Functional Maternity with Dr. Sarah Thompson: Rational Wellness Podcast 245

Dr. Sarah Thompson discusses Functional Maternity with Dr. Ben Weitz.

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Podcast Highlights

1:38   Dr. Thompson started out treating musculoskeletal pain as an acupuncturist until she became pregnant with her first child.  She felt that there was a need for better nutritional prenatal care and dedicated herself to being able to provide that care.  Dr. Thompson also found Functional Medicine and pulled that into her maternity care.

4:28  Dr. Thompson calls her book, Functional Maternity because she puts the focus on the care of the mother and not just on the care of the baby.  Conventional prenatal care may end up with a healthy baby and a sick mom, which can lead to postpartum dysfunction that affect the mother adversely for the rest of her life.  If we have a healthy mom, we’re going to have a healthy baby.

5:36  The US has a shockingly high maternal mortality rate for an advanced country and that rate has gone up in 2020 by 18%.

7:05  Dr. Thompson often jokes that we are failing women before they even know that they are women through the standard American Diet and through childhood nutrition.  One in five children are now overweight in the US and the food served in the school breakfast and lunch programs is not healthy and these children are 30% more likely to be obese.We have poor nutrition education in childhood, and then we have the lunch systems that teach kids to eat shitty food.”

8:28  NHANES studies show us that 80-90% of women aren’t consuming the minimum vegetables per day and we see that young women who are eating poor nutrition have lowered reproductive powers.

9:00  There are a lot of nutrients that support maternal physiology both before pregnancy and then during pregnancy.  Vitamins B12, folate, vitamin D, etc  are very important for maternal health during conception and pregnancy. AMH, Anti-Malarial Hormone is associated with egg quality and low B vitamins, low zinc, and low vitamin D are all associated with low AMH levels.  This can create poor quality eggs, which can lead to poor quality embryos, which can lead to poor placentas, which can lead to pre-eclampsia and gestational diabetes.  While Dr. Thompson sometimes does run nutrition panels preconception, there is also a lot you can tell just from a CBC. For example, if the MCV is little high, this may indicate a B12 or folate deficiency. Homocysteine levels can confirm this.

17:10  There is no prenatal vitamin that is right all the way through pregnancy, since the need for different nutrients changes in each trimester.  Plus, it would be better to call it a maternal vitamin, rather than a prenatal.  For example, in the first trimester, women often have up to 15 times more insulin being produced, so certain vitamins, including thiamine, magnesium, and vitamin D that can help with that.

18:50  The reason that there is up to 15 times more insulin being produced in the first trimester is because of the need for glucose to facilitate the cellular development of the placenta in the uterus and this is stimulated by the production of HCG.  One of the primary causes of morning sickness in the first trimester is due to low blood sugar, so it is important to increase the consumption of low glycemic carbs during this time.  Of course, these carbs should be paired with good fats and proteins and this is why following a low carb diet during pregnancy is not optimal.

22:02  Women who have PCOS and existing blood sugar dysregulation going into pregnancy have more trouble balancing their blood sugar. It is important that their blood sugar does not drop below 80 or 75 at the lowest.  Gestational diabetes is more placenta related than mom related.  The placenta produces a lot of hormones, including lactogen, which tends to be increased in the third trimester. Lactogen’s role is to block the maternal physiology from bringing sugar into her cells to raise blood sugar levels to give baby sugar to help stimulate fetal growth in those last months of pregnancy.  There is a metabolic shift in moms where they actually burn their own body fat to fuel their energy, so all of their glucose in their diet goes to baby. What happens in gestational diabetes is that you have an excessive production of lactogen, so no dietary glucose gets into mom and her blood sugar rockets.


Dr. Sarah Thompson is the founder of Sacred Vessel Acupuncture & Functional Medicine, the creator of the website www.functionalmaternity.com, and the writer of Functional Maternity  Using Functional Medicine and Nutrition to Improve Pregnancy and Childbirth Outcomes.  She is a certified functional medicine practitioner, licensed acupuncturist, board-certified herbalist, birth doula, and educator with a passion for pregnancy care. 

Dr. Ben Weitz is available for Functional 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 and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.


Podcast Transcript

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

Hello, Rational Wellness Podcasters. Today we have an interview with Dr. Sarah Thompson on functional maternity. Dr. Sarah Thompson is the founder of Sacred Vessel Acupuncture and Functional Medicine. She’s the creator of the functionalmaternity.com website. She wrote a book called Functional Maternity: Using Functional Medicine and Nutrition to Improve Pregnancy and Child Outcomes.  She’s a certified functional medicine practitioner, a licensed acupuncturist, a board-certified herbalist, a birth doula, and an educator with a passion for pregnancy care. Dr. Thompson, thank you so much for joining us today.

Dr. Thompson:                  Thanks for having me.

Dr. Weitz:                          Great. Tell us a little bit about your journey. How did you go from becoming an acupuncturist? And were you treating patients with acupuncture for a number of years before you changed your focus towards helping women with their nutrition from fertility to birthing and beyond?

Dr. Thompson:                  Yeah. So, I started out I think like most acupuncturists, when I graduated school, wanting to do sports medicine, pain management, those things. I spent the beginning of my career working for an interventional pain management specialist. I trained with some of the best orthopedic acupuncturists in the world. And that was my focus. Now, as far as nutrition and functional medicine, my undergraduate is in nutrition. And I’ve always known that nutrition played a very important role in treatment success, whether it’s conventional medicine treatment, acupuncture treatment, chiropractic treatment, you name it. You have to have a solid foundation. And that foundation is nutrition.  So, even with my orthopedic patients that I had way back when I first started practicing, over 16 years ago, we always talked about diet and nutrition and how certain things they were doing in their diet could be increasing their inflammation affecting how their neurology was working and trying to improve their pain responses and improving their treatment success.

It wasn’t until I became pregnant with my own first child that I discovered how cool pregnancy was.  Up until that point, and people who knew me from childhood and my early adulthood, as soon as I told them I’m pregnant, they were like, “Excuse me, what? You weren’t going to have kids.” And I was like, “I know, but this happened.” And here we are, and we’re having a kid. And it’s the coolest thing I’ve ever done. And why didn’t anybody tell me that this would be so fun? And I completely changed my focus.  And I changed my focus through my own experiences and the experience or lack of experiences really that I had in my own prenatal maternal care. And I felt that there was a very substantial need that wasn’t being met with pregnant moms across the board, whether they’re in midwifery care, OB care, home birth care. There was this lack of education and a little bit of a lack of focus on the importance that nutrition played into these pregnancy and childbirth outcomes.  And that’s when I really changed my focus in my practice with acupuncture and found functional medicine and did the certification programs and pulled that all into the practice in maternity care.

Dr. Weitz:                          Yeah, absolutely. I think traditional care for pregnant women basically consists of taking your prescription prenatal and that’s it.

Dr. Thompson:                  And we know that prescription prenatals are really subpar when it comes to even prenatal care, let alone maternity care.

Dr. Weitz:                          Right. So, you call your book Functional Maternity, rather than a functional medicine approach to fertility or pregnancy. Why is that?

Dr. Thompson:                  My goal is to bring the care of women back into the care of pregnancy. Pregnant women who become lost in this system of baby-

Dr. Weitz:                          Instead of the whole focus being on the baby.

Dr. Thompson:                  Exactly. When we look at the actual medical definitions, we look at what does prenatal means. Well, it means the care of pregnancy. What does maternal mean? It means the care of the mother. And the goal here is to bring the care of the mother back to the care of pregnancy. There’s so much that happens in maternal physiology that gets left to the wayside as long as baby looks good, and you can have a healthy baby, but you can have a really sick mom because that baby is taking everything from her and leaving her very dysfunctional.  And she’ll end up having a cascade of postpartum dysfunction that can transfer throughout the rest of her life. Well, if we focus on mom, we’re going to have a healthy baby if mom is healthy, and we can prevent these issues in mom later on down the road.

Dr. Weitz:                          Yeah. That’s super important. I think that’s great that you’re doing that. And let’s not forget that even in an advanced country like the United States, you might be shocked to learn what some of the maternal mortality rates are, especially in certain populations, in certain parts of the country, it’s really shockingly high.

Dr. Thompson:                  It is, sadly. As far as first-world developed countries go, we have arguably the worst maternal statistics. And that’s very disheartening for any mother coming into a maternal program of any sort because her risk of complications is significantly higher than a mother who’s having a baby in Spain, or a mother who’s having a baby in Iceland.

Dr. Weitz:                          Right. And that probably goes with the ability of the average American to be able to handle any health challenge, whether it be pregnancy, a virus, or any other thing that might challenge our health if we already have a whole series of what are being called now comorbidities I would call chronic diseases like obesity, and diabetes, and hypertension, and on and on and on, which you and I and most of our audience know is directly related to our standard American diet, our sedentary lifestyle, our stress levels, or our lack of good sleep, et cetera, et cetera.

Dr. Thompson:                  Oh, absolutely. One of the things I jokingly say, but not jokingly at the same time is we’re failing women before they even know they’re women. And we’re doing that through the standard American diet, and more importantly, childhood nutrition. One in five children is now considered overweight. That’s a problem. That is already setting these-

Dr. Weitz:                          It’s crazy. It’s completely insane. Right.

Dr. Thompson:                  Absolutely. There’s a lot of things that go into that. Definitely, the standard American diet. Big, big part of that is a lot of the childhood nutrition programs themselves. We have poor nutrition education in childhood, and then we have the lunch systems that teach kids to eat shitty food.

Dr. Weitz:                          Right. And that ketchup is a vegetable, and let’s bring fast food and some of this garbage into the school system. So, kids are used to eating that.

Dr. Thompson:                  Yeah, there was a study done by the University of Michigan that actually showed a direct correlation between kids who ate school breakfast and lunch programs and a 30% increase in their risk of obesity in childhood.

Dr. Weitz:                          Wow. Yeah. We got to start early with educating our population on how to be healthy if we really want to be healthy as we age.

Dr. Thompson:                  Yeah, we look at, again, NHANES studies, those sorts of things from the CDC and everything show that 80% to 90% of Americans aren’t consuming the minimum vegetables per day. Again, that starts in childhood, and we see that young women who are eating poor nutrition from just before puberty through their high school years is very indicative of their reproductive prowess later in life.

Dr. Weitz:                          Right. So, how do we determine which nutrients a woman needs for optimal health, especially when wanting to get pregnant and bring a healthy baby to term?

Dr. Thompson:                  Yeah, and there’s a lot of nutrients that go into supporting the maternal physiology, even before pregnancy ever happens. I always say preconception nutrition is more important than anything a mother does in pregnancy.

Dr. Weitz:                            Do you recommend nutritional testing?

Dr. Thompson:                  Sometimes. It depends. Preconception. There’s some definitely serum vitamin panels that we can do that assess certain nutritional profiles. I do definitely a lot more testing preconception than I do in pregnancy it seems like because that’s the foundation. And it’s amazing what you can find in just basic panels as you’re aware. You look at a CBC very differently than how a Western doc looks at a CBC where they’re looking for overt anemia. And we’re looking for function where we can say, “Ooh, that MCV is a little high. Maybe that’s a B12 deficient folate issue. Let’s check that homocysteine and see if we have some components that could lead into methylation issues in the early pregnancy phase.”

We’re always looking at Vitamin D. Vitamin D is crucial to anything pregnancy-related and you could definitely dive into all the cool biochemical components there that’s a pretty fun one. There’s definitely a number of tests that we do. I always do if I have patients who may have been on long-term birth control use, we always run a day three lab panel where we’re looking at their anti-malarial hormone and their LH to FSH ratio, because that’s very telling of the quality of eggs that she has and sometimes the quantity too.  There was a study done. The researcher on it was Sharon Briggs.  And it came out in 2020, I believe, and it was one of the first studies that actually showed a direct link between chronic birth control use and lower AMH levels.  And for those of you who don’t know what AMH is, it’s that anti-malarial hormone that is produced by the tiny little follicles in the ovary pre-ovulatory follicles. And we use those to measure the quantity of eggs. Right? If you don’t have very many eggs in your ovaries, we don’t get a high amount of that hormone because there’s just not eggs to make that hormone.

But the other thing we see is that it also represents quality of the eggs if we have lots of oxidative stress. If we have low B vitamins in there, low zinc levels, low vitamin D, all of those are associated with low AMH levels. And interestingly, birth control tends to deplete the body of these B vitamins and zinc above the body over the course of time and thus we create poor quality eggs.  And if we have poor quality eggs, we have poor quality embryos. If we have poor-quality embryos, we can have poor placentas. If we have placentas, then we can have preeclampsia and gestational diabetes, and all these things being at an increased risk.

Dr. Weitz:                          And obviously having a high-quality sperm as well.

Dr. Thompson:                  Absolutely, yeah. Male factor fertility accounts for 50% of infertility issues, miscarriages, and there are studies that now link male factor, nutritional deficiencies basically with the increased risk of preeclampsia.

Dr. Weitz:                          Right. Interesting. What about running a NutrEval or one of these more extensive nutrition panels?

Dr. Thompson:                  I don’t do that as a general rule. But yes, if we have people who are we’re doing all this fertility work, we’re not getting where we need to go, definitely, we would run something like that to look for maybe some of those more obscure nutrient deficiencies that can be dominoing through the system. All the vitamins-

Dr. Weitz:                          Serum levels of nutrients for some nutrients, like vitamin D are very helpful. But when looking at serum levels for other vitamins, they’re not so helpful.

Dr. Thompson:                  No, not at all. Not at all. I tend to run more functional tests than, definitely, the NutrEval tests are great. But I do a lot more like the homocysteine, methylmalonic acids. I look at the comprehensive metabolic panels. If alkaline phosphatase is low, that’s usually indicative of a zinc deficiency. If protein is low, too, we add in all these factors together to look at that overall body function to get a clue of that, versus this is how much is in your blood. And it’s like, “Well, that doesn’t help us that much.”

Dr. Weitz:                          What about genetic testing like MTHFR, which you mentioned in your book? Is that something that’s helpful?

Dr. Thompson:                  It can be. It very well can be. I run it in specific cases, but not as a general rule of thumb. I tend to, again, look at that functional relationship. Is homocysteine elevated? Is the MCV in the CBC elevated? Right. All indicative of that folate B12 dysfunction. If those are showing some signs of, Oh, yeah, no, you’re maybe having issues with breaking down that oh, like, let’s definitely run more than just MTHFR. Seeking health has a great panel now, where they look at all the different genetics that go into methylation because there’s so much more than MTHFR out there.

Dr. Weitz:                          Of course. I just mentioned one that’s always in-

Dr. Thompson:                  Oh, I know. We tend to focus on that MTHFR quite a bit because there’s a lot of research on it. It’s been the one that most of the research has been based on since they found it. But I think there’s now more and more studies starting to pop up with all these different components and how… I’m sure you’re aware there’s changing school of thought on MTHFR, versus do we up methylated folate or do we pump choline instead? Right? Do we use may be the pathway that’s a little more functional, and just go, “Well, that one’s broken. Let’s move on.” Right?

Dr. Weitz:                          And, of course, what does this say about folic acid versus folate?

Dr. Thompson:                  Oh, yeah. Yeah, I have a whole section, a little mini-nutrient highlight on folic acid versus folate, because there is a lot of debate over it. And when you look at the idea of folic acid, it totally makes sense, theoretically, that folic acid should be better. But it’s not.

Dr. Weitz:                          And unfortunately, a lot of the older studies on preventing neural tube defects and things like that were done with folic acid, not with folate.

Dr. Thompson:                  Yeah, it’s very interesting. There’s definitely a lot of back and forth on that.

Dr. Weitz:                          Well, it’s too bad that folic acid isn’t a billion-dollar drug because then all those studies would be repeated with folate, but of course, it’s not. We don’t have that advantage.

Dr. Thompson:                  Right. And there was a couple of studies I referenced in my book, too, that talk about the difference between folate and folic acid and how… Really, natural folate has these little proteins attached to it. And we have to break those down in the gut in order to absorb folate. Folic acid, they’ve done it for you. And they just said, “We broke it down.” We’ve got one protein attached to it. You can easily absorb it. And you see those studies.  When you compare the two on absorption, folic acid is significantly more absorbable through the gut when you look at serum levels. But when you start, again, looking at those functional values, how is this folate and folic acid getting used in the system once it’s in the bloodstream? That’s where it changes, right? Or if you just look at what happens to the serum, yeah, folic acid raises those levels significantly more than dietary folate.

Dr. Weitz:                          Right. But if it doesn’t get properly metabolized, and we know that unmetabolized folic acid can be a risk factor for a number of things.

Dr. Thompson:                  Exactly. Certain studies have linked higher levels of unmetabolized folic acid with autism with some of these neurological components because it can get into the brain.

Dr. Weitz:                          And estrogen-related cancers as well.

Dr. Thompson:                  Exactly, exactly.

Dr. Weitz:                          So, you write that no prenatal vitamin is right all the way through pregnancy, because the needs for nutrients change during the different trimesters. I’m sure they change for each woman, depending upon a lot of other factors too, or diet or stress, whether or not she’s exercising, et cetera. So, what’s a woman to do?

Dr. Thompson:                  I would love to say, and I know, godly, there is a brand of prenatal that just came out that has trimester-specific prenatals. And I haven’t done my due diligence and really looked into what’s in them.

Dr. Weitz:                          Yeah, there was one company that had three different ones that didn’t sell so they stopped it.

Dr. Thompson:                  Right. Because women are like, “I don’t want to do that.” And a lot of women, they choose the one a days, right? Because who wants to take eight pills a day? That’s hard.

Dr. Weitz:                          I hear that all the time. Yeah. I can’t swallow a bunch of pills. I’m feeling nauseous. What can I do?

Dr. Thompson:                  Yeah. And-

Dr. Weitz:                          Open up the capsule and put in the shake.

Dr. Thompson:                  Exactly. When you look at the material physiology, it is true. There isn’t a prenatal out there that follows all of the maternal needs because a prenatal is designed to help that baby grow. A maternal vitamin would be definitely more of a better nomenclature. We look at first trimester for example. There’s so many metabolic changes that happen. Women have oftentimes up to 15 times the amount of insulin being produced in the first trimester. Certain vitamins like thiamine, magnesium, vitamin D, those become super essential in that first trimester to help for that.

Dr. Weitz:                          It’s interesting. Can you talk about why there’s 15 times more insulin being produced?

Dr. Thompson:                  Let’s thank HCG for that. And the need of glucose to facilitate cellular development of the placenta in the uterus. That takes a lot of really quick energy. And sugar is our best source of really quick fast energy and cellular development. And so, when HCG, so it’s the embryo as it develops its little trophoblast cells that become the placenta, we get that production of HCG, which is what we measure in, say, pregnancy tests. HCG in that first trimester completely hijacks the maternal physiology.  The first thing it does is it wants to get a lot of sugar to that uterus to help grow that baby and that placenta primarily. And it does that by stimulating the pancreas to increase a lot of insulin. And some studies measure up to 15 times normal levels of insulin production. It’s one of the reasons that women have a lot of morning sickness.  To me, it seems like just a horrible biological mechanism that when your blood sugar drops, you get nauseous. Why would your body want to vomit when you actually need more food? But that’s what it does. People who get hypoglycemic, they get a little shocky and they get nauseous. And we see that in that first trimester, is one of the primary causes of morning sickness is low blood sugar.

Dr. Weitz:                          So, does that tell us what we can do to decrease the likelihood of morning sickness?

Dr. Thompson:                  It’s one of the things. One of the things is, there’s a reason that women crave carbohydrates in that first trimester. It’s because they need them. Now they don’t need Snickers, right? They don’t need that. But they can totally get away with some good white potatoes, sweet potatoes, whole grains, starchy vegetables, those things go a long way.

Dr. Weitz:                          So, increasing carbs in the first trimester might be helpful in decreasing that nausea that a lot of women feel.

Dr. Thompson:                  Absolutely, and pairing it with some good fats and proteins so we don’t get that quick up and down of blood sugar, right? So, it’s nice and sustained.

Dr. Weitz:                          Slow carbs. And this is why perhaps, it might not be optimal to follow, say, a ketogenic diet during pregnancy.

Dr. Thompson:                  Right. I have a lot of moms that I work with who did a really strong keto or a paleo diet before they got pregnant. And they’re beating themselves up in the first trimester because really all they want is something like mashed potatoes. And you have to go, “It’s okay.” By all means, eat the mashed potatoes, right? Your body needs that. It’s craving it for a reason. Don’t deny it.

Dr. Weitz:                          Yeah, on the other hand, we know that in our society, rates of diabetes, pre-diabetes, insulin resistance are sky-high. And those things actually make it more difficult to get pregnant.

Dr. Thompson:                  Absolutely, yeah.

Dr. Weitz:                          So, it’s not unusual that there’s going to be a percentage of women who are following perhaps a lower carb diet to get pregnant.

Dr. Thompson:                  Yeah. And I’ve definitely worked with fertility patients who, that’s what we recommend. Women who do have insulin resistance, PCOS, those conditions do significantly better.

Dr. Weitz:                          Exactly, exactly. PCOS goes hand in hand, right.

Dr. Thompson:                  Yeah. And those are the women who actually tend to have that higher insulin production, closer to that 15 times production, is seen a lot of those women who do have insulin resistance. So, it becomes a fun balancing game to make sure their blood sugar stays and more of that mid-range, and they don’t drop too low and they don’t jump too high. And that’s a lot of coaching.

Dr. Weitz:                          Is there a functional blood sugar range you might want to see during the first trimester, for example?

Dr. Thompson:                  I don’t like to see fasting glucose that drops below 80, 75 in moms. We don’t run them very often, but sometimes we’ll have midwives, sometimes I’ll run things like a comprehensive metabolic panel that has that. If it’s dropping lower than that, then we’re getting hypoglycemic.

Dr. Weitz:                          Well, we know that sometimes there are blood sugar problems during pregnancy. We certainly want to prevent those.

Dr. Thompson:                  Yeah. And when we look at gestational diabetes, that’s more placental-related than it is mom-related. Now, if mom has type two diabetes coming into pregnancy, that’s a completely different pattern. Right? That’s typically not “actual gestational diabetes.” That’s pre-existing type two diabetes that has now turned into pregnancy-related type two diabetes, very different pattern.

Dr. Weitz:                          So, what causes gestational diabetes?

Dr. Thompson:                  So, it has to do with really a lot of this hormonal work and more of a placental dysfunction issue. And one of the things that we see-

Dr. Weitz:                          So, what do we mean by placental dysfunction?

Dr. Thompson:                  Yeah, so the placenta produces some different hormones. One of those hormones is lactogen. Now lactogen increases in more that third-trimester range, which is typically when we test for gestational diabetes. Lactogen’s job is to block the maternal physiology from bringing sugar into her cells to raise blood sugar levels to give baby sugar to help stimulate fetal growth in those last months of pregnancy. Baby has to put on a lot of body fat. Baby has to stimulate a lot of growth in that last phase.  And so, we see a metabolic shift in moms where they go, and they actually burn their own body fat to fuel their own energy and most of the glucose in their diet goes to baby. What we see in gestational diabetes is excessive production of lactogen. So, that, really, no blood sugar gets into mom, and their blood sugar skyrocket. Does that make sense?

Dr. Weitz:                          Yeah.

Dr. Thompson:                  And so, when we’re looking at dietary management for gestational diabetes, it’s very different than when we’re looking at type two diabetes dietary management.

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Dr. Weitz:                          So, what do we do for gestational diabetes?

Dr. Thompson:                  It varies on the woman. We do a lot of blood sugar watching, and it’s fun to help moms through that sometimes, because some of the foods that they think would be good or would be bad are actually very beneficial, like sweet potatoes, for example. Oftentimes, I have a mom doing a lot of sweet potatoes, even though they’re high glycemic because they also have a lot of nutrients in there that help to regulate a lot of it.

Dr. Weitz:                          Sweet potatoes are not necessarily high glycemic.

Dr. Thompson:                  I know, but if you look at a type two diabetes type thing, they’ll tell you, “Don’t do sweet potatoes because they’re high in sugar.”

Dr. Weitz:                          Well, if you look on the glycemic index, they’re much lower than white potatoes.

Dr. Thompson:                  Absolutely, absolutely. Usually, white potatoes are something that we’ll consume them, but we pair them, right? We’re going to put a lot of fat with them. We’re going to change the glycemic load of what’s happening. So, usually, we’re monitoring glycemic load over glycemic index, basically. How foods pair together in a meal to balance blood sugars, because we do need those sugars. We just don’t need a lot of the processed sugars.  It’s a lot removing of those things. Women who are eating a lot of cereal for breakfast, have cereal, right? It’s a lot of just bringing them back to that whole foods-based diet that they’re probably struggling with to begin with.

Dr. Weitz:                          It’s amazing. The women I speak to think that eating the cereals are beneficial because of all the advertising and all the things on the boxes that talk about all these health benefits of eating those packaged cereals. It’s incredible.

Dr. Thompson:                  Yeah, we’ve been sold on that for generations, right? It’s low fat. It’s whole grain. We’ve added vitamins to it. It’s good for you. Pair it with some skim milk. Right?

Dr. Weitz:                          Exactly.

Dr. Thompson:                  That’s a great meal. And we wonder why everybody’s sick.

Dr. Weitz:                          Exactly. Let’s talk about the importance of thyroid function for pregnancy.

Dr. Thompson:                  Yeah, so going back to that first-trimester aspect, that HCG hijacking the maternal physiology. One of the things that we see is that HCG mimics thyroid-stimulating hormone. It’s structurally very similar and it can bind to the TSH receptors on the thyroid. And what happens is it then hyperstimulates the thyroid to produce more T4 and T3. And so, we’ll see a natural dip if we’re doing lab work, right? You’ll see a drop in TSH, and you’ll see an upswing and reverse T3.  And what’s happening is that HCG is basically throwing mom into a borderline hyperthyroid pattern, because we need thyroid hormone to grow placental tissue.

Dr. Weitz:                          So, let me just stop you for a second. What level are you seeing on TSH and reverse T3 so we have an idea of what we’re talking about?

Dr. Thompson:                  So, several studies will show that if you have a TSH over a 2.5, you’re at a high risk of miscarriage. You want that TSH to drop to closer to one. Some people drop below one and they’re in the 0.8 range. Okay? Some women dropped even lower and they’re full hyperthyroid, that can get into a little bit of a hyperemesis type pattern. So, we do see that the lower TSH goes to, the more likely we are to have a little bit of a hyperemesis, so severe morning sickness type pattern. Really cool studies that talk about excess iodine in the blood causing, maybe being a cause of some of that hyperemesis.

Dr. Weitz:                          Okay, so if we have a patient with hyperthyroid during pregnancy, we might want to look at iodine intake.

Dr. Thompson:                  Exactly, yeah. We may want to lower that intake. And what happens is, T4 comes down to the placenta. We have the deionized enzymes, which are zinc-based enzymes that break down T4 into T3. Some of that T3 stays in the placenta to grow placental tissue, then we have reverse T3 that goes up. And usually, we’re seeing that in right around 23, 25, somewhere in that range. It’s usually above the reference range. And I’ve had homebirth midwives, for example, do full thyroid panels, and I do mentorship and different things, and coach practitioners as well, who send me these labs, and they’re like, “What’s wrong? What do I do? “I’m like, “That’s normal, it’s good. Don’t touch it. It’s fine.”  And then, what you’ll also see is you’ll see iodine levels in the blood that pop up as we break that iodine off of T4 to make T3. And so, that elevated reverse T3 and that elevated extra iodine in the blood, there’s a couple of studies that are associating that, again, like I said, with a higher morning sickness type pattern.

Dr. Weitz:                          What about the women where you see hypothyroid?

Dr. Thompson:                  Yeah, that gets concerning. I can’t tell you how many recurrent miscarriage patients that we look, and their thyroid looks beautiful before conception, and within four weeks of conception, that TSH is going up, not down, and it hits that 2.5, 2.6, 2.8, 3. And they lose their baby, and it gets missed, and these physicians are running it. Fertility doctors tend to know this. I have 10s of fertility doctors who will see that creeping up and immediately give a level thyroxin.  But I think general OBs, midwives, for sure, aren’t typically trained in seeing that. And you will see that creep up and that’s a sign that that thyroid just cannot keep up with the demand of pregnancy. And when that happens, you go back and you have to go, “Okay, well, what’s the underlying cause? Is it autoimmune? Is it Hashimoto’s? Is that what’s happening? Or are we looking at something closer to like an iodine deficiency, a zinc deficiency, selenium,” something along those lines.

Dr. Weitz:                          Yeah, I was just going to ask about that outside of giving thyroid hormone. What about making sure they have enough iodine, making sure that maybe some of the halogens, bromine, chlorine, fluoride, which are on the same pathway as iodine if you look at the periodic chart, those can block iodine. Do we need to make sure the woman is not consuming a bunch of those? I know, for example, in Los Angeles where we are, chlorine is put into the water to kill bacteria.

Dr. Thompson:                  Yeah, those are definitely things that we look at and-

Dr. Weitz:                          And they throw fluoride in there, too.

Dr. Thompson:                  Yeah, absolutely. Sadly, these are things that we don’t even start looking at until someone’s probably had a couple of miscarriages and that’s sad to me. I hear somebody who has a miscarriage especially if it’s a later first-trimester miscarriage, second-trimester miscarriage, and I automatically want to hug that woman and try to help her not have that happen again because that is physical and emotional loss. It’s a toll and it’s something that we shouldn’t expect moms to have to do three times before the medical system starts to treat it seriously.

Dr. Weitz:                          Anemia during pregnancy, you touched on that a little bit. I’d like to go into that a little more. You mentioned if you see an elevated MCV, that might show the need for B vitamins. What else do we want to look at as far as preventing or helping to manage anemia?

Dr. Thompson:                  Yeah, so, anemia. We look at anemia. And of course, we focus a lot on iron. Right? Iron deficient anemia. It is very important. And when you look at classical-

Dr. Weitz:                          What do you actually consider the best marker for iron? Is it serum iron? Is it TIBC? Is it ferritin levels? Is it a combination?

Dr. Thompson:                  Yeah, in pregnancy, we look at ferritin mostly, because we have to have a store of ferritin. And there are studies that show that low ferritin levels in the first trimester are indicative of anemia later on.

Dr. Weitz:                          And what level of ferritin makes you concerned?

Dr. Thompson:                  Anything below 40. If we’re coming into the third trimester and it’s low, we’re going to have some problems. And it has to do with how, again, changes in maternal physiology. We focus so much on iron, but once a mom hits about mid-third trimester, she is not going to be able to change those ferritin levels. So, part of what happens in second trimester when we are doubling down, we say doubling down, it’s really a 35% increase in red blood cells and a 50% increase in plasma, doubling down on these red blood cells, is she’s storing iron.  And I always, again, I joke, everything in pregnancy is preparing for preparing, and what’s happening in this trimester really is to support the mom’s body in the third trimester when everything shifts. And iron is a perfect example of that. A mom’s body accumulates iron, yes, to double down and make that 35% increase in her red blood cells, but more importantly, to store ferritin for the third trimester, where her body actually breaks down ferritin to support the iron needs of both her and her baby.

Because what happens, the same thing, we see a shift just like we did in insulin and blood sugar, and it all gets diverted to baby in that third trimester. Same thing happens with iron. Babies have to accumulate just under 400 mg of iron in their own ferritin stores before birth, because in the fourth trimester, the postpartum period, they can’t absorb iron out of their breast milk, and they are living off of their ferritin reserves.  So, in that second trimester, we focus so much on the iron component of anemia, not because it’s the primary cause of anemia, but because if we get to third trimester and a mother doesn’t have her ferritin stores, she is going to struggle and then she’s going to struggle postpartum recovery. Does that make sense?

Dr. Weitz:                          Absolutely.

Dr. Thompson:                  And so, ferritin to me is way more important. If I see somebody who’s got a hemoglobin level that’s hitting that 11-mark, yeah, we’re going to run a ferritin and we’re going to see, are you making ferritin? Is that why you’re a little low? Because your body is really focusing on this. We need that to be at a certain level. When we look at the studies in reality, iron deficiency anemia only accounts for about 30% of all pregnancy anemia cases. We look at the function of red blood cells, how they’re made, well, there’s a lot of things that go into it, right?  We have to have vitamin C to pull the iron into the cells. Vitamin C deficiency is surprisingly common in pregnancy. It’s one of the things that we see associated with preterm labor, early cervical remodeling can be associated with not enough vitamin C.

Dr. Weitz:                          Let’s not forget vitamin C. In this age when we have all these exotic nutrients, we sometimes tend to forget the basics like vitamin C.

Dr. Thompson:                  Yeah, it’s so true. It’s so true. And it is a very crucial nutrient as the water-soluble antioxidant. It helps with the collagen. What is the cervix? It’s a big chunk of collagen, and it needs vitamin C and vitamin E to be stable during the remodeling process. And for those that don’t know, remodeling of the cervix actually begins around 25 to 28 weeks. By that time, the mom’s body is already starting to prepare for childbirth. And we have to have a high amount of antioxidants in the system to negate the inflammation that is occurring in the body so we don’t go into labor too soon.

Dr. Weitz:                          What’s the best way to get iron?

Dr. Thompson:                  Well, everybody’s favorite food, liver. I’m a big proponent of liver in pregnancy, but I also have a lot of plant-based patients who do really well just doing a bunch of legumes. Interestingly, again, in pregnancy, so outside of pregnancy, we see that heme-based iron is significantly more absorbed the non-heme iron. So, heme iron is the animal-based iron, non-heme plant-based. In pregnancy, the absorption rate is the same.

Dr. Weitz:                          Okay. But if we’re going to consume a bunch of legumes, we might be consuming lectins.

Dr. Thompson:                  That’s right. So then, we go into preparation methods. Right? And that’s where diet culture comes in. I’m not anti-legumes. I think we’ve just lost our innate knowledge of how to prepare so many different foods because we’ve lost our connection to culture and history. There’s markings on walls and Aztec buildings of food preparation methods. And one of them is soaking legumes, and not just doing a quick overnight soak. That’s not what we’re talking about. We’re talking about sprouting these legumes, right?  Here in Colorado if I’m going to sprout my grains or legumes or nuts and seeds or any of the high lectin, oxalate, phytate type things, I’m not just going to do it overnight. I’m doing it, especially now in the winter, like 20 degrees out right now. I’m going to be doing it for three or four days. And I’m looking for the chemical reaction.

Dr. Weitz:                          I can’t even remember to do it overnight.

Dr. Thompson:                  I know, right? I’m waiting for that chemical reaction. And anybody who’s done that will notice that the water gets bubbly. Right? There’s gases that come out of those legumes. That’s what you’re looking for. You’re looking for a breakdown in these anti-nutrients. And in that process, they release gas. And that’s what you’re looking for. And then, you know you’ve really broken those legumes down and now they’re more like-

Dr. Weitz:                          What about using a pressure cooker?

Dr. Thompson:                  Pressure cookers can work.

Dr. Weitz:                          Need shortcuts.

Dr. Thompson:                  They’re not my favorites because they don’t allow for the germination aspect. Right? They just pressure and it does break down some of it, absolutely. But to really get the full nutritional benefit, soaking those legumes is the best way. And I’ve soaked them before and I’ve done big batches at my house and then taking them and froze them. And then, pull them out when I’m ready to use them.

Dr. Weitz:                          Right. So, for vegetarians, it’s legumes. We can’t eat the livers from plants. [crosstalk 00:40:26] So, another problematic condition during pregnancy is hypertension. We call it preeclampsia. What can we do to prevent and or help with this condition?

Dr. Thompson:                  So, study after study links dietary patterns with an increased risk of preeclampsia, preconception and during pregnancy. And the most causative or correlated factor in diet was the consumption of vegetables. So, those who consume more vegetables in their diet have a decreased risk of preeclampsia. And if you remember again, 80% of Americans are consuming the minimum vegetable intake. And we know that that’s probably really subpar anyways. So, let me even up that number a little.

Dr. Weitz:                          Yeah, especially since potatoes are considered vegetables. So, French fries qualify as vegetables in there. And the ketchup they put on is the second vegetable.

Dr. Thompson:                  That’s right. That’s right.

Dr. Weitz:                          And even then they’re not making minimum.

Dr. Thompson:                  Preeclampsia is a very complicated condition. But what seems to be the primary connecting factor between all the different theories as to the progression of preeclampsia is placental dysfunction. And the placenta really develops a lot of health, its functionality in the first trimester in the beginning of the second trimester. And so, a lot of preeclamptic conditions develop before the mom even knows she’s pregnant. And really, that first-trimester phase is highly dependent on what the mom and dad, the egg and the sperm, brought to that pregnancy in that initial development of those trophoblast cells that become the placenta.  Almost every vitamin and mineral deficiency is associated with preeclampsia. It used to be way back, decades ago, they talked about preeclampsia being a disease of B vitamin deficiency. They didn’t know why at the time. Now, we know things like methylation, right? B vitamins are really important for that. We know how B vitamins play into the Krebs cycle, and energy production, and oxidative stress and all those things.

Oxidative stress is a primary driver of preeclampsia. There’s a lot of things that go into that. Coenzyme Q10, antioxidants associated with oxidative stress. Very interesting studies in… Enrique A. Teran from Ecuador, he has done so many studies on linking Coenzyme Q10 with placental dysfunction and preeclampsia, and they’re fascinating. And links that show things like high elevation, age-related, dietary-related, associations with CoQ10. And this increased risk of preeclampsia.

We see in the body that the need for preeclampsia increases throughout pregnancy. As estrogen levels go up in pregnancy, as cortisol levels go up in pregnancy, we see a rise in LDL in the body. And with that rise, we also see a rise of CoQ10. Now, as we age, we don’t produce as much CoQ10 as we used to, right? And there’s interesting correlations with this low CoQ10 level and preeclampsia.  And so, it goes back to oxidative stress as the driving factor, whether it’s B vitamin deficiencies, whether it’s antioxidant issues like CoQ10 or superoxide dismutase. There was a study from 2020 that linked manganese deficiency and superoxide dismutase deficiency with an increased risk of preeclampsia. So, when we’re looking at-

Dr. Weitz:                          I’ve even seen a few papers with L-carnitine as being beneficial as well.

