Detoxification with Dr. Bryan Walsh: Rational Wellness Podcast 77

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

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Podcast Highlights

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

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

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

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

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

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



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

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


Podcast Transcripts

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Weitz:            Absolutely.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Weitz:            Okay.

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

Dr. Weitz:            Right.

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

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

Dr. Walsh:           Right.

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

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

Dr. Weitz:            Right.

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

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

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

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

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

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

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

Dr. Weitz:            Right.

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

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

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

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

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

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

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

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

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

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

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

Dr. Weitz:            Fake news.

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

Dr. Walsh:           Now-

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

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

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

Dr. Walsh:           I think that part of it-

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Weitz:            Okay.

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

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

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

Dr. Weitz:            Let’s go-

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Walsh:           I know.

Dr. Weitz:            How can listeners and viewers-

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

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

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

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

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

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



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

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

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


Podcast Highlights

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

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

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

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

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

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

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



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

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


Podcast Transcripts


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Hirsch:           I don’t.

Dr. Weitz:            Okay.

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

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

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

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

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

Dr. Weitz:            Interesting.

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

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

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

Dr. Weitz:            Yes.

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

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

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

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

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

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

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

Dr. Weitz:            Soy.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Hirsch:           Great, thank you.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Hirsch:           Exactly.

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

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

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

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

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

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

Dr. Hirsch:           Thanks so much.


EMF Radiation with Oram Miller: Rational Wellness Podcast 075

Oram Miller talks about how to reduce EMF radiation in your home and office with Dr. Ben Weitz. 

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


Podcast Highlights

2:17  Oram explains that the building biology profession that he is a part of is geared towards helping people who have sensitivity to toxins in their home. This includes indoor air quality, mold, chemical outgassing, lead, asbestos, radon, natural gas, and carbon monoxide. There is also the outgassing from paints and finishes, flooring, carpeting, glues, and adhesives in building materials, as well as trapping of moisture in walls.  Oram is the co-author of a book called Breathing Walls that talks about the best building methods, available on breathingwalls.com  Oram is also concerned about the EMFs (electromagnetic fields), that includes four specific types: 1. magnetic fields from house wiring that we recognize in the building biology profession; 2. electric fields from house wiring; 3. dirty electricity, and 4. all the radio frequencies from cell phones, Wi-Fi, Bluetooth, smart meters, etc. 

5:57  If you go into a bedroom with a Gauss meter that only measures magnetic fields, you will miss the magnetic fields coming from wiring errors due incorrect connections of the neutral wires between circuits.The black, hot wire naturally has a magnetic field that goes clockwise around it that is supposed to be canceled by the magnetic field going counterclockwise around the neutral coming aback the other way when they they’re together and equal. But if you have a wiring error, which occurs in up to 50% of homes in Southern California is that they connect these neutrals together under one lug, which is a violation of the code. But the code inspectors don’t look for this because they don’t care about magnetic fields–they just want to make sure that the lights work and there won’t be a fire.

12:24  Another source of magnetic radiation is current that runs along metal water pipes under your home.  These pipes are actually meant to conduct electricity as a path for lightning to get into the earth and we don’t want to disrupt that but we can shield our homes by having an electrician put a 3 inch piece of plastic near the beginning where the water comes into your home which will stop this magnetic field.     

18:35  You could have a broken neutral coming from your power line and power lines are difficult to shield against.  It’s also very difficult to shield against strong radio frequencies from cell towers if they’re close by. We can shield against those but it’s very expensive.  And we are going to 5G, which will result in more exposure from more cell towers closer to our homes. 1G (the first generation) was voice, 2G added texting, 3G added cellular data, 4G (fourth generation) added data at higher speed and greater volume. But we are running our of bandwidth in the frequencies that are currently in use below 6 gigahertz (6000 megahertz), in the 800, 900, 1800 megahertz range and the industry would prefer to stay in this range because it penetrates walls easily, etc. But some of the range of frequencies is being held by the military for future use and they are running out of bandwidth in this range.  But this new 5G bandwith, including the super 6 gigahertz range from 20 gigahertz and up, doesn’t go through walls easily, so they have to aggregate and focus the beam to drill through our walls easily, which require cell phone towers every 2 to 10 houses. Fortunately, these 20 gigahertz and higher frequencies can be blocked by YShield paint and you can also put foil in your walls. There are also transparent films for windows and there’s metal mesh window screens.

30:20  While it would be safer not to use cell phones, given that we are going to use them, it is safer to text than to make a call. It is better to use a set of headphones and a microphone with an air tube in the last six inches that you can get from LessEMF.com.  At home, it is better to use your landline to make and receive calls with a hard-wired phone. When you use your cell phone it is better to speak through the speaker rather than hold it up to your ear.  There are shields you can put on the outside of your cellphone that can reduce the levels somewhat.

When listening to podcasts in the car, like this one, the best thing to do is to have the podcast already downloaded onto your phone by plugging it into your computer and downloading it from Itunes. Then plug your phone into your car stereo through a wire and make sure to place your phone in airplane mode.

37:17  Oram explained that when he inspects someone’s home he finds lots of sources of electric fields that can affect their health, esp. in the bedroom. People who have electrical hyper sensitivity should have a kill switch to shut off all the electricity going into their bedroom at night. Even if you plug an ethernet cable into your laptop computer, your will still be receiving radio frequencies unless you turn your wifi off. They may also have a Nest thermostat sending out a signal every five seconds or so. They may have a smart meter on the outside of their home. They may have smart speaker like the Echo sending out signals constantly. Your Bluetooth, your router, your cordless telelphone, when you hang up the phone and place it into the base unit, it’s still emitting radio frequencies 24/7, like an ashtray full of burning cigarettes. In fact, France has recently voted to ban wi-fi in day care centers and nurseries for children and they’ve banned cell phones in schools up the middle level.  So you want to avoid such sources of electric fields, esp. in your bedroom, and at least turn them off at night. Do what you can to reduce and limit them.


Oram Miller is a Certified Building Biology Environmental Consultant and Electromagnetic Radiation Specialist based in Los Angeles. Oram provides on-site & phone healthy home & office EMF evaluations for clients throughout Southern California who have electro-magnetic sensitivities, as well as those who want a healthier home or office. He also consults on the healthy design and construction of new and remodeled homes. His website has lots of great information createhealthyhomes.com and his phone is 310.720.7686.

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


Podcast Transcripts

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

Our topic for today is EMF radiation, which is a very important topic. A lot of people are not really clued in to it, these are forces in your home, at work, in your car that can potentially negatively impact your health. Today with us today we have Oram Miller, Building Biologist, expert on EMF radiation. Oram, thank you so much for joining me today.

Oram:                   You’re welcome and thanks for having me.

Dr. Weitz:            Yeah, so why don’t you tell us a little bit about your background and how you got interested in this field.

Oram:                   I’ve always been interested in biology. I was interested in particularly the environmental aspects of this work and how they impact people’s health. So, I took training in the building biology profession. It is headquartered in New Mexico, although originally it was in Florida, because this knowledge was brought to America by an architect from Germany, Helmut Ziehe, who married an American woman 30 years ago and started the International Institute for Building Biology and Ecology in Clearwater, Florida.

He and his wife ran this and trained many people, and those individuals, 30 years ago, are now the faculty today and they trained me and now I teach with them as well. So, our profession is geared towards helping people who have sensitivity to toxins in their home, and that expands the gamut from indoor air quality, mold, chemical outgassing, lead, asbestos, radon, natural gas, carbon monoxide, and then the out gassing from paints and finishes, flooring, carpeting, glues, adhesives that you’d have in building materials, as well as trapping of moisture in walls.

I wrote a book called Breathing Walls that talks about building methods. Actually one of the writers for the principal author George Swanson who’s in Texas, a building biologist and builder, who is the principal person with that knowledge on how to build homes that don’t develop mold in their walls, that’s called Breathing Walls, and you can go to breathingwalls.com for information on that.

Then there are EMFs and that stands for electromagnetic fields, and that includes four specific types that we recognize in the building biology profession. That would be magnetic fields from house wiring, electric fields from house wiring, which most people don’t know exist, and then all the radio frequencies from cell phones, Wi-Fi, Bluetooth, smart meters, and so on, and then so-called dirty electricity. Those are the four EMFs that we focus on.

Dr. Weitz:            What’s the difference between the electric forces and the magnetic forces?

Oram:                   So, when we talk about EMFs, they’re really talking about two fields. The E of EMFs refers to the electric field, and the M of EMFs refers to the magnetic field and they’re actually … So, let’s start from the beginning and here we have a sine wave going from zero to maximum, to zero to maximum, to zero in a positive direction and negative direction. That’s one cycle, and there’s 60 of these per second.

I don’t know if you can see that on the camera, but that’s what we deal with with alternating current here in the world for the last 100 years. The voltage varies from zero to maximum, to zero to maximum in a positive, negative direction. That’s actually Tesla who convinced Edison to switch from DC to AC back in before they turned from the 1800s, so the 1900s, late 1800s that’s when that happened. Ever since, we’ve had alternating current, which allows-

Dr. Weitz:            It’s all Edison’s fault.

Oram:                   Well, in the sense that … In a way because the voltage varies, but it’s 120 times a second and it’s able to go down the wires for many miles because with DC, which is the way it was all distributed in the 1880s and 1890s, the voltage dropped within a block or two.

Dr. Weitz:            Okay.

Oram:                   There were little decentralized coal-fired power plants in throughout all urban areas in the world for 20 years or so, and they just couldn’t get industry to develop because everything had to be generated. All electricity had to be generated locally. So, when they switched over to AC, alternating current, then they could send electricity at 120 volts for many miles and that allowed industry to develop, but there are health effects from being in the field of these power lines within your home and from power lines that are outdoors.

So, what you have here is electric fields and magnetic fields at right angles to each other. I don’t know if you can see that, but see the red here going vertically and the beam here coming out horizontally, so you have these two fields and they’re either coupled or uncoupled. I won’t get into the physics of it, but when you’re in the near field which is three wavelengths within three wavelengths you don’t have couplings of the electric and magnetic field.  That means if you go into a bedroom with a Gauss meter that only measures magnetic field and it’s low, you could have low magnetic fields, and usually do in a bedroom especially on the second floor at night because most of the magnetic fields that occur in the home are either from power lines outside, in which case that would involve the second floor bedroom.

But if you don’t have the power lines there in the front or back of the house, then the other three sources of magnetic fields in the home are wiring errors, current on water pipes and other grounding paths and point sources like being near a refrigerator. So, the wiring errors are due to incorrect connections of neutrals between circuits that the electrician does, but the code inspector doesn’t catch because they’re not looking for them.  But that’s only there, the magnetic field from wiring errors are only there if you have loads on. So, at night, you turn all the loads off so there really aren’t any magnetic fields from wiring errors. That’s a day and evening time problem when the lights are on and current-

Dr. Weitz:            What is a wiring error?

Oram:                   It’s a misconnection between different neutrals, we call them. This is an example here, I know you can’t see this at home but it’s from a book by Karl Riley, who was a science teacher who worked with some parents in Southern California 20 years ago at the invitation of them and their electricians, and he helped them find the wiring errors that were causing the magnetic fields, and so he wrote a book about it called Tracing EMFs in Building Wiring and Grounding, which is available from lessemf.com, and also Southern California Edison the electric utility here outside of Los Angeles municipal.  For most of Southern California, except for San Diego, they have their own utility. Southern California Edison hired Karl Riley to come and do a video, a 22-minute video explaining wiring errors and that is available from Less EMF, 22 minutes there. The EMF consultants from Edison give that video to their customers who call up for EMF information.

Dr. Weitz:            Both have a positive, a negative, and a ground, is that right?

Oram:                   Well, you’ve got the hot wire.

Dr. Weitz:            Okay, so the hot wire is where the electricity is.

Oram:                  You’ve got the hot wire, which is the black wire here.

Dr. Weitz:            Okay.

Oram:                  That’s the hot wire.

Dr. Weitz:            Right.

Oram:                  Here’s the neutral, and here’s the ground, so the hot wire carries current to the loads when you turn on a light, and then the current goes through the light and comes back on the neutral wire, which is the white wire here, and there shouldn’t be any current on the ground. That’s just for safety in case you have a short, the ground will trip the breaker.  So, basically you have a magnetic field which is a circle of energy invisible around the flow of electricity through a single wire, and if you have two wires where the current goes out from your breaker panel or from your light switch, and then up the wire in the wall, so it would be the black wire in here going up to the light, and then the neutral carries the current from the light back down again, which is right next to the hot wire.  The magnetic field around any wire goes clockwise if you look from behind, the right-hand rule. These arrows are actually backwards, but the point is that the current, when it’s present, causes a magnetic field in every wire, in every circuit, in every house. The reason why you don’t have magnetic fields in the room is because the magnetic field that goes clockwise around the black hot wire going one way is canceled by the magnetic field going counterclockwise around the neutral coming back the other way when they’re together and when the currents are equal.

Dr. Weitz:            That’s good. That’s what you want?

Oram:                   When they’re equal, yes. But if you have what’s called a wiring error where you have two circuits in this particular case here in what we call the junction box, and they’re separated the blacks are separated because there is a chance, depending on which leg you’re on, that if you turn them both on or turn them on, they’ll trip the breaker if the blacks are connected. Every electrician knows this, although occasionally we still see that happening.  But what’s very common in up to 50% of homes in Southern California and 30% of homes throughout the country is that they’ll gain these neutrals together under one wire lug, which is a violation of this particular code in the National Electric Code. But the code inspectors don’t look for this, because they don’t care about magnetic fields. The lights work and they’re more concerned with making sure that fires don’t occur from having too much current on a wire that’s not rated for the amperage that it carries.

I’m not disparaging code inspectors. When they learn about this, it’s in the code, it’s just that they’re so understaffed and overworked that they just don’t have the time. They don’t care. Nobody looks for these. Now, these new arc fault breakers are mandated to prevent tripping or they trip the breaker when there’s fraying of the insulation, and that’s a safety feature to prevent fire.  Those arc fault breakers, which are now code required in the last two cycles, so every three years they update the National Electric Code, so the last two cycles so six years or so that’s been in there. All the homes built in America in the last six, seven years, some circuits need that.

Now in the most recent edition a revision of the National Code from what I understand all circuits require this, and they’ll trip the first time the electrician turns on that circuit when they do the installation if there’s a wiring error. Now, in France, they’ve had these variations on that for 30-40 years so they don’t have wiring errors in their housing stock going back half a … Maybe 50 years.

Dr. Weitz:            If the wiring’s not done properly, if the white wires are connected together like that, then you won’t have this balancing of the current.

Oram:                   Right.

Dr. Weitz:            Then you’ll get excessive amounts of electrical field-

Oram:                   Magnetic field.

Dr. Weitz:            Magnetic fields.

Oram:                   In this case.

Dr. Weitz:            And so those can affect us.

Oram:                   Yeah.

Dr. Weitz:            Okay.

Oram:                   Right, all right. So, that’s an example of one type of EMF, the magnetic field in your home when certain lights are turned on. It can be lighting loads or it can be things you plug in.

Dr. Weitz:            Right.

Oram:                   So, wiring errors are one of the important four types of, four sources of magnetic field. Another source is current on water pipes, and that’s a little bit hard to explain, but it’s all on my website www.createhealthyhomes.com, homes is plural. If you go there and click on articles on EMFs, then you’ll see an introduction to EMFs that I wrote, and then four separate articles on each of these types of EMFs.  So, click on the magnetic field EMF article, and then I explained the four sources power lines, wiring errors, current on these water metal grounding paths like water pipes and TV cables coming in and out of the house, and the last is point sources like transformers and motors that have a big field close up when you measure with a Gauss meter, but as you move away from the field, from the source like the back of a refrigerator, it drops off exponentially.  Instead of linearly, it drops off quickly so 90% of the reduction is in the first one flow, and then the last 10% takes another two feet to drop away. So, you’re okay, distance is your friend. The shielding is very difficult and expensive, and it doesn’t work very well because the magnetic fields will creep around the edges. So, it’s better to just distance your-

Dr. Weitz:            I’ve even seen paint that’s supposed to be a shield.

Oram:                  The paint is not for magnetic fields. It’s for radio frequency fields.

Dr. Weitz:            Okay.

Oram:                  And electric fields, which we haven’t talked about yet, if you ground it. That basically covers magnetic fields. If there’s current on your water pipe, and I explained in the article how that happens.

Dr. Weitz:            And the water pipes in most of our homes are made of copper.

Oram:                  Yes, so that they conduct electricity, and they’re meant to as a path for lightning to get into the earth. Their code requires for that, and we don’t ever disrupt that but if we do put a piece of plastic in the water pipe, we’ll put an earth rod in this place.

Dr. Weitz:            Right.

Oram:                  The point is that water pipe doesn’t end like an earth rod does eight feet in the ground. That water pipe keeps going and then connects to a water main that every other house is connected to so your house is electrically connected to the grounding system, to every house of every neighboring house, and so current which … So, if 8 amps comes in on the two hot wires overhead or underground from the utility transformer, that’s the only way that the electricity comes in. But when electricity goes back, it will take all available paths not just the path of least resistance. It does that primarily, but not exclusively. So, if you give it parallel paths, then it will take all of them.  So, 85% will go back on the path it should, which is on the neutral wire of the overhead service drop cable, but that means that there’s 8 amps coming in and 7 amps going back, so there’s a 1 amp net difference. So, there’ll be a magnetic field coming down into your yard and up the side of the house from that cable, two hot wires coming in, one neutral wire going back and that comes into your house and maybe a bedroom there.

But what’s most important is there’s that 1 amp will go from there to the water pipe, which could be in the front of the house under your living room floor right here into your kitchen, and there’s a big magnetic field coming up through the floor 24/7. If you have a bedroom on the first floor, it’s under your bed and under where you sit because that’s the way that that extra 1 amp gets out.

Dr. Weitz:            What can you do about that?

Oram:                  Plumbers can put in a piece of plastic outside that they dig down, and in California where it’s warm, it never freezes, the pipes come out of the earth right in front of the house and then turn 90 degrees and go in and there’s a valve for a hose and a valve to shut our hose bib and then they have a valve to shut the water off there and a pressure regulator.  The plumber will cut a three inch section and put a piece of plastic in there, a plastic dielectric union or copper brass with a ring of plastic and rubber in it to block the flow of electricity, and that takes care of that magnetic field among the entire right through the middle of your house. Just one fell swoop you take care of it that way, few hundred dollars and the problem is solved.

We also have a cable isolation filter for $15 that I can put in to the TV cable that the sheeting of that can carry current. That’s another parallel path because they’re all grounded in the house and at the utility pole, so they’re all connected. The cable company grounds the sheathing of their incoming coaxial cable to the electrical system at the utility pole or underground. So, there are several ways that that can happen so we now have-

Dr. Weitz:            Is that the same thing if you have your internet through a high-speed cable from the phone company?

Oram:                  Yeah, telephone lines tend not to have this phenomenon.

Dr. Weitz:            Okay.

Oram:                  Overhead.

Dr. Weitz:            So, cable lines but not phones lines.

Oram:                  If they’re underground, sometimes they can but we check for it.

Dr. Weitz:            Okay.

Oram:                  Usually it’s … And it’s not always the case with cable, and it’s not always the case with water pipes either because in Southern California, the municipal water departments like Los Angeles Department of Water and Power, and et cetera, have been putting in little pieces of plastic, these dielectric unions, themselves for decades at least up until recently.  They did it for completely different reasons to stop the leaking because if you have current on your copper pipe, then that means that the coppers are at one potential, the salts of the earth are at a different potential, when we watered our lawns before the drought there was some moisture of the soil and electricity and different potentials it caused little pinhole leaks, electrolysis caused little pinhole leaks.  So, the water would leak out like a sieve and the water pressure was dropping all over the neighborhood over the decades. To stop that, they had to stop the current. They understood that. They had no concept of magnetic fields being an issue as well, but by doing that they stopped the magnetic fields. But they didn’t get to all the houses and then they stopped the program.

Dr. Weitz:            Right.

Oram:                  Their EMF expert told me that, at least for DWP. So, about half the neighborhoods that I go to in Los Angeles County have this and half don’t, so in those that don’t we have to put that in. You could have a broken neutral, which causes a big magnetic field from your power lines.  Power lines are difficult because we can’t shield against that. That’s the one thing we can’t do anything about, and also strong radio frequencies from cell towers if they’re close by it. We can shield against those but it’s very expensive.

Dr. Weitz:            There’s more and more cell phone towers especially as we go from 3G to 4G and now 5G?

Oram:                  Yes, that’s true. 5G is a whole another can of worms we’re moving into, and 5G is not 5 gigahertz by the way, which many of us already have. It’s one of the two Wi-Fi frequencies there’s 2.4 gigahertz and 5.8 gigahertz, so you’ll see 5G which is an abbreviation for 5.8 gigahertz on your router, 2.4 and 5G and that’s gigahertz. But what we’re talking about here is fifth generation.

Dr. Weitz:            Right.

Oram:                  So, every 8 to 10 years for the last 40 years or so, the cell phone industry has moved from voice originally, which was 1G, second generation added texting, third generation, which was 20 years later or so, added cellular data, fourth generation or 4G plus LTE is the last most recent changed 10 years ago, and that added data at a higher speed and greater volume than 3G and ramped that up considerably.  So, we’re at the point now where we’re heading towards the fifth generation and the difference there will be we are running out of bandwidth in the frequencies that are currently in use below 6 gigahertz, which is where the industry is now and all of our phones have transmitters and receivers in frequencies that are less than 6 gigahertz or 6,000 megahertz.  So, we’re at 800 megahertz, 900 megahertz, 1800, 1900, 700, and this is where industry would prefer to stay because those frequencies get through walls and and we all have equipment that can pick it up. But some of that frequency is held by the military for future use and the FCC knows it’s going to have to free that up for the industry to obtain it through auction, and that’s where they prefer to stay.

What they’ve been talking about is expanding to the super 6 gigahertz range, which is the millimeter band from 20 gigahertz and up, and we’re not using that now and the problem … Oh, except we do use it, satellites use those frequencies 20, 30, 40, 50, 80 gigahertz and the wavelength is so short it’s called the millimeter band, because one way there’s only like a quarter of an inch or a few millimeters.  The problem with that for use by cell companies is it doesn’t go through walls easily at all. You don’t even have to have special shielding material like the paint we talked about or foil, or certain fabric like margin mesh here, which is a silver fiber and I believe this is rayon, and this blocks radio frequencies maybe 80, 90% but 5G is blocked by any wood wall, any plywood, piece of plywood or asphalt shingles or bricks.

So, they have to aggregate and concentrate and focus the beam to drill through those materials and they’re going to exceed FCC limits to do that, but they’re going to get a waiver in order to do that. But beamforming means it’s going to be certain when you have these small cell antennas that you’re planning to put in neighborhoods every two to 10 houses at lower power than legacy macro cell towers, which exist now using for fourth generation and LTE technology, which is at 800 to 1,000 watts that’s what those cell towers out there send out, and your cell phone is at three-quarters to one watt.  So, these small cell antennas are going to be … We don’t know yet what the power is going to be and they’re going to still send out 4G frequencies, right … You’re going to have like a mini cell tower right outside your neighbors.

Dr. Weitz:            So we’re going to have a lot more of these.

Oram:                   Yes.

Dr. Weitz:            So, we’re going to get more exposure, unfortunately.

Oram:                   Yes, yes, unfortunately. But they’re going to add to it the gigahertz signals up in the gigahertz above 20 gigahertz range, and those are not going to go through the wall so they’re going to focus them and use beamforming, which means the antenna’s going to search. That’s what everyone’s worried about because those are the frequencies that they don’t penetrate the skin, but they affect the skin greatly. Those are the frequencies that we use.

Dr. Weitz:            Is there any way we can block this?

Oram:                  Yeah, yeah. Okay, so here’s the-

Dr. Weitz:            I mean, society wise do we have to go to 5G?

Oram:                  The reason-

Dr. Weitz:            Are we running out of frequencies? Is that what it is?

Oram:                  Well, we’re running on a bandwidth even though they have technologies that they’ve been working on for decades actually, but they’re perfecting to increase the amount of traffic in the existing frequencies we have in the sub-6 gigahertz range.

Dr. Weitz:            Right.

Oram:                  Fifth generation, 5G is going to include sub-6 gigahertz. All the frequencies we have now we’re going to keep. We’re not giving them up, and then they’re going to open up the 20 gigahertz and above so everyone’s focusing on this but this will still be there. However, there’ll be more data push through those pipelines and those channels, but the difference is we can measure those with the radio frequency meters that we have.  There are frequencies that we already can measure now and we can shield them easily with materials that we have. The 20 gigahertz and higher frequencies will not be blocked by cloth very well, but they will be blocked by YShield paint, which is currently in use now for sub-6 gigahertz frequencies that we currently use for cell towers, and foil that you can put in your walls.

Then there are transparent films for windows, there’s metal mesh window screen, and well as I said for the 20 gigahertz and above a millimeter band cloth will not help with that, but the film should. The windows are your big Achilles’ heel because they’re a hole in the wall, even if you put YShield paint on the outside or inside as a primer and then cover it with whatever color you want and it’s a non-toxic paint or foil if you’re building a house or remodeling it, you could put foil in and then put your Sheetrock over that. I have done that before.  That will block the frequencies coming through the wall even in the millimeter band, even with the beamforming and the aggregation that they’re going to do. But your window, you’ve got to be very careful with windows. These meters, by the way, can’t measure up in the millimeter band but there are two people I know of, Rob Metzinger, who is at Safe Living Technologies, and a gentleman here in Southern California are both working on a version of this, something like this that can pick up these millimeter band frequencies of 20 gigahertz and above.

They’re just waiting for the industry to zero in on certain frequencies and then they’ll tune their crystals and chips to those frequencies and it will be affordable. Now, Rob Metzinger at Safe Living Technologies just released this called a Safe and Sound, which is only $140, very accurate radio frequency device and this is almost $2,000. This is from Gigahertz Solutions and he sells it.  This is from Safe Living Technologies, but this is only … It’s a fraction of the cost and it has sound, that’s your router. You’ve a router in the house here because that sound, which sounds like a very fast helicopter, well tick-tick-tick tick-tick-tick, that’s the sound of a router. So, I know when I turn my meter on what a person has in their house. That’s the sound of a router. That’s the sound that a router makes. Then you have this little guide.

Dr. Weitz:            Well, this is actually connected by wire, but there is a router in the house for sure.

Oram:                  Yeah. So, you see here where we’re at in the orange and so that corresponds to 100 to 1,000 micro watts per meter squared. That’s how this works. You get a little guide here, and you could have without sound or with sound. That’s about 100 to 1,000, so let’s see. That’s exactly what we’re getting here about 140. Now, if I turn it just right, it’ll go blank and that’s over 200. So, we’re right in the ballpark, okay?

Dr. Weitz:            So, basically if you don’t understand what we’re talking about, that’s because our brains have been totally fried by the Wi-Fi electromagnet radiation.

Oram:                  Right. Now, this is the new TriField Meter. This is the old TriField Meter, the 100 XE, which many of you have. We don’t recommend this because it’s not as accurate. It’s not at all accurate as far as we’re concerned to get into levels that we consider to be safe in the electric or radio frequency band, and the magnetic field settings it tends to overstate the case.  That was the frequency weighted model, so they came out with a model that has little magnets in it to dampen that effect, and they called it the flat frequency response model, and it says flat frequency response on the back if you have one of those. This is not that one, or one of those, so you don’t see that here. If you called up Less EMF or went to Amazon online and just ask for a TriField Meter, this is what you would get, the frequency weighted one.

Dr. Weitz:            I know there’s … Yeah, go ahead.

Oram:                  So, what TriField did was they came out with a new one this year, 2018, the TF2 TriField 2, and it’s excellent. I love it. It’s very accurate. You have standard mode or weighted mode in terms of the frequency response. So, Ben, you have a good magnetic field level in this room, less than one milligauss is what we’re looking for and it’s hovering around 0.6 to 0.9 milligauss, occasionally flipping up to one.  You have sound, you can hear the … You can turn that off from the back here, now it’s quiet. So, that’s for magnetic field, and then electric field it’s much more accurate, and then you can … We don’t use, in my profession, the weighted mode for electric or magnetic, we go with standard because that is similar to the Digital Gauss meters that we use.

Then we have RF, and this is … You hear the ticking here, which is not the ticking of the router. This is different. This is just a Geiger counter. These other meters, this one from Safe Living Technologies is called Safe and Sound, and this one which is the Acousticom 2, which is the little brother of the Acoustimeter from Alasdair Phillips in England, EMFields.  They both have the real sound. These both have the real sound of the radio frequency source in the room. This one is just a Geiger counter for the level, but still I credit Alpha Labs with the TriField 2, for being much more sensitive and so we’re getting numbers that are very similar to the numbers that we get from these other meters, in the RF mode for Wi-Fi, cell phones and so on.

Dr. Weitz:            I’d like to use the rest of the time we have to focus on cell phone and Wi-Fi radiation, because I know that’s something a lot of us are concerned about and I’d like to see what we can do about making some recommendations for some of the best choices we can make, given the fact that we’re going to use cell phones and then cell phones do emit this radiation.

Oram:                  Okay.

Dr. Weitz:            I know it’d be better not to use cell phones, but that’s not going to happen, so I wonder if you can give specific recommendations. When I’m using a cell phone, first of all, what are the best things to do? Is it better to text rather than call? Is it better, if I’m calling, to hold the phone here? Is it better to have a plug, a wire connected into my ear with a little microphone? Can you make some of those recommendations for us?

Oram:                  Yes, and everything you just said is accurate, spot-on. The general recommendation that my profession makes, based on European research, is reduce use generally.

Dr. Weitz:            Meaning try not to use your cell phone at all, but that’s very hard to do.

Oram:                  Well, increase distance.

Dr. Weitz:            Okay.

