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

 

                        



Dr. Jose Colon is a 

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

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Detoxification with Dr. Bob Rakowski: Rational Wellness Podcast 69

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

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

 

Podcast Highlights

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

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

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

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

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

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

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

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

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

 

                        



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

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


 

Podcast Transcripts

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Weitz:                            Bomb proof coffee.

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

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

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

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

Dr. Weitz:                            Yeah.

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

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

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

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

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

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

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

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

Dr. Weitz:                            Wow.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Weitz:                            Wow.

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

Dr. Weitz:                            How much melatonin do you like?

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

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

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

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

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

Dr. Weitz:                            Oh, yeah.

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

Dr. Weitz:                            Interesting.

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

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

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

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

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

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

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

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

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

Dr. Weitz:                            Zoom, okay.

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

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

Dr. Rakowski:                     You’re welcome.

 

 

,

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

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

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

 

Podcast Highlights

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

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

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

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

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

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

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

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

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

 

                            



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

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


 

Podcast Transcripts

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

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

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

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

Dr. Cohen:          Thank you for having me.

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

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

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

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

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

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

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

Dr. Cohen:          Great question.

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Cohen:          Love it. Excellent.

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

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

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

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

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

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

Dr. Weitz:            Yeah.

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

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

Dr. Cohen:          Right. Exactly.

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

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

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

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

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

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

Dr. Weitz:            Okay.

Dr. Cohen:          Chia seeds …

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

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

Dr. Weitz:            Okay.

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

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

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

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

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

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

Dr. Weitz:            Next super food?

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

Dr. Weitz:            Okay.

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

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

Dr. Weitz:            Okay, yeah.

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

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

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

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

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

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

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

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

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

Dr. Cohen:          Thank you Ben.

 

Endometriosis with Dr. Felice Gersh: Rational Wellness Podcast 067

Dr. Felice Gersh talks about how to manage Endometriosis with diet and lifestyle changes 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

3:15  Endometriosis, the growth of uterine tissue outside of the uterus, begins with retrograde menstruation, the movement of cells from the uterine lining up the fallopian tubes. Each month when women shed the endometrial lining of their uterus, some of the cells are still living and go through the fallopian tubes into the pelvis and then the body’s immune system gets activated. During this period, estrogen levels are lower, which is inflammatory, and this activates the immune system to do it’s job an remove these endometrial cells.  Because women today get pregnant later in life and have fewer pregnancies, women today have so many more menstrual cycles than women used to, which increases their risk for endometriosis and also breast cancer.

6:52  It turns out that estrogen is a potent modulator of inflammation and while low levels of estrogen are pro-inflammatory, high levels of estrogen are anti-inflammatory.  These inflammatory cells secrete enzymes called matrix metalloproteinases that dissolve these endometrial cells in the pelvis, along with the other immune cells. As women go through the monthly cycle to prepare the body for possible childbirth, estrogen levels slowly rise, peak and then drop in this beautiful ebb and flow cycle. But in women with endometriosis, this whole system is not working properly and it creates really a disaster for these women because this very elaborate, very well-programmed system is not working properly in them.

9:48  One of the things that disrupts this cycle of estrogen rising and falling and the immune system being primed at the right time are endocrine disrupting chemicals like pesticides, pthalates that are in scents and plastics and BPA and BPS in cash register receipts. We put them in children’s mouths in dental sealants and many other plastic products. These endocrine disrupting substances disrupt our normal hormonal flows and balance and they change our genetic expression (epigenetics) and actually have effects for generations. And so it’s really creating a tremendous challenge for reproductive functions when the hormones that are so intricately involved in all these functions are not going to work properly. And endometriosis is like the perfect storm of all of this coming together to create really a massive negative impact on these women’s lives.

16:29  Since estrogen receptor beta as being a key factor in endometriosis, should we avoid an estrogen receptor beta agonist like soy be avoided?  Dr. Gersh feels that because soy contains weak estrogenic substances, it serves as a blocker for estrogen receptors for stronger estrogens, so organic soy can be protective for women.  She also recommends consuming antioxidants, polyphenols, and quercetin, all of which can help with reprogramming hormone receptors. In endometriosis we have total body immune dysfunction, so it is really an autoimmune disease. Women with endometriosis have significantly higher rates of certain cancer. But we can use food as medicine. Foods like apples and onions that have a lot of quercetin can have an impact because quercetin is a mast cell stabilizer and mast cells are the first responders of the immune system and they are filled with inflammation, containing preformed tumor necrosis alpha. Mast cells also stimulate substance P, which stimulates nerve production, which results in more pain in the pelvis and bodies of patients with endometriosis. Quercetin, green tea extract, resveratrol, and vitamin C can all help to calm down the immune system. Studies also show that women with endometriosis have an altered gut microbiome, so improving the gut is also beneficial. And the interaction between estrogen, the immune system, the gut, and the brain is incredibly complex. And this new pill that has been approved to help with endometriosis that shuts down the brain stimulus to the pituitary to shut down estrogen production is not likely to be effective for modulating the condition, because it’s not just about having only high or low estrogen but the rhythm of the highs and low of the estrogen/progesterone cycle. 

28:52  Dr. Gersh likes to have her patients go through a 4 week liver/estrogen detoxification program to improve estrogen metabolism using DIM and broccoli sprouts to encourage estrogen to be metabolized in the healthiest way and produce the right estrogen metabolites. 

36:24 The body and our hormones need to be in balance and when you place women on hormone replacement and give them the same amount of estrogen daily for years, these women are not getting the fluctuations of estrogen from low to high that are so important for modulating the immune system and the other hormones. For example, when you get the spike of estrogen that is right before ovulation in a normal cycle, that spike upregulates progesterone receptors, and testosterone, and thyroid so that they actually work better. Women with endometriosis, their progesterone receptors are malfunctioning so they don’t receive the progesterone. It is clear that what we are doing with hormone replacement therapy is not physiological, though we need more research to tell us how to do it better.

 

                              



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 the Fall of 2018.

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. I’m very excited that we’re gonna be talking about a very important topic related to women’s health. A condition known as endometriosis. Now, I’m sure a lot of you are not quite aware of what this is unless you suffer from it, but this is a condition that actually affects 10% of women in the United States. And this is when endometrial tissue … That’s the tissue that lines the uterus, ends up growing outside of the uterus. Most commonly on the ovaries, the fallopian tubes, or the intestines. Though it could occur anywhere in the body. The most common symptoms are pelvic or other pain, menstrual irregularities, and infertility. There can also be pain during sex or during urination. The conventional medical treatment typically consists of hormones, surgery to remove the tissue, and various types of pain medications. And then I just read an article that was sent to me by our guest, Dr. Gersh, about it. A new medication that is a hormone blocking agent that seems to have some effect as well.

And so I’m very excited that I’m going to get to interview and share some information with you from Dr. Felice Gersh. I just want to say I’m really excited about the fact that I get to interview these really super smart people on this podcast. And apart from being able to serve you, my audience, it’s also great for me to be able to interview these really smart people and do a little mini symposium every week about a new topic. Oh, by the way, those of you who enjoy the Rational Wellness Podcast, if you can go to iTunes and give us a ratings and review, that will help more people to find out about it.

So Dr. Gersh is a board certified obstetrician and gynecologist. And she’s also fellowship trained in integrative medicine. Dr. Gersh is a director of the Integrative Medical Group of Irvine where she sees patients. She also lectures around the world and writes on various topics relevant to women. And her first book on polycystic ovarian syndrome will be released this fall. Dr. Gersh, thank you so much for joining me today.

Dr. Gersh:           Oh, it’s my pleasure. And I definitely am thrilled to be able to discuss endometriosis with you and for all of your listeners to learn about it.

Dr. Weitz:            Yeah, it’s great because it’s really a very difficult condition for the women who deal with it, painful, and the treatments so far are not really that helpful. So I’m happy that we can bring a Functional Medicine approach to understanding it. So when we try to understand endometriosis, it’s hard to understand how tissue from the uterus ends up in another part of the body. And I was trying to put my head around it until I read that retrograde menstruation, which occurs in up to 90% of women, is believed to be the mechanism by which it occurs.  Can you explain what that is and how that happens?

Dr. Gersh:           Sure, that’s step number one. Because you have to have a root for the lining tissue from in the uterus to end up in the pelvic cavity. So every time a woman has a cycle … And that’s another issue is that women in this day and age have about 400 or more cycles per lifetime for their reproductive years. Whereas in more ancient times, women started having babies at a very young age and then they would nurse, which would delay the resumption of their menstrual cycles. So they spent a lot of their reproductive years either pregnant or nursing. They had fewer often than 100 cycles for their entire reproductive life. So that is another problem is that we’re cycling so often and having so few pregnancies and at a much later age. So what happens-

Dr. Weitz:            And by the way, that’s also a risk factor for breast cancer and a lot of other things too, right?

Dr. Gersh:           Well, there are apparently some amazing things that happen when women have their first pregnancy.  And actually the risk for breast cancer … A whole separate issue we can talk about another day, is actually dramatically reduced in women who have their first pregnancy before the age of 20.  But nowadays, that’s hardly something that we encourage women to do is to get pregnant, and have babies, and then nurse for three years before they’re 20 years of age. But there are all these interesting things that actually happen in the breast and with receptors, like the way the receptors work in the different parts of the body when the body does what it was originally programmed to do, which is to start reproducing.  And I say this over and over in all of my lectures is that whether we like it or not, we are what we are.  We’re animals of the animal kingdom.  And the prime directive of life is reproduction and survival to raise the young.  And that’s how the female body is designed.  And we have beautiful mechanisms, but nowadays with the world we’re living, we’ll touch on the role of endocrine disruptors. Which I know you’re aware of and how that relates to endometriosis and what that’s doing to women’s reproductive health. And of course, reproductive health is linked to all of health for a woman. They’re completely intertwined.

So what happens, if we go back to retrograde menstruation. So every time a woman has a period, the vast bulk of the lining which is shed goes out, of course, out through the vaginal canal and out of the body. And it’s like a renewal. And it allows the body to try again and to try to get a pregnancy going on the next cycle. And then a significant but certainly a small fraction of the uterine lining tissue actually goes backwards through the tube. So they call it retrograde menstruation. And some of these cells, they’re actually living. And a lot of the tissue is actually half alive, half dead. It’s filled with a lot of inflammatory cells.  And as it goes into the pelvis, the body’s immune system is activated.  So it turns out that estrogen in a normal woman and when things are working properly, low levels of estrogen are actually pro-inflammatory.  It actually calls the inflammatory cells to come and then do their jobs.

So you can think of estrogen as sort of a modulator of inflammation. High levels of estrogen are actually a very anti-inflammatory, while low levels are actually pro-inflammatory. And that’s why a woman has this beautiful cycle with highs and lows. It actually regulates how the immune system works. So during a menstruation cycle, the estrogen level is very low. And the inflammation is going to be higher. And so the lining is … The elimination of the uterine lining is actually an inflammatory process and the uterine lining is infiltrated with these inflammatory cells.  And the same thing happens in the pelvis. But these inflammatory cells at that time are there for a purpose. They do what they’re supposed to do in a healthy woman. They secrete these enzymes called matrix metalloproteinases. And these enzymes are specifically designed to dissolve these aberrant cells because they’re not supposed to be in that place for long. These cells that come up from the uterine lining, they’re supposed to be dissolved. And then the macrophages, those inflammatory cells that arrive, and the neutrophils, they are designed to gobble up these now dead pieces of tissue from the uterus. And they gobble it up and all’s well with the world.

And then the estrogen level starts to rise. And mid-cycle when you have that really high level of estrogen. And then for the next little while when the progesterone level starts to really rise, then at that time, the inflammation is the lowest. The actual level of time in a woman’s menstrual cycle when inflammation is lowest is when her estrogen peaks. That spike of estrogen because that’s when you wanna prepare for ovulation and then you prepare for implantation. And then at the very end, then of course the inflammation starts up again if there’s not a pregnancy.  So it’s this beautiful ebb and flow between the ups and downs of the immune system. But in women with endometriosis, this whole system is not working properly and it creates really a disaster for these women because this very elaborate, very well-programmed system is not working properly in them.

Dr. Weitz:            That’s great. Because that’s one of the thoughts I had. When I read that 90% of women have this retrograde menstruation, the next thought was why don’t all women have endometriosis?  So the explanation is that the immune system normally knocks out those cells. And so in some women that immune system doesn’t function quite as well as it should.  What are some of the most important factors that allow this endometrial tissue to survive and grow outside of the uterus?

Dr. Gersh:           Well, it’s complex. But more and more what we’re finding is it’s those ubiquitous endocrine disruptors. That’s what’s happening in women with endometriosis is that they’re malprogramed in terms of the way the receptors are working. And it involves at least estrogen and progesterone and probably others like melatonin. It gets very complex. So these hormones are very involved in multi-tasking. Like I mentioned, estrogen is very involved in immune system regulation, but so is progesterone. And they work with many signaling agents and growth factors. So it’s incredibly complex the way this whole thing works. But it all relies on the proper programing of the receptors so that when the hormones arrive in the receptor, the right thing happens. So hormones are signaling agents. They tell the cell what to do. Depending on how it reacts, it can make a protein, it can make a certain kind of enzyme. And so it all correlates and it’s very finely tuned.

So if you have endocrine disruptors that are in the mother and it gets into the fetus during the developmental time, when these receptors for estrogen and progesterone are actually developing, then you can have malprograming from the get go. And then it’s also been shown-

Dr. Weitz:            Can you mention a few of these endocrine disrupting substances?

Dr. Gersh:           They’re everywhere. So there’s been a lot of research on the organophosphates that are in pesticides and the phthalates that are in scents and plastics like vinyl and such. And then the bisphenol A’s and the bisphenol S’s that are in cash register receipts. And we would put them in children’s mouths for dental sealants and they’re in a lot of different plastics. That’s why you don’t want to heat things in the microwave in these hard plastics because it gets released. And water bottles-

Dr. Weitz:            By the way, even if it says BPA free, still don’t trust it. Because what they do is they take the BPA out and they put BPS in which just isn’t on the radar yet and probably soon will be as an endocrine disruptor.

Dr. Gersh:           Oh, it is. Right. And then there are these other things that are banned but they’re still out there. And in some countries they’re not banned and they’re like the aromatic hydrocarbons like dioxin. And these have enormously long half lives. They’ll live for at least a dozen years before the body can excrete them. And they are concentrated in fat tissue. And these things stay in the body for huge amounts of time. So we are inundated and it turns out that depending on the dose and the timing in pregnancy and also in the infant after birth and even around the time of puberty, all of these can combine to alter in every which way the way that these hormones work. So there’s been a lot of focus on the receptors, but it also … It’s more complex than that. It all involves the production, the dissemination, the excretion, so basically every facet that can be involved with these hormones is impacted by these endocrine disruptors.

So they are chemicals that work in the body to mimic hormones, but they’re not hormones.  But they interfere with the development in the embryo, in the fetus. And it changes what are called the genetic expression. What we call epigenetics. I’m sure you probably talked about that. And this thing that is so frightening is that it can last for generations. That it alters the way that genes work and then it gets passed down. So even if, say, a future mother then has a very careful lifestyle and somehow avoids as many of these endocrine disruptors as possible, she may be genetically programmed to actually have a baby who has malfunctioning of the receptors. And she didn’t … It wasn’t even from her. It was from her grandmother. So these things are now getting passed on and the human evolution maybe really being altered by these chemical endocrine disruptors.

And the thing that is so disturbing is how little press this is getting. That’s why I’m so excited that you are allowing me to talk about it. I’m sure you talk about it all the time. I hate to use these words. It sounds so ominous. But I kinda say we live in poison world because we do. Because we’re just eating things and we have all these pesticides, and herbicides, and chemicals, and plastics, and we now know that things can off gas from the rooms that you have. The indoor air pollution and the outdoor air pollution. And all of these things impact. And so it’s really creating a tremendous challenge for reproductive functions when the hormones that are so intricately involved in all these functions are not going to work properly. And endometriosis is like the perfect storm of all of this coming together to create really a massive negative impact on these women’s lives. It just breaks my heart that there’s so many women now that are having to live with this condition.

Dr. Weitz:            Yeah, I think it’s so important we talk about the importance of these endocrine disrupting substances. For one thing, a lot of these substances, they’re not even listed on the ingredients. So if you’re using any personal care product and it has the word perfume or fragrance, it most likely has phthalates in it and they’re not required to list that because it’s an inert ingredient. So this is something as consumers I think we need to speak out and maybe not now, but maybe some time in the future, we can demand that these substances at least be listed on the ingredients so we can avoid them. But-

Dr. Gersh:           Something I was gonna say exciting is that in California, the state senator Dianne Feinstein, has introduced a bill that hopefully will get passed. And it’s like … Step number one is just labeling and acknowledging what you’re actually putting into your products.  And so hopefully that will get passed.  It actually has bipartisan support. So at least step one may actually come to pass in the near future.

Dr. Weitz:            Good, good, good, good. Nice to hear that. Yeah. Because we need to … As a consumer if you’re trying to avoid these things, you at least need to know if they’re even there. In the meantime, I encourage people to go to the Environmental Working Group, ewg.org,  which is a great resource for listing toxins in various personal care and cleaning products.

I read an article about estrogen receptor beta as being a key factor in fueling endometriosis. Should women avoid estrogen receptor beta agonist like soy and are there any natural estrogen receptor antagonists that we can include to help counter some of this?

Dr. Gersh:           Well, those are great questions. And it is true that as part of this whole endocrine dysfunction and the way that the body is now being sort of redesigned, is that it turns out that there … Well there’s … As a background, there are three types of estrogen receptors. Alpha, and beta, and what are sometimes called GPERs (G protein-coupled receptors) or membrane receptors. And it turns out that different areas of the body may have a propensity of one type or another type. There are estrogen receptors on every type of immune cell. So the T cells, the B cells, and the mast cells, and all the different … Every single immune cell has these receptors. And in the uterus and in the pelvis, there is a lot of the beta receptor. The gut, by the way, is predominantly beta receptor.  And so it turns out that you have this imbalance of having too many receptors. And so you have this inappropriate estrogen sort of stimulation that occurs. That’s right. And they’re actually looking at what can you do. And it turns out that it may actually turn out … That soy, if it’s organic … It has to be organic, may actually be somewhat of a benefit because it’s very weak. And it can actually create these phytoestrogens that can circulate. And actually also work in the gut which we can talk about how all the microbiomes are disrupted including the gut and women with PCO … And with endometriosis, not PCOS. They actually also have that too. And it seems like that’s involved in everything now, right? The gut microbiome.

Dr. Weitz:            Absolutely.

Dr. Gersh:           And everything.

Dr. Weitz:            There’s no conversation in Functional Medicine that shouldn’t involve the gut at some point.

Dr. Gersh:           It is. It gets into endometriosis as well. So it may be that if you can fill these enormous numbers of extra beta receptors with something that’s really weak … So it’s filled with a weak estrogen instead of a more powerful estrogen, it would actually work something as a blocker. So you’re filling it with something weaker. So we need to have more data. The problem is that Big Pharma of course … And you mentioned that there’s a new drug that’s in the pipeline that may come out and may have some benefit as far as pain. But they’re not looking at things like eating soy. They’re not looking at eating flaxseeds. They’re not looking at the phytoestrogen. There’s no money in that.

Dr. Weitz:            No there’s no billion dollar drug coming out of flaxseeds.

Dr. Gersh:           Right. And funding for these kinds of little studies. And they’re so complex too because it’s very hard to have controls. But when you look at it at least theoretically and what we do know from other studies is that if you fill … And even like breast cancer. If you fill a receptor with something that’s weak, you’re going to block the effect of something strong coming along. So I do think … And we have to be careful because there’s so many crappy soy products. I’m sure you talk about that. Soy pretending to be chicken is not what we’re talking about. It has to be organic because so much of the soy is GMO. So it has to be organic soy, it has to be unprocessed, it can’t be fermented.  But I think there will be some definite benefit with that.  And in fact, as a functional medicine doctor, and I’m sure all of your listeners are into that world as well, we use food as medicine.

So there’s definitely a role for giving antioxidant containing foods. The polyphenols that work … In fact, one of the things that I really push of foods that have a lot of quercetin because we can’t … We don’t have the power yet to know how to reprogram hormone receptors. I wish I had that power to … We can’t go back. We talk about this with the brain a lot. You get one chance to make a good brain for a child. You don’t get, oh, let’s do a redo. And the same thing with hormone receptors. When these things happen and they get altered, we don’t know how to undo it. So we have to create what I call workarounds. We find other ways. Because the body has many different back roads to try to stabilize things. So if we have an out of control immune system because their receptors, remember, also are not functioning either because it’s not just in the pelvis, it’s the pelvis in the female with endometriosis becomes the focus because their everything is so totally out of whack because of the menstruation cycle and all that inflammatory tissue with the endometrial cells coming into the pelvis that’s creating all this havoc. This chaos.

But these same processes are occurring elsewhere in the body in the woman with PCO … I keep saying PCOS. In the women with endometriosis. So they have dysfunction in more sites. That’s where the focus is. And it’s really now a whole total body immune dysfunction. And it’s actually linked with autoimmunity as well because we know the immune system is one. So you can call it autoimmunity. But the new term that’s often used is autoinflammatory which actually makes more sense because it can manifest with allergies, with this type of crazy reaction in women with endometriosis and autoimmunity, they’re all linked. And of course, unfortunately, it also links with cancer. And women with endometriosis have significantly higher rates of certain types of cancers as well because you have to think of it as total body immune system dysfunction.

And we can do what we can do. But we can do a lot. We can use food as medicine like using organic types of whole soy and the polyphenols and the foods like apples and onions and such that have a lot of quercetin because quercetin is a mast cell stabilizer. And it turns out that the first responder of the immune system which is so heavily involved in this process in women with endometriosis are the mast cells. So they’re like the first responders. And if you can stabilize them so they are not so crazy and they’re doing … Because they put out all their inflammatory products. They’re the only cell in the body that has preformed tumor necrosis factor alpha. They’re just filled with all the inflammation to try to destroy an invading bacteria. But now they’re just exploding in the woman’s pelvis and they’re creating high levels of protein P, Substance P that is now producing more pain fibers.

So I’m sure that you’re aware because we were looking at the articles together that women with endometriosis have a different nerve innervation that they … And this all stimulates from the mast cells that explode and that creates more of the substance P which then stimulates more nerve production. It’s like the worst of all worlds. So you have all this inflammation and then you’re actually creating more nerve innervation to these endometrial implants so that you create more pain, so you’re getting this hyperesthesia. You’re getting more pain and more nerve fibers that are coming in that are all sensory. All about pain. So if we can just calm down those most cells, we can really have a big impact.

 So I use lots of antioxidants and these … All those different tools that we have to calm down the immune system. So I give quercetin and I’ll give green tea, and resveratrol and vitamin C.  All of these can really help to stabilize the immune system in women with endometriosis and as well when you help to get the gut healthier and you work on the gut health and the microbiome because they do have … We have studies now that show that women with endometriosis do have an altered gut microbiome. And also vaginal microbiome. It’s just sort of the uncharted territory that is going to be the next really area of explosive research is the role of the vaginal microbiome in women with all these different disorders including endometriosis which is altered.

Dr. Weitz:            The vaginome.

Dr. Gersh:           It’s everywhere. Yeah. And so we can do so much to improve the gut barrier health. So if we can reduce impairment of the gut barrier we call leaky gut, we can … Which also then creates more inflammation right because then you have these endotoxins or lipopolysaccharides that come out and then cause this immune system which is already in an up regulated state because of the way that the estrogen receptors are working on them. The mast cells are filled with estrogen receptor alpha. And it turns out when you have a lot of beta, it actually down regulates alpha. The whole thing is so complex, we’re just barely scratching the surface and understanding all that’s going on, but we do know that if you can improve gut health, if you can help restore the microbiome, if you can help to maintain gut barrier structure and reduce leaky gut, and reduce systemic inflammation, and calm down the response that’s so overwhelmingly inflammatory in the pelvis every time a woman has a menstrual cycle, then we can have so much benefit for these women.

And really, the whole mind body can make a lot of difference. We know that emotions and that our brain function can actually alter immune function. It’s so amazing. You can do … My personal favorite is guided imagery and you can envision in your mind how your brain can control and calm down these immune responses. And so the role for mind body and energy medicine in women with endometriosis is really huge. And happily, the mainstream medicine, which is usually entrenched in pharmaceuticals and surgical procedures … Which they still are by the way. But there is a group that have come out officially and said we need to rethink what we’re doing for women with endometriosis because it isn’t working. The conventional world of giving birth control pills is not stopping the progression. It usually has very minimal impact on the pain as well. Taking away women’s hormone is a horrible solution. Because hormones are not just about reproduction, hormones in women are about every function. It’s about cardiovascular health, and immune health, and brain health. So just taking away women’s hormones is a terrible solution and isn’t really solving the problem.

And this new pill that’s coming down the pipeline is sort of a variant of drugs that have been out for a while, which basically is to completely shut down the production of hormones so that you have no estrogen. And it starts at the level of the brain. So it just shuts down the brain stimulus to the pituitary. So it’s all shut down. So you don’t make any estrogen. And this drug, instead of being a shot, like the former drugs, like the depo lupron. Instead it’s a pill and it can apparently be more titrated so that instead of it being a total shut off of hormones, it’s gonna be a partial shut off. But as we mentioned, it’s not just about having estrogen, it’s about having this beautiful rhythm because you need to have the lows and you need to have the highs. You need to have that spike of estrogen in order to have that whole antiinflammatory effect. And if you simply have a low but static level, you’re gonna have chronic inflammation if you have chronic low levels of estrogen. Or even if you have chronic moderate levels, you’re not gonna have the right effect. You need to have the right cycle but it’s a problem if you have too many cycles.

It’s definitely complex, but I welcome even pharmaceuticals that can help with symptoms because these women have so much suffering that even if we can help reduce their pain and we’re not really solving underlying problem, for some women, short-term, that could still be helpful. We have to think about the suffering too, as well as the underlying cause sometimes.

Dr. Weitz:            Great. I only have about 100 questions after this discussion.

Dr. Gersh:           It’s so complex. Yeah.

Dr. Weitz:            I just want to mention quickly, I don’t know if you ever use detox programs. But since we’re talking about toxins-

Dr. Gersh:           Oh, yes.

Dr. Weitz:            Yeah. Is there a benefit to doing a liver detox, or an estrogen detox, or some sort of a detox program to decrease some of that burden in our body of some of these stored endocrine disrupting substances?

Dr. Gersh:           Well, we definitely … I always include that. Of course like so many things that we do, we don’t have hardcore published data on a lot of these things. But in practical use, what we really need to do is have proper metabolism of estrogen as well. It turns out that estrogen metabolites are so key to actually a lot of functions. So the estrogen metabolites production begins in the liver. So estrogen has to be detoxified, it starts off by going through the liver where it goes through the first phases, phase one, phase two, until you have glucuronidation and all these different processes. Sulfations, all these different things … Methylation that can then create the first step of metabolites. And then it goes into the gut and the gut has its own set of bacteria. The estrabolome that actually work to further detoxify and create other metabolites. And these metabolites actually have action. They even have some of their own receptors that are separate from estrogen receptors. And they’re actually very key to function.

 And you can’t have any of this work properly if you don’t have a healthy liver. So absolutely, I start every one of my patients for just about everything with a four week detox. And I would, for a patient like this, I would definitely use something like DIM or indole 3-carbinol absolutely and use sulforaphane. We definitely want to have broccoli sprouts and all of that because we definitely need to have the estrogen that’s in the woman’s body to get properly detoxified, and eliminated, and have the right metabolites produce. Not the wrong metabolites. 

Dr. Weitz:            For those of us who don’t know about the metabolites, if you’ve gone to your doctor or you’re a doctor and you’re just measuring hormones through serum, you won’t know anything about these metabolites so you have to look at your hormones in urine to see how the estrogen is getting metabolized, what pathway. Do you use urine testing for hormones?

Dr. Gersh:           I’m looking at it more and more now because like you said, the first step may not be that, but that is part of the process in Functional Medicine is to understand these pathways which are totally ignored. We know that what’s going on with the metabolites really does matter. There’s … One of the metabolites which is 2-methoxyestradiol has been shown to be very, very critical for liver health. So it’s one of those feedback things that you make … The liver is involved in detoxifying. And one of the detoxification products which is a metabolite, which is 2-methoxyestradiol is a back key to keeping the liver healthy. And it also works to … They found … We don’t even know too much about it. But we know it helps to maintain liver health, it also maintains myocardial health.

Dr. Weitz:            Wow.

Dr. Gersh:           So it helps to maintain the actual muscle fibers of the heart to be healthy. But you need to have the liver working properly to make that one metabolite. And that’s just one of other metabolites that … And then of course like you mentioned, you can also make the wrong metabolites that can then be carcinogenic even. So it’s very very complex, but you can’t have anything work properly in the body if you don’t have that incredible organ, the liver, doing its job right.