Dr. Thompson:                  Yeah, absolutely. And that goes into some of that metabolic factor stuff, and when the mom is really super catabolic and she’s breaking down her own body fat. And the acetyl L-carnitine or L-carnitine, in general, helps her break down those fatty acids into energy.


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If you go to chilisleep.com and you use the affiliate code, Weitz20, that’s my last name, W-E-I-T-Z, 20. You’ll get 20% off a chiliPAD. So, check it out and let’s get back to this discussion.


Dr. Weitz:                            In the last 10 minutes, let’s focus on some of the most important nutrients, a number of which we’ve already talked about but maybe we need to talk a little more about. So, Vitamin D. I know you mentioned that the amount of vitamin D in the typical prescription prenatal is still like a joke compared to what we really know is needed.  It’s still recommended that people get 400 or 100s of mg. All the data that I’ve seen working with patients for a number of years with functional medicine, actually decades, is they need 1000s or sometimes even 10,000. So, taking 400 is like a joke.

Dr. Thompson:                  No. Yeah, the current RDA for pregnancy on vitamin D is 600 international units, 400, preconception. Now, there was a study in 2011. And this is 10 years, I mean, 12, so 11 years ago now. Right? I can do math. It was a decade ago. And we’re just now starting to take the study seriously. Right? What this study did is, the whole premise was to see how much vitamin D supplementally a mother needed to maintain, 32 was their magic number, 32 ng/mL of vitamin D in the serum throughout pregnancy. Okay?  Now, for those who know reference ranges, the reference range of Vitamin D is between 30 and 100. Studies now show, really, it should be more like 40 and above. This study was looking to keep it at 32. And they needed a minimum of 4000 international units per day to maintain that level throughout pregnancy. That’s a lot. That’s way more than 600 that we’re currently telling women they need. And vitamin D is essential for almost every function of pregnancy

Dr. Weitz:                          So, what do you do? You give them a prenatal and then you give them extra vitamin D?

Dr. Thompson:                  That’s what we do.

Dr. Weitz:                          And then, they freak out and say, “Oh, my God”, and the medical doctor says, “Oh, I don’t know. It sounds like a lot.”

Dr. Thompson:                  It sounds like a lot, right? They’re worried about increasing calcium buildup in the placenta and all these things. This study at 4000 international units per day found zero negative side effects, zero. No negative implications were associated with that 4000.

Dr. Weitz:                          Has anybody looked at vitamin K, making sure there’s no calcium buildup in the placenta?

Dr. Thompson:                  Not that I’m aware of. But that’ll give me something to look for. You gave me something I need to research. I love it.

Dr. Weitz:                          Because that’s what we do in the functional medicine world when we prescribe vitamin D, is make sure we prescribed vitamin K2 because that reduces arterial calcification. It makes sure that the calcium that gets upregulated doesn’t end up in the soft tissues.

Dr. Thompson:                  Right, right. And that’s what we do, too. Every vitamin D supplement I give has K2 in it, and we have to have it. K2 is essential for so many other things in pregnancy too. And again, it’s a forgotten nutrient, especially in maternal care. It’s one of those primary drivers of regulating blood clotting. And when you go into labor, it is a very important part about not dying in childbirth, is the ability to clot.  And they take care of babies, like, “Oh, well give him a vitamin K injection,” because historically, they found that that was an issue because moms were deficient. But instead of treating moms, they just said, “Well, we’ll fix babies. It’s fine.”

Dr. Weitz:                            Exactly. Forget about the mom.

Dr. Thompson:                  They don’t care about mom. But back to vitamin D, vitamin D, again, does a number of things in the body. One of the things it does and why it’s really this important gateway nutrient to a number of different complications in pregnancy, is that it regulates the P450 enzymes that go into steroidogenesis. So, these enzymes that help to make estrogen, progesterone, cortisol, testosterone, all these hormones that are skyrocketing throughout pregnancy.

Dr. Weitz:                            It’s hard to find a system or physiological process in the body that vitamin D doesn’t have some role.

Dr. Thompson:                  It’s so true. So true. And the most nutritionally deficient nutrient in the diet.

Dr. Weitz:                            So, my next most favorite nutrient besides vitamin K and D is omega-3. And this is another reason why that prescription prenatal that’s just that one a day, there’s no way you can pack any substantial amount of omega-3 in that tablet or capsule. And yet we know that omega-3 especially DHA is super important. Can you talk about that?

Dr. Thompson:                  Yeah, and DHA is really important, so I have a whole section in my book on this because it’s something that, again, I don’t have a study that really solidifies this idea that I have, but a lot of studies that link to a possible complication if we isolate DHA in prenatal supplementation. So, the studies who look at the beneficial effects of DHA on brain development, on all these things we talked about in prenatal care, they used a combination of EPA and DHA in the studies and found high amounts of DHA in the brain and said, “Oh, we got to do DHA.”  But we also know that DHA if it’s isolated, we see that in cardiovascular studies, blocks the ability of thromboxane A2 to work in the body. Now, what is thromboxane A2? Thromboxane A2 is the primary coagulant in childbirth. So, when we go into labor, our body produces a large amount of this blood-clotting agent. It’s the primary driver that makes the uterus and the placenta as they detach caught, right?  DHA blocks that. It prevents that thromboxane A2, in studies, from doing its job of clotting the blood. If you add EPA to it, that doesn’t happen. EPA becomes prostacyclin. Prostacyclin and thromboxane A2 balance each other’s effects. So, if we remove that EPA aspect, all we have is an anticoagulant.

Dr. Weitz:                          So, make sure we take EPA and DHA together.

Dr. Thompson:                  Yes. And EPA helps bring DHA into the fetal brain. The whole reason that moms are trying to take DHA. Without EPA, that DHA doesn’t get into the fetal brain.

Dr. Weitz:                          Okay, now, what about the ratio? Is the ratio of EPA and DHA that’s found in fish oil, is that optimal? Or would it be better, say, to have instead of this range to have maybe EPA and DHA together and then some extra DHA?

Dr. Thompson:                  I lean towards what is the natural balance found in fish? The original study was done on Inuit women, and how much fish they consumed. And looking at that ratio of EPA and DHA in their blood, and comparing that to cord blood. Right? Nature isn’t dumb. And sometimes we try to over science nature. And I feel like the fish oil, EPA, DHA, omega-3 world is really trying to outsmart nature. So, what I do with my patients is I push just straight fish oil.

Dr. Weitz:                          Right. But this will also say to those vegetarian patients that they’re algae-based DHA supplement is not optimal.

Dr. Thompson:                  Right. I dislike the algae-based DHA supplements for a number of reasons. I just don’t like them. I don’t see any studies that show that they are better. I see more studies that show that there might be more of a risk.

Dr. Weitz:                          Right. And you certainly don’t want to eat tuna every day while you’re pregnant.

Dr. Thompson:                  And that gets complicated too.

Dr. Weitz:                          Right. Consider mercury. So, I think we’re just about out of time. We did not say anything about a lot of stuff. But one thing is calcium. So, I just want to touch on calcium, which is yet another controversial mineral.

Dr. Thompson:                  Yeah, well, we talked about preeclampsia earlier. Calcium supplementation is the only nutrient so far in research that has been shown to have an acute effect on preeclamptic symptoms, meaning calcium supplementation reduces the symptoms of preeclampsia. And it’s the only nutrients that we know in research has that actual effect, but yet it’s one of those ones that we just go back and forth on.

Dr. Weitz:                          So, how much calcium should women during pregnancy consume, supplemental?

Dr. Thompson:                  I think it depends on the individual, their diets, all those things. I don’t do additional calcium supplements.

Dr. Weitz:                          You don’t?

Dr. Thompson:                  No. Nothing outside of basic prenatal-

Dr. Weitz:                          Well, some prenatals have a lot of calcium, some have a little bit.

Dr. Thompson:                  That’s true.

Dr. Weitz:                          And once they have multiple pills, they’re going to have separate calcium magnesium supplements. The one a day is only going to have a little bit. So, is 50 mg enough, 500 mg? What’s optimal?

Dr. Thompson:                  I tend to aim for 1000.

Dr. Weitz:                          A thousand?

Dr. Thompson:                  Yeah. We’re aiming high. And the goal again is to get it in diet. Anywhere we can get it in diet is going to be better.

Dr. Weitz:                          But then, you have problems with consuming dairy. Right? Because the proteins in dairy that are allergenic.

Dr. Thompson:                  And it depends on the person. I’m not opposed to dairy. I’m not. In pregnancy, sometimes we use dairy high diets, specifically in cases of preeclampsia. I will have women, I will have them try to drink half a gallon of milk a day. Good quality, full fat, grass-fed milk.

Dr. Weitz:                          Wow. A half a gallon of milk per day.

Dr. Thompson:                  Yes. And we’re talking severe preeclamptic situations where they’re spilling proteins. And we know we need to keep that protein level elevated, plus we need the calcium, the vitamin D, conjugated linoleic acid in the milk also helps. The other thing is milk contains insulin-like growth factors, right? One of the things that we worry about today, people with PCOS.

Dr. Weitz:                          Right, because it’s added, right?

Dr. Thompson:                  Exactly. But in cases of preeclampsia, the placenta itself produces insulin-like growth factors. And in preeclampsia, they don’t. And you have to have that insulin-like growth factor to stimulate a number of different functions in the physiology of both the baby and the mother. And the milk facilitates that. We’re supplementing insulin-like growth factor that the placenta should be making that it isn’t making.

Dr. Weitz:                          Interesting Wow. This conversation had a lot of clinical pearls. I want to thank you for that.

Dr. Thompson:                  Yeah, of course. My pleasure.

Dr. Weitz:                          I really enjoyed this. How can our listeners find out more about you and how to contact you?

Dr. Thompson:                  Yeah, absolutely. So, my website-

Dr. Weitz:                          And how to get your book as well.

Dr. Thompson:                  Yeah. My website is www.functionalmaternity.com. People can find the book there. They can link my clinic there. I have patients all over the world that I follow through pregnancy, whether it’s just general health, specific complication management. I also offer practitioner mentorship programs. We’re working on a group mentorship thing that we should be doing the summer, mostly case study review. So, all of that will be found on that website.  Social media-wise, we are at functional.maternity on everything. And then, currently, the book is on Amazon. And it should be in some retailers here before too long as well.

Dr. Weitz:                          Barnes & Noble as well.

Dr. Thompson:                  Hopefully. You can request it from them. They don’t carry it yet. But it’s in their system. They can order it.

Dr. Weitz:                          Okay, I’ll do that. Thank you so much, Dr. Thompson.

Dr. Thompson:                  Thank you.

Dr. Weitz:                            Thank you for making it all the way through this episode of the Rational Wellness Podcast. And if you enjoyed this podcast, please go to Apple podcasts and give us five-star ratings and review. That way, more people will be able to find this Rational Wellness Podcast when they’re searching for health podcasts. And I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica Weitz Sports Chiropractic and Nutrition Clinic.  So, if you’re interested, please call my office, 310-395-3111 and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz. Thank you and see you next week.



Immune System Testing with Dr. Aristo Vojdani: Rational Wellness Podcast 244

Dr. Aristo Vojdani speaks about Immune System Testing with Dr. Ben Weitz at the Functional Medicine Discussion Group meeting on January 27, 2022.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.] 


Podcast Highlights

9:49   Dr. Aristo Vojdani published a review paper along with Dr. Elroy Vojdani in the journal Pathophysiology, The Role of Exposomes in the Pathophysiology of Autoimmune Diseases I: Toxic Chemicals and Food. Pathophysiology 202128 (4), 513-543; https://doi.org/10.3390/pathophysiology28040034  While genes play a role, environmental factors, the exposome, are responsible for two thirds of the cases of autoimmune diseases.  These environmental factors that trigger autoimmunity include food sensitivities, infections, toxic chemicals, and the gut microbiome.  Environmental factors affect the immune system and the Lymphocyte Map test is a sensitive biomarker for these immune changes.  A number of environmental factors affect the immune system and affect our barriers and can result in autoimmunity, including silica, trichloroethylene, smoking, mercury, pesticides, pristane, and many other toxic chemicals, inducing reactive oxygen species and lipid peroxidation.

12:45  Reactive Oxygen Species can inhibit good genes and enhance bad genes, such as DNA damage. Lipid peroxidation can cause neo-antigen formation, which means they can bind to our tissues and result in auto-antibody production and over activation of Th1 and Th17, which are the autoreactive lymphocytes.  We end up with dysregulation between our T reg cells and our Th1 and Th17 T cells, which communicate with our B cells, which produce autoantibodies and autoimmune disease.

15:13  The exposomes include the external environment, which include stress, lifestyle, indoor air pollution, outdoor air pollution, diet, additives, salt intake, vitamin D, medications, infections, and xenobiotics. There are also internal environmental factors like protein modification.  More than 600 different proteins get modified internally for many reasons that we don’t even understand. Our microbiome also plays a role in inflammation and autoimmunity.

17:50  Any miscommunication between the immune system, the nervous system, and the GI system may result in autoimmunity. 

18:18  The immune system has two parts: the Mucosal Immune system (aka, the Innate Immune system) and the Humoral Immune system (aka, the Adaptive Immune system)The Mucosal Immune system is our Homeland Security and includes our mucous membranes and secretory IgA.  The SARS-Cov2 virus breaks down our mucous membranes before getting into the lungs and then secretory IgA antibodies start protecting us. Three important cells–dendritic cells, mast cells, and macrophages–start by attacking the foreign pathogens like the virus.  In the case of the coronavirus, the macrophages take it up and internalize it. But because it is such a huge molecule, they break it down into a smaller size, which we call antigens and includes the nucleoprotein and the spike protein. These antigens, like the spike protein, then get taken up by antigen presenting cells and present it to T helper cells. The adaptive immune response will then release either Th1, cytokines such as interferon gamma and IL2 and activate some T cells to become cytotoxic lymphocytes, that go after the corona virus or cells infected with coronavirus.  When cytotoxic lymphocytes finish the job, they leave behind memory T cells and memory cytotoxic T cells.  T cells then collaborate with B cells, that become plasma cells, which have the capacity to produce IgG, IgA, IgM, and IgE antibodies that will recognize the coronavirus in the future.  These antibodies will last months or a few years but after that there will be memory B cells that last many years and continue to recognize that virus and can make antibodies again within a day or two to fight off a future coronavirus infection.  Memory B cells continue to provide protection against the virus for many years, unlike what we may have heard in the media.

28:17  The immune system is as diverse in different people as their appearance.  Cyrex’s lymphocyte immunotyping is different and this is why we need personalized care for each person and why different people may respond differently to the same medication.  B cells in the presence of different environmental factors (exposomes) will become Th1, Th2, T-reg cells, Th9, Th17, Th22, combination of Th2 and Th22, and Follicular Th9.  Each of these T cell sunsets have different functions.  Th1 is involved in pathogenic inflammation and autoimmunity. Th2 is involved with allergies and hypersensitivities. T-reg cells provide protection against pathogenic inflammation and autoimmunity. Th9 is involved with allergic response. Th17 both protects us against extracellular pathogens and when they are overactivated they will participate in inflammation and autoimmunity.  The most pathogenic lymphocyte is the hybrid between Th1 and Th17, which participates in both inflammation and autoimmunity. Th22 is involved in skin dermatitis and psoriasis. Th2/Th22 are related to allergies and hypersensitivities. The combo of Follicular (TFh) and Th9 has a high affinity for autoantibody production.

31:13  Some Labs/Researchers/Doctors in the past have claimed that we can classify patients as having Th1/Th2 imbalances based on the cytokines that they produce and this is not an accurate way to do this because the same cytokine may be produced by different lymphocytes. For example, Interferon gamma can be produced by Th1, but also by Th9.  IL-17 is produced by Th17, but it is also produced by natural killer cells. The best way to determine Th1 and Th2 balance and other lymphocyte imbalances is by staining and counting each of these cells directly, which is what Cyrex Labs is doing with their Lymphocyte Map test.  Also, both red blood cells and platelets also produce cytokines.

34:10  Our immune system is essential to protect us against infection and cancer and abnormalities of the immune system can lead to autoimmune disorders, allergic diseases, immune deficiencies, including Alzheimer’s disease, Parkinson’s disease, cardiovascular disease, etc.  Advancements in immunology have now made it possible to do complete lymphocyte immunophenotyping.

37:30  When investigators looked at hundreds of patients with COVID-19 they found one group that had hypoactivation of their immune system, low white blood cells, low lymphocytes, low CD-4, low CD-8, etc., another group that had hyperactivation of the immune system, and a third group that had an immune system that was more balanced, but yet all of these patients were treated with the same cocktail of medications.  It should be no surprise that they did not all respond well to the same protocol. If you give dexamethasone to a patient with a depressed immune system, this will suppress their immune system even more.

52:37  Measuring cytokines became obsolete after this new method of directly separating and staining lymphocyte cells.

52:52  If we look at a patient with Systemic Lupus Erythematosus, we often see Th2 low and Th17 high.  Vitamin D can help to lower Th17 by increasing the number of T reg cells. If you find a patient is Th17 dominant and you don’t do anything about it, they have an increased risk of having lupus or some other autoimmune  disease.

55:38  The next case is a patient with Lyme Disease, multiple chemical sensitivities, and repeated concussions. This patient has elevated 21 hyroxylase, meaning adrenal insufficiency, elevated paraben antibodies, and reactions to 70 out of 180 foods measured by Cyrex.  This patients has an elevated CD4:CD8 ratio and has elevated Th1 and Th17. This patient is classified as Th1 plus Th17 dominant and while this patient does not currently have autoimmune disease, they will likely develop full blown autoimmune disease if not treated for Lyme and toxins and food sensitivities.

1:00:39  This is a case of patient with low IgG subclass 2, Epstein Barr Virus early antigens, meaning that EBV became reactivated. This patient also had exposure to mold and mycotoxins.  This patient had low IgG and EBV early antigen, which means that EBV became reactivated and the B cells became activated to produce more antibodies. This patient has Th17 dominance and elevation of natural killer cells, which were probably elevated to fight the EBV virus and perhaps for the mold. 

1:02:03  The clinical Importance of lymphocyte immunotyping.  In the case of Grave’s thyroid autoimmunity, most of the patients were Th1 dominant, and when they were treated with antithyroid drugs, the Th1 went down and the Th2 went up, creating more balance.

1:03:04  Patients with rheumatoid arthritis often have Th17 dominance and studies show that methotrexate lowers the levels of Th17. 1:03:16  Patients with Multiple Sclerosis often have Th1 and Th17 dominance, since under inflammatory conditions, these cells can break down the blood brain barriers and get into the brain and cause brain inflammation, resulting in neuronal cells death resulting in either rheumatoid arthritis or Alzheimer’s or Parkinson’s and when they get treated with medications, they can bring down the levels of Th1 and Th17 cells.

1:05:12  In relation to COVID, patients who had low lymphocytes and T cell subsets were less likely to survive.

1:05:46  25% of the tests that come into Cyrex show low lymphocytes and exercise and good nutrition are the most important factors that improve this. Exercise increases the production of growth factors that enhance production of lymphocytes.  Other factors that can help include the following: 1. Green jackfruit flour, 2. shitake mushrooms, 3. ganoderma mushrooms, 4. Turkey tail mushrooms, 5. Oyster mushrooms, 6. Glutathione, 7. Curcumin, 8. Resveratrol, 9. Berberine, 10 Lactobacillus ramnosus GG.   To promote the production of B cells we have 1. Probiotics, including lactobacillus casei, 2. Fish oil, 3. Curcumin, and 4. Beta glucan from oyster mushrooms. 

1:07:22  To stimulate the production of CD4 T Helper cells, we have 1. IVIG, 2. vit D, 3. Fish oil, 4. Oyster mushrooms, 5. Ganoderma, 6. Whey protein, 7. Soy protein. 

1:07:32  To promote the production of CD8 cells we have 1. BCG vaccination, 2. vit D, 3. DHEA, and 4. peanut agglutinen.

1:08:09  To bring down the activity of Th1 cells, we have a lot of research and among the molecules that have been shown to help include 1. Corticosteroids like dexamethasone, 2. monoclonal antibodies, 3. Chloroquine, 4. Metformin, 5. IVIG, 6. Dimethyl fumarate, which is a new class of medications called nrf2 activators, 7. vit D, 8. fish oil, 9. resolvins, 10. probiotics, 11. zinc, 12. green tea, 13. vit E, 14. probiotics, 15. curcumin, 16. bromelain, 17. polyphenols, and 18. naringenin.

1:08:45  To lower Th2 activity we have 1. probiotics, 2. vitamin E, 3. fish oil, 4. resolvins, 5. zinc, 6. L-citrulline, 7. L-arginine, 8. L-tyrosine, 9. H. pylori(?).

1:09:12  To promote Treg cells we have 1. IVIG, 2. Azithromycin, 3. Rapamycin, 4. Chloroquine, 5. Dexamethasone, 6. Indole-3-carbinol, 7. Vitamins A and D, 8. zinc, 9. Short chain fatty acids, 10. fish oil, 11. L-arginine, 12. Testosterone, 13. Astragalus, 14. Berberine, 15. Quercetin, 16. Genistein, 17. Curcumin, 18. Lactoferrin, 19.

1:15:20  Natural Killer Cells.  The following substances can promote Natural Killer Cells: 1. Vitamins A, B, C, D, and E, 2. Resveratrol, 3. Probiotics, 4. Short chain fatty acids, 5. Blueberry, 6. Ginseng, 7. Garlic, 8. Ashwaganda, 9. Oyster, 10. Medicinal mushrooms, 11. Astragalus. 

1:19:07  The following conditions are associated with an abnormal Lymphocyte Map: 1. Multiple Chemical Sensitivities, 2. Chronic Fatigue, Fibromyalgia, 3. Certain forms of cancer, 4. Asthma, 5. Allergies, 6. Lupus, 7. Rheumatoid arthritis, 8. Multiple sclerosis, 9. Chronic inflammatory demyelinating  polyradiculoneuropathy, 10. Thyroid disorders, 11. Systemic sclerosis, 12. Autoimmune disease of the Liver, 13. Phospholipid syndrome, 14. Psoriasis, 15. Diabetes, 16. Multiple system atrophy, 17. Uveitis, 18. Heart disease, 19. Alzheimer’s disease, 20. Parkinson’s, 21. Schizophrenia, 22. Recurrent pregnancy loss, 23. Chronic obstructive pulmonary disorder, 24. COVID-19 and other infections.




Dr. Aristo Vojdani is the Father of Functional Immunology and he has dedicated his life’s research to helping us figure out what are the triggers for autoimmune diseases and many of the tests he has developed for Cyrex Labs are focused on this.  Dr. Vojdani has a PhD in microbiology and immunology and he has authored over 200 scientific papers published in peer reviewed journals. Dr. Vojdani is the co-owner of Immunosciences Lab in Los Angeles, which offers testing for various types of infections, including Lyme Disease. He is the Chief Science advisor for Cyrex Labs, whom he has developed all of the testing for, including his new Lymphocyte Map test, which is the subject for this talk. He is also a professor in the Department of Preventative Medicine at Loma Linda University.  

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 and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.


Podcast Transcript

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

Welcome everyone to the functional medicine discussion group meeting tonight. And we’re very happy to be joined by one of our favorite speakers, esteemed Integrative Immunologist, Dr. Aristo Vojdani, who will be telling us how to identify immune system imbalances that are common in autoimmune diseases, and hopefully give us some suggestions about how to address them. I’m Dr. Ben Weitz, and I’ll start by making some introductory remarks before introducing our sponsor for this evening, which is integrative therapeutics. And then, I’ll introduce our speaker for this evening.

I encourage each of you to participate and ask questions by typing in your question in the chat box. And then, I’ll either call on you or simply ask Dr. Vojdani your question when it’s appropriate. And so, I hope that you’ll consider joining some of our future functional medicine discussion group monthly meetings. We usually meet on the fourth Thursday of the month at 6:30 Pacific Standard Time. And I guess, we’ll continue meeting through Zoom for the foreseeable future. Hopefully, will have in-person meetings at some time soon. Some of our upcoming meetings are February 24th, we have Dr. Howard Elkin and he’ll be speaking on integrative cardiology. March 24th, Dr. Julie Greenberg will be speaking about integrative dermatology. April 28th, Dr. Paul Anderson will be speaking about an integrative approach to treating cancer and May 26th, we have functional maternity with Dr. Sarah Thompson, and if you’re not aware, we have a closed Facebook page, Functional Medicine Discussion Group of Santa Monica that you should join, so we can continue the conversation when this evening is over. And I’m also recording this event and I will include it in my weekly Rational Wellness podcast, which you can subscribe to on Apple Podcasts, Spotify or YouTube. And if you enjoy listening to my Rational Wellness podcast, I would appreciate it if you could go to Apple Podcasts and give me a five star ratings and review. We have many excellent interviews with many of the top doctors in the functional medicine world.

Now, I’d like to invite Steve Snyder from Integrative Therapeutics, our sponsor for this evening to give us a little information about some of the integrative therapeutic products, which is one of the few professional brands of products that we carry in our office, Steve.

Steve:                                   Hello, everyone. I actually had a couple slides too, but I’ll just not do it because I don’t want to complicate stuff, but Dr. Waserman was asking about some immune stuff for COVID and that’s kind of what I was going to show you guys. We have a few just pretty unique things for immune function that are super popular for us. And the biggest one is called V-Clear. It used to be called ViraClear. We’re not allowed to say virus anymore. So, that sort of gives you an idea of what it’s about. It is an extract of pelargonium sidoides that’s grown and produced by our parent company in Germany. And because it’s marketed as a supplement in Germany, it requires a lot of clinical research to actually launch it.  So, we have about 25 clinical studies on this product, over 10,000 patients, over 3000 kids in all kinds of upper respiratory tract infections, including coronavirus before the pandemic.  There’s actually a study going on right now with the original coronavirus from the pandemic. It’s not done yet, but it looks pretty good.  And basically the bottom line of all of these studies is shorter duration of episode and reduced severity of symptoms. The way it’s marketed is to be taken at the first sign of symptoms.  So, Dr. Waserman, if you want some, I can send you some to try, but we should do it fast, but the reality is, it can be taken preventatively, it works really well for that.  It’s just not super practical, the way that it’s packaged, but in full disclosure, I’ve been taking it for about two years.  It has multi-mechanisms.  It inhibits viral implantation on the cell wall.  It improves ciliary activity. It has virucidal action of its own. There’s actually a study showing better efficacy than amoxicillin in sinusitis. So, it’s the real deal. It’s something that we literally can’t make enough of.  So, if anybody [who is a practitioner] has any questions about it or would like to try it, my email is steve.snyder@integrativepro.com.

The other one I really wanted to mention real fast is our sort of the integrative version of quercitrin. It’s called Alpha-glycosyl isoquercitrin. It’s about 18 times more bioavailable than regular quercitrin. So, one of our 33 milligram capsules is equivalent to about 500 milligrams of the other brands on the market. It’s been a huge, like literally can’t make it fast enough. Everybody wants that and zinc because the course of it helps get zinc into the cells and zinc is, there was a point where you couldn’t get zinc anywhere.  The AGI we call it, because it’s hard to say, is another thing that’s been super popular for us over the last two years. Typically, people think of it as part of an allergy regimen or anti-allergy regimen and we sell it for that. But over the last two and a half years, the immune aspect of it has become a major point. And then, we have a zinc, standalone zinc chelate. It’s 30 milligram capsules, a hundred capsules in a bottle and it’s nine bucks retail. So, there’s nothing as inexpensive as that out there. And so, that’s pretty much it for right now. So again, if you have any questions, email me and we’ll set you up.

Dr. Weitz:                            Great. Thanks, Steve. And somebody asked if you could type your email into the chat box.

Steve:                                  I can try.

Dr. Weitz:                            Okay. Thank you. So, let me introduce our speaker for tonight is Dr. Aristo Vojdani, the Father of Functional Immunology, and he’s dedicated his life to helping us to better understand some of the root causes of autoimmune diseases as well as how to treat them. And many of the tests he has developed for Cyrex Labs are focused on this, including his newest test, the Lymphocyte Map Test. Since we are speaking about autoimmune diseases, I just wanted to mention the shocking news report from a new paper that was just published today in a British medical journal. I know this will come as a surprise to all of you, but they are reporting that vitamin D and fish oil reduce the risk of autoimmune disease.

Dr. Vojdani has a PhD in microbiology and immunology, and he’s authored over 200 scientific papers published in peer review journals. Dr. Vojdani is the co-owner of Immunosciences Lab in Los Angeles, which offers testing for various types of infections, including Lyme disease. He’s the chief science officer for Cyrex Labs, for whom he’s developed all their tests. He’s also a professor in the department of preventative medicine at Loma Linda University. Dr. Aristo Vojdani, my friend, Ari, thank you so much for honoring us with your presence tonight.

Dr. Vojdani:                        Thank you so much, Dr. Weitz. And thank you all the participants. Tonight, I’m going to speak about a very, very important test, which from the bottom of my heart, I believe that every one of us should have this test once a year as part of our annual checkup. So, I hope by end of the presentation, Dr. Weitz, at least I will convince you hopefully that you’ll decide to do this test on your own blood.

Dr. Weitz:                           Oh, absolutely. I just got the test kits in yesterday.

Dr. Vojdani:                        Okay. Thank you.

Dr. Weitz:                           I can’t wait to do it.

Dr. Vojdani:                        Thank you. So, recently, very recently, about a month ago, I published this article in the journal called Pathophysiology about the role of exposomes in autoimmune diseases. And this figure is taken from there. So, what are exposomes, you’ll see a little bit later on, but they are in general infections, dietary components, toxic chemicals, gut microbiome and effect on the immune system, which may result in autoimmune disease. For genes plus exposomes are responsible for many, many autoimmune diseases, but gene or genetics is only one third. The exposome or the environmental factors are the other two third. So, we have to pay attention more to the environmental factors when we talk about inflammatory and autoimmune disorders. I like very much this article and look at the title of this article, which was published in Frontiers in Immunology about a year ago, environmental exposure and autoimmune diseases contribution of gut microbiome.

That’s exactly what was in those in earlier slide. So, they talk about this dysbiosis of gut microbiome is another important environmental factor, which can alter our immune system, our barriers, our mucosal immune system, that can result in autoimmunity. But you’ll see, I emphasize this sentence in blue and that is the most challenging aspects of autoimmunity is to identify the early events that trigger immune dysregulation and autoimmunity.  So, environmental factors affect the immune system and the more sensitive biomarker based on my opinion is lymphocyte mapping.  And that’s what we are going to talk about tonight.  In the same article, you see that they talk about environmental factors, silica, trichloroethylene, smoking, mercury, pesticides, pristane, and many other toxic chemicals, inducing reactive oxygen species, lipid peroxidation.  ROS can affect, inhibit good gene, enhances bad genes, for example, DNA damage.  And all of that will have a significant effect on the immune system because lipid peroxidation results in neo-antigen formation, what is neo-antigen formation meaning?  Some of these chemicals such as mercury bind to body components, albumin, hemoglobin, smooth muscle, IgG, then results in auto-antibody production, for example, rheumatoid factor is IgM produced against our own IgG.  Furthermore, you see that these neo-antigens affect the T-cell. Tonight, we’ll talk a lot about the balance between Treg versus TH1 and TH17. Tregs are the good guys regulating the immune system and TH1 and TH17 are the autoreactive lymphocytes, when become overactivated by releasing all these inflammatory cytokines can have significant effect on body composition in general. So, these regulation in T-cell, low Treg, high TH1 and TH17 causing cell mediated immune overreaction, and then communication between the T-cell with the B cells results in activation of the B cell, which the B cell then produces auto-antibodies such as anti-nuclear antibodies, rheumatoid factor already mentioned, double stranded DNA, smooth muscle antibody, mitochondrial antibody. And the final result is going to be autoimmune disease. I really love this article, which was published in Frontiers in Immunology, actually summarizing probably my work of 25 years.

So, what are the exposomes?  You can see in here, there are two parts associated with exposome, the external environment, which I talked about, but we have to include stress, lifestyle, indoor air pollution, outdoor air pollution, diet, and additives. Please do not forget salt. This is an opportunity. Too much salt is activating T helper 17 and vitamin D downregulating TH17.  So, when you talk about, we have to take our vitamin D, please also think about reducing the amount of salt that you take.  Medications, infections, xenobiotics.  So, those are external environmental factors.  Now, we have internal environmental factors, protein modification. We have more than 600 different proteins get modified internally for many, many reasons that we don’t know about. Our gut flora plays a significant role in inflammation and autoimmunity and on this side you have proteins adducts and many other factors. So, we have to pay attention to the exposome factors.

This is a cover of one of my books that you see the immune system right here, the GI, and the nervous system, and direct communication between these three systems. And of course, if you ask the neurologist will say, this one is the most important one, the nervous system. Ask the GI, they will say, yes, the gastrointestinal is more important. I am as immunologist, I’m going to fight with them and saying the immune system is more important because it’s communicating both with GI and with nervous system. So, any abnormality anyway, in result of miscommunication between immune system, nervous system, and GI system may result in autoimmunity, which should be in the middle. So, this is gut brain immune access.

So, that will take us since I believe that the immune system is the most important one. Let’s classify the immune system in a simple manner. The mucosal immune system, which our first line of defense, our Homeland Security. Mucous membrane, secretory IgA. SARS-CoV-2 should break down the mucous membrane before getting into the lungs. And secretory IgA is the most protective against SARS-CoV-2. The next humoral immunity, which is the antibodies, IgG, IgA, IgM. And of course also in the case of allergies, we produce IgE. So, remember game, IgG, IgA, IgM, and IgE. Those are the antibodies, but tonight, I’m going to talk mainly about cell-mediated immunity.

T-cells, B cells, NK cells, cytokines, I’m not going to talk about, but indirectly, yes, I will talk about. So in each one of these, these components of the immune system, we have both innate and adaptive. So in the case of innate immune response, three very important cells, dendritic cells, mass cells, and macrophages by taking up the foreign materials can protect the body against these pathogens. The adaptive immune response, also dendritic cells play a role, but by communicating with not even T-cells, which are not being differentiated, they become TH1, TH2, TH3 which is Treg, T17, some natural killer cells and together protecting the body against all the enemies. So, that was a little bit introduction about innate and adaptive immune response. So, let’s put together the picture because unfortunately in the media or the media misled people about the immune system and how the immune system works.

That’s why I put the neuron in here, and you’ll see why I put the neuron in here. So, when we get exposed to a virus such as Corona, the first line of defense, as part of the innate immunity, the macrophages will take that up, internalizing it. And since the virus is very huge molecule, they have to break it down to smaller size called antigens, like nucleoprotein, spike protein. Then, the nucleoprotein or spike protein and other proteins taken up by antigen presenting cells presenting it to T helper cells. So up to here, we are talking about innate immune system, but here, these are components of adaptive immune response that will release either TH1, cytokines, such as interferon gamma, and IL2, activate some T-cells to become cytotoxic lymphocytes. And the job of cytotoxic lymphocyte is to go after the corona virus or cells infected with coronavirus in order to protect the body against that infectious material. When cytotoxic lymphocytes finish the job, they are going to leave behind memory T-cell and memory cytotoxic T-cells.   So if the vaccine did not protect us, which we know that is a reality now, and we get for the second time, or for the second time the same virus get into our body, this memory, cytotoxic memory cells and memory T-cells immediately will go after the virus and try to stop the virus to infect even the macrophages. And that’s how the body become victorious against different pathogens. This part of cytotoxic lymphocyte is also part of innate immune system, because unconditionally will go after pathogens and try to stop them from infecting our body.

Now, in the presence of Th2 cytokines, such as IL-4, IL-13, and others, becomes T helper cell, either Th1, or Th2, and then collaboration with B cells becomes plasma cells, and plasma cells have the capacity to produce antibody IgG, IgI, IgM, and IgE antibodies, and in this particular case, the antibodies will recognize the coronavirus. However, after finishing the job of producing antibody, in majority of the cases, this antibody may stay in the body for a year or two, six months, depends on the antigenicity or structure of the antigen, but that will leave behind short term and long term memory B-cell.  So when the next time the body will have some encounter with the same virus, these B-cells on the normal condition take 14 days to be in place. But this time within a day or two, they will become activated, especially the long term memory cells will start making antibodies and antibodies will go after coronavirus. So altogether the cytotoxic lymphocytes, T-cell, memory T-cell, memory cytotoxic T-cells, and memory B-cell protect the body, not only against the viruses today, but against the viruses tomorrow and even next year, and probably even in next 20 years. So please, based on this principle of the immune system, do not accept what they told us in the media, that the memory lymphocyte will stay in the body only for one year or two. No, the memory lymphocytes are comparable to memory neurons.  If I will see Ben on the street, because I have seen him before, right away, I can recognize you, right? That’s thanks to my memory cells in my brain. The same thing, our memory B-cells, our memory T cells are going to recognize the virus if we had an encounter with that virus six months ago, five years ago, 20 years ago.

Dr. Weitz:                            Now, what’s the difference between the memory B-cells and the memory T-cells?

Dr. Vojdani:                        Okay. Each one of them have different function. The memory T-cells, as you could see in here that mainly they are memory cytotoxic lymphocytes. Their lineage is they have different receptor on their surface. Their job is different.  The memory B-cells job is when the antigen is in the body, they will become plasma cells, and will double produce antibodies. So T-cells do not produce antibodies, the B-cells are going to produce antibodies. So together, the T-cell response plus B-cell response in the form of antibody is going to protect the body against the pathogens. So this was the most important slide. That was the main reason I spent so much time on this. So let’s move on.