Oram:                  And then use hardwired connections whenever possible. When you’re home, for instance, don’t give up your landline just to save money because you’re going to be penny wise and pound foolish, because in the end your risk of developing tumors goes up.

Dr. Weitz:            But you know with all due respect, nobody is using a landline.

Oram:                   I have clients who do.

Dr. Weitz:            Very few. I mean we have one, we never use it.

Oram:                   Right. Right, okay.

Dr. Weitz:            Then when we were, we had a wireless phone which is just as bad, right?

Oram:                   It is. It is just as bad.

Dr. Weitz:            Okay.

Oram:                   The effects are cumulative, and so here this is-

Dr. Weitz:            If I hold my phone and speak through the speaker option, is that significantly better than holding it here?

Oram:                   Yes, and the reason is because the transmitter is now here instead of here.

Dr. Weitz:            Okay.

Oram:                   So, when it’s here-

Dr. Weitz:            So, the signals are not going through my head.

Oram:                   When you use a cell phone, and I forgot to bring my … It’s in the car but …

Dr. Weitz:            Yeah.

Oram:                   When you use a cell phone, the cell phone is transmitted 360 degrees.

Dr. Weitz:            Right.

Oram:                   Now, there are shields, there are technologies, Pong and many, many different shields and that redirect the energy that’s helpful, and again, I have in the car a shield that opens up and then you can start your call, close it up, and if you hold it here, which I don’t recommend but it is shielded. It does reduce, but the level that it reduces down to even if it’s 80, 90%, it’s still way above what we recommend.

Dr. Weitz:            Is it better to have a headphone plugged in to it rather than use the speaker part?

Oram:                  With an air tube in the last six inches, yes.

Dr. Weitz:            The air tube? What’s an air tube?

Oram:                  Well, I’m sorry, it’s in the car. I forgot to bring it in, but it’s called an air tube earphone, so it’s wire from you plug it into the phone and it’s a wire with a little microphone in it.

Dr. Weitz:            Right.

Oram:                  Then it ends with a little speaker that goes up through a clear plastic tube, sometimes it’s blue, where the sound just goes through the tube to a little diaphragm that you put in your ear and they call it an air tube earphone.

Dr. Weitz:            Okay, so it’s different than the typical one.

Oram:                  Yeah. Oh, yes. You don’t get one of those with your cell phone.

Dr. Weitz:            Where do we get this?

Oram:                  Less EMF and a whole host of other companies that sell these that are EMF.

Dr. Weitz:            One more time, best way to talk on your cell phone is to use …

Oram:                  Well, the best way to talk on your cell phone is to hold the cell phone here because the transmitter, which sends out a signal 360 degrees is this far from your body, okay?

Dr. Weitz:            Right, and so let’s say you have … Is it better to use the speakerphone or better to use this wire thing?

Oram:                  Well, that’s your choice relative to privacy and the ability of the other person to hear your voice.

Dr. Weitz:            Well, let’s say in terms of just radiation, is it better … I can either use my speakerphone here or I can have a wire, what’s better?

Oram:                  It doesn’t matter that much.

Dr. Weitz:            Okay, so those are both going to decrease.

Oram:                  Well, it does because there is some coupling of the radiofrequency onto the wire, but it stops here.

Dr. Weitz:            Okay.

Oram:                  Now, of course, there can be some effect.

Dr. Weitz:            Okay. But the bottom line is don’t hold the phone up to your ear, okay. How about in the car, what’s the best way to speak on the phone in the car? If I plug it into my radio on my car …

Oram:                  Most people have Bluetooth where they sync up, so then-

Dr. Weitz:            Let’s say I don’t use … So, one choice is it just syncs up with the Wi-Fi or what if I plug a wire into my phone and plug that into the car sound system, does that change anything? Does that make it safer, better?

Oram:                  What, through the earphone? That won’t work, because the microphone and …

Dr. Weitz:            It doesn’t go directly into the sound system?

Oram:                  No, no.

Dr. Weitz:            Okay.

Oram:                  Not that I know of. Not for years. There was a technology in the past that allowed that to happen, and then we also had access to a jack for an external antenna that we put on the roof of the car, but they don’t have those anymore.

Dr. Weitz:            Okay.

Oram:                  These new phones are completely sealed. You can’t take the battery out.

Dr. Weitz:            Okay.

Oram:                  The new generation of phones, you have one port and that’s for … Well, you have your charging port, your lightning port if it’s an Apple or your USB.

Dr. Weitz:            So, is it worse talking in the car using the Bluetooth than it is speaking through the speaker of the phone?

Oram:                  You’re getting strong signals no matter what. There’s no way around that, Ben, in the car.

Dr. Weitz:            Okay.

Oram:                  Let me take two steps back and say-

Dr. Weitz:            Okay, let me just ask one more question and get to that. If I want to listen to music or a podcast like this one in my car, and I have downloaded it onto my phone already, I’ve gone to my computer, I downloaded it to my phone. So, now the podcast is on my phone. I’m not getting it from Wi-Fi, and I plug that into the sound system, so now the sound system is just taking that recorded podcast-

Oram:                  Through the speaker.

Dr. Weitz:            Through the speaker, is that-

Oram:                  Or through the earphone jack.

Dr. Weitz:            Right, is that safer than receiving it-

Oram:                  Yes.

Dr. Weitz:            Is it a safer way to do it?

Oram:                  Provided you put the phone in airplane mode.

Dr. Weitz:            Okay.

Oram:                  Because if you don’t put the phone in airplane mode, it’s still sending out a beacon signal every minute or so.

Dr. Weitz:            Okay. I see.

Oram:                  Especially when you’re traveling, because then you’re in the mode where-

Dr. Weitz:            So whenever possible, put your phone in airplane mode.

Oram:                  Yeah, but then you can’t get a call.

Dr. Weitz:            Okay.

Oram:                  Now, I say that because people need to understand when I go to a person’s home I’m there for six or eight hours, because I spend the first hour going over what we’re talking about now, what EMFs are, where they come from, how they affect your health, and what we do about them. Then the other six to seven hours is spent going through the house with the client to each room where the client and their family sit, sleep, and stand to measure magnetic fields, electric fields, radio frequencies, and dirty electricity.  Now, some people tell me, “I know all about EMF, so you can skip that part.” I said, “No, no. You need me to go over it with you, because I’m going to show you things that you haven’t heard before.” Nobody knows about electric fields, which we haven’t talked about yet, and electric fields are very important. You must get them down where you sleep, because otherwise you’re not going to get the deep stage four rest every 90 minutes, and you’re not going to get the melatonin you should have.

Dr. Weitz:            Right.

Oram:                   We have clients shutoff breakers, and then eventually do it automatically with a kill switch. So, I can explain that to people at createhealthyhomes.com. They can call me and email me through my website, and there are articles on that. That’s the missing link. There are a lot of people who have electrical hypersensitivity, who come to me who’ve done everything right from all the EMF websites that they’ve looked at.  They’ve got chips and pendants everywhere stuck on every device, and including your cell phone. They’re still using their cell phone, which I can’t even fathom if they’re electrically sensitive that they don’t have a hardwired. Some of them can’t use a cell phone, so they have to go to a hardwired line, and they think that they’ve gotten rid of all the radio frequencies in their house.  But if they don’t have one of these little meters, then they don’t know for sure and they plug in an ethernet cable to their laptop and their router and say, “I’m hardwired.” I say, “Yeah, but you didn’t … Did you shut off the Wi-Fi?” They said, “No, it happens automatically, doesn’t it?” I said, “Let me show you,” and then I turn this on and then we get that and they say, “What’s that? I have an ethernet cable.” I say, “You didn’t turn off the Wi-Fi.” “I didn’t know I had to.” This is the dialogue I have with my clients, so they don’t know.

Dr. Weitz:            Right.

Oram:                  Or they have a Nest thermostat that sends out a signal every five seconds, or they have … Not just a smart meter. There’s so many things inside the home that are filled with radio frequencies now. We’re in the Internet of Things, the era of the IoT, the Internet of Things. So, there’s Wi-Fi and Bluetooth coming out of everything now.

Dr. Weitz:            Especially now you have the device like the Echo.

Oram:                  Yeah, yeah those smart speakers.

Dr. Weitz:            Yeah.

Oram:                   They’re constantly emitting Wi-Fi. Your Bluetooth, your router, your cordless telephone, when you hang up the phone and that base unit that’s in the kitchen or God forbid, next to you on the bedside table that has the cord that goes to the phone. That thing is emitting radio frequencies 24/7 like an ashtray full of burning cigarettes.  I’ve showed people where the cigarettes are. Now, people say, “Well, I have a chip. I have a pendant. I have a Home Harmonizer. I’m good. I have this round thing.” I don’t mean to cast aspersion on any of these manufacturers. There is evidence, and I believe it, I’m one of the few in my profession, because the other guys are engineers they poo-poo all those things, which is unfortunate because they do work. They do help people, by a technology we don’t understand, but-

Dr. Weitz:            They just don’t help us as much as we-

Oram:                   Well, that’s our opinion in the building biology profession. Here’s why, because it’s like someone having four ashtrays with burning that cigarettes filling the room with smoke who then brings a person in who says, “I have an air purifier that will clear the room of smoke.” It does, but the ashtrays are still producing the smoke.  So, we say let’s find the ashtrays and get rid of them, at least the ones you have control over in your house, and if necessary shield the ones the frequencies coming in from outside not power lines. We can’t shield the magnetic fields, they’re too vast but the radio frequencies, we can. So, depending on how sensitive the client is, we can do that.  But they still have stuff inside their house, or they can’t get their family to give them some safe space. I always work with family members to get them to understand what this person who brings me in needs for them to be more comfortable and healthy.  What we do is we educate people and say if you want to best help yourself, reduce these sources and find hardwired alternatives and learn how to disable the Wi-Fi on your laptop there and your cell phone and switch over to corded telephone, why hard lines ethernet cables and telephone lines, and then you can still use the chips and pendants. We’re not opposed to those.

Dr. Weitz:            Right.

Oram:                   But we don’t recommend them as the sole way of protecting yourself.

Dr. Weitz:            They’re beneficial, but they’re not really fully protecting you. They’re helping a little bit, but you need to do a lot more.

Oram:                   Right. So, in Europe, France has voted to ban Wi-Fi in day care centers and nurseries for children under three, two years ago, and now they’ve completely banned cell phones in all schools up to the middle level and it’s voluntary in the senior level as of this year, this month.  In England, the benign tumors went down over the last 20 years, aggressive tumors went up on the side where the cell phone is used. They balance each other out so all that gets reported is tumors are unchanged in England. That’s what gets reported. You can’t win.

In 2015, in Brussels, electrical hypersensitivity and multiple chemical sensitivity is being declared in a scientific declaration, they care about that sort of thing. This was in the Nation magazine last March, “How Big Wireless Made Us Think That Cell Phones Are Safe: A Special Investigation by two investigative reporters. It’s been a year. Great, great article and follow-up interviews on Democracy Now, and so on. That’s on my website, createhealthyhomes.com.

Scientists warn a potential serious health effects from 5G, fifth generation cell technology, over 200 scientists. Here, we have the FCC which says on page 67 of this bulletin from 1997, “Evaluating compliance with FCC guidance for human exposure to radiofrequency electromagnetic fields,” and they say one milligauss excuse me, one milliwatt per square centimeter is safe.  But if you look at the table here, the one milliwatt per square centimeter, which is a thousandth of a watt striking a half inch by a half inch, so that’s a square centimeter, is equivalent to 10 million micro watts, which is a millionth of a watt per square meter, which is three feet by three feet. That’s the unit of measurement that Europe uses, and therefore, the unit of measurement here is micro watts per meter square because this is a German meter from Gigahertz Solutions.  So, the international … This is Powerwatch Alasdair Philips website from EMFields who makes the Acousticom 2 and the Acoustimeter, and he says here if you have a link in my RF radio frequency article, he has a table here that shows the FCC at the top, and look at all these other countries that are lower than that in terms of recommended levels, going all the way down to 100 micro watts, not 10 million like the FCC. But all these other countries Belgium, Italy, Russia, China, Switzerland, that consume they’re all 10, 100, 1,000 times lower.  My profession is way down here, six orders of magnitude less. Then it went from 10,000 down to 1,000, I’m sorry to 10 in four years, because more and more research came out showing that there was evidence of harm and that was included here in the Parliamentary Assembly of the Council of Europe. This is seven years ago, potential dangers have left magnetic fields and their effect on the environment. This would be like the FCC in America saying, “Take precautions.” I won’t take the time to go over this, but this is a stunning document, and in every newspaper in-

Dr. Weitz:            That’s not really surprising that these European countries are more proactive on this. On many health issues, they’re more proactive. A lot of these countries have already banned-

Oram:                   GMOs.

Dr. Weitz:            GMOs, require labeling, and we don’t even require labeling.

Oram:                  Every newspaper in every capital in Europe carried an article about this, this Parliamentary Assembly of the Council of Europe in 2011, not a word in the United States.

Dr. Weitz:            Isn’t it the case that even though none of us read our cell phone contracts when you get your cell phone, there’s actually specific warnings?

Oram:                  I had a little booth at the Vitamin Barn in Malibu, and this guy came by and I told him this sort of … He said, “I’m a producer and I live here in Los Angeles and New York. I have a friend who’s a producer who was hired by one of the big cell phone companies based in Europe to film seven TV commercials for the European market, and they said, ‘Your models have to hold the cell phones at arm’s length. You cannot show any model with the cell phone next to the head.’  He said, ‘Okay, I’ll follow that instruction, but I’m just curious, why did your company have you tell me that?’ The guy said right now flat out, ‘Because they cause cancer.'” These companies know this. They know this, and so-

Dr. Weitz:            Doesn’t it even say on your contract that the cell phone company cannot be held liable?

Oram:                  Right, because insurance companies will not write insurance for cell companies.

Dr. Weitz:            Right.

Oram:                  They’re in for a big train wreck, a big collision down the road but they’re all … They have money set aside. If you listen to George Carlo, he was a keynote speaker at our conference 10 years ago this year, and back then he already knew about this. Because he was the one, and this is saying that Nation magazine article from last March, they interviewed him extensively. Also, I forgot to mention the documentary Generation Zapped, go to generationzapped.com and you’ll see a link that you can download it.

Dr. Weitz:            Is it now available?

Oram:                  Yes, and also at the top of my homepage at createhealthyhomes.com, I have links to, you can get the DVD, iTunes, Vimeo, Apple, or Google Play. It’s all available there for streaming or purchase, and it’s a hour and a half documentary. I’m one of the contributors to it. I gave the …  She’s a client of mine, Sabine El Gemayel, and four years ago she said, “I know we can do better,” not that there was anything wrong with the documentaries that were out at that time but she said, “I’m a Hollywood documentary filmmaker, we need a Hollywood quality film on this topic, but I don’t know who to interview, and I don’t have the money for it.”  So, she crowdsourced it for the next four years or three years and released it a year ago in beta, and I gave her the names of all the people she needed to contact within the industry. Then she contacted them, flew all over the world, and they gave her more names. So, those are the people, she has the top people in this field in that documentary, Generation Zapped.  It came out, and they had screenings all last year, and she was trying to get a distributor and ended up doing it herself. So, it’s now out as of July, as of two months ago. It’s really a game changer, that and this article in the Nation magazine last March.

So, the word is getting out, and with fifth generation cell technology where they’re going to blanket both outside the home and inside the home with more and more radio transmitters that the industry just completely thinks is safe because that’s what they’re told. That’s what they’re told by their own scientists and by the FCC that there is no evidence of any harm.  It’s all swept under the carpet, but it’s front and center as far as Europe that there are at least a dozen countries that have banned Wi-Fi or are in the process of banning Wi-Fi in public places, in schools, hospitals, and libraries. France, Germany, Switzerland, Austria, Ireland, Italy, India, Russia, Australia, China, they’re all contemplating this or have done it.

So, what do they know that we don’t know? What evidence are they seeing that we don’t see? For one thing, they don’t have the same campaign finance laws that we have, where the lobbyists provide money and all of our Congress people need a lot of money to get reelected. In these other countries, elections are quick, they’re all publicly funded, and industry does not have a toehold or foothold in that process.  They all have government-funded health care delivery systems, so there’s no profit motive. So, if they see something, this is the fourth or fifth health crisis in 60 years, the first being asbestos, tobacco, and lead in gasoline, and then the next one was GMOs, and now this, and they’re looking at what happened.  They know what happened in the past, and they’re already seeing an uptick in disease in people who are of childbearing age and so on using these technologies and having many symptoms including not being able to hold a job. That’s a serious problem, and they expect some Alzheimer’s and dementia to develop in midlife in some of these people who use these wireless devices exclusively.

Dr. Weitz:            Wow, that’s amazing information or we could talk for hours about this, but thank you so much for what you’ve provided for our audience.

Oram:                   You’re welcome.

Dr. Weitz:            I know you mentioned your website several times.

Oram:                   Www.createhealthyhomes, with an S, dot com, all one word.

Dr. Weitz:            Right, and for anybody who lives in the Los Angeles area, you’re available to come out and do it.

Oram:                  Throughout Southern California, Santa Barbara to San Diego, and then I get a lot of calls and emails from people outside of this area, I occasionally will travel and I have been brought to other places. I do a lot of work over the phone. I have people have a building biologist come to their home, if they have one in their area and we just finished a training program. We do this once a year and I help teach it last week in New Mexico where we gather together and train 20 to 30 students every year in the beginning entry level.

Then every other year, we have the advanced next coming up later this year, a training program to make more of us so that we have people all over the country in Canada to do this work. If there’s nobody nearby, then my clients can … They’ll get meters and then they’ll take readings on their own, and I’ll guide them. They’ll give you the data and then they know how to use the meters, which is helpful.

Dr. Weitz:            Right. Thank you, Oram.

Oram:                  Okay, you’re welcome.

Dr. Weitz:            Talk to you soon.

Oram:                  Thank you.

Insulin Resistance with Dr. Ritamarie Loscalzo: Rational Wellness Podcast 74

Dr. Ritamarie Loscalzo talks about insulin resistance with Dr. Ben Weitz. 

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


Podcast Highlights

0:53   The topic of this episode is insulin resistance. When you ingest sugar or carbohydrates, this raises your blood sugar levels. The body reacts to elevated blood sugar by having the pancreas secrete insulin, which signals the muscle cells to take in the sugar, thus lowering blood sugar levels. High glucose levels are inflammatory in the blood stream. If you regularly consume sugar and high glycemic carbs (carbs that cause a large spike in blood sugar levels) and thus your pancreas is secreting a lot of insulin, the cells will become resistant to insulin, which we refer to as insulin resistance. This requires the pancreas to secrete more insulin to have the same blood sugar lowering effect. Eventually, the pancreas will burn out and not be able to produce ever increasing amounts of insulin, which is what we diagnose as type II diabetes.

3:00  Dr. Loscalzo explained that as her chiropractic practice was developing, she realized that some of her patients had blood sugar dysregulation.  She had her patients buy glucose meters and test their own blood sugar every 15 minutes after a meal and they found out that they were having blood sugar and insulin problems. She feels that when you eat, your blood sugar should go up, but not to more than 110.  But many of her patients were on high carb diets, even though some of them were eating whole wheat bread and brown rice, and their blood sugar would peak at 140 or 170. Dr. Loscalzo had one client who was putting raisins on her salad, who’s blood sugar would go up to 220 after eating that. She feels that ideally after a meal, the blood sugar should not go up to more than 110 at the peak, which is usually 45 minutes to an hour after the meal. This patient may have normal fasting sugar levels, even though their sugar level after a meal shoots up too high. She finds that insulin levels will start to rise before fasting blood sugar levels go up, which is an early sign of blood sugar problems.  Insulin damages blood vessels, so Dr. Loscalzo likes to test levels of insulin and Hemoglobin A1c, which will go up before fasting blood sugar levels go up.

7:21  Dr. Loscalzo said that rather than ask her patients to do a standard glucose challenge test by going to a lab and getting their blood sugar tested and then having them drink a 100 gm of glucose and then get their blood drawn every 30 minutes for six hours, she has them do a home version of this test. She has them purchase a home glucose meter to test their glucose and then eat their highest carb meal and then monitor their blood sugar after regularly for 5 or 6 hours. Some patients discover that their blood sugar drops 20 points or so below their normal fasting level, which indicates hyperinsulinemia.

10:17  Stress causes cortisol to rise, which raises blood sugar levels for your muscles to use.  Our stress response is to help us run away from a lion on the savannah, so a spike in sugar provides fuel for our muscles.  If you were going to be running away from a lion, we would burn that glucose, but if you’re sitting at your desk and worrying about the stock market or about your kids grades, then it’s raising your blood sugar, your blood pressure, your heart rate, your breathing rate and it’s happening consistently day after day, hour after hour, this has negative impacts on our health and results in insulin resistance and heart disease. Dr. Loscalzo likes to use a target fasting glucose level of 75-85 with 75 being ideal. For hemoglobin A1c, she likes to see it a bit below 5, because at 4.5-4.8 it means your average glucose is in the 80s. At 5 it means your average glucose is in the 90s. At 5.6, where MDs consider it normal, it means your average glucose is around 117, which is way too high. 

16:26  Dr. Loscalzo prefers her clients with pre-diabetes or diabetes to be on a whole foods, plant based diet that is rich in plant based fats, like avocados, olives, nuts, seeds, and coconut.  They should be consuming a lot of fiber. She personally is vegetarian, but she is ok with a small amount of organic, grassfed meat. But 75% of your plate should be vegetables. She pointed out that a cup of spinach has 5 grams of protein and she advocates eating 10 cups of green leafy vegetables per day. As far as legumes, they don’t work for some people, but she has her clients test them out and see if they raise their sugar levels too high.

20:33  The negative effects of high blood sugar and insulin resistance include peripheral neuropathy, which is damage to the peripheral nerves.  Dr. Loscalzo said that studies show that when blood sugar goes above 120, you start to damage those nerves. The nerves get glycosylated, they essentially get a sugar coating and they can function. You get retinopathy, which is one of the leading causes of blindness in the US. The endothelium of the blood vessel walls become thickened and damaged and less elastic.

21:58  Dr. Loscalzo doesn’t like the idea of patients eating every 2 to 3 hours to balance their blood sugar and thinks that this is the worst advice anybody could give. She recommends going at least 4 hours between meals, preferably 6 hours. She likes them fasting overnight for at least 12 hours and preferably 16 hours.  Healing happens during fasting and not feeding.  She is a big fan of water only fasting.

25:58  Rita-Marie likes using certain supplements to help her patients combat insulin resistance, including chromium, magnesium, and omega 3s, esp. DHA, which she calls her craving crusher supplements. She also has used cinnamon, berberine, olive leaf extract, and lipoic acid.

28:43  Exercise is also very important for balancing blood sugar and Dr. Loscalzo likes burst training, where you do some exercise very intensely for 30 seconds. Some weight training is also helpful to increase your muscle mass and trained muscles are more resistant to insulin resistance than untrained muscle.

30:15  Sleep is important, since a ton of studies show that even one night of bad sleep in an otherwise healthy person will induce a temporary insulin resistance.

30:34 For stress reduction Dr. Loscalzo likes meditation using a device called The Muse, which measure your brain waves. She also likes Heart Math, which is this breathing appreciation combo that you do throughout the day for 30 seconds at a time.




Dr. Ritamarie Loscalzo is Dr. Ritamarie is a licensed Doctor of Chiropractic and the founder of the Institute of Nutritional Endocrinology. She can be contacted through her website http://www.drritamarie.com/ where she offers online courses, including her program for blood sugar balancing, The Sweet Spot Solution as well as a program for health care practitioners on helping patients to improve insulin resistance, Insulin Resistance Solution Practitioner Training.

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

Podcast Transcripts

Dr. Weitz:                            This is Dr. Ben Weitz with The Rational Wellness Podcast bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field.  Please subscribe to The Rational Wellness Podcast at iTunes and YouTube. And sign up for my free e-book on my website by going to drweitz.com. Let’s get started on your road to better health.  Hello, Rational Wellness podcasters. Dr. Ben Weitz here. Thank you so much for joining me again today. For those of you who enjoy the Rational Wellness Podcast, please go to iTunes and leave us a ratings and reviews so more people can find out about the Rational Wellness Podcast.

Our topic for today is insulin resistance. When you ingest sugar or carbohydrate foods that are turned into sugar in your body, your pancreas secretes insulin, which is a hormone that stimulates the muscle cells and liver to take in the sugar. The body doesn’t like having high sugar levels. And as the cells take in the sugar, that lowers the sugar levels in the bloodstream. And if you regularly consume a lot of sugar and carbohydrates that cause your blood sugar to spike, what we call high-glycemic carbohydrates, over time, your cells will become resistant or less sensitive to insulin. This is what we refer to as insulin resistance. And this will slowly become more severe. And this is the process that eventually leads to type 2 diabetes.

Today we have Dr. Ritamarie Loscalzo who’s a licensed doctor of chiropractic and the founder of The Institute of Nutritional Endocrinology. She specializes in using the wisdom of nature to restore balance to hormones with a special emphasis on thyroid, adrenal, and insulin imbalances. She’s a best-selling offer. Her latest book is Unstoppable Health. She’s a speaker and internationally recognized nutrition and women’s health authority with over 25 years clinical experience. Dr. Ritamarie, thank you so much for joining me today.

Dr. Loscalzo:                       Thank you so much. I’m very excited to be here. This is one of my favorite topics to talk about, so.

Dr. Weitz:                            Good. So how did you, personally, become interested in insulin resistance as an area of focus for your practice?

Dr. Loscalzo:                       Well, it just kind of found me. It’s like I started practicing back in back in, I don’t know, 19 whatever it was ’92, when functional medicine wasn’t as well known as it is now, and nutrition. And there’s wasn’t an internet. And there weren’t summits. And there weren’t podcasts. And there wasn’t any of this. So I started out. And I just started out getting people in, and some people came to see me because they had back pain. But I would quickly educate them to what their various aches, and pains, and other things … you know, you do a comprehensive health history, find out they don’t just have back pain, they have irritable bowel, and fatigue, and brain fog, and all this. And so as I worked with people more, I just used the common logic of knowing how the body works and what it could be going on that’s causing their symptoms because we’re all about root cause, not about, “Well, what herb is good to treat this symptom?” Or “What nutrient treats that symptom?” It’s more about going to the underlying cause.

And the more and more I found it, I just got that these people had blood sugar dysregulation. It wasn’t at the point where it could be clinically diagnosed yet as insulin resistance. So I started to actually have them buy glucose meters and test their own blood sugar because I suspected that even though they’re fasting glucose was low, that they were having big spikes based on what they were telling me the were eating and based on other things in their life. And so I just started doing that, and watching, and going, “Oh, my gosh.” And I had the, what’s the word? It’s not ammunition. I had the influence of being able to have these numbers and say to them, “Hey, you don’t have diabetes. You don’t even have clinically diagnosable insulin resistance. But you have something that comes before that that is eating away at your body for 30 years before all those complications of that stuff comes up. Would you like to address that?” And they’re like, “Well, I’m looking at these numbers, and yeah.”

So I just started, more and more, doing it with a clinical practice and seeing great results. Like when people shifted and they kept their blood sugars in a manageable level, I personally think their highest peak of blood sugar, the 45 minutes to an hour after you eat where the blood sugar actually peaks before the insulin brings it back down, should not be any more than 110. And most people who were on these high carb diets, typical, even the ones that are educated and just doing whole wheat bread, and brown rice, and all this, were actually having these peaks that were 140, 150, 170. And even one lady who put raisins no her salad. She’d been eating her salad and she’d been testing and everything looked good. She put raisins on her salad and her sugar shot up to 220.

And then they started telling me that when they found their blood sugar is the highest is when they felt like they had low blood sugar. You know, people will say, “I’m hypoglycemic. I can’t go more than two hours.” What I was finding was in any of those, their blood sugar was actually high, not low. So this just got me into really doing the research. And the more I thought about it and looked back, I really felt like this was the straw that broke the camel’s back, so to speak, for my parents who died very young of heart disease. That the heart and the vessel stuff was happening for decades before they even realized it, and they actually died of heart attacks before it was even clinically recognizable.

Dr. Weitz:                            Why is it important to focus on insulin resistance rather than just looking at blood sugar levels?

Dr. Loscalzo:                       Yeah. So the typical way that they test is, right, fasting blood sugar. That’s actually the last thing to shift. It’s usually … there’s a lot of other signs beforehand that there’s something problematic. And insulin actually goes up … I actually look at it as a spectrum. And I think high insulin is actually the very first step. It’s like, but most people are adapting to it. And there they go. The insulin works, and it brings it down, and it brings it down. But those high levels of insulin are what’s causing problems. And insulin damages blood vessels. Insulin causes restriction of arterials. Insulin causes all kind of damage in the body that nobody’s seeing or attributing to it. So I think testing insulin levels early on, not waiting for somebody to be diabetic to see what their … or to see if their pancreas is failing. But no. Check it real early on to see if they’re over-producing.  So that and hemoglobin A1C, I think, should be routine blood work that’s done on people with any kind of history, with any kind of brain fog, fatigue, belly fat, all those sorts of symptoms that indicate that there’s probably a blood sugar imbalance going on. They should be tested for insulin and hemoglobin A1C because those are going to shift way before the fasting glucose does.

Dr. Weitz:                            Do you do a glucose challenge test or an insulin challenge test?

Dr. Loscalzo:                       What I do is I teach people how to measure their own glucose. And I have them do a kind of a variation of a glucose tolerance test, but at home. I dare not send these folks off to a lab to be taking 100 gram solution of pure sugar and watch them feel miserable for the next couple of days, and flair up, and whatever else. Because most of them are educated, and then you been bringing you down. So I have them do it at home. And I have them get their own glucose meter. And they measure. They measure their fasting right before their meal. And then they measure every 15 minutes to catch the spot, the peak, so we know when they catch the peak. Because some people peak at a half an hour, some people 45 minutes, some people an hour, some people an hour and a half. So it does vary, although the average is somewhere around 45 minutes.