Dr. Weitz:            Isn’t it amazing how the body works when it’s in balance and can function properly?

Dr. Gersh:           It is. And it’s so … The thing that Big Pharma has done and it has been such a big disservice is what I call the dumbing down of medicine. Telling doctors, “Here, they have these … You have this patient with these symptoms. Just give this drug and don’t even worry about how it works because somebody at the big pharmaceutical company took care of that for you.” When in reality, of course, the drugs are going to have tremendous amounts of collateral damage because you can’t alter one area and think you’re not altering others because it’s this incredible interrelationship of enzymes, and pathways, and hormones, and neurotransmitters, and everything. And how they interrelate. And we are not smart enough to go in there and alter one pathway and think you’re not gonna then imbalance all kinds of other pathways.

So we have to go back to basics and start with having a healthy gut, and healthy food, and healthy liver, and healthy environment in utero. And as an OBGYN, I talk over and over that you have to be healthy before you get pregnant. Because you’re impacting your child’s life and future generations because of the epigenetic modification. So we have a system where women have a lot of infertility now. It’s just such a high problem. A big problem, high percentage. 

Dr. Weitz:            By the way, men also.

Dr. Gersh:           Men. Oh yeah. Sperm counts are plummeting. It’s a huge problem. A lot of it is coming from things like phthalates. So you end up going to these fertility centers where they put everyone on fertility drugs and then they do in vitro fertilization. And they don’t even think is this really a problem because nature is saying, “This is an unhealthy couple.” This woman or this man, they shouldn’t really be making a baby because they’re not healthy. It’s like a clue. Fertility is a vital sign of health. If you’re infertile, it means something is wrong with you. Unless you just had your tubes tied, but other than that, there’s something really wrong and you need to go figure out what that is before you then trick a body into getting pregnant and then of course have lots of pregnancy complications and then have children who then have significant problems because we now know the children are very much the product of the environment that they are growing in, in every which way.

So we have to change the whole paradigm of how we consider fertility. We have to look at the health issues before we try to get people pregnant and not just trick the body into getting pregnant and then having all these repercussions down the line. So we just have to change the way we think about everything. And endometriosis is the perfect example of a medical condition that is so prevalent that is really the result of all these things that we have done wrong.

Dr. Weitz:            Yeah. You talk about the gut and one of the important things about the gut is that estrogen, after it’s metabolized, needs to get excreted. And if you’re constipated and you have gut problems, gut dysbiosis, that estrogen may not get excreted so it’ll just keep recirculating and causing more havoc.

Dr. Gersh:           That’s right. You want the perfect balance when people talk about the different enzymes that detoxify estrogen. They’re not good, they’re not bad. You just need the right amount like everything. They’re not evil enzymes. Beta-glucuronidase is not evil. You need it. Because it actually can help recycle estrogen and get more, especially in women in the menopause. But you don’t want it at the wrong amount. Everything is supposed to be in the right balance. And we live in a world that has become very imbalanced. So we’re struggling. All of us health care providers, we’re just struggling to try to help our patients get back in balance. And it is a challenge, but we can do so much good with all these different things that you’ve mentioned.

Dr. Weitz:            When you talk about the hormones and the importance for estrogen and progesterone, and all this and how all that serves a purpose, I think sometimes about hormone replacement therapy and the way sometimes it’s done is to give women an exact same level of estrogen every day for the rest of their life. And if all these fluctuations are so important, I wonder how beneficial that way of approaching it is.

Dr. Gersh:           You are so brilliant and you hit it right on the head. That is exactly what we’re doing and it is absolutely wrong. The reality is that there’s never a time in a woman’s existence when she has a static amount of estrogen. And of course, this also goes back to birth control pills which we can talk about another day which are … Actually, they are what they are. They’re endocrine disruptors and they create a static situation and that’s why they’re involved with a lot of metabolic problems including higher rates of breast cancer. And women in the menopause are not getting treated in a physiologic way. Estrogen, as I mentioned … Low levels have one effect. High levels have a different effect. And the body made this beautiful balance. And in fact, there’s now some data that the way that the estrogen ebbs and flows impacts dramatically the hormone receptors of other hormones and itself as well. So when you get the spike of estrogen that is right before ovulation in a normal cycle, that spike upregulates progesterone receptors, and testosterone, and thyroid so that they actually work better.

So if you live in a world where you have a static amount of estrogen and you’re never gonna have that upregulation of those hormone receptors, so those hormones may not work properly. And in fact, in women in menopause, for example, they may have physiologic or so called normal levels of thyroid circulating. But they have all the symptoms of being hypothyroid. And of course the doctor says, “Oh, another crazy woman. She says she has low thyroid and all the symptoms and I measured her thyroid and it’s perfect.” Well it doesn’t matter what you have if it doesn’t get in the receptor and work. And if you have static low levels of estrogen … Either if you’re taking a little bit or you’re not having any, then those thyroid receptors are not gonna be working properly. And neither will the testosterone, neither will the progesterone receptors. And none of them are gonna be working properly.

And as … And unfortunately like in women with endometriosis, their progesterone receptors are completely malfunctioning. They don’t receive … They have them, but they don’t receive the progesterone, so you don’t get the desired effect. The same thing can happen if you don’t have progesterone or you have little bits or if the receptors don’t work. So it’s not just about how much is in your body. It’s how the receptors are actually working with it. And you need to have that beautiful up and down of the estrogen with the menstrual cycle in order for all these hormone receptors to do their job properly.

And it gets even more complex because there are tumor suppressor genes that are actually activated when you get that estrogen spike. And then that actually sets the tone for what happens as far as program cell suicide. To kill off … Our body’s ability to kill off the incipient or growing cancer cells. And there’s actually some data that when the menstrual cycle happens, which is sort of a purging of these cells from the uterine lining, that a similar thing happens in a normal menstrual cycle in the breast. And that crappy pre-cancerous cells of the breast are actually creating programed cell suicide or apoptosis and they’re killing themselves off. So nature actually has it’s own tools to actually eliminate breast cancer cells in a normal cycling woman.

But of course, none of that is going to come into play if you have a static situation. So I really think we need … And I’m actually supporting a new nonprofit that’s actually trying to create … To raise funds to do research on doing hormone research on women in menopause where you actually try to do a more physiologic replacement to mimic the ups and downs because we need data. We absolutely need data. Because all I can say is what we’re doing is not physiologic and it can’t be the best. It cannot be the best. Is it better than nothing? I think it’s definitely better than nothing. But I know it’s not best.

Dr. Weitz:            Right. One more quick question because I know you have to get to your practice. Is … You touched on some natural substances that can be helpful for women with endometriosis and you talked about antioxidants, and phytonutrients. And a couple that I saw in some articles, one was pycnogenol which is for pine bark extract at 30 milligrams twice a day. I saw melatonin and any inflammatory substances like quercumin, boswellia, fish oil, and there was also discussion about NAC which seems to be one of the most amazing nutritional supplements for almost anything.

Dr. Gersh:           Yeah, actually pretty much all those are wonderful antioxidants and antiinflammatory agents. Quercumin is actually very important. I’m glad you mentioned that. Specifically quercumin for women with endometriosis. Because it seems to act as a blocker of the enzyme aromatase. So you actually can have some blockage of this really excessive amount of estrogen that’s produced locally. And because of all this … What’s going on in the pelvis of women with endometriosis, they actually can produce high amounts of estrogen. So remember, high amounts of estrogen in a normal woman, what did I tell you? They’re antiinflammatory, right? So high levels of estrogen actually is antiinflammatory. So what happens in the pelvis, there’s so much inflammation in the woman with endometriosis, that her body locally produces more estrogen. There’s a lot of areas of the body that have the enzyme aromatase and can produce their own local estrogen. We call that a paracrine effect as opposed to an endocrine where you make the hormone where it circulates through the body. In these cases, it’s made and used locally. So the pelvis is one of those places that it can make its own estrogen.

So the body is making humongous amounts of estrogen trying to put out this fire. All this … To reduce the inflammation. But it doesn’t work. Because the hormone receptors aren’t working properly and you’re actually creating more havoc because the alpha, the beta, none of this is working properly. So you have this explosion of inflammation and estrogen production. Quercumin can actually help block the enzyme aromatase. So you’ll make less of this estrogen that you don’t want in this case. You want to drop the estrogen. And that’s the same thing with breast cancer. Where the breast can also make it’s own estrogen, it has … And that’s why dense breasts are a warning sign because it means the breast is inflamed and it’s making a lot of estrogen. And estrogen is all about healing. It’s about proliferation, it’s about growth. But when you have an abnormal environment whether it’s cancer or endometriosis, you’re taking what is a good thing and you’re sort of turning it on it’s head and it’s actually creating havoc instead of healing which is what its original plan and goal is. So quercumin is an absolute must in women with endometriosis. Or boswellia, wonderful- I’m sorry.

Dr. Weitz:            Do you have a recommended dosage for quercumin for the average woman?

Dr. Gersh:           Well, why don’t you … I would say start with 500 milligrams three times a day. And you definitely want one that’s absorbed. So quercumin or turmeric. If you take it in one format, it’s very good for the gut. Which is I’m totally in favor of. But if you wanna make it a systemic treatment, you have to make sure that it’s on the absorbable form. So that you get it in systemically. So that is a very important thing. And NAC, like you mentioned, it’s a precursor to glutathione, the master antioxidant, detoxifier of the body. But it has amazing functions in its own right. So NAC is part of many detoxification protocols. So I use it all the time.

And melatonin is essentially an estrogen related hormone. And people don’t realize that estrogen is actually in control of the production of serotonin. There are actually serotonin neurons and they’re actually controlled by estrogen. So when you don’t have enough estrogen or it’s not properly received, you will not make serotonin properly. Which is one of the reasons why women in menopause have more depression and sleep problems. And serotonin goes on to make melatonin. So you’ll have this problem as I mentioned in the beginning. Melatonin has many functions in the body and it’s one of the most potent nonrecyclable antioxidants. So melatonin is another very wonderful tool for women with endometriosis to use.

Dr. Weitz:            Awesome. Awesome. Thank you so much, Dr. Gersh. You’ve given us so much important information and some great tools to help with women with endometriosis, both for patients and also for practitioners to use. For patients and practitioners who’d like to get a hold of you, what’s the best way for them to contact you?

Dr. Gersh:           Well, we see patients in the office. So you can certainly give us a call. I have an office website-

Dr. Weitz:            What’s your phone number by the way?

Dr. Gersh:           Oh. Our phone number is 949-753-7475.

Dr. Weitz:            Great. And that’s in Irvine, California?

Dr. Gersh:           And we’re in Irvine. Right, right. Central Orange County. In Irvine. And our website is www.integrativemgi.com. That’s for … The name of the group is the Integrative Medical Group of Irvine. So it’s integrativemgi.com.

Dr. Weitz:            Great. Excellent. Thank you so much for spending this time with us, Dr. Gersh. It was very [crosstalk 00:46:38]

Dr. Gersh:           Oh, it’s my pleasure. And if people … If you live far away, you can’t come, if you go to the website, you can also sign up and we’ll send you our regular newsletters as well.

Dr. Weitz:            Okay. That’s great. Excellent. Talk to you soon.

Dr. Gersh:           Oh, bye. Have a wonderful day.

Improving Depression & Anxiety with Dr. Jesse Armine: Rational Wellness Podcast 066

Improving depression and anxiety with Dr. Jess Armine using a Functional Medicine approach.

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

 

Podcast Highlights

4:30  Dr. Armine explained that he loves chiropractic, but he always felt this draw to what we call Functional Medicine and what drew him in more was his son who developed schizophrenia at age 14. He has a high IQ and was very talkative but when he got treated by conventional psychiatrists with medications, he would just sit there on the couch rocking and became a non-entity. He had to find a better way, so he dug into the research and consulted an integrative psychiatrist and he developed a methodology of treatment that looks at both ends of the disease process down to the core molecular level, which he applied to his son.  And his son was able to graduate college and now he is an incredibly functional person who runs his own business and leads a normal life.

6:58  Dr. Armine found that in his son’s case, chronic, neurological Lyme was an important factor that he had to deal with. They also had to deal with strep and biotoxins.  His son also had gained a lot of weight because of the medications and all the fat created increased inflammation, so losing the weight also helped. 

8:57  Common mood disorders like depression and anxiety are caused, at least in part, by neurotransmitter imbalances, with serotonin being an issue for depression and too much adrenaline or too much dopamine being an important factor in anxiety.  Dr. Armine has developed a model of practice that looks both at neurotransmitters and at the the causes of altered neurotransmitters like exposure to chemicals, heavy metals, benzene, mold, fungi, bacteria, parasites. Also various psychological factors like being brought up in a non-nurturing environment or being exposed to yelling, abuse, social isolation, and PTSD can be important factors. All these stressors can affect the cell and neurotransmitter imbalance. (Neurotransmitters are substances that transmit neurological impulses from one nerve to another.)  Dr. Armine believes in addressing both the causes of neurotransmitter imbalance just mentioned and also supplement with nutraceuticals to boost neurotransmitter levels.

17:32  Dr. Armine uses urinary neurotransmitter testing, which has been criticized as not reflecting the level of neurotransmitters in the central nervous system.  But taking a brain biopsy or getting a spinal tap is not practical for use in clinical practice and urinary neurotransmitter levels should be correlated with symptoms and treated as biomarkers that tell you about trends, rather than as absolute levels.

21:12  Organic acid testing is helpful to let you understand metabolism. You can see what’s being absorbed, what’s not being absorbed. You can see the reasons why. You can see the mitochondrial pathways.

23:38  Genetic testing also helps him by giving him a heads up into what areas might have problems.  MTHFR does one thing and one thing only. It takes 5,10-methylenetetrahydrofolate and turns it into 5-methyltetrahydrofolate. That’s it. 

35:30  Treatment should always involve improving leaky gut.  You can use digestive enzymes, a demulcent herb, colostrum, and a probiotic.  Fix Lyme if it’s there. You need to treat the foundation of the body first, which means decreasing various stressors to the body, by cleaning up your environment.  Drinking good water with as good a water filter as you can afford. Check your house for mold. You have to heal the cells with vitamins and minerals that can get into the cells and phospholipids to rebuild the cell walls. You want to consider mitchondrial function.  Autoimmune Paleo diet works well to reduce inflammation, but it doesn’t work for everyone. If they have neurotransmitter imbalances, you should treat the inhibitory neurotransmitters before the excitatory, which means you want to increase GABA. You want to either use the liposomal form from Quicksilver Scientific or the 4-amino-3-phenylbutyric acid form of GABA that came out of Eastern Europe, such as PheniTropic from Biotics or Kavinace from Neuroscience.  For serotonin it’s better to use 5-HTP than tryptophan, since the tryptophan pathway can lead to quinolinic acid, which is a nasty excitotoxin. You can take SSRIs all day long, but if you are not producing enough serotonin, it won’t work.

 

 



Dr. Jess Armine is a Doctor of Chiropractic and a Registered Nurse and has been in healthcare for over 37 years. His focus is using a Functional Medicine approach to treating various neurological and immunological conditions in patients with a focus on taking a careful history, lab work, and also looking at genetics. You can contact Dr. Armine at his website DrJessArmine.com Dr. Armine offers new clients a free 15 minute consultation to see if he can help them and he does consultations via phone or Skype.

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, and for those of you who enjoy our Rational Wellness Podcast, please go to iTunes and leave us a ratings and review and go to YouTube and sign up to become a subscriber to our YouTube page, which is Weitz Chiro, or you can search for Rational Wellness in YouTube.

Today, our topic is how to deal with mood disorders like depression and anxiety by trying to balance our neurotransmitters. Depression is characterized by persistently depressed mood or a loss of interest in activities, and it affects more than three million Americans per year. In fact, it’s been in the news a lot. There have been a series of celebrity suicides, so depression is really in the news. Anxiety is characterized by feelings of worry, nervousness, or fear that are strong enough to interfere with one’s daily activities.  Depression and anxiety are typically treated by mainstream medicine with medications like selective serotonin reuptake inhibitors, also known as SSRIs, like Prozac, Zoloft, and Lexapro, which are among the most commonly prescribed medications in the United States.  According to a new analysis of federal data by the New York Times, long-term use of antidepressants is surging in the United States. Some 15.5 million Americans have been taken the medications for at least five years, and the rate has almost doubled since 2010.  Most of these antidepressants were originally approved by the FDA for short-term usage, and there was only a few studies lasting longer than a few years, but yet many patients are put on these drugs indefinitely. It’s very difficult to get off these drugs. A large percentage of patients who take them report severe withdrawal symptoms when trying to ween themselves off or are unable to ween themselves off.  Other than talk therapy, what other approaches can help such patients?

This is why I’ve asked Dr. Jess Armine to join us today for a functional medicine approach to dealing with mood disorders. Dr. Jess Armine is a doctor of chiropractic and a registered nurse, and he’s been a healthcare professional for over 37 years. He’s trained in chiropractic, anhelation, genetic research, neuroendo immunology, functional medicine, applied kinesiology, and cranial manipulation.  Dr. Armine is one of the few specialists in the United States specializing in correlating genetic SNPs, which are single nucleotide polymorphisms like MTHFR with neuroendo immunology. He also correlates this with acquired mitochondrial dysfunction and cell wall integrity to help identify hidden imbalances–that’s a mouthful–hidden stressors in the body. He develops individual treatment plans specific to the health history and physiology of each patient. Dr. Armine, thank you so much for joining me today.

Dr. Armine:         Thank you for the opportunity for being here and talking to your listeners, and that was a great introduction. Thank you so much.

Dr. Weitz:            Thank you. I’d like to give a quick shout out to the chiropractic profession because this just occurred to me this morning. For some reason, some of the smartest doctors in the functional medicine world, like yourself, are chiropractors.

Dr. Armine:         Yes.

Dr. Weitz:            I just recently interviewed Dr. Tom O’Bryan, Dr. Michael Ruscio. We were talking a little bit about Dr. Kharazzian, so anyway, for whatever that’s worth. Dr. Armine, what got you so interested in researching and treating mood disorders?

Dr. Armine:         Well, when I became a chiropractor, chiropractic is wonderful. I always had a really good time with it. Always felt this draw to what we now call functional medicine. It’s something that interested me because I could put the puzzle pieces together, but essentially, what threw me into high gear was my son, who is now 31, developing schizophrenia at about age 14.  I did exactly what every good father should do. I took him to the doctors and this child with 160 IQ who was glib and had frankly exceeded me intellectually when he was 10 became a nonentity with the medicines. He would sit there on the couch just rocking. I’m a fairly spiritual guy and I looked up at the spirit of God and said, “This disease is squaring with the wrong daddy.” I apologize for the bad word.  I launched into studies and as it would happen, I had a lot of good people put in front of me and I learned an incredible amount of stuff that as you mentioned, the neuroendocrinology concepts, neurotransmitter analyses, and so forth and so on, that helped me develop a methodology of treatment that looked at both ends of a disease process right down to the core molecular level.  I applied this with my son. Of course, I worked with an integrated psychiatrist also, and between us, he graduated college. He became an Eagle Scout when he was younger. He was a director of a nature program in the Boy Scout camp. He now runs a business on his own and he is himself. He still has some issues, but you know something? He’s a functional, incredibly functional person. He is my hero, actually.

Dr. Weitz:            That’s a great story.

Dr. Armine:         He really is. That’s why I’m here. That’s where my passion in the circles that I run in. If anybody comes to them and they have severe neuropsychiatric challenges, they tend to refer them to me because that’s my passion, figuring out why, the base reasons, and the downstream effects is my passion. I like to think I’m pretty good at it.

Dr. Weitz:            If you don’t mind my asking, were there one or two keys that you thought were really helpful in your son’s case?

Dr. Armine:         Yes. Number one, like I said, he was an Eagle Scout, so to think that he didn’t get bitten by a tick is kind of foolish. Lyme disease, neural Lyme, was one of the issues. The medicines made him gain weight like crazy, and just the adipose tissue increased inflammation to a degree, and to think inflammation like a forest fire. Once it gets going, once it gets really going, and you’re out in California so you have a feeling for this. I’m in Pennsylvania. We don’t see forest fires, but they will just get so hot that they’ll burn everything, even things that aren’t supposed to burn. It feeds on itself. We know why now.

That’s in the whole cell danger response thing. We can interrupt that, but the keys were chronic cerebral inflammation, what’s now called chronic inflammatory response syndrome, that can be done by biotoxins, by Lyme, by strep, by so many things. Those were the keys to putting the fire down and then replenishing. Yes, it was done with medicines and nutraceuticals because of the severity of the pathology, and as I’m explaining neurotransmitters, you’ll see why. Those were the keys. The keys were cleaning up his physiology, because let’s face it, the bugs don’t like a normal environment. They like their own environment.  If you can do that and take care of what the bugs have done to you, the damage they’ve done, reversed or in other words, work in both ends, even the most severe pathology … He was suicidal. He was seeing demons. This is a boy that I would committed suicide myself. That’s why he’s my hero. I meet very few people who can go through that and survive.

Dr. Weitz:            That’s awesome. What causes the common mood disorders like anxiety and depression?

Dr. Armine:         Well, even though there may be arguments on both sides of the issue, there is no question that neurotransmitter imbalances cause mood disorders.  Remember that the neurotransmitter imbalances don’t happen by themselves in a vacuum. They happen for reasons.  Typically, we think of depression as being a serotonin issue. We think of anxiety as being too much adrenaline or too much dopamine. It’s not always like that. It’s really a matter of balance. The neurotransmitter balance is what you’re looking for, and also the imbalances will cause mood disorders.  The resulting mood disorder is based on genetic predisposition with something causing that genetic predisposition to express, which is usually the neurotransmitter imbalance and the resulting mood disorder. If we look at it in a line like that-

Dr. Weitz:            By the way, doc, what are neurotransmitters?

Dr. Armine:         Okay. Neurotransmitters are substances that transmit neurological impulses from one nerve to another, okay?  Very simply, nerves are not connected. They have a synapse. We’re not going to use big terms. They have a synapse.  The neurotransmitters, the chemicals are sitting in warehouses called vesicles.

Dr. Armine:         When a nerve impulse comes down, it comes down, somebody at the synapse, I always call them the warehouse guy, the guy with the hardhat, says, “Hey, send me some,” I’m from Brooklyn, okay, “Hey, send me a bit of serotonin here. I’ve got to get this over there,” right? The serotonin vesicles will release some serotonin into the synapse, take that information, go to the other nerve, and the nerve impulse continues.  When that neurotransmitter, that substance goes off the receptor, it’ll sit around in the synapse and does one of a few things. It either hangs out with its buddies for a while or it gets broken down by COMT, Catechol-O-methyl transferase, or MAO, monoamine oxidase, or it gets reabsorbed. That’s the reuptake, so it can be reused again.  That’s the normal process. Your food intake, your amino acid intake goes into the axons of the nerve and produces neurotransmitters, and so people have a good understanding of it, I’m going to share my screen for a real, real short visual. Let me hit slideshow.

Dr. Weitz:            Okay.

Dr. Armine:         We’ll handle this from the current slide. Okay. This is the stressors that can affect the cell. This is what causes all the problems. This is from the metabolic features of cell danger response by Dr. Naviaux, who’s at the Metabolic Disease Center at the University of California San Diego. He discovered all the things that can damage a cell, as you might expect, for chemical, physical, heavy metals, benzene, microbial, mold, fungi, bacteria, parasites, parasites is a biggie, by the way.  What most people fob off as being non-essential or not significant are the whole psychological constructs of yelling, abuse, isolation, PTSD.  People who have been brought up in a non-nurturing environment, people who were exposed to various forms of abuse, either on a single or ongoing basis, will damage the cells just as much as microbial or chemical influences.

This is a little animation. We’re going to talk about dopamine here. Dopamine is created in the axon, as you can see. It’s degraded by monoamine oxidase, but you see the little vesicles where it is stored. When dopamine is necessary, those vesicles will release dopamine into the synapse so that the dopamine in this case will go into the receptors, do their thing, and then either get degraded or get reuptake, like I told you before.  Now, this is optimal activity, and on a scale, this is what it looks like. Your neurotransmitter stores are good. The activity is just fine. When you encounter stressors, the stress increases the neurotransmitter activity. In other words, more neurotransmitters are needed at the synapse, and the stores become depleted. This is a process that takes some time. You have high activity. You’re able to respond to the stress, and it’s a good thing.  If you’ll notice the scale, the activity goes quite high, and the neurotransmitter stores start dropping. When you have chronic stress, the fact is that the stressors use up the neurotransmitters rather quickly and we can only produce neurotransmitters at a particular rate, even if there’s no problems, even if the system’s perfect. We can only produce it at a particular rate.   What you have here is optimal looking activity because the stores are decreasing, and they’re decreasing rather chronically. Look at the scale again. The scale is the neurotransmitter activity starts dropping, the stores are dropping, but you don’t even have symptoms yet. This is the thing. You don’t have symptoms yet. This is happening way before you have symptoms.

Now, when the stores are depleted, you have inadequate neurotransmitter levels because the stores have nothing in there. The warehouses have nothing in there, so it doesn’t matter how hard you try, there’s simply low activity. Now, this is where you get symptoms where the neurotransmitter stores have bottomed out, the activity has bottomed out, and now you become depressed, now you become anxious, now you have whatever.  Reuptake inhibitors, if you go back one slide, go back two slides, sorry, prevent some of the reuptake and give you optimal looking activity because what they’re doing is preventing the reuptake by inhibiting some of the receptors that would tell you to reuptake the serotonin or dopamine or norepinephrine, whatever it happens to be.

Really what’s going on, what we really must understand is that by the time you have symptoms, you have incredibly low neurotransmitter stores and the reuptake inhibitor will work, give you optimal looking activity, but if you’re lucky, between five and 10 years before you simply have absolutely nothing, as these medicines do nothing to talk about why you’re like this, why you’re not getting the neurotransmitters that you’re looking for.  When people argue about, “Well, neurotransmitters have nothing to do with mood disorders,” what they’re really saying, and they’re saying it inartfully in my estimation, what they’re saying is you should be concentrating more on the rationale or the reason for the neurotransmitter imbalances, neurotransmitter storage, however you want to put it. Instead of treating from the bottom end, by treating the neurotransmitter imbalance or the supposed symptoms, you should be looking at the rationale or the reasons or the root causes, if you will.

My theory, my method of practice, which has been really successful, is to identify and treat the root causes and treat why you’re not producing your neurotransmitters, and then as you can see, since you need to fill up these warehouses or vesicles, you need supplementation for a period of time, serotonin, let’s say.  You cannot put enough tryptophan into your body to fill up those stores in anything like realtime. Unless you want to eat a turkey a day or three turkeys a day, it’s not going to happen, assuming that your GI tract will handle it. That’s how this actually works, so you have to look at things from both ends, both points of view.

Dr. Weitz:            Interesting. How do you measure neurotransmitters in your patients and which lab do you like to use?

Dr. Armine:         I can see that you like to open up Pandora’s Box of controversies, so let me address the unanswered question. I use urinary neurotransmitter testing. Urinary neurotransmitter testing, urine comes from the circulating serum of the body. Whether you do serum neurotransmitter, platelet neurotransmitter, or urinary transmitter, you’re taking it from the same pool.  The ubiquitous argument is, and it’s usually against urinary neurotransmitters, is that they don’t represent central nervous system neurotransmitters. You know something? That’s absolutely correct. If you want to measure central nervous system neurotransmitters, you have to get cerebral spinal fluid or take a biopsy of the brain, which is usually a bad thing to do with people, especially in your office.  Listen, I’ve been in ER, an emergency department nurse, critical care nurse. I was head nurse of coronary intensive care unit. I’ve been in critical care, so I know how to do a lumbar puncture. I’ve never done one. I’ve seen it happen, but to do a lumbar puncture to get cerebral spinal fluid is usually done with meningitis and stuff, is not a benign procedure. Frankly, you’re not going to do that on an office-based basis.

Urinary neurotransmitters give you a balance of what’s in the periphery and what’s in the central nervous system in order to be used as biomarkers. Biomarkers means that you don’t take the number as an absolute. You look at the pattern, what’s high, what’s low, what’s going on. You can tell the pattern, and then if you have somebody who has a particular symptom, you can correlate your nutraceutical or pharmaceutical intervention based on the pattern.  The reason I use urinary neurotransmitter testing is because there’s been a ton of studies, a ton of research, and they have good databases. When I do a serum neurotransmitter test, and I’ll make my typical joke, dopamine is normal between zero and 140, which begs the question, if I have no dopamine, is that normal? I’m serious. That’s what it says.