So the immune system in people is as diverse as height, beauty, intelligence, and other human features. Our genome, lifestyles, and exposomes affects our immunotypes. Immunotypes, meaning the pattern of lymphocytes. And so therefore, we cannot treat every individual with specific disease with the same medication. So this is the message of lifestyle medicine and personalized medicine. So now, if B cells in the presence of different exposomes, they become Th1, T helper one, T helper two, T-Reg cell, Th9, Th17, the combination of Th1 and Th17, Th22, combination of Th2 with Th22, and the last one is follicular T helper 9.  As you can see, each one of these T-cell subsets have different function. For example, Th1 is involved in pathogenic inflammation and auto immunity, Th2 involved with allergies and hyper sensitivities. T-Reg cell, protection against pathogenic inflammation and autoimmunity, keeping the balance. Th9 is involved with allergic response, T helper 17, although is protecting us against extra cellular pathogens, but when become overactivated participate in inflammation and autoimmunity. And of course, when we have the hybrid cell, hybrid between Th1 and Th17, this is the most pathogenic lymphocyte. So because it does participate in pathogenic inflammation autoimmunity, Th22 in skin dermatitis, psoriasis, Th2 Th22 allergies hyper sensitivities, and Th9 high affinity auto-antibody production.

But there is a point I would like to make in here. Each one of these cells, as you can see, produced different cocktail of cytokines. In the past, I’m saying in the past, many individuals were classifying Th1 and Th2 based on the cytokine they produced.  In fact, there are some practitioners still, they measure Th1 and Th2 cytokines, and they tell you the patient is having Th1 imbalance, or Th2 imbalance. And tonight, I’m going to tell you that’s wrong. Why? Because let’s look at interferon gamma. You’re seen here, it’s produced by Th1, right? Look at interferon gamma here, it’s produced by Th9. So when you measure interferon gamma as a measure of Th1, how do you know it’s produced by Th1 and not by Th9? IL-17 is produced by Th17, but IL-17 also is produced by natural killer cells, NKT cells. So when you measure that as a measure of Th-17, how do you know that IL-17 is not produced by NKT? So in summary, I would like to tell you the best way is to stain and count each one of these cells directly, and not to go after indirect bio-markers. And that’s what exactly we do at Cyrex.

So, furthermore, did you know that in addition to lymphocyte that release cytokines, red blood cells produce cytokines, or release cytokines, or absorbs cytokines, and then release them. Platelet release cytokines. So again, when you measure Th1 or Th2 cytokines, how do you know they’re not produced by red blood cells, platelets, or other type of cells? So that’s the question I’m putting in here? How are you sure the cytokine that is measured is produced by Th1, Th2, Th17, or T-Rex? We are not sure. So that’s why we have to measure immunity by counting different lymphocytes directly, which we call this lymphocyte map or lymphocyte mapping.

So why we have to measure immunity with lymphocyte map, because immune system is essential to protect our body against infection, I already mentioned that. Cancer and other environmental factors. The exposome factors, intrinsic and extrinsic factor have a significant effect on the immune system years before disease development, and sometimes 20 years, that’s the beauty of lymphocyte mapping. So these are some of the factors associated with effect on the immune system. And abnormalities of the immune system can lead to autoimmune disorders, allergic diseases, immune deficiency, and many more that I’ll show you, even Parkinson’s and Alzheimer’s, cardiovascular disease, and more. So quantitative and qualitative changes in the composition of lymphocytes subsets provide an opportunity for not only for early detection, but for prevention of many immune disorders that affect one out of three Americans.

So here, the list of cells that I started measuring in 1989, the time which AIDS was discovered. And so therefore we were doing lots of close cytometry, including T cell, B cell, CD-4, CD-8, and natural killer cell, that’s all. But with advancement in the field of immunology and availability of monoclonal antibodies specifically made against different cluster differentiations, now we can stain additional cells directly, such as Th1, Th2, T-Rex cells, Th17 and other type of natural killer cell. So we used to call this partial immunophenotyping, which was very limited.

And today, this is what we are measuring. The upper part, what we used to do all the way up to 2010, and this is the addition including Th1, Th2, the ratios, T-Reg cell, Th17, and the ratios that we are doing today, which is the major breakthrough. And by the way, this is done in many research laboratories, but Cyrex is the only clinical laboratory doing the lymphocyte immunophenotyping, including all of these, which we call it comprehensive immunophenotyping, or the lymphocyte map. So let’s go back to COVID profiling, deep immune profiling of COVID patients, and talking about distinct immuno type with therapeutic implications. And Dr. Weitz, if I need to stop for 30 seconds after this message, you are more than welcome to interject something in here.

Dr. Weitz:                            Okay.

Dr. Vojdani:                        Because the message is extremely important because what they found that when they looked at several hundred of patients with COVID during hospitalization, they found one subgroup, they had hypo activation of the immune system, low white blood cell count, low lymphocyte, low CD-4, low CD-8, low Th17, low Th1, low Th… Everything was low.  Second group, hyperactivation of the immune system. Everything was elevated. And you’ll see some examples. And the third group were comparable… They had COVID, but they were comparable to healthy people. Their immune system was comparable to healthy people. So the question I’m putting in here, and I had COVID, I was hospitalized for four days. So how come, even until today, all patients with COVID are treated with the same cocktail of medication.

Dr. Weitz:                            Well, when all you have is a hammer and we use the hammer for every job you have.

Dr. Vojdani:                        Yeah. So we realize, or we know we appreciate that personalized treatment. And if you read this sentence right here, these immunotypes may have implication for design of therapeutics and vaccines for COVID 19. This was published more than a year ago.

Dr. Weitz:                            Now, what about we hear all the time, the real risk of severe COVID has to do with this cytokine storm that happens in the lungs, and so that’s the reason, I think, for using the dexamethasone is that everybody with severe COVID has this cytokine storm is extreme inflammatory process that we’re trying to intervene in.

Dr. Vojdani:                        I will have an answer for you. First of all, there are lots of articles, and you’ll see in my continuation of my presentation, that the one with low white blood cell counts, low lymphocyte, low CD-4, low CD-8, it makes sense. When you don’t have enough soldiers to fight for you, then the body’s not going to survive. The cytokines storm and other… Whatever factors produced by these few lymphocytes in our body. So the one who did not survive in the hospitals were the one who were suffering from hypoactivation of the immune system, not hyperactivation of immune system, relatively. Okay. So let’s continue. So here example, this article, I think published very, very recently.

Dr. Weitz:                            But by the way, you’re saying that patients had low white blood cells prior to getting COVID, not that their white blood cells got low after getting COVID.

Dr. Vojdani:                        They say at the time of hospitalization. So obviously they had probably low white blood cell counts and low lymphocytes before.

Dr. Weitz:                            Right.

Dr. Vojdani:                        I believe so. Yes. So here example, and in this article, they found that the threshold for T-cell was 400, CD-200, and again, we used to say individual with less than 400 CD-4 cell, they may have AIDS. Now they reduce that to 200. So this is the extreme, CD-8 less than 100, B-cell, less than one to 20. And I believe that also is less than 100. So conclusion, the results of this study suggest that evaluation of peripheral blood lymphocyte in COVID 19 patients could be valuable in the study of the immune responses to the disease and the prognostication and of the outcome. So if you have a picture like this, the probability of surviving the virus is very low. But in individual with hyper activation of the immune system, even you have cytokines store, the probability of surviving the disease is much, because you have so many soldiers that are fighting for you.

Okay. So let’s look at some examples. So this is my own blood. Okay. So what are we looking at? This is before COVID. White blood count, very nice, total lymphocyte, beautiful, and B and T-cell ratio 5.6, CD-4 CD-8 ratio 2.7, and you’ll see the normal ranges, Th1, Th2, 3.9, right in the middle, Th-17, T-Rex 1.5 again, in the middle, and NK cytotoxic, NK normal, I had few extra NKT cell, which I don’t think in here cause any problem in my body.

So these are the seven components that we use for interpretation of the test results. That’s why I call them the magnificent seven to look at these for interpretation of results. So please remember this is before COVID. Now, when I was in the hospital and few, when I released from the hospital, this is what I did. Look what happened. This is hyperactivation of the immune system. The T-cell were increased by 20, 30%, helper cells were increased, Th1, Th2, T-Rex cells went down, and NK T-cell also went up significantly. So this is five months after, because the test was not available. Okay. Then I repeated the test three months after that, look what happened.  So almost everything, almost went back to normal. So this is the beauty of lymphocyte immunophenotyping and classification to hyperactivation and hyperactivation of the immune system. So yes, Dr. Weitz, I had cytokine storm, hyperactivation of the immune system, but I did survive the disease, because my soldiers knew how to fight, because of my lifestyle, my normal lifestyle.

Dr. Weitz:                            And, and somebody who had low white blood cell count, if you give them dexamethasone, that’s going to suppress their immune system even more, and that could be why those patients who don’t respond don’t do well with that treatment.

Dr. Vojdani:                        That’s the exact point I made and I agree with you that imagine the person is having only 600 lymphocytes instead of having couple thousands. You put them on dexamethasone. So even if those cells could produce some beneficial cytokines, they’re not going to produce them anymore. You inhibit them. So that’s why, unfortunately, those who died in hospitals, they were suffering from low number of soldiers. Okay. Let’s continue now.

Dr. Weitz:                            And what percentage of our population probably has low white blood cells, especially considering, since the topic is autoimmunity, how common these drugs that suppressed part of the immune system are that are often used to treat autoimmunity.

Dr. Vojdani:                        We have a round table discussion every other week, by Cyrex. Another meaning you order your own lymphocyte map. Then two weeks later, you can participate in this round table discussion and I’ll put your test result, without of course, revealing your name. We’ll discuss your patient’s test results. Only based on what we got at Cyrex I can attest that about 20 to 25% of those orders came through Cyrex had very low lymphocyte count, T cell and B cells helpers, suppressor, and so forth. Okay. So now let’s go to methodology.

Dr. Weitz:                            Hang on one second. Somebody asked a question. Since your immune system was working so well, why did you end up being hospitalized?

Dr. Vojdani:                        First of all, it wasn’t needed to go to the hospital. But always, you have to listen to your wife. Because the doctor told her that, “He has the beginning of pneumonia.”

Dr. Weitz:                            On the basis of what?

Dr. Vojdani:                        Well, was listening to my-

Dr. Weitz:                            Okay.

Dr. Vojdani:                        … Lungs. And, by the way, they put me on a medication, Remdesivir. It is proven that Remdesivir prolongs stay in the hospital, or prolong the patient’s stay in the hospital. So they’re not using it anymore. Was published in several articles.

So let’s move on to methodology. The methodologies is called flow cytometry. What is flow cytometry? The study of cells, as they move in fluid suspension, allowing multiple measurements to be made per cell. Another meaning, we can count more than 20,000 cells in less than one minute. Imagine when I was in graduate school and the professor put me behind the microscope to count 20,000 cells. How long would’ve taken? Probably a week. So now, in a minute with, high reproducibility can report a results.  So what do we do? We take drop of blood, mixing it with mixture of monoclonal antibodies, which each one have different color. And each cell we have different cluster differentiation, CD. Like T cell has cluster differentiation, 23, or three. B cell has cluster differentiation 19, specifically. And the same thing for Th1, Th2, Th17 and Treg cells. Okay? So the antibodies now, if they are red, they will bind only to cluster differentiation specific to that monoclonal antibody.

So now when this mixture of cells go through the sheath fluid, they get separated based on their color, red or green. And then, when it goes into very narrow area, the laser will hit. The red cells will go to one direction and the green cells will go to another direction and will count 20,000 cells and will give us the percentage of T cell, B cell, T helper 1, T helper two, Th17, regulatory T-cell and natural killer cell. So this is the principle of the methodology.  So again, you see that B cell has specific cluster differentiation, CD19, it’s right here. You are not going to find that on CD4, you are not going to find that on CD8. And CD4 cell, okay, there is cluster differentiation at four, you are not going to find that on B cell, you are not going to find that on CD8 cells. And the same thing, CD8, which is covered in this area, is going to be found on cytotoxic lymphocyte and not on other type of cells. Therefore, monoclonal antibodies going to stain specifically CD4, CD8, Th1, Th2, Th17 and more. So in less than one minute, the computer will count 20,000 cells and classify them based on their characteristics or their CD marker on the surface of lymphocytes. So that’s why measuring cytokines became obsolete after this, because we are directly staining the cells and we are counting the cells.

So now let’s look at some examples of patients with autoimmune disease. This is a patient with systemic lupus erythematosus. So please, just be with me, and let’s look at up to CD4-CD8 ratio. What do you see? That was a test I used to do between 1989 to 2010. I would’ve reported everything normal for this patient, correct? But when you do measure, Th2 is low, Th17 is high. Then the ratio Th17-Treg is high. The NK cell is high, but overall, this patient is Th17 dominant. And therefore there are many nutritional factors, medications can decrease the number of Th17 and increase the of regulatory T cell, and return the immune system to complete balance. And that will help patients with lupus erythematosus. And by the way, vitamin D is one of those, can bring down the number of Th17 by increasing the number of regulatory T cell.

Dr. Weitz:                           Now is she Th17 dominant because of lupus? Or is the Th17 dominance part of the causation of lupus?

Dr. Vojdani:                        No one really can answer that question. Based on my opinion, could be both. Okay. Environmental factors can increase the number of Th17 years before systemic lupus erythematosus. But if you don’t do anything about it in individual who is Th17 dominant, most probably that person will end up five years, 10 years, 20 years later, with full blown lupus or other type of autoimmune disease.

Dr. Weitz:                           Sorry, what do you say-

Dr. Vojdani:                        Do we have-

Dr. Weitz:                           What are you saying will bring down the Th17 more directly, other than vitamin D bringing up the Tregs.

Dr. Vojdani:                        Please, please. Wait.

Dr. Weitz:                           Okay.

Dr. Vojdani:                        I have slides specifically for that.

Dr. Weitz:                           Terrific.

Dr. Vojdani:                        Okay. Yeah, let’s go. So the next item is patient with Lyme disease, multiple chemical sensitivity, repeated concussion, and Dr. Mosnik is very familiar with those patients. Elevated 21-hydroxylase, meaning adrenal insufficiency, elevated parabens, toxic chemical exposure, reaction to many foods like out of 180 measured by Cyrex about 70 of them were abnormal. So highly reactive, antinuclear antibody one to 80.  So when we did this, guess what, first of all, you see that number of helper cells are elevated, 1,174. And relatively CD4-CD8 ratio is 3.9. The ideal for me is around two. Then T helper 1 is increased, and T helper 17. So this individual was classified as Th1 plus Th17 dominant. And this is an answer to your question, Dr. Weitz, this individual doesn’t have autoimmune disease, but is having Lyme disease, exposure to chemicals and adrenal insufficiency, chemical antibodies, food immune reaction. So this is a classical patient. If the doctor will not take care of this individual down the road will develop full blown autoimmune disease.

Dr. Weitz:                            Now, if you correct the Lyme disease and some of the toxins and, and food sensitivities, will the immune system go back into better balance?

Dr. Vojdani:                        I have no doubt. I have no doubt. Yes. But as we do more testing, we learn every day. So now, that was relatively high CD4-CD8 ratio. So look at these patients. Multiple chemical sensitivity, they react to everything. Look at the ratio of CD4-CD8, even is less than HIV and AIDS. We used to call this chemical induced immune deficiency syndrome. So, unless you take care of chemical sensitivity, which is not easy, these patients react to everything, perfume, name it, everything. So never CD4-CD8 ratio should be less than one. The best is two. As soon as goes higher than three, it goes towards autoimmunity when it goes below than one that goes towards immunodeficiencies. So we have to take care of that.

Now this is the opposite case. Look at CD4-CD8 ratio of 5.6. This patient is having inflammation and autoimmunity. What kind? I don’t know. That’s what the doctor told us. But again, high CD4, relatively low CD8 resulted in ratio of 5.6. I do see this in patient with rheumatoid arthritis, lupus, thyroiditis, multiple sclerosis, and many other disorders. And then you see the patient also is having very high Th1. So it is also Th1 dominant. So the high number of T helper cells actually, most of them are Th1 and some of them also are Th2. So the patient is mainly Th1 dominant, and therefore they have to take care of the increasing, probably, the number of cytotoxic CD8 cells return the balance between CD4-CD8, and hopefully that will also result in correction in the number of Th1 and Th2 cells.

Go to the next one. This individual, as you can see, had low IgG2. EBV early antigen, this is not IgG antibody elevation. Early antigen, meaning EBV became reactivated and B cells became activated to produce more antibodies, whether mold exposure was part of that, I really don’t know, but here we see combination of two different pathogens, molds and Epstein-Barr. Caused what? Significant elevation in Th17. This individual is classical Th17 dominant, with elevation of natural killer cells, because natural killer cells probably tried to fight the Epstein-Barr virus, and maybe even the mold.

So you see these, abnormalities are found not only in patient with autoimmune disease, patients exposed to environmental triggers. So those were some of the cases. What is the clinical importance of comprehensive lymphocyte immunophenotyping. And as you can see in here, first of all, this is based on articles I read in scientific journals, and this evidence is in different journal articles in relation to different autoimmune diseases. For example, in Thyroid autoimmunity, they found patients, most of them, were Th1 dominant. When they treated them with antithyroid drugs, the number of Th1 went down the number of Th2 went up, and therefore more balance between Th1 and Th2. And that shows that the treatment that the doctor gave to that patient was working for that specific patient.

Dr. Weitz:                            So this was patient with Grave’s, right?

Dr. Vojdani:                        Yes.

Dr. Weitz:                            Okay.

Dr. Vojdani:                        The same thing, I’m not really going to read this again, in rheumatoid arthritis, Th17 dominant, they claim that methotrexate brought down the number of Th17 and there some publications in scientific journals that I read about, and this is one of them.  I read more multiple sclerosis, Th1 and Th17 dominant. Why? Because these are, remember, the hybrid cells. These cells, under inflammatory condition, have the capacity to break down the blood-brain barriers and get into the brain area, cause inflammation in the brain, resulting in neuronal cell death that result in multiple sclerosis and in some cases, even in Alzheimer’s and Parkinson’s disease. So when they put them on medication, they could bring down the number of Th1 and Th17. And the patient did not have relapse for a long period of time.

The same story about scleroderma and lupus, mainly Th17 and also Th1 and Th2. After treatment, they saw significant improvement in the patient’s condition by doing the lymphocyte immunophenotyping. Psoriasis also, when they were treated with Anti-IL 17, that’s a new medication that they block production of IL17, by so-called Th17, but other cells also producing IL17, they could see significant improvement in inflammatory condition in patients with psoriasis. In relation to COVID, already talked about that those who had low lymphocyte and T cell subsets relatively did not survive the disease. And many of them passed away in the hospital, unfortunately.

So this is the proof of concept that lymphocyte immunophenotyping and treatment, where if works, we can see that by follow up testing with lymphocyte immunophenotyping. So now I’m going to share with you few flowers. Okay. So you see the lymphocyte. I said that 25% that tests that come to Cyrex, they have low lymphocytes. How can we increase that? All of these are in here, but none of them can get close to this and this. Exercise and good nutrition.  At least, three or four articles published in science or nature that showed that exercise increasing production of growth factors that enhancing production of different lymphocytes. And of course, good nutrition. And therefore, I’m not going to read all of this. Okay. Because we don’t have time to go through each one of this.

Next, B cells. We have only few items, but definitely probiotics and specifically Lactobacillus Casei. IgG, this one. So you see lactobacillus, lactobacillus, DHA, fish oil, beta glucan, curcamine. So all these can increase the number of B cells, which is very important.

Next, CD4 cells. IVIG, vitamin D, again fish oil and many others. CD8, so unfortunately we have only few, and BCG vaccination is one of them. And by the way, BCG vaccination also is protective against COVID, because BCG shares homology with SARS-CoV-2. Peanut agglutinen, it’s only one publication. And again, vitamin D. So vitamin D is really the most important molecule. DHEA, five milligram per day.

Look at Th1. Monoclonal antibodies, there are medications, corticosteroids, you have dexamethasone and metformin. The rest are fish oil, zinc, vitamin D, green tea, fish oil again, resolvins, polyphenols, curcumin, bromelain are instrumental in bringing down the activity of Th1.

Th2, you’ll see sometimes the same item may be in both. Why? Because sometimes the issue is immune regulation. They regulate the immune system and therefore, back to balance. So these are, again, you’ll see vitamin E probiotic, zinc, fish oil and many others.

Treg cell is one of the most important one that you should take care of in patients with autoimmunity. So here IVIG, azithromycin. It is enhancing the activity of Treg cells. Chloroquine, if I’m allowed to mention today also increasing the activity of Treg cell. Dexamethasone, and of course, indole-3-carbinol, short-chain fatty acid, L-arginine, DHA, astragulus, Quercetin, berberine, curcumin, lactoferrin, you’ll see that all these factors can regulate the Treg cells and bring down or back to balance Th1 and Th2 imbalance.

Th17 again, chloroquine, IVIG, dexamethasone, metformin and the other factors. But again, remember sodium chloride is increasing, not decreasing the number of Th17 and increasing their activities also to produce more IL17.

So now sub item in the almost was everywhere, correct? So now I would like to share with you the article that I read yesterday in nature immunology, roll of the T-cell vitamin D receptor in severe COVID-19. And they showed that giving vitamin D can bring down the activity of Th1 and increasing the Trx cells, bringing down Th1 and Th17. And so therefore should be recommended for patients with COVID-19. And this is the cover of nature immunology. So bear with me for a few seconds.

So CYP24A1 is a gene that provides instructions for making an enzyme called 21-hydroxylase, the blue. This is the enzyme, this is the vitmain D. Correct? So this enzyme help to convert vitamin D to di-hydroxylated vitamin D. And di-hydroxylated vitamin D get into the nucleus and down regulate Th1 and Th17 and that’s in the next slide. Okay?

So in individual with vitamin insufficiency, T-cell become over activated and they do suffer from inflammation. And if we do not correct that individual may end up with autoimmune disease. Because they produce lots of IL17, because Th17, IL22, interferon gama, they produce less IL6 and IL10, which IL10 is regulatory cytokines. Now we give vitamin D to these patients and they become vitamin D sufficient. So vitamin sufficient, they produce less the cells.

Dr. Weitz:                            Somebody asked is it –

Dr. Vojdani:                        Less IL17, they produce less IL22, they will produce less interferon gama, but will produce more IL6 and IL10. And these cells in the presence of vitamin D can resolve inflammation. This is the message of this article from nature immunology. Did you have any question?

Dr. Weitz:                            Yeah. One of the questions is, it’s common in the functional medicine world that we typically prescribe vitamin D with vitamin K2. In this context, is that also important?

Dr. Vojdani:                        I personally take vitamin D with vitamin K and they do not mention in this article, but other articles discuss the importance of additional vitamin K to vitamin D. Thank you for asking that.

Dr. Weitz:                            Okay.

Dr. Vojdani:                        So that is very well accepted.

Dr. Weitz:                            Also, are you able to share your slides with us and if not, can we get a list of these nutrients that work with these different factors?

Dr. Vojdani:                        Okay. I can provide you with a list of references.

Dr. Weitz:                            Okay.

Dr. Vojdani:                        By the way, for each one of these, I have between two to five, sometimes 10 different articles. For example, resveratrol, I can name 10 different articles that can activate natural killer cells. For example, for some, I have one or two. Some I have five, some I have 10, so I can share with you definitely. The references is better that way.

Dr. Weitz:                            Okay.

Dr. Vojdani:                        Because I’m not promoting any product in here.

Dr. Weitz:                            Right.

Dr. Vojdani:                        But references definitely you can share with audience. Tomorrow morning that will be the first thing I’ll do for you.

Dr. Weitz:                            Great. Thank you.

Dr. Vojdani:                        So natural killer cells. Again, I did work with vitamin C 500 milligram to 1000 is the most ideal, but there are others, including ashwagandha, medicinal mushrooms, astragalus, all of them can increase the activity of natural killer cells.  So now in the last few slides, I really would like to bring your attention to this fascinating article published in Journal of Immunology. It was so important that the editor in chief wrote some review article about all of this. So they emphasizing the importance of microbiome. Remember in my second slide, environmental factors, plus the gut microbiota, the bad microbiome may contribute to all autoimmune disease, but here they emphasize the importance of good microbiota and recommending very strongly to use prebiotic and probiotics. Why? The mechanism is right here. Let’s look at why you have to have one apple a day. So you see the picture of the apple, right?  It has lots of inulin, which makes good microbiome to produce short-chain fatty acids, such as butyrate rate and that butyrate rate activate Trx cell and inhibiting the inflammatory cells. This is one example. Liver, colic acid, gut microbiome can change that to deoxycholic acid. Again, deoxycholic acid activate Trx cell and inhibit. First of all, inhibits macrophages, but improves or enhances gut barrier function, which is the root cause of many autoimmune diseases. That’s why detoxification is so important. And again, the reference is right there. This is in journal of immunology about three months ago.

The third one in is the tryptophan that they took it out of the market years ago, unfortunately, but food containing tryptophan is metabolized by the gut microbiome, production of indole and indole derivatives by the gut microbiome and again inhibits, like Th17, but enhancing the gut barrier function. So therefore the importance of probiotics, prebiotics, vitamin D and other nutritional supplements for patient who may have abnormal lymphocyte map. So let’s conclude that what disorders so far based on the articles that I read in scientific journals could be associated with abnormal lymphocyte map, multiple chemical sensitivity, chronic fatigue, fibromyalgia, cancers, asthma, allergy, hypersensitivity, variety of autoimmune diseases, all the way to here psoriasis, phospholipid syndrome, diabetes, multiple system atrophy, uveitis, heart disease, including cardiomyopathy, Alzheimer’s, Parkinson’s, schizophrenia. And also I have read this article about recurrent pregnancy loss, especially when they have too many natural killer cells, especially NKT cells, and then also COPD, and of course COVID and other infections.

So the last two slides in conclusion, I would like to summarize again, why is so important to measure immunity with lymphocyte map? Because the immune system is our homeland security. It is our policeman, our police department. It is our army that is protecting us against many environmental factors. And these are the environmental factors and abnormalities of the immune system. Down the road can lead to immune disorders, auto immunities and immune deficiencies. And quantitative and qualitative changes in the composition of lymphocyte subsets provide an opportunity for the early detection and prevention of many immune disorders that affect one out of three Americans. And finally, I would like to emphasize the importance of personalized immunity for personalized medicine. So it is important to look at lymphocyte map and based on abnormalities in lymphocyte map to provide the patient with personalized medicine.  Hopefully that personalized medicine will take care of abnormalities of their lymphocyte map. And so finally, finally, I would like to emphasize that and go back to that slide from science that individual with hypoactivation of the immune system should be treated differently than the one with hyperactivation of the immune system and with the one even they don’t have any abnormalities of the immune system.  And with that, thank you so much. And I’m ready to answer any question if you have.

Dr. Weitz:                            So that was excellent, Dr. Vojdani. So my first question is, let’s say a patient comes into your office and they already have autoimmune disease. Let’s say they have rheumatoid arthritis or some other autoimmune disease. And we know that we have toxins, food sensitivities and infections that can trigger autoimmunity. And now we know that these immune imbalances can be factors. If we were going to decide what to do first, would it make sense to address food sensitivities, infections, toxins, or would we want to try to balance the immune system first?  What would you think a reasonable clinician should do?

Dr. Vojdani:                        I will answer your question a little bit differently, but I will answer also that specifically. A patient is coming to you for the first time. Where do you start? And that’s the question. Some start with array 2, which they do measure the integrity of gut barriers. Some start with the lymphocyte map, but I will start with lymphocyte map and looking at the barriers. Because the barriers plus lymphocyte map can guide me to the environmental triggers, which causes some of these abnormalities. In one person could be food, in one person could be toxic chemicals, in another person could be pathogen and in some could be all the above. So that’s how I will start.

Dr. Weitz:                            So somebody asked, if we’re treating their immune imbalance based on lymphocyte map, are we treating the root cause? Are we treating a downstream effect of say food sensitivities or toxins?

Dr. Vojdani:                        You are not treating the root cause, unfortunately. You are treating the results. Hopefully after lymphocyte map also you’ll get to the root cause of the problem. Because, let’s take example, your patients is reacting to lectins and agglutinins. They could not or they cannot digest lectins and agglutinins, especially wheat germ agglutinin and phytohemagglutinin, which is produced by beans, kidney beans example. If they don’t digest that and they make antibodies against these agglutinins, those antibodies cross react with thyroid for oxidase and causing thyroid autoimmunity. Unless you remove that food from the diet of the patient until the gut barriers are repaired. Until you provide digestive enzymes to that patient, make sure that undigested molecules in this case, lectins and agglutinins will not get into the blood of the patient.

Dr. Vojdani:                        And patient will not make antibody against that regardless how much the patient’s Th1 and Th17 is abnormal. If you don’t take care of the root cause still six months later, some of these may go back to square one where we started.

Speaker 1:                          Dr. Vojdani, how often do you find that people test positive to antibodies to lectins to more than one lectin?

Dr. Vojdani:                        I would say about 20% of the cases.

Speaker 1:                          Okay. Thank you.

Dr. Vojdani:                        Welcome.

Dr. Weitz:                           Now, Dr. Vojdani, what do you think could be the best marker for, let’s say we’re treating a patient with autoimmune disease. From a functional medicine approach, we’re trying to get to the root cause. Let’s say they get whatever treatment they need maybe for symptoms, but we’re trying to get to the root cause. What is the best marker that we’re treating the underlying auto immunity? Is it, can we expect autoimmune antibodies to go down? Can we expect the lymphocyte map test to improve? What do you think is the best way for us to know show objective progress, not just say on the fact that their TSH is normal, but that we’re getting to the underlying autoimmune process?

Dr. Vojdani:                        I have no doubts that we have to look at both, the antibodies and also the lymphocyte map. Because in many autoimmune diseases, both antibodies and cell-mediated immunity play a significant role. So you have to look at antibodies and you have to look at lymphocyte map in order to find whether or not your treatment made a difference in the life of your patient.

Dr. Weitz:                           So do we have good data that say, for example, antibodies going down correlates with, say less likelihood of destruction of their thyroid on a long term basis?

Dr. Vojdani:                        I think there are lots of articles in the literature and also in relation to lymphocyte map, I will show three or four slides towards the end of my talk.

Dr. Weitz:                           Okay, great. So both those could be measures of -?

Dr. Vojdani:                        Yes.

Dr. Weitz:                           Great. Okay. Any other question? How often should we retest for this patient’s evaluation with a lymphocyte map, say?

Dr. Vojdani:                        You can learn from my test after COVID between three to six months. Because cell-mediated immunity, for example, we have abnormal Th17, is not going to change overnight. The same thing for Th1 and others. They’re not going to change overnight. When you make intervention, wait, please, at least three months, but even I will recommend six months and then repeat the test.

Speaker 1:                          Dr. Vojdani, when you’re talking about cholic acid, we’re basically talking about bile acids, is that correct?

Dr. Vojdani:                        Yes.

Speaker 1:                           So it sounds like it’s important for us to make sure that our patients bodies are producing bile acids adequately.

Dr. Vojdani:                        Yes. Correct. Thank you for mentioning that.

Dr. Weitz:                         Okay.  Okay, great. We’re going to wrap it there unless there’s any final questions. That was a fantastic presentation, Dr. Vojdani. Thank you so much for the information.

Dr. Vojdani:                        My pleasure, and tomorrow I will send the references.

Dr. Weitz:                           That’s great. I can’t wait to take my lymphocyte map test. Okay. Thank you everybody and we’ll see you next month.

Dr. Vojdani:                        Bye-bye.

Dr. Weitz:                          Thank you.



Dr. Weitz:                            Thank you for making it all the way through this episode of the rational wellness podcast. And if you enjoyed this podcast, please go to Apple Podcast and give us a five star ratings and review. That way, more people will be able to find this rational wellness podcast when they’re searching for health podcasts. And I wanted to let everybody know that I do now have a few of openings for new nutritional consultations for patients at my Santa Monica Weitz Sports Chiropractic and Nutrition Clinic. So if you’re interested, please call my office (310) 395-3111 and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Dr. Ben Weitz. Thank you and see you next week.




Parasites and Chronic Diseases with Dr. Todd Watts: Rational Wellness Podcast 243

Dr. Todd Watts discusses the Role of Parasites in Chronic Diseases with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.] 


Podcast Highlights

1:16  Dr. Watts went through a lot of stress in 2008 during the recession and he lost his houses, his cars, and his health crashed and he suffered with Lyme Disease and Babesia and parasites and he had massive fatigue and brain fog and chronic back pain and joint pain, even while going to chiropractic college.  He discovered that parasites tend to upregulate Th2, which suppresses Th1.  He discovered that Mimosa Pudica Seed is really effective for both Lyme Disease and for parasites, so he launched his company Cellcore with a Mimosa Pudica product that he calls Para 1.  Mimosa helps in cleaning the GI system out and helps in clearing parasites that allows the immune system to rebalance and help take care of Lyme disease.

7:19  Dr. Watts believes that parasites are very common and parasites come through mosquito bites, flea bites, tick bites, through food, water and through being around household pets.  He does not feel that stool tests do a good job of screening for parasites. Stool tests will only screen for parasites that are in the stool and parasites are throughout the body and not always in the stool.  DNA based stool tests will only pick up parasites that they screen for and they only screen for a small handful of all the known parasites. Parasites upregulate part of our immune system and downregulate our Th1 function. This also results in motochondrial dysfunction and fatigue. 

11:47  Protocol for removing parasites. Dr. Watts said that when removing parasites the first step is to treat the gut, because if they’re not moving their bowels well and their lymphatic drainage isn’t working well, then they won’t be able to clear parasites and they will get swelling and headaches and skin problems. He recommends starting out with Para 1 and Para 2, which is a blend of Ayurvedic herbs, which helps to balance the gut and is antibacterial, antifungal, and antiparasitic.

14:46  Clearing parasites does not mean that we need to eliminate all toxins, but significantly reduces them and it also means that we have to deal with clearing toxins and we also need to restore our gut flora and the microbiome.

15:40  Toxins can store in our bones, fat, and other tissues in our bodies. A common understanding is that only oral chelating agents like DMSA and DMPS can pull these toxins out, but these substances may not really be true chelators because a chelator has ionic bonds, while fulvic acid and humic acids are natural substances that have many of the same properties as chelators and can help to remove toxins, though the FDA says that they cannot be called chelators.



Dr. Todd Watts, who’s nickname is “The Parasite Guy”, is one of the founders of CellCore Biosciences and he speaks regularly on foundational medicine and overcoming chronic illness.  He speaks often about parasites, Lyme disease, mold toxicity, and mitochondrial health.  He is the owner of Total Body Wellness Clinic in Meridian, Idaho.  CellCore is a professional supplement company that only sells through the offices of health care practitioners and their website is CellCore.com

Dr. Ben Weitz is available for Functional 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 and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.


Podcast Transcript

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

Hello, Rational Wellness Podcasters. Today, I’m excited to interview Dr. Todd Watts on how to overcome chronic health challenges like parasites, Lyme disease, mold toxicity, and other toxins. Our special guest today is Dr. Todd Watts, whose nickname is The Parasite Guy. He’s one of the founders of Cellcore Biosciences, and he speaks regularly on foundational medicine and overcoming chronic illness. He often speaks about parasites, Lyme disease, mold toxicity, mitochondrial health. He’s also the owner of Total Wellness Clinic in Meridian, Idaho. Dr. Watts, thank you so much for joining us today.

Dr. Watts:            Dr. Ben, good to be here. You can call me Todd.

Dr. Weitz:            Okay. Thanks, Todd. So perhaps you can start by telling us about your personal health journey and how you were able to overcome your challenge with Lyme disease.

Dr. Watts:            So in 2008, the markets took a big hit, a lot of stress in my life and my health just crashed down and I lost everything, my houses, cars, and I went back to school to get my doctorate at the age of 41. With that, as I was going through that process, I had a lot of common symptoms that people have, chronic headaches, joint pain, a lot of brain function issues, word recall stuff, and I just couldn’t, even being at chiropractor school, I couldn’t get rid of my chronic back pain. I had wrist pain, joint pain in my hands and I couldn’t even recuperate it or work out. I went about almost nine, 10 years without being able to work out and recover. Probably the worst thing for me was fatigue. So I had fatigue, just general, this massive general fatigue, wanted to sleep all the time. Then the other thing was I had brain fatigue and muscle fatigue.

So I broke it down. Three things I had to overcome in fatigue world. For me, it was I got my overall energy back, but I still couldn’t work out. I still couldn’t recover, and then my brain started coming back after that. I realized later on that there’s different reasons why those other areas took longer to recover and have energy again.  So in my journey, and then becoming an doctor and helping other people with Lyme and Babesia. Babesia was probably a bigger factor than the Lyme was. Then in that journey, I realized that I kept cycling, and cycle issue is what a lot of us go through that have Lyme disease. I would do well for a while and then I’d crash, and do well for a while and crash.

I had this doctor say, “Hey, Todd. You probably have some issues with some parasites and you need to address parasites.” Well, I don’t know anything about parasites. I’ve heard of them. I lived in South America for a couple years, and I knew about them down there because you didn’t want to drink the water and you had to be careful what you ate. You didn’t eat the lettuce, and there’s a few things you didn’t eat because you know you’d get parasites. Well, I was 19-20 years old when I was down there and you’ll have diarrhea for a month. That’s just normal for being in South America, but I probably got parasite when I was down there.  So I started this journey and as I was working with people with chronic illness that as I started addressing parasites and understanding the immunology of how it works, all of a sudden my patients stopped cycling. My energy came back. I stopped cycling with Lyme and Babesia, and I got up to 90% better, and that’s where I then dove to more into the toxin world and understanding heavy metals and then getting into environmental toxins and glyphosate, and later on mold and mycotoxin illness, which wasn’t a struggle for me, but was a struggle for other people that I worked with quite significantly.

That’s where it helped me understand the importance of mitochondrial function and how that interacts with the immune system and then also Th1 versus Th2 immune function because if one side is suppressed because the other side is upregulated, which happens with parasites, parasites upregulate Th2, which suppresses Th1, which then you have all these viruses and Lyme and protozoan infections. It’s really hard to overcome that unless you take care of the other issue or mold will suppress them both and suppressing just overall mitochondrial function is an issue.  So for me, that was a big major hurdle in my area, and as I come across some new products that I brought to the market worldwide, which was Mimosa Pudica Seed, which is our Para 1 product, that massively changed my life, that also helped many thousands and thousands of other people in their journey. So my company, Cellcore, was launched with one product, and then we’ve developed other ones to help the process of people going through phases to get better in that long, long run.