So I help them to figure out what their peak is. So when we’re doing this challenge, I just have them eat a meal that’s the highest carbohydrate meal that they would typically eat. So for some people, that might be popcorn and orange juice. Right? For other people it might be toast and orange juice. For other people it might be a piece of pizza. For other people it might be a salad with a bunch of raisins on it. Right? So wherever they are in their evolution of diet, I want to see how their diet is impacting them so they can clean up their own diet. And so we have them do this challenge over the course of six hours, and we’re measuring it. The one meal over the course of six hours to see where did they peak, how high did they go, and how low did they go. Now, do they just go back down to baseline and stay steady out to five or six hours? Or do they drop down below 20 points or so, indicating that the hyperinsulinenemia probably caused a hypoglycemia.

So that’s how I do it. And I teach people to do it at home. And people love the fact that they can do it at home, and they don’t have to go sit in a doctor’s office, spend several hundred dollars, or fight the insurance company to get it paid for, feel miserable. Like I did a glucose tolerance test, and I got cold, and I got shaky, and my blood sugar went down real low. And I was like, “Oh, I don’t want to put people through that. I can tell if they have a problem, and they need to know that they have a problem.”

But further, I teach them how to do that kind of testing on an ongoing basis. Not with a challenge meal, but more with their own meals. And they go, “Wow. I had this salad today and it just was this beautiful salad with all kinds of veggies, and coconut, and whatever else, and my sugar stayed nice and steady.” And, “Oh, today I had that with a bowl of brown rice, and my sugar shot up.” So I try to teach them how to identify the foods in their diet that are causing them to go up.  But it’s more than food, too. So, as you know, it’s a lot more than food. It’s the food, but it’s also the stress, the kind of exercise they’re doing, how much sleep they’re having. So I have them map all these things out. And it empowers them to know what behaviors they’re doing that’s throwing their blood sugar out of balance.

Dr. Weitz:                            Can you explain how stress impacts blood sugar?

Dr. Loscalzo:                       Sure. While stress causes an increase in a hormone called cortisol. Cortisol’s job is to help you get away from those tigers, and the lions, and anything else physical that’s chasing you that’s creating this fear. And in order to do that, you need to use your muscles. You need to be able to fight, and run, and jump, and all that. And it basically breaks down stored glucose into blood sugar so that you can use that to get away from tigers. So that’s how it impacts it. And when you do this once in a while to get away from a tiger, no big deal. Right? Because you’re actually running, and you’re burning that sugar.  But if you’re sitting at your desk, like worrying about the stock market, or your kids grades, or your aging parents, and you’re getting all stressed out, that same cortisol response is happening. And in addition to raising your blood sugar, it’s raising your blood pressure, it’s constricting your heart, it’s increasing the rate of your heart, and it’s increasing your breathing. So if that happens once in a while like in the olden days of tigers chasing us, didn’t matter. Right? But if it’s happening consistently, day after day, hour after hour, those levels just, they stay high and they create an insulin resistance.

Dr. Weitz:                            What kind of target level do you shoot for for fasting glucose and also hemoglobin A1C-

Dr. Loscalzo:                       Great question.

Dr. Weitz:                            … that are ideal?

Dr. Loscalzo:                       I consider ideal, I like 75 to 85 as the range. I really like to see it at the 75 because I think that that’s a healthier long term. But it’s different from person to person and all. For hemoglobin A1C, I like to see it at 5. 5 or a little bit below 5 because at 4.5, 4.8, it means your average glucose is in the 80s. At 5 it means your average glucose is in the 90s, which accounts for the after the eating and then the all night fast, which is a good level. But at 5.6, where the medical puts it, that means your average glucose is around a 117. That’s not good. That’s way too high.

Dr. Weitz:                            From testing a bunch of people, do you see a lot of people under 5?  I don’t think it’s that common.

Dr. Loscalzo:                       It’s not that common. But I do see after they’ve gone through the program I see them get down to 5.2, 5.1, 5, 4.8. Now, if it’s below 5 and they have not followed the diet, then I’m suspicious that what’s happening is a lot of periods of hypoglycemia. And I’m suspicious of hyperinsulinenemia. So I’m also testing their insulin. Because what will happen is that they may be waking up in the morning with 75, 80 as their fasting glucose. And then they’ll eat a meal and it goes up.  Maybe it goes up to 180, and then it drops back down to 50. And then they get the shaky and irritable and all that. So I’m a little suspicious if somebody comes in off the street without having been through the education and the program with that 4.8 to 5. I’m suspicious that they’ve got this other situation going on, and I check for it. But after they’ve been on the program?  Yeah, they’re good.

Dr. Weitz:                            Now, what about target ranges when you’re dealing, say, with type 2 diabetic who’s on, say, oral medication?  And maybe you could address the same issue with a type 1 diabetic.

Dr. Loscalzo:                       Yeah. So you can’t really create a target range. You have to see where they’re at, right?  So they’re on the medication and they’re maintaining at this.  With a type 2 diabetic, if they go on and they change their diet like we recommend, then what you see is that it starts to drop.  And if they’re on medication, then I’m much more careful.  If it drops below 80, I’m careful because they can overshoot because they’re on medication, especially if they’re on insulin.  So I’m more likely to want to keep that fasting 80 or above. And the after meal, well, as low as they can get it. Right? Because if they’re at a fasting glucose of 120, and they’re diagnosed, and then they’re put on medication, and they get it down to 90, then it’s harder to keep them in that range of 90 to 110.

So it may be higher. But we’re always looking at like what does this meal or this activity do to your sugar levels? Does it raise it more than 25 points? It’s probably something to consider that you don’t want to be having something that’s raising you more than 25 points. So whereas I try to keep my regular people that are new to the program and I’m just working with below 110. With a diabetic I’m telling them, “I want you to watch your meals, and anything that causes your sugar to go up more than 25 points after that meal, it’s in the suspect column.” And we write lists. Right? Good stuff, absolutely bad, and then the suspicious ones in the middle. So that’s how I do it with them.

With a type 1 diabetic, much more careful. But with a type 1 diabetic, the chance of getting them completely off of insulin is probably slim unless they’re very young. If they’ve been type 1 and on insulin for many years, there’s a lot of damage done and you probably won’t. But I also do, with them, because they’re on insulin, much more careful about the low. Right? And so I’m watching that really carefully, that they don’t go too low. But we can control it and we can control the amount of insulin.  And the goal with a type 1 diabetic is to get them down to the minimum amount of insulin possible because insulin has its downsides. Insulin causes weight gain, although, in type 1, it generally doesn’t because they’re not making any of their own.  But it also, like I said, stiffens those arterial walls and creates a breeding ground for cardiovascular and stroke.  So I’m real careful with type 1s, but I’ve seen that it goes way down.  Type 1s, they need the exercise.  And they need consistency because they’re on insulin. Right?  So consistency in exercise, and daily rigorous exercise is important. And if they miss a couple of days, they’re going to need more insulin. Right? So it’s good information to take back to type 2s or pre-insulin resistance folks as well.

Dr. Weitz:                            So what kind of dietary regimen do you find to be most effective for patients either with pre-diabetes or diabetes, for managing their blood sugar?

Dr. Loscalzo:                       Well, it depends on the person. But I find that a whole foods diet is mandatory. So no processed food. I find that a lower carb, for most people. And I, personally, find that the best results I get for myself and for others is a whole foods, plant-based diet that is good and rich in whole food fats, whole food fat, plant-based fat. So yeah. If they want to do meat or chicken or whatever, it’s a small amount of their diet. And the majority is vegetables and plant-based fats like avocados, and olives, and nuts, and seeds, and coconut, and I said avocado. I’ll say it twice because it’s my favorite.  So those sorts of things are super important. And a lot of green leafy vegetables, and a lot of vegetables. The fiber tends to slow down the absorption of sugar. And if they are going to eat fruits, then I have them do it with a big plate of greens or with a green smoothie where they’re having a bit of fruit, a bunch of the greens, and then a couple of bites of fruit. And I find that people who on like a mango by itself will shoot their sugar through the roof. When they do it with this bed of greens, it slows it down enough that they can deal with it and not raise their glucose too much.

Dr. Weitz:                            So when you say plant-based diet, people usually think of vegetarian. But you’re talking about a plant-based diet with meat?

Dr. Loscalzo:                       Well, it depends on the person. Personally, I don’t do meat. Haven’t done it for 35 years.

Dr. Weitz:                            Oh, okay.

Dr. Loscalzo:                       But some people do a small amount of organic, grass-fed, et cetera. But when I say plant-based, I mean plant strong, the majority of the diet. Like 75% of your plate should be vegetables. Right? And that’s where I get the most results. And then on top of that, there’s the whatever, the nuts, the seeds, the avocado, all of the … the whole food fats. I’m not a big fan of oil. I just don’t think it’s a good food. It’s kind of empty calories, and it’s kind of filler. And some people need it because they have high metabolic rate, and they’re real thin, and you have to give them something that they can not take up too much room in their stomach that they can tolerate. But yeah, that’s how I work it.

Dr. Weitz:                            And how do you get your protein as a vegetarian?

Dr. Loscalzo:                       From my foods. From all my foods. Right? I mean, spinach. A cup of spinach has about 5 grams of protein. And that’s just representative of any green leafy vegetable. I probably eat 10 cups of green leafy vegetables in the course of a day. That’s 50 grams of protein. Now you add that hemp seeds, and pumpkin seeds, and chia seeds, and all the seeds, which have a little bit more protein per calorie, well, not even per calorie. I think there’s more protein per calorie in the greens. But more protein per unit that you’re willing to eat. Yeah. That’s where it comes from. Right? The protein is, it’s just this crazy myth that people don’t get enough protein. People don’t absorb their protein. That’s more of a problem. Low stomach acid and digestive incapability, that they can’t actually absorb their protein, and so they require higher amounts. And so they move to meats or fish or whatever.

Dr. Weitz:                            Do you recommend eating legumes?

Dr. Loscalzo:                       Depends on the person. Like they don’t work for me. They work for some people. I think if you’re going to do them, they’re better off that you soak them really well. Maybe start to germinate or sprout them and then lightly cook them. And mix them with tons of vegetables. So yeah. Yeah. I mean, it depends on the person. That’s why we do the testing. Some people try the legumes, and some people, it shoots their sugars up too high.

Dr. Weitz:                            And then, so people with gut problems with legumes, it-

Dr. Loscalzo:                       Exactly. Exactly. It could be lectin sensitivity. There’s a lot of things, leaky gut, that would create problems with that. And they get gas and bloating.

Dr. Weitz:                            Can you talk about what is some of the negative affects of having high blood sugar insulin resistance?

Dr. Loscalzo:                       Absolutely. Well, high blood sugar, we know that the end range complication of diabetes are peripheral neuropathy. Right? So it’s damage to the peripheral nerves. So studies I’ve found show that when the sugar goes above 120, you start to damage those nerves. 

Dr. Weitz:                            How do those nerves get damaged?

Dr. Loscalzo:                       They get damaged by the sugar. They get glycosylated. They get coated with the sugar and then they can’t function. The red blood cells get coated. And that’s what hemoglobin A1C is a glycosylation or a sugar coating, and they can’t function properly. So the nerves get damaged by the high sugar. The retina, retinopathy, one of the leading causes of blindness in this country is diabetic retinopathy. But people think, “Well, I’m not diabetic. I’m not diabetic.” They think that the damage starts to happen when they cross the line and become diagnosed as diabetic. But, seriously, its been happening for decades with these sugar highs and lows, and the insulin highs and lows. And insulin causes an increase in C-reactive protein. It, like I said, thickens the cell, the walls of the endothelium of the blood vessels, so it makes them less elastic. So instead of them flowing and, “Oh, yeah.” You need a sudden burst of energy, more blood flow. They can’t go. And that’s part of the cause of ischemic attacks.

Dr. Weitz:                            What do you think about the timing of meals? Should we be eating every two or three hours to keep an even blood sugar? What do you think about intermittent fasting, which, essentially, is like skipping breakfast, or a fasting mimicking diet, which a lot of people are doing now for anti-aging purposes?

Dr. Loscalzo:                       Yeah. So I think eating every two hours is the worst advice anybody could ever get. There are exceptions to it. There are times when a person needs to be weaned and the meals slowly separated as you’re rebuilding and restoring their system. When you eat every two hours, you have insulin in your system every minute of the day. Insulin is a catabolic hormone. Insulin causes the lay down of fat. Insulin is damaging blood vessel linings. Insulin interferes with growth hormone which we need for growth and repair and laying down of lean tissue. So eating every two hours is, I think it’s a nutritional nightmare, time bomb. I love the fact of having longer periods. I recommend people do at least four hours between meals, preferably six. And then I also recommend a long overnight fast. So at least 12 hours, but 16 hours is even better, so the intermittent fasting concept.

I don’t equate intermittent fasting with skipping breakfast because it doesn’t have to be that way. For some people, they do really well with having breakfast. And they have breakfast and lunch, a later lunch, and then they don’t eat again until breakfast again. And some people do better by skipping the breakfast and eating later. And some people just eat moderately early, like a breakfast at maybe 10:00 AM, and then skip 8 hours and eat a dinner at 4:00, and then that’s it. So intermittent fasting is just giving the body a rest, a real rest in between. And healing happens during fasting and not feeding. Feeding is when we’re doing all this metabolic stuff, generating metabolic waste. But healing happens during fasting. So I’m a big fan of that.

I’m a big fan of fasting. Like I look at intermittent as that’s one method of intermittent fasting. Another method is the 24-hour fast where you have one meal in a day. You pick dinner or breakfast or lunch, it doesn’t matter which, and then you go all the way around to that meal. And the studies who that that elevates level of growth hormone, decreases levels of insulin without decreasing metabolic rate. Now, if you do multiple days, more than five days or so, it could decrease the metabolic rate, which counteracts the whole process of weight loss.

But if you just do it for 24 hours or these longer periods, it actually has been shown to work better than long-term caloric restriction because caloric restriction, over time, will definitely lower the metabolic rate. “Oh, you’re only going to give me 1,000 calories? I’m only going to burn 1,000 calories. Thank you very much.” And then its like, “Okay. Now I got to decrease it further, and further, and further.” Whereas, fasting is very healing. And so the fasting mimicking diet is very low calorie diet over the course of four or five days once a month where you’re actually getting the benefits of fasting without actually having to fast. Personally, I’d rather fast. I just fast four or five days a month. And it’s easy for me because I’ve done it many times. And if you can, get amazing healing benefits when you do a fast.

Dr. Weitz:                            And do you consume anything during your fast?

Dr. Loscalzo:                       Water. Yeah.

Dr. Weitz:                           That’s it?

Dr. Loscalzo:                       Yep.

Dr. Weitz:                            Yeah.

Dr. Loscalzo:                       That’s what fasting means. People think that fasting is juice cleansing, or drinking sauerkraut juice, or drinking coffee with butter in it. That’s not fasting. Right? Let’s find a different name for that. That’s fasting mimicking maybe. But that’s not fasting. Fasting is water. And dry-fasting is without it, but I haven’t seen any benefit. I haven’t studied it much, but the whole idea of that turns me off, so I don’t do that.

Dr. Weitz:                            Do you ever use nutritional supplements to help patients balance their blood sugar?

Dr. Loscalzo:                       Absolutely. Yeah. Absolutely. In fact-

Dr. Weitz:                            What are your favorite supplements for that?

Dr. Loscalzo:                       Sometimes what I do is before I even tell them to start doing the diet stuff because that’s real hard and they’re having cravings that are related to their insulin imbalances, so what I’ll do is I’ll put them on chromium, and magnesium, and some omega 3s, a DHA. Especially DHA because that has the most profound, the DHA-EPA is very helpful. And I’ll start with those three. And I call them my craving crusher supplements. You go, “Oh, I’ll take the craving crusher supplements.” Because people say that after a week or two, they’re like, “Oh, I don’t have my sugar cravings as much anymore.” Then, I can start with the diet. But because if I start with the diet, which I used to do, they’re like, “Oh, but I need. And I need.” And they’re always falling off.  But this way, they feel really good. I use cinnamon. I’ve used berberine, olive leaf extract, lipoic acid. But my main core three that I start with are those, the magnesium, chromium, and DHA.

Dr. Weitz:                            What do you think about some of the resistant starch products on the market? You know, there’s powders with resistant starch, medical foods?

Dr. Loscalzo:                       I’m not a big fan of powders and potions. That said, I haven’t really tested them much. I mean, the research looks like if you take potatoes, which are very high glycemic, and you cook them, and then you put them in the refrigerator, that it’s better. I haven’t actually tested it on myself just because I haven’t eaten potato in like six or seven years. And I really have no interest. But I could do an experiment with some of my clients. A lot of my clients find is that if they do that and then they ferment that, like take a sweet potato, and cook it, and then put it in the fridge. And then they take that sweet potato, and they blend it up, and they put in probiotic organisms, and they let it ferment, like make a yogurt, make a sweet potato yogurt, that that lowers the glycemic-

Dr. Weitz:                            Sweet potato yogurt?

Dr. Loscalzo:                       Yep. I have a friend how makes lentil yogurt.

Dr. Weitz:                            Really?

Dr. Loscalzo:                       I haven’t tried these things. I’ve tasted them, but I haven’t really tried making them. I stick to coconut yogurt. I do cashew yogurt. I do a combination of hemp, and brazil nut, and cashew. I do all kind of nuts and seed type yogurts and kefirs, but I haven’t tried those yet. It’s just I have to stay away from the starchy foods, personally, for me.

Dr. Weitz:                            Yeah. The grains and beans et cetera. Okay. So I think that’s all the questions I have. I think that was … You gave us some good information. Any other topic, any other final thoughts you want to give us about improving insulin resistance?

Dr. Loscalzo:                       Yeah. I would say it’s not just about the food. So you really have to look at these five lifestyle factors that I teach. You have to be moving. We have to move. It’s so-

Dr. Weitz:                            Oh, yeah. We didn’t really talk about exercise. What kind of exercise you think is most effective for blood sugar balancing?

Dr. Loscalzo:                       I like burst training. I think that’s the most effective-

Dr. Weitz:                            Burst training?

Dr. Loscalzo:                       Burst training.

Dr. Weitz:                            Explode, you know?

Dr. Loscalzo:                       Where you just explode 30 seconds of really intense exercise. And then you stop. And you could either do that as part of an aerobic routine where you’re running along, and then you go way on, and then you run back to normal speed. You can do stair, up and down the stairs. You can do jumping jacks. I have a little stair-climber thing that I get on there and I just go, “Err,” as fast as I can. And that helps to really burn. It’s been shown that that increases growth hormone as much as a half an hour of aerobics in 30 seconds. So it’s very effective. And I know people who have … They eat something, you go, “Oh, my God. My sugar just went up.” And they’ll just go do some bursts and bring it back down.

Dr. Weitz:                            Is that part of your exercise program? Do you also do steady state aerobic?

Dr. Loscalzo:                       Oh, yeah. I do. Yeah. I do. I run or I swim. I do weights. I mean, it’s part of it. But that’s something to add to. Yeah. And then, for some people who are not that fit, walking. Just get out there and walking in 10 minutes at a time, plus the burst training. And you can really reverse things dramatically. Trained muscle is much less resistant to insulin than untrained muscle.

Dr. Weitz:                            Right. I think doing some weight training probably helps stimulate muscle in the body.

Dr. Loscalzo:                       And weight training is great.

Dr. Weitz:                            Yeah.

Dr. Loscalzo:                       Because you increase muscle. Right.

Dr. Weitz:                            Yeah.

Dr. Loscalzo:                       And yes. You increase the metabolic rate by increasing the muscle. Right. And sleep is super important. Tons of studies that show that even one night of bad sleep in an otherwise healthy person will induce a temporary insulin resistance. So I find that on days when I haven’t gotten enough sleep, I’ve stayed up, I’ve flown, whatever the reason, that I’m ultra careful the next day with my food. Yeah.

Dr. Weitz:                            For stress relief?

Dr. Loscalzo:                       Stress release. My favorite is Heart Math. And I also mediate using a device called The Muse, which kind of measures my brain waves. You wear a little band around your head and it measures your brain waves. It’ll give you like “Tweet, tweet, tweet,” on the birds if you’re in calm state. And it’ll do these like, “Whish, whish, whish,” to show you that your mind’s just gone off and come on back.

Dr. Weitz:                            What’s that called, The Muse?

Dr. Loscalzo:                       Muse. M-U-S-E.

Dr. Weitz:                            Oh, okay.

Dr. Loscalzo:                       Yeah. Yeah. It’s really cool.

Dr. Weitz:                            You wear this thing on your head?

Dr. Loscalzo:                       Yeah. I do it for 20 minutes a day in the morning. And it’s my meditation. I’ve always had a hard time meditating because it’s like, “Am I done yet. Am I done yet? Am I done yet? How’s the timer?” And then I do Heart Math, which is this breathing appreciation combo that you can do throughout the day in 30 seconds at a time. So I’m into quick-fix stress relief. And it’s helped me dramatically from that.

Dr. Weitz:                            Right. Great.

Dr. Loscalzo:                       Yeah.

Dr. Weitz:                            Good. Okay.

Dr. Loscalzo:                       Yeah.

Dr. Weitz:                            Okay.

Dr. Loscalzo:                       Yeah.

Dr. Weitz:                            So how can listeners and viewers get a hold of you?

Dr. Loscalzo:                       Yeah. So my main website is drritamarie.com. I have a couple of free things I could tell you about that they can get that are related to this. One is called hormonehackingbreakfastmenus.com. For those of you who don’t want to skip breakfast or want that really balancing, hormonehackingbreakfastmenus.com, and it’s just little 20-page booklet that has 5 different menus, and, I don’t know,, 12 different recipes, and guidelines for how to put together a breakfast that’s going to keep you steady throughout the day.

Dr. Weitz:                            Okay. And I understand you have some courses for-

Dr. Loscalzo:                       Yes.

Dr. Weitz:                            … for both patients and practitioners, for blood sugar insulin balance.

Dr. Loscalzo:                       I do. I do. I have a program called The Sweet Spot Solution. It’s thesweetspotsolution.com, and that’s where people who want to get their own blood sugar under balance do. It’s like a three-month program. And we guide people through. And we have a Facebook group. And they really get to learn the process and go through the steps. And we guide them and we coach them. And then we have for practitioners, we have the Insulin Resistance Practitioner training which is at insulinresitancepractitioner.com. And we take them through, and they get a free seat in our individual programs. They can actually go through themselves or take a client through. And we teach them all the ins and the outs and the tracking. And we have coaching calls where they get on and ask questions so they can bring their client cases and that sort of thing. And that’s a certification program.

Dr. Weitz:                            Okay. Cool. That’s great. Thank you for spending the time with us. And I’ll talk to you soon.

Dr. Loscalzo:                       Thank you very much. Bye.

Women’s Heart Health with Dr. Felice Gersh: Rational Wellness Podcast 73

Dr. Felice Gersh talks about how to improve heart health in women with bioidentical hormone therapy with Dr. Ben Weitz. 

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


Podcast Highlights

1:52  Prior to menopause, women tend to have a significantly lower risk of heart disease then men because estrogen is protective of the heart.  This is one reason why many doctors were prescribing estrogen and hormone replacement therapy (HRT) to women after menopause. But then in 2002 the Women’s Health Initiative Study was published that showed that HRT was dangerous and raised a woman’s risk of heart attack and stroke, as well as breast cancer, and many doctors stopped prescribing HRT. 

2:58  Dr. Gersh explains that this study was really disastrous for women’s health and amounted to a roadblock in the developing story of estrogen and women’s health. First of all, they did not study human estrogen. The compound studied is Prempro, which is derived from the urine of pregnant horses. It’s not even the estrogen that the horses wanted. It’s the estrogen that they excreted, which is why it is known as conjugated equine estrogen. And the form of progesterone used in this study is Provera, which is a synthetic form of progesterone known as progestin, or medroxyprogesterone acetate, which is actually an endocrine disruptor.  It’s a chemical that binds to progesterone receptors, but it has variable effects, and it turns out in the uterus, in the uterine lining, it acts as a big blocker of estrogen, but when you look at the other parts of the body, you look at the cardiovascular system, and the brain, and so forth, what you find, it actually is a progesterone blocker. The same in the breast, so it actually is like an anti-progesterone. And these were also women who were in their 60s, so most of them already had some pre-existing cardiovascular disease since they were often more than 10 years out from when they actually went through menopause, which we know is a big risk factor for cardiovascular disease.  It turns out that Premarin increases the risk of blood clots by 400%, so it is really disastrous for women’s health!

7:30  Estrogen is very protective for the heart, especially estradiol more so than estriol.  Estradiol protects our arteries through stimulation of the endothelial nitric oxide synthase, which produces nitric oxide, which maintains the dilation and the health of the endothelium (the lining) of our arteries. Without estrogen you get reduced levels of nitric oxide. There are estrogen receptors in the gut, which is why that after menopause you tend to get leaky gut. There are estrogen receptors on the immune cells, like macrophages, neutrophils, and mast cells, which are part of the gut-associated lymphoid tissue, so this sets up systemic inflammation, which is a major factor in arterial problems in heart disease. Also, estrogen reduces platelet aggregation and blood clotting. Without estrogen you have the perfect scene for trouble–platelet aggregation, reduced dilation of your blood vessels, leaky gut, and inflammation. You also get more oxidized LDL because estradiol maintains an enzyme system called the peroxidase 1, PAN1, which reduces the oxidation of LDL. Without estrogen you also get an increase in ADMA, which further reduces nitric oxide. All this is happening very rapidly as women proceed through menopause, which is why women have higher rates of stroke than men and women tend to die more commonly than men from their first heart attack and they actually start to surpass men in terms of percentages of women dying from cardiovascular compared to men, and none of this is recognized by our conventional medical world, and they fear estrogen.  Dr. Gersh said that she fears lack of estrogen and this is just the tip of the iceberg. There are also estrogen receptors in the mitochondria that keep the heart beating properly, so without estrogen you’re more likely to get arrhythmia, atrial fibrillation, and heart failure.  2-methoxyestradiol is an estrogen metabolite that helps to maintain heart function. Basically, the entire cardiovascular system is reliant on estradiol, not estriol. It is shocking that renowned cardiologists are denouncing estrogen and telling women to stay away from estrogen and they are equating issues with birth control pills, which are estrogen endocrine disruptors. They are the evil twin of estrogen. Everyone, unite to defend our hormones.

17:22  Many doctors, especially Functional Medicine doctors, who recommend bioidentical hormones to women tend to prescribe a combination of estradiol and estriol (Biest) in the belief that estriol is a weaker form of estrogen and that this will balance the stronger effects of estradiol and that this will reduce the risk of breast cancer and have other beneficial effects.  Dr. Gersh explained that these doctors are basing this on data that is 30 years old, but at that time, we didn’t know that there were alpha and beta receptors of estrogen and we didn’t know about membrane receptors.  For generally healthy women who are hitting menopause, estriol is really not a good tool. There can be some specific uses for estriol if you’re treating specific condition, maybe even breast cancer or autoimmune disease, like multiple sclerosis. But estriol, which is a very dominant estrogen in pregnancy, only works on the beta receptor.  The B cells of the immune system have primarily beta receptors, while the innate immune cells primarily have alpha receptors. During pregnancy, the estriol down-regulates the immune system so that you don’t reject the baby. This is why if a women has autoimmune disease, it will often go into remission during pregnancy. This is also why women who are pregnant are more likely to die if they get the flu or chickenpox. This is why it may be useful to use estriol in women with MS because it down-regulates the immune system, like a biologic drug like Humira.  Prior to menopause, women tend to survive septicemia at higher rates than men because they tend to have a stronger immune system than men.  If you give women estriol instead of estradiol, you will be down-regulating their immune system, which is generally not a good thing.  In addition, alpha receptors are in the brain in the hippocampus, and women already have three times the rate of Alzheimer’s as men, so if you give estriol you will not be stimulating the brain to function as well as estradiol does.  Also the beta-receptors tend to up-regulate the appetite center in women, which is good in pregnancy but not in menopause, so giving estriol may encourage women to gain weight. And if you give estradiol, the body will make some of it into estriol.

We also should consider the interplay of various hormones in the body and the importance of estrogen and progesterone for allowing the other hormones to work properly.  For example, when you have the normal surge of estrogen that occurs during part of the month up-regulates thyroid receptors, so thyroid hormone works properly.  That’s why so many women in menopause have symptoms of low thyroid. Low T3 is associated with heart failure. If you have no estrogen and no progesterone, then you will have worse thyroid receptor function. If we get estrogen, progesterone, and testosterone right, then thyroid, oxytocin, and growth hormone will all work better. 

28:18   Progesterone, which is estradiol’s sidekick, also has receptors all over the body. The key is having the right amount of hormones in the right rhythm. We should not give a small static amount of estrogen and progesterone every day.  We want to try to mimic the rhythms of hormones that occur in a healthy 25 year old woman, though we to do need more research on this. Even pulsing the progesterone so that you do it 14 days a month is better, and there is some published data that that lowers the risk of breast cancer.  Progesterone is not just there to counteract estrogen’s effect on the uterus.  Progesterone has amazing effects all over the body and it’s very neuro-protective. It actually down-regulates estradiol receptors. It’s all a beautiful balance of proliferation and anti-proliferation. As far as the appropriate dosage, Big Pharma has recommended either 100 or 200 mg, but we don’t have enough data on what the optimal dosage should be. Dr. Gersh said that she is working with a nonprofit doing research to answer the question of what is the best dosage of progesterone to be used for each woman. 

35:50  For the 60 or 70 year old woman who decides that she would like to take hormones, we should start with a lower dosage because the receptors have been in hibernation and work our way up. 