If I see something that’s, I’m just making up numbers now, 15 to 140, does that mean 16 is normal? No. That’s low. By the way, our rule of thumb when you’re looking at your lab tests, use Armine’s rule of thirds. I have to put my name on something. Really, let’s face it, all right? Take that reference range. Just a rule of thumb. Not always, but it works pretty well. Take the reference range, divide it into thirds in your head. If your number fits in the middle third, it’s probably okay. If it’s in the lower third, especially the low part of the lower third, it’s suboptimal. If it’s in the upper third, it requires interpretation.  I look at people and I look at their blood tests and say, “You know something? 12 to 16 hemoglobin, you’re 12.1. You’re 250 pounds. I don’t think that’s good for you.  You don’t have enough blood cells.  You’re not bringing in oxygen around.”  They’re like, “But it’s normal.” I say, “It’s not normal.”  That’s an average.  That’s an average.

Dr. Weitz:            No, that’s great. I love this.  Armine’s rule of thirds.

Dr. Armine:         I know it’s silly, but I just think Hashimoto has got his thyroiditis. Everybody’s got it, right? I said, “I’m going to put my name on something that’s pretty benign, but I’ll be remembered for it, so it’s okay.”

Dr. Weitz:            What do you think about organic acid testing as a way to get a sense of what’s going on?

Dr. Armine:         Organic acid testing, by the way, happens to be one of the better ways of discovering what is going on with your body physiologically.  I’m also an expert in epigenetics. That’s where I’m known in the MTHFR community, and I’ve been with Dr. Ben Lynch for many years and did research, and his strategy and application was my invention. I gave it to him because he’s got money, I don’t, and he developed it.  There’s a new one coming up that’s going to be better than anything that’s been previously here.

When you look at genetics, you’re looking at probabilities. You can look at a pathway and say, “Gee, that pathway might not do well under oxidative stress,” but you don’t know. Organic acid testing tells you because that’s the result of the pathways. So when it comes to the neurotransmitter part, you always have to remember that you’re looking at metabolites. Dopamine will metabolize either down the cascade of dopamine, norepinephrine, norepinephrine, epinephrine, metanephrine, all the way down to something called VMA, or we’ll go down the pathway where it becomes homovanillic acid, HVA, which is what’s measured.  Always remember that pathway requires co-factors and co-enzymes, so that pathway requires SAMe, B1, B2, B3. If you don’t have enough of that, you might get a false reading, but you can read an organic acid test. You can see what’s being absorbed, what’s not being absorbed. You can see the reasons why. You can see the mitochondrial pathways.

Yes, if you correlate, remember, a test is only a test. You don’t treat tests; you treat people. Remember, doctors say that a lot, but then they treat the tests. If you walk out of somebody’s office with a shopping bag of vitamins, that doctor’s treating each line of a test. Before you spend 300 or $400, walk out. Do me a favor, because that healthcare provider is supposed to correlate your symptoms with the testing and then figure out what your body needs, and it’s usually not done by reading one line after another after another and then trying to supplement each line. Organic acid testing is one of the better ways of determining what’s going on with you globally to include neurotransmitters.

Dr. Weitz:            How does genetic testing help in analyzing and treating mood disorders?

Dr. Armine:         Genetic testing will give you a heads up into what areas might have problems, again, under an oxidative stress load. I say that a lot. Remember, oxidative stress is microbial stress. It is stress of biotoxins, of regular toxins, of the psychology. All of those things cause an increase in inflammation/oxidation compounds/oxidative stress.

Dr. Weitz:            By the way, oxidative stress is also often known as free radicals, right?

Dr. Armine:         Exactly. Free radicals, reactive oxygen species, reactive nitrogen species. There’s a bunch of names. It all comes from Durk Pearson and Sandy Shaw back in the ’70s, who wrote that big thick book called Life Extension.

Dr. Weitz:            I remember that.

Dr. Armine:         Yes. I actually read it. Oh my god.

Dr. Weitz:            I did, too.

Dr. Armine:         Even when I move around, books, I do everything online anymore, but I keep that book because it’s a badge of courage that I read it. I was like, “Aha.”

Dr. Weitz:            I love that book, but one thing is I still have in my memory those horrible images of them showing what they look like.

Dr. Armine:         No, no, please. It’s burned in my brain. It’s burned in my brain. Please, please. “Hi, I’m strong.” “No, you’re not. No, you’re not. Don’t show pictures like that. No, no, no. Oh god.” You want to get a mood disorder, look at those pictures. Of course, America came in, the American business came in and I won’t say a bad word, but took pieces of it and said, “Oh, you can take this and lose weight,” and that-

Dr. Weitz:            Right. By the way, for those who aren’t familiar with this book, this was really the first book that came in and expressed clearly the relationship between free radicals and antioxidants and disease and this was the new key to solving a chronic disease epidemic.

Dr. Armine:         Exactly. It was mainly about aging and how cells were injured, and they went and discovered the ROSs, reactive oxidative species free radicals, but guess what? This is why Dr. Naviaux, the panel I just showed you, he took that concept, brought it way out, not only described what created the oxidative stress, but what that oxidative stress did to the homeostatic mechanisms, what you got you ill, and what interfered with them and how you can go about interrupting the forest fire, which takes it way out into orbit.  Genetic studies, well, you can look at different pathways. Those people who are stuck in the MTHFR paradigm, MTHFR does one thing and one thing only. It takes 5,10-methylenetetrahydrofolate and turns it into 5-methyltetrahydrofolate. That’s it. It’s not a deity. It’s not a devil. It’s not waiting in the tall grass to get you.

The reason that people misinterpret it is because when they first studied epigenetics, they looked at homocysteine, and they said, “Gee, high homocysteine is a cardiac marker. MTHFR is connected to that.” They only checked two variants, by the way, the C677T and A1298C, which are where they are in the particular person’s genome. They made a correlation that if we treat this, which you can’t treat it, that would be able to control the homocysteine, but that didn’t work out so well.  Anybody who had any kind of chronic illness who was testing for this said they developed databases because the erroneous conclusion was if you have MTHFR polymorphisms or SNPs, that’s going to cause clotting, that’s going to cause different disorders, it’s going to cause foot fungus, which the last one’s a joke. That’s not true. It’s a combination of things because that’s one gene, one enzyme in a pathway, that folate pathway, going to methylation, going to methionine and doing methylcobalamin and so forth.

When you look at genetic studies, if you’re looking at a list of genes, it’s hard, but if you’re looking at it into the pathways, you can say, “You know, that pathway has a lot of polymorphisms, and if there’s a lot of oxidative stress, we’re not going to get the products we’re looking for, so maybe I should look in that direction.” Believe it or not, it’s predictive in that if you look at it properly, you can say to yourself, “Gee, this person’s mitochondria is kind of on the weak side, so let me look at the glutathione pathway. That recycling mechanism doesn’t look like it may be working.  Let me see if that’s the reason,” because that person recycles glutathione, which is going to give you a lot of oxidative glutathione, and that’s going to block the mitochondria.

You can have a big old heads up of where to look and then how to intervene. It shortens the diagnostic process. Once you find out why, it’s difficult, but the how becomes easier. It’s that whole finding out why, and a lot of my medical colleagues tend to stop at a certain area. We all know that, since you’re a chiropractor, you’ll understand this, the medical physicians are taught not to say three words, “I don’t know.” They would rather look and say, “Gee, I can’t figure it out. It must be you.” Don’t ask me where that legal logic came from. “It’s in your head.” Yes, it’s in your head. They’re neurotransmitters. You’re blaming the patient because you can’t figure it out. Makes no sense to me whatsoever, yet if we look at the genetic pathways and don’t take them as godlike or absolute, you’re going to get a pretty good idea of how that patient will fail.

 A little hint for you and your listeners. You can know the genetic pathways. If you want to know how they express, as they express differently in different people, you would see the pathways. Ask the person who they look like. If your daughter looks like Grandma Gale, for instance, ask about Grandma Gale and what kind of problems she had because they’re going to express that way. That’s the direction they’re going to go. Not absolute, but that’s the direction they’re going to go.  If Grandma Gale was a schizophrenic who committed suicide, god forbid, and your daughter has chronic Lyme and has the same genetic disposition, you’ve got a problem that you might want to deal with a little bit more strenuously than if they just had a little bit of depression. That’s a little diagnostic clue that tells you why things happen the way they happen. It also gives you a big jump onto the how.

Dr. Weitz:            I know every case is different and we have to take it case by case, but can you give us a little more detail in maybe some of your treatment protocols, say, treating a patient with depression?

Dr. Armine:         Absolutely. Not even a problem.

Dr. Weitz:            Let’s say we have a patient with mild to moderate depression. How would you work them up? Give us an idea of some of the types of protocols that you might use in treatment.

Dr. Armine:         Absolutely. The first thing is in real estate, it’s always location, location, location. In medicine, it’s history, history, history. Sir William Osler in 1895 said, “Listen to your patient. He’s telling you the diagnosis.” He was one of the founding fathers of Johns Hopkins. One of the things they teach and they teach the practitioners is how to use historical information.  That’s a lost art, by the way, because when you fill out a history form, nobody really looks at it and they go right to the chief complaint. You take a really good history. You look for temporal relationships. This happened and then that happened. This happened and that happened. That tells you where to look. It often tells you what’s wrong.

Dr. Weitz:            By the way, for those of you who are not familiar, if you take the practitioner training program through the Institute of Functional Medicine, they really do preach taking a very detailed careful history starting with birth and childhood and everything else.

Dr. Armine:         They do, and they also teach putting things on a timeline.

Dr. Weitz:            Timeline, yeah.

Dr. Armine:         When I took some of their courses, I’m sitting there and they put it all on the time line. I’ve been practicing like that for at least a decade before I did that, and as I looked at the little arrow, I said, “Not a bad idea. Good idea.” You’re forcing people to use it and then take the information.  Now, if you take that information and if you have testing or if you do testing, it should be targeted to what your suspicions are. You have somebody who’s got depression, you know that you have a neurotransmitter imbalance, so if you have an organic acid test, the neurotransmitter test, and by the way, I used to use Pharmasan Labs, but they’re not in existence any longer. I tend to use Labrix right now. They do a pretty good job.

Dr. Weitz:            Which is now owned by Doctor’s Data.

Dr. Armine:         Yes, exactly, and Doctor’s Data does a good job. It’s a blood test, though, and they’re neurobiological amines. The Labrex is a urine test, which is a whole lot easier to get. You’re going to get the same information. You’re going to get the same patterns. You can also get from the urine the cortisol levels and the four point cortisol you can get from urine with the Dutch test, but you can also get the saliva test that will tell you what the adrenal cortex is doing, as well as the adrenal medulla because you’re going to get insight into that.  What I’ll do is normally I’ll do an organic acid test if it isn’t already there because it gives me so much information. If they have the genetics, I’ll look at the genetics and see where the probabilities are, but that’s only telling me the why, why they’re like that. I also listen for what the probabilities are for their root causes. That’s really wide.  People, once you develop a relationship with them, they will tell you everything and anything. You can almost tell somebody has had severe psychological trauma if there’s portions if their childhood they cannot remember. They blocked it out. I see this with women who’ve been abused sexually in their childhood usually by family members. It’s a terrible thing. I don’t have them talk about it or anything. I just recognize it as being a form of PTSD.   I’ll listen for if they’re a camper or if they went out of the country and they had diarrhea and their stomach was never really the same. If they went to Cambodia, I know they got parasites. Let’s call a spade a spade. Lyme disease is rampant, but Lyme disease, you always have to consider. Don’t look at the maps because those are the CDC positives. Lyme disease is everywhere. They have found Lyme disease in the emperor penguins in Antarctica.

Dr. Weitz:            Wow.

Dr. Armine:         The ticks were brought over by the sea birds. Let’s face it. It’s everywhere, so you must consider it and you have to know how to test for it. You have to know how to read the test. You have to know which test to do at what stages, and that becomes a bit of a quagmire because Lyme disease diagnosis is a clinical diagnosis, not a testing diagnosis. There’s a whole mess of things that can cause it, thyroid problems, not just polymorphisms, strep, anemia. It’s endless. When you have that-

Dr. Weitz:            Gut disorders.

Dr. Armine:         Especially. Thank you very much. I appreciate it. Gastrointestinal leaky gut syndrome is the major reason. It can be primary or secondary. It can happen and then you have the problems, or you can have the problems and then the leaky gut can happen, but all the antigens getting through the gut into the base of the membrane cause immunological dysregulation that causes chronic inflammation, chronic neurotransmitter imbalances, a whole mess of things. When you’re treating somebody, regardless of what the testing says, it’s a good bet to treat leaky gut syndrome.

We talked about treatments. Well, treatments are based on treating the foundation of the body first, which is decreasing stressors, which is environmental stressors, drinking good water, getting good air, asking about their house, because a lot of people are sick in their houses and they’ve never tested for mold. It’s a very easy test to do. You don’t have to spend a lot of money.  Generally, cleaning up their environment as best as they can within their means. We can have people buy horrendously expensive house water filters, but if they’re a family with three children with a single provider who’s bringing in the money, maybe just a Brita filter would be okay. At least you can get most of it, okay? Decreasing other kinds of stress, giving them advice in certain areas.

Some people need certain types of therapies, EMDR, EFT, things like that, then you want to heal the cells themselves because leaky cells, dysfunctional cells are a common ubiquitous issue. That’s supplying vitamins and minerals that will get into the cell and phospholipids that will help rebuild the cell walls. When you’re having gut problems, that becomes a real issue, so you start thinking about transdermal or liposomal products.  Once you start attending to that, a lot of times, people start getting better just by virtue of the fact that everything begins to work, then simultaneously with that, I’m going to fix the gut almost in everybody because I haven’t met a person that doesn’t have leaky gut, regardless of what the leaky gut tests say.

By the way, that’s the worst test in the world. If you have a test that says you don’t have leaky gut and you have a chronic illness, throw it out. If you don’t believe me, here’s a way of thinking about it. Think of the risk benefit for that. What is the risk of giving somebody digestive enzymes, let’s say a demulcent herb, maybe colostrum or something else to heal themselves, a probiotic, versus what happens with leaky gut syndrome, which is chronic inflammatory response. No risk, and the probability of benefit if you seal up that gut is incredibly high. When you have that kind of safety profile, you treat the blessed thing. If you do that, you prevent antigenic entry, which lowers inflammation, which is what most of the body’s energy is just trying to do everyday is drop inflammation, and then it becomes more specific and individualized.

I’m always considering mitochondrial function. That is comparatively easy these days to support. You can use coenzyme Q10, PPQ, you can use a transdermal patch that has everything in it depending on the individual and their lifestyle, and you have to consider that and how well they’re going to take the nutraceuticals. You have to consider the nutrients that are going in. If they can’t absorb it, then give them things that are more easily absorbed, either on a protein powder basis or at least talk with them about being on an antiinflammatory diet. AIP paleo is kind of a typical thing that works with a lot of people, but doesn’t work with everybody. You have to be individualized about it, but you want to pull back from grains and sugar and go more on the antiinflammatory range. That’s easily looked up, and there’s a couple of books out there that are not expensive.

Then, I get real specific as to what I’m treating. It depends on what I’ve tested for. If we have Lyme disease, if we start getting to the root causes, and if we have neurotransmitter imbalances, the guidance for that is very simple. You treat the inhibitory neurotransmitters before the excitatory, which means you want to increase GABA. GABA, gamma-aminobutyric acid is the particular molecule that calms the human brain. That is available in a liposomal form from Quicksilver Scientific. It’s also available in phenolated form.  Now, I know everybody argues with me about Phenocol or Phenoblast. The reason for that is that the common one is beta phenyl gamma amino butyric. That’s a big word. That’s the one you usually buy. It has all kinds of problems, but there’s another molecule, the form of 4-amino-3-phenylbutyric acid that comes out of eastern Europe. All the studies for those were done in eastern Europe and they were done in Russian. I happen to speak Russian and read Russian, so I read the studies, and they don’t have it. I’ve been using this stuff for decades. No problems whatsoever. It gets through the blood brain barrier. The reason things like Pharmagaba and the regular GABA is that they’re water soluble. They don’t get through the blood brain barrier. If you get better with those common GABAs, that’s proof positive you have a leaky blood brain barrier.

Dr. Weitz:            What form of GABA are you talking about that’s used in Russia?

Dr. Armine:         Well, let me bring it down to what you can get here. From Biotics, it’s called PheniTropic, from Neuroscience its called Kavinace. I’m sure a couple of other people have them, but those are the two products I use. It’s the 4-amino-3-phenylbutyric acid. People argue with me that it’s just a nomenclature thing, but I’m going to tell you that those molecules, the ones I’ve used have never had any problems, and I’ve been using them for decades.

Dr. Weitz:            Either that one or the liposomal one?

Dr. Armine:         Right. Liposomal works really well. I’ve had people like this in front of me. I’m like, “Open your mouth. Open your mouth.” Four sprays and I wait there for five minutes and then they’re sitting back going, “All right.” Remember, the difference between a benzodiazepine and giving somebody GABA is a benzo stimulates the GABA and intercepted to release GABA, and the constant use of benzos damages the GABA receptor. That’s why you have so many problems. Giving somebody GABA gives them what they need without stimulating the receptor and yes, you burn through it after a while.

Serotonin, you can give someone L-tryptophan or better yet, 5-hydroxytryptophan. What’s the difference? Early on, we were giving people just L-tryptophan, and some people were getting excitatory with it. In the late ’90s, Kelly Olson, PhD, who was the R&D director of Neuroscience found the pathway that tryptophan can actually connect to an enzyme called IDO. That enzyme, when it’s stimulated by inflammation, yeast, microbes, stress, will start looking for substrate, pulls the tryptophan out of the pathway, and creates kynurenic acid, which is neuroprotective, and then quinolinic acid, which is a nasty excitotoxin. Then, it produces NAD, which is B3, which I think is a hell of a way to get B3 for your body, to have to go down that pathway.  The quinolinic acid is what creates the excitation, so under inflammatory conditions, tryptophan is pulled out of the pathway that should create serotonin, but it doesn’t. Part of it’s pulled out, at least, so you’re creating excitation on top of excitation from the microbes. That’s the reason people don’t use tryptophan, so when you went to 5-hydroxytryptophan, this tryptophan is metabolized with BH4 and iron and B6 to 5-hydroxytryptophan. It’s a one way pathway.  If we use that, we can create serotonin, and then the serotonin will either get degraded or become melatonin. You need serotonin for practically everything. 80% of it is produced in your gut, which is one of the reasons we have so much serotonin problems, because we have so many gut problems, so you’re not producing enough serotonin.  You can take SSRIs as much as you like, and yes, it will work for a while by increasing the serotonin, the synapse. You won’t correct your problem. That will fail. In typical medical thinking from big pharma, it’s not working, let’s give you Abilify. An atypical antipsychotic? Are you crazy? We’re not crazy. We’re just greedy. I know that, but you’re also crazy. Okay, if you say so, but you’re nobody. You’re a chiropractor. I’m like, “Whoever I can influence, I will.”

When it hits you, it’ll be like tsunami. Let’s do more. Let’s not fix you because we’re in a chronic disease management society. There’s no money in curing cancer. There’s money in treating cancer. There’s no money in curing diabetes. There’s money in treating diabetes. You ever wonder why there’s such a thing against Lyme disease? There’s no Lyme disease in Australia. You know why? They don’t allow the diagnosis. How can you have it if there’s no diagnosis? They have people believing there’s no Lyme disease there. Duh.  In England, at least it’s turned around because of certain things, but for the longest time, somebody would get a positive Lyme test. They’d do their own test. It was always negative, and so they treated people for chronic fatigue and depression. The downstream effects. There’s more money in treating the downstream effects than there is in curing the disease. Yes, the consciousness is raised towards Lyme, but how many other things are doing that? We have to be our own advocates.  The unfortunate thing is we’ve lost our general practitioners. We’ve lost our generalists who used to be the kings that coordinated everything. Now we have specialists, specialists, specialists, who are very, very good at what they do, but that’s all they do. They don’t coordinate with one another. The coordination of correlational, putting the dots together or the puzzle pieces together is left to the person who is least trained to do it, and that’s the patient themselves.

Dr. Weitz:            That’s because of the insurance model that limits the amount of time that doctors can afford to spend with patients because of the reimbursement rates, which we didn’t talk about, but unfortunately that’s the reality of it.

Dr. Armine:         They’re forced into eight minutes a patient to include the documentation time. You’re absolutely correct. Most of the doctors I know are frustrated as heck because if they can even tap at the chief complaint, that’s all they can do. They don’t have the time and they’re not allowed the time. That’s the whole thing. They’re not allowed the time.

Dr. Weitz:            This is why I think patients would be best served, and by the way, I think I have to end it here, but I think most patients would be best served having both a conventional primary care doctor and a functional medicine doctor like yourself or myself and working as a team together because we can have some of the time that the primary care doctor doesn’t have because we’re not going to be limited by [inaudible 00:47:02].

Dr. Armine:         Exactly. That’s coming to fruition. I see it in England now. I travel around the world training people, but I see it a lot in England now. I see it a lot here where there’s true cooperation happening. That’s what you look for in a functional medicine or a healthcare provider, somebody who is willing to advocate for you, do the correlation, and coordinate with your other healthcare providers.

Dr. Weitz:            Dr. Armine, this has been a wonderful discussion.

Dr. Armine:         Thank you.

Dr. Weitz:            I’d love to continue it. Unfortunately, I’m up against a hard break.

Dr. Armine:         I know.

Dr. Weitz:            Can you tell us how practitioners and patients can get a hold of you and contact you?

Dr. Armine:         Well, certainly. They can go to my website at DrJessArmine.com. What I offer that a lot of people don’t is I offer a 15 minute get acquainted session. You can schedule that. We can discuss your problem, and then I can tell you if I can help you or not, which makes me comfortable, makes you comfortable. That’s the way that people can access me. They certainly can go to my website and make an appointment. Most people speak with me on a little 15 minute get acquainted session and we can really determine in that short a period of time if this is an appropriate case for me. That’s the best way to get in touch.

Dr. Weitz:            That’s great. Excellent, Dr. Armine. Keep doing the good work. I’ll talk to you soon. You take care now.

Dr. Armine:         Thanks so much.

 

Reversing PCOS with Dr. Fiona McCulloch: Rational Wellness Podcast 065

Dr. Fiona McCulloch tells how to reverse Polycystic Ovary Syndrome with diet and lifestyle changes with Dr. Ben Weitz.

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

 

Podcast Highlights

4:04  Polycystic ovary syndrome has been around for a long time, since these symptoms were mentioned in ancient medical texts, but it is on the rise today for several reasons. One is because of all the endocrine disrupting chemicals in our environment, such as Bisphenol A found in plastic bottles, canned food, and shiny cash register receipts, which if a woman who is pregnant gets exposed to, then their offspring might get PCOS.  These endocrine disrupting chemicals commonly found in our environment, like plastics and pesticides, disrupt the way the ovary develops, and the ovary doesn’t go through its usual development. The follicles around the eggs have an abnormal structure and they produce too much testosterone, which inhibits them from getting ovulated on time and they accumulate in the ovary, which is what is seen on ultrasound as cysts.  Also, women with PCOS have insulin resistance, which is one of the underlying causes, and our modern diet with all the high glycemic carbohydrates encourages insulin resistance and diabetes.

7:32  Inflammation is the main underlying factor in PCOS, as it is in many chronic diseases.  Inflammation in PCOS is primarily metabolic inflammation, so reducing insulin resistance with diet is the most important thing you can do.  Following an anti-inflammatory diet, exercising, and taking high EPA fish oils and antioxidants like grapeseed extract and resveratrol can be helpful.

9:15  Dr. McCulloch prefers that her clients with PCOS eat a lower carb breakfast and only include a carb like berries with some protein, a lot of non-starchy vegetables that add a lot of fiber, and some healthy fats, like avocado or nuts or seeds. The starchy carbs she recommends are sweet potatoes, squash, root vegetables and quinoa. She recommends a little with lunch and bit more with dinner. She recommends that women stop eating three hours before bed and not to snack between meals.  She also likes resistant starch with dinner that comes from cooking and cooling potato and then eating it.  Dr. McCulloch feels that eating every 2-3 hours to maintain a more constant blood sugar doesn’t tend to work as well with women with PCOS. 

13:49  While the glycemic index is often recommended as a guide for which carbohydrate foods to eat, Fiona prefers to use the food insulin demand, aka, the insulin index

16:35  High androgen levels are a common factor in PCOS and balancing your insulin levels will reduce that and you can also take spearmint as a tea and you should put 3 spearmint tea bags in one cup of tea. Saw palmetto lowers DHT which is a strong androgen that causes hair loss in women.  Also N-Acetylcysteine, which is an antioxidant, it lowers testosterone in women, but not in men.

18:55  Anti-Müllerian hormone is a hormone that’s secreted by the ovary that is primarily used as a marker of how many eggs a woman has left in her ovaries, but in PCOS the ovary secretes more of this hormone than is related to the number of eggs. So, it’s a functional marker that she likes to follow to chart a patient’s progress. As a woman’s PCOS gets better, this level actually lowers and becomes more normal. Serum testosterone levels may look normal, even if the woman has PCOS. 

20:56  Since testosterone levels are difficult to measure in serum and serum test results often are normal, Dr. McCulloch prefers to look at urinary testosterone metabolites, and she likes to use the dried urine DUTCH test. However, she may test androstendione, DHEA, and DHT in serum.  She will often run a cycle day two or three FSH and LH, with the FSH typically being higher than the LH in PCOS but the opposite if there is no PCOS.  She will also run a two hour glucose insulin challenge, which is similar to the glucose tolerance test but we check insulin at every marker. So, the person has 75 grams of glucose and then we check them fasting at their insulin and glucose. Then we check them every half hour and we see how high did their insulin go?  She also often tests HsCRP to look at inflammation.

24:05  To deal with the infertility associated with PCOS, Dr. McCulloch often recommends a myo-inositol and D-chiro-inositol supplement and they should be in a ratio of 40:1 to be effective.

 

                              



Dr. Fiona McCulloch is a Naturopathic Doctor and founder of White Lotus Integrative Medicine in Toronto, Canada, serving thousands of women with hormonal conditions. Dr. Fiona’s book, 8 Steps To Reverse Your PCOS, offers her well-researched methods for the natural treatment of Polycystic Ovary Syndrome (PCOS). Dr. McCulloch is available to see patients and can be contacted through her website   https://drfionand.com/ where she has a quiz you can take to find out what your unique PCOS type is.

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


 

Podcast Transcripts

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

Hello Rational Wellness podcasters. Thank you so much for joining me again today. For those of you who enjoy the Rational Wellness podcast, please go to iTunes and leave us a ratings and review and subscribe to our YouTube channel which is Rational Wellness or Weitz Chiro. Our topic for today is polycystic ovarian syndrome. PCOS. This is actually the most common hormonal disorder among women between the ages of 19 and 44, affecting up to 20% of women in this age group depending upon how it is defined. It’s also one of the leading causes of infertility. According to the Rotterdam Consensus, PCOS is present if two out of the following three criteria are present. Number one is delayed ovulation or menstrual cycles known as anovulation. Basically if your cycle lasts 35 days or longer, that qualifies for this.  Number two is high levels of androgenic hormones like testosterone and DHEA. Three polycystic ovaries seen on ultrasound. Besides irregular periods are often associated with PCOS. Weight gain and difficulty losing weight, fatigue, facial hair and male pattern baldness in women, acne, infertility, mood swings, pelvic pain, headaches, and sleep problems.

Here to help sort things out for us with PCOS is Dr. Fiona McCulloch. She’s a naturopathic doctor and the founder of White Lotus Integrative Medicine in Toronto, Canada, serving thousands of women with hormonal conditions. Dr. Fiona wrote a book, 8 Steps To Reverse Your PCOS, which offers well researched methods to the natural treatment of polycystic ovarian syndrome.  Fiona also developed a nutritional methodology for the open source health PCOS project which analyzes molecular, genetic, metabolic, and hormonal markers in women with PCOS. Thank you for joining me, Dr. Fiona McCulloch. Would you rather me call you Dr. Fiona or Dr. McCullough?

Dr. McCulloch:                   Oh you can just call me Fiona. It’s great to be here on the show.

Dr. Weitz:                            Excellent. So, how did you come to be so interested in polycystic ovarian syndrome?

Dr. McCulloch:                   Well, I do actually have this condition myself. So, because of that, I went through many many years of not being diagnosed with this and not knowing what was wrong. So, as I went into practice, I became more and more interested in different kinds of hormonal issues. I just always found hormones really fascinating and so obviously having these issues myself, I became more and more interested. It’s such a misunderstood condition, so I love unraveling different mysteries and help solving problems. So, I guess it just was really really fascinating to me.

Dr. Weitz:                            Yeah. That’s great. That’s one of the things that attracts me to functional medicine as well is solving the mystery of the person and peeling back the layers of the onion until you can help them achieve better health. Why is PCOS seemingly such an epidemic today?