Dr. Weitz:            Interesting. Interesting. We’re going to have Dr. Vojdani speak to our functional medicine group this month, and he’s got some new immune testing to look at Th1, Th2 balance and some other parts of the immune system.

Dr. Watts:            He’s great, and that’s fantastic. I remember listening to him speak before, and he said 60% of autoimmune disease is caught by toxicity, 30% by pathogens, and 10% other things. That stuck in my mind because at the time I thought, “Well, I thought pathogens, Lyme, and viruses, and these things cause most of autoimmune disease”.  He said, “No. It’s toxicity.”  He was right in what I’ve learned going through the process of understanding all the different types of toxins in today’s world and how we’re exposed to them on a daily basis through air, water, and food.

Dr. Weitz:            I noticed that one of the nutrition products you like to use for Lyme disease is Mimosa Pudica, which I interviewed Dr. William Rawls a few years ago and he mentioned that product and that’s not something I had heard of before. Is that something that you use regularly for Lyme patients?

Dr. Watts:            Well, when I first learned about it probably seven years ago, Dr. Klinghardt had been using a little bit of BioPure, but he didn’t have it available. As I dove into that product, he was using the bark of the whole seed, the whole plant. So I found a source out of India through an importer here from the US that I worked with, and he brought back to me one of the times was the seed itself. That’s where we launched our company four and a half years ago with just that product and how it works with Lyme disease is that it helps in cleaning the GI system out and also helps with clearing parasites in toxins that then allows the immune system to rebalance and help take care of Lyme disease issues.

Dr. Weitz:            Now, what do you think is the best way to test for parasites?

Dr. Watts:            Well, I always joke around is you put a couple fingers here and if you feel a pulse, you got a parasite. We live in this world that we all have them, and parasites can be in a whole variety of things, which 70% of them you can’t visualize or see. They come through mosquito bites, flea bites, tick bites, through food, through being around animals, through your water. I had a client I worked with, she was a pharmacist. Her husband was an engineer back east, and they found that they had parasites, and we found it in their water, in the municipality water that they had nematode larva in their municipality water. So it’s amazing where you think you’re getting clean access to stuff in the US but not always. So in reality-

Dr. Weitz:            We do a lot of stool testing and they screen for parasites and I have to say it doesn’t come off that often.  No. I totally agree with you. It rarely comes up. So I had to stop looking at that. I look at that as a factor of, “Okay. What’s going on maybe with different things?” but it rarely comes up with it, but then a proof I found is right in the toilet, and then in the research that I did with a lot of symptoms and the different types of parasites, if 78% of them are visible and they’re microscopic and they’re throughout the body, then how are you going to get that on a stool sample test?

Dr. Weitz:            Well, will the DNA technology pick it up?

Dr. Watts:            Oh, not necessarily because they’re not testing every parasite, right? They’re limited on how many parasites they’re testing and then are they testing Babesia? That’s a parasite. That’s like malaria. They tested malaria?  No, they’re not testing that. They’re testing for toxoplasma gondii or you start going into schistosoma or some of the hookworm stuff or the lung flukes. Lung flukes don’t come out in stool. So then you have liver flukes and you have pancreatic flukes. There’s blood flukes, and they start doing this deep dive into parasites, and there’s so many different kinds that they’re not testing for very many of them.  I just had to realize that I had to use more of my clinical knowledge and research versus relying on lab testing. Lab testing, there’s not a single lab test that’s accurate by itself, and that’s where I’ll use multiple lab tests to get a conclusion, but I also use common sense, assessment forms to help these people that have been sick for so long.

Dr. Weitz:            So you’re saying there’s really not a definitive task for parasites?

Dr. Watts:            No, not at all, not whatsoever. None of them are good. You have to assume that they have parasites. Otherwise, you’re going to have an imbalanced immune system because this is what happens. When people are coming to my clinic, they have a stack of labs like this and you look at, “Okay. What don’t they have?” So they have Lyme, and they have Bartonella, and they have cytomegalovirus, and they have HHV-6, and they have Epstein-Barr. There’s this whole list of everything they have. Do they really have an infection problem? No. They have an immune system problem.  So Th1 was suppressed. What suppresses Th1? This is my research. Then I found parasites do that, and it upregulates IgE and it upregulates other interleukins such as Interleukin 4, 5, and 13. That then will cause other suppression of issues within Th1 function. So when you start understanding the immune system with that, that just triggered my mind. It’s like, “Oh, wait a second. I’m treating Lyme all wrong years ago. I’ve been trying to treat the infection instead of looking at the bigger picture of how the body works, how the immune system works,” and when I did that, everything changed because when you’re looking at the function, what triggers the immune system?  There’s a cytokine called a mitokine. It’s an ATP molecule, which is what we use for energy, but also as a cellular signaling molecule outside the cell. So it tells our immune system, “Hey, look. There’s something going on here. So you’re going to be tired to fight this, and we’re not going to use that to make energy. We’re going to use that to fight and help your immune system work.”  That got my mind thinking like, “Okay. This is why I’ve been tired. This is why I’ve been fatigued. This is what I have going on here, why I can’t create this energy and work out again. It’s because there’s mitochondrial dysfunction due to toxins causing this problem.”

Dr. Weitz:            So what’s your protocol for getting rid of parasites?

Dr. Watts:            So what we do at first is because in my journey of helping people, the problem, “Oh, hey, let’s go after the gut and treat gut first because in functional medicine we learn you want to treat the gut first.” Now, what I’ve learned is people, if they’re not moving their bowels well and their drainage process isn’t working well, then they can have reactions and they can swell up. They can have headaches. They can have skin problems and breakouts. So the first step is to one, upregulate mitochondrial function so enzymatic processes can work, organs and systems can work. Make sure the bowels are moving, which we have a product for that and make sure the bile flow is moving.

So as you start getting these processes up, you get the bowels moving, the bile moving, the lymphatics moving, all this process, then the second phase to go in and start to clear things out of the bowels. So we have Para 1 and Para 2, which is the Mimosa Pudica Seed that helps to start clearing and scrubbing the gut, but also then a product that is Ayurvedically blended to help all three doshas, according to Ayurvedic medicine, and it really helps to balance the gut flora, clear out whether it’s bacteria, fungus, parasites. It’s a good broad overall herbal product.

Then we go deeper after that into more systemic parasites or infections as we go down the process. All along we’re we’re clearing and binding and we’re supporting drainage and we’re supporting energy. That process has really transformed my practice as well as many other doctors’ practices as we train and teach doctors, thousands of doctors that we’ve taught and trained now on this process, which has really helped people with chronic illness.


Dr. Weitz:            Interesting. I’ve really been enjoying this discussion, but I’d like to take a minute to tell you about a new product that I’m very excited about. I’d like to tell you about a new wearable called the Apollo. This is a device that can be worn on the wrist or the ankle, and it uses vibrations to stimulate your parasympathetic nervous system. This device has amazing benefits in terms of getting you out of that stressed out sympathetic nervous system and stimulating the parasympathetic nervous system. It has a number of different functions, especially helping you to relax, to focus, to concentrate, get into a deeper meditative state, even to help you sleep, and there’s even a mode to help you wake up. This all occurs through the scientific use of subtle vibrations.

                                For those of you who might be interested in getting the Apollo for yourself to help you reset your nervous system, go to apolloneuro.com and use the affiliate code, Weitz10. That’s my last name, WEITZ10. Now, back to the discussion.



Dr. Weitz:            How long do you find it typically takes to clear parasites?

Dr. Watts:            That’s a really good question because really, it’s an individual based thing because what I’ve learned is clearing parasites is not just about clearing parasites. It’s also helping support in the process of clearing toxins. You’ve got to clear toxins when you’re clearing parasites. You have to really help the emotional health because if you’re not clearing the parasites in your life, then parasites aren’t going to leave your body completely. You’re not going to balance it.  I don’t know that we ever clear parasites altogether because they have a role and function, but we have to get them down to a level that is not affecting our immune system so bad that then it doesn’t work, but there’s an emotional part to it. There’s a toxicity part to it, and then there’s a gut flora, restoring the microbiome in there that will then restore balance with parasites.

Dr. Weitz:            Now, one of the issues about toxins is that toxins tend to store in the body. They can store in the bone, they can store in the fat, they can store in various organs. From what I understand, I think the only way we can really get the toxins to come out of the bone and the other tissues is to use … I’m drawing a blank on the … What’s the oral DMSA, DMPS, the chelators, right? My understanding is if you use binders or something like that, that can get the toxins that are floating around the bloodstream, but the only way to get the toxins out from where they’re stored to get them out of the cells is to use oral chelating agents.

Dr. Watts:            So let’s take a look at what those oral chelating agents are, right? So you’re talking about DMPS, DMSA, and things. They have a very short life that they live, right? You have to constantly take them. They clear through the liver or, excuse me, through the kidneys. So you have to be cautious using these products. The other thing is they’re not a true chelator. So when we have a mixture what a chelator is, a chelator is those are ionic bonds, a double tail bond. They discuss that as a true chelator in certain realms of functional medicine, but a true chelator is a covalent bond, an organic process that occurs and happens, which happens with fulvic and humic acids.  So I think there’s just not full education on what a true chelator is, but we just put it out there just like we put out there, well, you have to be alkaline versus acidic. It’s a complete another rabbit hole that is inaccurate in functional medicine, as well as adrenal fatigue, which is another inaccurate thing that’s taught out there.

So when you’re looking at going deep in detoxing, part of it is supporting the proper enzymatic reactions within the body to do it. The other part is understanding what helps to chelate in the body. Well, metabolized toxins are bacteria. So then the bacteria and fungus and parasites all play a role with detoxifying or trying to balance the body itself, which is why people can have higher loads of fungus or candida or parasites or pathogenic bacteria because of the pleomorphic forms that have occurred.  So the toxins cause these things to pleomorph or to proliferate, which then become a problem, and what we’re doing or trying to do is to address those and just clear those things out without understanding that the processes is why is DMSA … You’re talking what are they chelating. So you’re thinking heavy metals is what I’m guessing, right?

Dr. Weitz:            Yup.

Dr. Watts:            So to me, heavy metals aren’t the main problem. Are you exposed to high heavy metals on a daily basis that are killing you and causing problems? No, you’re not. The key part that’s causing problems in people’s health is the 80 some thousand chemicals that is in the environment today and in our foods, whether it’s glyphosate, whether it’s all the different derivatives that go along with that, all the plastics. I mean, you can start going into a huge list of environmental chemicals. That’s what’s in your food, water, and the air that you’re getting at a much higher dosage than you are in heavy metal.

Dr. Watts:            Now, what makes a heavy metal bad for our bodies? I’ve asked this question to many doctors and they’re like, “Well, it’s just bad.” No. It’s the oxidative state of the heavy metal.

Dr. Weitz:            I mean, heavy metals have a whole lot of different negative effects. You take something like mercury, it’s estrogenic, it’s oxidative, it’s inflammatory, it’s neurogenic.

Dr. Watts:            When you look at the state of the chemical or the metal or the mineral because mercury is a mineral, it’s a metal, heavy metals are minerals, all metals are mineral, minerals or metals, so what makes it that way? It’s the oxidative state that causes the damage or stress to the body or the ability to interact with other molecules in the body. So if you can neutralize that, if you can neutralize that by either donating or giving electrons or protons, then you’re going to downregulate the damage from those and then allow the body to clear those out.  Also, you go in there with other molecules like our binders that will help to attach to those molecules in many ways, those metals in many different ways in a covalent bonding system, which is a chelator. We can’t call then chelators because FDA won’t allow us to call them a chelator, but in the research, it’s what it shows it as. So only drugs can chelate. So only drugs can chelate according to the FDA. So anybody else that says that something chelates is is making an FDA claim that’s inaccurate.  So we have to be careful with what does that, but scientifically, a chelator is something that’s organic, uses carbon to bond with the science part of it. I work with work with metallurgists, biochemists, chemical engineers, quantum physicists in this stuff to understand why metal are bad. It’s the oxidative state and ability to interact with other molecules within the body. The other chemicals-

Dr. Weitz:            Your company has certain products that essentially serve the same function as our chelators?

Dr. Watts:            Exactly. Our goal is to do on a natural side and that have a lot longer lifespan, and not that you have to be on it every two hours or every four hours to go through and take these, and you don’t even have to take the binders on an empty stomach two hours away from everything. You can take them at any time with food, without food at any time. So that’s what we teach in our system with Cellcore Biosciences is we teach doctors the science behind all this information and why people even have lead toxicity or other heavy metals within the body, what’s the source and what’s going on.  What I have found clinically, this is really interesting, is that it’s rare that I find that heavy metals are the main source of people’s health issues. What I find is that it’s mycotoxins, it’s other toxicity from environmental toxins that drive other things that cause most of the problems because the amount of exposure is much higher level than heavy metals.

Dr. Weitz:            So for parasites, are you using typical anti-parasitic herbs?

Dr. Watts:            So we have three products. The fourth one is coming out later this month, Para 1, 2, 3, and 4. They’re different in their blends and what they do, and are they typical? No, they’re not typical. One is an Ayurvedic blend. One is Mimosa Pudica Seed on its own, which is we’re the founding company to bring this worldwide to the market. The other ones is the Ayurvedic herb with neem, clove, vidanga, holarrhena, kutaja, triphala, and then there’s another blend that’s a tincture that has a variety of herbs that aren’t always common that people utilize, but what I’ve found is I spent two and a half years on formulating this to be able to go and clear specific, really hard parasites to clear out, and to really have high effectiveness and see the results whether they’re parasites coming out of people’s noses, parasites coming out of people’s skin, ears, eyes, people pulling parasites out their mouth. I had people pulling parasites out their back end.  So when I look at, “Is my product effective?” well, according to the thousands of practitioners that are using my products, they say these are more effective than anything on the market because of the results their patients are getting. So I’ve used a lot of brands in my clinic right before I’ve ever had these products. I just didn’t find the same results that I was getting with that. So a big part of it was because I was trying to get my own self better and experimenting in that direction.

Dr. Weitz:            So some of these products that you’re using that are serving as binders or are made from humic acid and-

Dr. Watts:            So fulvic, humic acid extracts with other co-factors that will allow them to be highly effective and be able to have high energy, to bind, to remove and repair, as well as to feed the microbiome.

Dr. Weitz:            So what are humic and fulvic acid?

Dr. Watts:            So that’s a huge, long story, but fulvic acid and humic acid is … The humic tends to be black, and the fulvic tends to be a light powder. Combined, they can be great looking, but it’s a binder that a lot are familiar with that have high energy and ability to bind a variety of different toxins, especially the way we build them and the variety of the PHS that they come in makes a big difference. The electrical connectivity of those are certainly high to be able to have that energy to get them through the body and be able to bind and have the energy to pull them out of the body.  So they’re organic material. That is plant material that has been decomposed over thousands of years, that has been pulled out of the soil and decomposed by bacteria that then is utilized and extracted from the earth.

Dr. Weitz:            Okay. So let’s move on to mold toxins. Yep. So how do we test for mold toxins, and then what are some of the strategies for removing mycotoxins when patients are dealing with this issue?

Dr. Watts:            So there’s a variety of labs. I’ve used Great Plains Labs before. I’ve used Vibrant Labs in testing. They test a lot of different types of mold, but there’s Realtime labs, and there’s a variety of them. It just depends on what your favorite is. Currently, I’m using Vibrant Labs because they test for a lot of different types of mycotoxins. So I like to do the testing especially as I’m going through. So I have an assessment form that takes people through a variety of questions that will help me to look at do they possibly have Lyme or Bartonella or Babesia or parasites or mycotoxins and things, and then it helps me with the testing and I test everybody for mycotoxins because when I think I know the answer that they may not have mycotoxins and the next thing I know they’re not getting better, and then I test for mycotoxin and they have mycotoxin. So everybody that comes to my clinic, we test for mycotoxins.

What they do is they can suppress both Th1 and Th2 immune function. They suppress mitochondrial function, which suppresses immune function, which also suppresses energy. So then it creates a lot of oxidative stress in the body, and that’s why these people are a lot of times the worst when they’re sick because then they have Lyme and they have Epstein-Barr, and they have the mycotoxins and every illness out there, and then they’re sensitive to the environment.

So our process is to be able to help upregulate the processes and things that, one, clear and bind the mycotoxins, but two, also upregulate the enzymatic reactions that the mycotoxins suppress. So mycotoxins will downregulate NRF2 pathway, which in the cells downregulates the ability to convert these free radicals to water and also recycle glutathione in there that converts the free radical to a superoxide molecule all the way through to water.  So our goal is to get that process working, turn the energy factories on, and then bind the mycotoxins out and get the body working. It’s worth phenomenal. We’ve had great results looking from a clinical standpoint, looking at labs zero, three months, six months, nine months, and just seeing fantastic results on clearing mycotoxins out.  The key part, though, is they can be living and continue to live in mold and expect awesome results or if they have mycotoxins, which I have found in breast implants, if they’re in their body, then it’s really difficult until they get the breast implants removed.

Dr. Weitz:            Right. Do you use glutathione as part of your protocol for getting rid of mycotoxins?

Dr. Watts:            I actually don’t because glutathione doesn’t go systemic in the body. It’s utilized up in the digestive system. It’s a peptide, which means that it’s composed of three amino acids, and those three amino acids will be broken down in the stomach acid or through the pancreatic proteases that are created and then broken down to the individual amino acid and then utilized in the body.  So the best way to get glutathione in the cell is to recycle it, and that’s where we utilize our CT minerals, our MitoATP products, our HydrOxygen product, biomolecular oxygen type of products to be able to recycle the glutathione molecule, to upregulate the oxygen and upregulate all the protons and electrons within the cell function. That’s what our company specializes in is understanding things at a cellular level to recycle enzymatic reactions and processes to be able to take care of these problems.  Glutathione is best in the cell. The way it gets fixed is it goes from an oxidative state to a reduced state. It’s this constant recycling process and taking glutathione is not going to do that. So I haven’t had to use it, but I know a lot of doctors that do use it through functional medicine, but with the clients I’ve worked with it, it hasn’t been a necessary factor because I’m clearing the toxins, I’m clearing the infections, I’m upregulating the actual enzymatic processes that the body works on.  For example, the liver detoxification process, you have the phase one, phase two, and either phase three or transportation, bile flow. In phase one, what’s utilized in that process for cytochrome P450 is electrons, protons, oxygen, and a little bit of iron. Our products provide all those building blocks of life to be able to do that, and that’s what we did down to, and as my background I was telling you in biochemistry on teaching these things, that’s the basic molecules we’re looking at to repair the body is not a specific product, but how is that product helping at that cellular level to then make the changes that it needs.

Dr. Weitz:            Okay. Can you tell us about this TUDCA product that you use to help get the bile flowing?

Dr. Watts:            Yeah. So interesting. Years ago, Dr. Jay was looking at, “Okay. Hey, what do people do, all these body builders, what do they take to repair their liver from all those damaging, from all this steroids they’re taking?” They have a biohack. What is that biohack?” He learned, “Oh, it’s TUDCA.” So he started using the TUDCA or the TUDCA.

Dr. Weitz:            Body builders taking this stuff? I don’t recall hearing about that.

Dr. Watts:            Yeah. That’s what it shows in the research. So that’s Dr. Jay research. He’s a fanatic researcher. So he figured out because he loves to biohack it and buy all the machines and buy all the different things. He came across that. So this is years ago. So he started using it with his chronic Lyme patients. All of a sudden, all these heart issues people were having went away when they took TUDCA. He’s like, “Okay. What’s happening here?”  So we researched it for about two and a half years to finally get a product that would be sustainable and reproducible. So what it does is it is an anti-inflammatory bile acid. The body makes bile. It dumps into the intestines, the duodenum, and then from there, the microbiome, the bacteria will convert that into TUDCA, which is an anti-inflammatory bile acid that has all these huge health benefits. There’s tons and tons of research that we’ve produced and put out there on that stuff that can help from brain issues to leaky gut, to bile flow. So it helps the body recycle bile. It helps to produce more bile from the liver. It helps to repair the liver in many functions in there.  It’s been a phenomenal product for that process because if you get a stagnant bio, it’s a real thick bile, then you’re going to absorb more toxins and it’s going to go more systemic, and you’re going to have a constant problem with not just toxins and hormones and a lot of other things that you need to clear out through the liver. So that’s part of the process of our drainage funnel is, “Hey, let’s be sure that we have good movement of our colon, and let’s be sure we have good bile flow, unless we have good lymphatic flow so we can drain and clear the body in this natural way versus just trying to detox it.”

Dr. Weitz:            So what does TUDCA stand for?

Dr. Watts:            TUDCA is tauroursodeoxycholic acid.

Dr. Weitz:            Okay, and this is one of the bile acids?

Dr. Watts:            Yup. It’s one of our products called Advanced TUDCA. It has a few other products, a few other ingredients in there with that to make it effective for liver function and repair and all the things we talked about with repairing liver function and anti-inflammatory process throughout the whole body down at the cellular level.


Dr. Weitz:                            I’d like to interrupt this fascinating discussion we’re having for another few minutes to tell you about another really exciting product that has changed my life and the life of my family, especially as it pertains to getting good quality sleep. It’s something called the chiliPAD, C-H-I-L-I-P-A-D. It can be found at the website chilisleep.com, which is C-H-I-L-I-S-L-E-E-P dot com.

So, this product involves a water-cooled mattress pad that goes underneath your sheets and helps you maintain a constant temperature at night. If you’ve ever gotten woken up because temperature has changed, typically gets warmer, this product will maintain your body at a very even temperature, and it tends to promote uninterrupted quality deep and REM sleep, which is super important for healing and for overall health.

If you go to chilisleep.com and you use the affiliate code, Weitz20, that’s my last name, W-E-I-T-Z, 20. You’ll get 20% off a chiliPAD. So, check it out and let’s get back to this discussion.


Dr. Weitz:            So what are you typically finding for say a patient who comes in to see you with some chronic health issues, and you determine that they have parasites or most likely have parasites, and maybe they have some Lyme disease or mycotoxins? How long does it usually take to get resolution for this patient of their underlying condition as well as their current symptoms?

Dr. Watts:            That’s a complicated question, Ben.

Dr. Weitz:            Of course, it is, and everybody’s different, we’re all individuals and some people respond well and some people don’t respond well, but I’m just asking for some ballpark idea.

Dr. Watts:            Yeah. So that’s a great question to the fact that has that person been sick for 20 years and haven’t found the solution? Has that person been sick for two years? It’s a completely different thing. Is that person sensitive to even their environment versus somebody that can actually take products, right? I’ve worked with somebody that I worked on just trying to get to one capsule, one product for six months because of where they were beginning at and they couldn’t take anything.  We have a comprehensive protocol, which is a 10-month protocol that takes people through the whole process of what we call our Roadmap to Health. We also have a condensed version, our foundational protocol, for the average person that can go through clear toxins and get optimal health from what we have there. Then we also help guide doctors that a lot of people I work with and what our clinic has worked with. We go through and see how they do within that 10-month period of time or 12-month period of time because most of them have been sick for so long. Then it may be another year at that standpoint, but typically, we see results usually right away with things because we’re addressing the core issues. What are the core factors? How can we neutralize the oxidative stress in the body from these toxins that are in there or these infections that are in there? How can we upregulate the body’s ability to do work on its own? That’s the whole thing-

Dr. Weitz:            With oxidative stress, basically, we could potentially take a bunch of antioxidants, right?

Dr. Watts:            No, no, because antioxidants aren’t the problem. It’s not a lack of antioxidants. It’s what’s causing the oxidative stress in the first place, and that’s the approach is do you want to go to the source or do you want to just give something that’s going to help with the oxidative stress? My goal is, “Sure. All my products are chicken butt on oxidative stress.” There’s no doubt about that. My focus, though, is what’s that causative factor? So one of the things that we talk about here is toxins create deficiencies. If you have a deficiency problem, then there’s a toxin problem or you have a really, really, really bad diet, but most of the people I work with have impeccable diets because they’ve been trying to work on themselves for so long. I’m sure you work with a lot of people like that, too, where they really try and eat healthy. I don’t get the average person off the street that’s a diabetic person that’s eating horrible McDonald’s and everything else. They’re eating keto. They’re eating paleo, they’re eating autoimmune paleo. They’ve done every diet possible.  So it’s not that they have a lack of antioxidants. It’s the fact that we’re missing the exposure to the chemicals. We’re missing the chemicals that are in the body that are causing the problems. I tell you what, man, I have in here, in my office, as well as at my house, I have a distiller. I drink distilled in water because all the other systems have chemicals in their water and they don’t get the chemicals out. So it’s a huge, huge issue that we have. Of course, everything’s sprayed nowadays. So you have a huge, huge issue with all your foods.

Dr. Weitz:            Is reverse osmosis good enough or not?

Dr. Watts:            No.

Dr. Weitz:            What’s the difference between reverse osmosis and distillation?

Dr. Watts:            So distillation takes it from a liquid to a gas and then back to a liquid. So you can’t transfer those chemicals through that process. Reverse osmosis isn’t good enough to be able to do that, and there’s all kinds of problems. We have on our Cellcore website, we have a presentation that we go through an hour long discussing all the different types of things there.  So our goal is I don’t sell any of this stuff, but our goal is to be educated, to get the least amount of toxins in your body that are causing the problems. It has been amazing how I’ve seen changes just on changing the water they drink. In fact, Dr. Jay, I locked him one time, he’s like, “When I go to the airport, the only water that I seem to resonate with, smart water.”  I’m like, “Jay, you ever read it? It says distilled water. That’s why.” So he is drinking distilled water without even know he is drinking distilled water.

Dr. Weitz:            So where do you get this distilled water system from?

Dr. Watts:            So we got ours from a company called mypurewater.com. It’s one of Gerson clinic and some of these huge clinics that have been around for 20 to 40 years have been buying them from for many, many decades.

Dr. Weitz:            Is this a whole house thing or is it something under your sink that gives you drinking water?

Dr. Watts:            There’s a couple different systems. There’s not a whole house system. It’s a drinking water system. It’s not going to be all your water. The most important water is the water you consume. So that’s what we focus on. So they do have automated systems. One in here I have the water goes through it and then into a little thing. You push the button on your sink and you get the water. That holds 25 gallons at a time because I have 80 people that work here. Then at home, I have one that holds 12 gallons. It makes 10 gallons a day. It keeps it for my family of six and it’s our main system. I have another one that’s just at top, one that just sits on the countertop that can make up to three gallons a day, and it’s a small system.  So they have a variety of options that you can look at, but one of them, I forgot the clinic name. They had had that distiller for 40 years, and they’ve made it for NASA and some of these big companies. So I know it’s a quality unit and it’s a mom and pop place. It’s fantastic. It’s been in the family generations and a couple generations.

Dr. Weitz:            What is the company called again?

Dr. Watts:            Mypurewater.com.

Dr. Weitz:            My Pure Water, I’ll check it out. We drink distilled water here at the office. Now, one of the criticisms we get from that is, “Oh, you’re going to leach out all the minerals. Everybody’s going to be mineral deficient.”

Dr. Watts:            That’s a really good question. So let me ask, because I get the same thing. So the minerals you get in your water, let’s take a look at that and see what it does to the glass in your shower, what it does to your windows. Are those organic minerals? Oh, wait. They’re inorganic minerals. It’s like drinking rock. It actually doesn’t do good for your body. It’s not bioavailable minerals. Your minerals come from your food sources, not your water. Your minerals come from your foods, your vegetables and fruits. That’s where minerals come from.

Dr. Weitz:            Okay. So the minerals in the drinking water are inorganic and can’t be utilized.

Dr. Watts:            Exactly.

Dr. Weitz:            Okay.

Dr. Watts:            That’s why it’s called hard water.

Dr. Weitz:            Now, is the distilled water going to leach the minerals out of your body?

Dr. Watts:            So water is made up of two molecules, hydrogen and oxygen. The really necessary proton, hydrogen is the proton, and oxygen is the thing that binds up free radicals, and it’s interesting. People drink water and it goes into their body and you can cut them open and all of a sudden, where did that water go? Oh, that’s right. The body has this amazing natural way of getting oxygen from water and hydrogen.

Dr. Weitz:            You know that whole thing about heavy water and deuterium depleted depleted water, all that stuff?

Dr. Watts:            Yes, I know about that.

Dr. Weitz:            Okay.

Dr. Watts:            It’s still a theory, and I think the most important thing is that you have water that doesn’t have chemicals in it that is causing disease.

Dr. Weitz:            I’m with you on that.

Dr. Watts:            Okay? Pure, clean water, that’s all I care about. Just stop putting chemicals in your body. Stop going and buying food that has all these chemicals sprayed all over it and you wonder why you have a gluten problem because you’re eating glyphosate.

Dr. Weitz:            Right. Of course, yeah. Unfortunately, as you mentioned, there’s chemicals in our water, our food, our air. So the more we can do to reduce as many chemicals as possible, the better we’re going to be. We’re never going to get rid of all of them, but-

Dr. Watts:            No, we’re not, and that’s where our whole company is based off of products for detoxifying and helping to upregulate the body’s ability in infections and root cause illness. That’s all Dr. Jay and I study and research and then educate doctors on, the same thing of why, why are metals bad, what is radioactive elements, and did you know radioactive elements is a massive problem and maybe why people in maybe the Upper Midwest get a lot of Lyme disease because radium is only tested by the EPA. So you’re never going to do a heavy metals test and never see radium because it’s only tested by the EPA, and it’s in your water source.

177 million Americans have high levels of radium in their water. So you can go to environmental working group and you can see that information, and then if you just Google radium in water and you wonder why you have candida all the time, you wonder why you have fungus or you have a parasite problem, maybe you’re you’re drinking water or exposed to a lot of radioactivity that then goes where? Oh, yeah, the bones. So then you have a problem with calcium, not lead. I think lead probably is trying to offset all that radioactive elements in your body.  So I learned this really cruel story. I had this gal come to see me from New York and she had done 180 chelation, not kidding, chelation IVs.

Dr. Weitz:            Oh, wow!

Dr. Watts:            180. Is there a medical doctor over there?

Dr. Weitz:            That’s a lot. I can only imagine how much that costs and how much time it takes because it takes hours to chelate.

Dr. Watts:            Hours. You know her lead levels, how far they went down? They never even got into reading levels. They’ve been off the charts.

Dr. Weitz:            Wow.

Dr. Watts:            So my theory, I was talking to a scientist I work with because I’d like to talk to these other more organic or chemists and metallurgists and biologists and stuff, physicists that I work with because they think differently than us doctors do from a standpoint. He says, “Well, if you think about it, when you do an X-ray, what do you wear over at most of your body that you’re not X-ray”

Dr. Weitz:            Lead.

Dr. Watts:            Lead. What does lead do? It absorbs radiation. He’s like, “She probably has high amounts of radiation in her body, but the lead won’t let go because it’s trying to play a role.” Then I got me researching into, “Well, and I’ve heard of uranium.” I see that on the doctor’s data test and there’s thorium and there cesium, and then got into more, “What’s radioactive material in water? Radium.” I’m like, “What’s radium?” I started researching radium, and then now we have whole presentations and PowerPoints on radium and stuff and understanding how damaging that is to the body’s ability to heal.  Talk about oxidative stress. What’s worse oxidative stress wise than radioactive material? Nothing. Then first thing to grow back after Chernobyl is fungus and mushrooms to absorb all that radioactive material. Some people have chronic candida forever. It’s probably because they got radioactive material in their bodies.

Dr. Weitz:            I was just listening to a podcast recently, this Lex Friedman podcast and Elon Musk on there and Musk was totally dismissing the dangers of nuclear radiation and claimed that he actually went to Japan and ate food locally grown there shortly after the nuclear accident they had.

Dr. Watts:            Well, I could tell you that if you look at Chernobyl and some of these other things, there’s a lot of people that died of cancer after that and had deformities, babies having deformities. I don’t know. I’m glad you didn’t get sick. Fantastic. I don’t know what they did, but the fact is is there’s a lot of other research that shows otherwise.

Dr. Weitz:            Right. I totally agree with you. So Dr. Watts, this has been great. I’ve really enjoyed this discussion. How can our listeners and viewers find out about your products and your programs?

Dr. Watts:            So our website is cellcore.com, C-E-L-L-C-O-R-E. If you don’t have a practitioner, you have to have a practitioner to order products. So they can order through your account. They can get it through your patient direct code if you wanted to share that with them, but they can’t get Cellcore products without going through a doctor that way.

Dr. Weitz:            Oka. Great. For practitioners who are listening, who want to sign up to get an account, where do they go?

Dr. Watts:            Cellcore.com. Then we have account reps. So depending on your state, you’ll have a rep that you can work with and you can come. We have a phenomenal learning center on the back end of our website that we share a lot of the science behind it. Our goal is to educate and provide solutions that makes sense down to that cellular biochemical level. I have a passion for this because it changed my life. I’m 53 and I have way more energy than I did the last 15 years of my life, and it’s same thing for many of my patients I’ve worked with and clients I’ve worked with, whether they’re throughout the US, internationally, that their lives have been dramatically changed because of the research that we do in helping going after the core issue of how to repair the body.  We call it foundational medicine, going down the foundational core issues to restore that, and then going deeper later on into the functional processes that will help support the body. As you do that, the results are amazing by treating these root cause solutions. I just appreciate guys like yourself, Dr. Ben, that you’re out there really putting this information out there. You’ve had a lot of great people you’ve interviewed on your podcast and that are sharing a lot of great information about how to get better and what to do. Our goal is to help doctors and help people understand, take them to a new level of understanding of what makes us ill and how do we fixed that.

Dr. Weitz:            Absolutely. That’s the functional medicine model is not just treating symptoms, but getting to the root cause.

Dr. Watts:            Yup.



Dr. Weitz:            Great. Thank you very much. Thank you for making it all the way through this episode of the Rational Wellness Podcast. If you enjoyed this podcast, please go to Apple podcasts and give us a five-star ratings and review that way more people will be able to find this Rational Wellness Podcast when they’re searching for health podcasts. I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica Weitz Sports Chiropractic and Nutrition Clinic. So if you’re interested, please call my office, 310-395-3111 and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz. Thank you and see you next week.




Autoimmunity with Dr. Ben Weitz: Rational Wellness Podcast 242

Dr. Ben Weitz discusses a Functional Medicine approach to Autoimmunity.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.] 


Podcast Highlights

0:45   Autoimmune Diseases are very common and are increasing in the United States.  Autoimmune diseases are where our immune system, instead of fighting off foreign invaders, like viruses and bacteria, attacks our own cells, tissues, and organs.  Common autoimmune diseases include Hashimoto’s thyroiditis, Grave’s hyper thyroid, rheumatoid arthritis, vitiligo, Alzheimer’s disease, Parkinson’s, psoriasis, hair loss known as alopecia, inflammatory bowel diseases like Crohn’s disease and Ulcerative colitis, IBS, multiple sclerosis, and type I diabetes.

4:31  How should autoimmune diseases be treated?  Conventional medicine is focused on treating the symptoms, such as by giving thyroid hormone to patients with Hashimoto’s thyroiditis, but often ignores the autoimmune condition.  And when medicine treats the autoimmune condition, such as in Inflammatory Bowel Disease, like Crohn’s disease and ulcerative colitis, drugs are often prescribed that suppress part of the immune system to decrease this attack by the immune system on the body. These drugs can be chemotherapeutic agents like methotrexate or Cyclophosphamide and there are various types of newer drugs that target specific parts of the immune system, like the TNF alpha blocking drugs Remicade, Enbrel, and Humira.  The downside of such drugs is that by suppressing the immune system, they increase our risk of infections and of cancer. 

10:18  In Functional Medicine we try to find the root cause of their autoimmune disease, so we look at a number of possible triggers, including gut health and infections.  We might do a good stool test or we might screen for systemic infections through blood work.  If the protein structure/amino acid sequence of the bacteria or virus is similar to structural proteins in the body, you might have cross reactivity and the immune system attacks that organ or tissue in the body.  We may treat with herbal antimicrobials, other diet and lifestyle factors, as well as other gut healing formulas.

13:39  Food sensitivities.  You can have cross reactivity between the proteins in certain foods like gluten or dairy and proteins in the body and antibodies that attack foods can attack our organs, like our thyroid gland, leading to Hashimoto’s. Food sensitivities can be addressed by either following an elimination diet in which you avoid some of the most common foods that cause sensitivities or to do food sensitivity testing and then avoid foods that show reactivity to.



Dr. Ben Weitz is available for Functional 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 and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.


***Get 15% off your first month’s supply of Seed’s Daily Synbiotic by visiting  seed.com/drweitz 

or by using code DRWEITZ at checkout.


Podcast Transcript


Hey, this is Dr. Ben Weitz host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates. And to learn more, check out my site, dr.weitz.com. Thanks for joining me. And let’s jump into the podcast.  Hello, Rational Wellness podcasters. Today, I will be doing a solo podcast. Typically, I interview another doctor or practitioner or researcher, but today I wanted to discuss a functional medicine approach to autoimmune diseases.

So what are autoimmune diseases? Well, autoimmune diseases are an increasingly common cause of sickness and death in the United States. And these diseases have been on a rise for at least the last 30 or 40 years. So what happens in an autoimmune disease is your immune system attacks yourself.  So our immune system, this is a system of cells and communication systems in the body that is designed to protect us from bacteria, viruses, parasites, our immune system’s involved in tissue repair and what our immune system does is it creates an inflammatory process, that’s how it keeps us safe. And because our digestive system is one of the ways in which we’re open to the world, food and liquid particles come into our mouth, go down through our digestive tract, come out the other end.  And therefore a huge portion of our immune system is centered around our digestive track, our intestines, et cetera. And that’s because that’s one of the ways that we most commonly interface with bacteria, and viruses, and fungi, and parasites, and also toxins that come into our bodies. It’s not the only way, but it’s one of the most common ways.