39:40  Testing for women with cardiovascular disease is often different than men.  Coronary calcium scores are less important and have less predictive value for women.  Many women who die from heart attacks don’t have severe atherosclerosis. They tend to die from spasm.  Checking their blood pressure is very important. Echo stress tests have virtually no predictive value for women, though echo cardiograms can be helpful.  She will often see patients who return from the cardiologist with mild diastolic dysfunction, which they are told is normal. But this is not normal and it indicates that your heart is stiff and is deficient in energy.  This is a sign of mitochondrial dysfunction in the heart muscle and such women will have higher rates of conduction defects and will have higher rate of arrhthmias and Afib. For such women, having more estrogen can be very helpful.  Estrogen controls the enzyme matrix metalloproteinases, which are involved in tissue remodelling and hyperplasia of the heart muscle. It can result in heart valve problems.  Dr. Gersh prefers to look at carotid intima media thickness. It is important to look at labs for inflammation. 

44:43  Since women have so many mitochondrial problems with their hearts, then statin medications, which are known to negatively impact the mitochondria, probably are not a good medication for them. The two areas of the body that have the most energy needs are the brain and heart, which is why they both are so dense in mitochondria. One of the better supplements for managing lipids in women is citrus bergamot. We should remember that as women age, low cholesterol is more associated with higher mortality than high cholesterol. What you want is to do to reduce cardiovascular disease risk in women is to drive down oxidized LDL, which we know is controlled by the enzyme PAN1, which is controlled by estradiol.



Dr. Felice Gersh is a board certified OBGYN and she is also fellowship-trained in Integrative Medicine. Dr. Gersh is the Director of the Integrative Medical Group of Irvine and she specializes in hormonal management. Her website is http://www.felicelgershmd.com/ and she is available to see patients at 949-753-7475, she lectures around the world, and she will be releasing her first book on PCOS in November 2018, which is called PCOS SOS: A Gynecologist’s Lifeline to Restoring Your Rhythms, Hormones, and Happiness.

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


Podcast Transcripts

Dr. Weitz:            This is Dr. Ben Weitz with the Rational Wellness Podcast, bringing you the cutting-edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to Rational Wellness Podcast on iTunes and YouTube, and sign up for my free e-book on my website by going to drweitz.com. Let’s get started on your road to better health.  Hello, Rational Wellness Podcasters. Thank you so much for joining me again today. For those of you who enjoy listening to the Rational Wellness Podcast, please go to iTunes and give us a rating and review so more people can find out about the Rational Wellness Podcast. Normally, I introduce the topic first and then the speaker, but today, I’m going to introduce the speaker so I can tee up the first question for her when I do a short intro on the topic.

Our guest speaker today is Dr. Felice Gersh. She is a board-certified obstetrician and gynecologist. She’s fellowship-trained in integrative medicine. Dr. Gersh is the director of the Integrative Medical Group of Irvine where she sees patients. She also lectures around the world on various topics relevant to women, and her first book on PCOS will be released very soon. Hi, Dr. Gersh.

Today, our topic is heart disease in women. We all know that heart disease is the leading cause of death for men, but what about women? Well, you might be surprised to know that just as many women die of heart disease each year in the US. Prior to menopause, women tend to have significantly lower risk than men, and we have known for a long time that estrogen is protective for the heart.  However, after menopause, heart disease rates rise in women. This is one reason why prescribing hormone replacement therapy became popular to not only deal with the problematic complaints of menopause like hot flashes and night sweats, but to reduce cardiovascular disease risk.  And there were quite a number of studies showing reduced risk of heart disease in women taking hormone replacement.  But then, in 2002, poof, a bomb went off in the hormone replacement world when the Women’s Health Initiative was published. This large study showed unequivocally that women who took estrogen and progesterone replacement therapy after menopause had an increased risk of heart disease. Doctors stopped prescribing hormone replacement therapy for women in order to reduce their risk of heart disease. Is this the end of the story, Dr. Gersh?

Dr. Gersh:           Well, it actually is, what you might call, a deviation in the story. It’s a big bleep, and it’s been really disastrous for women’s health and really, for moving forward the whole conversation because of this … Well, I call it a gigantic roadblock. Right? We’ve got to really detour around this, and what they studied in the Women’s Health Initiative was not human hormones, and there’s so much more to it than even just that. But again, if you just start with what they actually studied, it was a compound called Prempro, and that was really what they mostly studied. They had in the women who’d had hysterectomies say, “Just use Premarin,” and they actually had somewhat of a better outcome, but Prempro itself has some really bad things about it.

First of all, there’s no human Prempro. It doesn’t exist in any female anywhere on this planet. Premarin is actually derived from the pregnant horse’s urine, which has the actual … sort of the unwanted parts of estrogen. It’s actually metabolized estrogen. It’s really what it wanted to get rid of. It’s not the actual good estrogen that the pregnant horse even wants. It’s after it’s metabolized and it’s gone through conjugation. It’s all out. That’s why they call it conjugated estrogen. It’s actually altered to get rid of by the lovely pregnant horse. Of course, there has been some concerns about mistreatment of horses as well, which is a separate topic.

Then, the progestin. Progestin is a man-made-up word for a chemical endocrine disruptor for progesterone, the real human hormone, so medroxyprogesterone acetate, which is what is Provera, is really an endocrine disruptor. It’s a chemical that binds to progesterone receptors, but it has variable effects, and it turns out in the uterus, in the uterine lining, it acts as a big blocker of estrogen, but when you look at the other parts of the body, you look at the cardiovascular system, and the brain, and so forth, what you find, it actually is a progesterone blocker. The same in the breast, so it actually is like an anti-progesterone, and that’s why they call them endocrine disruptors.

Depending on where they are, they can be agonist or antagonist, and so we have a completely foreign substance that’s being put into women’s bodies, and these were generally speaking a little bit older women. They were in their early 60’s was the median age, and they already had some pre-existing cardiovascular disease because after all, they were … Many of them, at least 10 years or they were more than 10 years out from when they actually went through menopause, which we know is a big risk factor for developing cardiovascular disease, and it turns out that Premarin increases the risk of blood clots about 400%. Then, of course, what is a heart attack or a stroke? It’s really a piece of blood clot that breaks off of a ruptured piece of plaque, so you’re going to have dramatically increased blood clotting.

In fact, thrombophilia, when you have increased clotting, which happens as women age and men as well, is a very bad thing, and a lot of people look at cardiovascular risk as directly reflective for heart attacks and strokes of how clottability, the clottability factor of the blood. Here, you’re taking a drug that increases it four times, so it’s a big problem. Prempro is disastrous for women’s health, and even then, it actually didn’t kill as many women as you might think. Over time, women seem to adjust to it, so as you move further out, like more than a year out, it seemed like you knocked off the women that were going to get knocked off, and then it kind of seemed to adjust, but it was really disastrous for moving the whole conversation of women and cardiovascular health forward.

Dr. Weitz:            What is the answer about when and … What is the appropriate type of hormone replacement that women should consider using if they choose to do it after menopause?

Dr. Gersh:           Well, it’s a personal decision, but as many of you know, I love estrogen. I defend estrogen and progesterone too, when it’s needed. Progesterone doesn’t get quite as maligned as estrogen does.

Dr. Weitz:            By the way, can you explain how estrogen is protective for the heart?

Dr. Gersh:           Oh, yeah. Estrogen actually mediates most every function in the entire body. It’s really quite phenomenal as you learn more and more about estrogen, and the estrogen we’re talking about really is estradiol, and that’s really important because a lot of people are using estriol.  And estriol has very beneficial effects, particularly when you’re pregnant, but it’s really not … It’s going to create some problems if you use a lot of estriol in menopausal women, which I can explain if we have time, but …

Dr. Weitz:            Yeah. Well, I think a lot of the Functional Medicine doctors and people who prescribe estrogen bioidentical hormones tend to use estriol in the belief that it has a lower risk of cancer, of breast cancer.

Dr. Gersh:           Well, we definitely want to touch on that, for sure.

Dr. Weitz:            Okay.

Dr. Gersh:           If we jump on estradiol, so it turns out that estradiol is very key if we just start with the blood vessels. Okay? Arteries. There’s this magical substance. It’s a redox signaling agent called nitric oxide, and nitric oxide is made in various places all over the body. One of the ways that it’s made is through an enzyme system, nitric oxide synthase, and one form of that is endothelial, which obviously suggests it’s in the endothelium of arteries, which it is, and estrogen is very key to making that enzyme work.  Okay. You need estrogen. You need estradiol, and without that, you tend to get reduced levels, and nitric oxide really maintains the health of the artery and all the different layers of the artery. It maintains dilatation, health of the endothelium, so loss of nitric oxide occurs, dramatic decreases when you lose your estradiol production from your ovary, so that’s very important.

Then, estradiol has … It’s so complex because estradiol has receptors in the gut, and we all know now in functional medicine how key the gut is in every aspect of health, and without estrogen after menopause, leaky gut actually happens. We know that there’s a change in the microbial environment, the microbiome changes, and you get dysbiosis. You lose that protective mucus coating, and you lose the tight junctions, and you end up getting leaky gut.

The other thing that’s very key to this is that estrogen has receptors on every one of the immune cells, including the innate immune cells like macrophages, neutrophils, mast cells, which we know are in heavy numbers lining the gut and the gut-associated lymphoid tissue. Now, you have the perfect setup for systemic inflammation. You have leaky gut and you have powder kegs because I call them like weapons of mass destruction with no control like you have all these mast cells that contain tumor necrosis factor alpha and histamine. All this, which is designed to attack randomly any invader, right? Only now, you’re having … The least little thing is triggering them because they’re not controlled.

Women in menopause are inherently inflamed, so you have the perfect situation for arterial problems. You have loss of your nitric oxide that’s declining. You have leaky gut. You have inflammation, systemic inflammation, which we know is the trigger to most bad things that happen in the body, including cardiovascular events, and then it turns out that estrogen maintains blood … reduce blood clotting, so through these different enzymes and like the precursor of prostaglandins, the enzyme prostacyclin, which actually maintains reduced blood clot ability. It maintains healthy platelets and reduces the aggregation of platelets.  Estrogen controls platelets, so now you have the perfect scene for trouble. You have platelets that are becoming more aggregating. You have more clottability. You have more inflammation. You have reduced dilation of your blood vessels. You have inflammation rampant everywhere, so of course, that’s the perfect recipe for developing cardiovascular disease, and then on top of that, we have oxidized LDL. We have more inflamed or rancid LDL because estrogen maintains another enzyme system called the peroxidase 1, PAN1, which reduces the oxidation of LDL.

Without estrogen, you’re going to have more oxidized LDL, and when you have more oxidized LDL and you have more inflammation, you increase this product called ADMA. Okay? ADMA then blocks even further the production of nitric oxide, and without estrogen there to come to the rescue, you have this perfect recipe for a cardiovascular disaster, and all of this is happening very rapidly as women proceed through the menopause. We know that in menopause, women have higher rates of stroke than men do. They tend to die more commonly from their first heart attack, and they actually start to surpass men in terms of percentages of women dying from cardiovascular compared to men, and none of this is recognized by our conventional medical world, and they fear estrogen.

I fear lack of estrogen, not having estrogen, and you can see, and this is just the tip of the iceberg. I didn’t even touch on … We can go into that that there are estrogen receptors in mitochondria that keep the heart beating properly. Without estrogen, you’re more likely to get arrhythmia as an atrial fibrillation and heart failure. The myocytes, the heart muscle themselves have estrogen, and even more than that, they have receptors for what they call estrogen-related receptors, which are all about creating energy. Even the metabolites of estrogen, one that’s called 2-methoxyestradiol has its own receptors. It’s so important. It’s an estrogen metabolite that helps to maintain heart function itself.

Basically, the entire cardiovascular system is reliant on estradiol. These are all estradiol, not estriol, mediated events, and that’s like another important take-home message, and then we’ll get into estriol whenever you’re ready, but I just am … Obviously, I’m exploding. I’m a powder keg. I am trying to get the word out, and it is shocking that even “renowned,” we’ll put that in quotation marks, “renowned” cardiologists all over the world are denouncing estradiol and saying women should stay away from estrogen, and they’re equating issues with estrogen and, for example, oral contraceptives, which of course are not healthy for a heart.  We wouldn’t give someone who just had a heart attack a birth control pill, and then they … So, they’d maligned estrogen because of the evil twin, right?  Estrogen endocrine disruptors are being called estrogen, and progesterone endocrine disruptors are being called progesterone, and we have to defend this.  Everyone, unite to defend our hormones.

Dr. Weitz:            Great, so I want to get into estriol in a second, but you mentioned 2-methoxyestradiol, and I just interviewed Dr. Berkson, and she talked about taking 2-methoxyestradiol.

Dr. Gersh:           Wow, how funny.

Dr. Weitz:            What do you think about using that particular compound?

Dr. Gersh:           I am very simple. I say do what nature designed us to do. We are not smart enough to micro-manage much of anything. That’s why we can’t micro-manage receptors. We can’t micro-manage estrogen metabolites.  Give estradiol. Okay? Let the body make … Do everything to have a healthy gut, and that, of course, includes a liver, right, because it’s all part of the same process.  Try to have the systems working as best we can make them work so do as … I like to use like a 25-year-old as my goal.  If I can do things to try to mimic what goes on in a healthy 25-year-old, and some of them are not healthy at 25, but if you get the healthy 25-year-old woman, that’s my gold standard for what I’m trying to mimic, so I’m not going to give anyone metabolites.  I don’t want to give pieces of anything.  I want to give the whole.  Right?  It’s like the whole food, right?  I try not to … I love to use supplements, but I see them for what they are.  They’re pieces of the whole, right?  If I give a polyphenol, that can be helpful, but what if I give the whole food, right, and it has not only the polyphenol magic, but it has the fiber magic, and it has the other antioxidant magic?  Right?  I give estradiol magic and let the body make its own metabolites and so forth, and work the magic that it does in the female body, but you have to have the systems working, of course, or else you’re not going to get the right metabolites. That’s why the estrobolome exists. That’s why livers exist, but we have to nurture them so that the body will do its thing. We are not smart enough to try to break it into little pieces. Start with the whole and let the body do its thing. Oh, I’m not smart enough anyway.

Dr. Weitz:            That’s great. We mentioned estriol, and it’s common among doctors who prescribe bioidentical hormones to give a compounded product that contains a combination of estriol and estradiol with the belief that estriol has a lower risk of breast cancer.

Dr. Gersh:           Right, and I understand that that is data that goes back maybe 30 years, and in its time, it was very … No, extremely forward-looking, recognizing that there were different forms of estrogen, but it missed a lot because they didn’t know a lot. You can’t blame anyone for coming up with something without knowing. At that time that that idea came out, we didn’t even know there were alpha and beta receptors of estrogen. We didn’t know about membrane receptors. All they knew is that if you gave estriol, it seemed to reduce breast cancer, but now, we know that it really is not a good tool, and I’ll explain why, for generally healthy women who are hitting menopause. There can be some unique uses of estriol if you’re treating a specific condition. Maybe even breast cancer. Maybe things like autoimmune disease like multiple sclerosis, but that’s not replacement. That’s different. That’s treatment.

It turns out that estriol, which is a very dominant estrogen in pregnancy has only beta receptive functions, so it only works on the beta receptor. Now, there’s alpha and there’s beta receptors, and they’re both very critical, and then we won’t even get into membrane receptors, which actually trigger kinesis, I mean, and it turns out that alpha and beta, which we used to think were purely nuclear receptors are not. Everything is much more complicated than we ever thought. It turns out that they also have membrane receptor function, and they also up and down regulate each other, so everything … That’s why I say we can’t micro-manage because everything turns out to be more complex than we ever thought.

Beta receptors tend to cluster in certain areas. Nothing is exclusive. They tend to be in the lining of the gut, in the enterocytes. They’re in the lining of arteries. They tend to be in certain other areas like in the vagina, and if you think about pregnancy, you’re going to have a lot of beta, and that would want to be in the vagina so that you have this incredibly stretchy vagina. For example, if you were suddenly magically a woman … Not you. If a woman were magically pregnant and she had no estriol, normal amounts, but not the amounts that you’d have in pregnancy, and suddenly, she had to deliver a baby, she just rip apart because she wouldn’t be stretchy. I always think of it like a snake swallowing a big pig or something.

Dr. Weitz:            Yeah.

Dr. Gersh:           It’s like, “How does it do that?” But because of all the estriol. Okay, and the estriol helps block some of the estradiol effect in the breast or women would probably be size quadruple Z or something. Right? It would be impossible, so there is this beautiful balance between estriol and estradiol in pregnancy, but it turns out that it gets more complex because if you think of pregnancy, it’s a very special immune state. Right? You do not want to reject the fetus. It is a foreign tissue, so it turns out that the beta receptor is the receptor that’s primarily on the B cells, and the alpha receptor is the primary receptor on the innate immune cells, like I mentioned, like mast cells, and the macrophages, neutrophils, macrocytes, and so on.

Those are primarily alpha, and B cells are beta, so it turns out that in order to basically dismantle the innate immune system to down-regulate it, you have a lot of beta. It turns out that beta down-regulates alpha, so in pregnancy and a lot of people know this that if a woman is pregnant often and she has autoimmune disease, she goes into a remission only to flare afterwards, but why is it? Has anyone ever thought about like why is it that in pregnancy, women often have a remission?

Also, women who are pregnant are more likely to die if they get the flu, if they get chickenpox. I’m sure a lot of people know that. They are more at risk if they get an infection that they may die, but they’re less likely to have flares of their autoimmune conditions than they often go into very dramatic remissions. It’s because the beta, which is estriol, is down-regulating the alpha receptors, so basically, it’s like an immune modulator that you’re getting. This big dose of estriol is like an immune modulator. That’s why I do some research on using it, for example, in MS. It’s down-regulating just like a biologic, just like an immune modulator like ramicade and humira. It’s down-regulating your innate immune system, but it’s …

Dr. Weitz:            That’s good because women have such a high risk of autoimmune, and in fact, depending upon how you look at it, heart disease is an autoimmune disease.

Dr. Gersh:           But the problem is that women, for example, pre-menopause have dramatically higher survival rates if they become septic and they … Women have higher survival rates than men across all ages when especially though the difference is very dramatic pre and post-menopausal. There are some innate benefits that’s actually built into the X chromosome. That’s why even girl children tend to outsurvive boy children if they get an infection, but it’s dramatically increased with the reproductive years when they have estradiol on board, so it really … Women have a very robust immune system. Much, much more powerful than males at fighting off sepsis.

Women survive septicemia much higher rates, but not after menopause, so this is the problem just like if a woman is on an immune modulator like humira, ramicade, and so on. It says on the fine print you may die like of an infection, right? “Do not take this if you have a fever. Blah, blah, blah.” Right? What you’re doing to women in the menopause, if you keep them like in this pregnancy state where their immune system is down-regulated. You’re making them much more susceptible to die if they get pneumonia, if they get the flu. I don’t think that’s a really good idea, so the alpha is part … You’re taking out your immune system, your innate immune system, so that …

Dr. Weitz:            Right, and that’s going to put you at higher risk of cancer as well.

Dr. Gersh:           That’s right. You need an innate immune system. If you have estradiol, you will make estriol, and they’ve actually shown that you do … Of course, it’s part of the equilibrium, so you will make the right amount that your body needs. In addition, alpha isn’t just on the immune cells. Alpha is in the brain big time in the hypothalamus, in the hippocampus. You’re down-regulating your memory centers when you take just estriol, and women who are pregnant, often they say they have pregnancy brain. Oh, why is that? Because they’re down-regulating their alpha. It’s affecting the hippocampus. You’re affecting memory.

Women already have three times the amount of Alzheimer’s as men. Please stop doing us in. Okay? Don’t do that to us, and it also regulates the appetite center. Nature did this on purpose. Women who are pregnant are supposed to want to eat more, right? Especially think about ancient times when food was scarce, right? Women’s appetite is up-regulated so that they can gain weight, so you want to do this to your post-menopausal women. You’re down-regulating their appetite control centers. Don’t do it, so stop playing like you’re in charge. Stop being in charge. Give the body what it’s designed to have and stop micro-managing this. You’re micro-managing receptors. You have no clue what you’re doing, and that’s just the tip of the iceberg, I’m sure, of what we’re doing here, so we don’t want to give all this estriol and down-regulate all your alpha receptors. You’re doing harm.

If your patient dies of an infection, you may be responsible. If your patient gains weight, you may be responsible. That’s really not what we want to do, and I used to use bias too because I didn’t understand, but now we understand. I would never touch it because it’s really … It’s not what nature wants us to have, and we want to protect our women from infections, and that’s a big cause. Pneumonia is a big cause of death. We want to keep women on hormones for their lives. I mean, I don’t see any reason to stop it. I’m never going to stop mine unless they claw it out of my hands or something, but I think we should recognize our limitations, and there’s so much we can do just to help women to be healthy and have healthy cardiovascular systems without trying to be super clever. Just give the body what it would have when it’s a healthy 25-year-old.

Remember, think about a heart muscle. The heart turns over, and you get a new heart about every four years. Right? Every heart muscle in a woman’s body and yours as well is somewhere between just born and four years old on average. Those heart muscle cells don’t know how old you are. They’re born with the same set of genes that when you’re 20, or when you’re 50, or when you’re 70, every heart cell that’s created has the same genetic programming. If you give it what it needs to do its job, it will perform the same at any age, so that’s my goal. It’s recognizing that every heart muscle, every cell in the body is not the same age as you. Right? It was born later, and it doesn’t know how old you are, so give it what it needs, and it will behave the same as it did when you were young.

Now, of course, we can’t truly do that because it’s much too complex, but we can come a lot closer than we have been if we just do everything to feed those cells what it needs, the nutrients, the foundation, so it can run its machinery. Right? So it has the foundational tools, and then we give it the foundational hormones. It will do its job at any age, and that’s what we call health span. Right?

The thing that stops us from living forever is that at some point, our cells can no longer replicate, and then as they die, we can’t replace them, but until that point comes, there’s no reason we can’t be really healthy. I mean, not perfect because we can’t replicate a 25-year-old’s body, but we can come so much closer, and our society does not recognize it. Of course, we know that we’re always playing whack-a-mole. “This problem, we’re going to replace this joint. This problem, we’re going to do this surgery. We’re going to give this drug.” If we just give the cells what they need, they’ll keep performing for us, and that’s every cell in the cardiovascular system.

Dr. Weitz:            Great, and what about the progesterone part of the story?

Dr. Gersh:           Progesterone. I call it like estradiol’s sidekick. Progesterone has receptors all over the body as well. The thing about these hormones is that, and this really … We desperately need more research is that it’s not just having hormones. It’s having hormones in the right amount and in the right rhythm. We’re learning this with food. Right? Everybody is knowing that it’s not just what you eat, it’s how much of it and when you eat it. Right? You can’t just say, “I have one vegetable bite a month.” That’s not going to do it, so why is this whole idea of you have the smallest amount of estrogen possible to keep you alive? What is that all about?

You don’t want the smallest amount of anything. You want the right amount, and we are rhythmic. Women are so rhythmic. They have circadian rhythms, and lunar rhythms, and seasonal rhythms, and ultradian rhythms. That’s the rhythm through the day like the pulses, so we have just one giant rhythm, and when we give hormones the way we give them traditionally along with progesterone, we’re not recognizing the rhythms of progesterone. Let alone the rhythms of estrogen, but certainly, we’re not recognizing the rhythm of progesterone.

Progesterone is often given the same amount every day. Now, even if you don’t truly rhythmic hormones, which is probably really what we should do, whatever we should do, we want to, like I said, mimic a healthy 25-year-old. A woman who’s 25 not on birth control pills, thank goodness, a healthy 25-year-old woman has this incredible rhythm, the lunar rhythm of her hormones. She doesn’t have static dosing. Right? She doesn’t have a little bitty bit of estrogen and a little bitty bit of progesterone the same amount every day. That is not physiologic.

Even if we aren’t mimicking and menstrual cycle, which is where I think we should go, but we definitely need more research, but even pulsing the progesterone so that you do it 14 days a month is better, and there is some published data that that lowers the risk of breast cancer. We are not meant to have a little bit of progesterone every day. Progesterone is not just there to counteract estrogen’s effect on the uterus. We know that. Right? Progesterone is all over the body. It’s very neuro-protective. It has amazing effects all over, but it needs to be in a rhythm.

Progesterone is not supposed to be present every day, and we know that when progesterone in a normal luteal phase when progesterone is at its peak, it actually down-regulates estradiol receptors, so it helps to … It’s all a beautiful balance of proliferation and anti-proliferation. Right? We don’t have that balance when we just give the same thing every day. Also, receptors can get resistant. It’s just like, “Blah, blah, blah, blah,” you stop hearing. Right? The receptors stop listening after a while, and what’s not recognized is thyroid. A lot of women in menopause have symptoms of low thyroid, but they get to the doctor, and they test their levels, and they say, “They’re normal. You’re fine. You’re not a crazy lady.” Right? “You have all these imaginary symptoms. Go home and read a magazine or whatever.” They just brush them off.

It turns out that you can have plenty of thyroid hormone. It doesn’t matter if it isn’t working in the receptor. We all know that was insulin. Right? You’re getting high levels of insulin, but your blood sugar is sky high because it isn’t working. Well, the same can happen with thyroid. For thyroid hormone to work properly, you actually need the rhythm of estrogen and progesterone, so when estrogen spikes, which precedes ovulation, that estrogen spike opens up or up-regulates thyroid receptors, so the thyroid actually works. That’s why so many women in menopause have symptoms of low thyroid.

Now, is thyroid important for the cardiovascular system? You bet. Right? We know that low T3 is associated with heart failure and has a high mortality rate associated with it. That’s the last thing we want is low T3, but it doesn’t matter if you have it if it doesn’t work on the receptor, right, and you need this beautiful rhythm of hormones. If you have no estrogen produced by the ovaries and you have no progesterone, then you’re going to even have worse thyroid receptor function, so we need this. That’s why I like to look at the top tier: testosterone, progesterone, and of course, estrogen. If we can get them sort of right, then we get this, the downward cascade, so thyroid will work better. Oxytocin will work better. Growth hormone will work better. All the like next tier hormones will work better if we get the top tier working.

Dr. Weitz:            How do you determine how much progesterone to give?

Dr. Gersh:           That is the question of the year. There was no data. We have no data. That’s why I’m actually working now with a nonprofit that is going to be doing research in Mexico because it’s a lot cheaper to do human research in Mexico to look at those very questions. No one has looked at that. Big Pharma came out with these random doses, right? It’s like you can use 100 if you’re using oral, which of course, metabolized also, but if you use 100 or 200, oh, that’s only a double dose. I mean, like what is that?

Dr. Gersh:           The answer is we don’t know. That’s what’s so terrible. That’s why the Women’s Health Initiative set us back decades in terms of women’s research. We can use progesterone cream, but we don’t know what we’re doing. I mean, the bottom line is that we are all now, either ourselves or our patients, a little bit are guinea pigs because we don’t have published data on any of this. What we have to start with is just making it clear that women’s health matters and that we have to get more research on this. Otherwise, we’re just flying by the seat of our pants because we don’t have data on any of it.

Dr. Weitz:            What about trying to measure uterine lining thickness?

Dr. Gersh:           Well, that is something that can be done, but what’s interesting is how variable that response is in women.

Dr. Weitz:            Okay.

Dr. Gersh:           You can give the same dose to women and get quite different responses. Certainly, if you get a level, a thickness that’s like three centimeters, you did something wrong. A lot of times, like if you’re doing rhythmic hormones, what you end up looking for is clinical results. You end up looking for a woman having a regular period like lead, and it’s about the same amount. It’s at the right time, so you’re almost using clinical guidelines more than any kind of blood, urine, or salivary measures because we really don’t know what we’re doing, and I have to be honest with my patients about that too that I can’t create data if it doesn’t exist.

A lot of times, we do end up treating clinically and saying … which is not optimal, but it’s what we have like, “How do you feel? Do you feel like you felt when you were 25? Are you having periods like when you were 25? Are they regular and so forth?” because we’re having to use human metrics rather than lab metrics for some of these because we don’t know what we’re doing. We don’t even know what the correct lab test is. It’s that bad.

Dr. Weitz:            What about the 60 or 70-year-old woman who avoided hormones and now wants to consider taking them? What advice to give then?

Dr. Gersh:           Well, number one, you have to always people that whatever you’re doing, you’re not standard of care, and so the standard of care is terrible care, but it’s very difficult when standard of care is women should have no care. It’s really how I see it. You have to be telling women that. Also, we do know that estrogen receptors do shrivel with time. The serotonin receptors, which are actually estrogen-dependent in the brain and also in the gut are very much going to shrivel. We don’t know how to bring things back when they’re too far gone, when they’re too off. They’re dead.  It’s like hair follicles. You can do so much to restore hair, right, with like PRP. If the hair follicle is dead, it’s not coming back. If you have some neurons that are really gone making serotonin, you have estrogen receptors that have really shriveled up and they’re gone, then we’re not going to bring them back to life, but we know from vaginal treatment. I use this as my beacon of hope. Okay? If you take a woman at any age and you give her vaginal estriol or vaginal estradiol, she’s going to have improvement.

What that tells me is that receptors are not dead, and you could do this in a woman who’s 70 or 80. You’ll still have some improvement. You won’t have a vagina that’s like a 25-year-old, but it’s not going to be maybe the 70 or 80-year-old one that it was before, so there is still hope. I tell women, “Is it optimal? No, but the receptors are not all shriveled up. Some of them are still there, and we can work if you want to and give it to them.”