Dr. McCulloch:                   That’s actually quite an interesting question. So, we know that it’s been around for a long time because even in ancient medical textbooks, there were these symptoms of PCOS that were mentioned but it does seem to be on the rise. What we know now is that it’s a combination of genetic predisposition along with something from the environment that turns it on. So, for example we know that certain endocrine disrupting chemicals can cause PCOS if a woman is exposed to those while she’s pregnant can cause PCOS in the offspring. So, we know that’s definitely a big part of things. The other interesting components are that most women with PCOS have insulin resistance which means higher level of insulin and it’s much easier to gain weight.  Our food these days is actually often quite aggravating to that. With insulin resistance, the more insulin resistant you get, the worse PCOS gets. So, it also makes the condition itself worse. So, we see more of it in medical practice because of that.

Dr. Weitz:                            Interesting. You mentioned the endocrine disrupting substances. In your book, you talk about the connection with BPA as being directly correlated with PCOS and one thing I find really interesting is these endocrine disrupting substances like plastics and BPA and there’s a whole bunch of other pesticides we often think of as estrogenic. I just think it’s so interesting that in men, these substances often reduce testosterone levels, whereas in women, they’re increasing testosterone levels.

Dr. McCulloch:                   Yeah. It’s actually very interesting. So, what actually happens with these is not so much that they act directly like an estrogen, although they do have estrogenic properties but it’s when a baby is developing and the ovaries are developing, when you expose the ovaries to something unusual from the environment, it just disrupts the way the ovary actually develops. What we know in PCOS is that the ovary doesn’t go through it’s full and normal development at puberty. It kind of gets stuck in a state where too many androgens are produced because this is actually a normal state temporarily but in PCOS, it’s like it gets stuck and we think that the endocrine disrupters actually cause the blockage, but really the development of the ovary amongst other things.

Dr. Weitz:                            Interesting. Is that correlated with the development of the cysts?

Dr. McCulloch:                   Yeah. So it’s quite interesting because although it’s called polycystic ovary syndrome, the cysts aren’t actually real ovarian cysts. They’re just eggs that haven’t fully gone through the development process so they kind of get stuck. So, the follicles around the eggs, they have abnormal structure and they make too much testosterone. Because of that, it inhibits them from getting ovulated on time and they just sort of accumulate. So, it makes the look cystic but they’re actually just a whole bunch of eggs that haven’t ovulated.

Dr. Weitz:                            Oh. Interesting. You write that inflammation is the main underlying factor in PCOS. Of course we’ve been learning that inflammation is one of the main factors in so many different chronic diseases, heart disease, etc. etc. What are some of the best ways to reduce inflammation?

Dr. McCulloch:                   That’s a great question. So, inflammation and PCOS is very much typically metabolic inflammation. So, we’re looking at the inflammation that comes really from fat cells. Especially abdominal fat. So, the type of fat that’s around our liver. So, obviously the best way to deal with that is to reduce insulin resistance because that is what causes us to gain weight around the abdomen and so diet is definitely the most important thing that you can do for this specific kind of inflammation. There are also many other things that you can do which include for example exercise is anti-inflammatory. Hot and cold therapies can be anti-inflammatory and there’s many different supplements that are anti-inflammatory. So, high EPA fish oils or antioxidants like grapeseed extract or Resveratrol.  So, there’s all of those elements too. So, of course no supplement is really going to make up for a poor diet, so it’s always those cornerstones first and then the supplements can definitely help as well.

Dr. Weitz:                            So, when it comes to insulin resistance, what type of diet do you think is optimal? Today, there’s a big emphasis on low carb diets and we have ketogenic diet being utilized more. What is your take on diets for insulin resistance?

Dr. McCulloch:                   So, yeah. I feel that women who have PCOS are a little bit different in that they often have other hormonal imbalances. So, they often have thyroid conditions or problems with their adrenals. So, the types of diets that tend to work well for them are not often the typical diets that might work well for other people, but if we think about what insulin resistance is, it’s that we’re secreting too much insulin at all the wrong times. So, normally we’re supposed to make insulin when we eat and it’s supposed to go down in between the meals. So, what I really like to focus on is creating meals that really balance the blood sugar. So, starting off with a protein. A source of protein and then a lot of non-starchy vegetables to add fiber and then a source of healthy fat. So, something like avocado or nuts or seeds.

Then the carbohydrates I typically recommend would be in the morning a lower carb breakfast. So, something like berries along with those other components of the meal. A little bit more at lunch and more of the carbs with the dinner. I often recommend not to snack in between the meals. The reason that we have the lower carb breakfast is not to spike the insulin first thing in the morning.  But having those solid meals keeps the blood sugar stable, so there’s no tendency to eat or snack or feel that you have to raise your blood sugar by having carbs. It just breaks the pattern and allows the blood sugar to be very stable and then the insulin to come down in between the meals.  Then I always recommend women stop eating three hours before bedtime or even earlier if possible and leave that nice long window without eating overnight, so that the insulin can come down. That’s usually a 12 hour window is really helpful to do that.

Dr. Weitz:                          Now some people recommend shorter spans like snacks in between so that you have something to keep your blood sugar stable every two or three hours during the day.

Dr. McCulloch:                   So, yeah. That is one of the methods that works for some people, but most women with PCOS it does not work very well for them because what happens is every time they eat in between the meals, they actually raise their insulin again. We’re trying to train the cells to be more sensitive to insulin. So, when we just create those really solid meals with quality food, really stabilizing impacts on blood sugar, there’s no real need to eat in between. So, we often see a lot of women, they just stop having to snack and their insulin levels just become more normal.

Dr. Weitz:                          So, what kinds of carbs do you recommend for lunch and dinner?

Dr. McCulloch:                   So typically I like to recommend root vegetables. They’re great. They’re very nutritious. So, sweet potatoes or squash are fantastic. Quinoa is also a really good carb. It has many different vitamins and minerals in it. So, these would be my general top choices I think.

Dr. Weitz:                          What about legumes?

Dr. McCulloch:                   Oh sorry. I like to recommend usually resistant starch with dinner because it really stabilizes the blood sugar. So, you can get that by cooking and cooling potato and then eating it. This actually causes all the starch to crystallize and it keeps the blood sugar very stable.

Dr. Weitz:                          Interesting. What about legumes?

Dr. McCulloch:                   Legumes. So, I think legumes are actually quite nutritious. They have a lot of beneficial nutrients in them. They have a lot of very beneficial starch and carbs. A lot of times people think of them as a protein, but they’re actually a combined carb and protein. Some people don’t tolerate legumes very well and they might have issues with their microbiome if that’s the case, they might have to be a little more careful with them or take an enzyme to make sure that they’re actually digesting them properly. And then I usually recommend that people don’t eat them with every single meal, because they can contain components that can bind up different minerals and vitamins.

Dr. Weitz:                          The dreaded lectins?

Dr. McCulloch:                   The lectins. Yeah. But I do think that we see in all of our population studies that eating them is associated with very good health benefits. So, I think if they’re incorporated for the right person here and there, I think they’re actually quite helpful.

Dr. Weitz:                          Good. So, it’s common for practitioners to recommend the glycemic index for helping to balance blood sugar, but I understand you’re using a different strategy. Can you tell us what that strategy is?

Dr. McCulloch:                   Yeah. Absolutely. So, I guess the most important thing is the structuring of the meals, but then I use something called the food insulin demand.  This is a metric that was actually developed by the same researchers that developed the glycemic index at the University of Sydney.  What they found was that as they were testing type one diabetics who actually have to inject insulin after every meal because they don’t make any, they were finding that looking at the glycemic index wasn’t really predicting how much insulin they needed to inject. They were like, “Well, what’s going on with that?” So, the glycemic index only includes carbs. So, that’s a limitation of that. What we know now is there are other components to what we eat that affect our insulin other than carbs.

So, the proteins but especially the type of amino acids that’s in a protein that we’re eating. For example, dairy proteins is extremely stimulating to insulin which is why a lot of people who are weight training they use whey protein in proximity to the workout because it raises insulin which drives those amino acids into their muscles. Now, if you’re waking up for breakfast and you’re not weight training, you’re not a body builder and you’re drinking a big whey protein shake or a big yogurt, you’re going to drive your insulin up. So, that’s the metric I tend to use.  We know the food insulin demand of many different foods now and even combinations of foods. So, I usually recommend a certain food insulin demand of protein, healthy fats, non-starchy veggies and carbs for each meal.

Dr. Weitz:                          If whey protein stimulates insulin so much, what’s a better source of protein for those who want to use a protein powder supplement?

Dr. McCulloch:                   Yeah. So I mean I think whey protein is totally fine if the person is not sensitive to it and if they’re working out and actually going to have that into their muscles.

Dr. Weitz:                          Well, let’s say this is somebody with insulin sensitivity, blood sugar problems.

Dr. McCulloch:                   So, I would usually recommend the vegan types of protein that are out there. They do have different kinds of amino acids so they’re actually not as stimulating to insulin. So, there’s a lot of really good ones. Just check the label and the amount of sugar is low, the grams of sugar because a lot of them do hide sugar in these shakes.

Dr. Weitz:                          Okay. So, let’s see. High androgen levels are a major factor in PCOS and they tend to result in facial hair and acne, male pattern baldness, infertility. What are some of the most effective natural herbs and supplements to lower androgenic hormones in women?

Dr. McCulloch:                   Yeah. There are actually quite a few that we know of. I guess the first and most important thing to consider is that insulin causes women to make the testosterone. So, any way that you can work on that first you’re going to get way more benefits from what you’re doing.

Dr. Weitz:                          Always start with diet first. Absolutely.

Dr. McCulloch:                   Exactly. Then looking at some of the supplements that you can take or herbs, so one of the ones that we have a good amount of research on is actually spearmint. So, spearmint actually has been found to reduce the hair growth that a lot of women that PCOS have on their chin or their face. It has a lot of antioxidants but it’s also an anti-androgen in women. So, this is actually something that’s really easy to incorporate as a tea. Most of the studies are in three cups a day. I usually suggest that you just put all three tea bags in to one big cup and drink it all at once just to make it easy. So, that’s one option. There are some other herbs that are anti-androgenic. There is for example, saw palmetto which is often something that we see used for prostate conditions, but it does have the effect of lowering DHT which is a very strong androgen that tends to cause hair loss amongst other unpleasant types of issues.  Then some of the other supplements that lower testosterone work a little bit indirectly but for example, N-Acetylcysteine which is an antioxidant, there’s quite a bit of research only in women with PCOS however showing it lowers testosterone. It wouldn’t do that in men.

Dr. Weitz:                          Is there anything that NAC can’t help with? This is one of the most amazing supplements ever. Every topic I research NAC seems to have benefits for.

Dr. McCulloch:                   It’s so true. It’s one of my favorite supplements just because it works so well for so much. Glutathione is such an important antioxidant for our cells in general.

Dr. Weitz:                          Cool. I’m sorry to cut you off there.

Dr. McCulloch:                   Yeah. No.

Dr. Weitz:                          You mention in your book anti-Müllerian hormone. I think for sure most patients and quite a number of practitioners are probably not aware of what this is. Could you talk about it for a minute and what role it plays in PCOS?

Dr. McCulloch:                   Sure. So anti-Müllerian hormone, it’s a hormone that’s secreted by the ovary and it’s not something we’ve been able to test until maybe the past decade or so. It’s primarily been used to test a woman’s ovarian reserve. So, just as a marker of how many eggs she has left in her ovary. What they noticed was that women with PCOS tend to have very high levels of this hormone. This is always related to age. So, there are different ages for different ranges, but in PCOS, what they found is that the ovary secretes more of this hormone than is related to the number of eggs. So, it’s a functional marker. As a woman’s PCOS gets better, this level actually lowers and becomes more normal.  A study was recently released showing that even in utero, women with PCOS secrete high levels of AMH and that this may also be one of the endocrine disruptors that’s involved in the development of the condition because it can affect the brain.

Dr. Weitz:                          Do you monitor that hormone as a marker for how they’re progressing in managing their PCOS?

Dr. McCulloch:                   Yes I do. Absolutely. It’s also another marker. Sometimes it can be hard to see PCOS in lab tests because it changes at different times in the life span and the serum testing for testosterone, it’s not very accurate in women. So, a lot of women, their testosterone looks normal, but yet it’s actually high. They have a lot of the symptoms. It’s just that the marker itself isn’t very sensitive. So AMH is another marker that is quite sensitive. So, we do consistently see that it’s higher in women with this condition so it’s great for diagnostics if I’m unsure.

Dr. Weitz:                          So, what is the best way to measure testosterone levels in women?

Dr. McCulloch:                   So, I prefer generally to look at other androgens unless the PCOS is very severe. Because most of the time, the serum levels do look normal. There are urinary metabolites which do tend to be a little bit more sensitive. So, I’ll run some of those urinary hormone metabolite tests. Another marker-

Dr. Weitz:                          Do you do a 24 hour urine or do you do the dried urine?

Dr. McCulloch:                   Yeah. I usually do the dried urine, the DUTCH test. So, that’s definitely one of the more common tests that we do. The great thing with that is it picks out a lot of different testosterone metabolites. Different types of androgens from either the adrenal or the ovary. A lot of research shows that a lot of these hormones actually that are androgenic come out of the adrenal glands. So, that test gives us a little bit more information. Androstenedione is one in the blood that I do a lot because it does tend to be a little bit more of a sensitive test. Some women also have high DHEA levels, but not all. So, it depends. There are certain women with PCOS that that will come up as an issue as well.

Dr. Weitz:                          So, if you were to just name maybe the top five lab markers that you like to use for PCOS, what would those be?

Dr. McCulloch:                   So, I would definitely often do a cycle day two or three FSH and LH. So, follicle stimulating hormone and luteinizing hormone. We would tend to see that the luteinizing hormone is higher. Without PCOS it would be the opposite. Typically the FSH is higher than the LH so that’s one I do quite a lot. I always test for insulin resistance. So, I tend to do a two hour glucose insulin challenge which is similar to the glucose tolerance test but we check insulin at every marker. So, the person has 75 grams of glucose and then we check them fasting at their insulin and glucose. Then we check them every half hour and we see how high did their insulin go? You can really see huge differences with that.

Anti-Müllerian hormone is definitely one that I test quite frequently. I often test CRP so high sensitivity CRP to look for inflammation. So, that’s definitely one. Then I’ll try to look for androgens as well. So, either Androstenedione or looking at DHEA-S, so I’ll choose some different androgens depending on the presentation. Sometimes if it’s hair, I’ll test DHT. So, if a woman is losing a lot of hair, I’ll go right for that because that’s definitely one of the ones that has the biggest effect on hair lost.

Dr. Weitz:                          Okay cool. You test that with serum or with urine?

Dr. McCulloch:                   Yep. Serum usually. You can see that in urine as well though.

Dr. Weitz:                          Okay. We respect to PCOS and infertility, I know this is a huge topic and we could probably talk about it for a while, but can you talk a little bit about it? When I was looking at your book, I notice that one of the supplements you mentioned was this myo-inositol and D-chiro-inositol supplement. So, can you talk about infertility a little bit?

Dr. McCulloch:                   Sure. So, PCOS is the number one cause of ovulatory infertility which is definitely a huge cause of infertility, but regardless of that, I don’t like to think of it as an infertility type of condition. Because usually women are just less fertile because they’re not ovulating at the right time. They have too much inflammation that can affect egg quality and implantation, but it’s really something that’s quite treatable. So, the vast majority of women with PCOS will get pregnant. It just takes a little bit longer and they have to work on it. One of those ways to work on it is absolutely with inositol which is probably the most researched supplement toward PCOS in general.

So, when we’re looking at the ovary and a good quality eggs, they have a lot of myo-inositol inside of them. Myo-inositol works as a messenger for insulin. So, when insulin attaches to the cells receptor, inositol is the one that takes the message inside the cell. The inositols are really involved in so many different processes, but we’ve seen in studies over and over again that using inositol can improve egg quality, it can improve ovulation rates, it can improve insulin sensitivity. So, even for women not trying to conceive who have PCOS, inositol is still helpful. But especially if they’re trying to conceive it has that added benefit for egg quality too.

Dr. Weitz:                          Cool. I know we have used a project that contains both of those. Myo-inositol and d-chiro-inositol. I actually just checked the label and they didn’t say exactly what the ratio was, but I guess the ratio is really important. Isn’t that right?

Dr. McCulloch:                   Yeah. It seems that the physiologic ratio of 40 to 1 is the best with respect to looking at seeing the most impacts for both egg quality and insulin sensitivity. We do know that if a woman takes a high amount of d-chiro-inositol that it seems to actually have a negative effect on embryo quality. So, we know that this 40 to 1 ratio is very good for both fertility and also for insulin sensitivity. Myo-inositol alone is also okay but that combo seems to be particularly powerful. It’s actually the same ratio that’s in our bloodstream.

Dr. Weitz:                          Cool. Is the Designs For Health product, are you familiar with that one? Does that have that ratio?

Dr. McCulloch:                   I am not sure because it’s proprietary so I don’t know what the ratio is in there actually.

Dr. Weitz:                          Yeah they didn’t say but I looked at their technical literature and they do talk about the fact that the d-chiro shouldn’t be too high.

Dr. McCulloch:                   Yeah. So, it may be okay. The one I tend to use a lot is Ovasitol by Theralogix. So, yeah they have the 40 to 1 and then they have individual pouches which are really convenient. So, a lot of patients just pop those into their bag and bring them with them. It’s a really good product, but I love Designs For Health and I use a lot of their products as well.

Dr. Weitz:                          Great. So, I think that’s all the questions that I had prepared today. Are there any other things you’d like to tell our listeners about PCOS?

Dr. McCulloch:                   Well, yeah. It does affect 1 in 10 to 15 women. There’s about 50% of women going around with this that don’t know that they have it. They’re suffering. I remember in my case I went I had cystic acne which was super severe and all kinds of issues. Nobody really ever looked into that for me. So, if you have any of those symptoms, go ask for a workup. Definitely educate yourself because a lot of the times, many doctors don’t really understand that PCOS is a very big spectrum of different issues. So, if you feel something is up with your hormones, try to seek out a functional medicine practitioner who can really get a good look at and get some of these tests done for you so that you can really understand if that’s what’s going on.

Dr. Weitz:                          I think it’s really important. You pointed out some of the subtleties of the lab markers because I’ve seen other patients who went to see typical practitioner, a conventional doctor and they ran certain testosterone and maybe hemoglobin A1C and they said everything is fine. So, I guess it’s really important to be a little more detailed in looking at some of these markers more carefully.

Dr. McCulloch:                   Oh totally. Yeah. I get lots of women coming in and saying, “Oh, my A1C and my fasting glucose are normal so I’m not insulin resistant. Meanwhile they’re carrying all their weight around their stomach, they’re not able to lose weight no matter what they do. So, it’s just the wrong tests are being done a lot. So, I think make sure and educate yourself and find someone who does functional medicine because they’re going to be able to help you with these things.

Dr. Weitz:                          That’s great. Getting the right testing done is so important. How can viewers and listeners get a hold of you and contact you? I understand you have some programs out there that are available?

Dr. McCulloch:                   Yeah absolutely. So, my website is drfionamd.com. I have a PCOS quiz there, a lab test guide so feel free to hop over and grab those. I have an online nutrition program called Eating for PCOS which if you head to that website you’ll be able to find me there. Then I have a clinic in Toronto. Which the website for that is whitelotusclinic.ca.

Dr. Weitz:                          That’s great. Thank you Fiona. You in a very short amount of time shared a lot of really good, interesting, clinically useful information.

Dr. McCulloch:                   Thank you so much for having me on your show, Dr. Weitz. It’s been great.

Dr. Weitz:                          Sounds good.

 

How to Fix Your Brain with Dr. Tom O’Bryan: Rational Wellness Podcast 064

Dr. Tom O’Bryan explains how to fix your brain and prevent and reverse neurological diseases like Alzheimer’s and Parkinson’s Disease with Dr. Ben Weitz.

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

 

Podcast Highlights

4:48  Dr. O’Bryan pointed out that autoimmune diseases are recognized to be the third leading cause of getting sick and dying in the world. And now since we now know that the mechanism of atherosclerosis is autoimmune, autoimmune becomes the number one cause of morbidity and mortality.

6:00  Dr. O’Bryan explained that the main mechanism for autoimmunity is molecular mimicry. He cited the work of Dr. Alan Ebringer from the 1970s where he wrote about the link between the HLA-B27 gene, an infection with Klebsiella pneumoniae, and ankylosing spondylitis.  If you have the HLA-B27 gene and you get an overgrowth of Klebsiella pneumonia, which is an environmental trigger, you are now very much at risk of developing the autoimmune disease, ankylosing spondylitis,  since the immune system that attacks the Klebsiella then attacks your spine. Here is the reference for the paper: https://academic.oup.com/rheumatology/article-abstract/16/3/190/1778858 

8:34  Dr. O’Bryan went on to give another example of molecular mimicry where the immune response to the measles vaccine leads to a cross reactive attack on the thyroid. Or your immune system may go after your myelin sheath on your nerves, which is what MS is, etc.

12:45  Dentists may give you antibiotics, esp. if you have a history of heart problems, because when they probe around in your mouth, you may get leaky gums and since you have lots of bacteria in your mouth and if any of that bacteria, esp. if you have streptococcus bacteria that gets through the leaky gums into the blood stream, through molecular mimicry, your immune system may go after your heart valves and you get rheumatic heart disease. Dr. O’Bryan said that he saw Dr. Ebringer in Portugal presenting at the Autoimmune Conference and he found that when they swabbed the noses of MS patients and found that every one has high concentrations of Actinobacter. When your immune system makes antibodies to that actinobacter, then it goes after the myelin sheath of your nerves and your brain, creating MS. Once you understand this mechanism, then you have to do what you can to reduce the environmental triggers, such as exposure to toxins, such as breathing in the benzene when you pump gas in your car.  Or the BPA in the plastic coffee lids at the coffee shop.

19:05  The World Wildlife Foundation did a meta-analysis and they found that there has been a 59% reduction in the sperm count in fertile, healthy men. Scientists worry about extinction of a species at 72% and we’re at 59% in 37 years. What do you think is gonna happen in the next 20 years? We have to wake up. And where’s this coming from? It’s all the toxic chemicals that get into our body. We should stop storing food using plastic wrap and stop cooking using aluminum foil. Over time, it’s the accumulation of all these toxins that store in our bodies for years and years. You eat fish, which is healthy but fish often have pesticides, PCBs that were leaked into the ocean from the farms and they tend to accumulate in our bodies, esp. in the tissues with estrogen receptors like the breasts, uterus, ovaries and the testicles, which is one of the reasons for the lowered sperm count.  And then these pesticides are passed from the mother through the breast milk into the babies and these chemicals like PCBs are neurotoxins. Dr. O’Bryan recommends that women should detox their bodies for six months before getting pregnant so their baby has the best shot to develop the best brain.  And if our kids are going to be the ones to save the planet, they need to have good brains.

26:00  We now know that pathogens like bacteria and viruses can get into the brain due to a leaky blood-brain barrier and when the immune system in the brain, the glial cells attack, they produce amyloid plaques which can create an inflammatory cascade in the brain that leads to neurodegenerative diseases, like Alzheimer’s and Parkinson’s diseases, over time.

32:32  Dr. O’Bryan advocates spending one hour per week learning about how this autoimmune mechanism gets activated by our environment and what we can do about it.

 

                                          



Dr. Tom O’Bryan is a Doctor of Chiropractic, a best-selling author, and an internationally recognized speaker focusing on food sensitivities, environmental toxins, and the development of autoimmune diseases. His 2016 book, The Autoimmune Fix won the National Book Award and the docuseries he released the same year, Betrayal: The Autoimmune Disease Solution They’re Not Telling You  has been seen by over 500,000 people worldwide. He also organized The Gluten Summit – A Grain of Truth. His website is www.theDr.com  He will be releasing his second book You Can Fix Your Brain: One Hour a Week to the Best Memory, Productivity, and Sleep You’ve Ever Had on September 18, 2018.

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


 

Podcast Transcripts

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

Hello Rational Wellness podcasters, thank you so much for joining me again today. And for those of you who enjoy the Rational Wellness podcast, please go to iTunes and give us some ratings and reviews so more people can find out about the Rational Wellness podcast. And if you want to see the video version, go to YouTube and search for Rational Wellness or Weitz Chiro. Our topic for today is autoimmune diseases. Autoimmune diseases are becoming increasingly common causes of sickness and death in the United States. Autoimmune diseases have been on the rise for at least the last four decades.

Now, our immune system is designed to protect us from bacteria and viruses and parasites, and to repair our tissues when they’re damaged. Autoimmune diseases are when they are diseases where the immune system, instead of attacking outsiders, starts attacking our own cells and organs. This means that our immune system is out of balance. There are approximately between 80 and 100 different autoimmune diseases and at least 40 other diseases are suspected to have an autoimmune basis. According to Dr. Tomas O’Bryan, if we include diseases that have an autoimmune basis, autoimmune diseases are the third leading cause of death in the United States, since most of these diseases are chronic and often life threatening.

Some of the more common autoimmune diseases include Alzheimer’s disease, Parkinson’s disease, rheumatoid arthritis, psoriasis, Crohn’s disease, Hashimoto’s hypothyroid, multiple sclerosis, and diabetes. Conventional medical doctors typically treat autoimmune diseases by trying to control the symptoms, such as providing thyroid hormone in the case of Hashimoto’s thyroiditis, or by using medications that suppress the immune system. Such as corticosteroids, chemotherapy agents, or the now very common but very expensive injectable TNF alpha blocking agents like Humira and Remicade. These drugs, often referred to as biologics simply block your immune system, or part of it, which is a problem ’cause you need your immune system to fight off infections and cancer.

But Functional Medicine treats autoimmune diseases by looking at some of the underlying triggers and factors that have led to the immune system becoming dysregulated, such as leaky gut, food sensitives, toxins, infections, nutritional deficiencies. And this is very important, if I have a patient with hypothyroid of autoimmune origin and most women in the US with hypothyroid, have Hashimoto’s autoimmune disease, and all this patient is treated with is with thyroid medication. Sure, they’ll feel better for a period of time, but it doesn’t do anything for the underlying, smoldering fire of the autoimmune disease that has been attacking her thyroid gland and chances are, this will continue. The patient likely will need a higher dosage of thyroid medication over time, or they may end up with another autoimmune disease.

So, not just regulating the thyroid but doing something about the autoimmune disease is crucial for this patient’s long term health. I’m so happy that we’re joined today by Dr. Tomas O’Bryan, internationally recognized speaker, educator, and Functional Medicine doctor. He’s a member of the prestigious Institute of Functional Medicine Faculty. Dr. O’Bryan is a best selling author, and in fact, his last book, The Autoimmune Fix, won the National Book Award. And he’s most known for his work on the dangers of gluten and on autoimmune diseases, and he has an upcoming book on autoimmunity in the brain that we are going to pick his brain about today. Thank you for joining me, Dr. Tom.

Dr. O’Bryan:                        Oh, thank you Dr. Ben, it’s really great to be with you and that was a wonderful introduction and summary, and I would just tweak one thing that you said. And that is that immunologists have known for at least 15 years that autoimmune diseases are the third leading cause of morbidity/mortality, getting sick and dying in the world, just across the board. When you include what we now know is true, that atherosclerosis, the plugging up of your pipes that causes cardiovascular disease, atherosclerosis is autoimmune. Now autoimmunity becomes the number one mechanism in getting sick and dying in the world, ’cause we’ve always thought that heart disease is the number one cause of dying, but now we know that heart disease is autoimmune in it’s initiating phases so that means the mechanism. Whether it manifests in your heart, or your blood vessels, or your brain, or your kidneys, or your lungs, or your liver, the mechanism of getting sick and dying is your immune system trying to protect you, attacking your own cells.

Dr. Weitz:                            Right. And that’s something that’s really interesting is how we always want to ask, “How is it that our body’s creating disease?” But in autoimmunity, the body’s actually trying to protect us.

Dr. O’Bryan:                        That’s right, that’s right. So that we don’t just geek out here between the two of us and lose people, let me give you this analogy.  And this puts it in perspective because what most researchers say the number one mechanism behind all of this happening is something called molecular mimicry.

Dr. Weitz:                            Yes.

Dr. O’Bryan:                        I’m gonna give you an example of what molecular mimicry is. It was 1978, in my first genetics class and I still remember the day when the instructor came in. The professor came in and he had this research paper in his hand and he was so excited, so excited, because here was a paper that he said was a paradigm shift in medicine and in genetics. And the paper was by Dr. Alan Ebringer from King’s College in London, who I was with just two weeks ago in Lisbon at the Autoimmunity Congress, now 40 years later. This is when Dr. Ebringer was a graduate student working on his PhD, and he had published this paper that if you carry the gene HLAB27, and that’s just one of the genes.

Dr. Weitz:                            Right.

