. Zincov:           Not necessarily, actually.

Dr. Weitz:            Okay.

Dr. Zincov:           So, from personal professional experience, I feel like, as someone who sees both men and women in my private practice, men tend to have fewer food cravings, from just my observation. I find that women, and this is where I get, even in my book, I go a lot into hormones, women, due to just natural fluctuations in our hormones throughout the month, tend to be a little bit more impulsive around food, tend to have more of the sweet, that salty, crunchy, savory-like cravings, and they can be very overpowering.  But the thing with cravings is that they are multifaceted.  It’s not just, “Oh, I’m craving chocolates because I’m just craving chocolate.” There’s usually many more biochemical things that are happening behind it. You could have a genetic predisposition of why you’re craving sweets. You could be skipping meals and just not eating right, and you’re craving those things, right? For a women, she could be nearing her cycle and her progesterone is tanked, and that’s why she’s craving those things. So, cravings can be multifaceted, we all experienced them differently and there needs to be a unique approach when you’re addressing them.

Dr. Weitz:            Cool. So, in your book, you go through various concepts, and one of the concepts you talk about is genetics. So, perhaps you could talk about some of the genetic factors that might affect our craving for sweet foods or bitter or different types of foods.

Dr. Zincov:           Yeah. That was actually really interesting just in my research, and frequently, I won’t go into too much of scientific detail, but many people have heard of MTHFR mutation, and it’s how our body utilizes B12, well, and B12 is a really important nutrient that if it’s not metabolized properly or used correctly by the body.  And MTHFR prevents us from getting methylated B12 in our system that we can have a lot of neurochemical imbalances, mood disorders that can actually predispose us to craving more junk food, can predispose us to feeling more irritable and really not understand why we’re feeling the way that we do, and of course, Dr. [crosstalk 00:06:23]-

Dr. Weitz:            It’s interesting that you describe MTHFR as primarily about B12 when most people think of it as primarily about folate.

Dr. Zincov:           Yes. Yeah, and I think it’s a fine balance between the two, but predominantly from my experience, I really see B12 being an issue from just clinical or professional background, but I think it needs to be both, right?   Just like we need to talk about methylated B12, we also need to take methylated folate into consideration in this case.  So, that’s a really common one, right?  And that’s the low hanging fruit as far as genetics go. It’s easy to test, it’s easy to address, sometimes supplemental form.

Dr. Weitz:            The tricky part is how much. How do I know how much methyl B12, folate, methyl B vitamins do we need to take, should we take, can we over methylate?

Dr. Zincov:           Yes.

Dr. Weitz:            How do we measure levels?

Dr. Zincov:           Right. Yeah, and you actually bring up a really good point, and I had this conversation with one of my colleagues that I think we’re over methylating people to some extent, because a lot of providers are not testing for MTHFR and they’re just prescribing, let’s say methylated B12, right?    And so I get that many people are actually deficient or they have this mutation, but some of the things that I tell my listeners and my viewers and followers is that if you take methylated B12 and things like skin breakouts or feeling a bit more irritable than you were before, are signs that you could be over methylating.

Dr. Weitz:            What about testing? Because we do a fair amount of testing and I often find serum B12 is high, maybe serum folate is high, but then they could have sky high homocysteine levels, so obviously they don’t have enough folated B12, so testing is tricky and I think it can easily get confused if we run the wrong test.

Dr. Zincov:           Yeah, absolutely. I don’t know what your perspective is. I personally like more white blood cell testing than red blood cell testing, especially for B12. So, this is something when we do like a micronutrient test, I think that can show, I would say, not more optimal levels, but more accurate levels of nutrients.

Dr. Weitz:            Are you still using SpectraCell?

Dr. Zincov:           Every once in a while, I do, but for me, I’m at the point where I am seeing more of how my patients are feeling.  If I see somebody’s B12 are through the roof, but they’re presenting that they’re deficient in B12 and folates, I’m not just going to go for the labs, right?  I think that there’s something more involved, and I’m a conservative lab prescriber just because I’m sensitive sometimes to, when patients come in and they have like a 10 year history of not feeling well, and they’ve had all sorts of lab testing done, functional and nonfunctional, I’m more interested in talking to the patients and hearing how they’re feeling rather than maybe ordering another lab test, right?  Because I do cost-benefit analysis, pros and cons.  What is this lab test really they going to show us? Right? Are labs always 100% accurate? And do they always show the full picture? And so I’m really just sometimes more interested in seeing and hearing what the patient is all about. There’s so many times where we’ll do a serum B12 test and it’s like 2000, right? Whatever. It’s through the roof, but we still supplement, or we do a nutrient shot like a hydroxocobalamin, methylated B12 combination and they feel great. So, who’s to say that they have too much, quote unquote, air quotes-

Dr. Weitz:            So, my argument would be because that’s the wrong test, that serum B12 levels are not indicative of tissue levels, that doing a methylmalonic acid or homocysteine is a more functional test, so my argument would be, you got to run the right test.