We know that Dale Bredesen certainly at every age to try to do his Alzheimer’s reversal program has been giving estrogen to women at every stage in order to help their brains because there’s estrogen receptors all over their brain, every different part of the brain.  I felt that that was really encouraging for us because we’re less out on a limb. If we can say, “Well, you have some memory issues like who doesn’t, right?” and then you say, “Okay. Well, this has already been established by Dale Bredesen, and he has very big clinical status and so forth. He’s respected, and he’s giving estrogen to women at any age to help their brains, so now, I have at least a leg to stand on.” As long as my patients understand that, I will start, and because the receptors are pretty much in hibernation, we might say, I usually with an older population, I will start low and work my way up like we would do with thyroid, right?  If someone is severely hypothyroid, we don’t start them out on the physiologic final dose. We start them low and work our way up, and that’s what I do. Do I have any guidelines? Do I have clinical data? No. I have just my own experience for this, but for older women who’ve had a big gap, and certainly, that’s not what they did in the Women’s Health Initiative, of course, I would start them and try to build up their receptor function and work my way up rather than starting high. Whereas totally different if a woman is pre-menopausal or right at menopause. I’m not going to start them low. I’m going to start them at physiologic levels.  I mean, this whole idea of the smallest dose, that’s crazy.  We want the right dose, and the right dose is a physiological dose, so I’m going to go with higher dose. It’s not high, high. I mean, talking about this whole low dose notion is junk science.  That’s not … but I do different things in different age groups.  Certainly.  Older people, I’m going to be generally starting.

Dr. Weitz:            I know it’s a big topic, and I know we only have so much time, but what about testing for women with heart disease?  Should it be different than testing for men?

Dr. Gersh:           Well, I tend to not do so much in terms of calcium scores. I don’t think that they’re as useful in women as in men, and they just look at the calcium, and women as we know … Many women who die from heart attacks, they don’t even have severe amounts of atherosclerosis. They die from spasm. Right?  Sometimes, it’s called broken heart syndrome. I really want to know what their blood pressure is, how it responds.  I think that’s really, really important.

We know that by age 75, 85% of women, especially if they’re not on hormones, they are going to be hypertensive, and women have very, we’ll say, very powerful autonomic nervous systems, and emotions can cause spasm of their arteries, so just getting a calcium score doesn’t really have very much predictive value, and we know that doing echo stress tests has virtually no predictive value in women in particular. I like to do carotid intima media. I like to know what the status of their arterial health is and if they have inflammation in the intima and if they also have a lot of plaque, recognizing the limitations of that as well because plaque never kills anyone. It’s ruptured plaque, and it’s arterial spasm, and it’s having that extra clottability. That’s really where it’s at.

I definitely want to look at inflammation, so I use labs that look at inflammation because we know that without inflammation, you’re not likely to have ruptured plaque, and so for women, we want to work with their emotions. We want to have them have the tools so that when they feel stressed, they know what to do even if it’s simple yoga breathing because stress kills women. We know that, and so I want to know the status of their arteries, and I’d like to do echo cardiogram. This is something that isn’t really talked about.

Women have very different hearts because of all the estrogen receptors and the loss of estrogen, and it really changes the heart muscle dynamics. One of the earliest signs of cardiac problems, actual heart muscle problem, a deficiency of energy in the heart is what’s called mild diastolic dysfunction. It’s really a stiff heart. You can actually see it on an echo cardiogram. The heart has two basic functions, contract and relax.

Well, we always have focused on the contract part, right? That doesn’t pump out the blood. Well, it turns out the relax part, when it feels is really key, and that has been ignored, and it’s even … I see patients coming from cardiologists with echo cardiograms, and on it, it says, “Mild diastolic dysfunction.” I’ll say, “What did your cardiologist say about this?” He said, “Oh, it’s normal.” No, it is not normal. Your heart is deficient in energy. You have a stiff heart. This really matters, and it’s really a sign of mitochondrial dysfunction in the heart muscle itself and loss of energy.

Of course, this all relates to loss of estrogen, and we need to get some estrogen going into that heart muscle because women often with mild diastolic dysfunction, they’re going to have higher rates of conduction defects within the heart go into more arrhythmias, which we know that’s what kills people is the arrhythmias, and they’ll get Afib, which we know is now at epidemic levels. It’s like the whole world seems to be getting Afib, and they’re more likely to get heart failure itself, so we need to like look at these warning signs.

I believe that it’s really important and as well, looking at the echo cardiogram, you can look at the heart valves because one of the things that estrogen controls is what’s called the enzyme matrix metalloproteinases. These are about tissue remodeling, and the heart muscle actually can remodel and not in good ways. It’s not like remodeling your house. This is like bad, bad, and so you get this hyperplasia of the heart muscle. You get remodeling, and it can actually move the heart valves so that they don’t fit together properly, and you can start seeing that on echo cardiogram.

I think the echo cardiogram is the very underutilized tool, very non-invasive, completely non-invasive to get a really good view of what’s happening in the female heart in the menopausal years so that you can really gauge what’s going on, and then hopefully, do something about it, but at least you need to let people know what’s going on with their hearts, and this isn’t even happening in the cardiologist’s office. They’re ignoring all this stuff. They’ll say, “Oh, you have a little regurge. Oh, you have some mild diastolic dysfunction. That’s normal.” It’s normal to have problems. I guess you could say that, but normal is like having cataracts. Well, people don’t ignore cataracts, so having heart dysfunction and calling it normal doesn’t work for me.

Dr. Weitz:            If women have mitochondrial heart dysfunction, then probably, one of the worst things you could do would be to prescribe a statin which is going to block your Coenzyme Q10, which is necessary for the mitochondria. Right?

Dr. Gersh:           Oh, absolutely and this … The two areas of the body that have tremendous energy needs and lots of mitochondria, of course, the brain and the heart, and we know that both of them are impacted by statins, especially in women, and women are much more prone to develop diabetes as well. It’s just statins have no place probably in very much of anybody, but certainly, the data in women is really bad. I mean, the number needed to treat to do anything is ridiculous. The number needed to harm is not very high. You don’t need to treat very many women to harm women.

I see no benefit in giving statins, and we even went through these committees. It was almost a tie. I mean, it’s not like it was overwhelming, and they looked at the people who were on the committees. They were all … Almost all of them were on the payroll. If they weren’t then, they became afterwards. We now know that the committees that approve pharmaceuticals are very uncontrolled, and many of the participants … I’m not going to say all, but many of them receive humongous amounts of money after the fact. There isn’t even any law regulating what happens after they approve the drug. None, or the recommendation that they give for how it’s used.

There is no control, so they could say, “I have no ties to the industry,” now. But then, after they approve it or they make recommendations, like two months later, they could be on the payroll of the big pharma company that makes that drug, and actually, that’s considered completely legal. We have a crazy system, so there’s been a lot of problems, we’ll say, with statins.

In terms of herbals, while you’re trying to get things right by giving hormones and lifestyle, one of my favorites is bergamot. I’m sure you’ve probably heard of bergamot. It’s from a citrus fruit, and there’s actually published data on it that bergamot can help to regulate abnormal lipids, and so that’s good. Remember, as people age, which is more associated with a higher mortality, low or high cholesterol, it’s actually low cholesterol because low cholesterol … I defend estrogen. I also defend cholesterol. I defend the defenseless.

Cholesterol is essential for life. It’s driving down … LDL is crazy. What you want is to drive down oxidized LDL, which we know is controlled by the enzyme PAN1, which is controlled by estradiol, so it’s like … This is like a dying duck. If you have estradiol, you don’t need to have low LDL because you’re not going to have oxidized LDL, and that’s what harms people, not LDL. LDL, if without enough LDL, your immune system doesn’t work properly. I mean, excuse me. Cholesterol is not there for no reason. Cholesterol is so precious to the body that we have a recycling mechanism in the gut to pull it back in so that we save it. That’s how precious cholesterol is. We want to keep it. We’d like to have cell membrane’s brain and steroid hormones.

Dr. Weitz:            Well, it is an amazing conversation. Unfortunately, I have to bring it to a close because I have patients coming up. I love talking to you though.

Dr. Gersh:           Yeah, me too. We could go on all day, but probably other people have things to do as well.

Dr. Weitz:            How can listeners get a hold of you?

Dr. Gersh:           Well, if people want to be my patient, I’m an old-fashioned doctor. I have a brick-and-mortar practice in Irvine, California called the Integrative Medical Group of Irvine, and the practice website is integrativemgi.com. I also have a little personal website where I put out … I attach like things like this, and other articles, and blogs, and you can find out information about my PCOS book, and that is just my name. It’s felicelgershmd.com. It’s pretty easy to find my practice or to find my own website, and if anyone wants to follow me, I welcome it. I just love educating, and having fun chats, and trying to get the word out, and defending the defenseless.

Dr. Weitz:            You’re such a wealth of information, and when is your book going to be published?

Dr. Gersh:           Probably, it will be out in November.

Dr. Weitz:            Okay.

Dr. Gersh:           It’s called PCOS SOS: A Gynecologist’s Lifeline to Restoring Your Rhythms, Hormones, and Happiness.

Dr. Weitz:            Great, great. Talk to you soon, Felice.

Dr. Gersh:           Bye-bye. Have a wonderful day.

Dr. Weitz:            You too.

Hormonal Health with Dr. Devaki Lindsey Berkson: Rational Wellness Podcast 72

Dr. Devaki Lindsey Berkson talks about the benefits and issues with using bioidentical hormones with Dr. Ben Weitz. 

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Podcast Highlights

2:23  Dr. Berkson first got interested in natural medicine from hearing a lecture by Scott Nearing, who was the father of the back-to-the-land movement, which is what organic gardening was originally called.  Unlike many stories of people who were eating the standard American diet and got sick and found natural medicine, Dr. Berkson was eating healthy and teaching yoga and she still got multiple forms of cancer and had 7 organs removed.  The key for her to regain her health was taking bioidentical hormones, which allowed her to combat hormone altering chemicals that damage your tumor receptor genes. 

9:10  Since the 2002 Women’s Health Initiative, many doctors stopped prescribing hormone replacement therapy after menopause. Dr. Berkson disagrees with this position. Also, the North American Menopause Society now is saying that hormones are ok if used for only five years after the onset of menopause. The re-analysis of the Women’s Health Initiative found that the estrogen only arm of the trial found that women on estrogen only had 33% lower risk of breast cancer and heart disease, even with this horse metabolite of urine.  It is only when they added this synthetic progestin that breast cancer rates and heart disease increased. And this is for women who were past menopause for at least ten years before starting them.  Doctors in Europe did not stop giving hormones like we did here because they mostly give estriol and more natural hormones most of the time.  It’s important to initiate hormones as close to the beginning of menopause as possible and hormone replacement is as close as we have to the Holy Grail of slowing down aging.

15:31  Dr. Berkson said that every hormone you take should be tested and tracked. A woman shouldn’t have heart disease if she initiates bioidentical hormones. You should have a fast CT scan of your coronary artery. You should have an ultrasound of your carotid artery. You should have a vaginal ultrasound of your endometrial stripes, the thickness of your endometrium, so after you’re on hormones for 6 mths to a year you can monitor it and make sure it’s not growing out of control.  Some hormone specialists say that you should not take progesterone if you don’t have a uterus, but there are other reasons to take progesterone since there are also progesterone receptors in the brain, the gut, and the vagus nerve.  There are some forward thinking neurologists today using progesterone to tamp down inflammation in the nervous system. It’s very hard to find practitioners who know what the heck they are doing with hormones.  Our hormones are all under attack from endocrine disrupting substances in the environment.

18:57  In January 2017 there was a public forum put on by Harvard in the Huffington Post and these scientists agreed that the three major threats to humanity were: 1) nuclear war, 2) global warming, and 3) hormone altering chemicals. 

20:28  There is definite scientific, reproducible studies showing that young men in their 20s now often have the testosterone levels that men had in their 60s. There are androgen disrupters just as much as estrogen disrupting substances.  It’s a big deal because hormones are not just for sexuality. Hormones run our brain, run our central nervous system, and they run our gut.  We have receptors for estrogen, progesterone, DHEA, estriol, cortisol, all throughout the gut, let alone thyroid and hunger hormones and satiety hormones.

23:15  I asked Dr. Berkson in her own hormone therapy, what percentage of estriol versus estradial does she use?  She said it depends upon the person.  Estriol signals mostly the Estrogen receptor beta, which controls growth, while Estrogen receptor alpha stimulated growth. One of the new theories about cancer is that if estrogen receptor beta signals are shut off, that cell is more prone to cancer. Because women have less ER beta receptors in their lungs than men do, they are more at risk of lung cancer from second hand smoke. This is why soy is not such a bad food, because soy is the only food that turns the estrogen receptor beta on.  We also have the rhubarb product from Metagenics that stimulates the Estrogen receptor beta known as Estrovera.

25:58  Dr. Berkson said that she learned about hormone testing from Dr. Jonathan Wright, one of the fathers of Functional Medicine, and she used the 24 hour urine test for hormones for four decades. But she has worked with good Functional Medicine doctors who successfully use serum testing, like Dr. Block in Tulsa and David Brownstein, and with Dr. Jack Monaco in Nashville, who uses saliva. You have to listen to the patient more than the laboratory results.  When we measure serum or urine we measure hormones produced endocrinologically by our glands, but it doesn’t measure whether they are utilized by the receptors.  It also only measures hormones produced endocrinologically.  But a lot of hormones are produced intracrinologically, in the periphery, which are produced by post-menopausal women.  We have no test to measure these hormones produced in the periphery.

31:30  There’s not only the importance of the level of the hormones but also the issue of receptor functionality, which can be affected by chemicals and also by nutrient status.  If you don’t have optimal levels of zinc or magnesium or B vitamins, your hormone receptors cannot function properly and those hormones will not have the desired effect no matter what the serum levels are.

35:07  It is important that women have a healthy gut and that they are pooping daily and ideally twice per day, so they excrete their excess estrogen, so that it does not accumulate. If you are constipated, then estrogen will be reabsorbed instead being pushed out of the body.  You want to have this healthy flow of estrogen and then you want to get rid of it.

49:45  The final metabolite, 2-methoxyestradiol, nobody knows about that, but it’s what saved Dr. Berkson from more cancers. She takes that as a biodentical hormone. It has many applications, including for cancer patients.



Dr. Devaki Lindsey Berkson is a Doctor of Chiropractic, Certified Nutritionist and Functional Medicine practitioner.  She has specialized in gut disorders and hormones and she has authored over 25 books, including Healthy Digestion the Natural Way, Hormone Deception, Safe Hormones Smart Women, and her newest book, Sexy Brain.  Dr. Berkson has taught hormones to doctors for A4M and she is a formulator and inventor of nutraceuticals and pharmaceuticals.  She consults with both patients and providers and she can be reached at her website at  https://drlindseyberkson.com/  She also offers a series of online courses that are available on her website, including her new Sexy Brain: Redefining Hormones course.

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


Podcast Transcripts

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

Today we have an interview with Dr. Devaki Lindsey Berkson. She’s been in practice in functional medicine with an emphasis-

Dr. Berkson:                       For a long time. Longer than most of you have been alive.

Dr. Weitz:                           Not me. I’m old, too.

Dr. Berkson:                       How old are you?

Dr. Weitz:                           I’m 60. I just turned 60. I just turned 60.

Dr. Berkson:                       No, it’s not longer than that. You look good, real good.

Dr. Weitz:                           Thank you. Her practice is focused on nutrition, hormones, digestion. She’s one of the thought leaders in natural medicine. She’s trained many doctors in the science behind natural medicine. She’s published original research. She’s taught for functional medicine programs. She’s a best-selling author. She enjoys a beer when she gets home from work. She’s written a number of books including How Beer Creates … no, Healthy Digestion the Natural Way, Hormone Deception, Safe Hormones, Smart Women, and her newest book, Sexy Brain. Dr. Berkson thank you so much for joining me today.

Dr. Berkson:                       Oh, it’s really great to be here. I think your audience is about ready to be blasted with molecules from every portal of existence.

Dr. Weitz:                           Okay. Can you tell us your personal story? How did you become so interested in natural, Functional Medicine?

Dr. Berkson:       Natural, Functional Medicine just made sense to me. I heard when I was 17 or 16 1/2 years old a lecture by Scott Nearing, which many people will not remember Scott Nearing. He was the father of the back-to-the-land movement. That’s what organic gardening was originally called was back-to-the-land movement. He had been a professor of economics at Penn State. He saw that children were being abused in the workplace. He fought for child labor laws. He became blackballed to teach. He had to figure out what the hell to do if he couldn’t teach. He had a PhD. Went through all that trouble and now, because he fought for the rights of children, he couldn’t teach. So he went to, first, Vermont. He started a maple syrup business. He started gardening without chemicals. He was the first guy.

And then he gave some land to Eliot Coleman. The two of them are really credited with the whole organic gardening movement. I heard a lecture by Scott, who was very famous. He wrote 55 books. His very famous book was called Living the Good Life. And then when he was 100 years old, he always said when he was no longer a contributing member to society, he would fast himself to death, so at 100 years he fasted himself to death. His wife wrote a book called Loving and Leaving the Good Life. They became best friends to me.

I heard a lecture at the Theosophy Society when I was 16 1/2 or 17 by him. He wrote the foreword of my very first book, and we have all kinds of things that happened between our lives together. They said you are what you eat. This was in the early 1970s. He said you are what you eat. What you eat is going to create your future. Well, that made a lot of sense to me, so I started eating organically. My mother was a major athlete. She was one of the very first women in the United States to be a state champion and athlete and also a dancer. I was exposed to that when I was very young. So I did all those things. I’m the totally different story than you hear.

You hear stories that people were living the standard American diet, get ill, get terribly ill, see the light, do everything better, and get well. That was not my story. My story was I heard Scott, so I ate organically. My mother was an athlete. I became a yoga teacher. The Beatles came back from India from following the Maharishi. I said, whoa me. I’m going to go to India. I went to India, and I learned Ayurvedic medicine. I was a yoga teacher for many years. I kept getting cancer after cancer.

Dr. Weitz:                           Wow.

Dr. Berkson:                       And illness after illness doing everything right. Food isn’t the whole answer for everything. That is not the answer for everything. It’s certainly what drives our microbiome and a lot of our consequences, but it’s not the only thing that’s involved in wellness. My path, my karma was that I was doing the things that people are getting the memo on now: food and nutrients and meditation and forgiveness and detox. I was doing all that. I was getting cancer after cancer and tumor after tumor after tumor.

Dr. Weitz:                           How many forms of cancer did you have?

Dr. Berkson:                       I had breast cancer, then was diagnosed with kidney cancer. I lost seven and a half organs before I figured out what the heck was going on. I had to hack my own health out of the mountainside. Now in my older age … Can people see us? Am I on video as well as-

Dr. Weitz:                           Yeah, there’s going to be a YouTube video version as well as the iTunes version.

Dr. Berkson:                       I’ve been in practice for 47 years.

Dr. Weitz:                           You look great.

Dr. Berkson:                       So I’m not a spring chicken. In my older age I now can enjoy the youth that I never was able to enjoy in my younger age and the looks and the vitality and the energy, because I figured out what to do. It’s not just food. I got so enticed by Scott Nearing, by Bernard Jensen, by Paavo Airola, the early speakers, Jeff Bland. I was just enthralled with natural medicine, but it wasn’t because I was ill because I was already doing all the things that natural medicine said to do. Thus, my path took me on hormones, because hormones were my answer and how to combat hormone altering chemicals that damage your tumor suppressor genes and reboot them. I couldn’t go to any Functional Medicine internist or any chiropractor or any nutritionist. There was nobody who could give me that information.  All that was offered to me was that you have a very complex case. You keep having cancers. Let’s whip out those organs.

I have such an interesting tale because I now am I professor for A4M and PCCA, which are the … If an MD or a nurse practitioner wants to go further after allopathic medicine, they can take these further higher board certification courses, which are usually about four years long and cost about 50 to 60 grand. Now I’ve become a professor on those. Usually when the number of the professors … I’m on the gut module and on the hormone module and environmental medicine module. A lot of the docs talk about being a straight doc until they get ill, and then they have to clean up their diet, clean up their food, and they get better, but that wasn’t my story. My story is the story of hormones. So my book Sexy Brain and a lot of my books are the story of hormones. Based on one of my very first books on the environment, Hormone Deception, which came out about 24 years ago, which was one of the very first books on how things in our environment are futzing with our hormones. That came out a long time ago.  I was invited based on that book, which took me six years to write because nobody knew about that stuff back then. I was invited to be a scholar at an estrogen think tank at Tulane Med School. I got to work with the number one scientist in the world, Elwood Jensen, who discovered how hormones even work and Jan-Ake Gustafsson, who was the second scientist who discovered how the second estrogen receptor, ER beta, works. So it’s unusual to learn hormones from your own health story and then learn hormones from the guys who are making the field and then be in practice to have the honor with which to navigate that and explore that with patients.

Dr. Weitz:                            Now, since the Women’s Health Initiative, most doctors are telling their patients not to take estrogen replacement and hormone replacement therapy, but you have a different opinion about that, right?

Dr. Berkson:                       Well, I don’t think that’s really true anymore. The North American Menopause Society, NAMS, which is the most well distinguished society and sends all the data downstream to the gynecologists and endocrinologists, they’ve been coming out and saying, well … In their last several consensus statements they’ve come out and said hormones are okay if used for a period of five years for symptoms. They’re okay in breast cancer and high risk women if they’re given vaginally. They’re fudging the lines a little bit. But honestly, it’s stupid. Stupid. I just can’t take it anymore. If you read my book, Safe Hormones, Smart Women, which I actually have a book that I already updated but unfortunately the first molecule I discuss in the new updated book, the FDA is having an issue with, so I didn’t publish that book yet. The Women’s Health Initiative came out with bad news in the beginning of July 2002 saying that hormones really didn’t do anything that we thought they did and you should, doctors and women, throw them out the window because they’re going to cause breast cancer. At the re-analysis that began fervently because it was the number one selling med over proton pump inhibitors and antidepressant meds at that time, so there was lots of re-analysis by very prestigious statisticians at Yale and all over the world.

They saw very quickly that the women who were used within those trials, the estrogen only trial and the estrogen and progestin, synthetic progestin, the Prempro trial, were older women who had been out of menopause for over 10 years. Most of them were obese. They used a synthetic hormone. After you looked at all the data, all the data, and even the guy that wrote the fertility gynecology book that all the gynecologists say. I’m trying to think of his name. Leon. I can’t think of his name right now. He’s a professor at the University of Oregon. He said you can’t throw the baby out with the bath water. The clinical experience and hormones makes such a difference based on this trial. The reanalysis of this trial ultimately said that the estrogen only arm when re-analyzed showed that women on estrogen only had a 33% less increase of breast cancer and ultimately the arm, that means the group of women, that had estrogen and progesterone, it was the synthetic progestin that actually, if a woman had a preexisting cancer, really ratched that up or gave her a higher increase of stroke. So, first of all, doctors in Europe did not stop giving hormones like we did here, because they mostly give estriol and more natural hormones most of the time. Not all of the time.

Doctors who read the data and listen to the data or read my books or listen to my podcast gave up what the Women’s Health Initiative was saying or didn’t even listen to it. So there was a group of doctors who said that’s based on synthetic hormones. That’s based on women who were off hormones for at least 10 years. Because there’s a window of the best time to initiate hormones. The younger the woman, the healthier the woman, the less or zero the heart disease, the better the outcome of taking hormone replacement. But hormone replacement is as close that we have to the Holy Grail of slowing down aging of anything. Anything, anything, anything, anything.

When I used to work at the family practice clinic here at Wiseman Family Practice, Dr. Wiseman, who started the practice … I love to work with doctors who have been in practice 50, 60 years before they retire, because they’ve been around for so long, they’ve seen so much. They’re such rich resources. At the water fountain he and I would have these great conversations. He would say, “You know, Lindsey, if you have 100 people in a room and they all got the memo to do exercise, to eat right, but half of them are on hormone replacement or doing some intervention to balance their hormones, which there’s a debate about those interventions and the delivery modes and which way you take your hormones and how you assess your hormones, you could cherry pick them out.” Out of the 100 people where everyone’s doing, “everything right”, the people on hormones would have shinier hair, have bigger posture, be talking faster. If you have a lot of women sitting right here on your radio show about my age, they will not be speaking the way that I’m speaking right now. They won’t be. They won’t be as upwardly lilting as I am. They won’t look as I am. I want them to be this. I don’t want to be the only one on the block being like this, but hormones make a difference.

I had breast cancer 24 years ago.  A lot of doctors will never give a woman hormone replacement if she’s had breast cancer.  I’ve come to realize that that’s not true. It’s hormones out of balance that put your genes at fear of disregulating to put you more at risk of your tumor suppressor genes not working. You have to have somebody who knows all this, which aren’t a lot of people.  In fact, I just created an online course last year called Redefining Hormones in Today’s Toxic World.  It’s a 30-hour plus hormone course on what is really going on with hormones in light of hormone altering chemicals and all the new stuff we know, because doctors aren’t given this.  Whether you’re a naturopath or whether you’re an MD, you’re not trained in this in school.  I thought mostly smart patients were going to take my course. I had gynecologists, family practice docs, and internists, and everybody was saying to me why don’t we learn this in med school?  This information just has not yet entered the academic curriculum of docs.  It hasn’t trickled down yet into the clinical arena.

Dr. Weitz:                           Now, do you personally take natural progesterone along with the estrogen?

Dr. Berkson:                       Well, every hormone that you take should be tested and tracked. A woman shouldn’t have heart disease if she initiates bioidentical hormones, because in some women, and those are the women that it could be dangerous. I never see any patients whose doctors have done this. You should have a fast CT scan of your coronary artery. You should have an ultrasound of your carotid arteries. You should have a vaginal ultrasound of your endometrial stripes, the thickness of your endometrium, so after you’re on hormone replacement, after six months and a year, you can monitor it and make sure it’s not growing out of control. You got the right mix.

Dr. Weitz:                           And that’s the benefit of having a progesterone to keep the endometrium from over growing, right?

Dr. Berkson:                       Right, exactly, but a lot of doctors still feel if you don’t have a uterus you shouldn’t use progesterone.  Tori Hudson, who leads the female health department at National Naturopathic College, where I went when I was going to chiropractic school in Portland, she teaches at her conferences, if you don’t have a uterus, you don’t need progesterone.  Progesterone doesn’t just have receptors in the lining of the uterus. It’s got receptors in the brain. It’s got receptors in the gut. It’s got receptors in the vagus nerve.  Forward thinking neurologists are using progesterone to tamp down inflammation in the nervous system.  It has a lot to do with the health of the nervous system.  So it’s very hard to find practitioners these days that know what the heck they’re doing with hormones.  And then that leaves the woman or the man, because there’s manopause was well as menopause.  We’re all, all of our hormones are under attack, younger and younger.  Harvard just came out with a study. The pediatricians at Harvard just did this shocking study.  It was in February of this year. They looked at girls who had problems with body image, anxiety, over exercising.  We’re such an obsessive society about beauty and thinness and all that stuff. They measured their estrogen levels. They found many of the to be deficient. They slapped an estrogen patch on girls from 14 years old to 20 years old.  I’m kidding you not.  Fourteen years old to 20 years old because these women were insufficient in estrogen. The majority of those people felt totally better, lost their body dysphoria, did a lot better in school, and functioned better. These pediatricians in Harvard diagnosed hypoestrogenism in young girls.  Why in the heck would that be?

Dr. Weitz:                            Because of the toxic estrogens in the environment that are glomming onto the estrogen receptor sites and preventing their natural estrogen from working.

Dr. Berkson:                       That is definitely one of the reasons. And too much stress, cortisol, can promiscuously block estrogen receptors or if people have bulimia and eating disorders and eat too little. Fat makes estrogen, so if you get too thin you stop making estrogen because you have less fat cells and you conserve your energy. There’s multifactorial reasons today between stress and the demands on a young girl. So many young girls hate their body and hate themselves.

Dr. Weitz:                            Anorexia, bulimia.

Dr. Berkson:                       Right. In January 31st of 2017 there was a collaborative public forum put on by Harvard in the Huffington Post.  A lot of the guys that I worked with at Tulane were on that forum.  They said that there are three major threats to humanity.  The first one is nuclear war.  Everybody agrees to a nuclear war. The second one is global warming.  Most of the scientists agree with global warming.  Trump’s base doesn’t agree with global warming.  We won’t go there.  The third one they said, which is really huge, because it’s making issues with pregnancy, issues with milestones of reproduction.  When a young girl goes into menarche, she starts menstruating.  When a woman goes into menopause, it’s changing the pattern, the template of the human race, are hormone altering chemicals.  That’s what I wrote Sexy Brain about was hormone altering chemicals and its effect on intimacy in the brain.  They actually said this was the third threat to humanity.

Dr. Weitz:                            Wow. Yeah, endocrine disrupting substances, which include BPA in the plastics and mercury, which is spewed into the air by coal-fired power plants, and pesticides and chemicals in personal care products and phthalates. There’s so many endocrine disrupting substances, it’s amazing that anybody’s hormones are even halfway normal.

Dr. Berkson:                       Well, there is definite scientific, reproducible studies showing that young men in their 20s now often have the testosterone levels that men had in their 60s.

Dr. Weitz:                            Yeah, I just called one of the labs that we use.  We’ve been using Spectracell.  It’s 75% of the men of all ages have low free testosterone.  I said is your lab wrong.  They said no, we double checked them.

Dr. Berkson:                       There’s androgen disrupters just as much as estrogen.  When I first was going to write Hormone Deception, which stands as well today if you want to understand endocrine disruption.  You go to Amazon.  You get Hormone Deception. You will learn everything about what we’re talking about.  When I first tried to sell it, even with an agent, people said, “What the hell is this?”  Nobody had heard of endocrine disruption.  They said this is only worth a little teeny magazine article.  This is not worth a book.  Until McGraw-Hill believed in me. Judith McArthur, my agent at McGraw-Hill believed in me.  Now it’s on everybody’s lips.  Is it in lipstick?  Is it in makeup?  Is it in personal care products?  Is it in the air?  It’s a real deal because hormones aren’t just about sexy and reproductive things.  Hormones run our brain.  They run our central nervous system.  They run our gut.  We have receptors for estrogen, progesterone, DHEA, estriol, cortisol, all throughout the gut, let alone thyroid and hunger hormones and satiety hormones.