Dr. O’Bryan:                        And if you get an infection to a bacteria called Klebsiella pneumoniae, which is the most common cause of pneumonia for old people in hospitals, it’s this bacteria. If you get a Klebsiella infection and if you have this gene, you’re very vulnerable to developing the autoimmune disease ankylosing spondylitis and it’ll kill you. That’s not an easy diagnosis, you don’t want that diagnosis. But this was the first paper that said, “Genetics?” Now what are genetics? Genetics are the deck of cards you’ve been dealt in life, you can’t do anything about your genetics. You got the gene, you got the gene, but it’s genetics. And then there was an environmental trigger, that’s the category we’re gonna talk about, environmental triggers.  In this example, it was the bacterial infection Klebsiella, ’cause we all have a little Klebsiella in us, but when it grows and it starts to take over, now it’s an infection. So the genetics and the environmental trigger, you’re at risk of developing the autoimmune disease ankylosing spondylitis, and this was 1978. Here is the reference for the paper: https://academic.oup.com/rheumatology/article-abstract/16/3/190/1778858   

Dr. Weitz:                            Wow.

Dr. O’Bryan:                        And I’d forgot about it after that, I didn’t pay any attention to it until now, this whole world of what we’re talking about is molecular mimicry. Let me give you an example of molecular mimicry. When you get a vaccination for measles, they give you a shot of the bug measles. It’s an injection and your brain says, “Whoa, what’s that in the bloodstream? That’s not good for me. General! You and your immune system, you have army, air force, marine corp generals, sitting around with nothing to do. General, you now are General Measles, take care of this.” General Measles builds an assembly line, that assembly line starts producing soldiers, or actually special forces, and they’re trained to just go after measles. They’ve got high powered rifles and they go out into the bloodstream, looking for measles, they’re called antibodies.  These antibodies are going through the bloodstream, they’re going everywhere looking for the … and it’s a protein signature of the bug measles. So General Measles has programmed these special forces, said, “Look for this protein signature.” And I’m gonna say it’s AABCD, I’m just gonna make up the numbers of the signature of that particular protein. These soldiers are going through the bloodstream everywhere looking for AABCD, wherever they find it, they’d fire a chemical bullet. AABCD, boom, and they fire the chemical bullet. Now you have to remember, the bloodstream is a highway, it’s just a highway. Everything’s going in the same direction, but it’s a highway, there’s no lanes of traffic. It’s like bumper cars in there all the time. Like, remember the circus when you were a kid? Driving bumper cars, crashing into each other. That’s what’s going on in your bloodstream all the time.

You’ve got these special forces going through there, bumping into everybody looking for AABCD and wherever they find AABCD, they fire their chemical bullet. Now, the blood’s going past … I’ll use the example of the thyroid. The surface of the thyroid facing the bloodstream is made up of proteins and fats, the proteins are made up of amino acids, and the amino acids are hundreds of amino acids long, but in that sequence of the surface of the thyroid facing the bloodstream, the amino acid sequence includes AABCD. So now you’ve got special forces looking for measles bugs AABCD, over to AABCD, all of a sudden they go, “Hey look, over there! AABCD.” Boom. And they fire their chemical bullet at the wall of the thyroid facing the bloodstream. Now you’ve damaged that thyroid cell.

You have an entire new body every seven years, every cell in your body regenerates. Some cells are really quick like the inside lining of your guts, every three to five days, some cells are very slow, like bone cells are very slow. But you have a whole new body every seven years. And how do we get these new cells? Well, your immune system makes antibodies to get rid of the old and damaged cells, like thyroid cells, to get rid of the old and damaged cells and make room for new thyroid cells to grow. And there’s antibodies to your muscles. and to your brain, and to your liver, and to your kidneys. That’s like if you do a blood test looking for antibodies, there’s a normal reference range for those antibodies. So you’ve got special forces looking for measles, they mistakenly see AABCD and they fire their chemical bullet at that, you destroy or damage that thyroid cell, so your body makes a few extra thyroid antibodies to get rid of the damaged cells.

It’s not a problem, except it keeps happening day after day, after day, and then eventually your immune system becomes … it’s a continuous loop making more thyroid antibodies and you develop an autoimmune disease of your thyroid, called Hashimoto’s thyroid disease. And it’s molecular mimicry that the AABCD of measles looks like the AABCD of your thyroid, and the same is true for the myelin, the saran wrap around your nerves and if you go after your nerves, if you go after myelin, that’s what MS is. The same is true for your muscles and your heart. Why do dentists give you antibiotics when you go to see the dentist? It’s because when they’re probing around in there and you rinse your mouth out, you’ve got pink water, right? There’s a little blood in the water. What does that mean? Well, it means you’ve got leaky gums now. If you’ve heard about leaky gut, you get leaky gums when they’re probing around in there and the blood comes out, you got leaky gums.

There’s thousands of bacteria, different types of bacteria in our mouth, if any of that bacteria gets through the leaky gums, especially streptococcus … everybody knows about strep throat, so you got strep in here. If strep gets through the leaky gums into the bloodstream, your immune system makes antibodies to strep, but it’s very, very common that because of molecular mimicry, AABCD to the strep, it goes after your heart valves and you develop heart disease. That’s why dentists give you antibiotics is to kill the strep that may have gotten into your bloodstream through the leaky gums, so that you don’t make a bunch of antibodies to strep, which because of molecular mimicry, may go after your heart, and you get rheumatic heart disease.

That’s the mechanism, that’s a very common mechanism and what causes MS. As I said, I was with Dr. Ebringer two weeks ago in Portugal, and he was presenting at the Autoimmunity Congress that every single MS patient that they check, every single one, they do nasal swabs and they check for the bacteria up in the sinuses. And every single MS patient has actinobacter in high concentrations in their nasal cavity, and actinobacter via molecular mimicry, goes after myelin, the saran wrap around your nerves, and if it does that, you get MS. And every single MS patient … and he published on this and he presented his papers to the Scientific Congress, there were 500 doctors in the room. Just our jaws dropped because when you see … the only other one we know as 100% is celiac disease, 100% of celiacs have a problem with wheat, no question about that, everyone knows that. But now we know with MS, they’ve got actinobacter infections up in their sinuses.

That goes right up into the … that bacteria gets up and it goes up into your brain and if you make antibodies to that bacteria because of molecular mimicry, AABCD, it may go after the myelin of your nerves and of your brain and you develop MS. That’s molecular mimicry, the number one mechanism in getting sick and dying in the world, your immune system attacking yourself. And now we’re learning, why does this happen? Where does it happen? And that’s what this book is about. That’s why it won the National Book Award is because you read this and you go, “Oh my god. Wow, that just makes sense.” ’cause there’s over 300 studies in the back references of this book.  It’s 35 years of my life, right? But I mean, that’s the mechanism.  So every parent, every person, but especially every parent needs to understand this, so you can protect your children and ’cause when you learn about this mechanism, you start doing the little things to reduce the environmental exposures that activate your immune system. Remember I talked about you’ve got the gene, you get the environmental exposure, then you get the disease? So you want to reduce the environmental exposure. For example, you ever pump gas and you can smell the gas?

Dr. Weitz:                            Sure.

Dr. O’Bryan:                        You’re smelling benzene. Benzene is a neurotoxin, it goes up into your brain and it fries your brain, it causes inflammation in the brain. We’re just so used to it ’cause we don’t feel sick when we smell it, we think it’s fine. It’s not fine. You’re standing downwind and you’re smelling benzine, so what do you do about that? You have to pump gas. Walk around to the other side of the hose. Now you’re upwind and you don’t smell it anymore.

Dr. Weitz:                            Yeah, I usually just get back in the car and close the door till it’s done.

Dr. O’Bryan:                        Exactly, exactly. Even better. But we have to start thinking differently about how to protect our bodies ’cause if you go, “Oh I’m smelling something. Oh, I’m downwind.” And then you get back in the car or walk around to the other side, but we don’t think that way, we just stand there and say, “Oh yeah, I can smell the gas. And fine, it’s not harming me. I’m fine.” No, you’re not fine. It’s killing off brain cells, but it’s not enough to make you feel sick at the moment so you think it’s okay. But if you make antibodies to benzene or benzene binds onto your own tissue, then the immune system goes after that tissue to kill that tissue. That’s the other mechanism, the primary one’s molecular mimicry, and the other one is called neoepitopes. That’s geeky stuff, we don’t have to get into that.

But the message is, we have to wait … listen, we don’t have time to mess around anymore, we don’t have time. I’m gonna tell you two studies. The first one, the World Wildlife Fund published this study almost two years ago, and between 1970 and 2011, that’s 41 years, there has been on average, a 58% reduction in populations of all vertebrae species on the planet. Anything with a spine, insects, birds, fish, mammals, 58% that are gone in 41 years. Now, for the birds, the average as a category was 35%, for mammals living near fresh water, it’s 78%. 78% of the beavers are gone in 41 years, 78% of the bobcats, of the porcupines, the woodchucks, they’re gone. 78% gone in 41 years, why? They’re drinking the water and if you were drinking the water coming out of the streams by your house, or out of the rivers by your house, you’d get cancer quicker, you’d be unable to reproduce, just like the animals.  That’s the first study. They say, “Oh well, that’s too bad. We don’t need bobcats anyway.” Some people think like that, that’s okay if you think like that-

Dr. Weitz:                            I’ve heard people say that.

Dr. O’Bryan:                        Yeah. That’s okay if you think like that, but here’s the one that you can’t ignore. They did a meta analysis, that means they looked at many studies on one subject. And the subject, it was 186 studies between 1974 and 2011, so 37 years. Same time period as the World Wildlife began wiping out the animals, same time period. Between 1974 and 2011, the topic for 186 studies? Sperm count in healthy men, not in fertile men, healthy men. And it’s a 59% reduction in sperm count across the world, 59% reduction. So what? Scientists worry about extinction of a species at 72%, we’re at 59% in 37 years. What do you think is gonna happen in the next 20 years? We have to wake up. And where’s this coming from? It’s all the toxic chemicals that get into our body, it’s the plastic lids on the coffee cups at Starbucks and every other coffee shop, it’s the saran wrap you put on your food, and the plasticizers in the saran wrap leak into the food. You can’t have food touch plastic wrap.

Dr. Weitz:                            I know, you go to the store and you try to buy organic chicken and it’s sitting on styrofoam covered with plastic wrap.

Dr. O’Bryan:                        Exactly right. Exactly right. We have to wake up, we have to wake up. Aluminum foil breaks down, you bake with aluminum foil, 185 degree centigrade, which is 365 Fahrenheit for an hour and a half, you can bake a turkey in there or a chicken, hour and a half. And then you take the aluminum foil and you put a magnifying glass to it, it’s all broken up into thousands and thousands of little pieces of aluminum. You can’t see it with the naked eye but use a magnifying glass and go, “Holy cow, look at that.” That stuff is in the food. It’s in your food, you get aluminum in your food, you say, “Oh so what? I can’t taste it, it tastes good.” Just Google “aluminum and Alzheimer’s” and look at hundreds of studies, I’m not exaggerating. “Well, where’s it come from? Where do we get aluminum?” It’s from your aluminum foil, it’s from the vaccinations that they use aluminum, there’s a whole list of places, it’s in the chem trails. There’s so many places that we’re getting minor amounts of aluminum exposure.  And the industry-

Dr. Weitz:                            In the antiperspirants that people put under their arms.

Dr. O’Bryan:                        Exactly, exactly. Aluminum chlorohydrate, and the industry, the way they get away with this, there’s no study ever that’s shown, when you use aluminum chlorohydrate in your antiperspirant, it causes a problem in humans. There is no study, none. However, the aluminum has a half life in your body at 7 to 11 years and it’s the accumulation of all of the little exposures that build up over time. The plasticizers, they’re called phthalates that’s in all plastic, the heavy metals like aluminum, and arsenic, and lead, and mercury, the PCBs. They did a study in Norway, two and a half years before they closed the study, this was a government commission. Should we tell women not to breastfeed in their first pregnancy? Two and a half years, it’s like, “What? I thought breastfeeding was good for you, that’s the best thing you can do for a baby, the very best thing.” Well, what are they talking about?

People in Norway eat lots of fish. The fish come from the fjords, the fjords run along the country going up and down the country, they’re narrow and they’re deep. But the farmers have been using insecticides and pesticides for generations, the rain carries the insecticides and pesticides down into the fjords. The fish have pesticides, insecticides, PCBs in their meat. There’s no evidence that the amount of PCBs in any fish is dangerous, there’s no evidence. But it stays in your body for decades and when you grow up eating a lot of fish, which is healthy for you, these PCBs accumulate. Where do they accumulate? In the estrogen loving cells. In women, that’s the breasts, the uterus, the ovaries. In men it’s the testicles. Yeah, there’s estrogen receptors in your testicles. It’s one of the reasons why loss of sperm count.

The women are accumulating these PCBs in minor doses for 20 years, for 30 years. Then they get pregnant, hopefully they have a wonderful pregnancy and a wonderful delivery. Now, as they’re in the delivery phase, the brain’s sending message down to the breasts saying, “Okay, it’s time to start lactating, start making some new milk, make milk.” And the milk is made by the fat cells in the breasts. Well, the fat cells in the breasts is where all the PCBs have been hanging out for 20 years and accumulating, so mother’s breast milk is highly toxic to this poor, immature immune system, vulnerable baby. And these PCBs are neuro toxins, they fry your brain. Just think of a hot pan and you put an egg in there, that’s what these PCBs do in your brain. And it inhibits the child’s brain from developing properly and you read the studies and you see kids that have PCBs exposures, their IQs are down when they’re seven, eight years old. Not a lot, but they’re down, they’re not as functional, they’re musculo-skeletal coordination is less, it’s cause the brain didn’t develop properly.

So, what do you do? The commission said, and there’s so much politics in this, and finally, “No, no. Breastfeeding is more important than the other, pros and cons of both.” And I agree, breastfeeding is more important. There are too many benefits to breastfeeding, but what do you do? Every woman of childbearing age, should detox their breasts before they get pregnant. For six months beforehand, you learn how to detox your body and get the stuff out of you so that your baby has the best shot to develop the best brain they can, because it’s the future generation that’s gonna have to save the planet. We’ve messed it up so bad and it’s those kids who will think outside of the box. They’re the ones that’ll save the planet, so we need their brains working as good as possible.

Dr. Weitz:                            That’s great. You were talking about infections and we’ve learned recently that we used to think that the brain was a completely sterile situation because of the blood-brain barrier. But now we’ve learned that there are pathogens, bacteria, and viruses that actually get into the brain, isn’t that right?

Dr. O’Bryan:                        In my new book, which comes out in September, it’s called, You Can Fix Your Brain: One Hour a Week to the Best Memory, Productivity, and Sleep You’ve Ever Had. We have an entire chapter in here on the blood-brain barrier and I’ve coined a term that I hope becomes common language in the next year, capital B, the number 4, B4. “What’s your B4? Do you have B4?” What does that mean? A breech of the blood-brain barrier. You’ve heard of leaky gut, well you also get leaky brain, and when you get a leaky brain, these big molecules get in there and you have four different immune systems in your body. And the most potent one, the no mess around immune system is in your brain, called the glial cells. These guys have bazookas. They don’t have high powered rifles, they have bazookas.  Anything gets in the brain, they just blast it, which is great except if you’ve got B4, things are constantly coming into the brain, so you’re blasting, blasting, blasting. There’s lots of collateral damage and that starts the entire inflammatory cascade in the brain. Every brain dysfunction, depression, anxieties, schizophrenia, bipolar, Alzheimer’s, Parkinson’s, seizures, attention deficit, autism, they all have a breech of the blood-brain barrier because that’s how the molecules get in that your immune system gets activated to protect you from, that causes the inflammation that damages your brain tissue. When you do the right tests, and we talk about the tests in the book, for B4 and you say, “Oh my god, I’ve got B4.” That’s just like saying, “Oh my god, I’ve got a leaky gut.”  Okay, “How do I fix a leaky gut?” Okay, “How do I fix a breech of the blood-brain barrier?” And then you start applying the principles to fix the breech of the blood-brain barrier and then you go back and you recheck in three to six months to make sure you’ve dialed this thing down and it’s fixed now.

Dr. Weitz:                            Now, some people out there would be hearing all this talk about bacteria, and viruses and they might think, “Yeah, we just need to take more antibiotics and just kill these things.”

Dr. O’Bryan:                        Well, that’s probably the main reason we have the problem we do now today, is because that was a … it’s called reductionistic thinking. “Let’s just wipe out all the bacteria.”, the antibacterial soaps and all that kind of thing that generations have been focusing on. And what we now know, is that humans are designed to live in balance with Mother Nature, we’re all on the same planet. I don’t want to get airy fairy here ’cause some people say, “Oh, he’s too airy fairy.” But we’re designed to be in balance with the planet earth, when you’re in balance with the planet earth it means that you walk on planet earth, not concrete. I mean, even when you live in a city like LA, or New York, or Kansas City, wherever you are, on Sundays get out in a park and take your shoes off. Do the Pretty Woman thing that you know, he takes his shoes off and he’s like, “Oh, this feels different.”, and just get grounded.

Dr. Weitz:                            Earthing.

Dr. O’Bryan:                        Earthing, yeah. Right. I mean, there’s a lot of validity to that concept. Your brain works much better when you’ve done some earthing exercises, get grounded on the planet. Antibiotics are absolutely the last resort, not the first option. And we are exposed to so many of them because they spray most of the vegetables in this country with antibiotics. Some of the spray when the planes are going by over the fields, it’s full of antibiotics and they’re killing off the bugs and bacteria to let the plants grow, but then you get weak plants. You don’t have plants that are as strong as the others, but then the antibiotic residue’s in the food. But the industry says, “There’s no studies that show the level of antibiotic in broccoli is ever a problem for humans.”  They get away with that crap, but it’s the accumulation, it’s the accumulative damage that occurs that has caused problems for us today.

Dr. Weitz:                            Yeah, ’cause this stuff doesn’t leave our bodies. Yeah, I was going into the supermarket the other day and this woman’s taking those wipes and I said, “No, no. You should lick the handle of the supermarket cart, that’s the best thing for you.” She thought I was crazy and she just kept going.

Dr. O’Bryan:                        You are a nut case. Sorry.

Dr. Weitz:                            How do we protect ourselves and prevent these autoimmune diseases? What can we do? Besides trying to avoid some of these toxins, but avoiding toxins is not an easy thing, but assuming that we do get some of these toxins and what do we do?

Dr. O’Bryan:                        The first thing is, read the book. Read this book and I’m not saying it because I wrote it, I’m saying it because it’s a paradigm shift, that when you understand what you’re up against, it’s an OMG, it’s like, “Oh my god.” But then the way you approach it, and this is how you are successful, the way you approach it, there’s two concepts. The first one is … and in many of my talks, I start with this line in the very beginning. In the Museum of Science in Florence, Italy, there’s a display and it’s a round marble stand with a glass dome above it and inside the glass dome is Galileo’s finger, one finger, like this. Now, it happened to be his middle finger and it was his last message to the church.  There’s a couple of books on Amazon that you can read about Galileo’s life and how-

Dr. Weitz:                            Are we gonna put Trump’s middle finger in a glass?

Dr. O’Bryan:                        That’s a really interesting idea. But the one finger concept is one hour a week. You allocate one hour a week, Tuesday nights after dinner, Sunday mornings before church, whenever it is, but one hour a week every week. “To this topic, I’m going to learn more about how the autoimmune mechanism gets activated by my environment and by my children’s environment. I’m gonna learn more about this.” ‘Cause it’s overwhelming, and it’s so overwhelming, it’s immobilizing. You don’t know what to do, but if you allocate one hour a week, just one hour and you set the alarm on your watch for one hour, you can bite size chunks of those. ‘Cause my term is, “Base hits win the ball game.” So you just go for a base hit this week, “Okay, I’m gonna learn a little more about these PCB things and how that stuff accumulates. And then how can I reduce my exposures?”

You only need one hour, that’s it. And next week, “I’m gonna learn about mercury and how I can prevent so much mercury from my kids. Oh my god, all the tuna’s got mercury? I didn’t know, oh my god.” Well, there’s one that doesn’t, it’s called Ventresca, with a V, Ventresca from Vital Choice Seafoods, you can find them online, and that can of tuna fish, there is no measurable mercury in it at all, and there’s a reason why there is none. And it’s seven grams of tuna fish, so you give your kid a can of tuna fish once a week that’s Ventresca, doesn’t have the mercury poisoning that all the other ones do, once a week and your kid’s got brain food, the most important brain food, the DHAs for a week, from one can of tuna fish.

Dr. Weitz:                            How did they get the mercury out of the tuna?

Dr. O’Bryan:                        Randy Hartnell owns the company and Randy was a salmon fisherman in Alaska for over 20 years. All salmon fishermen, they get tuna in their nets. And if they catch a tuna, they put them in a different bin and then they sell them to the tuna guy when they come back to shore, but the baby tuna, nobody wants. So all the salmon fishermen throw them away, they throw them back into the water and it’s unfortunate, but that’s fishing, that happens. So Randy goes, “Well, wait a minute here.” ’cause he had learned how mercury accumulates in tuna because mercury comes from the rain coming down on the ocean and the mercury is in the air from cold burning power plants, the rain brings it down into the water, the plankton absorbs the mercury. The little fish eat the plankton, so they get some mercury. The medium size fish eat the little fish, they get higher concentrations of mercury. The big fish, like tuna, eat the middle sized fish, they get the highest concentrations of mercury, right?

Baby tuna haven’t had the time yet to eat a bunch of medium sized fish, they don’t get the mercury. So Randy found that the belly of the baby tuna, there was enough meat there to make it worthwhile, to lug it back and do whatever they have to do for the manufacturing stuff. So they’re canned tuna fish is the belly of baby tuna, it’s called Ventresca, it means fish belly in Italian. So that fish has no measurable … you can’t say none because you could find electro microscopic traces in there, but no measurable amounts of mercury compared to all other tuna fish.

Dr. Weitz:                            Right.

Dr. O’Bryan:                        And it’s much more expensive because it’s more manpower and more of these fish have to be … for each can, that kind of thing. But one can a week for your kid, they’ve got all the brain food, that DHA they need for a week.

Dr. Weitz:                            Cool.

Dr. O’Bryan:                        It’s very cool. Very, very cool.

Dr. Weitz:                            They can also eat sardines too, it may not be quite as good but also because it’s a smaller fish.

Dr. O’Bryan:                        That’s right, that’s exactly right. And they’ve got good levels, really good levels, I think it’s about three grams to three and a half grams EPA DHA in a can of sardines, which is a good amount, a really good amount. But seven grams in that can of tuna fish, dropped my jaw when I saw that. That’s a tremendously high-

Dr. Weitz:                            Yeah, that’s amazing. Yeah.

Dr. O’Bryan:                        That’s really great. ‘Cause most of the capsules are 760 milligrams.

Dr. Weitz:                            No, most of them are like 500 and some as low as 200, so you probably need like 15 capsules.

Dr. O’Bryan:                        That’s right. To get the same amount of brain food as you get in one can of Ventresca.

Dr. Weitz:                            Wow.

Dr. O’Bryan:                        That’s exactly right.

Dr. Weitz:                            That’s cool.

Dr. O’Bryan:                        I know, it’s just so cool. And that’s in my book, so it’s like one hour a week to learn that one little thing. You say, “Oh cool, I’m gonna order that.” Then you order it, okay, you’re done for the week. That’s it. Next week, you learn a little bit more, next week, you learn a little bit more. And that way it’s in bite size chunks that you can apply for you and your family and in six months, you’ve got it down. You’ve got it down. But we don’t live our lives that way, we want it all now. So we read this whole book all at once and go, “Oh my god, this is a really great book.” And what are you gonna do, “I don’t know where to start.”, right?  So, one hour a week with this stuff and you can implement it. And who cares if it takes you six months or a year, who cares, it’s the rest of your life, and you will have made these changes, these lifestyle changes, reducing the amount of exposures that you and your family are getting everyday.

Dr. Weitz:                            Great. How can we get rid of these toxins after they’re in us?

Dr. O’Bryan:                        There’s protocols for detoxification, you have to detox. One of the things you can do is aerobic exercise, you have to sweat ’cause sweat will just flush some of this stuff out. And aerobic exercise means you wear a pulse monitor. You wear a pulse monitor and you stay in your pulse range, and you set the alarm on your pulse monitor on the watch, and the formula is 180, minus your age, plus or minus five, that’s your range. And if you’ve been diagnosed with a disease, you do 175, minus your age, plus or minus five. And you stay in that range, and you set the alarm on your watch for that range. Let’s say it’s 130 to 140, so you’re walking on a treadmill and your pulse is going up and it gets up into that range, “Oh good, I’m in the range.” And then it goes, “Beep, beep, beep, beep, beep, beep, beep, beep. Oh, I’m at 149, wow. Okay, I better slow down a little bit.”

And you slow down a little bit and the beeping stops and you’re in your range again, and then it goes, “Beep, beep, beep, beep, beep, beep. Oh wow, I’m up at 152, what happened? Oh my gosh I was thinking about my uncle and what a jerk he is.” Whatever your brain does will effect your pulse, so you slow down again, you get in your range. And then it’s going, “Beep. Beep. Beep. Oh, I’m too slow. Oh, I better pick it up a little bit.” And then you’re training yourself to stay in the range where the alarm is silent. And you stay in that range 30 minutes … it’s 150 minutes a week, so it’s 30 minutes, 5 days a week. You go for walks around the block, that’s all you have to do, just get in your range. And if you’re walking and you’re not quite in your range, most people will be in your range by just walking, and if you’re not quite in your range, carry a couple of soup cans with you and then that will bring your pulse up a little bit.

Dr. O’Bryan:                        That’s the old Jack LaLanne thing, the soup cans, “Okay ladies, go in the kitchen and get your cans of soup.” Right? When they come back with their soup cans and they’re exercising and doing their thing, it doesn’t have to be difficult. So the first thing you do-

Dr. Weitz:                            By the way, you know Jack was a chiropractor?

Dr. O’Bryan:                        That’s right, that’s right. He was a great man and he was just a giant of a man.

Dr. Weitz:                            Yeah, I love Jack LaLanne, very inspirational.

Dr. O’Bryan:                        Yeah. Next, everybody when they wake up in the morning, they go to the bathroom, almost everybody, first thing they do is you go to the bathroom. The very next thing you do before anything else, drink two big glasses of water before anything else, two big glasses of water to start your day. And within a few days to a week, you’re looking forward to the water ’cause you notice you had a great bowel movement an hour later, or just feel a little bit better. You have to hydrate, you have to have the highway able to carry the traffic to get rid of the crud that’s in your body. So you start with two glasses of water, and then throughout the day, the amount is a half ounce per pound body weight. That’s how much water you have to drink in a day, a half ounce per pound body weight, and just figure out what you weigh, and then divide that by two, that’s the amount of ounces of water you have to drink.

It’s a lot of water. If you weight 150 pounds, that’s 75 ounces of water a day, that’s a lot of water. “Oh my god, I’m gonna pee a lot.” Yes, you are. And that pee’s gonna be full of toxic crud that you have to get out of your body, deal with it. “Oh no, I don’t want to go to the bathroom so much.” Then we’ll put that on your tombstone, “You didn’t want to pee it out.” I’m sorry, right? There’s just some basic things that we have to do to clean our bodies out. And when you do that, you notice in a week, a month, a couple of months, you’re just feeling better than you’ve felt in a long time, right? And people are saying, “Wow, you look good, you look good.” And say, “Oh, I’ve been drinking more water and I’m walking five days a week and yeah, it just feels really good.”

Dr. Weitz:                            That’s great, Tom. You’ve got tons of great information and thank you so much for sharing with us. We could talk for hours.

Dr. O’Bryan:                        Yes, we could. Yes, we could. My recommendation for everyone is read the book, if you go to my website, thedr.com, but just don’t spell the word doctor out. Thedr.com/book, and then it’ll take you to Amazon, but there are some handouts that you can download there that are extras, after I wrote the book. When you read the book, you’ll say, “My gosh, this just makes sense. This just makes sense. My son’s attention deficit, maybe we can help.” Or, “My husband’s rheumatoid arthritis, maybe we can help.” Yeah. Yeah.

Dr. Weitz:                            And when is your new book gonna be out, On The Brain?

Dr. O’Bryan:                        September 18th.

Dr. Weitz:                            Okay, good. We’ll be looking forward to that.

Dr. O’Bryan:                        Thank you so much.

Dr. Weitz:                            Okay. Anything else for people who want to contact you? I guess you gave us your website and we know about your book, so that sounds great. Thank you so much for joining me, Tom.

Dr. O’Bryan:                        Oh, it’s a pleasure. Thank you for having me.

Heavy Metal Detox with Wendy Myers: Rational Wellness Podcast 063

Wendy Myers talks about how to detoxify heavy metals like mercury and lead from the body with Dr. Ben Weitz.