And so what happens in autoimmune diseases, our immune system instead of fighting off these external threats, turns inwards and ends up attacking our own tissues, our own cells, our own organs.  And in one way or another, our immune system is out of balance. Now, let’s talk about a few of the most common autoimmune diseases. And we know now that there are over 100 different autoimmune diseases that have been identified. And there’s a number of other common diseases that have autoimmune components. For example, heart disease has an autoimmune component.  There’s an inflammatory condition inside the walls of the arteries that plays a role in why cholesterol plaques start to build up in those arteries and eventually block off the blood flow. So some of the most common autoimmune diseases, probably the most common is Hashimoto’s hypothyroid. And this is a form of decreased thyroid function and probably the second most common one is Grave’s hyperthyroid.  After these two, the more common autoimmune diseases include rheumatoid arthritis, vitiligo, Alzheimer’s disease, Parkinson’s, psoriasis, hair loss known as alopecia, inflammatory bowel diseases like Crohn’s and ulcerative colitis. And now Dr. Pimentel has identified that the most common gastrointestinal condition IBS, often has an autoimmune origin, multiple sclerosis, Type 1 diabetes, on and on and on.  There’s a huge number of these autoimmune diseases.

Now, how should patients with autoimmune diseases be treated? Now, our medical system is essentially our conventional medical system is focused on finding out what symptoms patients have and then providing the treatments that are going to help modulate those symptoms. So, for example, if a patient comes into the office with hypothyroidism, well, that patient will typically be given thyroid medication.  In other words, their thyroid is not working the way it’s supposed to, so we will give thyroid medication. And then that’s the end of the story. But we know from lots of research that in the United States, the majority of cases of hypothyroidism are caused by an autoimmune process. We refer to this as Hashimoto’s. So what that means is your immune system is attacking your thyroid and over time, there’ll be more and more damage to your thyroid gland.  And essentially your thyroid will stop working, will the function of the thyroid will decrease. You may need more and more thyroid medication.

And the same thing occurs in autoimmune conditions that attack other systems of the body, whether it be other organs like your digestive tract, take somebody with Crohn’s or ulcerative colitis. These patients have an inflammatory condition in their intestinal tract.  Their immune system is attacking the lining of their small intestine, large intestine, et cetera. And so over time you’ll have damage, ulcerations, and all sorts of inflammatory situations going on in that epithelial layer of their intestinal tract.  That damage will lead to leaky gut. Over time, these patients tend to get worse. And when they do get worse, they sometimes require having part of their intestinal tract resected.  Just cut out because it’s so inflamed and damaged, it may not be able to come back or it could kill them.

Now, these autoimmune conditions are treated by the medical profession in general with drugs that suppress the immune system.  So we have an immune system that’s attacking our own tissues, and you can see how it could make sense to suppress the immune system.  The problem is that the immune system is needed to fight off infections and cancer.  And so when you suppress part of the immune system, you decrease its… But you potentially decrease its effectiveness for fighting off infections, and cancer, and for the other functions of immune system.  So what’s typically done for treating these autoimmune diseases is in a crisis situation or at the beginning, typically corticosteroids are used. These may also be used when there is flareups. Sometimes chemotherapy agents are used, sometimes older chemotherapy agents like methotrexate or other newer chemotherapy agents. And now we have a series of injectable drugs like the TNF alpha blocking agents like Humira, Remicade, and a bunch of newer medications and these all block some part of the immune system to dampen down the damage that’s liable to continue.


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But what do we do in Functional Medicine?  Well, in functional medicine, we’re trying to find… We’re not just trying to treat the symptoms, not that patients don’t need their symptoms taken care of, not that patients with Hashimoto’s hypothyroid don’t need thyroid medication, they certainly do. But we also need to focus on the autoimmune condition, this situation where the immune system’s attacking your own organs and cells.  And we want to decrease that from happening because we don’t want the patient to have more and more damage over time.  So a functional medicine approach we’ll look at a number of different factors that affect the proper functioning of our immune system.  For one thing, we have issues like gut health and infections.  We can have gut infections like certain bacteria that can lead to autoimmunity.  We can have various types of chronic infections, some in the gut, sometimes systemic chronic infections.  We can have viral infections. And what happens with infections and a similar process happens with food sensitivities and toxins. And we’ll go into those in a few minutes, is that your immune system attacks say the virus or the bacteria, and then the protein structure of that virus or bacteria or the amino acid structure is similar to tissues in your body. And we get cross reactivity. So we get cross reactivity from the antibodies that are attacking the bacteria or virus, et cetera.  And then those antibodies start attacking part of our body. And so if we can determine what some of these underlying infections are, and then we can take appropriate steps.  In Functional Medicine, we tend to use specific types of herbs and other factors that we know can improve the health and help our body to fight off these infections. We’ll often use, say herbal products. And then we dampen that autoimmune process because we dampen that chronic infection.  And that’s one way in which we can help get this autoimmune process under control.

If there’s a big imbalance in the gut, we’ll often have leaky gut. Leaky gut is another process that can lead to increased auto immunity. And so healing up the lining of that gut, there’s specific protocols we can use with diet, lifestyle and targeted nutritional supplements.

We can also look at things like food sensitivities.  So what happens with food sensitivities is let’s say you have a food sensitivity to gluten, what happens in that case is your immune system attacks the gluten, and then it cross reacts because that gluten tissue has an amino acid structure that’s a similar to thyroid tissue and those antibodies that are attacking the gluten are now attacking your thyroid tissue. And so this can be one of the triggers for a series of autoimmune conditions such as Hashimoto’s thyroiditis.

So I like to use with my patients either an elimination diet, where we take out some of the most common food sensitivities, and then after a period of time, we slowly test them back in to see if they have any reactions. The other thing we’ll do is at times is do food sensitivity testing with one of the more sophisticated panels and then take some of those foods out. And then in some cases, if they’re very strong food sensitivities, we will recommend that the patient’s simply not eat for example, gluten or dairy anymore, or we’ll have take them out for a period of time and then test them back and see if there’s any symptoms.

Now, in some cases, there are no symptoms. And yet we know that some of these factors can reduce that inflammatory process. And so if we see, for example, antibodies, autoantibodies say, we are tracking a patient with Hashimoto’s and let’s say they have thyroid peroxidase antibodies, and we see those go down significantly. That’s an indicator that we’re getting to somebody’s underlying causes for this autoimmunity.  And so while measuring thyroid antibodies is typically not done by the average conventional medical clinician, and I’m not criticizing them for not doing this because it’s not really part of the protocol and using a conventional medical approach, they don’t really have tools. There’s no commonly used drugs that can really help to affect this unless they go to this, some of these more severe, pretty harsh injectable immune blocking drugs.  So there’s reasons why it doesn’t make sense for conventional medical doctors to do this, but we want to track these auto antibodies because this is a measure of this underlying autoimmune process. And sometimes we’ll have patients who don’t have any symptoms.

So take myself, I discovered that I had a TSH that was elevated. Didn’t have any symptoms of hypothyroid, didn’t have fatigue, or hair loss, or dry skin, or any of the other symptoms of hypothyroid and was tracking my other thyroid factors, my T3, my T4, which were normal.  And then at some point in time my thyroid, my TSH went up more, I had mildly elevated thyroid peroxidase antibodies. So I took a Functional Medicine approach. I looked at some food sensitivities eliminated certain foods. I did some stool testing that showed certain bacteria that were overgrown, that could be autoimmune triggers.  I used certain herbs and other nutritional protocols to get my gut imbalance.  And I saw my thyroid antibodies decrease.

And then I experimented with certain nutritional supplements because certain nutritional deficiencies can affect any autoimmune condition. In fact, nutritional deficiencies are actually not just frank deficiencies, but having less than optimal levels of nutrients. And this is something that we in the functional medicine world commonly see is there’s normal labs, and then there’s optimal labs. And when you look at a typical lab in the United States, there’s a reference range.  And that reference range, unfortunately is based on where the average American is and anything above that’s considered abnormal. Anything within that range, conventional approaches say, don’t worry about it. Unfortunately who wants to be like the average American. So when we look at something like vitamin D we’ll see that there’s a reference range that says under 30 is low, over 30 is fine. Don’t worry about it. However, there’s a ton of research showing that there is an optimal range that’s higher than 30. Now, there’s still debates exactly what it is.  Is it 40 to 60? Is it 50 to 70? Is it higher than that? So depending upon what you’re looking at, which studies, and your approach, but certainly the optimal range is different than the reference range. So when we’re going to look at nutritional deficiencies, we’re going to try to figure out what the optimal range is. So I had done some food sensitivity panels. I had done a nutritional panel on myself.

One of the nutrients that was especially was the most low was zinc. My vitamin D I struggled to get it up to… I try to target my vitamin D level in around 60. I try to get in that 50 to 70 range. For autoimmune disease. Sometimes it’s better to get it a little higher, and mine tends to go between 40 and 50. So I also did a genetic test and found out I don’t absorb zinc very well, or I have certain genetic factors that make it less likely that I’ll properly absorb zinc.


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So I started looking at some of these nutritional factors. I decided first to try adding a high dose iodine because some patients have reported doing better with high dose iodine. Iodine’s a crucial factor in thyroid. So when we talk about thyroid hormones, we have T4 and T3. The most commonly prescribed hormone is T4. T4 has four iodine molecules, T3 has three, T4 gets converted to T3. So iodine is crucial for formation of thyroid hormone.  So I decided to take a high dose iodine in my case, and in quite a number of cases of patients with Hashimoto’s. In fact, I would say most patients with Hashimoto’s don’t do well with iodine. So I took 12.5 milligrams of iodine and nature to eat some seaweed regularly. And my TSH went from nine to 25 and that’s certainly the wrong direction. So I cut the high dose iodine. I had then done that nutrition test. I decided to significantly increase my intake of zinc supplements, increase my vitamin D.  I went to 10,000 a day for a period of time while tracking it with lab testing. I also added 200 micrograms of selenium. I got stricter with eliminating certain foods that I sometimes tend to react to, that I enjoy eating and worked a little bit more on gut health. And I got my TSH down to four and a half and saw a decrease, an additional decrease in my thyroid antibodies.

So we know that nutritional deficiencies can be super important if you have nutritional deficiencies or levels of nutrient are less than optimal.  Those are another thing we can look at. We know that various toxins, heavy metals can play a role. And we also know that for depending upon which autoimmune disease, there’s certain infections, there’s certain heavy metals that tend to play a role. So one of the most important things, when I see a patient in a functional medicine consultation is looking at the whole picture, looking at their history from starting all the way from when they were born.  Were they born by vaginal delivery or C-section? Were they breastfed? Did they have a lot of ear infections? Did they have a lot of other infections? And I have to do multiple antibodies. Let’s look at where they live. Let’s look at their history, let’s look at all their symptoms. And then we get a picture of where the most likely potential underlying triggers might be for their potential autoimmune condition or their autoimmune condition that they may come in with that we know about.  And then we will try to target the things that look like the most likely possibilities. And we’ll do some very careful efficient lab testing that helps us to identify specific triggers, potential triggers for their autoimmune disease. And then step by step peeling back the layers of an onion, will try to eliminate some of those sensitivities, either food sensitivities or toxins and help maybe do a detox program, maybe do a gut health program, figure out what sort of environmental exposures they may be having, sure up nutritional deficiencies will hit the most likely factors first.

And then we’ll peel back that first layer of the onion. And then as they start feeling better, we may dive into the next layer. And as we do this, hopefully over time, and this is what I’ve seen in most of my patient population, we get people feeling better. We see their autoimmune markers improving and this is a way to treat the root causes of their chronic diseases and not simply treat their symptoms. And that’s something that functional medicine is really uniquely designed to do.

Now I did mention a number of things that can affect our autoimmune diseases. There are many, many other things. We know that stress, lack of sleep. We know that the way they other factors in their lifestyle, their amount of exercise or lack of exercise, and there’s quite a number of other things that affect our lifestyle factors that can affect their potential for autoimmune diseases. And these are things that we look at by taking a careful history by doing screening exams.  And then we want to do some careful testing. We want to be judicious about that. Over testing. We want to do the most efficient test. First, we want to get them done in the most economic manner for patients because some of these tests are expensive, but if we don’t test, then we’re just guessing. And I think from a functional medicine perspective, we want to get our patients feeling better. And we also want to put out the smoldering fire of autoimmunity that may be affecting this patient’s long term health and leading to more and more chronic diseases.

We know that patients who have an autoimmune disease are more likely to have another autoimmune disease. And are more likely to have damage to those targeted organs over time. So I hope I’ve given everybody some things to think about. Autoimmune diseases, how we can approach them from a functional medicine approach. The bottom line is by improving your diet and lifestyle, getting rid of toxins, shoring up nutritional deficiencies, improving our gut health.  There’s a lot we can do to reducing the chronic disease burden in this country and around the world. Thank you. And I look forward to speaking you with you next week.



Thank you for making it all the way through this episode of the Rational Wellness Podcast. And if you enjoyed this podcast, please go to Apple Podcast and give us a five star ratings and review that way more people will be able to find this Rational Wellness Podcast when they’re searching for health podcasts.   And I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica, Weitz Sports Chiropractic and Nutrition Clinic. So if you’re interested, please call my office (310) 395-3111 and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben weitz. Thank you and see you next week.



How to Improve Your Sleep with Dr. Damiana Corca: Rational Wellness Podcast 241

Dr. Damiana Corca discusses How to Improve Your Sleep with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.] 


Podcast Highlights

2:50  What is good sleep?  It is falling to sleep within 10-20 min and sleeping for seven and a half to nine hours, depending upon the person and depending upon the season. Ideally you would like to sleep through the night, but it’s okay if you wake up once or twice briefly, such as to urinate, as long as you back to sleep pretty fast.  Our sleep typically happens in cycles of about 90 minutes and we typically have 5 or 6 of these cycles.  It is probably best not to wake up in the middle of one of these cycles.

6:34  There are very few people who only need 5 or 6 hours of sleep, despite claims from many that that is all they need.  Most of these people are just very driven for work and they run on the stress hormone cortisol.  But this is not that healthy.

10:18  Taking a 15 to 30 min nap is very beneficial, but take it no later than 1 or 2 pm in the afternoon. If the nap is too late, it might interfere with night time sleep.


Dr. Damiana Corca is a Holistic Sleep Specialist with training in acupuncture, Chinese medicine and functional medicine. She is committed to supporting people who struggle with sleep issues, by helping them discover the root cause of their sleep issue so they can get good sleep and continue to do so for the rest of their life.  Damiana has a local private practice in Boulder, CO and serves her clients worldwide through private telemedicine consulting and group sleep programs. She is the Founder of the Corca Sleep Method Program. Her website is DamianaCorca.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 and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.

***Get 15% off your first month’s supply of Seed’s Daily Synbiotic by visiting  seed.com/drweitz 

or by using code DRWEITZ at checkout.


Podcast Transcript

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

Hello, Rational Wellness podcasters. Today, we will be talking about sleep. We all know about the importance of sleep, and there are so many people have problems with sleep. In fact, it’s rare. when I talk to somebody who says their sleep is great and they never have any issues. Today, we have Dr. Damiana Corca, who’s a holistic sleep specialist, and she’s also trained in acupuncture, Chinese medicine and functional medicine. Dr. Corca is committed to supporting people who struggle with sleep issues by helping them discover the root cause of their sleep issue so they can get good sleep. Damiana has a local private practice in Boulder, Colorado, and sees clients through telemedicine and group sleep program. She’s the founder of the Corca Sleep Method program. Dr. Corca, thank you so much for joining us today.

Dr. Corca:            Thank you for having me.

Dr. Weitz:            So how did you come to specialize in sleep problems?

Dr. Corca:            The people let me know that they have trouble with sleep, and I started learning more and more about it and loved it, and eventually decided to focus on this to be able to serve people better. I remember my very first patient in private practice, I was living in Chattanooga, Tennessee and I believe she had fibromyalgia and also had some sleepy issues and I remember thinking, I’ll never forget that sensation in my body or not only a mental explanation of it that, “Oh, if I could just get her to sleep well, I think her pain will get a lot better.” Of course there are other components to this, her gut health and so on, but it was exactly that. And then little by little, I kept noticing, even if people didn’t come in with sleep issues as their main complaint, I noticed that if I just got them to sleep better, somehow everything got better. So eventually over the years, I just decided to focus on this and specialize in this.

Dr. Weitz:            Yeah, it’s really important to have a niche and it’s good to have a practice focus like that, and of course, sleep is so important for everything else. It allows our body to rejuvenate, our brain to heal and get rid of toxins and it’s just so important. Let’s start by defining what is good sleep?

Dr. Corca:            Yeah, good sleep I would say it’s falling asleep within 10 to 20 minutes, 30 minutes maximum and sleeping for seven and a half to nine hours, depending on the season, depending on the person and sleeping through the night ideally, but it’s okay if you wake up once or twice either briefly or just to urinate, as long as you go back to sleep pretty fast.

Dr. Weitz:            In fact, don’t we have these cycles of sleep throughout the night where we go at least into very light sleep?

Dr. Corca:            Yeah. We do that all throughout the night. Typically, a sleep cycle lasts about 90 minutes. It can be a bit longer. That’s why I tell people if we sleep five of those chunks at seven and a half hours, if you want to sleep longer, you don’t want to just increase by half an hour, ideally increase by an hour and a half. So you respect these sleep cycles. And the same thing if you wake up half an hour before the alarm clock, it’s best not to try to go back to sleep because you’re just going to wake up usually groggier or frustrated if you don’t fall asleep. If your body wakes up without any-

Dr. Weitz:            You mean because you’re in the middle of a cycle?

Dr. Corca:            Right, yeah. If your body woke up half an hour before the usual time, it’s doing you a service. It probably just ended a cycle. And it says, “Okay, it’s about time. It’s not quite, but it’s there. We don’t have enough time for another hour and a half of sleep.”

Dr. Weitz:            Now we’re going to get into the quality of sleep, but just for a minute to talk about the amount of sleep, most sleep experts say seven to nine hours. Is that what you think is a sweet spot?

Dr. Corca:            Yeah, I would say seven and a half just because it gives you five hour and a half chunks of sleep. So I see when people thrive, when people do well, they do seven and a half to eight and that’s because it might take a few minutes to fall asleep, you might be up for a little bit, so usually it completes that amount of cycle. So seven, I feel like it’s on the shorter side, and definitely we are told sometimes that nine hours is too much, but especially in the winter, if you can, it’s really wonderful. I’ve had a lot going on myself and I’ve noticed over the last month of two, I go to sleep at 9:00 and wake up at 6:00 and I feel amazing, So I just do that, which something of my patients can’t do, so that’s what I’m trying to help them with.

Dr. Weitz:            Now we know that taking too long to go to sleep is a problem. You were mentioning how long it takes to go to sleep, but apparently if you fall asleep right away, that’s not that good either. In fact, I’ve been tracking my sleep with an Oura ring in the last six months and I’m constantly finding out that I have low sleep latency because I fall asleep within one minute.

Dr. Corca:            Yeah. When we fall asleep within one minute, maybe you’re a little bit sleep deprived possibly, maybe we need a little more sleep. I tell people that it should take our body like five, 10 minutes to fully relax, to fully go into sleep, to like fully assess the environment, but if you are reading right before that, and you’re very relaxed and you’re so sleepy you’re just about to fall asleep and then you put your head down and fall asleep within one or two minutes, then that I wouldn’t say that’s a problem. That’s a good thing.

Dr. Weitz:            So what about people who say, “I sleep five, six hours. I’m fine. I don’t need more sleep.” What do you have to say to them?

Dr. Corca:            Well, I’ve only met, I think, a couple of people, two people, in the last decade when I talked to them, I questioned them, I came to the conclusion that yes, I think they might have some genetic variant and truly they do fine with six hours. They didn’t say five. I’ve never met anyone that I thought they just need five hours and that’s it and they’re very healthy.  Most people who run on five, six hours, they push themselves so hard and they run on the stress hormone cortisol and basically say it as kindly as possible, you’re basically lying to yourself. You’re so stressed and you’re pushing yourself so hard and maybe you are okay now, but it’s going to catch up with you. So it would be really wise to slow down because usually we get a lot more done actually, instead of putting all this physical and mental work, we can use our energy instead and life becomes a little easier. So then we don’t have to work so hard and keep telling ourselves that we only have so many hours in the day, we have to go faster and harder.

Dr. Weitz:            Yeah, I think unfortunately our society is very driven for work and more work and less sleep. I think that there’s a tendency to actually look down upon people who don’t work as many hours and it’s a different attitude in other parts of the world. I know in Europe, for example, it’s common for people to take six, eight weeks of vacation.

Dr. Corca:            Exactly.

Dr. Weitz:            Certain countries, I think Switzerland requires a week of vacation for every six weeks of work and here in the United States, you almost looked down upon for taking a vacation or taking time off or not working. Now, unfortunately, because of this work at home thing, it seems like people are being asked to work longer hours, like just keep taking phone calls and emails into the evening when normally you would be off work.

Dr. Corca:            Yes. It’s very important that we draw boundaries because otherwise there is always something to do. It never ends, truly, when you think like, “Okay, I’m all caught up on things and it’s all good,” and there is more and more and more, and of course at our place of work we can get asked to do more and more. So it’s up to us to draw boundaries.

Dr. Weitz:            So especially now where so many more people are working from home, do you have any advice for them, how do they draw those boundaries?

Dr. Corca:            Yeah. One of the most helpful things for my patients and people that I talk to and from my programs is to look at the day, to split it in 12 hour chunks. So if we have 24 hours, so let’s say 7:00 AM to 7:00 PM is more about activity and work. I’m not saying to work all of those 12 hours, but to fit everything that’s more active within those 12 hours, and then the other 12 hours to really slow down. We typically only slow down for seven or eight and maybe some of that we’re not even asleep. So that’s the first step, to have those clear boundaries and say, “I’m never opening my computer, unless I want to watch a movie or something, after 7:00 PM. I’m not going to answer some emails after dinner,” nothing like that. That’s one place.

The other thing that you can draw some good boundaries, especially if you’re at home, is when you take your lunch break after lunch to lay down for 15, 20 minutes. You are at home, you can lay in your bed, you can get cozy and you can just listen to a meditation. It’s so beautiful, so luxurious, can be so pleasurable and you can just feel your body relaxing. Many people in the past, they said, “Well, I don’t have time. I don’t have the space,” but if you are at home, this is perfect. Just take a break in the middle of the day.

Dr. Weitz:            So you think, for example, taking a 30 minute nap is good for sleep?

Dr. Corca:            It’s very good. It’s amazing. It’s actually-

Dr. Weitz:            See, I’ve heard other sleep experts say, “No, no, no. It’ll take away from the sleep at night.”

Dr. Corca:            I have done this with multiple, multiple people and for some of them has been life changing. The people who are very sleep deprived, say they can’t sleep at night. The problem when you sleep deprived and stressed, is that the more stress you are, the more tired you are, the harder it is to fall asleep. It actually takes the same amount of energy to fall asleep as to stay awake. So we feel as if falling asleep is this passive thing that happens, and it feels like that when we’re healthy and it’s easy to fall asleep, but actually it takes a lot of things that need to happen within our body and our brain to fall asleep.  So if you’re stressed, if you’re sleep deprived, taking that 20 minute nap, I tell people to just set a timer for half an hour, 40 minutes at the maximum and lay down. It does not matter if you fall asleep or not, just focus on resting and maybe listening to a guided meditation, anything along those lines works. If you do it at least about eight hours before your bedtime, so typically, 1:00, 2:00 and you keep it under half an hour, I have never met a person that impacted them negatively.  The problem arises when you sleep too long and too late in the day. People usually sometimes wait until they get really sleepy around 3:00, 4:00, 5:00. Well, that’s dangerous, that’s too late. Then the body feels like, “Oh, I took a good nap, now I have energy,” and then they have trouble falling asleep or [crosstalk 00:12:33]

Dr. Weitz:            So it’s good to take a nap, but try to keep it to, say, 30 minutes and no later, say, then 3:00 in the afternoon?

Dr. Corca:            Perfect.

Dr. Weitz:            Okay.

Dr. Corca:            Perfect and focus on resting, it’s okay. So many people, it took them weeks until… They said, “Oh, I can’t fall asleep. I can’t nap. That’s not a thing for me,” and I’m like, “You’re just focus on resting. Even if you’re just allowing to feel your breath, feel your body, it’s amazing the way you feel in the afternoon.” So it’s very valuable.

Dr. Weitz:            Great. So let’s talk about quality of sleep and particular, two of the things that I’ve been tracking since I’ve been using the Oura ring is deep sleep versus REM sleep. Can you talk, what’s the significance of deep sleep and REM sleep and what do we need to know about them?

Dr. Corca:            These devices are really wonderful in the sense that they’re able to help us track how we sleep, but-

Dr. Weitz:            By the way, what is the best device for tracking sleep or devices?

Dr. Corca:            The most important thing actually, is that we feel good the next day. That is the most important thing is how we feel. Do we have energy? Do we feel clear minded? Secondarily, if we have one of these devices, I don’t endorse any of these companies, a lot of my patients use the Oura ring and it looks beautiful, it gives really fairly accurate information, and this is fairly accurate in comparison with how they feel. I always warn everyone not to look at the data first, but rather see how they feel and then later look at the data because what we do, we look at it and then we decide, “Oh, it doesn’t look good. I should be feeling bad,” and you just want to like really feel, “How do I feel? I feel okay,” and then yes, we can look at the data. The Fitbit is good and there are a bunch of other ones out there that can be helpful.

Also, I ask everyone not to focus so much on how much deep sleep you have exactly, how much REM sleep. Yes, it’s important, but also these devices are not perfect. Also, some of us move a lot more and yes, that can tell us information in itself. So I have found that it’s important to look at the bigger picture. Now, if we don’t have enough REM sleep, deep sleep, it reasonably looks really low. Like let’s say you have friends and they have the same device and you’re like, “Whoa, I only have half an hour of deep sleep and you have an hour and a half,” we want to look at the bigger picture, what could be disrupting the function of the body and understand this. Functional medicine really looks at the whole body and take gut infections, just chronic low grade gut infections that don’t necessarily take you to the hospital or drive you into the doctor’s office, but something is not quite right. Maybe you feel bloated, maybe you’re restless at night. There can be things that can be improved, that can increase the amount of deep sleep that you have of REM sleep.

So we want to look at the whole function of the body, looking at the gut health, because as you know, like if you improve the gut health, you improve serotonin, production, 90-something percent of it is produced in the gut. So that’s the way I look and I ask everyone not to over focus on that data, but the data is very helpful, especially if you have been collecting data from the Oura ring, for example, and then you do things to change and then you can see the improvement. Then that’s really, really helpful.

Dr. Weitz:            So what is the significance of deep sleep?

Dr. Corca:            It helps with numerous, numerous functions in the body and memory consolidations and emotion processing. So with the REM sleep, it all has its own function. Even light sleep is very, very important and one thing that I want to point out is that we typically have more of the deep sleep at the beginning of the night and that’s important to remember because some of my patients come in and say, “Well, I don’t have any deep sleep later in the night. Is there something wrong?” And a lot of people know that you’re supposed to have that at the beginning of the night, some people don’t. And so you want to keep in mind-

Dr. Weitz:            And then the REM sleep seems to occur more in the last several hours, right?

Dr. Corca:            Exactly, and that’s also important to know because sometimes people say, “Well, I seem to be more aware of my environment in the morning,” and that’s partially because of that and also we have more dreams in the morning. So I like to bring some normalcy because when we have sleep issues, we build a lot of anxiety around it and then we attach meaning to everything that we’re looking at and how we feel.

Dr. Weitz:            So, yeah, anxiety seems to be a factor that decreases our ability to sleep well. It’s interesting how anxiety and depression, which are often linked as common mood disorders, but they sort of have the opposite, it seems, significance with respect to sleep, whereas it seems like even though a lot of patients have both, patients who are anxious have more trouble sleeping, whereas patients who have depression tend to sleep more.

Dr. Corca:            That can be true, definitely with depression, especially here where I live, because we have winter and less sun and colder days. Definitely environmental-

Dr. Weitz:            And you’re in Colorado?

Dr. Corca:            Yeah, in Colorado, the seasonal effective disorder, some people get more depressed, they sleep more. Unfortunately, some of those people who develop seasonal effective disorder, even though have depression, they can also develop insomnia, which makes the depression worse. And yes, with anxiety, we have this over activated nervous system being in fight and flight mode, and then it’s not safe to settle into sleep. If you think about it, in order to fall asleep and stay asleep, the body and mind and spirit has to feel fairly safe because we’re very vulnerable. Think about it. You’re laying there in bed, you’re not aware of your environment.

So a certain amount of deep safety, and I’m not even talking about safety in your room because we live in houses with doors that are locked, so there isn’t really… generally, depending on which neighborhood you live, of course, you’re generally safe. It’s more about the stresses from our daily life, and even these, as I mentioned, gut infections or hormonal imbalances or just not having enough nutrients or having a food sensitivity that’s constantly aggravating your body, all of those like stressors in the body as well.

So I just want to say that’s not only emotional stress because I work with people, they tell me, “But my life is so good. I just can’t sleep and have anxiety and I don’t understand why.” So partially that physiological aspect is very important, and of course there is trauma from the past as a result that people are not consciously aware, but it’s still residing in their body.


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Dr. Weitz:            How important is it to respect our circadian rhythm for getting a good night’s sleep? I know that as it gets darker and the light tends to become a redder light, if you look at the sun setting, it’s redder and that tends to lead to melatonin secretion, which helps sleep, and then in the morning when the light comes up, we get the white light, which has a blue light, which stimulates cortisol, which tends to wake us up. How important is the timing of our sleep to, in some way, try to coordinate with our normal circadian rhythm?

Dr. Corca:            It’s very, very important a routine signal safety to the body, having that chaotic schedule creates stress, so that’s very, very important and then in the evening, as I was talking earlier about slowing down after 7:00 PM, I like to call it life after 7:00 PM because it can be kind of a different life and something that you do for yourself, you want to have that slowing down process and then making sure that you dim the lights, that you don’t look at the screens as much. It’s okay to watch a movie or if you want to scroll a little bit on social media and such, but I would allow about 45 minutes to an hour or putting away electronics and having a dimer yellow light. There’s those blue blocking glasses that you can use as well, but it’s not only about the light, it’s also about the activity that comes at you.

 So you want to calm it all down, read a book, listen to some music, do a little bit of stretching if you want to, whatever brings you pleasure. I always tell people you don’t want this to become another things or another thing that you have to do in the evening in order to fall asleep, but focus on what feels good because if you think about it, if you focus on what feels good for half an hour or an hour, that secretes a lot of feel good hormones and decreases cortisol, and as a result of that, you sleep better, but you also feel wonderful in the moment and that’s amazing.

This is what living in the moment is, it’s experiencing how you feel right here, right now. So that’s for the evening and again, kind of going at the same time to sleep consistently is important, but more important is also listening to your body. So if you’re not quite sleepy yet when it’s 10:00 and that’s your bedtime, don’t push it. Maybe you read a little longer, even if you’re going to be in bed a little shorter, because if you go to sleep a little slowly and your body’s not quite ready, then you’re laying in there and you can develop anxiety. So you don’t want to do that. So listening to your body and making sure you’re groggy and sleepy is very important.

Now, when you wake up in the morning, I would say it’s very, very important to keep it consistent and at the same time and not sleep in. If you need extra sleep, I’ll always tell people wind down earlier in the evening and go to sleep earlier and wake up at the same time because if you wake up at the same time the sleep becomes very efficient. Talking about increasing the quality of your sleep, that will increase the quality of your sleep because we have an internal clock and it kind of knows. I don’t know if you’ve slept well most of your life and a lot of you, you notice that you wake up at the same time no matter what, and that’s a really good thing. You want to honor that.

Dr. Weitz:            What about your sleep window? What if you tend to go to sleep at 2:00 in the morning? Is that less than optimal, for example?

Dr. Corca:            It is less than optimal, but some people have night jobs, and if that’s what it is, making sure you have your routine and consistency is very, very important. You’re not sleeping in, not fluctuating when you wake up and then it doesn’t matter if you wake up at 6:00 or 8:00 or 10:00 AM, to wake up at the same time and expose yourself to light, taking a walk, having some movement, eating breakfast, plenty of protein, 20 to 30 grams of protein is very important. If you are like me right now, like in Colorado, there is not enough light-

Dr. Weitz:            Why is eating 20 to 30 grams of protein so important?

Dr. Corca:            Because a lot of people do the opposite. They eat too much sugar, and then they have blood sugar fluctuations and that messes up with the cortisol, the stress hormone. So eating protein really sets up your body for stable energy, fully waking up and keeping your cortisol level steady, and then more so for the cortisol is just to eat in the morning. I know we live in a world where intermittent fasting is really popular and that can work too, I suppose, but for people who have sleep issues, I tell them for the time being to have breakfast. It doesn’t have to be a huge breakfast.

Dr. Weitz:            Yeah, you’re referring to the fact that intermittent fasting right now is considered very trendy, especially in the functional medicine world for promoting longevity and a lot of people do it by skipping breakfast.

Dr. Corca:            Right, yeah. And oftentimes, we go, we’re stressed in the morning and I think black coffee is allowed, so we just get this immense kick. We force the adrenal to give energy, but it’s also stressful to the body, so it’s not the healthiest way to go about it. Now, if you still want to do that, then you could do collagen powder, MCT oil in the coffee, doing two scoops of collagen powder gives you about 20 grams of protein. So that could be a possible alternative.

Dr. Weitz:            Now why collagen powder?

Dr. Corca:            The collagen powder gives you about 20 grams of protein and [inaudible 00:27:30] so-

Dr. Weitz:            Could use why protein or other forms of protein?

Dr. Corca:            You can, yes. I often recommend collagen powder just because a lot of people have issues with dairy products and even whey protein, so then collagen feels like the safest, but yeah, and it could be pea protein if you’re okay with the peas. So there are several choices there that could be replacing the full meal, but I do like to… I have a regular meal for breakfast, just some kind of a fish or meat and lots of vegetables. That’s typically my breakfast and it’s very helpful. So the other thing that I wanted to say about the morning is that if you don’t have access to the sun in-

Dr. Weitz:            You mention you have meat or fish in the morning.

Dr. Corca:            Yes.

Dr. Weitz:            But for some reason when you talk to a lot of people at the out breakfast, they’ll say, “Well, that’s not breakfast food. I have to have breakfast food.”

Dr. Corca:            I know.

Dr. Weitz:            What’s breakfast food? “Breakfast food.  I have to have cereal or waffles or toast, or I have to have all these carbs in the morning.”

Dr. Corca:            I know, I get it and I certainly like I literally sometimes miss it, I think about it and I’m like, “Wouldn’t really nice to just have some waffles with some butter and some fruit. That sounds so amazing,” but especially for women and for myself… For men too, but more so for women, especially women who go through menopause, it just really causes blood sugar issues and then morning you are hungry again and you reach for more coffee, your energy drops and you might have some more sugar.

If you want to lose weight or have a steady weight, if you want to have good energy, if you have thyroid issues, and you have want to have good energy, just try. Just try for me, just for a week, try have that different kind of breakfast and see how you feel. Don’t take my word for it from my experience, but just try it and see if you feel amazing and crave less sugars throughout the day and feel more stable and energized and you reach less for the coffee and for the stimulants and even in the afternoon, then… And most people, when they realize how good it feels, then they just do that and have the occasional typical breakfast some days just as a treat.

Dr. Weitz:            One thing, I don’t know why this came to mind for me, but among the people who have… A lot of people have trouble with sleep, but it seems like there’s a certain group of people that I’ve noticed and for me it tends to be women over the age of 70. I know a number of them have just given up, “That’s it, I don’t sleep. I’ve tried everything. Even if I get five hours, I’m happy.” Why do you think women and especially older women tend to have more problems with sleep?

Dr. Corca:            Yeah. I think the functions on our body as we age, they’re just not working as well, they’re not optimized as well. Just, for example, the gut is not functioning as well, so maybe not enough probiotics to even make serotonin. They’re just, it’s just [crosstalk 00:30:48]

Dr. Weitz:            Do you think it’s a hormonal thing, lack of estrogen and…

Dr. Corca:            I think partially can be and partially neurotransmitters. I often do a neurotransmitter test, I look at GABA and serotonin and dopamine and histamine and all of that, and I think that’s partially what’s happening sometimes. I see those inflammatory kind of…

Dr. Weitz:            So when you run a test like that, what kinds of results do you get and what types of changes do you make as a result of the results?

Dr. Corca:            So to pick up on something that comes to mind, that this is a 70-something year old woman, I can’t remember exactly how old she is, one of the inflammatory markers that comes from the tryptophan kind of on the serotonin pathway, is very high, so that creates a certain amount of inflammation in the brain. I don’t think it allows us to sleep properly. So for her, I think just doing a high dose of procurement of active ingredient of Turmeric, it’s going to be really important, especially since she has pain as well.

Dr. Corca:            So I think spot on that would be helpful for her and I think it will impact her sleep. And she always said, she says, “I’ve gone through menopause for so many years and still I have a little bit of a temperature fluctuation at night.” We don’t want someone at that age to go on hormone replacement therapy, but a little of support with herbs, just a little bit to optimize the function of the body can move the needle a little bit.

Dr. Weitz:            So what kind of support will that be?

Dr. Corca:            Just herbs that support, it could be even for some women Black Cohosh. do different herbs, different combinations-

Dr. Weitz:            Okay. So many herbs that help with menopause?

Dr. Corca:            Exactly, yeah. Some of the combinations, I have Chinese herbs in them that can be helpful.

Dr. Weitz:            You used the rhubarb extract?

Dr. Corca:            Yes. Yeah, I believe. What is that company? I can’t remember the Metagenics who has that?

Dr. Weitz:            Yeah.

Dr. Corca:            That’s a wonderful, wonderful one. Also, the other thing that I tell people as they get older is-

Dr. Weitz:            Isn’t it amazing. I have some patients in that category too, that women in their 70s are still getting hot flashes or night sweats?

Dr. Corca:            I know, right? Because we’re told that like once [crosstalk 00:33:18] menopause you-

Dr. Weitz:            It can’t be because having big fluctuations in estrogen anymore. What is causing it?