I have a new textbook coming out that I haven’t finished yet, about an 800 page monster. I put huge amounts of the unappreciated role of hormones in the gut. Hormones are like our physiologic internet system that send emails to little satellite dishes called receptors that run a lot of who we are. Being that our environment is rife with hormone altering chemicals, especially in the womb and in this egg and the sperm, that’s being attributed to the increasing rapidly incidents of diverse diseases in kids, behavioral issues, autism, cancers, et cetera. That’s a lot about what I discuss in the class is trying to put that together. How often when you go to see a doctor if you have an issue with your hormones, they say go see the gynecologist. Go see the endocrinologist. They’re not trained in any of this. Who does the patient go to if that’s influencing their health or they want to really caretake their hormones? That’s become my mission. In my own experience I had to do that for myself to get well. And my passion.

Dr. Weitz:                            Interesting. As far as your own hormone therapy, what is the percentage of estriol versus estradiol in what you use? Do you use a formulation that has a higher percentage of estriol?

Dr. Berkson:                       It depends completely on the person. Estriol signals mostly estrogen receptor beta. When women think of the bad estrogen dominance, they think of growth out of control, gaining weight, feeling bad in your premenstruum, all the negative things. Everyone has heard about the bad estrogen dominance.  But estriol signals the good estrogen dominance. It signals estrogen receptor beta, which controls growth.  In fact, the new theory of cancer is that you have estrogen receptor beta signals that are being signaled that protect a cell from turning into a cancerous cell.  If the estrogen receptor beta signals are shut off, that cell is more prone to cancer.  A hormone delivers a signal to a set of proteins in the shape of satellite dish called a receptor.  Hormones signals into a receptor, simplistically.  Estriol signals to the estrogen beta signal and that controls cancer.  So women have a lot less ER beta receptors in their lungs, which is why they are much more at risk of lung cancer from second hand smoke or primary smoke than a guy is. Because we don’t have those protective receptors in our lungs like guys do.  That’s why soy is not a bad food, because soy is the only food that turns the estrogen receptor beta on.  In fact, the guy that discovered the estrogen receptor beta, who I worked with at Tulane, Jan-Ake Gustafsson, he’s been wooed over to a pharmaceutical company in Houston.  So now he’s a big, tall Swedish guy with a cowboy hat on trying to make an analog patentable drug that acts like the estrogen receptor beta, but he keeps finding herbs and nutrients that do that, like milk thistle and flax seeds and things that naturopaths and chiropractors have been talking about for a long time.

Dr. Weitz:                           Rhubarb extract, right?

Dr. Berkson:                       Rhubarb extract. Exactly. That’s what Metagenics came out with their-

Dr. Weitz:                           Estrovera, yeah.

Dr. Berkson:                       … Estrovera product. There’s a lot of ways to do it. I don’t believe that there’s only one formula for estriol to estradiol. In the olden days people gave all three. It was called tri-es. Estrone, estriol, estradiol. Most people do not give estrone because that can have pro carcinogenic actions. I think you have to look at somebody’s blood work or urine or 24-hour urine or saliva, whichever way.

Dr. Weitz:                           What do you prefer for testing for hormones?

Dr. Berkson:       Well, Jonathan Wright, who’s the father of bioidentical hormones was my mentor. Alan Gaby, when he was a student … Alan Gaby is considered the father of nutritional medicine, so to speak, along with Jeff Bland. Alan Gaby was a student. Both of us took our first rotation in integrated medicine with Jonathan in 1977. Jonathan fixed Alan and I up on a date, which is a whole other story. Alan and I have become lifelong friends. All of us that have started functional medicine have been really close from early on. Jonathan taught me to run 24-hour urine tests. That’s what I used for decades. So I’ve been running for four decades 24-hour urine tests, but I’ve worked now at many clinics studying under other very smart docs. I love to learn older smart docs that have been around for a long time. I worked with Dr. Block in Tulsa who taught at two different med schools and was triple board certified. He only used blood. David Brownstein, who’s a really good friend of mine in Michigan, he only uses blood. At the family practice here they only use blood, even though they do pellet insertion.

Dr. Berkson:                       I lecture a lot with Jack Monaco, who’s a OBGYN who’s now gone rogue and is a gynecologist and one of the smartest, nicest guys I know in Nashville. He wants me to move to Nashville, but I don’t want to move to Nashville because I love living here. But I love Jack. Jack only uses saliva. You can use anything to monitor hormones. I’ve come to learn that there is no one best way. It’s the way that you feel works. Because hormones aren’t just what’s in the blood that you can pick up, it’s not just a test. It’s also the patient. The real true doctor-

Dr. Weitz:                           In how the patient feels, you mean, right?

Dr. Berkson:                       Exactly. You listen to the patient more than the laboratory. The reason is is the study of hormones in the blood stream that we pick up on saliva or blood or urine is called endocrinology because the prostate or the ovaries make a hormone and it travels throughout the body. Everybody knows that’s endocrinology. But a lot of hormones are produced intracrinologically. Men mainly produce their hormones intracrinologically. A women, when she’s becoming peri and post menopausal mainly produces her hormones that way, which means they’re produced in the periphery. They’re produced in the periphery, and we have no test at this moment to pick that up. We have a whole contributing system of our hormones which we now know is true intracrinologic endocrinology, but we don’t have an assay, a test, yet for that, so a really smart dude of a doc or a lady will listen to what the patient is saying in how they feel along with whatever assay or testing method that they decide and their comfy with using. It’s unfortunate that today in training it’s mostly by algorithm because the insurance companies are what run everything. They want a doc to only run these tests and only do these meds. You become a smart person. You learn how to take all those tests, and you go into practice and you stop thinking.  And you stop listening to the patient.

Dr. Berkson:                       Most doctors are burned out because they know that this is true. They’re unhappy along with the patient. That’s why there has to be a revolution where people have the time to think, the luxury to think, and they don’t have to have a high volume practice with all these rules. We’re being regulated to death.  Everybody’s being regulated to death.  Our hormones are being regulated to death, and the patients are being regulated to death, the doctors … It has to get to where people are enjoying their life, because otherwise your hormones stay ill no matter what you do for them.

Dr. Weitz:                            Right.  Essentially what you’re saying is is that the hormones that get measured in the blood or the urine are not necessarily indicative of how much of the hormones actually get to the tissues and the organs where they’re really needed.  How much is being absorbed and utilized, we don’t know that.  We’re just looking at this measurement of what’s in the blood, and that’s not really representative of what’s really being utilized.

Dr. Berkson:                       You said that really well.  That is really true.  Once you really grok that, Vulcan mind-meld that, it’s shocking.  The other reason that’s true is you could, let’s say, have a perfect level. You go. You’re a guy, and your wife has badgered you to go get your hormones tested because she heard a podcast somewhere that testosterone will suppress the expression of the ApoE4 gene. Your family has had dementia.  She doesn’t want you to get dementia.  She happens to really love you, and she wants you to go see your doc. Your doc looks at your level of hormones and he goes, “You’re fine. It’s within normal limits.”  But that doesn’t mean anything because some men might operate better at high normal than other men.  So there’s that issue.  Then there’s the issue where it isn’t really representative of the intracrinological or local production.  But there’s another issue, Ben, and this is the issue that’s not taught anywhere.  That’s that the level in your blood or whatever way you assay it isn’t telling you if that could really deliver its signal to the receptor, the proteins in the shape of a satellite dish. That’s where hormones, where the rubber meets the road, is receptor functionality.

Receptor functionality is based on a tapestry of things.  Are those receptors clogged with chemicals from the environment or from other hormones, like a stress hormone? Those DNA binding sites have to be flush with nutrients. That’s where your diet makes a difference is in the binding capability, like a parking lot, for your hormone car to pull into the parking lot of your hormone receptor and be able to do a great job of parking and deliver its signal to the gene. You have to have magnesium and zinc and B vitamins. That all affects how long the signal is delivered, how effectively the signal is delivered to the gene. That’s where your eating choices make a difference is where hormones can or not deliver their signal. And then that depends on digestion because if you’re eating great choices but you’re not digesting, you still won’t get the nutrients there. So hormones tend to be this bigger tapestry that somehow for some reason is not taught there. But when I was at Tulane we put on 33 years. I was only there for about 12 years of the 33 years of estrogens in the environment.

The last six or seven years of symposia were called e.Hormones. The last two or three sounded like naturopathic conventions, because they were, well, B6 has a lot to do with how long estrogen gives its signal and the zinc fingers need to pull the whatever. It sounded like you were at the nutritional symposium because nutrition and hormones are absolutely intimately intermingled. But nobody seems to know about this. It’s in the textbooks. But the patient misses out. The doc says your hormones look great. I can’t give you to them. Or you’re on hormones and I don’t know why you’re not feeling better. It’s because there’s all these nuances. You have to check this and check this. There’s the bullet list to check to see if your hormones are working well or not. And then there’s the peripheral production of hormones that we don’t have a way yet of testing other than your symptoms.

Then just one other thing and I’ll shut up. When I wrote Sexy Brain I had a consultant. He has written all the estrogen books for the medical books. His name is Michael E. Baker and he’s the scientist from UC Davis. We had an interplay of 50 to 60 emails of writing my book, Sexy Brain, which is all about how estrogen came on the planet and what testosterone did and how you interpret that up into the bedroom and what does that have to do with your brain. Nature design didn’t enlist you to protect our brains. But with hormone altering chemicals that wonderful design of nature is being attacked. He’s discovered in some new papers a few years ago that a healthy microbiome actually produces hormones, too. So your microbiome, which of course is this explosion of research and flurry about it, is intimately related to your hormone health. But if you go to your gynecologist and say, “Should I take hormones,” you’re 98% of the time going to get a wrong answer. The answer isn’t going to include checking off all of these different nuances of what might be glitching your own hormones. That’s my passion is to try and pass that forward.

Dr. Weitz:                            Sure. You mentioned the importance of the gut and the health of the gastrointestinal tract. You look at the percentage of people who are constipated. If you’re constipated, you’re not excreting your estrogen. It’s getting recirculated. Having a healthy gut is so crucial to having healthy hormone balance.

Dr. Berkson:                       That is so right. When I wrote Healthy Digestion, the Natural Way, it was published by Wiley and one of their best selling books.  It came out about 25 years ago. I talked about the studies.  I’m trying to remember the name of the authors on the study.  I can’t remember it right now.  It came out in about the ’50s where they took women that had normal breasts but they aspirated their nipples. They forced liquid out of their nipples so they got some cells, some liquid and some cells.  And then they looked at the women’s bowel habits. It was such a great study.  It was done on several thousand women.  And then they replicated the study, which of course is the hallmark of science.  I don’t remember if it was replicated by an independent laboratory, which is more the hallmark of science. They found that if women went to the bathroom twice a day, had a bowel movement twice a day, they never had any abnormal cells that were able to be aspirated out of their nipples.

Dr. Weitz:                            Fascinating.

Dr. Berkson:                       If they went to the bathroom once a day, they had five percent abnormal cells. If they went to the bathroom every other day or had constipation, they could go anywhere up toward 30 to 40% of abnormal cells. Exactly for the thing you just said, estrogen accumulates. When you poop twice a day, it tends to rinse out of your body. You make estrogen. You get rid of it. You make it. You get rid of it. You want to have this nice flow, this tai chi flow of estrogen throughout your body and out of you. Part of the way you do that is through two bowel movements. I tell all my patients our goal is two poops a day. The larger the poop, the smaller the hospital.

Dr. Weitz:                            And how many women have one bowel movement every two or three days and consider that normal? They don’t even think that’s a problem. It’s very common.

Dr. Berkson:                       I’ve noticed this that in a lot of my patients, more and more today people are eating well, exercising and even being on hormones and they’re still very ill. They’re doing everything right, and they’re not getting well. When you go in, my intake is several hours long. When I go in their intake, often they will say my gut’s always been my problem or I was constipated for 20 years until I learned about magnesium and chia seeds and so forth. But they have a history of many years of things not being wiped out of them. Do you see that in your patients?

Dr. Weitz:                            Very common, yes. There’s probably I think 75% of the people out there have some problem with their gut. You really have to probe them because you ask them how’s your gut. Oh, it’s fine. You ever get gas and bloating? Yeah. How about constipation? Well … You get reflux? Well, sometimes, but I’m fine. Really?

Dr. Berkson:                       But gastroenterologists don’t believe that food has much to do for the gut other than fiber and probiotics. They really don’t. They’re nice guys. It’s not like they’re jerks.

Dr. Weitz:                            I know. it’s unbelievable.

Dr. Berkson:                       They’re making their money in those colonoscopy banks. It’s extraordinary.

Dr. Weitz:                            No, it’s really amazing. Just shocking, that the tube that the food goes through, food has nothing to do with it. Well, I think it’s changing a little bit. I know some of the local GI docs are actually buying machines to do their own SIBO breath testing. Maybe LA is a little different because Dr. Pimentel is here.

Dr. Berkson:                       I think LA is a little bit ahead of the times. When I lectured in Chicago at A4M and the Gut Module, there was a fabulous gastroenterologist from LA who I’ve fallen in love with. If he wasn’t married, I’d be-

Dr. Weitz:                           What’s his name?

Dr. Berkson:                       I’d be on it. I’d be in LA. I’d be on it. He was so marvelous. He was so great. His name is Dr. Sam Farshad. He runs the Los Angeles Gastroenterologist-

Dr. Weitz:                           Yeah, he’s a friend of mine. I had him on the podcast a month ago.

Dr. Berkson:                       He’s fantastic.

Dr. Weitz:                           He’s great.

Dr. Berkson:                       I use his breath test. We talk all the time now. He wants me to come down to LA and talk to about 500 gastroenterologists, but they didn’t want to pay me anything. I was, wait a second. These guys are making $30,000 a day in their colonoscopy banks. They want to make me come down. Just something stinks in Denmark. I don’t know. But I love him. He’s such a great guy.

Dr. Weitz:                           Sam is great, yep.

Dr. Berkson:                       My two specialties, I do see a lot of complex patients. That what I love to see are people that have been everywhere, seen everybody, and no one can help because I love to see if I can put a fresh set of eyes on it and help them as I’ve done with myself and many patients. I tend to see more of breast cancer patients probably because I’ve been there and inflammatory bowel disease patients. I’ve had quite a number of patients that either were told they had to stat get a colectomy and get their colon removed or they’ve had their colon removed and they’re still not doing well. Now after working with me for three to six months, it’s usually very fast. This isn’t a two to three year program. I add hormones to the mix. I add estriol to the mix. I add totally different things. I have pre and post colonoscopies of people who have saved themselves from getting rid of their colon. Usually they’re women in their early 20s or they’re somebody who had a colectomy 15, 20 years ago and they’re still ill. And then we now finally get a normal scoping.

I’ve gone and had a visit with the guys at Austin Regional Gastroenterology and I showed them four cases of pre and post colonoscopies.  Gave them the lay of the land of what I was doing. They laughed at me. They said there was no way we would ever do any of this. Hormones belong to the endocrinologist. They don’t belong to the gut, even though there’s gut receptors for hormones in the gut. If we were going to do nutrition, we would hire a dietician and they don’t know anything about this.  I said, but look it.  You wanted this woman’s colon out stat, and now there’s no evidence of disease.  No, we honestly don’t think that food has anything to do with the gut.

Dr. Weitz:                           You know who’s a great gastroenterologist in Texas is-

Dr. Berkson:                       Brown.

Dr. Weitz:                           … Ken Brown. Exactly, yep.

Dr. Berkson:                       I had him on my show. He’s a really great guy. He designed Atrantil.

Dr. Weitz:                           Exactly.

Dr. Berkson:                       I don’t know if he’s really a functional doc though in the same sense where he-

Dr. Weitz:                           No, not as much as Dr. Rahbar. No.

Dr. Berkson:                       He doesn’t approach it like Dr. Sam Fahid who is a true … In fact, when Dr. Brown heard that I was going to be lecturing with Dr. Fahid, he got all in a tizzy. He said can you please connect us. He’s my hero. He’s really doing functional gastroenterology like nobody in the world is. You’ve got him right there. You lucky ducky you. If anybody has any kind of gut issue, you’ve got the best doctor right in the world right there. And he’s your good friend?

Dr. Weitz:                           Oh, yeah, he’s great. He was on the podcast. We talked about IBD. I organize a monthly meeting of Functional Medicine docs, and he came and spoke. We got to chat. It’s great. Yeah, he’s a great resource.

Dr. Berkson:                       One of the things I appreciate about him, which I feel in you, too, which is so nice, is he’s very centered. In today’s world where everyone’s so spinning out of control, it’s so exhausting.  You just speak with him for a few minutes and you start having both sides of your brain resonate at the same speed and your chakras, if you believe in them, are lining up.  I tend with my closest friends to try and seek out people who feel grounded.  When I talk to patients and they’re trying to get well and they’ve seen 15 doctors and they’re spinning all over, I go, “You know, you’re not occupying yourself.  We have to talk about how you can not abandon yourself and maybe become more solid and in sync with your own self. That’s part of your healing, because our society pulled you away.  How can we pull you back? Because if you’re not occupying your own body, then how can any intervention you pay any amount of money for with any doc you use heal you?”  He just resonates that centeredness, which is why I found him such a delicious person on so many levels.  The real deal.

Dr. Weitz:                           Cool. Well, I think this has been a great podcast. We haven’t got to talk about your book.

Dr. Berkson:                       You got to go buy my book. You’re crazy if you don’t.

Dr. Weitz:                           I have your book. I bought your book. I have a digital copy of it. Everybody should buy her book, Sexy Brain. It’s a great read.

Dr. Berkson:                       It really is. Although, every single scientist and mentor, doctor I’ve sent it to, the first thing they go is go to the sex chapters. Look, I have to be honest with you. I just went to the orgasm chapter first.  We have all this crazy science and translating estrogen and testosterone.  No, I went right to the A spot, the B spot, the C spot.  Okay, you’re a guy. You’re a guy. It’s okay.  I’m not a woman who doesn’t like guys. I think the American male is in such an interesting position today, because there’s the Me Too Movement and women have been reading books and taking exercise classes and becoming bigger, stronger, better. Wow. Guys, we need to have some iconic figures with guys to help them feel more comfy inside themselves. The definition of the male today is somewhat confusing as it’s been with women, so we forged our living out loud to embrace it. This is great that you’re having a show like this. Maybe you can be an iconic figure for some guys.

I hired a guy to come build a closet in my office. My kits, my gut kits and my DNA kits, my office is overrun with kits. Turns out that he had done a book on photographs of men and their sons but with famous men, with Presidents and their sons. He was on Oprah. He was on Joan Lunden, if you remember her. He was on all these shows. I said, “You should be doing this now. Men need you now. I want to get you on my show now.” We got into this whole conversation. We have such a gender confusion and a gender exploration where a lot of young kids today, teenage kids, are saying I’m not the right gender. I want to be a different gender. That’s really trendy at the moment. I go into that quite a bit in Hormone Deception.  

Sexy Brain is more for hetero couples, but I talk a lot about what might be contributing to that. It’s an interesting thing finding out who you are and how to really connect with another human being. The whoever you are, you can have the hormones that turn on your brain and allow you to be who you want to be. But if hormone altering chemicals are suppressing that and you don’t want a lot of intimacy because so many people today, young kids even, don’t care about intimacy. That’s with Sexy Brain.  It takes you on an exploration that is a story that needs to be told.

Dr. Weitz:                           Awesome.  So for our listeners who want to get a hold of you, what’s the best way for them to contact you?

Dr. Berkson:                       I have a website, drlindseyberkson.com. That’s D-R-L-I-N-D-S-E-Y-B-E-R-K-S-O-N.  There I’ve got my radio show, Dr. Berkson Best Health.  I’ve got my blog.  I do all kinds of fun things in my blog.  In fact, this week I’ve got a new thing coming out about the new a2 Milk.  I don’t know if you know about a2 Milk.  In fact, DABSE just said they were going to publish that in their journal.

Dr. Weitz:                           Oh, yeah. I know a little bit about that. Right.

Dr. Berkson:                       I talk about a lot of stuff.  My last blog was on the heavy metals in prenatal vitamins and how you should know-

Dr. Weitz:                           I saw that article, yeah.

Dr. Berkson:                       And the one right before that is why do we hate older women and three ways to stop that. With all the research about the bias against … Now that we’re turning women on, we’ve left out a group of the women.  We’ve left out the older women. We’ve left them in the dust. I wrote an article on that, because in that dust clumping myself.  They can also, if they want to feel like they want to have a consult with me, I consult with people all over the world. I work with your own medical team.  My number is 512-507-3279. My intake and the notes I write up and everything, it takes about five hours all together.  It’s all personalized for you.  You get my 47 years of experience and of writing 21 books and of having radio blah, blah, blah, blah. I get that focused onto you for hours to try and see if we can tease apart how to really get you well from another viewpoint.  Nobody can help everybody, but I have a good track record of helping very complex cases because those are the ones I like the best because I love to think.  Let’s see.  Is there any other way people can get a hold-

Dr. Weitz:                           You have some online courses that are available as well. Right?

Dr. Berkson:                       Oh, thank you. I have a little growing Berkson University. I’ve got a 30-hour course called Sexy Brain, Redefining Hormones. And then I’ve got a course called the New Estrogen because nobody knows all about the new estrogen. There’s many things that estrogen does that the new academic research … Did you know that estrogen drives epigenetics?  Did you know that estrogen protects mitochondria from damage?  It has a lot to do with mitochondrial health.

Dr. Weitz:                           Interesting.

Dr. Berkson:                       That’s a course on that. Then the final metabolite of estrogen called 2-methoxyestradiol, nobody knows about that.  That’s what saved me from more cancers. That was the molecule that I couldn’t talk about because the FDA … Anyway-

Dr. Weitz:                           I see. And that’s the benefit of measuring hormones with urine, because you get the estrogen metabolites, the two, four and the 16.

Dr. Berkson:                       Right, but we give the final metabolite, we can give that as a bioidentical hormone. It has so many applications, but it’s-

Dr. Weitz:                           Ah, interesting.

Dr. Berkson:                       … very people know about that.

Dr. Weitz:                           Yeah, I didn’t know about that.

Dr. Berkson:                       It’s very useful in cancer patients, in many cancer patients. That’s what stopped me from having cancers is 2-methoxyestradiol.

Dr. Weitz:                           Wow.

Dr. Berkson:                       That’s what stopped me. That’s one of the main hormones I take.

Dr. Weitz:                           And you get that formulated by a compounding pharmacy?

Dr. Berkson:                       There’s only one compounding pharmacy right now that sells it. It’s called Key Pharmacy, and Jonathan and I have been using it for about 15 years in hundreds and hundreds of patients. That’s the only pharmacy at the moment that sells it.

Dr. Weitz:                           Wow, okay.

Dr. Berkson:                       I called the FDA. I said, “How come more compounding pharmacies can’t sell it?” They said, “There’s not a monograph.” I said, “Can I write the monograph?” They said, “Who are you? You need to be a researcher.” The Center for Bio and Environmental Research where I worked at Tulane had closed down, so I applied to become a researcher at the Health Sciences Collegium. I became one, and I just haven’t written the monograph yet, because that all took a period of time. I’d like to make 2 MEO available for doctors to decide to prescribe and make it available. Right at the moment it’s not so available. It’s quite extraordinary.

Dr. Weitz:                           Interesting. Fascinating.

Dr. Berkson:                       I have a course on that that’s available. I have a course called Hormones, Biomes, and Breasts, Oh, My. Hormones, and Biomes, and Breasts, Oh, My. I’m going to have new courses. I have Oxytocin, the Love Hormone, and the Role in the Gut. I’m going to be publishing that soon. I’ve got a course on birth control. What is really going on with birth control? What is it doing? What should you take when you’re on it? Who shouldn’t take it? What are the options for birth control? I’ve got a course like that. I’ve got a number of courses coming out. The Unappreciated Role of Stomach Acids and the Dos and Don’ts of Stomach Acid. I’m going to be populating all these courses. If people want them, they could just take them for so much money, and then if they want to get them and download all the slides, they could pay a little bit more money and get the slides.

Dr. Weitz:                           Cool. Awesome. Thank you. Thank you for your contributions to Functional Medicine in the world.

Dr. Berkson:                       I’ll have a sip of beer to this.

Dr. Weitz:                           Talk to you soon.

Spore-Based Probiotics with Kiran Krishnan: Rational Wellness Podcast 71

Kiran Krishnan, microbiologist, talks about the benefits and research on Spore-based Probiotics with Dr. Ben Weitz. 

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


Podcast Highlights

5:49   When Kiran was researching which strains of probiotics are most effective and have the most research, he kept coming back to the spore-based bacillus species. Because these probiotics are encased in a spore, they have the capability to survive through the acid in the stomach and the bile salts and the pancreatic enzymes in the small intestine.  This is why most other, non-spore-based probiotics are killed by the time they end up in the colon.   

6:59  The difference between soil based and spore-based probiotics is that most of the bacteria in the soil have no benefit for us in our gut as probiotics.  Only a few of the bacteria in the soil are bacillus species and have endospores and these are the ones that can survive the trip down our digestive tract and are native to our gut.

9:35  If you do a Google search for spore-based probiotics, mostly negative articles come up that claim that they are new and that there are very few studies on them.  This is the opposite of the truth. Some of the spore-based probiotic strains, like bacillus subtilis, have been used in most of the world (in Europe, Asia, and Latin America) as prescription drugs since 1952 and have thousands of studies on them. In fact, if you go to Pub Med you’ll find that some of these bacillus strains are the most well-studied of all probiotics.

15:32  Kiran explained that it is interesting to note that most people think that the strains like lactobacillus and bifido bacteria that you see in most conventional probiotics are the natural strains found in our guts. But this is not true, since the particular strains of lactobacillus acidophilus in the stores are different than the strains found in your gut.  Many of these strains were first pulled out from a human volunteer 35 years ago and since then, they’ve been growing in a factory and the strain has completely changed and has adapted to life in the factory. And each of us have a unique set of bacteria strains that we first got from our moms.

18:26  Like conventional probiotics, spore based probiotics do not permanently colonize the gut. They do colonize the gut and adhere to the wall and outcompete bad bacteria, but they only last about 20-21 days. Then they form spores and leave the body through defecation and then find another host through being eaten in some dirt. Our primitive ancestors were consistently eating dirt since they could not wash their food before they ate it, so they were constantly getting exposed to these bacilli. Not only do these bacilli crowd out pathogenic bacteria, but they increase microbial diversity in our gut.

22:15  I asked when we do a stool analysis on our patients, why don’t we see these bacillus strains listed as commensal bacteria?  Kiran answered that some of the panels will list bacillus subtilis under dysbiotic flora due to a misunderstanding. The resolution of some of the tests is not good enough to easily pick out the exact species and since we often have over 1000 species in our guts, but the tests usually do not list more than 15 or 20 commensal species, so they are not really a good representation of what’s in our gut. Stool tests that use culture are not very accurate, since 98% of the commensal bacteria are not able to be cultured in vitro outside of the body.

26:51  Bacillus subtilis produces a number of antimicrobial compounds that help get rid of pathogenic bacteria, including H. pylori. During World War II when the German army was in North Africa many of the troops were dying of dysentery. They noticed that when the locals would get sick that they would consume dried camel dung and that would cure them, so they started to do the same thing. After the war, they studied this camel dung and isolated the bacillus subtilis from it and in 1952 a German pharmaceutical company patented it as the first probiotic treatment for dysentery and gut infections. The bacillus gets into the gut, does quorum sensing, which is the ability to read the other bacteria signatures, and and produces more than 20 different antibiotics to precisely kill off specific pathogenic organisms.

30:31  One study has shown the bacillus clausii strain to be effective against IBS/SIBO.

37:03  These bacillus endospore probiotics produce various nutrients in our guts. Bacillus subtilis produces the enzyme nattokinase, vitamin K2-7, methylated B vitamins, and CoQ10. The bacillus indicus produces 12 different carotenoids: alpha carotene, beta carotenene, astaxanthin, zeaxanthin, lutein, lycopene, all at RDA levels and they will be absorbed 100%.


Kiran Krishnan is a microbiologist and researcher on Soil Based (Spore-based) Probiotics and designed the formulation in MegaSporeBiotic from Microbiome Labs. https://microbiomelabs.com/   https://microbiomelabs.com/products/megasporebiotic/ 

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


Podcast Transcripts

Dr. Weitz:                            This is Dr. Ben Weitz with the Rational Wellness Podcast, bringing you the cutting edge information on Health and Nutrition from the latest scientific research and by interviewing top experts in the field. Please subscribe to the Rational Wellness podcast on iTunes and YouTube and sign up for my free ebook on my website by going to drweitz.com.   Let’s get started on your road to better health.  Hello, Rational Wellness Podcastors. Thank you so much for joining me again today. And for those of you who enjoy listening to the Rational Wellness podcast, please go to iTunes and give us a ratings and reviews so more people can find out about our podcasts.

Our topic for today is spore-based probiotics. Probiotics as most of us know are live micro organicisms, usually bacteria, but sometimes also a fungi and other organisms that naturally grow in our colon, the rest of our digestive tracts, and other areas of our body. There’s increasing evidence that the healthy bacteria that live within us are crucial to our health for so many reasons, including for immune function, the production of various vitamins, cardiovascular health, brain health, we can go on and on about all the amazing benefits of probiotics for which the researches is proliferating.  Today, we’ll be talking about a particular category of probiotic, known as soil-based probiotics that contains one or more species of bacillus, such as bacillus subtilis. Despite the fact that most of the probiotics on the market contain the more conventional species like lactobacillus acidophilus and bifidobacteria, spore-based or soil-based probiotics have actually been around for a long time, and have actually been studied quite a bit. Today we’re going to be speaking with microbiologist and researcher, Kiran Krishnan, who has been doing a lot of research on these spore, soil-based probiotics.  Thank you so much for joining us today, Kiran.

Kiran Krishnan:                  Thank you for having me. It’s a pleasure to be here and always fun to talk about bugs, and dirt, and probiotics.

Dr. Weitz:                           Exactly. Tell everybody to eat some dirt, right?