Dr. Zincov:           Right. Yeah. No, I agree with you. Mm-hmm (affirmative).

Dr. Weitz:            Okay. So, talk about more, some of these genes that affect our cravings.

Dr. Zincov:           So, there’s definitely a few genes. For example, I talked about MTHFR and the reason why I call it the low hanging fruit, because it’s easier to address. There are-

Dr. Weitz:            So, what cravings does a MTHFR, if somebody… So, MTHFR they could have, there’s at least several different versions of this gene, and then they could have one or two copies of it. So, how many copies of one or both of these variations, and actually there’s 10 more that most people don’t measure, would affect food cravings? And in what particular food cravings would we tend to see with that?

Dr. Zincov:           So, I think just focusing on the MTHFR mutation can actually not be very beneficial because what I don’t want is for people to get hyper-focused that if they have even one or two genetic mutations of this gene, that all of a sudden they’re going to blame all of their life’s problems on MTHFR mutation.  So, I definitely don’t want people to walk away from this thinking, it’s like, “Oh my gosh, well, I have this one mutation, I have two mutations, therefore, all the things that I’m craving or all the things that I’m experiencing are based on this, because-

Dr. Weitz:            You don’t want them walking into your office saying “Dr. Zincov, my life is ruined. I have MTHFR.”

Dr. Zincov:           Exactly. I want to approach this a little bit more from a holistic approach, which is where, when you have just one mutation compared to two, chances are, yes, you could possibly be experiencing fewer food cravings, and particularly sugar, and the reason for that is we need B12 for serotonin synthesis, and serotonin is a really important neurotransmitter that regulates our cravings, regulates our habits.  It’s a desirable, right? Neurotransmitter, and so it causes us to feel pleasure, and food is just such an easy thing. It’s a quick fix these days, and so when someone has one or two mutations, chances are that they’re not producing optimal levels of serotonin, which can lead them to binge more, right? Because they got to get that pleasure from somewhere else.

                                So, the tricky part with the other genes is, some people like bitter foods, some people don’t like bitter foods, some people like fatty foods, some people don’t like fatty foods as much, right? When you talk to your clients, people have different food preferences, and those folks who are genetically predisposed to avoid bitter foods are not going to be eating as many leafy greens because the bitter and the leafy greens is going to be a deterrent for them, but that is to say, right?   I don’t want people to say, “Well, I’m not going to eat my leafy greens because I’m genetically predisposed not to eat them.” Right? One of the things that I talk about in my book is that there are different ways that if you don’t like bitter greens, guess what? There’s an area of other greens that are non bitter, that are neutral to taste that you can have, right? So, let’s not just blame our genes for our poor dietary decisions.

Dr. Weitz:            In fact, maybe if you don’t like bitter greens, maybe that’s a reason why you need them.

Dr. Zincov:           Exactly, right?

Dr. Weitz:            I know chiropractic, right? We get patients all the time, and they spend hours and hours stretching and they can put their leg behind their head and twist it around three times, and they think that taking more yoga classes is going to help them with their back pain, but they love doing things they’re really good at, and that person really needs strength training and is not going to benefit from more yoga classes, whereas the person who is super tight and only does strength training and hates stretching probably needs, or definitely needs stretching more.

Dr. Zincov:           Right. Exactly. So, that’s so funny because I’m actually, I’m a yoga practitioner myself, and I’ve been doing yoga for 20 years, but I learned early on that more stretching is not actually a good thing, and my perspective is that we need to strengthen more than we need to stretch.

Dr. Weitz:            Yes.

Dr. Zincov:           But that’s-

Dr. Weitz:            Let’s talk about some of the other genes. I’m sorry. I’m throwing you off track.

Dr. Zincov:           No, that’s okay. So, I think those are the main ones that I would talk about, not to get lost too much in the weeds. I really think-

Dr. Weitz:            You mentioned a dopamine receptor gene also in your book.

Dr. Zincov:           Yeah. The dopamine receptor gene. So, this is really interesting because serotonin and dopamine are partners in crime. So, if someone has, we talked about MTHFR, we talked about serotonin synthesis and how someone who has, let’s say, deficiency in serotonin just naturally biologically, for whatever reasons, will seek pleasure in other ways.