Dr. Corca:            It’s in the brain, there is the temperature regulation, actually that’s… Like there is this little window and it’s too narrow and I think different kind of hormone levels helps to regulate that a little bit. So once that’s off, the ratio, the space to regulate it is too small, and then we go back and forth too easily.  The other thing that I really want to say about people who are any age, but really in the 70s and 80s, I think we’re told a lot like, “You’ve got to sleep. This is dementia prevention. Sleep is very, very important.” And yes, you can do various things as much as you can, but I don’t want people to obsess over it because that’s more stressful. If you just get a little short of sleep, but you feel wonderful, then I don’t want people to stress over that because the stress of it is literally worse. Again, I’m not saying not to do anything about it, but also not to [inaudible 00:34:21] for nine hours.

Dr. Weitz:            Right. Stressing over sleep is the biggest disrupter of sleep.

Dr. Corca:            Excuse me?

Dr. Weitz:            Stressing about not sleeping is the biggest disrupter to keep you from sleeping.

Dr. Corca:            Yeah. It’s all these ideas that we hear that are true in some cases, but there is more to it and, and it’s very important to, to understand these different aspects and not get anxiety over a particular idea, for sure.

Dr. Weitz:            So you mentioned temperature regulation. One of the things that I’ve incorporated into my sleep routine is using something called a Chilly Pad, which actually he cools me because sometimes in the middle of the night, we’re either getting Santa Ana winds or something, but it seems like the temperature will go up five, 10 degrees, and that will tend to wake me up. So if I have this constant temperature, that seems to make it easier to not wake up.

Dr. Corca:            Yeah. We have to have a lower body core temperature in order to settle into sleep. That happens naturally. That happens naturally actually a little bit in the afternoon and that’s why I believe we’re made for siestas, so that’s why I tell people to take a little nap.

Dr. Weitz:            Do you recommend something like that to maintain temperature?

Dr. Corca:            Yeah, it can be helpful. It definitely can be so helpful for people. I’ve heard a lot of good things about the Chilly Pad and there are other devices that are similar that can be truly a life saving, especially depending on where you live and the temperature of [crosstalk 00:36:02] for many people.

Dr. Weitz:            What are the most effective nutritional supplements for sleep? I know you’ve talked about a few already in terms of herbs that help to regulate some of the hormonal issues, especially that women have and we talked a little bit about cortisol secretion. Do you ever do like the cortisol testing and do you try to use supplements for that and what other kinds of sleep supplements do you find or effective, A, for falling asleep and B, for staying asleep?

Dr. Corca:            Yeah. So let’s talk about the cortisol. Yes, I do the saliva testing because it’s super helpful. It gives us valuable information. We don’t want to assume it’s always generally safe to take certain adaptogenic herbs like as Ashwagandha, Rhodiola, and Holy basil, but-

Dr. Weitz:            So for doctors who say, “Oh, there’s no point in doing salivary testing.” I just listened to somebody else’s podcast who said, “Oh, this is a complete waste of time and money. If the patients are stressed, just give them some adaptogens.”

Dr. Corca:            Yeah. I find value in testing because… Okay, let me think of another patient just a few days ago. On Friday, I reviewed the test with her and she’s very fatigued and then she has anxiety at night and I kind of assumed that probably her cortisol is too low in the morning and too high at night, but we don’t want to assume, because we want to look at the overall curve. It should be higher in the morning and then lower in the evening, but also we want to look at the total output because if, let’s say, we start clearing cortisol at night, it can backfire. If she doesn’t have enough of that total output, it clears it really fast and then the body says, “Ooh, we don’t have enough cortisol because cortisol is helping [crosstalk 00:38:00]

Dr. Weitz:            So let me stop you right there. So what you’re saying is, is let’s say, you assume, “Oh, this person’s stressed and they’re having trouble with sleep. So I’ll just give them some adaptogens that are going to calm their cortisol secretion, and I’ll have them take it in the afternoon or the evening and that’ll help their sleep,” but maybe don’t don’t know that they actually have a very flat cortisol curve. They’re not producing enough cortisol, and now you’re down regulating their cortisol production even more by giving herbs like phosphatidylserine that are decreasing their cortisol. You might need to use a different set of nutritional supplements that help the body to produce more cortisol, to get that curve the way it’s supposed to be and you wouldn’t know that unless you did the salivary cortisol testing.

Dr. Corca:            Exactly. That’s exactly right and if you use phosphatidylserine assuming their cortisol is high at night, but the total output is too low, then we need a certain amount of cortisol because it has a lot of different good functions and then the person will feel temporarily better and then hour later they’ll have more anxiety and be wide awake and they don’t know why. And also like-

Dr. Weitz:            Then instead of using those adaptogenic herbs, which some people say, “Well, you can just use these for everybody,” you might need to use a different set of supplements. For example, you might want to use an adrenal supplement that includes licorice root, or glandulars or some combination of herbs that are better at building up cortisol production instead of calming it.

Dr. Corca:            Exactly. Yeah, definitely. So there are all these different… Yeah, exactly, as you explained subtle aspects and there is really no… You can guess or you can make an educated guess, especially if you’ve done a lot of tests and have worked with people, but I like to test. It’s, what, $160, it gives us such valuable information and some of these tests, they actually even test in the middle of the night. If you wake up, you can take a sample, so then you can see is the reason why they wake up cortisol related or not and it’s not always. In fact, I find that more than half of the people, they’re not waking up or because of that, there is something else that wakes them up and [crosstalk 00:40:21]

Dr. Weitz:            Right. There you go. So the cortisol testing may lead you to not use an adrenal adaptogen, or it may help with the timing of it. So for example, I just recently had a patient who is having trouble sleeping and falling asleep and I was thinking maybe he’s getting a cortisol rise in the evening, but it turns out he’s getting this big spike in the afternoon. So I may have used the same adrenal adaptogens, but I timed it more in the afternoon rather than in the evening. So the timing of the use of supplements may change depending upon the curve as well, and that’s another reason why, in this case, testing can be beneficial instead of just guessing.

Dr. Corca:            Yeah and honestly, for sleep issues I don’t think I’ve never seen a perfect, maybe 1% of people they’re like, “I don’t have to do anything for your cortisol.” There is always something I can do, but it different degrees of it. So I always find it helpful. So yeah, the timing, the type of supplements, it’s so important and also having a baseline, it’s super crucial. So depending on that it can depend a lot-

Dr. Weitz:            What are some of the other important supplements for regulating sleep? I know it changes depending upon the underlying causes and that’s super important. So if we have blood sugar problems, we’ll maybe need to use supplements to regulate blood sugar, as well as the right dietary approaches, exercise.

Dr. Corca:            Yeah, exactly. We’re were looking at the gut, looking at the hormones that carry toxins, the liver, there are many things, but I do find myself often trying to supporting the calming neurotransmitters, like the serotonin and GABA, and for serotonin you can take 5-HTP, but that’s not always what I do. There are other things that sometimes, like supporting the gut, it’s very, very important, so I always do that, but [crosstalk 00:42:27]

Dr. Weitz:            How do you support the gut? Do you use probiotics? Do you use other supplements?

Dr. Corca:            Usually if there is a gut component, I’ll see what the problem is. Yes, I tend to use digestive enzymes if it’s needed, it the infection is cleared or the infections, if we need to do an elimination diet, do an elimination diet to food sensitivity [crosstalk 00:42:47]

Dr. Weitz:            How will you clear infections? You use like antimicrobial herbs?

Dr. Corca:            Yeah. So usually I do a stool test and so we look at the stool test, you probably do this as well, and we see what’s in there where the problem is and support that with herbs. Very rarely if there is a parasite or… Yeah, usually parasite is where I’ll recommend that maybe they get a short term prescription to support that, but in general, herbs and supplements seem to be super helpful to clear these imbalances and then support with probiotics and digestive enzymes and change the diet based on what they need. I try to not make it very restrictive because it’s hard on the people, but whatever I try to find whatever is the most helpful that moves the needle the most.

Dr. Weitz:            And if you make it too restrictive, that’s another source of anxiety.

Dr. Corca:            Exactly.

Dr. Weitz:            Yeah. So what are some of the best herbs or what are some of the best nutritional supplements for falling asleep? You mentioned five HTP. If you use five HTP, well how, how many milligrams will you use and then why will you sometimes use it and sometimes not use it?

Dr. Corca:            I tend to run this urinary test, [inaudible 00:44:07] he test, and that’s another test that if you look at some of the experts, they say, “Well, it’s not really representative of what’s happening in the brain,” and that’s true, especially because some of these, they get metabolized in the gut and the kidneys and all of that, but I have found it to be very helpful to give a general idea and I look at the trends rather than just taking everything literal.

Dr. Weitz:            Okay. So give me a couple of examples of results you get and then how will you supplement differently?

Dr. Corca:            Yeah. Like for example, this patient, I review the test just a few days ago. She had had dopamine, histamine and PEA, which is a neurotransmitter. They were all trending high and that told me that there is a methylation issue likely. And then we had another test where we could see that the B vitamins are a little bit off, which totally made sense. Now we need to help her body methylate better. She probably has a genetic mutation. So this is just a very complex process that happens in the body like, I don’t know, some huge number every second, every millisecond, so-

Dr. Weitz:            So what did you do to give support for methylation?

Dr. Corca:            I just gave her, to begin with, because she’s young and I think she’s going to respond well, just some B vitamins with TMG and a little bit of SAM-e.

Dr. Weitz:            Like a B complex or a-

Dr. Corca:            A B complex. I have Sam and TMG, so a couple of other nutrients that help make that-

Dr. Weitz:            Oh, what particular supplement would that be?

Dr. Corca:            Oh my gosh, I don’t remember the name, but-

Dr. Weitz:            Okay, but a particular supplement that has B vitamins with TMG and SAM-e.

Dr. Corca:            And SAM-e Yeah, that will help lower the histamine. It will help lower the dopamine. Dopamine is so wonderful to give you gust for life and having motivation, but if it’s too high, you will not feel well and you’ll get [inaudible 00:46:10]. So that’s one example and actually her serotonin was on the high end and she just so happens that she has gut issues. So if we have gut issues and bacteria, that imbalance is going to drive the serotonin high, which is also not good. We don’t want it to be too low or too high.

Dr. Weitz:            So there’s a case where you did this testing. You might have used a nutritional supplement help with sleep that included 5-HTP, but in her case, because she had high serotonin, that’s something you would not do?

Dr. Corca:            Exactly. Yeah, that person would say, “Oh my gosh, I did [crosstalk 00:46:45]

Dr. Weitz:            Another example where you would change your recommendations based on the testing because testing rather than guessing can be helpful?

Dr. Corca:            Yeah, exactly. And then I always take the testing and really think about the person. Like, does this make sense? If it doesn’t make sense, I do what makes sense at first and see how it changes and then we’ll go back and look at the results or retest and figure it out. So we take everything with the grain of salt, but I find testing super helpful and in time, the more you test you start, already seeing patterns before you even have the test-

Dr. Weitz:            Which urinary neurotransmitter test will you use?

Dr. Corca:            I use ZRT most of the time.

Dr. Weitz:            What’s it called?

Dr. Corca:            The ZRT lab. The lab called Z-R-T.

Dr. Weitz:            Oh, ZRT. Yes. Good.

Dr. Corca:            So I tried a few different ones and they’re pretty good, but that one is very complete and then also we get some neurotransmitter testing and the Dutch test we could do for hormones, and also we get the organic acid test. We get a little bit of data, but when I want to be specific, I go for the ZRT test.

Dr. Weitz:            Right. Organic acid test. Do you get that through ZRT or you get that somewhere else?

Dr. Corca:            From Great Plains laboratory.

Dr. Weitz:            From Great Plains. Okay. Great. So maybe a couple of other hints on sleep. What about patients who have trouble staying asleep? Will you tend to use certain supplements for that and what about melatonin? Does melatonin help? When do you use melatonin?

Dr. Corca:            Let’s see, I use melatonin when it shows more if I test it in the Dutch test and on older people, I do one milligram and see how they do with that. We don’t-

Dr. Weitz:            One milligram, that’s really low.

Dr. Corca:            I know. We only produced about, at the highest, as teenagers we produce 0.9 milligrams and then is adults around 0.4, 0.5, and then as we age even less. So I have the liposomal, where you can do drops and ask people to just do one milligram and then possibly increase to two or three.

Dr. Weitz:            So liposomal melatonin?

Dr. Corca:            Yeah. Quicksilver Scientific, they have a good product that I like, because then you can play with the dosages and also you can do it gradually. You can take one milligram, one drop at 9:00 and then another about a 9:30 if you want to do kind of a gradual. Yes, there is the time release one as well, but I like this one, it works really well. Also, when people travel using melatonin, I find that it’s helpful to help with the jet lag. As far as falling asleep and staying asleep, I would have to think about that. It almost doesn’t seem like they’re different necessarily.

Dr. Weitz:            Yeah. I guess I’ve heard people say, “Oh, melatonin is better for falling asleep. Five HTP is better for staying asleep.” You haven’t really found that to be the case?

Dr. Corca:            Not necessarily. Think about it. If you have no serotonin, you’re going to feel anxious and you might have to trouble fall asleep. What I do find though, is that people tend to have [inaudible 00:49:57] susceptibilities and tendencies. So like when people wake up around 1:00 or 2:00 AM, it’s more digestive issues, hormonal issues, more than anything. Yes, the neurotransmitters can also get affected, like serotonin and therefore use 5-HTP. And then when people wake up early in the morning, their there are certain patterns. It may be sleep apnea, it may be just a lot of emotional stress, it might be hormonals or digestion, it’s a combination of things, but it can vary and it comes down to that root cause that I’ve mentioned to you now, what exactly is happening with the person?

Dr. Weitz:            Yeah. I know we’re close to wrapping up here, but we haven’t really mentioned sleep apnea and I know this can be an important player in a lot of people with sleep.

Dr. Corca:            It is and I think a lot of us think that this applies only to people who are overweight and that’s so not true. Yes, it’s more likely people who are overweight, but if I have even the slightest possibility in my mind that the person has sleep apnea, I recommend that they do a sleep study. Nowadays they’re all done at home, it’s pretty easy, usually the insurance pays for them, but the very least I ask people to buy a continuous oxygen monitor. You can buy it online usually for around $150 and it’s not a sleep study, but it’s fairly good information. And with that, it measures your oxygen throughout the night. You can see if the saturation drops under 92%, and if it is, then you got to take steps in that direction because you can be working on various things from different angles, but you have to address that sleep apnea issue.

Dr. Weitz:            I think a lot of people are apprehensive about getting tested for sleep apnea because all they’re thinking is, “I don’t want to use that CPAP machine.”

Dr. Corca:            Yeah, it’s true, but there are other… Like in functional medicine, we always want to work on the inflammation and if it is that you have extra weight, we can decrease that, but at the root of it is inflammation and yes, it could be structural, and then as you age things get more slack around here, the tongue falls in the back of the throat more easily. If we have inflammation in that area or even gut inflammation, it can make it worse. So there’s things that we can do. Even blood sugar imbalance, then that can increase the inflammation.  So there are a lot of things that we can do. And then the CPAP is not the only thing. We also have these mandibular devices that can pull your jaw forward and that can be super helpful for many people. So there are alternatives. It’s better to find out and know and do something about it instead of suffering and having other health effects over the years that you really don’t want to.

Dr. Weitz:            And what do you think about drugs for sleep?

Dr. Corca:            I think they can be helpful at the right moment. I’d rather have a person not develop severe anxiety or end up in the ER because they’re in such a distress. I don’t recommend them for long term because you’re not really addressing the root issues and it could be a dependency, even if it’s just mental, and you just want to leave… Sleeping is such a vital thing, something that we need every night, ideally you don’t want to be completely dependent on something [crosstalk 00:53:25]

Dr. Weitz:            What about CBD and marijuana? I hear a lot of patients relying on these kinds of things for sleep.

Dr. Corca:            CBD can be helpful. Again, in my mind CBD is something that it can be supportive naturally for a little while, until you figure out what’s happening in your body. THC, I find sometimes that with inflammation and temperature regulation issues in people and I’m not a big fan of it, but CBD can be helpful, and again, I never tell people to take CBD. It’s more like, “Yes, that’s that works for now. Let’s figure out why you can’t sleep, and let’s address the root cause.”

Dr. Weitz:            Right. Great. Okay. Any final thoughts you have for our listeners and viewers about sleep?

Dr. Corca:            Yeah, it’s to focus on how you feel the next day and there’s a lot of things that we didn’t get to touch on. Like, I don’t know, caffeine and just various things. I actually have these three gifts that I want to offer to you. I just kind of summarize a few myths around sleep, things that we think they’re true, they might not be true and what’s true about that.  So if you go to damianacorca.com, D-A-M-I-A-N-A-C-O-R-CA.com/sleepmyths So that would be sleep M-Y-T-H-S, there is a wonderful handout that I have that I think would be further helpful. Those are kind of like some basic things that you can do immediately and make sure you’re aware off. So then I feel like if those basic things we don’t take care of, then you never know, it might be as easy as taking care of those things, like understanding really when to stop the caffeine and understanding like what’s enough good sleep for you. Simple things, like is it good to drink milk before bedtime? I think that’s a big one a lot of people ask me sometimes.

Dr. Weitz:            Drink milk.

Dr. Corca:            I know it’s funny. So I explain all of those things and it’s at that link at damianacorca.com/sleepmyths. Other than that, yeah, I’m happy to help if anyone has any specific questions. So can go to my website or email me at damiana@damianacorca.com. Do you have any final questions that come to mind for me?

Dr. Weitz:            You just brought up like five other things that we could have covered, like caffeine and alcohol, and there’s a bunch, but there’s a lot of stuff that impacts sleep. I think we covered quite a bit.

Dr. Corca:            Yes.

Dr. Weitz:            Yeah. Good. Great. So, thanks for spending some time with us and making us more knowledgeable about sleep.

Dr. Corca:            Great. Thank you for having me. I’m happy to be here with you.



Dr. Weitz:            Thank you for making it all the way through this episode of the Rational Wellness podcast. And if you enjoyed this podcast, please go to Apple podcast and give us a five star ratings and review. That way more people will be able to find this Rational Wellness podcast when they’re searching for health podcasts.  And I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica Weitz Sports Chiropractic and Nutrition clinic. So if you’re interested, please call my office, (310) 395-3111, and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz. Thank you and see you next week.



Nutritional Deficiencies with Tom Malterre: Rational Wellness Podcast 240

Tom Malterre discusses Nutritional Deficiencies as a Cause of Chronic Disease with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.] 


Podcast Highlights

1:35   Testing for Nutritional Status.  Standard lab panels like a CBC with differential and a chemistry screen pick up broad issues that may be catastrophic, but they don’t pick up nuances. This allows us to see if a person’s ingredients for optimal cellular function are happening.  If you see that someone has estrogen out of balance, but you want to know why and this could be because their fatty acids are out of balance.  It could be because the co-factors that are used by enzymes that regulate estrogen levels.  Just looking at a thyroid panel or a hormone panel or even a gut panel, we don’t necessarily find out what is going on in your cells today and how to help that person.  Tom said that he believes as Dr. Sidney Baker taught us that all disease is caused by two primary things: 1. You’re getting things you don’t need, like toxins, pro-inflammatory foods and foods that you react to, stress, et. and 2. You are not getting enough of the things that you need, such as vital amines (vitamins), minerals, essential fatty acids or amino acids.  If you have arthritis, it can helpful to find out why you have a pro-inflammatory state?  Are you missing your vitamin C? Are you missing some of the things that stabilize complex 2 in your mitochondria? Are you missing fat soluble vitamins that might stabilize the membranes within your cells and therefore reduce the amount of oxidative stress and lipid peroxides?

5:55  The average person sees their doctor, who orders conventional lab testing that is very limited and does not tell us anything about nutrient status.  If we see that a person has diabetes, we never ask why they have diabetes?  Why does this person not metabolize their carbohydrates very well?  Are they having trouble metabolizing their fats?  If they cannot convert their glucose into acetyl-CoA, then they cannot use that glucose for fuel.  Are they missing some co-factors for the actual pyruvate dehydrogenase complex to work, so they can process glucose or fatty acids.  If people are doing a keto diet and consuming a lot of fat, we need to make sure that the fat is brought into the mitochondria via the carnitine shuttle and once in the mitochondria, it needs to go through beta oxidation, which requires specific nutrient co-factors.  But if they have loose stools and their stool floats, this may be a pattern of fat malabsorption and if they are following a high fat, keto type diet, then that diet is not working for them.  Maybe it’s because they need additional riboflavin or carnitine or perhaps they don’t make enough phospholipids, which means they are not producing enough bile that enables them to emulsify the fat and to be able to absorb it. If you have too much fat in the stool, this will draw with it fat soluble vitamins, so fat soluble vitamins will test low, as will essential fatty acids.

8:53  Vitamin D.  If a patient has a low vitamin D, that could be because they have fat malabsorption. This is why it is helpful to have fat soluble vitamins being measured, such as with ION 40 panel, which measures vitamin D, vitamin A, two forms of vitamin E, and CoQ10.  If all of these are in the first quintile, then we know we have trouble with fat digestion/absorption.  And vitamins D and A are important for immune system function. We also see that if glutathione levels go down, so do levels of immune cell function.



Tom Malterre has a master’s degree from Bastyr University, as well as advanced training in Functional Medicine from the Institute of Functional Medicine, where he is also part of the clinical faculty.  Tom has lectured on nutrition and supplementation across the country and he currently coaches doctors and health care practitioners on Functional Medicine protocols and he runs Whole Life Nutrition.  He has written The Elimination Diet and The Whole Life Nutrition Cookbook along with his wife, Alissa Segersten. 

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 and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.


Podcast Transcript

Dr. Ben Weitz:                   Hey, this is Dr. Ben Weitz’s host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field, to bring you the latest in cutting edge, health information. Subscribe to the Rational Wellness Podcast for weekly updates, and to learn more, check out my site, drweitzs.com. Thanks for joining me, and let’s jump into the podcast. Hello, Rational Wellness Podcasters. Today, we have an interview with Tom Malterre on nutritional analysis, as part of an approach to helping patients overcome chronic health conditions. Our special guest today is Tom Malterre, who has a master’s degree from Bastyr University, as well as advanced training in functional medicine from The Institute of Functional Medicine, where he is also a part of the clinical faculty. Tom has lectured on nutrition and supplementation across the country. He currently coaches, doctors and healthcare practitioners on functional medicine protocols, in his progressive practitioner coaching program. And he also runs Whole Life Nutrition with his wife, Alyssa Segersten, and he’s written a number of books, including The Elimination Diet and The Whole Life Nutrition Cookbook. Tom, thanks for joining us.

Tom Malterre:                   Hey, Ben. Pleasure to be here, my friend.

Dr. Ben Weitz:                   Absolutely. We’ve been chatting a little bit on Facebook over the last several months, so I’m glad we finally put this together. So what are some of the benefits we can get from testing for nutritional status?

Tom Malterre:                   That’s a good question. So it’s interesting, I feel like I’m spoiled now. Anytime we’re trying to get an idea as to what’s going on with a person, we oftentimes rely on the person’s symptomology and we rely on conventional lab testing. And what I’m finding is, conventional lab testing, standard blood panels, don’t necessarily pick up nuances. They pick up broad issues that are occurring and whether or not it could be catastrophic. And when they don’t necessarily-

Dr. Ben Weitz:                   What do you consider, standard lab panels?

Tom Malterre:                   Just a standard blood count, maybe with differential, cholesterol, possibly some sort of vertical auto profile, like a Cleveland HeartLab type analysis, type thing. It tells us about what’s going on in a certain aspect of a person’s health. But the reality is, human beings are built up of organ systems, and organ systems are built up of tissues, and tissues are built up of cells. So the reality is, you want to make sure that a person’s ingredients for optimal cellular function are happening. So this is one of those things where you go out and you say, “Wow, look at this person’s estrogen levels.” And you say, “Well, why is the estrogen out of balance?” Is it possible that the substrates for the estrogen itself, like the fatty acids are out of balance?  Is it possible that some of the co-factors for the enzymes that regulate estrogen levels are out of balance? Is it possible that some of the co-factors for the enzymes that detoxify or bio transform the estrogen are out of balance? You want to know all those details. By looking far upstream, and looking at a thyroid panel, looking at a hormone panel, or even looking at a gut panel, we don’t necessarily find out how to help that person today. What’s going on in that cell today? How can nourish that person to metabolize, transform, to detoxify, to exist in the presence of certain bugs. You’re always wanting to create an environment of resilience in the cell. And how do you do that? The same today, as we’ve learned from Sidney Baker from the get go, which is, all disease is caused by two primary things.

One, you’re getting things you don’t need. Two, you’re not getting enough things you do need. So you’re getting too many irritants and not enough nutrients, you’re getting toxins from mold, from air pollution, whatnot. You’re getting stress, you’re getting some sort of anti, or I should say, pro-inflammatory food components, like oxidized, fatty acids or whatnot. But you’re not getting enough of the things you do need. And those things are vital amines, they’re vitamins. They are minerals. They are essential fatty acids. They are amino acids, which is probably the most under looked aspect of functional medicine that I would suspect, are amino acids. And we don’t analyze those things. They are the primary building box for neurotransmitters, for cell repair, for proteins, for everything. But we don’t look at them. So I’ve said, why not? I’m a nutritionist, one who nourishes.

I have both a bachelor’s and a master’s in science and nutritional sciences. I’ve been studying it since I’ve been 10. Why not? We go in and we get a doctor’s diagnosis, and they’ll look at a set of symptoms. And they’ll say to you, “Well, you have diabetes or you have arthritis, or you have osteoporosis”, but they don’t necessarily say, why. Why do you have arthritis? You have pro-inflammatory markers in your system, but why do you have pro-inflammatory markers? Are you missing your vitamin C? Are you missing some of the things that stabilize complex 2 in your mitochondria? Why do you have a pro-inflammatory state? Are you missing fat soluble vitamins that might stabilize the membranes within your cells and therefore, reduce the amount of oxidative stress and lipid peroxides? Why don’t you check these things? You just take it for face value, that you have an inflammatory state, but why? So I ask, why?

Dr. Ben Weitz:                   Well, I think one reason why, is because the average person is not really aware of all this. They go in and see their doctor and they say, “Well, all my labs were perfect. There’s nothing wrong.”

Tom Malterre:                   Right. Yeah. And that’s I think, where we run ourselves into little boxes. When you look at conventional lab testing and that’s all you know, or you look at a diagnostic code and that’s all you know, and you say, “I would like to treat diabetes.” Well, why does the person have diabetes? Does this person metabolize carbohydrates very well? Do they metabolize fats very well? Are they efficient with their mitochondrial energy function? It’s possible that this person cannot convert their glucose into acetyl-CoA. And if they cannot convert their glucose into acetyl-CoA, then they cannot use that glucose for fuel. Then that can cause a backing up of the system. They may have a lactate buildup. They may have symptoms of muscle pain and fatigue and whatnot. And they’ll have these blood sugar abnormalities. Why, what’s the chemistry?  How does glucose get broken down? Are we dealing with some sort of issue with the actual pyruvate dehydrogenase complex, missing some co-factors, to allow for the normal processing of glucose, or when it comes to fatty acids? I have a lot of people who are doing keto diets, carnivore diets, whatnot. They’re consuming a tremendous amount of fat and/or protein. And they’re not taking into consideration when they’re consuming the fat, that the fat has to be brought into the mitochondria, via carnitine shuttle. Once it’s in the mitochondria, it’s going to need to go through beta oxidation, beta oxidation needs specific nutrient co-factors. All these things are a chemical process.

Dr. Ben Weitz:                   This is so the fats can be converted into energy in their body, because they’re eating very few carbohydrates.

Tom Malterre:                   That’s exactly right. It’s interesting, right? You run these panels and you see people who have then, an inability to digest fat, and they’re eating tons of fat. So you’ll see low levels of fatty acid, whether it’s monos, saturates, essential fatty acids, and you’ll see low levels of fat soluble nutrients. And you’ll see on the intake form, a pattern of fat malabsorption. So they’ll say, “I have looser bowel movements. I have multiple bowel movements per day. They’re floating, they’re lighter in color.”  And you say to yourself, “Wait a second, keto isn’t working for you. Keto might be the best thing for you, metabolically, but it’s not the best thing for you currently, physiologically.” Why? Possibly, they have a carnitine deficiency. Why? Possibly, because they need additional riboflavin. Why? Maybe it’s genetic. Maybe they’re not making enough phospholipids, and the phospholipids aren’t allowing them to produce adequate bile. The bile is not allowing them to emulsify the fat and then allow them to absorb the fats efficiently. And they’re ending up with the fats in the stool. When the fats are coming in the stool, the fats then draw with them, all the fat soluble vitamins. So there’s these nuantic pieces that you want to put together. You can’t just-

Dr. Ben Weitz:                   Well, that’s a great point right there. You could have somebody with low vitamin D, and if the vitamin D is being pulled out of their body because of fat malabsorption, and then we’re giving them more vitamin D and we’re going, “Gosh, why isn’t this person’s vitamin D going up?”

Tom Malterre:                   That’s definitely a panel that you want to look at too, is constantly look at the vitamin D. The neat thing about these nutrient panels that include fat soluble vitamins, like the ION 40, they include the vitamin D. So you can look at vitamin D, you can look at vitamin A, you can look at two E markers, both the alpha and gamma tocopherols, and then you can look at coenzyme Q10, and you can form an image on these panels where you look at, across the board, they’re in Quintiles. So five little segments, and you can see if everything’s in the first Quintile, then obviously you have an issue. You have an issue with a person getting in enough, fat soluble vitamins. If they have that issue, then where’s the conversation about looking at additional ox bile or looking at lipase or looking at something that would help that person digest, and therefore absorb their fats and their fat soluble vitamins. Because if they can’t get the fat soluble vitamins in, then what’s the use of supplement?

Dr. Ben Weitz:                   Exactly. And we know vitamin D, among its many, many benefits, is immune system function. And we all know that right now, having a highly functioning immune system is super important.

Tom Malterre:                   Yeah. Well, that’s another aspect. It’s interesting. We’re seeing a lot of data coming out and I saw this through the Institute of Function Medicine, while studying toxicology. And when we saw that people were deficient in glutathione, and we saw their immune cell function went down. And when their glutathione levels go up, it appears their immune function improves. So you can track both, where the glutathione might be coming from, and the actual glutathione itself, indirectly, via some of these nutrient analysis. So if we were wanting to say, “Well, gosh, it’d be great if we could take a peak inside someone’s cell and determine if they’re taking their homocysteine and turning it into glutathione and keeping their glutathione levels up, and/or determining which specific amino acid substrates might be low in this person. This panel can’t look at cysteine, it oxidizes, but it can look at cystine, looks at homocysteine, looks at glycine and looks at glutamic acid.  So you can determine, am I low in all the substrates? Where is the metabolism going of these substrates? Am I producing enough glutathione. And we’ll see a imprint of that with pyroglutamic acid. So we can get a glimpse too, of what’s happening with the antioxidant detoxification systems, by looking in the urine and organic acids, by looking in the plasma, at amino acids or in some cases, the urine. But I always look at plasmas, it’s a longer picture of how long the amino acid levels have been low in the body, or high. Most of the time, people have low amino acids, not high. And in fact, once again, we have nine essential amino acids. Some are transitionally essential, and no one measures these things. These are the building blocks for all repair tissues.

You’ve got a person who’s got Ulcerative Colitis or Crohn’s, and they cannot seem to repair their intestinal tissue. And I run an ION panel on these people, and their amino acid levels are in the tank. Their phospholipid levels are in the tank, their magnesium levels in the tank, their zinc levels in the tank. They don’t have enough of the raw ingredients to help rebuild their own intestinal tract.  So when they’re actually getting injured by microbes, by food particles, by whatever it is, toxins, then they don’t have the ability to repair the tissue. So we know that the-

Dr. Ben Weitz:                   That right there, is a great clinical insight for patients with chronic gut problems. You could have a patient dealing with IBS, SIBO, one of the other forms of dysbiosis, and you might be taking the appropriate steps that, normally are supposed to work to help this person get rid of, or reduce the levels of the problematic microbes. And you could be giving them probiotics to build up their microbiome. But if they’re lacking essential nutrients to allow their intestinal system to function properly and to heal and to repair, none of those are going to be effective.  And we may be running down various wrong paths, looking for the next problematic microbe, when we have to go back to the basics, which is, looking at the importance of our nutritional status, which of course, is something that only us in the functional medicine world look at, because conventional doctors are not going to do this. They might run a vitamin D or a serum B12, but that’s about the end of it because all the other tests are not going to be covered by insurance. And they have a 10 minute office visit anyway, limited by what insurance pays.

Tom Malterre:                   Exactly, and it’s not just the intestinal lining, it’s the mucus layer. So you need specific nutrients for mucus. Ideally, we’d have optimal electrolytes. People don’t even think about that for mucus production. There’s so many different things when it comes to structure of the human body, that are all chemical. You need the actual chemical ingredients to build rebuild, repair, do anything you need to do, with a human cell. So if you’re not thinking of the nutrients, you’re not thinking of what’s the optimal health of a cell.  So that’s why I’m always trying to get people to run these panels. And when you have these panels, the interesting piece is, and a lot of people will say, “Well, I’ve run these things and there’s no validity on these. And there’s no science to back this up.” You got to be kidding. I have a textbook that I keep in my desk drawer right here, with all my supplements.  It’s the Laboratory Evaluations… Oh, you can’t see that, but Laboratory Evaluation for Integrative and Functional Medicine, 2nd Edition by Richard Lord and Dr Bralley.  I spent time with Dr Richard Lord over a decade ago. We hang out at all the Functional Medicine conferences. They’re wonderful people, the Bralleys’ and Dr Lord. They’re from Metametrix, that now got absorbed into Genova, right?

Dr. Ben Weitz:                   Right.

Tom Malterre:                   This crew was not wasting their time. They sat and buried themselves in scientific literature for decades, to come up with some of these evaluative tools. And then, the wonderful thing about this analysis is, there are checks and balances. So if you have a urinary organic acid, and it’s the only marker you have, like methylmalonic acid, for example, B12. And you’re like, “Well, gosh, does this person really have a functional B12 deficiency?” Well, the fatty acids that need to be transformed by adenosylcobalamin, into other metabolites that can be used for energy Succinyl-CoA at all, if they cannot be transformed, you’ll see a buildup in odd-chain, fatty acids on the panel. So you can see functional adenosylcobalamin deficiencies, via MMA and odd-chain, fatty acids. There are multiple, different ways throughout the test. Let me give you an example.  I had 46 year old female, just two days ago. And this 46 year old female has weight loss resistance. She has these immaculate standard panels. I’m working through another healthcare practitioner. I’m pulled in as a consultant sometimes, on cases.

Dr. Ben Weitz:                   Okay.

Tom Malterre:                   And this other practitioner shares these three different lab sets and they all look pretty immaculate, everything looks great on this woman. She’s fabulous, mentally, gut wise, supposedly everything’s great. How come she’s not losing weight, what’s going on? And so we look at essential fatty… Or excuse me, we look at essential amino acids. And all we see is these little things of this real big spike in valine real big spike in threeanine. And we’re like, “Huh, what’s the commonality between these two. Everything else looks relatively normal, straight down the middle.”

Well, those particular two amino acids need vitamin B6 in order to be metabolized. So you say, “Huh, okay. Let’s go down the list and look at alpha amino and butyric acid”, which is a marker of B6. And it’s skyrocketed. It’s huge. So immediately I can see, there’s this drastic need for vitamin B6. Well, B6 takes place in all these transaminase enzymes. So anytime you want to transfer one amino acid into a different shape amino acid, you have to have adequate B6. B6 takes place in the brain, when we’re transferring glutamate over to GABA. We need B6 as a specific co-factor, to calm down neuro excitability. B6 is needed all over the place. There are hundreds of different reactions, whether it’s a form of metabolism or metabolism itself, or for glucose or other things, B6 is everywhere.

B6 for tryptophan, B6 for the formation of melatonin, B6 for dopamine, it’s all over the place. So if you have a person who’s deficient in B6, you have a person who’s, malfunctioning across the board. And it’s interesting when you run nutrient analysis, one of the most common nutrient deficiencies I see in humans is B6. And it’s weird because you say, “Well, why B6?” Well, B6 can be wasted, via a certain gene analysis. You look at their genes and they might be having specific enzymes that allow them to either, use up or excrete or more B6. That’s one. Two is, certain medications will deplete B6. Come on, Ben, what kind of medication do we know in females all the time, is depleting B6? It’s oral-

Dr. Ben Weitz:                   Antidepressant.

Tom Malterre:                   Antidepressants, can be, and oral contraceptives. Well, guess what? This gal’s been on oral contraceptives for a couple decades. So it’s like, wow, she’s super deficient in the B6. Now, you partner that with a low tyrosine, she has a flat affect. She’s not really excited in life. And you say, “Oh, B6 is needed for dopamine metabolism.”

Dr. Ben Weitz:                   By the way, if that person were to get a serum B6, is that going to show us what we need to know?

Tom Malterre:                   Not always, interestingly enough. No, and you have this reflected here in a couple of different spots, but you’ll see it in the urinary organic acids, as kynurenate and Xanthurenate. And then you’ll see it again here, in the amino acids and alpha-Aminobutyric acid.

Dr. Ben Weitz:                   Now, why is it? I’ve seen a number of patients who, their serum B6 was actually high, but they needed B6.

Tom Malterre:                   Okay. Well, B6 is once again, needed all over the place. And so you’re not always going to find B6 just in circulation, where you want it to be. So if you’re using B6 intercellularly, if you’re using B6 in multiple use, and you’re looking in just one area in the serum to find out if your level is adequate, then you may not see what you’re looking for. Not only that, you need to transfer B6 into pyridoxal phosphate and if you’re looking at pyridoxine, and you’re looking at pyridoxine in the serum, you’re not necessarily going to determine if this person is utilizing the B6, in the bio available form because of their enzyme function, their co-factors for that enzyme, they may have insufficient magnesium, for example. And so they may not have functional use of their B6, even though they have B6 in circulation. So it’s not enough, right?

Dr. Ben Weitz:                   Right.