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

 

Podcast Highlights

2:47  Wendy Myers explained how she was feeling poorly with low energy, brain fog, and couldn’t lose weight and she went to her conventional doctor and found out that at age 37 she had the hormone level of a post-menopausal woman. But she didn’t want to take replacement hormones, so she sought out answers and found a program to detox heavy metals to improve your hormones and she did it and felt a lot better. Her hormones returned to normal and she felt better than she had ever felt, which inspired her to want to educate others about the importance of toxins and how to detox them, so she started her website, MyersDetox.com

4:54  Heavy metals like mercury, lead, arsenic, cesium, aluminum, tin, thalium, etc. can cause fatigue, brain fog, trouble sleeping, trouble losing weight, hypertension, heart disease, blood sugar problems, hormone imbalances, hypothyroid, and it can also interfere with hormone production and conversion. Such metals are common in our environment, in the air, food, and water. Wendy said that some of the most common metals found in southern California where we both live are mercury and aluminum. Mercury comes from fish mercury amalgam fillings, vaccines, and it’s in the air from coal fired power plants. Aluminum is in the air from chem trails and other sources, in vaccines, in aluminum foil, and underarm deodorant. 

8:03  I mentioned that I interviewed Dr. Pizzorno who told me about the arsenic in the chicken feed and Wendy talked about the arsenic in the rice, especially in brown rice, since the arsenic concentrates in the bran. She recommends rice grown in California over rice grown in the southern states or in China or India. Wendy Myers also talked about all the toxins found in personal care and makeup products as well as in household cleaners. 

9:39  What is the best way to test for heavy metals?  Wendy likes to start with hair mineral analysis and then she’ll determine if we should to a urine metals challenge test or a stool metals test. Stool is particularly good for cadmium and silver toxicity and cadmium does not show up in urine or hair.  She will then design a custom supplement program to get rid of particular metals that are present.  Unfortunately, metals are ubiqitous in our environment and they cannot be avoided, so you need to use detox protocols as part of your health routine regularly, including her Mitochondria Detox program, containing activated choline stabilized Silica, that is specifically chemically formulated to bind onto arsenic, aluminum, tin, thallium, and cesium. Thallium is in petroleum deposits, so it’s in car smog. We’re breathing that in every day, especially in LA, and so a huge factor on chronic fatigue. Cesium is a big issue from Fukushima, the nuclear disaster in Japan. It’s releasing tons of cesium into our environment. These metals are poisoning our mitochondria.  Her Mitochondria Detox also contains Modified Citrus Pectin and her Mitotox product, containing energized structured water and minerals.  Even if you support the mitochondria with nutrients like CoQ10, vitamin K2, B vitamins, and D Ribose, in order to improve your energy levels, but if you don’t get rid of the metals, the mitochondria can’t work properly.  People are desperate for energy, which is why they are drinking so much coffee.

19:06  I asked what Wendy thought about IV chelation and she cautioned that when patients are very sick, they may not be able to tolerate IV chelation and if done incorrectly, it can damage your kidneys.  She said that she prefers to use EDTA and DMSA suppositories when indicated. EDTA and DMSA are chelating agents that can be used intravenously, orally by prescription, or as suppositories.  EDTA suppositories are particularly helpful for removing cadmium. She gets them from a company called Kelatox and they are available from her online store, Store.Myersdetox.com

22:26  Wendy has a heavy metals quiz that people can take if they want to answer some questions and find out what their potential levels of heavy metal toxicity could be at MetalsQuiz.com  Wendy has lots of great content at her website, MyersDetox.com, including over 250 podcasts and hundreds of articles. 

 

                                            



Wendy Myers is a Functional Medicine practitioner who specializes in detoxification and bioenergetics in Los Angelesand her website is https://myersdetox.com/. She is the #1 bestselling author of Limitless Energy: How to Detox Toxic Metals to End Exhaustion and Chronic Fatigue. Wendy is the host of Theheavymetalsummit.com and she hosts two popular podcasts, Live to 110 and the Supercharged Podcast about Bioenergetics. Passionate about the importance of detox to live a long disease free life, she created the revolutionary Myers Detox protocol after working with thousands of clients.

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 the 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 give us a ratings and review so more people can find out about the Rational Wellness Podcast. If you want to see the video version, you can go to my iTunes (meant to say YouTube) page. You can go to Rational Wellness or Weitz Chiro.

Today our topic is heavy metals, what problems they occur, how do we get them, how do we get rid of them, all in the next five minutes, ha ha. Heavy metals like mercury, lead, arsenic, fluoride, et cetera, are very common in our food, water, and our environment. Mercury is common in certain fish, silver fillings in our teeth, and even in vaccines. Arsenic is very common in the water in certain parts of our country, including in southern California. It gets into rice and other foods grown in that water. Fluoride is actually added purposely to our water. It’s in toothpaste. It’s in mouthwash. Heavy metals are contained in tattoos. We could go on and on.

To help us figure out what’s going on with all these toxic metals and what to do about them, we have heavy metals expert, Wendy Myers, to talk to us today. Wendy Myers is a functional diagnostic nutritionist and a number one bestselling author of Limitless Energy: How to Detox Heavy Metals to End Exhaustion and Chronic Fatigue. She’s also the host of two separate podcasts, TheHeavyMetalsSummit.com, and she hosts two podcasts, including Live to 110 about detox and The Super Charged Podcast about bio energetics. She’s very passionate about the importance of detox to live a long, disease-free life and she created the revolutionary Myers Detox Protocol after working with thousands of clients. Wendy, thanks so much for joining me today.

Wendy Myers:                 Yes, thank you for having me.

Dr. Weitz:                        Great. How did you get into the health field? Tell me about your journey.

Wendy Myers:                 Well, I’m like a lot of health practitioners. I got into the health field dealing with my own health issues and trying to troubleshoot why I was tired, why I had brain fog, why I couldn’t lose weight, and why I just didn’t feel like myself. I looked in the mirror and I didn’t recognize the person in the mirror. I was kind of a shell of my former self and I just wasn’t feeling well. I just knew intuitively something wasn’t right.  I went to my doctor and she found out that I had really low hormone levels. I had the hormone levels of a menopausal woman at 37 and believe me, I was really thrilled to hear that. I had low thyroid function and I had adrenal fatigue and nutrient deficiencies. I wasn’t working at the time. I was a stay at home mom. I was working full-time on my health, and I thought, “How is this happening? How do I have all these health issues when I’m eating perfectly, I’m exercising almost every day, I’m taking a shopping bag full of supplements every day?”

I decided to not do the hormone replacement therapy, which was advised by my doctor, and I thought something caused my hormones to get out of whack. Doing something about that about that could help reverse them. There’s got to be a way naturally to get my glands functioning again how they’re supposed to. I was just typing in, “How to heal your adrenal glands naturally,” and I came upon a website that was talking about how heavy metals interfere in our hormones and interfere in thyroid and do this hormonal analysis and detox these metals as a start to find out what metals you have.  I tried it. I started taking a bunch of minerals and did the program. I felt a lot better. Over time, my hormone levels corrected and I feel better than I’ve ever felt. I’m 45 today. For me, something just clicked inside me and I wanted to educate other people about the importance of toxins and heavy metals and how to detox them, so I started my website, MyerDetox.com.

Dr. Weitz:                        Cool. What effects do heavy metals like mercury, lead, and arsenic have on our bodies and our health?

Wendy Myers:                 Well, really almost every conceivable symptom and health issue can have an underlying metal or chemical cause that’s outright causing it or promoting it, and just so many issues that people suffer from, fatigue, brain fog, trouble sleeping, trouble losing weight, a lot of the major health issues people deal with. Hypertension’s caused by lead and cadmium toxicity, magnesium deficiency. Heart disease, a big cause is cadmium toxicity, hardening the arteries, diabetes, people have iron toxicity and arsenic toxicity and other metals that interfere in their ability to regulate their blood sugar. I can keep going down the line, but-

Dr. Weitz:                        Depleting hormones.

Wendy Myers:                 Hormones, yes. So many people are suffering from low hormone production and thyroid issues caused by a mercury toxicity, interfering in thyroid hormone, thyroid hormone production and conversion of T4 to T3 and on and on and on. Metals are ubiquitous in our environment. They’re present in the air, food, and water, so we’re ingesting them all the time. Eventually, they’re going to break down some metabolic function in your body and start causing health symptoms.

Dr. Weitz:                        Cool. Which metals do you think are most common in southern California where both of us live?

Wendy Myers:                 Yes. Well, mercury is the most common metal toxicity that people have. The next one is aluminum. People are breathing in aluminum all the time.

Dr. Weitz:                        Is mercury mostly from fish or what other sources are there?

Wendy Myers:                 Yeah. People are mostly getting it from fish, but they’re also getting it from breathing air because of the coal burning that’s done. That just gets in the environment. We breathe it in. That’s how it gets into the ocean and into the fish. We also get it from mercury almagam fillings, which many people have or have had in the past, and lots of other avenues that mercury gets in our body, vaccines, some vaccines. People are getting a lot of aluminum also from vaccines and they’re just getting it a lot of different ways, mainly breathing air, and underarm deodorant as well, conventional deodorant.

Dr. Weitz:                        How does aluminum get into the air?

Wendy Myers:                 Well, a lot of different ways. I believe it’s getting into the air from chem trails, but there’s also spraying that’s done. It’s used for geo-engineering and it’s used in a lot of different industries and from industry, it just gets into the air and then we inhale it.

Dr. Weitz:                        Yeah. I had never really heard of chem trails. I interviewed Dr. Harani and she was telling me about them. Can you tell me about the chem trails?

Wendy Myers:                 I’m not an expert on chem trails. I need to do a little bit more research myself, but I know that the chem trails release barium, strontium, aluminum, and other metals into the air. They’re trying to do geo-engineering and do other things to control our environment, but unfortunately, it’s having health consequences for people.

Dr. Weitz:                        Interesting. What are some of the other common sources of heavy metals in the environment? I spoke to Dr. Joe Pizzorno, and he was telling me about arsenic in the chickenfeed, and I’d never even heard of that before, but I guess it’s pretty common.

Wendy Myers:                 Oh yeah, very common. There’s arsenic in rice. The brown rices typically will have more arsenic because the arsenic will concentrate in the bran.

Dr. Weitz:                        Is there any way to get rice with less arsenic?

Wendy Myers:                 Yeah, so you want to get rice that’s grown in soils that are low in arsenic.

Dr. Weitz:                        Where is that?

Wendy Myers:                 Yeah, in California, and I tell people to avoid rices grown in south United States or that it’s grown in India or China because they have a lot of heavy metal contamination there in the soils, in the air. I tend to avoid any products from China or India because of that.  A common source of toxins is actually products that we put in our body every day. Our skin is very, very adept at absorbing toxins through our skin and it’s a very effective absorption method, and so you want to be very, very aware of the beauty products and makeup and household cleaners that you’re using as well that you’re getting on your hands. People need to be focusing on using natural products, using vinegar, things that don’t have chemicals and preservatives like parabens and things of that nature.

Dr. Weitz:                        Yeah, personal care products really have a whole series of different toxins.

Wendy Myers:                 Yes, they do.

Dr. Weitz:                        Yeah. How can we find out if we have heavy metals? What’s the best way to test for them?

Wendy Myers:                 Well, I start with a hair mineral analysis with clients and that’s a great way to test for 37 metals and minerals. People can be toxic in certain minerals, as well. Once we do that, I’ll determine if they’re a candidate to a urine metals check challenge test and or a stool metals test as well. Stool is great to test for cadmium and silver toxicity. A lot of people have cadmium issues, but it doesn’t show in urine or hair. I’ll start there, and then once we find out what metals they have, then we can design a custom supplement protocol giving them supplements that remove their specific metals that they have on my Myers Detox Protocol.  I really focus a lot on toxic metals that cause fatigue. There are certain metals in our environment like arsenic, aluminum, tin, thallium, and cesium that interfere in our mitochondrial functioning and reduce our body’s ability to produce energy, and so for those people that have certain metals that they feel fatigued or they have chronic fatigue, a good place to start is doing my mitochondria detox, especially if they don’t have money to do testing or work with a practitioner.

It can get very expensive to do that and buy all the supplements, but for people that just want to get started doing something really simple, really effective, I developed the mitochondria detox, which is a really simple three step system. It’s inexpensive and it’s a great place to start if someone wants to start doing a detox but they just don’t want to start right away with doing testing.

Dr. Weitz:                         It’s interesting you mention tin. We do a NutraEval on a lot of patients and it includes a serum heavy metals screen. I’ve had three or four just in the last week that had high levels of tin.  I couldn’t figure out where they were getting it from. Where does tin come from?

Wendy Myers:                  Tin can be in the air. It can also be from industry that will release tin in the air. People that are working in manufacturing can get exposed to tin, but tin also can be part of a mercury amalgam. Tin is used in some mercury amalgams, so people can be getting it from there. Also, people that eat a lot of canned food, they can be getting tin from there, as well, but there’s other sources.  On my website, I have a toxic metals sources and symptoms guide. If you type in heavy metals or toxic metals, it’ll come up in the search. I have every metal and all the most common sources and another section on the symptoms that each metal can cause based on my research over the past decade. I always keep adding to it also.

Dr. Weitz:                         It’s interesting. If mercury’s just in the fish, you should stop eating the fish to reduce your exposure, but if some of these metals are in the air, I guess the conclusion is you’re never going to completely reduce your exposure. You just have to find ways to clear them out of your body and maybe do a periodic detox.

Wendy Myers:                  Yes. Unfortunately, metals are ubiquitous in our environment. You can’t escape them. You can reduce consumption of certain foods or remove certain beauty products you’re using. You can control some things and remove the most obvious intake of toxins, but you can’t control everything.  The most sensible thing is to really think of detox as a lifestyle and be adding detox protocols and supplements and doing certain things with infrared saunas just as a regular part of your health routine, rather than thinking, “Oh, I’m going to do this detox for 30 days or for a year,” or whatever you’re planning to do. You really have to incorporate detox on a regular basis into your health regime.

Dr. Weitz:                         Right. Interesting. Tell us about your mitochondrial detox program.

Wendy Myers:                  Yeah. This is a really simple thing that I developed because I noticed over the years working with clients the number one complaint was fatigue, and that was my number one complaint also. I really think that fatigue and mitochondrial dysfunction is the real underlying root cause of so much disease today because if you don’t have enough energy, you can’t sleep. You need energy to sleep. It’s a very energy intensive process and regenerative process. You need energy to heal your body for digestion, for your brain to work, to detox. You need energy to detox. If you’re chronically fatigued, detox goes to the wayside. Your body’s going to do more important functions before it’s going to spend energy detoxing.

For me, the key was really helping the mitochondria work better, and I happened upon the research that showed there were some specific metals that actually poison enzymes that transport nutrients into the mitochondria. People can be taking mitochondrial supplements like Ribose or NAD or whatever, B complex vitamins, and they’re not working or they’re not feeling more energy because the enzymes to get those nutrients into the mitochondria are not working.  Really, the key that a lot of people are missing is detoxification of these metals. That’s the key, and then once you do that, then you can do the mitochondrial supplements, like zinc and vitamin K and K2 and magnesium and all the other nutrients required for that Krebs cycle to make ATP or our energy currency in our body.  That’s the key a lot of people are missing when they’re looking to improve their energy levels. It’s why Starbucks is making billions of dollars. People are looking for that fix. They want to do anything to have more energy, and so that’s why people are drinking coffee all day long and they’re eating carbohydrates and sugar. They’re just reaching for anything. They’re self-medicating. That’s why a lot of people do stimulants and recreational drugs and things of that nature, because people are desperate for energy in any way that they can get it.  I developed the mitochondrial detox to help to clear out these metals and it starts with an activated silica. It’s a choline stabilized silica that is specifically chemically formulated to bind onto arsenic, aluminum, tin, thallium, and cesium. Thallium is in petroleum deposits, so it’s in car smog. We’re breathing that in every day, especially in LA, and so a huge factor on chronic fatigue. Cesium is a big issue from Fukushima, the nuclear disaster in Japan. It’s releasing tons of cesium into our environment. These metals are poisoning our mitochondria.

Dr. Weitz:                         It’s continuing to do that, right?

Wendy Myers:                  Oh yeah, every day. It’s incredible that that’s allowed to continue, but we just can’t seem to fix it. The mitochondria detox also involves a modified citrus pectin, which is a binder that will absorb dozens of metals, hundreds of chemicals. It’s incredibly effective. This simple system is a great inexpensive way to very effectively detox your body and recover your body’s ability to make energy.

Dr. Weitz:                         I guess there’s some controversy about the effectiveness of modified citrus pectin.

Wendy Myers:                  Yeah, there are. Like anything, there are varying degrees of quality of modified citrus pectin. There’s different types of modified citrus pectin. With silica, there’s many, many, many different types of silica and they all do different things and detox different metals. The formula that I have, we have actually studies that show that it kills cancer cells, that it kills prostate cancer cells. It feeds good gut bacteria and it detoxes certain metals. In studies, it shows this.

We have the scientific proof to back up the claims that I’m making, but there certainly are garbage modified citrus pectins out there, absolutely, like with any product. There’s garbage chlorella and chlorella that works great. There’s garbage what have you, multivitamins that work, and ones that work amazing. There’s always a range of quality. Same with zeolite. There’s a range of quality in stuff. It’s harmful.

Dr. Weitz:                         Right. No, yeah, I saw on your website, you have Isaac Elias’ modified citrus pectin. I interviewed him on my podcast, yeah.

Wendy Myers:                  Oh great, yes, yeah.

Dr. Weitz:                         Yeah, he’s a really smart guy.

Wendy Myers:                  Oh yeah, yeah, yeah, and so he’s the one that formulated our CitriCleanse product that’s our modified citrus pectin.

Dr. Weitz:                         Oh, okay.

Wendy Myers:                  Yeah, so he’s an expert. He’s been doing this for 23 years and pioneered the research on modified citrus pectin, so I’m very confident in our citrus pectin.

Dr. Weitz:                         Right, yeah. I interviewed Chris Shade a few weeks ago and he was telling me he didn’t think that modified citrus pectin was a good binder and it was better to use charcoal and clay and things like that.

Wendy Myers:                  Yeah. Yeah, well, there’s certain a case for that, but activated charcoal also is indiscriminate and detoxes a lot of minerals as well that can be problematic, but the citrus pectin is shown to be really, really effective for a lot of different metals.

Dr. Weitz:                         Yeah.

Wendy Myers:                  There are more effective binders, but there’s a price on the other side of that also, like what is the nutritional cost of that binder. There’s pros and cons to every product and modified citrus pectin is no different.

Dr. Weitz:                         Cool. What do you think about IV chelation?

Wendy Myers:                  Yeah, so that has its place. I think that some practitioners overuse it or it’s the only thing that they do for detox.

Dr. Weitz:                         By the way, for listeners who don’t know, we’re talking about intravenous where you go into a doctor’s office and they give you a drip of these agents that help chelate out metals.

Wendy Myers:                  Yes, yeah. It definitely has its place. If your life is at risk or you’re really high in heavy metals or you tried other things and they just don’t work, IV chelation, if it’s done correctly can be very effective, but it can also be done incorrectly and damage your kidneys. Some people are too sick to do that, to do IV chelation.  Every client is different. Every situation is different. I’m a fan of doing gentle, slow things first before I drop the nuclear bomb on that. IV chelation is probably the strongest thing that you can do, and it’s just a lot of people are not a candidate for that. Everything has its pros and cons, but some people, they’re just not able to detox on their own or they need that to save their life, and it definitely has its place.

Dr. Weitz:                         Yeah, no, I think the trend now in functional medicine is to do it slow and to use agents that bind and rev up your own glutathione production and things like that, that has side effects and may take a little bit longer, but just as effective.

Wendy Myers:                  Yeah, absolutely, yeah. I think there’s a lot of practitioners that are doing better practices with IV chelation. It does have its place. For me, I use supplements and I’ll use EDTA and DMSA suppositories when they’re warranted because I think for cadmium, which a lot of people have, you have to use EDTA suppositories to get rid of that. The EDTA suppositories are shown to be just as effective using three of those a week as one session of IV EDTA and it’s a lot less expensive. You can get a two month supply of EDTA suppositories for one session of IV EDTA. It’s a lot more cost effective and it’s safer, as well.

Dr. Weitz:                         Are those available over the counter?

Wendy Myers:                  They are. They are available through a practitioner. You can get them at Store.MyersDetox.com.

Dr. Weitz:                         Interesting. What company makes them?

Wendy Myers:                  Chelatox. It’s a company called Kelatox that makes the EDTA suppositories. They’re great. I have people take them about every other day and start them at night and really, really effective.

Dr. Weitz:                         Do you use glutathione or any C to stimulate glutathione?

Wendy Myers:                  I do. I have clients use NAC, N-Acetylcysteine as a precursor to make glutathione on their own. I have clients do coffee enemas to naturally stimulate the production of glutathione. I find that there’s some people that genetically, glutathione can make them worse, so I tend to not use glutathione with clients. I’ll just give them the precursors to make glutathione.

Dr. Weitz:                         Interesting. Great. Good. I think that’s most of the questions I have. Anything else that you wanted to tell us about getting rid of heavy metals?

Wendy Myers:                  Yeah. Well, actually, if anyone is interested, I have a heavy metals quiz that people can take if they want to answer some questions and find out what their potential levels of heavy metal toxicity could be, and they can go to MetalsQuiz.com and take that quiz. I also based on their toxicity level have some solutions for them on how to lower their heavy metal levels.  Lots of great content and information on my site, as well. I have over 250 podcasts and hundreds of articles, so lots of free information for people to dig into on how to detox their body and educating them about potential sources of metal toxicity that they might not be aware of.

Dr. Weitz:                         One more time, what’s your website?

Wendy Myers:                  Yes. It’s MyersDetox.com.

Dr. Weitz:                         That’s great. Thank you, Wendy. I really appreciate you providing some useful interesting information for us, and I’ll talk to you soon.

Wendy Myers:                  All right. Fantastic. Thank you for having me.

A New SIBO Test for IBS with Dr. Elroy Vojdani: Rational Wellness Podcast 62

Dr. Elroy Vojdani speaks about Small Intestinal Bacterial Overgrowth (SIBO) and Irritable Bowel Syndrome (IBS) and a new serum antibody test for SIBO 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

6:07  A 2017 review paper demonstrated that there is a very wide range of patients with IBS who test positive for SIBO on breath test, from 4-78%. I asked Dr. Vojdani why he thought there was such a wide variation in test results?  Dr. Vojdani explained that there is no standard definition of what IBS is and the breath test is complicated to perform and requires important pretest procedures in terms of diet and avoidance of certain medications. Also the breath test is a complicated set of procedures to perform and it requires being focused for three hours. And you can use glucose or lactulose as a substrate for the breath test, each of which will give you different results. And there is also controversy as to how to interpret the breath test results among the experts and there are several different consensus reports on how to interpret it. Dr. Vojdani estimated based on the research and his clinical experience that approximately 60% of patients with IBS have SIBO.

10:39  I asked Dr. Vojdani what role stress plays in IBS? Dr. Vojdani does feel that stress plays a big role in many patients with IBS. I pointed out that the small intestine has a lot of serotonin receptors and if you prescribe an SSRI for a patient with IBS to help with stress, that SSRI, by increasing serotonin, may be increasing the motility of the small intestine, thus helping with SIBO.  On the other hand, Dr. Pimentel does not think that stress has much to do with IBS and he argues that our flight or fight stress response does not involve suddenly having to go to the bathroom. If you are out on the Savannah trying to run away from a lion, the last thing you’d want to do is to have a bowel movement right then. 

14:48  Under normal circumstances the following mechanisms prevent bacteria from migrating back up into the small intestine from the large intestine: 1. Acid production in stomach, 2. Bile secretion into the small intestine from the liver and gall bladder, 3. Pancreatic enzymes, 4. The immune system is centered within the mucosa of the small intestine, 5. Ileocecal valve, 6 Migrating motor complex cleansing waves of peristaltic contractions. 

17:55  Dr. Pimentel developed a way to diagnose SIBO with a blood test–a serum that that measures anti-Cytolethal Distending Toxin and anti-Vinculin antibodies. Dr. Pimentel’s concept is that SIBO often starts with a bout of food poisoning that results in a release of Cytolethal Distending Toxin (CDT) from the bacteria that causes food poisoning (often Campylobacter Jejuni).  The immune system mounts an attack on the CDT and then via molecular mimicry, the immune system damages structural proteins in the intestinal wall (Vinculin), which affects the nervous system of the small intestine that produce the cleansing waves (the Migrating Motor Complex, aka, MMC). This results in SIBO.  What this means is that IBS is essentially an autoimmune disease

21:50  Elroy and his dad, Dr. Aristo Vojdani, looked at Dr. Pimentel’s research and noted that his test could not help in diagnosing the constipation subtype and even in the diarrhea and mixed subtypes, the sensitivity is only about 60%, which is good but not great. The Vojdani’s also noted that Pimentel’s test only looked at IgG antibodies, while the primary immune complex in the gut is IgA.  So they developed their test looking at IgA, IgG, and IgM antibodies to Cytolethal Distending Toxin the sensitivity of the test that the Vojdanis developed for Cyrex Array 22 has a sensitivity of about 88%, based on their validation data. 

25:47  Dr. Vojdani explained that if you are positive with their SIBO/IBS antibody test that this indicates an autoimmune subtype of this diease and this indicates that these patients have broken their oral tolerance, which is a major breakdown in the way that their immune system functions.  And if you don’t do significant work to restore the oral tolerance in that patient, the patient will never get better or they will get better but they will relapse.  In order to restore oral tolerance, Elroy suggested that some research shows that high dosages of vitamin A, vitamin D, vitamin K, and probiotics may all help with this.  And there’s a lot of really fascinating research being done into the use of helminths as a mechanism to restore oral tolerance.  Helminths are the therapeutic use of parasitic worms.  Low Dose Immunotherapy also holds some promise as a therapeutic option in restoring oral tolerance.

 

                                              



Dr. Elroy Vojdani is a practicing Functional Medicine doctor in the Brentwood section of West Los Angeles Regenera Medical and can be reached at 424-256-0272. His website is https://www.regeneramedical.com/ The new SIBO antibody test that he developed with his dad, Dr. Aristo Vojdani, is available at Cyrex Labs https://www.joincyrex.com/the-cyrex-system/array-22-irritable-bowel-sibo-screen

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. I’m very excited to be talking to Dr. Elroy Vojdani. And we’re going to talk about irritable bowel syndrome and small intestinal bacterial overgrowth. For those of you who enjoy 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.

                                                So our topic today is about irritable syndrome, irritable bowel disorder, or irritable bowel syndrome. And otherwise known as IBS. And this is the most common gastrointestinal disorder. It occurs in up to 15-20% of the US population. And irritable bowel syndrome is a condition marked by gas, bloating, abdominal discomfort, constipation, diarrhea, alternating one and the other, as well as a range of other symptoms.  Traditional medical treatment has been composed of medications for controlling symptoms. IBS is generally being considered to be a stress related condition with no known cause. However, a number of years ago, Dr. Mark Pimentel … This was about 10 or 15 years ago … from Cedars-Sinai became the first one to discover that small intestinal bacterial overgrowth or SIBO is actually the cause of IBS in up to 78% of cases. SIBO consists of bacteria that normally grow in the colon or the large intestine. And then those bacteria start to grow into the small intestine which normally is mostly free of bacteria. The gold standard for diagnosing SIBO is finding more than a small amount of bacteria upon jejunal aspirate.  I know that’s a complicated sounding name but what that means is if you were a gastroenterologist and you were doing an endoscopic exam where you stuck a tube down someone’s throat, when you get to the part of the small intestine known as the jejunum, you scoop out some of the liquid and then you analyze it via a culture. And if you find bacteria, more than a small amount, this is a positive indication of bacterial overgrowth.  However, this test is very invasive and is not regularly done in clinical practice. It’s basically done in research and by a very small number of clinical gastroenterologists. So Dr. Pimentel developed a breath test using either lactulose or glucose or other substrates for diagnosing small intestinal bacterial overgrowth in which the patient ingests the substrate, the lactulose, which is a fermentable fiber. And then, they blow into these tubes and then the tubes are measured for hydrogen or methane gas. And this is now a very common way for functional medicine practitioners to diagnose small intestinal bacterial overgrowth which often is the cause of IBS.

                                                Dr. Pimentel also developed a serum antibody test. He called it the IBS check test. And now it’s offered by Quest as IBS Detect Test. And it’s done specifically for IBS with diarrhea or IBS mixed. But it’s not indicted for IBS with constipation. Recently, Dr. Elroy Vojdani and his dad, Dr. Aristo Vojdani, developed a new serum antibody test available from Cyrex Labs that’s a number of steps more sophisticated than the IBS Check Test. And this is why I’ve asked Dr. Elroy Vojdani to talk with us today about IBS, SIBO, and the state of testing for this condition.