                                What would happen, so let’s say you do an activity or you eat a food that causes you pleasure, right? Then dopamine comes around and reinforces that behavior, right? Because this is where I always talk about how we live in very urban environments, but we’re very primal in certain ways, and so if there is a dopamine receptor issue, for example, maybe you have fewer dopamine receptors, right?

                                Genetically you’re predisposed to have fewer dopamine receptors, your body’s going to need more stimulus to gain the same effect, right? So, now you’re reaching for more pleasurable things and then you need more dopamine to reinforce that behavior. So, it’s a vicious cycle that people find themselves in, and then, God forbid, then you share that something was pleasurable, then you produce oxytocin, and that reinforces that behavior. So, it ends up being a hot mess.

Dr. Weitz:            So, neurotransmitters, you have a whole chapter devoted to neurotransmitters, like serotonin, dopamine, GABA, and so these are crucial for food cravings?

Dr. Zincov:           Yeah, absolutely. So, a lot of times-

Dr. Weitz:            Do you ever measure neurotransmitter levels? Have you done the urinary neurotransmitter testings?

Dr. Zincov:           Yeah. Yeah, and I find that to be really interesting. There’s simple quiz that people can take online, and maybe I can forward the one that I like, if somebody doesn’t have access to testing, but I think urinary metabolites, really, the breakdown products of a lot of these neurotransmitters can be a good indication of our natural production.  In fact, I think it should be more mainstream to test for this, right? Before we even prescribe something like a SSRI or an antidepressant or anything like that. It’s like, why don’t we test these things first? Right? And spare people a lot of pain and agony.

Dr. Weitz:            Absolutely. Because otherwise we’re just guessing at what we’re doing with neurotransmitters.

Dr. Zincov:           Yeah. Yeah, exactly, and so when it comes to craving-

Dr. Weitz:            In fact, very few studies really directly link low serotonin levels with depression, it’s much more complex than that.

Dr. Zincov:           Right. Right. Absolutely, and so it ends up being like a cocktail of neurotransmitters that are involved in regulating our emotions, our mood, and then in turn, our food cravings, right? It’s not uncommon for someone to say like, “I’m irritable.”   Or let’s say depressed, right? Since we’re talking about serotonin and SSRIs, “I feel depressed, I feel anxious, I’m going to have something sweet.” Right? Because it just provides that immediate release of serotonin to patch that pain for a short term.

Dr. Weitz:            So, can a therapeutic use of amino acids be beneficial in helping to support neurotransmitter production?

Dr. Zincov:           Yeah. Absolutely, and this is one of the things, even in my research and trying this with my patients as well, I’m not the first provider in the history of medicine, right? Who’s saying, hey, how about even just a little bit of supplementation of 5-HTP or L-Tyrosine, or how about a little bit of adrenal support, a little bit of thyroid support?   How about some B vitamins? Like we talked about some precursors for some of these neurotransmitters. I talk about GABA, pregnenolone, progesterone, all those things play with the GABA receptors, right? How about we try those things, right? And see if we can manipulate our physiology or optimize our physiology in that way.

Dr. Weitz:            So, how often do you prescribe pregnenolone?

Dr. Zincov:           I would say actually more nowadays than ever before.

Dr. Weitz:            So, give us an example of when you might prescribe pregnenolone.

Dr. Zincov:           Yeah. I have a couple of women that I’m working with right now where it’s actually made quite a big difference and I actually didn’t really believe in pregnenolone for some time. I just-

Dr. Weitz:            Going back and forth on it?

Dr. Zincov:           Yeah. Yeah. I was like, “Oh, does it really work?” And then I’ll go through phases where I’ll research something a little bit more and then I’ll dose it, and then I’ll just see how my patients react.

Dr. Weitz:            By the way, for people listening to this podcast, if you’re not familiar with pregnenolone, maybe you could just explain what pregnenolone is.

Dr. Zincov:           Yeah. Pregnenolone is one of the main hormones which then gives birth to all the other hormones, right? So, it’s higher up in the chain of command as far as hormones go, and we can’t really test for it because it has a super, super short lifespan in the bloodstream, so it’s not like you can… I don’t like it when I see providers testing for pregnenolone, because I’m like, “What does it give us?” Right? I mean, it doesn’t really give us a lot of information, but anyways, but what can happen, so I’ll give you an example. I have a postmenopausal woman who continues to have really poor sleep and we’ve tested her cortisol, we’ve tested her nutrient levels, we’ve worked on her thyroid, worked on all of the sex hormones.

                                She does exceptionally well with bioidentical progesterone, but terrible with any sort of estrogen, right? And so, one of the things that I wanted to explore with her is because I know pregnenolone has a really positive impact on GABA receptor. So, one of the pregnenolone metabolites can affect GABA receptors and can be very soothing to the nervous system, right? And so I added, I think, like 25 milligrams of pregnenolone to her nighttime routine, because technically, you can take it in the morning. For someone who tends to be anxious, pregnenolone can be really good to dose first thing during the day, but for her, I used it at nighttime and that really did the trick.