Tom Malterre:                   So anyway, so we find out right away, this gal has a B6 insufficiency. And then we look down the line and gosh, there’s all sorts of things. Her thiamin is insufficient. Well, what do you need thiamin for? Well, thiamin is going to be the primary determinant, to turn on pyruvate dehydrogenates. So when a person is taking glucose and they’re turning that glucose into acetyl-CoA, as we were talking about earlier, it has to pass through pyruvate and pyruvate has to turn into acetyl-CoA. Well, that complex, it’s a big protein complex, it has to have thymine first and foremost, to come in contact with that pyruvate and then break it down into multiple different steps, with the help of B2 and B3 and B5 for acetyl-CoA. And then we also have alpha-lipoic acid, which stimulates the whole response.

So if you’re missing a B vitamin like B1, the whole complex slows down, you can’t get the energy from the pyruvate. You also cannot get energy from your branched-chain, amino acids, your isoleucine and leucine, and valine. Those things need to go through alpha-keto acid dehydrogenase as well, which needs the thiamin. So you’re not getting energy from amino acids. You’re not getting energy from your glucose. Then all of a sudden, what happens? The system backs up. You have some issues. You’re not utilizing your energy from your foods. Now, partner that with one more thing, she’s eating mostly keto. And what do we see? We see that same scenario we were just talking about, where the fat-soluble vitamins are low. The coenzyme Q10, the vitamin A, the beta-carotene, the vitamin E, they’re low, the vitamin D was low as well.

And then we see monounsaturates low. We see saturates low, see essential fatty acids low. We see omega-6 low. So all of her fatty acids, all of her fat soluble vitamins, are trending low. So if these are all low, she may be on this higher fat diet. She may be trying to exist with keto. And she has a [inaudible 00:22:25] elevated, which is an indication of poor fatty acid metabolism. So we say, “Wait a second. Of course, she’s going to have fat loss resistance.” I don’t know if you’ve seen this, Ben, but I’ve run nutrient panels now, for 15, 16 years. And when I see people who are low in essential fatty acids, they hold onto their fat. The body, for some reason… I tell my own story here where I say, well, the body really needs these essential fatty acids.

And if it’s not getting the essential fatty acids, whatever fat it takes in, it will hold onto. It’s looking for that missing link. It’s wanting that piece. And so therefore, it has a difficult time letting go of the fat, until it receives the beneficial fats that make it function well. Now, if we looked at the fatty acid panel too, which is fascinating, we’ll see that she had a block on DPA, turning into DHA. We see she had some blocks from GLA to DGLA. Both of those things need elongase to work. And what does elongase need? Vitamin B6. So even some of her essential fatty acid, some of her prostaglandin forming, omega-6 fatty acids, they were out of whack, once again, because that B6 was missing. So there’s this wonderful story that gets told in your own chemistry, by looking at these nutrient analysis tests, but here’s the challenge-

Dr. Ben Weitz:                   So let me just stop you on this particular case. So then, how much B6 and what form of B6 did you give her? How did you know how much B6 to give her? And did you use… Which form?

Tom Malterre:                   Yeah, so the reality is, I’m usually using higher doses of B6 than the average bear. And I’ll usually use 25 milligrams throughout the day, three to four times a day. So up to a hundred milligrams of B6, depending on the response, and usually titrating up. What I find is that, B6 travels really well with magnesium. So I’ll do a magnesium-

Dr. Ben Weitz:                   Do you use the P5P form?

Tom Malterre:                   Yeah. Depends on the person. So you’ll see responses and tolerance in different ways. It’s weird, some people do not respond well to P5P and some people do not respond at all to pyridoxine. So I’ll usually start out with a P5P/magnesium combo. And if there’s any sort of negative response, then I’ll move over to pyridoxine. So just a standard facility.

Dr. Ben Weitz:                   Okay.

Tom Malterre:                   But magnesium, I’ll usually have the magnesium along with it. Now, the magnesium is especially important when it comes pyridoxine, because you need it to convert over to P5P, which needs-

Dr. Ben Weitz:                   How much magnesium will you use in a case like that?

Tom Malterre:                   Thank you for that, asking. I really appreciate it. So what I found with magnesium over the years is, number one, the magnesium receptor sites don’t really, optimally function above 200 milligrams per dose. So a lot of people who are doing single dosing of 400 milligrams or 600 milligrams at night for sleep or leg cramping or whatnot, I don’t see that works. I find that, when somebody does smaller dosing throughout the day, 125, 150 max, three, four times a day, that’s better, both absorbed and tolerance wise. And the reason people don’t tolerate magnesium is usually, they’re doing too high of a dose of a form that’s not well absorbed, that causes an osmotic gradient, draws the fluid out, causes the cramping. They flush out the content of the intestinal tract. So of course it keeps-

Dr. Ben Weitz:                   We sometimes use that for constipation patients.

Tom Malterre:                   Yeah. Well, a lot of people do. They’ll use a citrate.

Dr. Ben Weitz:                   Right.

Tom Malterre:                   Hopefully they’re not using an oxide or a sulfate, like the Epsom salts, but my goodness-

Dr. Ben Weitz:                   What’s the negative effects of using an oxide or a sulfate?

Tom Malterre:                   Oh, oxides are miserable. They usually cause terrible cramping in people. Sulfates can as well, it’ll clear out the gut pretty significantly. I have a tendency, not to want to draw out fluid from the intestinal tract like that as much as possible. I will look at motility issues. I will look at bacteriological issues, absence of growth of certain organisms. Lactulose is incredibly underused when it comes to constipation, it’s bizarre. It’s a sugar, it’s a disaccharide. And that specific sugar, not only increases motility like nothing else, but it’s also a prebiotic. It seems to feed, acid forming organisms that change the pH of the upper intestinal tract. They help lower SIBO. It helps to help repair the intestinal lining. It’s one of the few things that’s been used in the medical literature, to repair a leaky gut and lower liver enzymes.

Dr. Ben Weitz:                   Interesting. It’s only available a prescription now, though.

Tom Malterre:                   Yeah. There was a petition going around a couple months back, to make it a non-prescription.

Dr. Ben Weitz:                   It’s insane. We have a sugar that’s a prescription.

Tom Malterre:                   It’s a sugar. Yeah. Welcome to the United States. If you go to Canada or you go to Australia or you go to Europe, whatnot, it’s not. You can go up to a pharmacist, say, “Just hand this to me please.” And they’ll give you a big bottle. And when I used to be able to go across the border, that was an easy thing to do, but it’s crazy now. But I highly recommend considering things like that, as well as there’s probiotics, other prebiotics, dietary changes, essential fatty acids, which help. So instead of causing an irritation and causing something to flush out the contents of the intestinal tract, which will draw other minerals or nutrients with it, oftentimes I’m using secondary measures for normalizing bowel movements.


Dr. Ben Weitz:                   I’ve really been enjoying this discussion, but I’d like to pause for a minute to tell you about our sponsor for this episode. Seed’s Daily Symbiotic is a pre and probiotic, two in one capsule that supports your gut health, your skin health, and so much more.  It contains 24 clinically and scientifically strains of probiotics.  The first of its kind, not to mention they’re sustainably delivered every month.  In your first purchase, you’ll get a glass jar that is infinitely refillable. Your monthly refills are delivered in compostable, biodegradable and recyclable packaging.  Personally, since taking Seed’s Daily Symbiotic, I’ve noticed more bowel regularity and better gut motility.   So get 15% off your first month supply of Seed’s Daily Symbiotic, by visiting seed.com/drweitz.  So that’s visiting seed, S E E D .com/ D R W E I T Z, or by using code           D R W E I T Z, at your checkout.  And now, back to our discussion.



Dr. Ben Weitz:                 Can you talk a little bit about, what we can tell about neurotransmitter imbalances from looking at amino acids? Because as you know, in this country, rates of depression and anxiety are really, super high. And over the last several years, have gotten much higher. And the conventional way of treating depression and anxiety is to, assume that this is a result of neurotransmitter deficiency and simply putting all the patients on SSRIs and similar drugs that say, increase serotonin levels.

Tom Malterre:                   Well, first off, one of the most under utilized therapies for anxiety I think is, recognizing that if a person is magnesium and B6 insufficient, they will be anxious. So I shouldn’t say they will be, the chances of them being anxious or having racing thoughts, the monkey mind, startling at loud noises, not being able to turn off their mind at night so they can get some rest, always being hypervigilant, what we call, wired and tired. So commonly Ben, so commonly is associated with a magnesium and B6 insufficiency.

Dr. Ben Weitz:                   So which form of magnesium should we use for these patients?

Tom Malterre:                   Ah, thank you. So if the person has cognitive decline issues, the three and eight might be good to get in the central nervous system. If they are not dealing with that, then a maleate or glycinate, anything could work just fine, Atorate for cardiac stuff, whatnot. There’s or an orotate, whatever. But I’m less concerned about that. They seem to work even a citrate can work if it’s low enough dose and doesn’t create bowel spasms in somebody. But the big thing is, just the smaller doses throughout the day.

Dr. Ben Weitz:                   Okay.

Tom Malterre:                   That’s the thing that seems to get people to where they need to go.

Dr. Ben Weitz:                   200 milligrams, what, two to three times a day, or even more?

Tom Malterre:                   Yep. Three to four times a day, if they have a big issue with it, especially if they’re quite anxious. But you ask questions. Do you have the eye twitching? Do you have the arm twitching? Do you have something going on that’s leading you to believe you may have a magnesium insufficiency? Are you startling at loud noises, whatnot? Do you have the leg cramps? Those are all telltale signs to show that you may have some extra need for magnesium. And if you do, then holy smokes, let’s go, let’s do it. And honestly, out of all the things that we see as patterns on these panels, after 16 years now of running these panels, what is it that I see? Consistent magnesium B6 insufficiency, consistent magnesium B6 insufficiency.

When I have people who are anxiolytic, when I have people who are having a hard time going to sleep, what is it that I see? Deficient magnesium and B6. So it’s one of the most solid patterns. So when I was trying to figure this out chemically, I looked of course, at this book that I have here, and it talks about the NMDA or the N-methyl-D-aspartate receptor in the brain, which is a calcium channel. And that calcium channel is stimulated by glutamate. And the glutamate basically tells the brain, alert and alarm, pay attention, remember, remember, you need to know what’s going on right now. This could be something that’s incredibly beneficial to you or potentially harmful. So you need to know this, you need to know this, that glutamate signal is turned on by toxins, it’s turned on by blood sugar abnormalities.

It’s turned on by all sorts of different stressors. And that glutamate will turn on. Well, once the glutamate turns on, it causes an influx of calcium into that channel. And that causes that neuro excitability. How do you then regulate that? How does the body regulate the NMDA glutamate excitability? Well, two ways, primarily. Well multiple, actually. But the two primary ways that I’m seeing chemically is, you can take that glutamate and you can turn it into GABA. Glutamate is excitatory, GABA is calming. How do you do that? Well, you do that through an enzyme, and that enzyme is a B6 dependent enzyme. So you have B6 in adequate levels, you can convert that glutamate to GABA. Fantastic, there you go. You get the exact opposite effect. You get a calming effect. The other way is, you have this [inaudible 00:33:51] which is calcium that’s coming in, and you have another [inaudible 00:33:53], which is magnesium.

So two positive charges, two positive charges. And you can have adequate magnesium that will sit in the middle of this calcium channel. And as the calcium will come in, it will electrically repel the calcium. So if you have adequate magnesium, it regulates the amount of calcium that actually can come into this receptor. So you have two primary things, stopping the calcium influx and turning the actual signal of glutamate made into GABA, that can help you regulate the anxiety response. So Mag-B6 for anxiety. I would hope more and more people would start thinking about that. Now the other piece is, of course, you have the normal pathways of dopamine. Dopamine’s going to coming in, via phenylalanine going to tyrosine, tyrosine going into dopa, dopa going into dopamine, and then dopamine going down into norepi and epinephrine. And if you have too much, norepi or epinephrine, because you have a zinc insufficiency or riboflavin insufficiency, and you’re not working on the aldehyde dehydrogenase complexes, and you’re not really processing your adequate dopamine or R epinephrine, you’re going to have some issues with neuro excitability.

The neat thing about these nutrient panels is, you can get clues. You can say, well gosh, do I have enough zinc? Well, yeah, the mineral zinc is here on this panel. Do I have enough B vitamins? Well, there’s a lot of different markers on here that would indicate sufficient or insufficient B vitamins. So you can get these clues all over the place. Plus, you can look at the neurotransmitter precursors. So you see phenylalanine levels, you see tyrosine levels, you see the ratio of phenylalanine to tyrosine. So you see if the conversion’s happening very well. And then you also see some of these things like VMH, VA that are actual end-products of, part of the metabolism of these neurotransmitters. So vanilmandelate, homovanillate, these are markers to show you, are they succeeding in going down the process of both, making the neurotransmitters and metabolizing them successfully?

So you can start telling yourself stories about the chemistry of whether or not this person’s metabolism is working. Now, if you partner this with a gene panel, and this is where the magic comes in, when you start looking at the actual precursors, and then you start looking at the end products, and then you start looking at, how are their enzymes? Are they able to actually process efficiently and effectively? And if they’re not, and they have the co-factors that are challenged, well, no wonder this person is anxious or no wonder this person doesn’t feel like they’re satisfied with life or rewarded or whatnot. So you can really start putting the biochemical pieces together, as to where the blocks may be in neurotransmitter metabolism.

Dr. Ben Weitz:                   Awesome. This is fascinating stuff.

Tom Malterre:                   Yeah. And it’s actually quite freeing, Ben, because when I see standard clients that have not had lab analysis, whether it’s nutrient panel or gene panel or both or whatnot. The more pieces of information you get, the more of a story you can tell. I worked for a Alzheimer’s company for a while, that would charge people $50,000. They’d run these massive brain scans and $10,000 worth of labs. And then I would sit with the lab material for a number of days, and I’d put all the pieces together and then come back with a protocol or a plan. And it’s incredible, how specific you can get when you have all these pieces of analysis. You’re no longer guessing, you’ve tested, so you know exactly where to go next.

Dr. Ben Weitz:                   Yeah. And Dr Dale Bredesen has shown in the last year, that we can use a functional medicine approach on patients with Alzheimer’s and actually reverse the condition, and actually make people better, as compared to that recent drug that got approved for Alzheimer’s that cost $60,000 a year. Causes bleeding and inflammation in the brain, and nobody got better.

Tom Malterre:                   Yeah. That’s a wonderful breakthrough. He has done some fantastic work. And the amazing piece about his work was this. If you start with one intervention, you get zero results. Well, not zero, you get minimal results for a shorter period of time. The more interventions you add, changing your lifestyle, your sleep processes, your exercise, your psychological wellbeing. And then he has a whole host of nutritional items that he recommends for mitochondrial function or gut function, or essential fatty acids or whatnot, amino acids. There are all these different things that he’s examined that say, you know what, for each one of these that you include, the chances of this person getting better, improve up to a 38 point protocol.

Dr. Ben Weitz:                   And by the way, I know they included the NutrEval in the analysis as well, among their lab testing.

Tom Malterre:                   Yeah. And once again, the NutrEval overlays the ION panel and vice versa. There are some slight differences. They’ve added a couple of new things like, oxalates and whatnot, to the NutrEval, but the ION 40 still has 20 additional amino acid markers. And it still has fat soluble vitamin markers that I enjoy looking at. So I’m old school. A lot of people like the NutrEval, because it comes out with this wonderful readout that tells you about all these algorithms. And it says, “This vitamin is low. This vitamin is low.” I’ve been doing this too long to want somebody else to tell me how to do it. I’ll look at it and I’ll say, “Well, if that’s going here and this is going there, wow, this person needs more glycine. So it’s a little different for me, but I really wish people would examine this.

And if they need assistance, they would somehow contact me and start a study group or whatever we have to do. But I would hope that people would understand, there are answers. There are clues, there are pieces of this investigation that you can add into your repertoire. You don’t have to just walk in and assume you know the diagnosis. Therefore, you assume you know the chemistry. I have to tell you, man, I’ve been so humbled by this, because I’ve been studying this for a very long time. And I’m reading the research and talking to colleagues and training colleagues and working on case studies with groups of people. And every time I run these, I’m always finding something that’s counter to what I thought it would be. So I think it’s smart for us to be humble and recognize, while we may have a whole plethora of things in our tool chest, without testing, we’re guessing.

Dr. Ben Weitz:                   Right. I love your test, don’t guess approach. And I also have found it very helpful in my functional medicine approach with patients. There’s an interesting trend in our profession, where some practitioners are out there saying, “If you run all these tests, then you’re treating the test and you’re overburdening the patient with excessive cost. And if the patient presents with these symptoms, just put them on this diet first. And if that doesn’t work, then use a couple of simple interventions. And most of the time that’s going to fix it. And all this other stuff is over testing and over charging and all this kind of stuff.”

Tom Malterre:                   Yeah, totally. I get it. And here’s what I would say. If you’re not up on it, you’re probably down on it. So this is what David Primler talked to me about a long time ago when I was talking to him at an AFMCP, years and years and years ago, he used to say, “People are down on what they’re not up on.” So if you haven’t run these for a number of years, they’re confusing. You look at them and you’re like, “Ah, chemistry. I don’t understand this.” But I’ve spent years, literally years going through the individual markers, reading the research on it, looking at the biochemical pathway, seeing how one biochemical pathway interacts with another biochemical pathway, and you see patterns forming. And you see that, well, yeah, this one’s not really accurate in this particular client because they’re gut’s so out of balance.

And this one’s not really accurate here, because they’re not digesting this amino acid very well, or I can’t really rely on this MMA value because they don’t really have adequate BCAAs. And so it’s not really going to tell me what their methylmalonic acid is looking like. So there’s a lot of little nuances that you have to gain with experience and time. And until you do, you’ll poo poo it. You’ll say, “There’s no validity to that. This doesn’t work.” This is an incredible tool, if you choose to understand what it is. You look at its limitations and you use it how you can, with limitations. But once you see the patterns and once you see it come out as hundreds of and hundreds, and now thousands and thousands of clients, you go, “Oh.”

This is one of many tools. And while I used to order these when they were $1,800. And now you order them and they’re $465. They have so much value, that I’ve never thought that I’ve wasted a person’s time and/or money, ever, not once. So I understand those arguments, and they’ll say, “You’re treating now, the lab.” Well, no, you look at the person’s symptoms. You look at the person’s history. You look at what they’re presenting with, right in front of you. You layer that with some of the information from this lab, and then hopefully you can get a gut panel and the gene panel and some other standard lab tech panels. And you start putting all those pieces together. And then you form the actual picture that determines where your plan or protocol is going to go.

Dr. Ben Weitz:                   This is brilliant, Tom. I am really enjoying this discussion. I wish we had two more hours, but mither you, nor I have two more hours available. So we’re going to have to wrap it here. I’d love to come back and discuss some of these issues in the future. How can listeners and viewers find out more about the programs that you have to offer?

Tom Malterre:                   Yep. So some are on wholelifenutrition.net. So there’s a functional lab analysis course that I was teaching for a number of years, that I’ve stopped teaching now. But if I have enough interest, I’m happy to coach people on that. And they can just shoot me an email at plantsarewise@gmail and say, “Oh my gosh, I got to know this.” And if you got to know this, I’ll teach you, we’ll make it happen.

Dr. Ben Weitz:                   Awesome. Thank you so much, Tom.

Tom Malterre:                   Pleasure, Ben. Take care of yourself.

Dr. Ben Weitz:                   Okay. Have a great day.

Tom Malterre:                   You as well, my friend. Bye-bye, now.



Dr. Ben Weitz:                   Thank you for making it all the way through this episode of the Rational Wellness Podcast. And if you enjoyed this podcast, please go to Apple Podcast, give us a five star ratings and review. That way, more people will be able to find this Rational Wellness Podcast when they’re searching for health podcasts. And I wanted to let everybody know that, I do now have a few openings for new nutritional consultations, for patients at my Santa Monica, Weitz Sports Chiropractic and Nutrition Clinic. So if you’re interested, please call my office, (310) 395-3111 and sign up for one of the few remaining slots for a comprehensive, nutritional consultation with Dr Ben Weitz. Thank you, and see you next week.



Menopause with Dr. Felice Gersh: Rational Wellness Podcast 239

Dr. Felice Gersh discusses Menopause with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.] 


Podcast Highlights

1:45  Menopause.  Is menopause a normal part of aging?  It is a normal part of aging, but a very negative one and it can lead to many of the diseases that we associate with aging. But it is also independent of age, since some women go through early menopause such as through surgical removal of their ovaries due to some disease.  “Nature is beautiful and wise, but also can be quite cruel.” The same nature that brings us beautiful sunny days also brings us tornadoes and hurricanes.

5:48  The first stage of menopause is Perimenopause, which is really the stage before menopause.  Menopause is defined as 12 consecutive months without a spontaneous period.  Menopause could also be called ovarian senescence, because it is marked by the ovaries no longer being able to produce estrogen.  Menopause is a natural, gradual process, but we should not ignore it nor embrace it. As humans we have a reproductive destiny and the prime directive of life is to reproduce and have healthy babies multiple times.  Every process in the female body is designed to support fertility.  The hormones, estrogen and progesterone, are the glue that glue all of the different functions in the body involving metabolic, cardiovascular, and immune function that go into pregnancy. When your ovaries can no longer function and ovulate and produce these hormones, all the systems in the body have this profound change.  It’s natural but it is a problem for women and once we understand that, we can create some viable solutions.

13:12  There is no definitive test that a woman is in perimenopause, though you could do a cycle mapping of female hormones, aka menstrual mapping. This test is available through Precision Analytical Lab as part of their DUTCH testing and also though ZRT Labs, where you have a woman measure her hormones daily using dried urine for 28 days or so.  This test is not done by conventional gynecologists, but it allows you to see the various phases of the menstrual cycle and you might see that they start to get a shorter luteal phase and the estrogen spike that proceeds ovulation will tend to be dampened down. Next you will start to see a dampened progesterone response as well.  The progesterone ends up being produced in a lower amount and for a shorter period of time.  This test can help with many conditions, such as fertility problems.

23:27  Phytoestrogens can help to manage some of the symptoms of perimenopause.  Eating organic, whole soy, which contains phytoestrogens, does not increase breast cancer risk.  This can help with hot flashes, night sweats, and sleep problems.  Estradiol has at least 3 different receptors–alpha, beta, and a membrane receptor.  Soy and flax bind to the beta receptors.  Beta receptors are in the cerebrum of the brain and in the cells lining the gut, so phytoestrogens help with brain and gut function, but bone is more alpha, so they don’t benefit the bone as much.  You can eat organic, whole unprocessed soy beans or minimally processed like tofu and include a couple of tablespoons of flax seed. Take Siberian rhubarb supplements, which is another phytoestrogen that is all beta.

37:10  One of the symptoms of perimenopause is mastalgia, for which Dr. Gersh recommends taking 100-200 mcg of iodine.  Also anti-inflammatory supplements like curcumin and fish oil, as well as eating an anti-inflammatory diet.

38:41  If the balance of the estrogen and progesterone tips and the progesterone declines first, chaste tree or chasteberry, aka, vitex can be helpful at a dosage of 200 mg per day.



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 IntegrativeMGI.com, and she is available to see patients at 949-753-7475.  Dr. Gersh lectures around the world, and she has just written her third book, Menopause: 50 things you need to know: What to expect during the three stages of menopause.  Her other two books are PCOS SOS: A Gynecologist’s Lifeline to Restoring Your Rhythms, Hormones, and Happiness and PCOS Fertility Fast Track and she has also published a very influential paper in the prestigious journal Heart, which is part of the British Medical Journal family of journals: Postmenopausal Hormone Therapy for Cardiovascular Health: the Evolving Data.

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 and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.


Podcast Transcript

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

Today our topic is the three stages of menopause, with Dr. Felice Gersh. Dr. Felice Gersh is a board certified OB/GYN. She’s also fellowship trained in integrative medicine.  Dr. Gersh is a director of the Integrative Medical Group of Irvine. She specializes in hormonal management. Her website is integrativemgi.com. She’s available to see patients at (949) 753-7475. Dr. Gersh lectures around the world. She’s just written her third book, Menopause: 50 Things You Need to Know, What to Expect During the Three Stages of Menopause.  Her other two books are PCOS SOS and PCOS Fertility Fast Track. She’s also published a very influential paper in the prestigious journal, Heart, which is part of the British medical journal family of journals. Post-menopausal Hormone Therapy for Cardiovascular Health, the Evolving Data.  Dr. Gersh, thank you so much for joining me again.

Dr. Gersh:           Well, it’s always a pleasure.

Dr. Weitz:            How should we think about menopause? What is menopause? Is it just a normal part of aging? Is it a disease? What is menopause?

Dr. Gersh:           It is definitely a normal part of aging, but a very negative one. It depends on how you want to look at all the diseases of aging. Menopause is not a disease, but it is a staging event that can lead to many of the diseases that we associate with aging.  In fact, that’s been a very big discussion, which has been very frustrating from me, when I was looking on from the sidelines. So many things that are attributed to just aging, like chronological age, have really been misguided because they’re missing that, I always say the critical ingredient of the hormonal ingredient, like what’s happening to women when ovarian function ceases and they don’t make any more estradiol and progesterone from their ovaries.  That is, of course, related to age, but it is also independent of age in that, for example, if a woman goes into a surgical menopause like, for example, her ovaries are removed for some disease entity, or she is unfortunate one of those women who has premature ovarian insufficiency, where her ovaries stop functioning at a very early age. Then all those conditions start to accelerate in their presence.

So, we definitely don’t want to think of everything that happens to women as just related to their chronological age. That’s why I really want to bring back the picture of menopause as natural, but negative. So I always say, “Nature is beautiful and wise, but also can be quite cruel.” The same nature that brings us beautiful sunny days also brings us tornadoes and hurricanes.  So, we just need to recognize the boundaries that we have in terms of what we can do about menopause and all of its subsequent negative effects, and what we can really take charge of. We can’t avoid menopause. I always said, Benjamin Franklin, who was very wise also, but a guy, he said something. To paraphrase, there are certain things in life that are never going to be done away with, and that was death and taxes.  I said, “Wait a minute. Just one minute here. What about menopause?” We can’t escape menopause. At least at this time, although I hear there are some people working on cloning ovaries, but that’s not happening quite yet for the market.

Dr. Weitz:            Right. It’s interesting, the discussion about whether or not menopause is a disease. There’s also a discussion in the longevity section of medicine, whether aging is a disease. A number of doctors are lobbying for aging to be a disease, so it’s easier to justify treatments for it.

Dr. Gersh:           I would probably draw the line of calling aging and menopause diseases, but I would say that we need to look at what is happening. I’m always into mechanisms. I know you are, too.

Dr. Weitz:            Theoretically, of course, we don’t want to see aging as a disease. But the way our healthcare system is, where we don’t do anything for prevention, you have to call something a disease before you can even justify treatment.

Dr. Gersh:           If we need a CPT or ICD9 code, I guess for menopause and aging so that we can actually get coverage for caring for people, then I’m for that. I have to be pragmatic, as well, so I’ll buy in.

Dr. Weitz:            Let’s go into the stages of menopause. The first stage of menopause is perimenopause, which is really the stage before menopause, but you’re approaching menopause, right?

Dr. Gersh:           I have to work with the existing vocabulary. If it were my choice, I would abolish the word menopause because it has really misguided so many people into viewing this process of ovarian aging, or ovarian senescence, as really about the end of periods. By arbitrary definition, menopause is defined as 12 consecutive months without a spontaneous period. That is completely arbitrary. There’s nothing in nature that points to that as anything other than that it’s part of the process.  Part of the reason I wanted to do three stages, I can’t get rid of the word menopause. That’s stuck. In medicine, we’ve tried to change words. The old word is just added to the new word, and everyone falls back to the old word, because that’s what we feel comfortable with. So I’m not going to abolish the word menopause, so I have to work within that context.  To try to show menopause as what it is, it’s ovarian senescence, and it’s an evolving process. That’s why I, somewhat arbitrarily, created the three stages of menopause, so that people would see that there’s the prelude to this arbitrary definition, and then there’s the first decade. I put the first part of menopause, after the pre-menopause is 10 years because-

Dr. Weitz:            Maybe you should come out with two versions of the book, and call one Ovarian Senescence, and call one Menopause, and see which gets the most attention.

Dr. Gersh:           Okay. You know what? That’s an idea. I’m going to hire you, marketer.  We have to stop thinking of menopause as, you cross a finish line and you’re there. The event has happened and I made it, and I’m still alive!  But to view it as what it is. Of course, aging, people always talk about the minute you’re born, you’re aging. But the bottom line is that there’s certain things that, we’ll say accelerate the negatives of aging, or the process of menopause. We need to understand this if we’re going to actually put into place some pragmatic ways of approaching it. Just because it’s natural, doesn’t mean we ignore it or embrace it. In fact, everything in medicine is about recognizing things that may be natural, but are negatives, and then doing things that are completely unnatural to try to get people back to that state of homeostasis.  Everything that is medicine, even going back to the days of a tribe, where you had the person who was in charge of healthcare in a tribe, they were incorporating natural things. I’ll call it green medicine. They were looking for plants that could reverse a fever, or a pain, or something.  So, everything is about harnessing whatever tools we have to reverse something that’s happening, that we don’t view as a positive, like all the stages of menopause, and all the symptoms I put in there, that people will often experience, and what we can do about it, and recognizing, really. The takeaway that’s so essential from the get-go is that menopause is not a one time event, and that it’s an ongoing process, and that it’s a gradual process involving the declining function of the ovaries, which actually does parallel the declining state of fertility. That’s not an accident.

Dr. Weitz:            Right.

Dr. Gersh:           Once you also, I keep telling people this, and I want it to really come home to roost. Every process in the female body is designed to support fertility. We don’t like to think of, our bodies are designed just to procreate. We just need to recognize that we, as humans, are so unique in that we actually try to determine our reproductive destiny. Whereas, no other creature on this planet says, “This is not a good year to have a baby.” That is just not happening. Or, “I think I’ll go on birth control for the next 20 years.” That doesn’t happen. We do that to our pets when we castrate them, but nothing happens naturally in nature that involves trying to control reproductive function.  Since the prime directive of life is what it is, it’s the most amazing thing of life. Remember, I’ve delivered thousands of babies and it never ceased to astound me that this is actually happening; a baby was coming out of another person. It’s like, “Wow. This is amazing.” That is really the prime directive of life, so every system in the female body is really designed to help to have a successful reproductive status, and have healthy babies, and do it multiple times.

Pregnancy is such a stress test of women. It’s such a challenge, too, with altering the cardiovascular system, and changing the immune system. All these systems in the body are so amazing. I say that the hormones; estrogen, progesterone; they are really the glue that glues all of these different functions in the body involving metabolic functions, cardiovascular, immune functions, everything in the body to the reproductive functions. In fact, all of the different enzymes, pathways, are actually reproduced in the reproductive tissues that are out there in the peripheral tissues.  So, it’s a sink or swim together body. That’s the takeaway. When you lose reproductive functions, when you go through this dynamic change and your ovaries are no longer going to be ovulating, putting out the eggs, you really can’t have babies anymore; all the systems in the body have this profound change that occurs in them because of the loss of this vital force in the female body, which are these beautiful rhythmic hormones.  We need to recognize that, and be honest about it, and then decide, “Okay, what are we going to do about it?” That’s really my mission is really to first educate, because you’ll never solve a problem if you don’t first define the problem. The problem, I call it natural but I call it a problem for women, that menopause is a problem. If you cannot define that problem, I can consider a premature death as a problem, too.  So, if you define a problem, then you can come up with viable solutions to that problem. But if no one even understands what is menopause, what is happening, what are the implications, then clearly, we’ll never have any viable solutions. That’s not going to help women everywhere.

Dr. Weitz:            So how do we know a woman is in perimenopause?

Dr. Gersh:           There is actually no test. It’s a clinical. We do have clinical. I can’t believe this, but I am actually a very old fashioned doctor. I observe. I take a history. I do an exam.  We know, 100%, since 100% of women are going to go through menopause, that at a certain age, it’s going to be a process of ovarian decline and fertility decline. Women will manifest the symptoms quite differently. There’s really a huge range. But every woman, once she hits the age of 40, is definitely going to be having serious fertility changes and serious changes in her hormonal production.  Now, we can do certain tests. I say there aren’t any, but you could do a menstrual mapping. It’s very interesting because I’ve done a lot of those tests. That’s not really mainstream at all. But if you take a woman, and what’s very classic for women as they are in the last decade before the end of cycles, we’ll call it, they will often have changes in their menstrual cycles, but they’re still having them.

So often, the cycle will become shorter. So then you think, “Okay, why is the cycle getting shorter? What’s happening?” If you do a menstrual mapping, then what you will often find is a shorter luteal phase. What happens is, the estrogen spike that proceeds ovulation is dampened down. Then you’ll see a dampened progesterone response.  So, the progesterone should have this nice, rounded little mountain, like a hill. Then instead of being like that, it’ll often be like this. It’ll have a little spike and then it comes down. You’ll actually see that the progesterone is produced in a lower amount, and also in a shorter period of time.  Of course, we know, everyone should know that progesterone is essential for the establishment of a pregnancy. That’s why in IVF clinics, they’re always giving progesterone to everyone for the first three months or so, because progesterone is essential for proper implantation. It works with the endocannabinoid system, so it’s all complex. If you don’t make an adequate amount of progesterone for a long enough period of time, and then allow the placenta to take over and so forth, then you’re going to have a miscarriage. Miscarriages are much higher in their incidents in women who are older, in their 40s and such.  The bottom line is that there’s not a test. You could do things like FSH-

Dr. Weitz:            By the way, on the cycle mapping, just for those listening who don’t know what that is. Can you just explain what cycle mapping is?

Dr. Gersh:           Sure. It’s a wonderful test that can help with many diagnosis, like is a woman having an inadequate spike of estrogen, or LH spike and they’re having fertility problems, they’re having PMS, and so on. What it looks at is through urine, by measuring urine multiple times during a cycle, you actually get a mapping.  So, if you’ve seen a menstrual cycle that’s been graphed out over 28 days, you see the estradiol, and it goes up, and then you have the big spike, and then it comes down, it dips and then it comes up. Then, if you’re not pregnant, it goes down. Then you see the LH, and it will have a big spike right after the estradiol spike, and then you see the progesterone coming up right after ovulation. Then, if you’re not pregnant, it goes down.  All of this gets mapped out on your graph. Then you get to compare it to an ideal one. Then you can see, “Oh, my gosh.” Now, it’s only telling you that one cycle, but hopefully, it’s a classic, typical cycle for that particular woman at that stage of life. What you can see is her estrogen, and the estradiol level is not right. Or you see the LH may be hovering too high because she’s perimenopausal and she has too much LH. Then we also see the progesterone, which often will be inadequate in its quantity and duration.  So, you can really help, a woman has PMS. Then you say, “Oh, yeah. Her progesterone level, or her estradiol level is totally inadequate.” Then we can, instead of just randomly giving people hormones and saying, “Here, I’ll just give you this hormone and see.” No, it’s a much more scientific approach to actually measuring, and then treating, and then seeing, monitoring for the effect.

Dr. Gersh:           So, I love to be evidence based. I hate to just be throwing hormones at people, which is done too often.

Dr. Weitz:            This cycle mapping is available through Precision Analytical. It’s part of their suite of DUTCH Labs, and also through ZRT. This is the kind of test that you might get from a functional medicine practitioner, gynecologist like yourself, which is not, you’re not going to get this from a conventional medical gynecologist, or hormone specialist.

Dr. Gersh:           No. It’s really, actually when you realize what you’re getting, and how valuable this information is, and how completely off the grid it is for the standard OB/GYN, it’s really sad.  So for those of you out there, this is very easy to interpret, and the labs will also help you to interpret them. They give a lot of examples. It’s really fascinating because I have found that so many women who have even regular cycles, when you look at their hormone production, it’s really not optimal at all. It’s very interesting when you see perimenopause and you see where, sometimes, they’ll have an overshoot of estradiol, and you have a really high sustained LH.  So these are really interesting. These are not standard, run of the mill kinds of approaches. Because in the standard, conventional world, they do not do anything for perimenopause. They don’t even really recognize perimenopause. They just mostly, I hate to say this, but they put women, very frequently, on SSRIs. That’s the go-to. Really, it is, because women are having a lot of symptoms and they always say, “Ugh, another crazy woman.” Then, “Why don’t you just go on some Prozac or Lexapro?”  This is standard of care, which is really frightening because that is not addressing, we talk about root cause. That is not the root cause.

Dr. Weitz:            Unfortunately, it’s part of a small bucket of drugs that are used for conditions where they don’t know how else to treat. So, SSRIs are used for perimenopause. They’re used for irritable bowel syndrome. They’re used for, sometimes chronic pain patients. When you don’t know what else to do, try an SSRI, or try a PPI, or try an NSAID.

Dr. Gersh:           Right. When you know that these hormones are very involved in every organ system, including the brain. They’re involved with both cognition and with mood. Now it’s been published that the majority of women, as they are going through the perimenopause, in their 40s, they will have mood swings, sleeping disorder, and also some brain fog.  So, the go-to is traditionally to go on an SSRI. Upwards of 25% of American women in their 40s are now being prescribed an SSRI. That gets back to my, let’s define the problem so we can get a better solution than that. Because SSRIs, I’m not-

Dr. Weitz:            By the way, these drugs are not benign. They’re very difficult to get off of.

Dr. Gersh:           Very.

Dr. Weitz:            We’re manipulating brain chemistry in a very narrow way. We really don’t have much of a clue as to what we’re doing.

Dr. Gersh:           It’s really interesting because during the perimenopause is when bone loss is actually accelerated. It’s not really well recognized because you don’t have the fractures, but you have that accelerated bone loss as the hormones are going down.  SSRIs increase the risk of osteoporosis, so I call these the crazy maker drugs. There’s a ton of them. They actually promote the very problems in this specific demographic that we’re trying to avoid. Then we go on a drug that actually promotes the very condition that we ultimately are trying not to have.


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Dr. Weitz:            Let’s talk about some of the lifestyle factors and/or nutritional nutraceuticals that can help manage a woman with perimenopause.