                                                Let me introduce Dr. Vojdani. He’s the founder of Regenera Medical, a boutique functional medical practice in Los Angeles, California. Dr. Vojdani is the son of Dr. Aristo Vojdani, the father of functional immunology. And he is one of the most important doctors in a functional medicine world and he developed all the testing offered by Cyrex Labs. Elroy began his medical career as an interventional radiologist diagnosing and treating complex late stage cancers and other extremely debilitating diseases. But he really wanted to prevent these chronic conditions so he embraced functional medicine and now he’s in private practice utilizing that paradigm. Dr. Vojdani has also co-authored over 15 articles in scientific literature and continues to be involved in research in autoimmune and other medical conditions.  Dr. Vojdani, Elroy, thank you for joining me today.

Dr. Vojdani:                        Ben, it’s my pleasure. You and I have known each other for a little while now and I’ve always enjoyed our conversations. So it’s great to be here with you.

Dr. Weitz:                            Good, good, thank you. So irritable bowel syndrome, as you know, is a very common condition. There was a review paper in 2017 that demonstrated that there was a pretty wide range of number of people with IBS who test positive for SIBO. That paper indicated, based on a review of literature, that there was anywhere from 4-78%. In fact, Dr. Pimentel’s paper actually found 84% of patients with IBS testing positive for SIBO.  Why do you think there’s such a wide variation in results from these studies?  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347643/

Dr. Vojdani:                        It’s a really fascinating topic because on one hand, you have IBS which is this collection of clinical symptoms. Very common clinical symptoms. Urgency, constipation, diarrhea, alternating between the two. It’s something that many human beings experience. So IBS is this collection of symptoms. And then, when we talk about SIBO, we’re talking about this specific quantitative and qualitative dysbiosis that you mention where you have an overgrowth of bacteria in the small intestine.

Dr. Weitz:                            And by the way, can you explain what dysbiosis is?

Dr. Vojdani:                        Yeah. So dysbiosis is an alteration in some way of the gut microflora, the bacteria, viruses, and parasites that live in a symbiotic relationship with us in our gut. So when we talk about dysbiosis, it’s an alteration either in the number of those bacteria or in the type of those bacteria. And SIBO is actually both, right?

Dr. Weitz:                            Correct.

Dr. Vojdani:                        So essentially what was going on in the research world in the last 20 years was that we were discovering that this very common set of symptoms that we call IBS was starting to correlate very often with this type of dysbiosis that we call SIBO. So as you mentioned, the numbers as to the overlap between the clinical condition IBS and the dysbiotic condition, SIBO, were all over the place from as you mentioned 4% all the way to 84%.  Some of the reasons for that is that how we classify IBS, there’s a very wide range. There are Rome I-IV criteria. There are other criteria. Outside of Rome criteria. So it depends how you …

Dr. Weitz:                            The North American consensus.

Dr. Vojdani:                        Exactly. So we don’t have a firm idea as to what we call IBS. We also have various different ways of detecting SIBO so you can do jejunal aspiration, as you mentioned. You can do breath testing. And in breath testing, there are several different ways you can do that either with glucose or lactulose as you mentioned. And then, there’s different diagnostic criteria for what those results are on the breath test.  So basically, we have no standard definition of IBS and we have no standard way to diagnose SIBO. Put that in the mix with a bunch of geographic variations and you get a number that’s all over the map as to where the overlap exists between those two.

Dr. Weitz:                            I think another factor probably has to do with when you have a test that has to be performed by a patient. They have to follow a very specific dietary regiment for a day. And you know, it’s not easy to follow the specific protocols. The patient has to properly breathe into these tubes. They have to do it every 20 minutes. And this requires being really focused for three hours. And I’m sure that there’s a lot of variation in the way that the test is actually performed.

Dr. Vojdani:                        Yeah, absolutely. And each individual practitioner has their own unique instructions for their patients as to how to prepare for a breath test. And many have their own unique way of interpreting a breath test. So again, there really is no standard there that exists in how we diagnose SIBO via breath testing. So we get massive variation.

Dr. Weitz:                            So if you had to guess just from what you know, what would you say percentage of patients who have IBS who actually have SIBO?

Dr. Vojdani:                        I think it’s closer to the 60% mark personally. That number seems to make sense. IBS, we like to think of it as this one condition and I’m sure as we’re going to continue to talk about, it’s likely a collection of different disease processes that all have very similar manifestations.

Dr. Weitz:                            Right. What role do you think stress plays in IBS?

Dr. Vojdani:                        I think stress … Let’s go back in time 25 or 30 years ago when we would talk about IBS and IBS was this condition that we talked about as being entirely genetic and stress as being the only two factors that played a role, right?

Dr. Weitz:                            Right.

Dr. Vojdani:                        So we would treat people with some lifestyle intervention. Tell people to avoid spicy food and coffee. And if we were really inclined, maybe we’d prescribe an SSRI or maybe some benzodiazepines to remove the stress component from this disease. It certainly plays a big role. There’s no doubt about it.

Dr. Weitz:                            And by the way, it’s kind of interesting that if you look at SSRIs which increase serotonin production, the small intestine actually has a large percentage of serotonin receptors and so if you prescribe an SSRI and you increase serotonin production, you may be increasing the motility of the small intestine. So it may be that those antidepressants were actually having a beneficial effect.

Dr. Vojdani:                        So interesting, right?

Dr. Weitz:                            And not just psychological. Yeah.

Dr. Vojdani:                        We didn’t even know really that there was an enteric nervous system that existed in the gut when we were prescribing SSRIs. And many people do actually respond well to SSRI prescription when you’re trying to treat IBS. So we didn’t know why it worked. We thought we were treating the brain but it turns out there was some treatment to the gut that was going on.

Dr. Weitz:                            Right, right, right. Now Dr. Pimentel has another take on that whole stress issue. He feels very strongly that stress is not a reasonable explanation for IBS in a lot of cases.

Dr. Vojdani:                        Yeah. So I think it’s really important to understand that as we’re really learning more about the mechanism in which IBS occurs in individuals that we’re discovering that there’s an autoimmune or auto inflammatory component to this for many people. And when you just zoom out a little bit and maybe talk about IBS and the autoimmune and auto-inflammatory world, it’s really impossible to deny that stress plays some role in the initiation of autoimmune auto-inflammatory disease for people who have the genetic predisposition for it. It’s not a 100% factor the way we talked about it 25 years ago but I think it’s undeniable that it plays a role.

Dr. Weitz:                            Right. But I remember when we talked to Dr. Pimentel when he attended our meeting. I thought he made a really profound point which is when you look at it evolutionarily, if you’re out in the Savannah trying to run away from a lion and that’s the typical example of somebody who’s under high stress, last thing you’d want to do is having to have a bowel movement right then when you’re trying to run away. It doesn’t seem to make sense that that would be a normal stress response.

Dr. Vojdani:                        Yeah. I respect Dr. Pimentel a tremendous amount. His research is incredible and he gave a great talk but I think using an analogy in our paleolithic times is very difficult because we’re really seeing this massive epidemic in modern times of autoimmune and auto-inflammatory disease. I think because our lifestyle has migrated so much from where we were a couple thousand years ago and our body, our genetics, our composition, haven’t had a chance to catch up with those very rapid changes. So sure, maybe our stress would have been running away from some type of predator and we wouldn’t want to have a bowel movement while we were doing that back then, but our immune system was also vastly different. Our diet was vastly different. Our responses to these type of things were vastly different. I think when we talk about autoimmune, auto-inflammatory diseases, it’s really important to understand that these are unique things that are popping up in human beings today because of the new world that we’re living in in comparison to what we were in the past.

Dr. Weitz:                            Sure. So what normally, under normal conditions, keeps the bacteria from the large intestine from growing into the small intestine?

Dr. Vojdani:                        Yeah, you know, the human body in so many ways is really resilient in preventing these things from happening. And we have tons of mechanisms built into us, physiologic mechanisms, that prevent SIBO from occurring. It begins with gastric acid production in the stomach which helps to sterilize the small intestine as it moves through the small intestine. As it moves through the small intestine, you have bile acid production which through saponification efforts can also destroy bacteria.

Dr. Weitz:                            So you’re talking about bile that’s secreted by the liver into gallbladder and then released by the gallbladder into the intestine to help us digest fats, right?

Dr. Vojdani:                        The liver and the gallbladder both secrete directly into the duodenum which is the beginning of the small intestine, right? So if you have bile mixing around in your small intestine, that technically adds to the antimicrobial effect of all these juices that are being produced.  You also have enzymes which are being produced by the pancreas and the small intestine which can also break up the surface of these bacteria. We have a very powerful defense mechanism, our army, our immune system, is really centered within the mucosa of our small intestine. So we have this very powerful mucosal immune system that is … We have all these different mechanisms between all the surveying immune cells that are centered within the gut ileum. We have secretory IGA that’s being produced and floating around in the ileum. That’s all designed to prevent us against dysbiotic things like SIBO occurring.

                                                And then of course when you talk about the junction between the small intestine and the large intestine, that area between the ileum and the cecum, there’s a valve there. An actual valve that when functioning appropriately acts as a one way valve and prevents things physically from moving back into the small intestine.  There’s a lot of things that we’re born with that prevent SIBO from happening which begs the question, why is it happening so much?

Dr. Weitz:                            Right. You know, Dr. Pimentel’s theory is that it starts with a bout of food poisoning that leads to damage to the migrating motor complex which is nervous system of the small intestine and under normal conditions, another mechanism are these cleansing waves that occur which is when you haven’t eaten for a while and you hear your stomach gurgling, it’s essentially there’s peristaltic wave of contractions that go through your digestive tract that also helps to keep your small intestine clear.

Dr. Vojdani:                        To the migrating motor complex.

Dr. Weitz:                            Yes.

Dr. Vojdani:                        Right, so these forward peristaltic waves that occur in between times of eating predominantly at night also ensure that things move forward.

Dr. Weitz:                            Right. So I mentioned the antibody test that Dr. Pimentel developed. How effective do you think that test is? Because my experience was I used it not a large number of times but it didn’t seem to be that helpful. It seemed not to be positive in most of the cases of patients that really did seem to have SIBO.

Dr. Vojdani:                        You mind if I take a step back and kind of explain where Dr. Pimentel came up with the idea to start checking antibodies.

Dr. Weitz:                            Yeah, let’s do that.

Dr. Vojdani:                        So there was a ton of research that was being done as to what enteropathogenic bacteria do to survive within animals. And there was research that was being done into e-coli which is a very common pathogen. Clostridium difficile, campylobacter jejuni, and shigella were really the focus of this research the last 20 years or so. And we learned that they have something called bacterial cytolethal distending toxin. Their weapon for, I guess, survival in combating our defenses against them.

Dr. Weitz:                            Right. And by the way, this is part of a category known as bacterial endotoxins. And bacteria often secrete this and then it creates damage. The endotoxin creates a bunch of damage.

Dr. Vojdani:                        Exactly. The other example of an endotoxin is lipooligosaccharide or LPS.

Dr. Weitz:                            Exactly.

Dr. Vojdani:                        We talk quite a bit in many disease. Right? And we’ve known about LPS for a really long time. I think learning about bacterial cytolethal distending toxin was something relatively new.  So several labs including Dr. Pimentel’s lab started doing animal models where they would infect the animals with campylobacter jejuni, one of the enteropathic bacteria, and would observe that after infection, they would develop IBS-D symptoms in that animal model. So they came up with this idea that maybe IBS, at least the D or mixed subtype has a post infectious process.  So, they continued to study that and learned that this toxin is way more powerful than we thought it was. It didn’t have just the ability to kill cells. If you think about the name cytolethal distending toxin it’s all about its ability to inject a toxin into a cell and destroy it. But we also learned that our immune response to the toxin begins or initiates an autoimmune cascade that progresses the inflammatory attack even without progressive insertion of the toxin in different cells.

So what does that mean? This bacteria is way smarter than we thought. And infecting an intestine with this bacteria results in symptoms for much longer than a typical disease you should have symptoms, you end up with symptoms for maybe the rest of your life. So that was really, really fascinating research, right? We started to understand that at least a subtype of IBS had this autoimmune mechanism. And that’s because when we … once that cytolethal distending toxin is injected into the epithelial cell, it starts attacking something called the adherence junctions which are basically the cytoskeletal network of our small bowel epithelium. In attacking that, you start releasing new antigens into the bloodstream including the toxin itself and by attacking either the proteins at the adherence junction or attacking the toxins through molecular mimicry, you start attacking adjacent cells that might not be infected with the toxin. And then, you get disruption of the adherence junction and essentially your small bowel epithelium can’t function that way it’s supposed to.  So you end up with a lot of these symptoms. And also the migrating motor complex or the enteric nervous system is disrupted in this model as well.

                                                Basically, Dr. Pimentel’s initial research was done in a really large trial. He looked at over 2,000 patients that had IBS subtype D based on Rome III criteria and found that the clinical utility of this test was very useful in separating people who might have diarrhea predominant IBS from IBD, from celiac disease, and from normal controls which is a very typical, difficult, clinical scenario when these people come in the door for the first time, right?

Dr. Weitz:                            Yes.

Dr. Vojdani:                        So his research validated the use of an antibody to essentially an IgG only antibody to the cytolethal distending toxin of campylobacter jejuni and then he also looked for IgG antibodies on the vinculin. Found them to have a sensitivity of close to 60% in patients with the D subtype. Somewhere lower than 50%, maybe 45% for the mixed type. And then, the constipation subtype is much lower, maybe 25%. So that was his initial data through his labs, research, and work on this antibody model.

Dr. Weitz:                            Yeah, it’s kind of ironic because you would think that decreased motility of the intestine would be more associated with constipation but I guess there’s not a strict correlation there.

Dr. Vojdani:                        Yeah. That’s the really interesting thing about his research. It really only looked like it was going to be valid. And in my opinion, the sensitivity of 60% is good but it’s not great and when you’re trying to develop a clinical marker for a disease, you really hope for much better than a 60% catch rate because you’re a little bit better than flipping a coin which is not fantastic.

Dr. Weitz:                            Right.

Dr. Vojdani:                        I think when my dad and I looked at that research and looked at that autoimmune model of this disease, one of the first things that caught our eye was that they’re testing IgG antibodies only in that test. And when you think about the way the immune system works, IgA is no doubt the dominant antibody of the mucosal immune system. So it makes sense that if there were going to be an antibody that were to be formed, IgA would likely to be the most common. IgM can happen in early autoimmune diseases as well. IGG tends to be more chronic and more systemic so it made sense to us that if you were going to detect this, you should look at least at IgA on top of IgG and why not look at IgM as well to try to increase your net of capture because depending on the number of years that that patient has been post infection or post exposure to cytolethal distending toxin, they might have any one of those three antibodies.

                                                So, that’s essentially what we did at Cyrex in developing Array 22 which is what we call generation two of that antibody testing. And in our validation data, essentially we looked at 24 patients, all different types of IBS, basically to serum of 24 patients who show up to a clinician’s office for the first time with IBS. It didn’t matter which subtype. We had a sensitivity of 21 out of 24 were positive. So that’s about 88% or 89%. So much, much higher than what Dr. Pimentel’s data suggests. And our controls in our control group, we only had a positive result in one out of the 24.  So our data looks a lot more promising. And I think when you think about the mechanism of this disease, the test makes a lot more sense.  https://www.joincyrex.com/the-cyrex-system/array-22-irritable-bowel-sibo-screen

Dr. Weitz:                            And so your test, as you just mentioned, would also be helpful in diagnosing patients who have IBS/SIBO, with methane, the constipation type.

Dr. Vojdani:                        Yeah, so the constipation subtype, I will say is likely … Let’s say those three patients out of the 24. I don’t have a breakdown as to their subtype but I would say it’s more likely that the constipation subtype is going to be negative on this test. That comes from my personal clinical experience using it in patients with constipation dominant. That being said, I still find that test to be positive in may 50-60% of those patients. And to me, it’s really, really valuable information because you’re not just learning what does the patient have and giving them a diagnosis and then taking you down treatment road.

                                                You’re also learning that if they have this subtype of this disease, an autoimmune subtype of this disease, that they’ve broken their oral tolerance. That their immune system has a major breakdown in the way that it’s supposed to function. And if you don’t do significant work to restore the oral tolerance in that patient, the patient will never get better. You can eliminate them with whatever protocol you want to. You can put them on any diet you want to for any period of time. One day down the road, they’re going to get the symptoms again because there’s nothing that is resetting where the error in physiology occurs for those patients.

Dr. Weitz:                            So how is it that you do that?

Dr. Vojdani:                        Restoring oral tolerance is really challenging. And I just came back … We were just talking before we started the podcast about the annual conference for IFM in Hollywood, Florida which was last week. I just came back. And a very big push at this conference was research designed to do whatever we can to restore oral tolerance. And you have to understand that oral tolerance is something that begins and develops very early in life. This is where our thymus sends out lymphocytes to survey what’s in our body and deciding which of those lymphocytes to eliminate as they might be autoreactive. So that’s essentially what oral tolerance is so that you don’t … you also don’t attack the foods that you eat. You don’t attack your own tissue. And that you don’t have the set of autoimmunity.

                                                Restoring that process, takes a very significant period of time because it takes a very long time to break oral tolerance. But we’re finding that there are a lot of things that we commonly use that really help restore oral tolerance and restore to regulatory cell function which is what we’re trying to do. So high doses of vitamin A. High doses of vitamin D. Vitamin K. Probiotics do this. And then, there’s a lot of really fascinating research being done into the use of helminths as a mechanism to restore oral tolerance or at least to accelerate that.

Dr. Weitz:                            And by the way, helminths are worms which are being used therapeutically though not yet approved by the FDA here.

Dr. Vojdani:                        Yeah. Most of the research has been done on whipworms but Dr. Sidney Baker has been using a different type of helminth which is taken from the rat/beetle model which is much, much smaller than whipworms and their lifecycle is much less dependent on an animal that’s similar to us. So it seems like people are having less side effects from it.

                                                And then, of course, there’s a lot of work being done into how do we restore secretory IGA function. Maybe disrupt bio films. Doing whatever we can to reduce the inflammatory attack that’s going on within the immune system so that you give the immune system a breather and a chance to take a break from all the inflammatory insults and reset its oral tolerance essentially.

Dr. Weitz:                            Now in terms of treating SIBO, you didn’t mention anything about antimicrobials or antibiotics to get rid of the bacteria. Is that part of what you do as well?

Dr. Vojdani:                        Yeah, so I think antimicrobials whether they’re pharmaceutical or herbal certainly play a tremendous role in eradicating SIBO patients. I’ll tell you my clinical experience. I get patients who have been eradicated once, twice, three times, four times, are getting the issues with the recurrence and then they come into my office which might just be because I’m my dad’s son and there’s a reputation for seeing some complex cases but those are my typical SIBO patients. So really what we try and do in those patients is understand what is continuing to propagate the inflammatory insults. In most cases, the organism that is secreting the bacterial cytolethal distending toxin is long gone. If someone has C-Diff of campylobacter or shigella or e-coli. They tend to know about it.

                                                But it’s really more about understanding do they have leaky gut associated with their SIBO/IBS? Are there significant food immune reactions that are contributing to their inflammatory insults centered in their small intestine preventing the healing? Do they might have other GI organisms that are chronic stealth in nature. Things like giardia, other pathogens that are there that are contributing to this.  I tend to look at what other factors … thinking about this as an auto-immunologist, what other factors are contributing to this inflammatory insult against the gut? Why does the patient keep having recurrences? What can we do to restore the immune function and the physiologic function centered within the gut so that these recurrences don’t keep happening. That being said, medications are certainly very helpful for these patients at least to give them some symptomatic relief while they’re doing that work.

Dr. Weitz:                            Have you looked into low dose immunotherapy?

Dr. Vojdani:                        Yeah. Low dose immunotherapy, I think, is very, very promising. Particularly there are a lot of practitioners that are doing this. I don’t know for sure that every person is going to respond to it but I think it’s going to be very immune dependent. If you are really in the depths of the fires of a TH1 driven inflammatory autoimmune response, low dose immunotherapy has the potential to make your symptoms worse just because the immune system is so revved up that you can’t reset oral tolerance there. But I think it’s a very promising therapy.

Dr. Weitz:                            And I think using your test could actually enhance that particular therapy because once you determine which particular bacterial organism it is, you could design the low dose immunotherapy for the campylobacter or the particular bacteria and potentially get their body, their immune system, to be tolerant of it.

Dr. Vojdani:                        Absolutely. And leaky gut, because of the nature of the relationship between the adherence junctions and the tight junctions, if the adherence junctions are broken, the tight junctions are almost bound to break as well. So the symptoms that we see happening in IBS/SIBO where we have multiple immune reactions likely come from that breakdown of the tight junction.  So if you have the breakdown of the tight junctions, you end up with food immune reactions to numerous foods and maybe foods that are on the low FOD map diet or whatever diet you want to put them on. And you end up in this conundrum where you put someone on this diet because you want to help them with the symptomatic relief related to SIBO and it will do that but you’re still propagating an immune reaction to the gut because they’re being continuously supplied with an antigen in high levels that their immune system is reacting to.  So that’s where those two things become complimentary and that information is extremely useful, I think, in that situation.

Dr. Weitz:                            Now are you … do you feel that your antibody test should take the place of the breath test or should be used in conjunction with it?

Dr. Vojdani:                        I don’t have a very strong opinion one way or the other about the use of breath testing. I think the focus of our work and research was in Functional Medicine we really try to understand root causes. From a cellular level, where are the physiologic breakdowns occurring? So I think what really appealed to us about this initial research and even more so when we did our own research and our own validation in expanding the antibody testing and looking at this autoimmune mechanism more was that you’re really understanding at a cellular level where the disease is propagating. Right? And to me, that’s much more powerful in trying to help this person not have a recurrence five years from when they walk in your door which seems to be a really ongoing problem.

Dr. Weitz:                            Sure. I totally understand that. But from the small intestinal bacterial overgrowth world, there are sets of paradigms that I know I and other practitioners have been working with so there’s a set of paradigms that seems to work better methane SIBO versus hydrogen SIBO and Pimentel’s about to come out with a new hydrogen sulfite SIBO which and if people already have a whole different set of protocols. So that’s the only issue I have with doing your test is which … It would be nice to also know if it’s methane or hydrogen to utilize some of these protocols that we’ve found a certain amount of efficacy with.

Dr. Vojdani:                        Yeah, listen every practitioner when it comes into the SIBO world has their own unique way of doing things and I think that’s totally appropriate because every individual that walks in our door is going to be a different version of the disease from the next one that walks in the door. It’s just the way human beings work. And whatever tools you have at your disposal that are getting you results, I’m all for it. I have no issue with that.

Dr. Weitz:                            Yeah. No, I’m just thinking that I would still probably be inclined to want to do both testing.

Dr. Vojdani:                        I can see the rationale for that, sure.

Dr. Weitz:                            Yeah, yeah, yeah. So do you currently treat a lot of patients with IBS and SIBO?

Dr. Vojdani:                        I do. I do. Yeah. And as I mentioned, I tend to get the patients that …

Dr. Weitz:                            Are tough cases. Yeah. All different therapies.

Dr. Vojdani:                        There are some good cases going on in the SIBO world in that more of my western colleagues are becoming fluent in some fashion to the idea that SIBO exists. And they’re ordering breath testing and maybe doing Rifaximin therapy with patients. So a lot of that initial work is being done out there and I’m sure many patients get very significant symptomatic relief from that initial eradication and don’t need further eradication. But I tend to see the patients that have been eradicated a couple of times and are looking for some more complex answers.

Dr. Weitz:                            Right. Typically, we think of things like well, you’ve killed the bacteria but you haven’t reset the migrating motor complex. So now you need to give them some agents that could reset the migrating motor complex whether that be nutritional or there’s medications and then, sometimes we think well, you haven’t broken up the biofilm. So in addition to doing the antimicrobials, you’ve got to give biofilm agents or you have to do a phase two and rebuild the intestinal wall. And use probiotics and prebiotics and glutamine and things like that.

Dr. Vojdani:                        Yeah. I think our protocols for SIBO are getting much more complicated these days for a very good reason because it’s a very complicated disease process. Again, I really think of myself as an auto-immunologist so I tend to focus on where the disruption in the immune system is because people who have damaged their enterovenous system and migrating motor complex, if that happens because of exposure to cytolethal distending toxin, and maybe you form antibodies to vinculin, which is part of the adherence junction, those antibodies cross react with your enteric nerve.

                                                So you can give them all the 5HTP, ginger, B6, you want and that might help them get through the current symptoms but if you’re not working on stopping B cells from producing antibodies, they’re going to attack the enteric nervous system, what’s the point?

Dr. Weitz:                            Yeah, good point. It’s interesting. I could just imagine some pharmaceutical researcher out there right now where there is some very expensive drugs that are typically used for inflammatory bowel disorders. Drugs that cost thousands and thousands of dollars a year and basically are just prescribed for the rest of your life. And I could just see them salivating right now because if IBS is now an autoimmune disease and they could start selling those immune blocking drugs now to not just patients with Crohn’s and ulcerative colitis, but to everybody with IBS. Wow.

Dr. Vojdani:                        No doubt about it. I think they’re salivating for sure because we know that the epidemic of autoimmune disease in general is blowing up, right?  But we’re also starting to discover that so many more diseases at least have an autoimmune component like we were just talking about ankylosed and spondylitis at the conference now understanding that there are target auto-antibodies for ankylosing spondylitis.

                                                So we always knew that was an inflammatory disorder but we never understood that that was an autoimmune disorder. That’s one. We just published one, my dad and I, alone with [inaudible 00:39:40] and published the first of three articles in relationship to Alzheimer’s Disease. It’s in just the recently published June volume of the Journal of Alzheimer’s Disease. It really looks like we’re going to start thinking of Alzheimer’s Disease as an autoimmune disease in the near future too. The implications of that to the pharmaceutical world, I think, are probably huge. But thankfully, you and I are functional medicine doctors and we treat things in very effective and more natural means because when you start modulating entire branches of the immune system, you end up with very significant issues down the road.

Dr. Weitz:                            Right. Essentially what you’re saying is that we’re trying to reset the immune system. We’re trying to balance it. we’re trying to help re-regulate it. Whereas, the pharmaceutical approach basically is bringing down a hammer on your immune system. Just block a big chunk of your immune system. And of course it doesn’t work.

Dr. Vojdani:                        Because you might get some symptomatic relief, but your immune system is also responsible for surveying which cells in your body are starting to make genetic changes that are going to predispose them to becoming cancer in the future. So you take a whole arm of your immune system out and you reduce its ability to stop you from having cancer in the future.

Dr. Weitz:                            Right. Which is why the Functional Medicine approach in the long run is going to end up winning out.

Dr. Vojdani:                        No doubt about it. So you and I are on the right team.

Dr. Weitz:                            I’m happy about that, Elroy. Well, thank you so much for joining me today for patients and/or practitioners who would like to get hold of you, what’s the best way for them to contact you?

Dr. Vojdani:                        So our website is regeneramedical.com. R-E-G-E-N-E-R-A Medical, one word. You can reach our clinic at 424-256-0272.

Dr. Weitz:                            And you’re available to treat patients in person and also by …

Dr. Vojdani:                        Yes, we are accepting patients currently. Our office is in Brentwood right on Wilshire and West Gate. Just get in touch with us. Happy to answer any questions.

Dr. Weitz:                            Sounds good. Excellent, Elroy. Talk to you soon.

Dr. Vojdani:                        Thanks, Ben. Have a good one.

Migraine Headaches with Erin Knight: Rational Wellness Podcast 061

Erin Knight speaks about how to cure migraine headaches 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

3:50  I asked Erin what are some of the more common triggers for migraine headaches?  Her answer is that some of the more common triggers are weather changes, hormones, and food triggers, but she feels that the key to treating migraines is not to focus so much on the triggers, which can change, but to look at the body’s capacity to manage stress, which includes biomechanical stress, mental/emotional stress, and chemical and biological stress.  Figure out how you can reduce your body’s stress load and heal, so you become less sensitive to triggers. We used the barrel or bathtub analogy that the immune is filled to the top and tends to react to lots of things, but if you can pour out some of the barrel, then it won’t be spilling over the top so often and causing symptoms.

6:40  Erin discussed how gut problems can be a factor leading to migraines. They can help to fill up the barrel. Leaky gut can lead to more toxins. Gut problems can lead to nutrient deficiencies. She likes to use the GI Map stool test.

9:41  Erin explained that the most common finding she sees on the GI Map test is elevated H pylori infections, which she addresses with mastic gum supplements and saccromyces boulardi probiotics.   