                                However, I should also add that I also added DHEA to her routine, and for someone, let’s say, there’s a lot of women who are sensitive to hormones, right? And so we have to go through the back door, and the reason why I like pregnenolone, the reason why I like DHEA is because I’m not giving you exactly estrogen, I’m not giving you exactly testosterone, but those guys get converted, right? DHEA, some of it gets converted to estrogen, some of it gets converted to testosterone, and that could be the back door to boosting someone’s, even estrogen levels. So, that’s one way that I’ve used it in my practice.

Dr. Weitz:            Cool. What is the best diet for controlling food craving? Should we follow a low carb program? What about intermittent fasting?

Dr. Zincov:           Oh, the million dollar question. I get this asked a lot, and I actually, this is where medicine becomes really individual because some people who have a really hard time controlling food cravings, sometimes intermittent fasting or time restricted eating may not be the best thing, right? Because it can cause… Yes, it can help balance blood sugar longterm, but you almost have to clean up the diet first, get your emotions under control, and then later jump into some time restricted eating, right? What happens sometime is somebody eats the SAD diet, the standard American diet, they’re have uncontrollable sugar cravings, and they’re like, “Intermittent fasting or time restricted eating is going to fix all of my dietary problems.” Right?

                                And so they go from doing 0 to 100, and they find themselves really overwhelmed, really irritable, angry, and falling off track really quickly, and so in terms of what’s the most optimal diet, you’ve got to start with the basics, right? Let’s cut out the crap, all the processed food, all the processed junk. I’m okay with people, even initially when they’re battling food cravings, and having gone through this personal experience myself, it’s like, it’s okay to have alternatives, right? But have them healthy. Instead of having a chocolate bar, having a couple of dates with maybe some peanut butter or almond butter, right? So, still satisfying that sweet craving, but in a really more holistic and functional way.

                                And then later, once you have your bearings under you, right? You can start playing with time restricted eating. The other thing I should say is that a lot of times people experience cravings because they didn’t eat enough protein. They didn’t eat enough fat during the day, or they skip meals, not unintentionally. So, it’s different if you’re fasting, right? And you know that you’re skipping meals, versus, I’ll have breakfast, and then six hour later, I have a snack, and then I find myself staring at a refrigerator at six o’clock at night eating everything in sight. That’s, I call, the non-intentional fasting where you lose track of your day, versus time restricted eating, which is intentional fasting.

Dr. Weitz:            So, if not getting enough protein and not getting enough fat is important, should we follow a high protein, high fat, low carb diet?

Dr. Zincov:           I’m a huge proponent of a lower carb diet, but not necessarily keto. I think that I’m not a carbophobe, I think carbs are important. I think, obviously, a lot of carbs are not created equal. When I talk about carbs, I want people to get most of their carbs from vegetables, from starchy vegetables, maybe like squash, right? Or sweet potato. Maybe just limiting fruit to one to two servings per day. When I say carbs, I really am talking about the vegetable group of carbs, right? Not necessarily the pastas and the breads. I want people to avoid those things.

Dr. Weitz:            What about legumes?

Dr. Zincov:           Sensitive topic.

Dr. Weitz:            Watch out for the deadly lectins.

Dr. Zincov:           I know. Oh my gosh, I am fine with legumes. I think that they have lots of good nutrients, they can actually help people balance their blood sugar, they can be-

Dr. Weitz:            Lots of fiber to feed your microbiome.

Dr. Zincov:           Absolutely. The whole thing with-

Dr. Weitz:            Low in the glycemic index.

Dr. Zincov:           Yeah. There’s just so many benefits to legumes, and it’s more about the source, how you prepare them. I mean, there’s so many ways that you can optimize their digestion and breakdown and absorption. I’m just not 100% in the whole lectin theory that that’s at the root problem of our diets, like what do we eat? Just meat and kale? I mean, I’m all about moderation when it comes to diet.

Dr. Weitz:            It could be the new diet, the meat and kale diet.

Dr. Zincov:           God forbid.

Dr. Weitz:            The Carni-Kale diet.

Dr. Zincov:           Yeah, exactly. You never know, right?

Dr. Weitz:            So, how do nutrient deficiencies promote food cravings?