Kiran Krishnan:                  Exactly. Go back to nature, back to nature.

Dr. Weitz:                           Exactly. Before we get into some of the technical questions, can you tell us a little bit about your background and how you became interested in soil-based probiotics?

Kiran Krishnan:                  Yeah. I’m a microbiologist by training and I did a lot of research work. University of Iowa is where I came from. When I was at the University, I focused a lot of my research work on virology, on viruses, studying viruses. In fact, I got to work on HIV vaccine project with using live virus. I worked on some … But then I also ended up working on a project on E. coli. E. coli such a fascinating organism in many ways we know our gut is heavily populated with E. coli. It’s a common commensal bacteria, but we also know that there’s the E. coli that causes disease. And so when people hear about E. coli, they immediately think that, when there’s numerous, very beneficial, healthy E. coli species in your gut. In fact, if you’re trying to eradicate it, it would actually cause way more problems and than any benefit.

This dichotomy of having the species that are typically talked about in a negative way, like E. coli, versus the reality of them being actually really important beneficial is what drew me into the realm of probiotics where I wanted to focus on organisms that theoretically from a microbiologist standpoint would be very beneficial. But the perception in the market was that there’s something bad about them or unknown about them. That brought me to the bacillus endo spores. The bacillus endospores really was a set of probiotic strains that we came across doing probiotic research for a large multinational. I had a research company which I still do have and we still do some research trials through that, but we were hired by a large multinational to study the probiotic industry for them, study the products that are on the market, look at the way products that develop, they’re formulated. Does it make sense to be refrigerated versus non refrigerated? Do we need 100 billion, or 50 billion, or 200 billion? Do we need 17 strains or five strains? And there’s so much variety out there in the marketplace.  They wanted us to figure out what is really backed by science and what is really the right approach to probiotic use, and we came back to these spores, because we started looking that … We found that the vast majority of products in the market didn’t really have any scientific substantiation to them. There wasn’t any studies that showed that 100 billion CFUs was better than 50 billion, or that 200 billion was better than 100 billion. There’s no dose dependency in that way. There was also no studies that showed that 15 strains is any better than seven, or five, or three.

As it turned out, it was pretty much all marketing. When we dug deeper into what types of strains could really make a significant difference in the gut with measurable clinical outcomes, we kept coming back to these spores. Because the biggest thing about them is they have the capability to survive through the gastric system, so that passage through the stomach acid, the small bowel with the bile salts, which are very strong antimicrobials, and then even the pancreatic enzymes in the small bowel, that passage kills 99% of the bacteria that are used as probiotics.  The vast majority thinks that dying these are getting through and it’s my tendency to always look at evolutionary biology for answers. So in my view, they were designed to be able to get through the system and go and function in the gut. Because of that, my inclination was that they would play a significant role in the gut, and as we’ve been doing our studies and looking at all the other studies that have been done, our inclination was sure that these are significant players in the gut, in the microbiome.

Dr. Weitz:                            Just to clarify. Can you explain what the differences between soil-based and spore-based probiotics?

Kiran Krishnan:                  Yeah, that’s really important. I’m so glad you mentioned that because a lot of people are familiar with soil-based organism products. There have been a few prominent products on the marketplace in the last decade or more. There is a significant difference between a soil-based product and a spore-based product. Soil-based product is typically a product that has a whole bunch of bacteria from the soil that are typically not very well characterized. They have some genus and species mainstream, but these bacteria aren’t very well characterized, and then they put them in a capsule and utilize them as a probiotic.  The problem with that is the vast majority of bacteria that live in the soil really don’t do anything for us in the gut as a probiotic. Their job is in the soil. Their job is to break down plant matter, fix nitrogen for the roots, break down decaying animal matter, and so on. Now, exposure to them can be beneficial, because it up-regulates the immune system as it’s moving through, but those bacteria also die in the stomach, die in the small bowel, and you put them out 12 hours later. Now, spore-based organisms are unique in that you do find them in the soil. But the spore-based organisms actually live in the gut.

The difference is they use the soil as a vector to transfer from host to host, so when they leave the body, when they know they’re going out into the outside environment, they will cover themselves in this spore coat, which is basically a protein calcified coat that protects them from the elements outside the body. That allows them to exist indefinitely in the outside environment until they get swallowed again by a human or another mammal. They pass through the gastric system with this armor-like coating around themselves. The moment they get past it and they get into the small bowel, they will actually break out of this spore coat and become a live functioning probiotic cell.  When we were looking at the environment for answers to probiotics, we basically went and refined it and dialed down to the types of bacteria in the environment that can actually survive the journey of being swallowed and then function as a probiotic in the gut. That’s how we came across these spore-based organisms as being more than likely the ones that will do most of the probiotic function.

Dr. Weitz:                            When you go on the internet and if the average person just does a search on Google for spore-based or soil-based probiotics, even if you put scholar in parentheses, there’s not a lot of good research that tends to come up. I saw several articles including one that looked like it was written by somebody from Scientific American claiming that there’s only one small study and there’s really no research on these things.  Then I went to PubMed and you put in some of the specific names of the spore-based probiotics like bacillus subtilis, and you find out there’s thousands and thousands of studies there. What is the story about these spore-based probiotics. How long have they been around, and is there really good research on them?

Kiran Krishnan:                  Yeah. And I’m glad you bring that up, because I get that question a lot from people, because the vast majority of people, like you said, when they’re researching something, and the word research is a loose term when you use Google, right? When they’re researching something, they will go into Google and they will type it in and see what the first … Usually they’ll read only the first three or four things that come up. One thing that’s important to note about Google is that the first few things that come up aren’t based on their relevance or their accuracy in any way at all. It’s really based on the people who are behind it, doing good search engine optimization, so they’re back linking that link to many different websites and so on, and they’re putting a lot of content on the blog.

What I came to find out when I started looking into what is the market saying about the bacillus spores and finding all of these unfavorable write ups which, and I’ve read through vast majority of them, they’re all blatantly inaccurate in how they describe organisms, how they describe the microbiology of things, how they describe the microbiome and so on. I started digging into why are these out there, where are they coming from, and then you come to find out that many of these things are from companies that sell conventional probiotics and they basically pay people to put up articles about competitive types of probiotics to try to gain market share. And in fact, that was the main reason why we were hired by the large multinational company to do the research on the probiotics because they were looking at going into the soil-based or spore-based area and we’re seeing a lot of this misinformation on the web and wanted us to give them an overall real scientific review.

Now, when you look at the real science, which is like you said in PubMed and places where you can actually find scientific studies and papers, you’ll find thousands of research studies on bacillus subtilis. It is well known in the world of microbiology. They’re two of the most well studied bacteria in the world. We know more about these factor than any other bacteria that’s ever been discovered, and that is E. coli and bacillus subtilis. Bacillus subtilis is one of the most utilized bacteria in microbiology research. We use it in all different ways as bacteria transferring genes to another bacteria or as a way of testing things to grow on and exclusion media, all kinds of stuff that we do in directed evolution we use bacillus subtilis. It’s one of the most well known bacteria that have ever been discovered.  The thing about the spores is they have been in the prescription drug market since 1952 in Europe, Asia, and Latin America. In two thirds of the world, the spores have been prescription drugs for well over 60 years. Their use is actually far wider and greater than the vast majority of probiotics that we’re familiar with in the US because they’ve been used in hospitals, clinics, doctors offices and so on as prescription drugs. And when you start looking at the number of studies that are behind the spores, it’s staggering. These are some of the most well studied organisms on the market with respect to their probiotic function in the gut.

Dr. Weitz:                            That’s really amazing, mind blowing. I don’t think most people are even aware of that. To just clarify, these spore-based probiotics are typically forms of bacillus bacteria including bacillus subtilis, bacillus indicus, bacillus coagulans, bacillus clausii, whereas the conventional probiotics are species like lactobacillus acidophilus, bifido, Saccharomyces boulardii, these are the conventional probiotics.

Kiran Krishnan:                  Yeah, and I would actually put Saccharomyces more in the bacillus subtilis category, closer to that. Saccharomyces is a fungal probiotic, but when you look at the environment we would actually naturally pick up Saccharomyces from the environment, because you naturally find it on the outer skins of fruits and things like that, that our ancestors and early humans would have just consumed on a regular basis. Same thing with the spores. Our ancestors got huge amounts of exposure of the spores just by living on the earth, eating dirt, not sterilizing their environment, drinking water out of rivers and streams. These are ubiquitous organisms in the outside environment. So as humans, we naturally gain a huge amount of exposure to them.

It’s interesting to note from a microbiology standpoint, the things that we consider to be conventional strains like lactobacillus acidophilus, reuteri, bifidobacterium, and all of these that you see in 99% of probiotics. Out there, people say, well, those are the natural strains. The difference is the versions of lacto and bifido strains that you see in products are not the native strains in the gut. Even though they have the same name lactobacillus acidophilus, your lactobacillus acidophilus that you have in your gut, my lactobacillus acidophilus I have my gut are completely different than the ones that you find in the products in the stores. Those are not native strains to the gut. Not to say that they don’t have any benefit of the gut, some of them do, some of them do up-regulate the immune system, can control diarrhea, and things like that. But this concept that those are native commensals strains is totally erroneous, because they’re not.  The moment you pull out a strain like that from a human volunteer, 35 years ago, whenever they first isolated the strain, and since then they’ve been growing it in a factory, the strain has completely changed. It’s adapted to life in the factory than life in the gut. And as it is, we all have a unique set of lactobacillus and bifidobacteria in our microbiome anyway, right? No two individuals have the same distribution of those types of bacteria and our type, our version of the bacteria we got from our mom, and she got from her mom, and she got from her mom, and so on. Even identical twins born in the same mother will have up to 50% difference in their microbiome.  All our strains in our gut are completely unique. And so to think that the lacto bifido stuff you see at the store on the shelf are natural native bacteria, they’re not out there. They’re outside bacteria just as much as any of the bacteria are.

Dr. Weitz:                            Interesting. Now, we’ve learned that despite the fact that a lot of people don’t necessarily understand this, is probiotics don’t typically colonize the gut. They’re just temporary visitors there. Even though sometimes functional medicine practitioners will do a stool analysis and see that the person is low in a particular type of probiotic and may have the person ingest a product that has that particular species and even strain, those that you ingest actually are just there for a short period of time.  Now, we know that they help with developing a healthier microbiota, but they don’t permanently colonize our gut. What about sport based probiotics? How do they work?

Kiran Krishnan:                  Yeah, and you’re right that they don’t permanently colonize. Most of them just kind of move through like food does. Spore-based probiotics are interesting because they are designed by nature to leave the body, spend some time outside, and then come back in through the oral route, so through being consumed. They are perfectly adapted for that type of cycle, leaving through defecation and then re entering through oral consumption. Now, they do survive through the gastric system. They do get in the gut, and they do colonize, but as it turns out, they are transient in a way that they only colonize and stay within the gut for about 20 to 21 days. And when we initially discovered that, through some of the research we were doing, we were actually surprised, but then when you think about it, it makes complete sense.

The question I had in my mind is okay, if they’re so good at colonizing, meaning they’re really good at attaching and out competing bad bacteria and kind of changing the environment that they exist in. Why is it that they don’t just stay? Why do they leave? Well, two reasons. Number one, it’s we’ve developed this long term symbiotic relationship with them where we provide them a home and then they basically clean up the home for us. And in order for them to get transferred from host to host, to propagate themselves, they actually have to go out into the environment because they use the environment as a vector to transfer from host to host. And when you look at epidemiological studies and other types of environmental studies, they find that these bacillus spores are found in every corner of the earth and have been for millions of years.

Glacial ice core studies, for example, where they put long pieces of cores of ice out of glacial ice that measure few million years back into the Earth’s atmosphere, they found these spores in high abundance in the Tibetan plateaus in the South Pole in the North Pole. They’re virtually everywhere. And the way they get around is they use the environment, the air, the wind, the water to transfer to all of these regions. They need the environment as a vector to move, and so that’s one of their motivations coming out. The second thing is our ancestors if you imagine, would have gotten huge exposure levels to them on a regular basis. And if they never left at some point, they may be too many of them in the gut. What we want to do is promote the diversity within the gut and not have too many of any one species and so they’ve designed their own threshold level in the gut that they will not exceed. If any given area of the gut exceeds a certain threshold level of these spores, they will sporulate and they will leave.

Once they achieve what they think is their healthy balance, they will just continue to leave at the same rate that they’re coming in. And that’s very interesting, because as it turns out, once they get into the gut, one of the big effects of having these spores in the gut is a dramatic increase in diversity of the rest of the microbiome, and that’s never been shown with other probiotics. No one has ever published a research study showing that when you add any of these other conventional probiotic products, that it actually has any impact on the diversity or the population of the microbiota. We are submitting a paper for publication this year, showing that when you add the spores, in some cases, that almost doubles the diversity of the rest of the organisms.

Dr. Weitz:                            Wow.

Kiran Krishnan:                  Yeah. They get in there, and they affect change so much that they increase the growth of all of these underrepresented beneficial organisms.

Dr. Weitz:                            Interesting. How come when I get a stool sample back, that functional medicine based stool analysis that looks at the range of commensal bacteria, I don’t typically see these bacillus strains listed among them?

Kiran Krishnan:                  Now, some of the tests will, but some of the tests will list them under dysbiotic flora. When you look under the dysbiotic flora category, they’ll show bacillus subtilis, which again is just kind of misinformation and inaccuracy. And they don’t look for any of the other bacillus species. They just don’t know enough about them. There’s a lot of issues with stool testing. The ability to be very accurate with stool testing is really poor. Recently, the head of the American microbiome research which is based out of University of California in Davis, University of California, Davis, Rob Knight, he heads up American gut project. He’s a top microbiome researcher in the US. He came out with the papers and findings that the type of sequencing that’s used in pretty much all of the commercial stool testing systems is incredibly inaccurate.

The resolution is really poor is the problem. You can get down to this genius level, but you really can’t get down to the species level that accurately, so it’s very hard for those tests to identify all of the different species that could exist in the gut. And then their relative abundance as well. That’s another problem because you could have 1000 different species or 1500 species in your gut, you don’t get a stool test report back listing 1500 different species bacteria. You might get 15 or 20 that show pluses and minuses. It’s not a great representation of what’s actually going on in the bowel to begin with, and so certainly it doesn’t pick up on the vast majority things that actually in the bowel.

Dr. Weitz:                            Does it matter if we ordered a stool test that’s culture based versus PCR based?

Kiran Krishnan:                  No, it doesn’t matter because the culture based ones are severely limited because 98, 99% of the commensal good bacteria in your gut are not culturable in vitro outside of the body. They’re really hard to grow them because they’re strict anaerobes. The moment you pull them out, they start to die being exposed to oxygen. The PCR DNA based ones still use something called 16 S sequencing, which is low resolution and you can get a lot of false negatives. Just because it doesn’t show it on the test doesn’t mean it’s not there.

The other issue with the stool sample is the bacteria in the stool is not homogeneously distributed, right? That 15, 20, 25 grams sample that you’re taking is not a representative sample of the rest of the microbiome because you’re just looking at what’s in that sample. If you had taken a sample from a few inches away, it could look completely different. And you’re also looking at bacteria that’s being shed. Not necessarily bacteria that’s sitting in the mucosal well attached proliferating. The other thing is if you look at the manual for the stool testing, you’ll see that even in their manuals, they say that stool tests are representative of the micro flora and the distal colon. So it’s really a distal colon sample and it’s a snapshot in time of the distal colon. It doesn’t tell you anything about the ascending and transverse colon, it doesn’t tell you anything about the small bowel and so on.

It can be a tool to use. I in particular like the functional side of the stool test when you can look at things like short chain fatty acid production, secretory IgA, fatty acid degradation products, protein degradation products, that gives you a little bit more insight into what’s actually happening in the bowel. The microbiota component, what backers there, and what’s at high level, what’s at low level. That stuff is still very much in its infancy, and it’s almost never used in clinical trials for that reason, because it’s really hard to make any sense of it.

Dr. Weitz:                            Wow, interesting. Interesting. In some of the reading I did, I understand that bacillus subtilis strains can produce a variety of antibiotic, anti microbial compounds that can help crowd out potential pathogens in our gut including H. pylori. Can you talk about that?

Kiran Krishnan:                  Yeah, actually there’s an interesting story behind that, and the way this was discovered is actually, that’s where the interesting story comes from. During World War II when the German army was in North Africa and they had a whole campaign in North Africa, the vast majority of German soldiers were dying of dysentery because of the food and water in that part and their bodies weren’t used to it, their guts weren’t used to it. But they also noticed that the locals when they would start to get sick, what they would do is they would look for dried camel dung and they would consume the dried camel dung, and that would basically heal them of the gut infection. They took a bunch of this dry camel dung back and started studying it in Europe to figure out what is it within the dried camel dung that was curing the dysentery and they isolated the bacillus subtilis strain.

The bacillus subtilis strain from further research that they did was shown to have this capability of getting into the gut and then doing something called quorum sensing, which is the ability of bacteria to read other bacteria signatures, and they can find pathogenic or unfavorable organisms. They’ll sit next to them, and they’ll produce upwards of 20 different antibiotics to kill off that organism. But it does it in such a precise position manner versus when you think about taking an antibiotic prescription, which is like an atom bomb for your microbiome, right? It basically kills everything and it kills everything very quickly. And so, this is like a precision SEAL Team Six type of attack to those pathogenic bacteria. From that very research in the late 1940s, by 1952 a big German pharmaceutical company launched the first probiotic treatment for dysentery and gut infections from that work and that product is still in the market today. It’s been over 60 years and it’s still prescribed and used because it’s so effective.

Dr. Weitz:                           That’s amazing, and you just hear all these spore-based probiotics, they’re new, they just came on the scene, we hardly know anything about them. It’s pretty much the opposite.

Kiran Krishnan:                  Absolutely. They’re the most widely used probiotics in the rest of the world, and they’re using it in the medical setting, not even so much in health food stores and things like that. Their use has been very well documented because they’ve all been prescription drugs, and as prescription drugs, we know that there’s something called post market monitoring where all the adverse events and all of the negative issues that could about when a product is in a health food store, you might never know about it. But when it’s a prescription drug and doctors managing it, those are all reported and it’s all made public.  The fact that these strains have been used as prescription drugs for over 60 years and there’s so few adverse events or reports to them is really fascinating. It means that their level of safety and efficacy is unparalleled.

Dr. Weitz:                           I understand that there is at least one study using these spore-based probiotics for IBS/SIBO.

Kiran Krishnan:                  Exactly, yeah. In fact, bacillus clausii, one of the species that we work with in our product MegaSpore has a great published study showing that the bacillus clausii can reduce the overgrowth of organisms in the small bowel just as well as any antibiotic can, but it does so in a way that doesn’t disrupt the rest of the microbiome.

Dr. Weitz:                           I understand that you helped design and formulate the strains in the MegaSporeBiotic?

Kiran Krishnan:                  Yeah, exactly. When we came across these bacillus endospores and started to really understand their value in probiotic therapy and also manipulation of the microbiome for favorable outcomes, we saw that on the market in the US there was really only one strain that was marketed and used widely and that was bacillus coagulans. And then bacillus coagulans strain and product had actually been in the retail market for 10 years or so at that point. It was the one and only used one, but then there’s so many other useful spores that we went ahead and created the first multi spore probiotic product on the market and that’s the MegaSporeBiotic product.

We made that available only through physicians and health practitioners because it requires education. The product is really powerful. It has a lot of therapeutic benefit.  It’s really stuff that only healthcare practitioners, physicians, can understand and convey to their patients. And so we made it available only through physicians.  Now, we’ve engaged in a significant amount of research because in our view, when you have a multi spore product, and assuming you have the right spores, and they are in spore form, and they can survive through the gastric system and do colonize.  And that’s something important to talk about because there are differences among spores as well.  I’ll mention that after this part.  But what we saw was there could be significant therapeutic benefit to having a multi spore product. And as it turns out, we published our first study on the multi spore product in August of last year.

We have completed five other studies this year, which are all being written up right now and submitted for publication. And we have five or six other studies going on at the same time. In total, we’ve got 12 clinical trials either completed or ongoing on the multi spore product. From what we’re seeing so far, it’s quite fascinating, and our goal has been the moment we formulated this product, was to quickly become the most well researched probiotic formulation on the market because we want to dispel these myths. We want to dispel these nonsensical assumptions that are being made out there and we want to show through research that these spores have such important and significant functions within the gut. One thing I want to mention, so then, now we’ve seen other spores coming out and we’ve been testing them, so other companies are saying, “Hey, we want to do a spore product too and they’ve been coming out.  What we find is that there’s a couple of issues with the types of spores that they’re selecting. Number one, their spores are not completely in spore form in the product, right? That’s part of the technology that it took us almost seven years to develop was, when you grow these bacteria, they’re not in spore form. When they’re in spore form, it means that they’re metabolically inactive. They’re not multiplying, they’re not doing anything really, they’re just kind of sitting there inertly waiting to be consumed, to come out of this spore state, to becoming a live, functional, vegetative bacteria. When we were growing them in a fermentation tank to multiply them, we are growing them as a vegetative bacteria not as spore bacteria. They go into the spore form under conditions of stress and duress. That’s their way of protecting themselves.

What we found is that we’ve developed a way to be able to take this big 15,000 liter tank growing with trillions and trillions of spores in there, and then add a stress to that environment so we can get them all to go into the spore state, and then extract them in the spore state, and we were able to extract them 100% as in a spore state. What we see in other spore-based products is that about 50% of the strains in there are not in spore state, they’re in vegetative cells state. Now the problem with that is when spore forming bacteria is not in its spore state, it’s in its vegetative state. It’ll also die in the gastric system, like any other bacteria will. Only the spore state protects it. So some of these other products coming out, we’re seeing that they’re dying in the stomach, like any other probiotic product would and they’re not necessarily selecting spores that have shown the ability to colonize. Because there are spores that you can find out in the environment that will also move right through because they don’t express the right proteins in order to adhere to the mucosal layer and actually colonize.  Those are two very important things that one needs to look at when they’re trying to find and develop a spore for product for use as a probiotic.

Dr. Weitz:                            Interesting, interesting. How do you create stress in a spore-based probiotics? Do you show them clips of the News or something?

Kiran Krishnan:                  Exactly, yeah. That’s all you have to do, right? Just show them two or three News sources.

Dr. Weitz:                           Just show a loop of Rudy Giuliani.

Kiran Krishnan:                  Right. Let them go on Facebook for 10 minutes and they get stressed out. We do it through manipulation of the nutrients that are in there because the thing is you don’t want to stress them too much too fast or you will kill some of them. You want to create a really calculated stress where you give them a chance to go into their spore state and then you can extract them out into that spore state.

Dr. Weitz:                            A couple of other things I saw in some of the reading I did it that I thought was particularly interesting is bacillus subtilis helps to produce natto, which is one of the best sources of vitamin K2, particularly MK7 version, which is so important in reducing arterial calcification.

Kiran Krishnan:                  Yeah. In fact, one of the things that’s really interesting about the spores to me, which some of my earlier work, I was the first guy to bring nattokinase, if you remember that enzyme, to the US back in 2000. I was working with the Japanese company to make nattokinase from bacillus subtilis, actually, the natural fermenting bacteria and then develop ways to extract the nattokinase and then bring it into the US as a fibrinolytic enzyme.  One of the fascinating thing about the spores is that they are nutrient factories as well. When they get into the gut, they basically sit there, like the bacillus subtilis does, and when food comes in, they start fermenting and breaking down the food and converting them to things like vitamin K2-7 like you mentioned, but also methylated B vitamins. They produce ubiquinol. They produce CoQ10.  And one of our strains, which is a unique strain called bacillus indicus, produces 12 different carotenoid antioxidants in the gut for you, which is fascinating. It produces alpha carotene, beta carotene, astaxanthin, zeaxanthin, lutein, lycopene, all at RDA levels. Right at the site of absorption, right? They are the most bioavailable antioxidant, carotenoids that you can get into your diet, and they’re produced by bacteria sitting in your gut.  It’s a fascinating role that these bacteria play and the mutualistic relationship we have with them with this in this regard is really fascinating to me as a microbiologist because somehow we have created this communication with them that, “Hey, go into our gut. We’ll give you a home. Our immune system recognizes you as a normal part of the flora.” Our body is not trying to attack them, and so we give them a residency and in turn, of course, they kill the bad bacteria and get rid of them. They increase the growth of the good bacteria. They seem to be sealing up leaky gut, which is the study we published last year, and then at the same time, they produce the all of these nutrients for us that are directly absorbed into our intestinal lining, so it’s a really fascinating relationship we have with these bacteria.

Dr. Weitz:                            Wow, amazing.  Are you going to consider looking at the relationship between the indicus and macular degeneration because all those carotenoids have been well studied as helping to reduce the risk of chronic macular degeneration, which is one of the most common degenerative eye diseases.

Kiran Krishnan:                  Yeah. In fact, the rates of them are increasing the US and there is some talk that all of this blue light exposure that we get on a regular basis from screens and things like that are accelerating some of that and those are all theoretical, as I understand them right now, and not proven yet, but kind of makes sense when you think about it. But we are working with a neuro-ophthalmologist and we are looking at designing some studies around that. Because when you study carotenoids as a supplement, what you find is that the bio-availability of carotenoids as a supplement is less than 10%. It’s really hard to absorb carotenoids that are trying to pass through the gastric system, the small intestines, and actually gain exposure to the intestinal lining for absorption. Studies have been done on pure beta carotene, and they find that pure beta carotene by availability is a little less than 10%. When you compare beta carotene from the spores, it’s 100% bio available, because it’s produced right at the site absorption, past the gastric system.  I really believe that they are the most important sources of these carotenoids and antioxidants that we’re supposed to be getting in our diet.

Dr. Weitz:                            Wow, really amazing.

Kiran Krishnan:                  Yeah. Is that fascinating? And here’s what’s interesting. This indicus, that strain, one of the ways it was discovered was a huge European consortium study called The Color Spore Consortium. There was, I think, 14 different research institutes involved. They spent about five and a half million euros on funding this and what they were looking for are bacillus strains that produce carotenoids in the gut. And the reason they even thought of that is when you look at certain animals in the animal kingdom that express a lot of carotenoids on their skin, like flamingos are pink on their feathers because of a carotenoid. Salmon skin is pink because it’s of carotenoid stream, with the orange bands, those are carotenoids that they’re expressing.  The question is where do they get their carotenoids from, because they don’t eat colored fruits and vegetables, right? The investigation showed that these animals all have a probiotic bacteria in their gut that produces such high levels of carotenoids for them that it shows up on their skin. And then they said, “Okay, if those animals have those bacteria, there’s a good chance that humans have similar bacteria and are humans supposed to get our carotenoids from bacteria or we’re supposed to get it from the diet?” So they started looking at dietary carotenoids both from foods and supplements, and the bio availability of them had found that those were dramatically lower than we thought, and then they started looking, are there strains in the gut that produce carotenoids? And they found indicus in a couple of the strains that actually do.

Dr. Weitz:                            Fascinating. Really, really interesting information. Well, it’s been a great podcast, Kiran. Thank you so much for bringing us such great information. Anything you want to say about the products you’re working on and the availability?

Kiran Krishnan:                  Yeah, absolutely. And then again, thank you so much for having me. I love any opportunity to try to dispel myths and clarify rumors and things like that. I think accurate information in our world today is a rare thing as we know in every facet of our lives, and especially when it comes to your health and wellness, having the right information is really empowering.  The product that we work with healthcare practitioners and physicians with is called MegaSporeBiotic. You can find a lot of information about it and also about our research and webinars and all that stuff if you go to our website at microbiomelabs.com. That’s labs with an S at the end of it, and microbiomelabs.com. And of course people can get the mega spore product through their physician, through their practitioners such as yourself.  We believe you should always be working with a health professional with your supplements anyway. Because they have the capability of vetting the nonsense from the stuff that really makes sense, and so you’ll get your best bang for your buck. You will get your right nutritional therapy from your health practitioner.   We thank you for this opportunity and the ability to talk to you about this product.

Dr. Weitz:                            Awesome. This has been great. I’d love to catch up with you again sometime in the future.

Kiran Krishnan:                  Yeah, let’s do it again. I look forward to it.

Dr. Weitz:                            Sounds good. Keep up the good research. Talk to you soon.

Kiran Krishnan:                  Thank you.

Dr. Weitz:                            Okay.



Improving Sleep with Dr. Jose Colon: Rational Wellness Podcast 70

Dr. Jose Colon talks about how to improve your sleep with Dr. Ben Weitz. 

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


Podcast Highlights

1:49  Sleep is very important.  We spend a third of our lives sleeping and there’s a lot of regenerative processes, and encoding of memories, and healing the body that occur with sleep. A 12 mth old should be getting about 11 hours plus a nap in the daytime. A 10 year old should be getting about 10 hours of sleep. A ninth grader should be getting about 9 hours of sleep. Adults should be shooting for 8 hours and the elderly should get at least 7 hours of sleep per night.

5:06  The consequences of poor sleep can include cognitive problems in thinking and thought processing. ADHD when the diagnosis is made as an adult and pseudodementia can both be related to sleep problems.

7:17  Sleep quality is as important as the amount of sleep. You need to have uninterrupted cycles of REM, when your brain is actually very active and we are encoding our memories with emotions and we have our testosterone secretion, etc. and non-REM sleep cycles, which is our deepest sleep where our brain wave is really slow and we have growth hormone and gastric acid secretion and myoprotein synthesis. 

9:03  One of the biggest disturbances of REM sleep is untreated sleep apnea. Antidepressants tend to decrease REM sleep, as does light exposure during sleep.

10:49  Some of the most important effects of sleep deprivation is poor memory, poor performance such as driving, increased inflammation (CRP, IL6, TNF), decreased testosterone production in men, alterations in the menstrual cycle in women, increased cardiovascular risk, and increased insulin resistance.