13:32  Food sensitivities can be an underlying cause of migraines and she likes to do the ALCAT food sensitivity panel.  Almost all of her patients do better when they eliminate gluten for at least three months.

19:01  Hormonal migraines are very common and she does the DUTCH (Dried Urine) test to analyse hormonal status. 

23:58  Chiropractic can address some of the structural issues. Erin explained that there are three prongs to her approach to migraines: 1. mental/emotional stress, 2. biomechanical stress, which can be addressed with chiropractic, and 3. chemical/biochemical stress. Chiropractic can also help if they are under chronic emotional stress by relieving the tension in the muscles. Erin found that chiropractic worked, but she kept having to go back for adjustments weekly till she looked deeper and addressed problems with her gut, with heavy metals, and with liver detoxification and then she was able to hold her adjustments much longer and was able to just go in monthly or unless she fell off her bike.

25:40  What is the ideal diet for migraines? Erin said that she likes her clients to eat whole, organic foods with a lot of vegetables but not to get too stressed out over an overly complicated diet. 

27:33  Should we skip breakfast, which is how many people are now practicing intermittent fasting?  Erin explained that if you are having problems with blood sugar fluctuations, then skipping meals may not be such a good thing. She sees clients who are too busy at work to each lunch and they end up getting a headache from the roller coaster of their blood sugar crashing.

30:20  Magnesium is a very important supplement for migraine patients, since it can help with muscle spasm, sleep and constipation.  Erin prefers to do Micronutrient testing to see what people really need the most.  Test, don’t guess. 

34:23  For those who are looking for the quick fixes for migraines, Erin offers her Quick Fix Checklist for Migraines  Erin can be reached through her website, Engineering Radiance.com

 



Erin Knight is the founder of Engineering Radiance, believes that no one should miss out on life because of migraine headaches. Erin has her Masters in Pharmaceutical Engineering from the University of Michigan and advanced training in functional nutrition and nutrigenomics. Her website is https://www.engineeringradiance.com/  You can get her free Migraine Relief Checklist to help you with migraines https://www.engineeringradiance.com/migraine-relief-checklist/

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 Doctor Ben Weitz with the Rational Wellness Podcast, bringing you the cutting-edge information on health and nutrition, from the latest scientific research and by interviewing the top experts in the field. Please subscribe to the Rational Wellness Podcast on iTunes and YouTube, 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 the 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. Our topic for today is migraine headaches. This is the first time we’ve talked about headaches in a very common ailment among Americans. Migraines are occurring at the rate of more than three million cases per year in the United States, perhaps more that are undiagnosed. Migraines are typically severe, recurring headaches, usually felt on one side of the head. They’re frequently accompanied by nausea, vomiting, dizziness, sensitivity to light, sensitivity to sounds, and/or sensitivities to smell. A lot of times, there will also be a lack of appetite, and there may be a change of bowel function.

Up to 30% of migraine sufferers experience an aura ahead of time, letting them know that a migraine is coming. An aura is typically a visible, or a sensory, disturbance, such as blurred vision, seeing flickers, or flashes of light, or lights that distort your vision, or wavy or a zigzag vision. There could be pins and needles feeling on one side of the face or one side of the body. You may feel like things are spinning. It’s generally not understood what causes migraines, or how to prevent them. And for traditional medical practitioners, they’re generally treated with pain medication once they start.

However, from a Functional Medicine perspective, we always want to try to find the root causes of problems, and migraines are no different. Which means that we want to find the triggers that will increase the likelihood of a migraine occurring, which usually means that we look for food sensitivities, nutritional deficiencies, heavy metals and other toxins, hormonal imbalances, blood sugar imbalances, et cetera. And these are similar to a set of things that we look at for many different conditions, trying to find those underlying root causes and triggers.

I’m happy that we have Erin Knight here with us today to help sort some of these issues out with migraines. She’s the founder of Engineering Radiance. She believes that no one should miss out on life because of migraine headaches. She has a master’s in pharmaceutical engineering from the University of Michigan, and advanced training in functional nutrition and nutrigenomics.    Erin suffered from debilitating migraines for over a decade before uncovering the underlying biochemical causes. And she went on to reverse engineer what worked for her. This led to the development of her four-step migraine freedom process that’s now a blueprint for thousands of people looking for root cause solutions to their migraine pain. Erin, thank you so much for joining me today.

Erin Knight:       Thank you. It’s an honor.

Dr. Weitz:          Okay. So, Erin, let’s get right to the issue. What do you think are some of the more common triggers for migraine headaches?

Erin Knight:       The things that people are most aware of tend to be things like weather changes, or hormonal migraines, and even food triggers. But, from a more holistic, functional perspective, the way I see it is that your body’s … has a certain capacity for managing stress. The stress can come from … biomechanical stress, mental/emotional stress, and then of course, chemical and biological stress. And if that starts to pile on, then it’s set off by one little thing that just is … the straw that broke the camel’s back, as they say.

Triggers can seem kind of random and frustrating to even track. So, one day somebody might be … just cannot do chocolate. Chocolate puts them over the edge and puts them to bed for a few days. And then, other times, maybe at a different time of the month or a different time in the year, they’re totally fine, and that just tends to make you feel a little crazy if you’re trying to really figure out what your triggers are and just avoid them all of the time.  And if you look at it, instead of the sense of, okay, your body’s under a certain stress load, let’s lower that stress load and then build more resilience to those kinds of things, like weather change or jet lag, that we don’t have as much control over. Then, you can go around life being less sensitive to all those kind of common triggers and the things that people tend to be sensitive to. So, that’s how I work, and what I try to educate people on is really shifting their perspective instead of … chasing triggers or running away from triggers, just help your body heal and be stronger in general, and then you’ll be less sensitive to migraines.

Dr. Weitz:          Sure. I’m sure you’ve probably heard of the barrel metaphor, which is that your immune system is this barrel, and when it’s filled up to the top, any little thing will cause it to spill over, so you empty out part of the bucket by removing different things that stimulate the immune system, and then your body has enough room if there is a trigger or something that stimulates it, so it doesn’t necessarily enter into the point where you have symptoms.

Erin Knight:       Yeah. That’s exactly it. And you mentioned … on the intro that the things that we help people with with migraines are really similar to the same things people would do if they had eczema, or autoimmune issues, or aches and pains and things like that, because really, it’s the same concept. The migraines are just the way that somebody who’s prone to migraines, our body expresses the fact that it’s overburdened and at its limit by having the migraine. Other people’s bodies are just genetically set up to express that through a different route.

Dr. Weitz:          Right. In some of your writings, you mention that digestive issues can be one of the root causes of migraines. Not a surprise from the Functional Medicine perspective. How do you assess and test the digestive system?

Erin Knight:       Any digestive issues will make migraines worse, because they’re filling up that barrel … I call it a bathtub full of stress, in a big way they can impede digestion and absorption, so you end up with nutrient deficiencies. They can be adding to the toxic burden that your liver has to process. If you have a parasite, and its metabolism is producing extra toxins that your body just has to process. And then, on top of that, the different digestive issues can just increase overall gut inflammation, systemic inflammation. So, any … lot of different ways that can go wrong and be a contributor, and we look at that … My favorite test at the moment is called the GI Map. It’s very comprehensive, and we can get markers on people’s enzyme status, how well they’re breaking down their food, gut inflammation, as well as looking for different bacterial balance, or infections, like H pylori, or parasites and things like that.  So, it’s a lot of information and a lot of starting points. I haven’t found anyone yet that didn’t have something to work on. If somebody’s not feeling well, then they probably can trace it back to the gut, and that’s a good place to start for any investigation. We really recommend that. Everybody does that.

Dr. Weitz:          We’ve been using that test a lot lately, also. And I interviewed Dr. David Brady [who helped create the GI Map test] about a month ago, and we discussed some of the parameters involved in designing that test, so I find that very helpful. What about SIBO? Do you find SIBO as an underlying factor in some migraines?

Erin Knight:       Some, yes. Not as much. Just more like, if we’re not getting anywhere, or if somebody has obvious bloating issues or obvious symptoms, then we would talk about that. But, not necessarily the first thing to look at. But, gut health is a interestingly … it’s kind of a vicious cycle with migraines, because it may or may not have been the initial trigger, but if somebody’s had migraines for years or even decades, they might have been put on birth control to manage hormonal migraines, or they’re taking lots of lots Ibuprofen, like I did, and both of those are really destructive to our gut integrity and gut health, and it sets us up for more gut problems because we don’t have the same strong mucosal barrier, and healthy gut balance and things like that, that somebody should have, so then we’re more prone to getting infections, too.

I don’t think in conventional medicine, gut health is addressed very much for migraines. It may not be acknowledged, but it’s definitely our starting point. And what helps people realize that there’s more to the story, and that they have some room to heal.

Dr. Weitz:          So, why don’t you give me a few examples of a few recent patients that you’ve worked with with migraine headaches, and you did the GI map, and what did you find and how did you address it?

Erin Knight:       H pylori is pretty common. Like, maybe 50% of people will have that, and that impedes your digestion of your food, so it can lead to nutrient deficiencies and things like that. So, sometimes people with migraines are aware that they might be deficient in B vitamins, or magnesium, or this and that. But to backtrack, where do those deficiencies come from? If you have an overgrowth … So, H pylori is pretty common, and people argue whether it’s normal or not, but if it’s an active overgrowth, then it’s going to be eating … feeding on your stomach acid, if you will, and reducing that stomach acid’s availability to then digest your food, so that’s how it can impact that. And people always have the choice to take that information and go to their GI doctor, primary doctor, or we can talk with them about an herbal protocol to address that.

Dr. Weitz:          What kind of herbal protocol? Would you mind telling us?

Erin Knight:       So, kind of a first line of defense is I like to use mastic gum, and try to heal up the gut. Or sorry, the stomach mucosal barrier and things like that, and then also use probiotics like Saccharomyces boulardii, and things like that, at the same time. And then, if somebody’s not getting better, which happens occasionally, then sometimes the H pylori could be linked to heavy metals. So, we have to look a little bit deeper. If somebody’s had some dental work, or some kind of known exposure, or genetic impairment to their detox pathways and things like that, and that … if somebody’s fighting this H pylori, and it’s not getting better, not getting better, then we look … layer two. Or three or four, would be a detoxification and see what’s going on there.

Dr. Weitz:          How will you assess for heavy metals if you suspect them?

Erin Knight:       So, it’s not the first thing that I would do with somebody, but sometimes you do see … there are kind of obvious things, where somebody had got dramatically worse. Or even, their migraines just started a few months after having dental work. Or sometimes having their amalgam fillings removed, and then you’re like, hmm, we should talk about this.  But, before even testing, ’cause there’s so many different ways to test, and none of them are really considered perfect, and then when you find that information, what are you gonna do about it? So, my first line of defense with really anybody is just work on gentle detoxification, and opening up the natural pathways, and supporting the body. That could be … There’s a whole lot of things. This is a core part of our program that we work on with people, but things like moving their limbs, making sure their bowel movements are regular, sweating, dry skin brushing, so you have to pay attention to our largest organ, which is the skin. Taking binders, correcting mineral deficiencies. So, there are a lot of things you can do to just help the body work better, basically, and do its own job better. I would rather do that than do some harsh, actively detoxification protocol.  If somebody’s not responding, we have to look at that, then we can do … provoked urine test, or a hair test, and find something out. If somebody does have a really major issue, then I would connect them with a heavy metal specialist, because it can get pretty tricky to do that safely.

Dr. Weitz:          Okay, cool. You say that food sensitivities can be triggers for migraines, and we’ve heard that certainly before. What types of food sensitivities do you find most commonly, and how do you test or screen for these?

Erin Knight:       So, somebody’s listening right now and they have migraines, are probably more than aware of the migraine trigger food list. Like, processed meats, chocolate, red wine and those kind of things, and that’s not really what I’m talking about. They might actually find that they feel better if they avoid some of those foods, and some of them are just downright unhealthy, like MSG and things like that. They should probably all avoid MSG, but when I’m talking about food sensitivities, I’m talking about undigested proteins that are entering your bloodstream through your gut when they really should not, and then they create an immune response, ’cause your body’s like, “You don’t belong here. We’re gonna react to you.”

So, this wouldn’t normally happen because the gut is designed to really just absorb the smallest molecules and keep out larger ones, but if it’s been damaged by pesticides, by stress, or medications over years and years, then somebody’s gonna be more prone to this type of food sensitivity issue, and they could be getting chronic inflammation from reactions to even healthy foods, like chicken or broccoli, and things that aren’t on the typical migraine trigger list.  And this is especially helpful, I think, if somebody has several migraines a week, or even daily headaches. Because that just means your body’s super inflamed, and we want to do anything that we can to lower it. Wouldn’t do it with everybody, but if somebody’s really chronic like that, then we could discuss and see if they think it would be something that they could integrate and actually make use of. It’s a blood test, so it’s quick and easy to find out what’s going on, and all it requires is somebody change up their diet for a few months. So, sometimes people have some hesitation around testing ’cause they think that they’re gonna get this life sentence where they can’t eat their favorite foods and things like that, which it’s not what it is. It’s just trying to lower the inflammation and let your body heal.

Dr. Weitz:          So, which food sensitivity panel do you like to use?

Erin Knight:       I like the ALCAT test. Sometimes a LEAP MRT, depending on what people have access to.

Dr. Weitz:          Okay. I was just reading about two classifications of diabetes drugs, and they actually work by blocking certain enzymes to keep your body from absorbing carbohydrates. And one of those enzymes is the enzyme that allows you to digest gluten. So, we actually have patients who are gonna have an increased risk of gluten sensitivity as a result of taking one of the new classifications of diabetes medications. So, we talked about medications that can mess things up, but that’s just another example.

Erin Knight:       Yeah. Since you mentioned gluten, a lot of people do feel better if they avoid gluten and dairy. You can do some testing for that, if you need to see it on paper, or you can just try it for a few months and see if you feel better. I know sometimes people don’t want to hear that, ’cause it’s a major lifestyle factor. But, I don’t think anyone died from not eating pasta for three months, so it’s worth a shot and see if it helps calm that inflammation and you feel better.

Dr. Weitz:         What percentage of patients… what just happened?  Little bit of a technical glitch. There we go. Okay. Okay.

                          Okay, good. You can hear me now?

Erin Knight:       I can hear you now.

Dr. Weitz:          What percentage of your patients do you think do better when they avoid gluten?

Erin Knight:       Almost everyone. We do get a small indicator of that on the GI map, which can be motivating for people that have some hesitation to try it. But then, once they do, if they stick to it, they … that’ll be one of the top things that really helps them, and then that they end up sticking with because they found that it was a game changer.  So, one thing that can go wrong there though is, some people think that, “Oh, I’m just gonna reduce gluten.” So, they’ll just have less. Or maybe just have it once a week or something like that. That is pretty much pointless, because the gluten is so irritating for people that are sensitive to it that it takes weeks if not months to recover from one tiny exposure. So, if you’re gonna do it, give it a real shot. Give it a real shot at working to know if it’s gonna work for you or not. And then, you can always try later, if you don’t believe me. You can try it in three months and see how you’re doing. But, if you have never given it a 100% effort and 100% elimination, then you don’t know if it’s gonna help or not.

Dr. Weitz:          You wrote that hormones can be out of balance, and that this can be a factor in migraines. What types of hormones do you typically see as being a factor of migraines, and how do you assess and treat these?

Erin Knight:       Right. So, hormonal migraines are very common, and this is one of the things that people tend to be really aware of. They’ll know, for example, that their migraines are correlating with their cycle, or that their migraines either got better or worse during pregnancy. But then, I’ll hear some crazy things like, “Well, they’ll get better eventually, when I get menopause.” Or, people go then to try to suppress all their hormones with birth control and things like that as a solution. But, I really hope to convey and let people know that there’s more that you can actually do.

What a common imbalance would be, and probably the most common, is estrogen dominance, which can either be too much estrogen or just relatively more estrogen than progesterone. So, low progesterone, which can be low from chronic stress and things like that.  So, we can look at that really easily with at-home urine test called the DUTCH test. It’s a dried urine test that lets us look at, in a lot of detail, how your estrogens and other hormones are metabolized and processed through the body. So, we can see if it’s phase one liver detoxification that’s going wrong, or phase two. The methylation problems, and all this kind of things, can help us figure out, then, how to support the body’s natural hormone balance. Like supporting the liver, or looking more heavy metals and things like that, instead of just trying to tune, and play around, or fix your hormones with hormone replacement or birth control and things like that. We can actually figure out why they were off in the first place. And this can be something have been dealing with their entire lives, and they didn’t even know it was an option. So, I really … I’m excited to talk about the DUTCH test and all the information you can get.  Is that something that you guys use also?

Dr. Weitz:         You know, I haven’t. I’ve been mostly testing hormones either with blood, or 24-hour urine, and done a little bit of saliva. I haven’t done the DUTCH test. But you’re really happy with the results you’re getting?

Erin Knight:      Yeah. You can really … you can really get in there. I’ll show you sometime, if you want to look at an example, and it’s fascinating also, the things that I would have missed on a saliva test that I find out on the dried urine test. It’s really been around for a few years, I think. As things evolve, we’re able to help people be even more specific with their protocols, and more holistic with this testing.

Dr. Weitz:         Right. I know other urine testing, you can get the metabolites, you can tell about the estrogen metabolism, which is really important. And then, because you can easily get different measurements at different times of the day, maybe it tells you about some of the fluctuations that occur?

Erin Knight:      Yeah. The measurements throughout the day are especially helpful for the stress hormones, like cortisol and cortisone. Which, in functional training, that’s one of the core topics, ’cause we say, everybody has this stress hormone issue. But, not as much for migraine people. That’s not the most common thing that I see people dealing with. Occasionally, some adrenal issues or what have you, but mostly it’s more in the sex hormones.

Dr. Weitz:         And what is the issue that you see most commonly with migraines and sex hormones?

Erin Knight:      There’ll be clues that … For example, if the estrogens aren’t clearing well, then we have to question why. And, if the liver’s busy detoxifying other things in our environmental pollution.   Or toxins and toxic products in the household, or beauty products, or whatever else. Or, from parasites. Then, it’s not as capable of processing the estrogens correctly. Or even alcohol can slow down that process, ’cause you’re body’s like, oh, I’m always gonna prioritize the alcohol, and it puts estrogen on the back burner. So, it can help bring to the forefront the importance of cleaning up some of those common-sense things. But, once you see it in front of you, how it’s affecting you, how this plays a role even in cell health. Long-term avoiding cancer and things like this. So, I test myself regularly, even though I’m not getting migraines anymore, just because I want to have that all working and balanced, just give myself the best chance for healthy aging. Avoiding problems and having a smooth transition as my hormones change over the years and things like that. So, I think being proactive, it’s a good thing to take a look at.

Dr. Weitz:         Interesting. As a chiropractor, we’ve treated plenty of patients with migraines. Some with great success, and others not quite as much. And we’re using a structural approach. We’re particularly focusing on the joints in the upper part of the neck, and those suboccipital muscles that connect directly to the dura mater, and have you found structural issues to be a factor in migraine patients?

Erin Knight:      Of course. That’s one of the three prongs, if you will. There’s mental/emotional stress, biomechanical stress, and then this chemical/biochemical stress. So, by the time somebody comes and talks to me, they’ve probably already seen a chiropractor, but if they haven’t, then I highly encourage that they go see one. And it can be a great tool to either fix them completely, if it was maybe some kind of a structural issue to begin with, or car accident, or whatever else. Or, a relief, too. If somebody’s under this kind of chronic stress, then you can be out of alignment more often, which is my experience. I found that chiropractic helped a lot. But, I have to go regularly. I would go every month for probably close to 10 years. And my chiropractors would get frustrated with me, and then the insurance just stopped paying, and they’re like, “Why don’t you get any better?”  And it wasn’t until that I really looked deeper in the gut health, and supporting my liver, and getting rid of heavy metals and things like that, that I was able to hold alignment for months, or just go in occasionally for maintenance or if I fell off my bike or something like that. Which I think is how it’s intended to work. I mean, you tell me, is that … That’s kind of the goal of chiropractic, right? Is to get somebody where they can hold an alignment for a few months.

Dr. Weitz:         For sure. What do you consider the best, most healthy diet? I don’t know if there’s an ideal anti-migraine diet. But, what do you consider in the range of all these healthy diets out there, or is it depend on each person? I’m sure it’s gonna be some variance, but … among the healthy diets, do you tend to promote a vegetarian diet, or a Paleo, or a ketogenic, or what?

Erin Knight:      Well, I’m glad you asked that. ‘Cause there’s a lot of arguing back and forth about different diet philosophies, but it really doesn’t need to be that complicated, in my opinion. I think the best thing is just to go really simple. Eat whole foods, eat organic with lots of veggies. Like, veggies in the forefront and then whatever else you add. And sometimes people, especially it seems like people with chronic problems like migraines are desperate, so they go reading on the internet, and go finding healthiest complicated detailed diets, and that causes them more stress than I think it even helps. Like sure, some of them can be really healing in some sense, but if it’s causing you so much stress on a daily basis, you’re gonna have to weigh that.

And it doesn’t have to be that complicated, because a really healthy diet can be simple and delicious. So, that’s my philosophy, as some people need more fat, some people need more protein and all that kind of thing, is a little bit individual in what we work with people on, is to really tune in to how they’re feeling with different ratios. Even different timing of meals and things like that, and starting to listen to clues like your energy level. Not just headaches, but your energy level, your sleep, your focus at work, how your stomach feels, and once you start to really listen to that, I think it … will give you the motivation and the feedback to find what works for you.

Dr. Weitz:         What about the timing of meals?

Erin Knight:      Yeah. What about it?

Dr. Weitz:         I don’t know. We’re hearing so much these days about the timing of meals. You know, we went from you should eat every three hours, you have to eat as soon as you get up. The most important thing, you have to eat breakfast. Everybody skips breakfast. And now, we’re back to skipping breakfast is the best thing you can do. So, what about the timing of meals?

Erin Knight:      I do find that kind of entertaining, because … I wonder if … I’ve done that a little bit more recently, and I’m like, why?

Dr. Weitz:         30 years ago.

Erin Knight:      I save so much time.

Dr. Weitz:         When I first got into this, you have to eat breakfast. That’s why you’re fat, you’re skipping breakfast. Now, the key to anti-aging is skipping breakfast.

Erin Knight:      I know, and it saves you hours a day, and increases your productivity ’cause you don’t waste time making breakfast. But, in seriousness, I talk to people first and see … ‘Cause there’s a big portion of people who find that blood sugar crashing will cause their migraines. And if they’re in that cycle of unstable blood sugar, and we’re trying to heal some of the reasons for that, which again, go back to your liver, and hormones, and stress and all that stuff. So, if they’re still in that healing phase where all that’s unsteady, then I wouldn’t really push to skip meals, because I would rather just get it under control.

What I do see as an even more common a problem is people are so busy with work, they forget to each lunch. I used to do that. You’re so busy, you forget to eat lunch. You’re working at your desk, or in the lab, and then it’s like three o’clock, and all of a sudden it’s … that just brings on the headache freight train. So, kind of being conscious of taking care of yourself is layer one. And if you’ve got everything under control, you want to go to phase two and look into intermittent fasting or all these more advanced things, then go for it. We can talk about that. But I think layer one is just making sure somebody’s getting the nutrients that they need out of whole, healthy foods, and avoiding that roller coaster of … blood sugar crashing, which it sounds so simple to people, probably, that are living in this health bubble, but I still talk to people too that think having a granola bar or a banana as a snack is a good idea, but the fact is, something like that could really spike your sugar for a little bit, and then it will crash again. So, we spend more time talking to people about having well-balanced snacks with fat and protein, or even a mini meal instead of worrying about whether or not they should try intermittent fasting. That’s later. Let’s worry about the basics first, in almost every case.

Dr. Weitz:         So, what are your three or five favorite supplements for migraine headaches?

Erin Knight:      Magnesium is a big one. Sometimes, I have people write me. They write about magnesium, or heard me talk about that, and they’re fine now. So, they just wrote in for my newsletter, and they’re like, “Well, I followed your advice, and now I don’t have migraines anymore.” I’m like, that is so fantastic that it was so simple.

Dr. Weitz:         That’s great.

Erin Knight:      It’s really bad for business, but it’s really good for you. So, that’s probably number one.

Dr. Weitz:         I can say, not too many of my functional medicine patients come in, I give them magnesium, they say, “I’m all better,” and that’s it. I wish it was that easy.

Erin Knight:      But, yeah. Yeah, definitely not always, but sometimes it is. And the thing is, we’re just chronically deficient, and it solves a lot of issues with muscle tension, sleep, and helps people sometimes if they’re constipated, which leads to this toxic stuff circulating in your body. So, it helps with a lot of different things, and a lot of the different root causes.  After that, I would just tell somebody to … Sorry to do more testing, but I would tell somebody to test, don’t guess. Because otherwise, you can waste a lot of money on different supplements and trial and error to find something that’s working for you, and the stuff that works for quote-unquote “all migraine people,” like B vitamins and things like that … When I look at people’s SpectraCell Micronutrient reports, they will have … everybody has a different pattern. And I don’t think it’s … I think it’s kind of a waste of time to try to throw supplements at the problem, instead of figuring out what they are.

Dr. Weitz:         So, you prefer SpectraCell Micronutrient versus Genova NutrEval?

Erin Knight:      That’s good, too. It depends where somebody lives. ‘Cause the SpectraCell’s only in the US, as far as I know.

Dr. Weitz:         Oh.

Erin Knight:      In Australia and stuff like that, then the NutrEval. But, I think that one is a little pricier.

Dr. Weitz:         It depends.

Erin Knight:      Yeah.

Dr. Weitz:         If they have insurance that qualifies, it’s about 200 bucks.

Erin Knight:      Okay. Yeah. But, anyway, the point is just to look at your nutrient status, and then you can fill that gaps, ’cause … CoQ 10 is another example that’s recommended a lot of times, and can be very effective for people. But, the amount I test and find that you’re not deficient in that at all, then you can save your money that you were gonna spend on that and work on something else instead.

Dr. Weitz:         There you go. Okay. I think those are the questions that I had prepared. Do you have any other pearls of wisdom for migraine headache sufferers? Or for practitioners dealing with patients with migraines?

Erin Knight:      I’m curious to hear from your end too, because we were starting to talk about chiropractic a little bit, but … Since you’re doing both the functional approach and the chiropractic approach, do you find that there are all those people that don’t really get better until they address the underlying issues with their gut health, and hormones, and things like that?

Dr. Weitz:         Oh, sure.

Erin Knight:      Then it’s the magic switch, or?

Dr. Weitz:         I would say, of the patients that I see chiropractically for migraines, probably half of them get significant relief, but then of those, maybe half of them, just the chiropractic alone is enough. The other half are gonna need some sort of nutritional intervention, and then the other half of the patients who don’t respond to chiropractic, most of those will respond to some sort of nutritional intervention if they’re willing to hang in there and go through some experimentation. A lot of them want the quick fix, which when you deal with Functional Medicine, takes a little bit of time to sort things out.

Erin Knight:      It does. It does. We get that all the time. ‘Cause we’re so used to getting medications for migraines, and if somebody really wants to look at the root causes, it takes several months if not longer. But, if somebody is looking for the quick fixes, I have a gift I could share with them. Is that okay?

Dr. Weitz:         Yeah, of course.

Erin Knight:      It’s called the Migraine Relief Checklist. And maybe you can put that in the notes, or if you just click on my website you can find it. https://www.engineeringradiance.com/migraine-relief-checklist/  Erin’s website is https://www.engineeringradiance.com/

Dr. Weitz:         Yeah. Sure, I will. Sure.

Erin Knight:      It’s called the [inaudible 00:34:38] the fastest, most natural things that somebody can do. And it works best if you layer it. So, we have a whole principle thing that walks you through. So, if somebody having a migraine, or doesn’t feel very well … I don’t know about you, but when I don’t feel well, I just kind of lay there on the couch. And I don’t even want to think about what I should be doing. I don’t even drink water, unless I have it written out for me. So basically, it’s like, when you don’t feel good, you grab this, and then you don’t have to think so hard about what to do. You just follow the instructions. So, that’s the idea behind it.

But, we have essential oils, meditation tracks, and different things that work if you’re layering them. And, it’s very interesting. Usually, people need to get four or five working for them. Pick four or five, and trial and error them. But, that combination is what will be able to shut off a migraine, believe it or not. Just from natural things like that. So, it’s really … I love hearing the stories of what works for people, and what their combination is. But that’s the quick fix. I still want people to find the root causes, and heal their bodies so that they can live a long, healthy, happy life. But, in the meantime, there’s plenty of natural alternatives to support their nervous system and calm that down, and really stop a migraine before it gets out of hand. So, that’s my gift if somebody listening has migraines.

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

Erin Knight:       Okay.

Dr. Weitz:          For joining me today. And, I’ll talk to you soon.

Erin Knight:       Thank you.