Dr. Zincov:           Yeah, absolutely. So, a key example, like we talked about B12, right? And MTHFR deficiency, and that can predispose people to have more sugar cravings. Magnesium is a really common example. It’s like the poster child for food deficiencies or nutrient deficiencies that can lead to food cravings, so if someone, let’s say, is low in magnesium, they can have more chocolate cravings, and so that’s the poster child for that.  If you have low iron levels, that can cause, especially a lot of women, it can cause them to crave more red meat, right? We just run into a problem. Do you really need to eat more red meat? So, that’s where we need to individualize our medicine a bit more. So, those are really the common examples. The thing is that, what I’ve seen is a lot of deficiencies in B vitamins. Deficiency-

Dr. Weitz:            So, if I had a sugar craving right now, if I popped a couple of mag citrate caps, that would take care of it?

Dr. Zincov:           No. I think in that situation, when someone is like, “Oh, I really need sugar right now.” Chances are, maybe they didn’t get enough B vitamins, right? Because here’s the situation, is that, how do we get our energy? ATP? When we talk about, “I need more energy.” We need more ATP. That’s the unit of energy, right? Where’s your energy produced? In the mitochondria. What does your mitochondria need?  It needs, for the electron transport chain, right? How do we get the ATPs? We need CoQ10, we need, L-Carnitine, lots and lots of B vitamins, we need magnesium, we need B12, which is part of the B-vitamin family. So, there’s all of these nutrients that are involved in energy production, that if we’re deficient in those things, guess what? We’re going to crave more sugar because we can’t make those ATPs. Now, we’re getting into mitochondrial dysfunction.

Dr. Weitz:            Absolutely.

Dr. Zincov:           Yeah.

Dr. Weitz:            Functional medicine discussion without mentioning the mitochondria.

Dr. Zincov:           Or MTHFR.

Dr. Weitz:            What part does the microbiome play in food cravings?

Dr. Zincov:           Well, we’ve got more bacteria in our gut than we have the total amount of cells, right? In our body, and people talk about the microbiome as something like super cozy, working for us, but the reality is that the microbiome is there to serve itself, right? So, it’s us versus the microbiome, and the more certain foods you eat, let’s say you eat more meat. You’re going to create more microbiome that’s going to thrive on meat, right?   So, you’re going to produce that type of bacteria that’s going to make you crave more of those foods. Same thing with carbohydrates. I don’t remember off the top of my head, there are certain bacteria that when you do eat a higher starch diet, higher carb diet, those are the things that you’re going to crave, right? So, you create the microbiome by what you eat. The cool thing is that there’s a lot of research that shows that we can simply turn that around 24, 48 hours, right?  Which is pretty cool, and so I tell people, if you slip off your diet, don’t worry about it. You have the next day, or even the next moment to start making the change. So, certainly there’s a link between what we eat and the type of microbiome that we shape, and when I talk about microbiome, even I used to think that microbiome just talks about bacteria. Microbiome is viruses, microbiome is bacteria, it’s yeast, it’s parasites.  So, it’s a whole ecology that we’re dealing with. If you eat more sugar, chances are you’re going to grow more yeast, right? You’re going to crave more sugar, which is going to cause more yeast overgrowth, and it’s not just candida, right? There’s like 20 plus, some sort of yeast species that we can get exposed to or create.

Dr. Weitz:            Now, if we have a higher fat, higher protein diet, lower carbs, are we going to risk not having the fiber that a lot of the bacteria that are in a microbiome need?

Dr. Zincov:           Yeah. Well, and this is going back to what you were talking about, even legumes, right? I have no problem with people eating legumes or whole grains, things that they’re not sensitive to.  It’s really, the only foods that I want people to avoid are the ones that they’re sensitive to, right? Or that can be inflammatory, or that possibly can cause allergies or blood sugar dysregulation-

Dr. Weitz:            How do you determine which foods those are?

Dr. Zincov:           Ah, another sensitive topic. So really, I stay away from food allergy testing because I don’t think that it’s very accurate. Really, the gold standard of food allergy testing is, take a food out for an extended period of time, bring it back in to see if that’s something that you get a reaction to, and-

Dr. Weitz:            The elimination diet?

Dr. Zincov:           Elimination diet, exactly, is really the gold standard. There’s just way too many false positives and false negatives with food allergy testing, and don’t get me wrong. I’ve seen great success with those tests, right? But I think there’s few individuals who really benefit from it, and I think that it can be useful when we’ve exhausted all our options, and we have no clue where to begin, right? I’ve seen something like asparagus being a really big sensitivity for someone, and we didn’t know that until we did the food allergy testing. So, it’s not-

Dr. Weitz:            And there’s better and worse food sensitivity testing too.