14:19  The most important factors that affect sleep include electronics and perhaps most important is stress and stressing out over the fact that you are not sleeping. Dr. Colon recommends instructing your patients that if they can’t fall asleep, to do some relaxation training like awareness of breath meditation, which will tend to slow down your respiratory rate, which will put you into that parasympathetic mode.

19:14  I asked Dr. Colon if everyone who gets a sleep study has sleep apnea and is prescribed a C-Pap machine? Dr. Colon explained that sleep apnea is when you stop breathing in your sleep and he answered that not everyone who goes through a sleep study comes out with a diagnosis of sleep apnea and for those who do have sleep apnea, not every treatment is with a CPAP machine.

22:59  Vitamin D deficiency can affect sleep and even induce sleep apnea.

25:15  Restless legs syndrome can affect sleep and this is often related to inadequate ferritin levels, which Dr. Colon recommends to get the ferritin levels above 50 by treating with iron.

26:58  Cognitive Behavioral Therapy is the gold standard for treating insomnia. Another emerging treatment for insomnia is mindfulness based treatment for insomnia, which was created by Jason Ong.

29:15  Circadian rhythm entrainment 

33:11  Some of the more effective supplements for sleep are zinc, magnesium, lavender, melatonin, but it is more effective to run a Micronutrient test or an adrenal profile or a melatonin test or a urine neurotransmitter profile and find out what your individual patient needs and treat that. 



Dr. Jose Colon is an MD who’s board-certified in Sleep Medicine and Neurology. He teaches for the Institute of Functional Medicine and he’s the author of books for women’s sleep (The Sleep Diet – A Novel Approach to Insomnia), sleep and mindfullness in children, and sleep for infants. He’s the founder of Paradise Sleep, on organization dedicated to the education of sleep and wellness. www.paradisesleep.com  

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


Podcast Transcripts

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

Hello Rational Wellness Podcasters. Thank you so much for joining me again today. For those of you who enjoy listening to the Rational Wellness Podcast, please go to iTunes and leave us a ratings or review so more people can find out about the Rational Wellness Podcast. Today our topic is sleep. How important sleep is, how much sleep do we really need, what factors affect our sleep, and what we can do to improve our sleep. We’ll be interviewing Dr. Jose Colon, who’s an expert at sleep. He’s an MD who’s board certified in sleep medicine and neurology. He teaches for the Institute of Functional Medicine, and he’s the author of books for women’s sleep, sleep and mindfulness in children, and sleep for infants. He’s also the founder of Paradise Sleep, an organization dedicated to the education of sleep and wellness. Dr. Colon, thank you so much for joining us today.

Dr. Colon:            Hey, thank you. It’s wonderful to be here, and I appreciate your podcasting.

Dr. Weitz:            Great. So how much sleep do we really need? And I know it differs for kids versus adults.

Dr. Colon:            Yeah, so of course sleep is important. It’s a third of our lives and even more of that in kids. There’s a lot of regenerative processes, and encoding of memories, and healing the body that we’re having with sleep, so it is important. And when we ask how much sleep someone needs, I have to say it really is variable. There are things that we like to tell people. We want to tell everyone to get eight hours of sleep, to get seven to eight hours of sleep. And that’s true. That’s a good recommendation, but it really is variable. It’s also variable across the different ages. I like things that are easy to remember, so I’m gonna give you a couple of numbers that are easy to remember, but then we’re gonna talk a little bit more specifically about bright, okay? So easy to remember is that a 12 month old should get 11 plus one. 11 hours of sleep plus one nap in the daytime. A 10 year old should be getting about 10 hours of sleep. A ninth grader through high school, okay, your teenager, should be getting about nine hours of sleep. That’s a perfect storm of a lot of different problems because they’re asking them to wake up during non, you know, unphysiological times. When you have your eight to four job, okay, eight hour days into adulthood, you should be getting about eight hours of sleep. In your elderly, in your 70s, we try to shoot for about seven hours of sleep. And it’s not so much that the elderly need less sleep, it’s just that there are factors, medical factors, that occur that we get more sleep intrusions … sleep arousals, fragmented sleep, but seven hours is a number that’s easy to remember, plus it’s normal to reintroduce naps into the elderly period.

Now, all of these numbers that I gave you, you can plus or minus one of them. And many times it’s minus one of them. And even then, having said that, different people say different things. You know, Dr. Mark Hyman mentions that everyone should get about eight hours of sleep, and American Academy of Sleep Medicine and National Sleep Foundation reiterate that. Dr. Andrew Weil talks about how there are some people that can get less than six hours of sleep and have no ill effect, and he’s right, because international classification for sleep disorders also does have short sleep syndrome as a normal variant. There are some people that get less than six hours of sleep and have no adverse effects. Now, to classify for that diagnosis you need to have no adverse effects, of course.

Dr. Weitz:            I talk to people all the time who say, “I get five six hours that’s all I need”, but how do they really know if that’s really true? What are some of the things that they might not even be noticing that could be affecting them?

Dr. Colon:            Yeah, so let’s talk about consequences of poor sleep. And we all know consequences can be cognitive, they can be problems in thinking and problems in thought process. There’s a lot of diagnosis of adult ADHD that is made as an adult, where they haven’t had the symptoms before. And that’s someone that you really want to get a sleep study on and see how much sleep they’ve been having. Same thing with pseudodementia, I was taught that, in medical school, that if someone complains that they’re having dementia, the fact that they’re complaining means that they know it, so they may be depressed. Well, not so fast, you may want to make sure that they don’t have an untreated sleep apnea that’s causing that. Other factors-

Dr. Weitz:            What was that term you used, pseudodementia?

Dr. Colon:            Yes, pseudodementia. Pseudodementia. Yeah. And-

Dr. Weitz:            So these are people who don’t truly have dementia, they just have dementia because they’re not sleeping enough?

Dr. Colon:            Well, they complain of memory concerns, but then they do a … you know they do the cognitive testing and it turns out to be normal, so they diagnose them with pseudodementia, and they say that is from depression. And to put them on an antidepressant. But you know, I mean, it really could be an untreated sleep apnea. The other thing it could be, it could be mild cognitive impairment. Or subject cognitive impairment, as Dr. Bredison talks about in his book The End of Alzheimer’s.

Dr. Weitz:            And those are the beginning stages, before you get to full blown dementia, right?

Dr. Colon:            Yeah, correct, correct. Other consequences of disruptive sleep are insulin resistance. So if you’re seeing … any evidence of insulin resistance, unfortunately many times people will just check the hemoglobin A1C, but fasting insulin levels are higher before that. So these are all factors that you would look into, if they’re not sleeping well, take a look at their cognitive status, metabolic status, and that can tell you if it’s affected or not.

Dr. Weitz:            Interesting. So not only the amount of sleep, but there’s also the quality of sleep, and I know there’s the importance of getting the REM sleep, and can you explain what are some of the most important factors in the quality of sleep?

Dr. Colon:            Yeah, so that’s something that people commonly ask me. They’ll be like, “Dr. Colon, tell me about REM sleep”, and all the cycles are important. People many times think that REM is your deep sleep, but it’s actually a very active brain time. Very active brain time. And we’re taking today’s information and we’re encoding memories, in particular memories with emotions. In our REM sleep we also have increased blood flow that’s going through our organs. In that first REM cycle you have testosterone that is secreted. But this is all in balance with your non-REM sleep as well. The non-REM sleep, just like a washing machine has a deep soak, our deepest sleep is at the beginning where our brain wave is really slow and we have growth hormone secretion, we have gastric acid secretion, so all of this is important. And you have this really rhythmic setting to where you have this gastric acid secretion in the beginning of the of the myoprotein synthesis, and then with our REM sleep we have increased blood flow, delivering it to our body for healing our body. So it’s all very important.

Dr. Weitz:            What are some of the, how does your REM sleep get disturbed? Like can you get a normal amount of sleep but it’s just not the quality of sleep? What happens there?

Dr. Colon:            One of the biggest disturbances of REM sleep is actually a untreated sleep apnea. And the reason for this is because in REM, our body has less muscle tone, so you don’t act out your dreams, it’s a protective mechanism. But when we decrease our muscle tone, our muscle tone in our airway also decreases as well. So some of the problems that can occur with REM sleep can be an untreated sleep apnea. Other things that can affect our REM sleep are antidepressants decrease REM sleep, and that’s one of the major factors there. Another thing that can affect your sleep in general, whether it’s your REM sleep or your non-REM sleep, is light exposure. If you’re sleeping with light exposure, some new studies have shown that that increases insulin resistance as well.

Dr. Weitz:            Yes, so your room should be very dark, maybe even wear a sleep mask or something like that if it’s not.

Dr. Colon:            Absolutely. A quiet, dark room is helpful. Sleep masks can be helpful if they’re tolerated, I was actually in Iceland where they had 24 hours of sunlight, and I could not keep that on my face.  And I’m like, I’m a sleep specialist, I need to get to sleep, you know, but I couldn’t keep it on my face.  But other people can, other people sleep very well with it.

Dr. Weitz:            Yeah, I’ve got one from Tempurpedic, and it sort of pushes gently on your eyelid, and if you push gently on your eyelid it actually stimulates that oculocardiac reflex that causes you to relax.

Dr. Colon:            That’s a good tip, that’s a great tip, I’m gonna use that in my clinic.

Dr. Weitz:            So let’s go through some of the negative effects of what happens when you don’t get enough sleep. I know I was, I listened to your lecture and I was looking at your Powerpoint and you talked about decrease in performance, you talked about memory problems, maybe we could go through some of the more important ones.

Dr. Colon:            Yeah, one of the things that you see really early on is memory. And it’s been shown that sleep deprivation, when people do different functional memory tests and cognitive tests, that they work as if they’re impaired, sometimes worse than someone who is intoxicated. And they’ve actually done these studies where they give one group of people alcohol and they sleep deprive another group, and they put them on driving simulators, and consistently the sleep deprived group does worse. So if you combine sleep deprivation with alcohol, then that’s even worse. Other things that can affect, that can be affected if you have poor sleep is-

Dr. Weitz:            By the way, when it comes to memory, is it more long-term, short- term, or both?

Dr. Colon:            Definitely clearly short-term, you see some problems, like okay, I went to the kitchen to get something, what did I go to get? You don’t forget your own name, but I guess … both can be affected. But immediately you see short-term memory issues.

Dr. Weitz:            Okay. And then go ahead, you were gonna say something else?

Dr. Colon:            Well, other things that poor sleep affects and decreased sleep is your inflammation status. Inflammation and sleep are really bi-directional, where inflammatory disorders are associated with more sleep concerns, but likewise if you have short sleep, you have higher markers of c-reactive protein, Interleukins, and measures of inflammation such as Tumor Necrosis Factor alpha. That affects cardiovascular status as well, so they’re … doing findings that when you treat your sleep apnea with CPAP, that that also improves your cardiac status, but beyond that, when you treat insomnia with cognitive behavior therapy for insomnia in cardiac patients, they have better cardiac outcomes as well.  I also can’t emphasize enough the insulin resistance. Poor sleep really affects insulin resistance as well.

Dr. Weitz:            So you can be working with somebody who is a type 2 diabetic or a pre-diabetic, and maybe controlling their, let’s say you’re a Functional Medicine practitioner and you’ve got them on a low carb diet and still they’re waking up with high fasting blood sugar, it could be their sleep that’s actually affecting that?

Dr. Colon:            Yeah, and same thing with Polycystic Ovarian Disease. You know, likewise, all of those things, you’re very correct.

Dr. Weitz:            So it, can it directly affect your hormone levels?

Dr. Colon:            Yeah, absolutely. You know, for men you have that first REM cycle where you’re secreting the testosterone, and untreated sleep apnea has been associated with testosterone that’s low. And then also with women, I mean women have what, a 28 day cycle, that’s the lunar calendar. So I mean, yes, sleep does affect it, yeah.

Dr. Weitz:            So in men, is it more likely to affect total or free testosterone, or both, or?

Dr. Colon:            Both.

Dr. Weitz:            Interesting. So what are some of the most important factors that affect sleep? You talked about light, what about electronics, EMFs, what are some of the other factors?

Dr. Colon:            So all of those are really important. The light, the electronics, EMF, every single study that I read about electronics and sleep, there’s nothing positive, I mean nothing is, everything comes back that electronics really disturb sleep. But you asked me another question, you asked me what are some of the most important factors that affect sleep? And I gotta tell you, in my experience, the most important factor that a stress … that causes problems with sleep, is stressing out about sleep pattern, is people, some people can’t sleep because something’s bothering them and what’s bothering them is that they’re not asleep. And sometimes we overemphasize, you can’t overemphasize sleep, yet sometimes we overemphasize it to the point that it causes sleeplessness. So it’s important for patients to know this, it’s important for them to know that yes, we’re gonna try, we’re shooting for our seven to eight hours of sleep per night. But if you have a night that you haven’t slept, you’re not gonna drop dead the next day. You’re gonna be okay.  You know, if you’ve gotten those first four hours, the core sleep is within your first four to five hours. If you’ve gotten that, this is gonna help you, at least for the next day. Do we want to do that chronically? No. But some people literally lose sleep over not sleeping.

Dr. Weitz:            Right. So maybe you should say to yourself, if you had a poor night of sleep, don’t worry about it, and even if you just … I usually like to tell the patients, look, even if you just lay there and rest, that’s beneficial to your body. And don’t worry about the fact that you didn’t sleep.

Dr. Colon:            You know, so let me add something to what you just said. Alright, this is gonna help your patients, okay? You’re correct. Even if you’re not asleep, if you’re resting, that’s helpful. Everyone has a heart rate, everyone has a brain, okay, and these are interconnected with our breathing.  So you can instruct them, if you’re not asleep, this is the time to do some relaxation training.  This is the time to do an awareness of breath meditation.  And when you do this, you’re naturally gonna start to notice your breathing.  When you notice your breathing, your respiratory rate slows down.  As your respiratory rate slows down, you’re hitting that parasympathetic response. And this is so clutch, because if you’re not asleep, you’re at this parallel where one of two things are gonna happen. You’re either gonna stress about it, and you’re gonna go up at the sympathetic stress, or you can elicit that relaxation response and then at least you’re getting the decrease in cortisol, you’re getting the decrease in heart rate, and you’re starting to relax.  So you’re right, if they’re not asleep, you can have them do some type of relaxation response and they’re still getting some R and R, some rest and restoration.

Dr. Weitz:            So I have heard about the importance of breathing through your nose as opposed to mouth breathing and some people even tape their mouth, what do you think about those techniques?

Dr. Colon:            That … you know, so sometimes we use chinstraps so your mouth doesn’t open if they have an untreated sleep apnea, because-

Dr. Weitz:            People actually put tape over their mouth.

Dr. Colon:            Yeah, I don’t recommend that.  I haven’t heard of tape over their mouth. You know, we prefer to breathe through our nose, it’s more natural to breathe through our nose. Some people have some congestion to where they need to breathe through their mouth. Recently when I was in Lima, I told you that I had some congestion from some of the pollution that was over there, well one of the nights I woke up in the middle of the night and I had a lot of congestion.  I had to breathe through my mouth.  Now chronically you don’t want to do that, you’re right.  Chronically you don’t want to do that. And if you have that congestion, ideally you want to figure out what’s causing that congestion.  Do we have too much gluten or dairy in our diet?  Do we have environmental exposures?  What can we do to reduce that?

Dr. Weitz:            Yeah, I’ve always been a mouth breather for a number of years, and I took some training on breathing with a Butyeko breathing coach, and it really helped.

Dr. Colon:            That’s great.  At the same time, I also have some people that are retired boxers that they’re not going to breathe through their nose.  So you have to work with the clients where they’re at.

Dr. Weitz:            Right. So can you talk about sleep apnea and what exactly happens when you get a sleep study, and does everybody who goes through a sleep study end up with a CPAP machine, and what are some of the other concerns people have with that?

Dr. Colon:            So not everyone who has a, who goes through a sleep study comes out with a diagnosis of sleep apnea.  And even people who have sleep apnea, not every treatment is with CPAP. But sleep apnea is where you stop breathing in your sleep.  Your airway collapses while you’re in your sleep, and it’s restrictive, and you have less oxygen. That can induce cortical arousal so it affects your brain.  And then the known method, the single best known method for treating it is the CPAP machine, which cushions your airway open.  But there’s other people that can wear a dental device, a dental device that advances your jaw forward and just to kind of give a demonstration, okay, if I’m asleep, my jaw comes back.  Okay you hear a snoring sound? Now if I move my jaw forward, now I’m not making that snoring sound there.  So these are very effective, and … yes, they’re very effective for mild to moderate sleep apnea.  So you need a sleep study to see where you’re at. But the compliance of those have been shown to be better than that of CPAP, actually.

There are some patients that the sleep apnea may be positional only. So I do have some patients that I’ve treated successfully with a positional sleeping to avoid sleeping on their back, now they sleep on their side, and there’s positional devices that have been studied and have some robust literature. I typically tell people to get a full body pillow. When you have a full body pillow, that’s gonna align your shoulders to your knees, so you know what that does for your back, preserves your back and make it so you can stay in that position throughout the night. So those are the main treatments. There are of course some sleep apnea surgeries that are not really highly recommended. There are-

Dr. Weitz:            I’v had some patients get those surgeries recently where they carved out part of the back of their throat, and you know, tried to make some more room there.

Dr. Colon:            They’re serious surgeries … that I have referred some patients for it, and I’ve yet to have a surgeon in my area want to do it. They’re like, “No, why don’t you go back to Dr. Colon and work on that CPAP a little bit more.” They don’t have very good track records.

Dr. Weitz:            I just had a patient see a sleep expert who gave them some sort of device that stretches out the upper palate.

Dr. Colon:            So rapid palatal expansion is something that is very well established in the pediatric age group that decreases the incidence of obstructive sleep apnea and the severity, and I do advocate for that. In the adults, that is, I feel is an emerging topic. It is not being talked about by sleep experts. It’s being talked about more within functional dentistry, and I think that it has a bright future, but the sleep experts don’t have the data on that at this time.

Dr. Weitz:            I also interviewed a functional dentist who told me that he thinks that a fairly decent percentage of patients with sleep apnea really just have vitamin D deficiency.

Dr. Colon:            I have … the answer is yes, vitamin D deficiency affects sleep. In particular, sleep apnea. It also causes inflammation to where you can get tonsillar hypertrophy, which further affects sleep apnea. I had a patient that I saw for multiple, well I saw him for sleep. The patient has multiple sclerosis. Now when I diagnosed him with sleep apnea, and it was a marginal sleep apnea, but it was definitely present. It was present. And knowing that he has multiple sclerosis, knowing the functional medicine background that I have, I know that vitamin D can affect multiple sclerosis. So I got a vitamin D level on him, I started treating him with vitamin D, and his multiple sclerosis doctor endorsed it. “Yes, yes, let’s go ahead and treat.” Now, interesting. Something happened with his insurance company that they stopped paying for the CPAP machine. What happened, I don’t know, you can’t make sense out of nonsense, so don’t try. Regardless, it got denied. So I had to repeat a sleep study on him, and when I repeated it, sleep apnea was no longer there. This was after several months treatment on that vitamin D.

Dr. Weitz:            How much vitamin D were you giving him?

Dr. Colon:            We were doing … it was, I think, conservative. I think we were doing like 5000 units.

Dr. Weitz:            Okay.

Dr. Colon:            And some people will say, “Oh, 2000’s conservative.” No, I think 5000 was conservative. But even then, you know, it was only that much, and it was after several months of treatment, we repeated it, and it was negative. So what was wrong? I mean, was my sleep study wrong? No, I mean I looked at it, I read it. Both of them were quality, and I went back and looked at both of them. And the measurements were there. But he just didn’t have the sleep apnea. And he didn’t lose weight either.

Dr. Weitz:            So one of the things that can interfere with sleep is restless leg syndrome. And I know there’s some controversy over exactly what the causes are, and I saw one article that found a correlation between IBS/SIBO and restless leg syndrome, which I thought was really interesting, because I end up treating a lot of cases of IBS and SIBO. Can you talk about restless leg syndrome for a minute?

Dr. Colon:            Restless legs are uncomfortable sensations in your legs that are worse at night, worse when you rest, and they’re relieved by movement or by mental activity. There are many causes, and even then there’s two kinds, familial or non-familial. And there’s many causes, one of the main causes that everyone with restless legs needs to be evaluated is ferritin is  deficient. And notice I didn’t say iron deficiencies, because you can not have anemia but still have less ferritin. And if you don’t have the … enough ferritin you can have-

Dr. Weitz:            What’s the distinction there?

Dr. Colon:            So what are the main treatments that, medical treatments that people give, is the dopaminergic medications, right? Well you know, the dopamine receptor has ferritin in there, and further, so low CNS ferritin has been shown to cause restless legs and treating that. So the ranges, when you look at ferritin, you know it says that the range may be to 10 to 20, or if you’re at 20 that’s normal, but if you have restless legs, 50 and below, you know below 50, that’s symptomatic, and you want to be treating with iron in those patients.

Dr. Weitz:            Interesting. So how, besides restless legs syndrome, let’s go over some of the … I know you mentioned a few of these, but let’s go over some of the therapies to restore better sleep. You mentioned cognitive behavioral therapy, what exactly is that, and how does that work?

Dr. Colon:            Yeah, so CBTI is the gold standard for treating insomnia. And CBTI is working with a psychologist that really kind of helps retool sleep. That’s what I explain to patients. But one of the things that these therapists is doing is that they’re addressing our attitudes, our concerns, about sleep. You know how I said that some people don’t sleep because they’re stressed about sleep? Well, yeah, that’s what the psychologist works with. They’re like, “Okay so what’s gonna happen if you don’t sleep?” They’re like, “Well, if I don’t sleep I’m not gonna function the next day.” “Okay, and then what’s gonna happen?” “Well, I’m gonna go to work and I won’t be able to function. And if I can’t function, I’m gonna be fired, and if I’m fired, I’m gonna be homeless.” And literally people with insomnia can have some degree of catastrophic thinking that occurs. And the CBTI helps out with that.

And another emerging treatment in insomnia is gonna be MBTI, or mindfulness based treatment for insomnia. This was created by Jason Ong. And there is a perception, yet misperception that we can meditate ourselves to sleep. I mean, yeah, you can induce a relaxation response or sleep, and relaxation therapy and relaxation training is good for sleep, and I teach my patients how to do that. But MBTI is different, because you’re actually doing a practice of mindfulness, an eight week practice of mindfulness. What are some of the core concepts of mindfulness? Non-judgment. So if you stop judging yourself, you know that you’re not asleep, you stop … you worry about the present moment, don’t think so much about the future, the MBTI has been shown to be very helpful for insomnia as well.

Dr. Weitz:            Great, great. What is circadian rhythm training?

Dr. Colon:            Circadian rhythm entrainment is that we all have a 24 hour cycle. Everyone lives in a 24 hour society. Believe it or not, actually, our internal clock has a tendency to go 25 hours. So if you put people in a cave and you take them away from light cues, you disrupt their light cues, they stay up later, and later, and later, an hour later the next day. And what resets our cycle is that morning light, and then the darkness at night. So I’ll use, and even then, you really do have some people who are night people, and some people who are morning. You know, people have different circadian clock genes that predispose their circadian cycles. So circadian entrainment is trying to work on a particular wake up time with light exposure and you can even add melatonin, based on where their melatonin secretion should be coming out. When should they secrete melatonin? There’s a very, very helpful tool called a morningness-eveningness questionnaire. It has a German name to it that I can’t pronounce, so I just call it the morningness-eveningness questionnaire. And you can go online and get it, it’s called the AutoMEQ, M-E-Q, Auto M-E-Q.

Dr. Weitz:            Cool. And you talk about sleep restriction, restricting your time in bed, I guess this is for somebody whose sleep cycle’s all messed up, and if they’re having trouble sleeping at night and then they end up sleeping during the day, how does that work?

Dr. Colon:            So let’s, before we talk about how it works, let’s talk about what does not work, okay? So there are some people that spend extra time in bed, because they want to sleep more. And that sounds logical, okay if I’m not getting to sleep til … I’m throwing numbers out. If I’m not getting to sleep til midnight, let me go to bed earlier, so I can eventually get to sleep. The problem with that is that you’re spending more time in that bed learning not to sleep. And training your brain to not be asleep. So the key is to … the time. Restrict the time that you’re in bed until the times that we are going to be asleep. So that’s what we mean by sleep restriction, as well as also having a very strict wake up time, because that helps with the circadian entrainment as well.

So another thing that people say is, well if I didn’t sleep until this time, I need to sleep in longer. That sounds logical, but it’s causing a cascade of problems that’s disrupting your circadian system, which we have a natural tendency to run at 25 hour cycles, so if you didn’t get to sleep til whatever time, it doesn’t matter, wake up at the same time. And if you do that on a regular basis, that’s going to help your sleep drive, get to sleep a little bit earlier. So sleep restriction isn’t so much sleep depriving people, although you do go through a period of time where they might get a little bit less sleep, but you do that in a way that they end up getting to sleep on a regular time, a little bit early on a regular basis.

Now that is something that I would do either with a board certified physician in sleep medicine, or that would be a great period to find someone who, through the Society for Behavioral Sleep Medicine, a sleep psychologist.

Dr. Weitz:            Cool. What are some of your most effective herbal or nutritional supplements for sleep?

Dr. Colon:            You know, so whenever someone asks me what is the best supplement for sleep, I always say what are you deficient in? So I will commonly run some micronutrient analysis to see. I can show you evidence that zinc has been helpful for sleep, that magnesium has been helpful for sleep, lavender is helpful for sleep, melatonin is helpful. Everything that’s out there I can show you evidence. But what is it in your patient? So you run a micronutrient analysis and you look for a specific deficiency. Or you may run an adrenal profile, and you can find that they’re epinephrine or norepinephrines are high, or their cortisols are high, you know, some ashwaganda is gonna be good for them, or some rhodiola. If their cortisol is high, lavender has been shown to decrease the cortisol. Run a melatonin profile, and if their melatonin is normal, then giving them more melatonin is not gonna help out. If you see that their melatonin is low, okay then that’s someone that we may want to supplement with melatonin, or have them eat more foods that have both tryptophan to make your own melatonin, as well as also natural melatonin such as tomatoes, cherry juice, walnuts.

Dr. Weitz:            You do do urine neurotransmitter testing to see if their serotonin or GABA is low?

Dr. Colon:            I have, and the context that I do that is I’m saying, “Look, I’ve been seeing you, you’ve done the sleep hygiene, we’ve done the sleep studies, we’ve done the standard of care, and you’re still having some issues, do you want to do a little bit more?” And some people say, “Yeah, yeah, okay let’s do more.” And I’ve had a patient that their glycine was low. Alright, well let’s supplement glycine. Other patients that their serotonin could be off. I had one patient with excessive sleepiness that had high, really high GABA levels, well GABA is inhibitory. So they were complaining of insomnia, but in essence they were sleeping during the evening, it’s just that they were tired during the daytime. And we ran it, the GABA was high, well DHA can attenuate that response. So we targeted individualized treatment.

Dr. Weitz:            Interesting. GABA can also help with sleep, and some people use it in sleep formulas.

Dr. Colon:            Correct. GABA can help with sleep, but also if you have chronically high GABA levels, which many patients with idiopathic hypersomnia can have defective, overactive kind of GABA receptors.

Dr. Weitz:            So just like many things, not too much, not too little, gotta get it in that sweet range.

Dr. Colon:            Yeah, that and what are we treating?  So I get the question a lot, “Dr. Colon, what’s the one big thing that we can do with sleep?”  And number one is not worry about it, but number two is what are we treating?  Are we treating … do we have an unknown sleep apnea, if we have restless legs, do we have SIBO as you mentioned, do we have magnesium deficiencies, keratin deficiencies, and even sometimes throwing in micronutrient analysis and also the neurotransmitter profiles.

Dr. Weitz:            Right.  So basically try to get at the root cause, do a careful history-

Dr. Colon:            Yes, sir.

Dr. Weitz:            Do a certain amount of, you know, a reasonable amount of testing, and then let’s try to have some real target for what … you know, that we can really try to intervene and get to those root causes, which is really what functional medicine’s all about.

Dr. Colon:            You hit the nail on the head, doc.

Dr. Weitz:            Okay, Jose. So for those listening or watching this podcast, how can they get a hold of you? And how can they get a hold of your books and your training programs?

Dr. Colon:            Yeah, so all of my books are on Amazon. They’re also from my publisher, Halo Publishing, and yeah, I wrote a book for women for insomnia called The Sleep Diet a Novel Approach to Insomnia, which I wrote it at a time when I had no idea about nutrition, so it’s not so much about diet but about different lifestyle aspects. And I have, as you mentioned, children’s sleep book and a book for infant sleep. And I also put information on my website on sleep tips for free on paradisesleep.com.

Dr. Weitz:            And are you available for consultations in person and over the phone, or via Skype, or?

Dr. Colon:            I do work for a health system, so all of my consultations are within my clinic, actually.

Dr. Weitz:            Oh, okay. Great, excellent. And what’s your website?

Dr. Colon:            Www.paradisesleep.com

Dr. Weitz:            Excellent, thank you Dr. Colon, thanks for spending the time with us.

Dr. Colon:            My pleasure, you have a great one.


Detoxification with Dr. Bob Rakowski: Rational Wellness Podcast 69

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

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


Podcast Highlights

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

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

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

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

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

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

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

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

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



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

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


Podcast Transcripts

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Weitz:                            Bomb proof coffee.

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

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

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

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

Dr. Weitz:                            Yeah.

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

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

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

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

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

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

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

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

Dr. Weitz:                            Wow.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Weitz:                            Wow.

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

Dr. Weitz:                            How much melatonin do you like?

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

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

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

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

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

Dr. Weitz:                            Oh, yeah.

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

Dr. Weitz:                            Interesting.

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

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

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

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

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

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

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

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

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

Dr. Weitz:                            Zoom, okay.

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

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

Dr. Rakowski:                     You’re welcome.