Dr. Zincov:           Yeah, exactly. But when it comes to, going back to the question of, are we risking people eating lower fiber diets by choosing higher protein, higher fats? Yeah. We are. And that’s why I’m not afraid to prescribe, right?   Legumes and squash and the tubers, right? I’m not afraid to prescribe those things, and I encourage those things because fiber is super important and prevents against colon cancer and it supports the microbiome growth, and so it’s-

Dr. Weitz:            Yeah. I interviewed Kiran Krishnan a few weeks ago, he spoke at our functional medicine meeting and he was talking about how, if you have a higher meat diet, you have a higher level of Prevotella, and you throw off your Prevotella to Bacteroides ratio.

Dr. Zincov:           Yeah, yeah. And-

Dr. Weitz:            Yeah. And how that’s a negative and that affects blood sugar, so that could play into this whole thing too.

Dr. Zincov:           Yeah. And I’ve studied Bacteroidedes and Firmicutes species and some of those other proteobacterium like E. coli pretty extensively, and that can affect your estrogen, especially for women. This is really important.  Actually for men too, because sometimes when people think about estrogen, it’s like, “Oh, that’s a woman’s hormone.” Well, guess what guys? You don’t want your estrogen to be through the roof, right? And when I-

Dr. Weitz:            And you don’t want it to be too low either. Men need a certain amount of estrogen also.

Dr. Zincov:           Absolutely. Yeah, absolutely, and so when I look, let’s say I do somebody’s hormone panel and I see that their estrogen is through the roof-

Dr. Weitz:            What’s your favorite hormone panel?

Dr. Zincov:           So, I do a combination. I like urine testing, and I also like blood testing.

Dr. Weitz:            You like Dutch?

Dr. Zincov:           I like Meridian.

Dr. Weitz:            Oh. I don’t know them.

Dr. Zincov:           Yeah. Yeah. I-

Dr. Weitz:            Just like a 24 hour urine?

Dr. Zincov:           It is. So, it’s actually both Dutch and Meridian and I’m pretty vocal about my preference between the two.  I’m a Meridian fan for my reasons, but they’re similar in the technology-

Dr. Weitz:            You got to carry around the jug of urine, though.

Dr. Zincov:           No, that one, so it’s different. So, they’ve moved away from doing the jug of urine test, which is really inconvenient for people, to doing the dry urine strip testing.

Dr. Weitz:            Oh, okay.

Dr. Zincov:           So, a bit more convenient. I’m sure it’s not as maybe accurate as doing an actual jug of urine, but it’s a lot more convenience, the compliance rate is obviously a lot higher, and it gives us great data. I mean, everything from estrogens to estrogen metabolites to, right?  Progesterone, to androgen breakdown, cortisol curve, super essential to know, and so there’s just minor differences that I like in Meridian compared to Dutch. I don’t think we should go off of just urine testing alone, I think it’s important to also do blood testing, get a snapshot of the, actually, bioavailable levels, but when it comes to once someone is doing-

Dr. Weitz:            You often see discrepancies between serum and urine on hormones?

Dr. Zincov:           It’s not comparing apples to apples. So, there is, every once in a while, and I’ll tell you what it is. I’ll give you an example of testosterone, for example, right? So, someone can test really high on testosterone in the morning when they go get their blood drawn, right? But the benefit of doing something like a 24 hour hormone test is that-

Dr. Weitz:            It could drop later in the day.

Dr. Zincov:           Precisely, and I’ve had women who would say, “Well, my testosterone is high. Why do I need more testosterone?” And then I show them their test on the 24 hour, and I’m like, “Yeah. You could have been high at 8:00 AM, but then starting at 10:00 AM, it could significantly or exponentially drop, for whatever reason.   Maybe there’s an adrenal dysfunction, right? And so for whatever reason, and then they ended up feeling better, right? Once they’re in a little bit of testosterone, for example, or MOC or whatever we decide what the route of treatment is going to be, but that’s the benefit of using both tests, urine and blood, because the blood is great if we just get a snapshot, right?    And if you’re low, well, then you’re low, right? But someone could be low at one point and super high at another point, and this is where even the thing with estrogens we want to be really careful with, is that we want to make sure that we are understanding what are the total levels of hormones? I think that’s really the point, that, what are the total levels of hormones, given that they can cycle throughout the day, not just a month?

Dr. Weitz:            And also, how does your body process those hormones?

Dr. Zincov:           Oh, man.

Dr. Weitz:            Are you clearing your estrogens? Are you clearing them in a way that puts you at less risk of breast cancer?

Dr. Zincov:           I work with so many women who are post breast cancer, who have a high risk of breast cancer, I have a lot of women who don’t have breast cancer, but their mom, their aunt, their sister have all had had breast cancer, and so I’m such an advocate for women getting their estrogen metabolites tested, getting their estrogen tested.  I think there’s a misconception that when women hit, let’s say, perimenopause or menopause, that our estrogen declines. It does, but actually some women are still estrogen dominant even in menopause, and that’s a scary thing, giving what estrogen can do in terms of cancer.

Dr. Weitz:            So, what do you do about that?

Dr. Zincov:           So, we definitely want to offset estrogen. Estrogen, I see it more as a bully hormone. It’s an important hormone, but it can be nasty, right? When it’s I high amounts.

Dr. Weitz:            So, you give them progesterone?

Dr. Zincov:           We give them progesterone. That’s one of the best ways to offset estrogen. The other thing we can is-

Dr. Weitz:            And you like oral or cream for progesterone?

Dr. Zincov:           I like oral. Yeah. I like oral. Again, lots of benefits, especially if we’re dealing with estrogen dominance, I say, just go for the oral form. Every once in a while, and literature is really mixed on this as phytoestrogens, right? Phytoestrogens much more mild in terms of binding estrogen receptor sites, bu you got to be careful.

Dr. Weitz:            Like soy, black cohosh, things like that?

Dr. Zincov:           Yeah. Black cohosh, dong quai, all those things are great. Flaxseeds, ground flaxseeds are actually natural phytoestrogens, and of course soy, just making sure that it’s organic soy, but it’s really, again, it’s like people are so scared of soy. Well, it’s actually just maybe a couple of times a week as a phytoestrogen source, it might not be a bad option. Yeah. So, those are the two ways that I would offset estrogen, and of course we can get into some liver optimization, right?  Like DIM and NAC and glutathione and dandelion root and burdock root. Anytime there’s estrogen dominance, you actually got to work on the liver, but then you actually, like we were talking about, gut health and Bacteroidede species, it’s really interesting. I started my own case study research in my clinic, because I’m like, if someone is estrogen dominant, I bet if I test their stool, they’re going to be dominant in certain types of bacteria, and sure enough, right? And they’ll be high in Bacteroidedes, they’ll be high sometimes on Firmicutes or even E. coli, and people are scared E. coli.

                                It’s like, well, we have certain strains E. coli in us, right? It’s just, it’s when they outgrow their welcome, then it becomes a problem, and so when it comes to even estrogen dominance and people are like, “Well, how’s this related to food cravings? Well, if you’re estrogen dominant, you’re going to be an irritable mess, which is going to force you to make really poor food decisions, in a nutshell.

Dr. Weitz:            What’s your favorite stool test?

Dr. Zincov:           I liked Genova. The GI Effects. And again, some people prefer the GI-MAP. I really like Genova, I think they do a really great job of breaking down the different categories. It’s visually more pleasant to look at, it’s easier to explain, wrap your mind around it. I think they do a great job of showing the protein breakdown, the fat breakdown, if there’s missing short chain fatty acids, right? Which are important for the microbiome as fuel. So, I think they do a really great job of just putting things in their place.

Dr. Weitz:            So, you mentioned estrogen and progesterone and testosterone. What about adrenal hormones and thyroid?

Dr. Zincov:           Yeah. Yeah, absolutely, and I think those are the ones that people think about more frequently than the other hormones, the sex hormones. The thing is that, especially in times of stress, and a lot of people are under a lot of stress right now, right? Times of uncertainty. That’s an understatement. “What stress?”

Dr. Weitz:            “What stress? There’s no problem.”

Dr. Zincov:           “I don’t know what you’re talking about.”

Dr. Weitz:            “I don’t know what you’re talking about. Everything’s great.”

Dr. Zincov:           I know. Yeah, right? A little bit of denial can’t hurt us, right?

Dr. Weitz:            Just another pandemic. No big deal.

Dr. Zincov:           Yeah. Exactly.

Dr. Weitz:            “Our economy’s locked down.”

Dr. Zincov:           Oh, man. Don’t even get me started on that. So, the two really main organs, or not organs, glands that are really taking a beating is our thyroid and our adrenals. We’re not sleeping enough, we’re eating bad food, we’re angry, we’re frustrated, we’re stressed. We are dealing with things that are out of our control, right? And so your thyroid and your adrenal gland, the things that really keep your metabolism going, the things that keep your adrenaline pumping like your adrenal glands, they’re stressed. They’re also stressed.

                                And so what happens is that when your thyroid tanks, people tend to crave more sugar, and one of the reasons is because your thyroid regulates your insulin, it regulates your blood sugar, and when that system is broken, you’re going to get your sugar from elsewhere, right? Not from your innate reserves, for example. And then because your adrenal gland, which is actually located right on top of your kidneys, it helps your kidney. It helps your kidneys function, right?

                                It keeps your pH, keeps your concentration of your blood at a certain level and people crave salt. And it’s a synergistic relationship, right? Between the thyroid and adrenals and people are like, “Well, what if I create both sugar and salt?” Well, that’s a double whammy. We gotta address both, but that’s, again, from a functional medicine perspective, a lot of people are walking around with under functioning thyroid glands, and I just don’t understand, given the research that TSH is not the most optimal marker to test the thyroid gland, we’re still not feeling well.

Dr. Weitz:            So, what do you look at? What’s the most important thing to look at, and what are the key ranges?

Dr. Zincov:           Yeah. Yeah. So, I hope people have a piece of paper and a pen or their notes on their iPhone ready. So, I still like to test for TSH, but I like to test for total T4, total T3, free T4, free T3, always fired antibodies, sometimes reverse T3, mostly used for cancer monitoring or inflammation, but not really relevant, at least from my… I have not seen it professionally or in research that it’s relevant in terms of diagnosing thyroid dysfunction.  So, you want to test all of those thyroid markers and what’s the optimal range? There’s a lot of even research that shows that TSH below 2.2 has linked to less depression and fewer mood disorders. So, I like the TSH to be at least closer to 1. 1 is that optimal range. I like to look at free T4 and free T3 because those are the more bioavailable active hormones.   For free T4, I like for it to be at least between 1.2, 1.4, and a lot of people are walking around with like 0.9, 0.8, right? “Just because it’s not tanked doesn’t mean that I need to treat it.” And four free T3, some providers just look at free T3, what it’s doing, because that’s really the most active of thyroid hormones. Free T3, I like for it to be at least 3.3.

Dr. Weitz:            Oh, wow.

Dr. Zincov:           3.3, 3.5. Men actually do really well with at least like a 3.7.

Dr. Weitz:            Wow.

Dr. Zincov:           Yeah.

Dr. Weitz:            That’s that’s a high level.

Dr. Zincov:           Yeah. Well, I mean-

Dr. Weitz:            I mean, compared to the normal range, right?

Dr. Zincov:           Oh, yeah. Well, it’s really frequent that someone will, like during my initial consult with a patient, people will say, “Well, my thyroid is normal.” And I’m like, “Well, what is normal?” Because they’re coming to me from, let’s say conventional medicine, or even a naturopath, right?   I do a lot of second opinions on hormone testing and they’ll say, “Well, my thyroid is normal and they’re free T3.” So, the free T3 range, let’s say, is 2.0 to 4.4, and they’ll say, “Well, my free T3… let’s say, “… is 2.4.” “Wow, you’re low.” Right?

Dr. Weitz:            Yeah.

Dr. Zincov:           And so-

Dr. Weitz:            Oh, even though it’s in that range, because it’s at the lower end of that range, that’s something to look at, so don’t just pay attention to the things that come up in red, you’re saying?

Dr. Zincov:           Exactly, exactly, and my patients, they’ve become really educated about that. They know that I’m not just looking for something in the middle, right? I’m really looking at what’s the upper ends, but even though, we talked about B12, doesn’t matter. If you’re through the roof on B12, but you are feeling crappy, chances are, it’s either the wrong test, right? Or something else.

Dr. Weitz:            Now, some of the functional medicine labs will include the free T3 and a free T4, but not the total T3 and a total T4, so a lot of times I don’t do those. Am I really missing something?

Dr. Zincov:           I don’t think so.

Dr. Weitz:            Okay.

Dr. Zincov:           I think it’s really more essential to understand what the free T4 and the free T3.

Dr. Weitz:            Okay. Because those are the active forms?

Dr. Zincov:           Exactly, and that’s where you’re getting the real benefit, and the real result.

Dr. Weitz:            Yeah. Okay. Great. Any final thoughts for our listeners and viewers?

Dr. Zincov:           I think one of the things I’d want them to know is just pay attention to how you feel. So much we’re in a reactive mode, right? We just don’t take the time to pause and check in with ourselves, and whether it’s food cravings, whether it’s fatigue, whatever you’re feeling, we go from feeling something, to reaction, and so nowadays, I think it’s just really important to just take pause, right? You’re going to get a lot out of that 10 second pause. That’s where the change happens. That’s where the magic happens. That’s where you change your behavior and your habits for the best.

Dr. Weitz:            Cool. How can listeners get a hold of you and find out about your book and seeing you for a consult?

Dr. Zincov:           Yeah. People can go to my website, proactivehealthnd.com. There’s a lot of information there on the programs, on some educational things that we’re doing, and then I’m big on the Instagram. It’s Dr. Elena Zincov, really easy to find me. Try to basically share the knowledge of health with everyone.

Dr. Weitz:            Cool. Thank you so much for joining us today.

Dr. Zincov:           Thanks for having me.