Dr. Gersh:           I love phytoestrogen. Now, poor phytoestrogens have also gotten a bad rap, because people don’t understand them, and they think that somehow they promote all kinds of disease, when they actually are quite the opposite.

Dr. Weitz:            Like breast cancer.

Dr. Gersh:           Yeah. No, they’re actually not. If you eat organic whole soy, you’re not promoting breast cancer. It’s actually, these are actually agonist for the beta.  Now, we recognize plants are not estrogen. It’s a miracle of nature that certain plants can actually bind to our own receptors. We know cannabis binds to our endocannabinoid receptors. So, we have this miracle of nature where plants combine to our own receptors for our own benefit. There are a whole group of different types of plants. We can do plant extracts, as well, and utilize them for helping to maintain gut health.  There was actually a very interesting study that came out, maybe three to four months ago that showed that if you had an organic, soy based diet; a cup of organic soy like tofu or edamame; every day, that by the end of 12 weeks, hot flashes, night sweats, and sleep problems, which are so prevalent in this transitional time. Of course, it can go on for almost 20 more years. It can go on for a very long time, that something like close to 90% resolution of these symptoms, just by including these phytoestrogen foods.  Which is amazing, really, because they bind to the beta receptors. Estradiol has at least three receptors and variants now. There’s offshoot receptors, but the primary receptors are alpha, beta, and a membrane receptor. They have prevalence throughout the body, but in different proportions. They have different effects and they actually up and down regulate each other. They’re very interactive.

It turns out that certain foods like soy and flax seed predominantly bind to beta receptors. Beta receptors are in the cerebrum of the brain. So, it helps with that type of function, and as well, the gut lining cells are mostly beta. So, it helps with gut.  Now, unfortunately, the bone is more alpha, so it hasn’t been shown to improve bone health. It’s not a panacea. It’s not a panacea, and it’s not like having estradiol, but these are ways of harnessing nature’s gifts to us, to help us to feel better, sleep better, and all of those things are going to improve quality of life dramatically.  So, I recommend including organic, of course, if you have a food sensitivity, there are people that can’t eat some of the healthiest foods on the planet because of leaky gut and how their bodies have modified their ability to deal with them. But assuming you don’t have that problem, and you can do elimination diets and check it out, but assuming you don’t have a problem, and you can eat organic, whole, unprocessed soy, or minimally processed, like tofu, and include that on a regular basis, along with a couple of tablespoons of flax seed, that alone can have dramatic effects.  In terms of supplements, you can harness the Siberian rhubarb. The root of that plant is also a phytoestrogen that is all beta. That’s been well tested.

Dr. Weitz:            Let me just clarify for some that don’t understand. Phytoestrogen stands for plant estrogen. So, these foods like flax and soy contain these plant compounds that are very similar to the estrogen that’s in your body, and attach to those estrogen receptor sites.  Then the question is, do they have negative effects? Could they increase the risk of breast cancer, or some of the negative effects that can happen? Or are they more likely to have positive effects?  A lot of the data seems to show that most of their effects are very positive, that in some ways, they block out some of the toxic estrogens that are found from toxins in the environment, like pesticides and all these other chemicals. So, you’d much rather have phytoestrogens attached to your estrogen receptor sites than estrogenic substances coming from petrochemicals, or pesticides, or et cetera.

Dr. Gersh:           Yeah, plastics, right. Absolutely.  These, if you look at the chemical structure, a little bit of the molecule is similar enough that it can actually bind and have a positive effect. Then there are other foods that can also have that people don’t even realize, like pomegranates, which have been called a superfood, and people don’t realize that from pomegranates, you get urolithins. Urolithins are the breakdown from the different polyphenols; the aegisic acid and so on. These actually can also be phytoestrogen effects.  So, many of the foods that are called superfoods, when you actually find out about it, they’re actually phytoestrogens. So many so called superfoods actually do bind to estrogen receptors because, of course, men, I always say, should love estrogen, too. They have tons of estrogen in their body. They just make it locally, on site, in the different organs, from their testosterone. Because all estradiol is derived from testosterone. Men just do it on site. Women make it in their ovaries and then disperse it. Of course, we have different quantities, different ratios.  But in the end, these foods can also be beneficial. Breast cancer, by the way, is virtually always, when it says estrogen receptor positive, it’s working on the alpha receptor. Like soy, flax seed, they’re beta receptor. They’re more like estriol. They actually, we know that when you have a lot of beta receptor stimulation, it actually down regulates alpha. It’s an interesting thing.

So, it’s a little bit like taking raloxifine or tamoxifen, but better. These are drugs that have other interesting but not desirable side effects. It’s nature’s own way of giving these drugs that are actually marketed, like raloxifine, which is also called a SERM. The name SERM is not supposed to be used anymore, but like I said, nobody ever gets rid of the old words.  So, that stands for selective estrogen receptor modulator. But now you’re supposed to say estrogen agonist/antagonist. It means that depending on the location and the receptor, it either acts as a pro or a con. It stimulates or it blocks. So, that’s the new word, but we always say SERM anyway.  So, this is a drug, a pharmaceutical, raloxifene, and the brand name is Evista, that has an FDA approval for bone health, and to help reduce fractures of the vertebra, not of the hip. They haven’t shown hip. But in terms of breast cancer, it’s considered a prophylactic preventative, to help reduce the risk of breast cancer.  Well, duh. You could eat food and then you get all the other benefits of food, but those are natural ways of creating a similar effect to this pharmaceutical. So, I say go for the food.

Dr. Weitz:            What about topping off the benefits of the food by taking, say, genistein or diadzen supplements as well?

Dr. Gersh:           So, in terms of the isoflavone concentrates, I wish that the data was more robust in terms of its benefits. It hasn’t been as good as I would like. I don’t know of any real harm, but for those particular isolates of the isoflavones, you do better by eating the whole food.  So, I don’t actually push for those isolates. In terms of others, there’s been some extracts from what are called lignans, which are also phytoestrogen. Also, as I mentioned, the root of the Siberian rhubarb plant. That seems so arbitrary, but they figured that one out.  You’ve probably heard of black cohosh. Now, black cohosh has also not quite panned out as well as we had hoped. So, they’re just not really nature’s gift to the world as much as we’d hoped. So, I don’t really use a whole lot of black cohosh. I do use some of the others; the lignans, and I do use the Siberian rhubarb root. Then I use food. Of course, as an MD, I do use hormones.  That’s another thing that is not really recognized, that you can give a little bit of bioidentical estrogen, even to women who are cycling. That’s where, if you do the menstrual map, and you see that their estradiol levels are really sub-par, but it’s a crazy time, also mentioning the perimenopause, because there’s a lot of overshoot. That’s the one time when you can have actual estradiol dominance.  People always throw this term around, of estrogen dominance. I’m trying to get rid of it because people think of it as estradiol is evil, and that’s not what estrogen dominance is about. It’s about poor detoxification, endocrine disruptors. It’s not about, the ovaries are making too much estradiol. That’s not what it is about.  Except in one case, and that is when a woman is perimenopause, and she ends up having too little estrogen. The brain, which has a censor says, “Oh, there’s not enough estrogen being produced from the ovaries, so I will tell the pituitary gland to make more of its gonadotropins, LH and FSH, to then trigger the ovary to make more estrogen.”  Well, unfortunately, the ovary is now less responsive because it’s running out of eggs and it doesn’t really make the hormones as well. So, the gonadotropins, LH and FSH, are produced in higher quantities. When you still have some reserve, the ovaries are not completely done for yet, then you have this giant surge of LH and FSH. You can get a giant surge of estradiol, and you can also get multiple eggs coming out.  That’s why women in their 40s have the highest incidents of fraternal twins of any time in a woman’s life because they’re getting hyper stimmed. It’s like what they do when they’re trying to help women get pregnant, like in fertility patients. They give these medications to try to get them to ovulate. Then, sometimes, oops, now we’ve got too many.

Now, in the ancient days, they weren’t so careful and then people had octomoms, they got so many eggs out.  Now sometimes they’ll get twins. They’re very careful. They’ll just abort the cycle if there’s too high of a level. But in nature, nature can do that, and then you get twins. It’s like, “Oh, my gosh. I thought I was not even fertile anymore and now I’m pregnant with twins.”  That happens when someone’s 44. That actually can happen.  But women, because they’re going through this, I call it a roller coaster, where their estrogen is too low. Then they have this giant overshoot of gonadotropins, and suddenly their estrogen level is, I’ve measured sometimes, it’ll come out … A typical level for a woman would be around 100 or so, for picograms of estradiol. Then I’ll get a level of 800. It’s like, “Oh, my God!”  So, this can trigger horrendous migraines, and sleep problems, and mood swings, and breast tenderness. Suddenly they get really, really heavy periods.  You can just imagine how much uterine lining is made by all that estrogen.  Sometimes, if you give a little background, a little bit of estradiol, it’ll keep the brain from creating that giant overshoot of gonadotropins.  So it’s like, if you give a baseline of estradiol, the brain won’t create this roller coaster effect.  Sometimes that can really be a saving grace as women are going through this really challenging time because the conventional world puts them all on birth control pills.  I can tell you that.  But that has its own set of issues, as well.  So, we try to do it and let women still have real hormones, their own natural hormones. But we’re trying to tame the monster here a little bit, during that time when they can have this crazy overshoot.

Dr. Weitz:            Let’s go through some of the symptoms of perimenopause. I want to say, looking at the time, I don’t see how we’re going to get through all three stages because we’re still on stage one, but that’s okay. Let’s do a good job with what we’re doing.

Dr. Gersh:           Oh, they’ll have to read the book!

Dr. Weitz:            Exactly. Exactly.  So, you mentioned breast pain/mastalgia, and that’s often common in perimenopause. Why is that and what can we do about that?

Dr. Gersh:           Well, that’s because of this overshoot, often, of the estrogen. So, the best thing that you can do for that is to have a little bit of patience, and often to take a little bit of, I recommend a little bit of iodine can be helpful. Sometimes that’s a sign. We have massive iodine deficiency, so a little bit of iodine can be helpful. But a lot of patients can be really going-

Dr. Weitz:            When you say a little bit of iodine, you mean 100, 200 micrograms?

Dr. Gersh:           Yes. Yes. Always less than one milligram. So yeah, around 200 micrograms. I am not into massive dosing whatsoever.  Then you can do things that reduce inflammation because remember, pain is always inflammation. You can take some of the anti-inflammatory, herbals is very helpful.

Dr. Weitz:            I take curcumin or fish oil.

Dr. Gersh:           Yes. I love all of those things. Then having the anti inflammatory lifestyle. Really, it’s so important for women to know that this is just a stage, and that it’s not associated with breast cancer. Sometimes reassurance is the best medicine, rather than going on pharmaceuticals for something like that.

Dr. Weitz:            What about if the balance of the estrogen and progesterone is tipping, that the progesterone is starting to go lower, and maybe getting these spikes of estrogen? What about using something like chaste berry to help the body produce more progesterone?

Dr. Gersh:           Yes, absolutely. Chaste tree, also for the Latin name, vitex, is often referred to as the women’s herb. It has actually reasonable data that has been accumulated, showing that it can help with PMS and breast tenderness. Those are really key problems that often go together, actually, because it’s a hormonal imbalance. So yes, chaste tree, vitex is a very, very useful herbal for treating breast tenderness.

Dr. Weitz:            What dosage for that do you like?

Dr. Gersh:           Usually about 200 is a very good dose. For taking it, I always recommend just take the whole dose in the morning, just as a morning dose.


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Dr. Weitz:            So, fibromyalgia. That’s a not quite fully understood condition, seems to be fairly prevalent. Patients get pain throughout their body, up and down their spinal cord. How is this related to perimenopause and how frequently is this seen?

Dr. Gersh:           It’s seen all too often and it’s primarily in females. That’s why it’s been swept under the rug quite a bit, and treated a lot with Prozac in the past, and still treated with Cymbalta, which is duloxetine, which is in the SSRI/SNRI family. It’s interesting because some of the same centers in the brain that deal with pain response also deal with mood response.  So, in terms of pharmaceuticals, some of the drugs that are used are gabapentin. But we can do a lot without turning to the pharmaceuticals. So, understanding that there is a strong relationship to hormones. All of the hormones have a lot to do with balancing our endocannabinoid system and our opioids or natural endorphins. It turns out that these hormones are very involved, all of them; progesterone, testosterone, estradiol; in terms of the relationship of these different other systems of the body.  We have all these different interesting systems involving signaling agents. We have the peptides, and we have the fatty acids, which are involved with the endogenous opioid system, and the endorphins. We need to have proper hormones for transporting these molecules into the brain, for having them function properly in the brain, for balancing all of this.  We now know that, although fibromyalgia doesn’t typically have systemic inflammatory markers present, that they can actually be in the spinal cord. It still comes back to pain is inflammation and it’s going on in the central nervous system.

So, we still need a lot of research on fibromyalgia, but a lot of mind/body medicine can be helpful. Trying some balancing hormones, I find is actually very beneficial. Sometimes gentle body work, but not heavy, not pushing too hard. But gentle body work, lymphatic massage, mind/body medicine, and sometimes, short-term, some of the pharmaceuticals, and once again, all of the anti-inflammatory herbals. It’s amazing how we now know that without adequate vitamin D, you’re going to have more pain. Omega 3, you’re going to have more pain. We know that people have, often, very bad diets that are lacking in the antioxidants, the polyphenols.  So, just getting on a diet that is plant based, filled with different colorful vegetables, fruits, and proper fiber, because I’m sure there’s, we’d need more research, but there’s always a relationship to the gut microbiome. So, anything we can do to improve the gut microbiome, have proper short chain fatty acids like butyrate, that’s going to affect the brain.  So, we definitely have to work with lifestyle, mind/body medicine, and gentle exercise like stretching and yoga can be incredibly beneficial.

Dr. Weitz:            Some of the data seems to indicate that fibromyalgia is related to mitochondrial function.

Dr. Gersh:           Estrogen is also the under recognized, because a lot of people talk about aging is related to mitochondrial decline. Estradiol is essential for every single function that is involved with the production of energy in mitochondria.  Also, not just a production of energy. Most people in the functional medicine world know that when you produce energy through [inaudible 00:45:15], you’re also creating oxidative stress, like with superoxide. It turns out that estradiol actually is key to regulation of this very essential enzyme, superoxide dismutase, which helps to detoxify this toxic oxidative stress molecule, the superoxide. So, without that, you then have destruction of the cell and of the mitochondria.  The bottom line is that estradiol comes back to yes, you need estradiol to manage your healthy, functional mitochondria. Absolutely mitochondria, or the energy producing factories. If you don’t make energy, you’re not alive. In fact, everyone knows, if you flat line, that means you’re not alive. You need energy. That’s the spark of life. Estradiol is like the spark of life, by helping mitochondria to make that critical energy.

Dr. Weitz:            Certain minerals, zinc, coper, and manganese are precursors for SOD, so those should probably be included there.

Dr. Gersh:           Right. That’s why so many people have essential deficiencies of these key, I always say you can’t work the machinery of yourselves if you don’t have the right nutrients. That’s why everyone who comes in, and weight gain, we’ll have to come back after, but in terms of the gaining of the weight and the fat redistribution, which is so distressing to women. We know that this can also be very much related to declining estradiol levels, but we can do so much about that. Not just taking hormones, which is part of the equation, but doing proper stress management. There’s nothing that contributes to belly fat more than high phonic levels of cortisol. We’ve got to work on our stress and our sleep. Exercise revs up mitochondrial function. We know that you can have mitogenesis just by having great exercise.

So we have to work with what we have. I say, that’s why I dislike to the bottom of my heart, centers that are just hormone distributing centers. I’m not going to compare it to opioid distributing centers, which exist, where people would come in and get their dose of an opioid every month.  But just giving out hormones is offering false hope because hormones are just a piece of what makes women healthy or men healthy. You can’t just give hormones and expect that’s it. No. You have to do all these other things. You need to have stress reduction, sleep, and so on. Because this belly fat thing is so harmful to women’s self-esteem. Of course, it’s a metabolic poison and creates that chronic state of inflammation, creating that well known term, “inflammaging.”

Dr. Weitz:            Yeah, this whole concept of fat loss, and why different people gain fat in different areas; whether it be more in the abdominal region, more in the hips, more in the back, et cetera; it really hasn’t been studied that much. We know it’s related to these different hormonal balances.  I remember the late Charles Poliquin, who was not a medical doctor, but a very interesting practitioner of exercise and recommendations about nutrition. He would have these categories for, this is an insulin dominant person, this is cortisol, based on where their fat was distributed. That’s something I think really should be given some more attention and study.

Dr. Gersh:           Oh, absolutely. We’re always challenged, as you brought up earlier, with these ubiquitous endocrine disruptors that are really metabolic poisons. Then, when you don’t have your proper production of hormones, then what becomes the dominant hormone, if you can call it [inaudible 00:49:29] information.  So, once you recognize hormones are really the language of the body. There is multiple different languages, but these are the main language. They tell the cell what to do. They’re giving instructions. If you get endocrine disruptors, then you’re going to get the wrong instructions, and the cell will do the wrong thing; make the wrong protein, for example. If you have no information, then the cell goes into a default state, which is pro-inflammatory. The whole body goes into this default state of pro-inflammation.  It’s really interesting when you see estradiol as operating the switch. I think of it as a switch that turns the body from pro- or anti-inflammatory, back and forth. That’s why estradiol is an immune system modulator. That’s why it can be so confusing to people. It’s like, estrogen causes inflammation. Estrogen is anti-inflammation. It’s both because it’s modulating the immune cells.

So, that’s why when you get a pathogen that tries to get into your body, it’s estrogen in the form of estradiol that triggers the [inaudible 00:50:40] to become activated and the mass cells to become activated. So it basically revs up your innate immune system. Then later, it also triggers the production of antibodies, but then it dampens down. It flips the switch so that you go back into the homeostatic state where you have an anti-inflammatory state.  So, estradiol, when you have proper production, it modulates this entire immune system response. Which of course, is also activated if you have damaged tissue. Then, when you don’t have it present, you end up getting into this default system where you end up in a chronic state of pro-inflammation. That leads down the path to all the other things that happen in the other stages of menopause, like hypertension, and heart disease, and then really the fractures, and the disintegration of your joints, and then having the osteoarthritis.  So, all of these things stem from, really, loss of this modulation of the immune system that regulates how you’re either pro- or anti-inflammatory.

Dr. Weitz:            It’s hard to get my head around exactly how it affects immunity because we know that women tend to have stronger immunity prior to menopause. Yet, after menopause, they seem to have increased autoimmunity. So, if the estradiol is so crucial for immunity, and then the estradiol drops after menopause, shouldn’t they have less autoimmunity rather than more?

Dr. Gersh:           It’s interesting because it depends on, there’s different types of cytokines and the different immune cells, but every immune cell in the body has estrogen receptors. The dominant receptor on the cells that make antibodies is the beta receptor. The dominant receptor on the innate immune cells that make the inflammatory cytokines are predominantly alpha.  So, you have this balance between this whole immune system that is then lost. When you don’t have enough estrogen, and this has been shown, the innate immune cells will release their inflammatory cytokines at a lower threshold of stimulus. So, you get altered gut microbiome. This has been now shown. When you lose your estrogen, the microbes in the gut transform into a different set of population. Then you lose your protective mucus coating and you have the impaired gut barrier, or leaky gut.

As these endotoxins, the lipopolysaccharides cross between the lining cells into the gut associated lymphoid tissue where 70%, 80% of the immune system resides around the gut. These innate immune cells are triggered through the toll like receptors that activate them, that the little [inaudible 00:53:42] cells, they put their little fingers into the gut, and they communicate, they all line up.  Then you have this explosion of production of inflammatory cytokines. But as well, you have the connection between these innate immune cells and the lymphocytes that are in the peyer’s patches. These are segregations of lymphocytes that make antibodies that are embedded in the gut associated lymphoid tissue, and they make antibodies, and they communicate through these different types of toll-like receptors. So, they are then triggered into making antibodies.

When you lose estrogen, you actually lose a lot of your control over all these incredibly, critically important and very complex functioning immune cells, so you end up with that situation. We know, for example, when you’re exposed to a lot of endocrine disruptors, and I was trained in environmental medicine under Dr. Walter Crinnion, who I just miss every day. He’s an amazing pioneer in environmental medicine.  Basically, his foundational tenant of life is, most problems are due to pollution, and what is altering the ways our bodies are functioning, because we’re getting all these ridiculous toxic chemicals into our bodies, and that most of the auto-immunity that people are now facing in younger years is because these are endocrine disruptors that are interfering with the normal signaling.  So then, that promotes early onset, like Hashimoto’s, which is epidemic, and also lupus, and multiple sclerosis and such in younger people. Then in older women, rheumatoid arthritis becomes really prevalent. Of course, you can have endocrine disruptors that are contributing, but it’s really the loss of the control of the immune system’s homeostatic mechanisms, by loss of the estrogen.

Then the immune system goes into this crazy state of producing lots of inflammatory cytokines, and then communicating with the lymphocytes to make these antibodies. That’s why we now know that these autoimmune diseases, like rheumatoid arthritis are not just associated with joint damage, and motor disabilities, and pain, but also with cardiovascular risk. That because you have a systemic state of inflammation.  So, it’s affecting the immune system on multiple levels. That’s why you really want to be proactive, because we want to be helping women with both diet, lifestyle, and hormones, so that they don’t get rheumatoid arthritis, which is really incredibly prevalent, and really harmful in a myriad of ways. That tends to show up down in the later phases. But the precursors are happening in the perimenopausal years, when the immune system is starting to get this hit of lack of hormones.  Then of course, the immune system is everywhere, including in the brain. So women who have loss of the hormones have a much higher rate, and this sounds so politically incorrect, but I have to tell the truth. Women have two times the incidents of Alzheimer’s as men. It’s not an accident. It’s because their immune cells in the brain, which are these specialized macrophages called microglea, when they don’t have the proper estradiol to regulate their function, they too, go into this default state, like weapons of mass destruction. They produce enzymes. All these immune cells, these macrophages, produce enzymes that are designed to dissolve pathogens and damaged tissue and then gobble it up.  That’s our cleanup crew, our damage control mechanism. But what happens when they can produce and release these dissolving enzymes for no good reason. Then they dissolve our brain. That’s when the brain tries to have a healing mechanism. Then it produces the beta-amyloid. That’s why getting rid of the beta-amyloid doesn’t prevent Alzheimer’s, as I wished, because it’s a response to these out of control microglea, these immune cells that are producing all of this inflammatory response.  But this is what’s happening elsewhere. That’s what’s happening in our arteries. It’s a similar thing that’s happening in different organ systems. That’s why I love talking to you, to get the word out, because these are not in-solvable problems. Because it sounds so terrible, the future is so grim. But we can actually do so much to work out all of these issues.

Dr. Weitz:            But it’s going to take a lifestyle program. It’s going to take more of an Integrative, Functional Medicine approach, and there’s not going to be one drug that’s going to solve it.

Dr. Gersh:           No, including hormones.

Dr. Weitz:            We’re going to have to wrap here. I was worried about getting through the three stages of menopause, but we didn’t get halfway through the first stage.  Buy Dr. Gersh’s book.

Dr. Gersh:           Well, now really, to give a slight plug, it’s not a book that you have to read from beginning to end. It’s like a little compendium, like a little mini encyclopedia. You can just pick out, one of my favorites because I see women all day long, and they look in the mirror because that’s what we do. We say, “What’s happening to my lips? Why are they getting so thin?”  This way you can say, “I don’t know why my lips are getting thin.” You can look it up in the book. Or, “Why am I getting breast tenderness,” like you said or, “What’s happening to my bones?” You can pick up any topic you want and look up the stage of menopause and what’s happening with that particular symptom, and why it’s happening, and then what you can do about it.  So, you don’t have to sit down and read it cover to cover. It’s a reference book.

Dr. Weitz:           Thank you, Dr. Gersh. How can listeners and viewers get a hold of you? Where can they buy the book?

Dr. Gersh:           It’s on Amazon. I’m actually in one of my exam rooms, so you can find me in my office pretty much every day.

Dr. Weitz:           Is the book available on other booksellers?

Dr. Gersh:           It should be, but right now, as you probably know, there’s a supply chain problem. I think they’re actually having trouble printing books. Isn’t that amazing?  So right now, it’s just on Amazon, because it’s just hard to get printers to print books. So we’re just limiting it to Amazon for right now. That’s what the publisher said anyway. I go with what they tell me.  My office is in Irvine, sunny southern, usually sunny. It’s a little cloudy today. We need some rain anyway. Southern California. I can do some telemedicine. I can do telemedicine throughout all of California. For people in other states, now that things are changing, I do have to see people once a year in person. Unfortunately, that’s the crazy laws that we have. But I can do other stuff remotely and usually we can manage, because it’s a great place to have a vacation to.

Dr. Weitz:            There you go. Thank you, Dr. Gersh.



Dr. Weitz:            Thank you for making it all the way through this episode of the Rational Wellness podcast. If you enjoyed this podcast, please go to Apple Podcast and give us a five star rating and review. That way, more people will be able to find this Rational Wellness podcast when they’re searching for health podcasts.

I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica Weitz Sports Chiropractic and Nutrition Clinic. So, if you’re interested, please call my office. (310) 395-3111 and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz. Thank you and see you next week.



Essential Oils with Dr. Eric Zielinski: Rational Wellness Podcast 238

Dr. Eric Zielinski discusses Essential Oils with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.] 


Podcast Highlights

2:43  Essential oils are neither essential, nor are they oils. Essential oils are volatile organic compounds that contain the essence of the flavor and aroma of plants.  They are volatile in the sense that they readily evaporate at ambient room temperature, which is in contrast to chemical air fresheners like Febreze, which you can smell 100 feet away 10 minutes later. 

12:53  Artificial fragrances are killing people every day and they are extremely common.  They are found as fake smells in every public restroom.  They are very strong if walk into a Bed, Bath, and Beyond or a Bath and Bodyworks store or if you go down the cleaning aisle in Walmart.  ((% of us are born in a sterile hospital environment and we go home with all these fake smells from Mama’s perfume to the smells on their clothes and their blanket.  What does that do to our sense of smell, to our brain. You wonder why autism and learning disabilities and dementia and Alzheimer’s are on the rise?  We’re causing brain inflammation.  This is why we should surround ourselves with essential oils instead of with fake smells.

16:52  Essential oils differ from herbal medicines in their much higher concentration.  No herbal supplement can compare to the therapeutic efficacy of essential oils due to their incredible concentration.  One or two drops of cinnamon essential oil are equivalent to two to three teaspoons of cinnamon bark powder at balancing blood sugar.

30:28  Sleep. Lavender is a good essential oil for sleep.  Vetiver and Roman Chamomile are also very effective, though a little pricey.  Geranium and clary sage are both good. You can also use the tree oils like pine, frankincense, sandalwood, and cedarwood. 

34:08  Essential oils for dementia and Alzheimer’s disease.  Dr. Zielinski wrote in his book that hand sanitizer contains chemicals that might damage your microbiome and might increase the risk of brain inflammation and of dementia.  Also, between the VOCs often emitted by your carpets and all the artificial fragrances and aerosols people have in their homes, when they spend so much time in their homes because of working at home and stay at home orders due to the pandemic, we are subjecting ourselves to a huge toxic burden.  Rosemary is an essential oil that is the herb of remembrance, so it can help with memory.  Cinnamaldehyde, which is the primary component of cinnamon bark is a natural acetycholinesterase  inhibitor, so it can help with Alzheimer’s disease.  And of course, cinnamon can help with blood sugar balancing. Basil also has similar activity.  Other essential oils with acetycholinesterase inhibitor activity include sage, thyme, lemon balm, also known as melisma, lavender, and bergamot.  Clove oil is a natural blood thinner as well as some of the highest antioxidant activity.


Dr. Eric Zielinski is a Doctor of Chiropractic, a natural health guru, and a best-selling author with his wife, Sabrina Ann Zielinski. Dr. Zielinski is the author of The Healing Power of Essential Oils, which has sold over 200,000 copies and he has a new book, The Essential Oils Apothecary.

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 and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.


Podcast Transcript

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

Today, we’re going to have an interview with Dr. Eric Zielinski on essential oils. And my goals for the podcast episode today are to learn a bit more about what essential oils are and how they can be used in the treatment of specific chronic diseases, like sleep disorders, Alzheimer’s, diabetes, osteoporosis, heart disease and even cancer, among others.  As Dr. Zielinski points out in his new book, The Essential Oils Apothecary, soothing remedies of anxiety, pain, high blood, sugar, hypertension and other chronic conditions, essential oils are neither essential nor oils. They are actually volatile organic compounds and they’re the components of the plant that are released into the air when you smell, say, lavender. But they are oil soluble compounds so they’re used in a carrier oil like olive oil. But we’ll ask Dr. Zielinski to explain more how essential oils are made and work and how they’re different than herbal supplements.

Our guest today is Dr. Eric Zielinski, who is a doctor of chiropractic, a natural health guru and a bestselling author with his wife, Sabrina Ann Zielinski. Dr. Zielinski is the author of The Healing Power of Essential Oils, which has sold over 200,000 copies.  Dr. Zielinski, thank you so much for joining us today.

Dr. Zielinski:                        Well, Dr. Ben, thanks for having me. I got to say I have big shoes to fill. Not many people can boast a hundred five star reviews. You don’t even have a negative review on your podcast here. So I better not screw up. If I screw this thing up, you take it out of my pay, right? How much are you paying me for this? No, no.

Dr. Weitz:                            Yeah. Fortunately, I have a hundred relatives and friends, but-

Dr. Zielinski:                        I love that.

Dr. Weitz:                            … just kidding.

Dr. Zielinski:                        How many wives and kids do you have?

Dr. Weitz:                            So-

Dr. Zielinski:                        That’s funny.

Dr. Weitz:                            … let’s start by explaining: What is an essential oil and how is it made?

Dr. Zielinski:                        Ah, I’m so glad you mentioned that. They’re not essential… funny.

Dr. Weitz:                            Oh, who would’ve thought of that question?

Dr. Zielinski:                        Isn’t that cute? You mentioned something, though, they’re not essential and they’re not oil. I mean, they’re named essential oil because they’re known as the essence of flavor and aroma of plants. So when you put your nose into a rose and those volatile organic compounds are being emitted from the rose, you smell it.  And just to go back to biochemistry for people who might forget, volatile or volatile, meaning readily evaporate at ambient room temperature.  So that means when you spray your Febreze a hundred feet away in a room and you smell it 10 minutes later, it’s because those particles are floating.

Dr. Zielinski:                        Well, organic, again, volatile organic compounds. Organic meaning carbon based and compound meaning [crosstalk 00:03:34].

Dr. Weitz:                            Floating particles. I’ve got to get my mask. No, I’m kidding.

Dr. Zielinski:                        Yes. Again, don’t get me started. And compound meaning there’s a lot of chemicals, meaning there are a lot of components to it. So I’m holding up a bottle that’s used, almost done, of my favorite blends here. And you’re looking at 150 to 200 different plant chemicals. And what do you mean plant chemical, Dr. Z? Well, you’ve heard of menthol, I’m assuming, right? Eucalyptus menthol. What’s in your Vicks Vaporub? What’s in your Bengay? What makes your pain relieving stuff good? Well, people focus on menthol. So they extract the menthol from the peppermint and they create a drug out of it. Same thing with Pinene, Limonene, Eugenol, Carvacrol and one thing, I mean, let’s call it the elephant in the room.  Drugs today, highly, are based off of the chemical constituency that we see in plants. It’s not like a chemist or a pharmacist wakes up in the middle of the night with a vision thinking, “Oh, if we combine carbons and hydrogens and oxygens in a certain way we’ll create this structure.” No. I mean, what we see is what we have in nature and that’s the basis for virtually every drug on the market.  And the best example is Willow. For years, thousands of years, our ancestors have used Willow bark for its analgesic pain relieving property. It is a potent anti-inflammatory. They made pulses and salves and creams and all kinds of stuff out of it. Well, there’s a chemical in it. It’s a salicilin in the salicylate family. If you extract that out, if you manufacture it, synthetically mass produce it, put some preservatives in a white, shiny coating, it’s sold as aspirin. It’s literally aspirin. Same thing with your antibiotics; same thing with your Metformin, your diabetes drug; same thing with your cancer medication.  I want to stress the importance here. I love aromatherapy for the smell and the feel and getting in the mood for me and my wife to enjoy a nice evening together. That’s all great. But what I’m talking about is medicine. Actual, let’s treat disease, let’s prevent chronic conditions. And that’s the basis for this recent book that we published, advanced strategies and protocols for chronic disease and conditions that are robbing people of the abundant life.

Dr. Weitz:                            Yeah. It’s interesting. You talk about all the different compounds. We just recently had a discussion on a podcast with Dr. Pizzorno, and he did a lecture at the IFM’s annual meeting on Unimportant Molecules. And he was talking about the fact that how we analyze foods and he came up with, say 45, different vitamins and minerals, and, basically, said, those are the only important compounds in food.  And now when you go back and you analyze all these phytochemicals, there’s 50,000 chemicals in food and many of them have health promoting properties. We have flavanols and we have carotenoids and on and on and on. And so when you have an essential oil, you have all of these phytochemicals.

Dr. Zielinski:                        They’re actually known as bioactive compounds.

Dr. Weitz:                            Okay.

Dr. Zielinski:                        And so a bioactive compound is a secondary metabolite. So the primary metabolite of photosynthesis and plant biology are your things that you need to live: Your vitamins, your minerals, your carbs. See, here’s the thing. That’s why they’re not essential, right? We should go back to our little … They’re not essential. You don’t need essential oils to live. You technically don’t need fiber to live. You don’t need antioxidants to live. You need carbs, proteins, and vitamins and minerals, or you will die.  Now, that’s the difference. Essential nutrient versus non-essential. But non-essential nutrition, including essential oils, including those  bioactive compounds, are what give you health. So imagine a life without antioxidants. Imagine a life without fiber. Imagine a life without polyphenols and carotenoids and all those thousands of chemicals. That’s where sickness and disease come into play.  So when you’re looking at a nutrition label it’s completely useless. The only thing I look at a label for is to let me know what the ingredients are. Everything else is useless, in my opinion. And so that’s where you start focusing on, okay, what really is important? So that going back to this bioactive compound mentality is this mindset, “Okay. What do I need to live?” I got that. You’re going to get that, basically, … You’re not going to become carb or protein or fat deficient living in America or most industrial countries. You’re going to get that stuff. You’re going to get your basic vitamins and minerals. Very few people are dying of scurvy and vitamin deficiency in our nation.

We could talk about the connection between vitamin deficiency and death, but I’m just talking at a core level. You’re going to get, basically, the stuff that you need, but what’s going to make you healthy? What’s going to make you be able to fight disease? What’s going to give you an immune system? What’s going to help you live an anti-inflammatory lifestyle so that when infection does come in, when you are exposed to XYZ virus or whatever it is that’s out there, how is your body going to respond?  And so, to me, I’m glad you mentioned that because, yes, we’ve majored on the minors and we’ve made ants out of molehills kind of thing. And it’s, okay, how do we get back to the basics? And when you look at plant chemistry, you realize, you know what? There’s a lot out there that we’re taking for granted.  And that … I’ll propose this. This is my big sales pitch in my books, in my blogs, in my classes. Here’s what I’m trying to sell. Again, I’m not a snake oil salesman. By the way, I don’t even sell these oils. That’s my secret. I don’t sell them. I just educate. So now I could be, as I was taught in public high school, an unbiased researcher, and that’s important to me. So I don’t sell them. I’m not going to peddle them. I’m not going to invite you to my multi-level marketing party. Bless their hearts. I love it. Some of my best friends are the top ranked representatives of these companies, making millions of dollars. Good for them.  But I’m just trying to teach you how to look at a lifestyle. And this is my big sales pitch here, to look at a lifestyle a little bit differently. And I want to propose an essential oils lifestyle. I want to propose, when you look at your life, what is your toxic burden? Are you inundating yourself to things airborne, topical, through what you eat that are causing a metabolic burden on your life? Are you poisoning yourself at a microscopic level, not even realizing it?  And once you start to look at your life and once you start to look at the things that you use and buy and consume, here’s something that most people don’t know, is that you are surrounding yourself and are surrounded by essential oils all day long.  For example, what do you think flavors your Coca-Cola?  What do you think flavors any processed food, whether it’s a natural flavoring or an artificial flavoring?  It’s either a synthetic essential oil or an actual essential oil.  What do you think is the aroma in your Febreze or your plugin or your Wallflower or your candle?  What do you think makes your cleaner so effective or your Goo Gone?  What’s in your body care that gives it the aroma?

Essential oils are everywhere.  And it’s, “Wow. I never thought about that.”  And once you start thinking about it, how ubiquitous they are, you start to look at what’s the true danger with synthetically manufacturing these plant chemicals and inundating our bodies with it?  And you start to realize here’s the dangerous thing about the essential oil and the synthetic version of it. Because we talked about them being volatile organic compounds, they’re lipophilic hydrophobic, meaning they’re fat loving, water hating. They will penetrate into your bloodstream within minutes and seep through into your cellular level. They will penetrate your whole life, your whole body. You inhale them, immediately your brain’s impacted. There’s no thalamic relay. What’s that? It’s a fancy way of saying when you smell something, it immediately impacts your brain, the smell, unlike the sensation of pain.  So go back to the last time you might have accidentally hurt yourself, stubbed a toe, cut your finger chopping carrots. Remember that split second of, “Did I really hurt myself? Ooh, I did.” There is no split second when you inhale something. There is no relay center and interpretation center in the thalamus, a part of your brain. So when you inhale something, it sends a direct signal. Your olfactory system sends a direct signal to your brain where your limbic system is, your mood, your memory, your emotions are housed there. Autonomic function is controlled there: Heart rate, breathing rate, which is smart.  When you look at it, as a Christian, it’s awesome. I say, “It’s God’s design. From the evolutionary perspective, it makes sense.” So when you smell smoke, you get in this fight or flight state, this sympathetic state, you get on a high alert immediately. You get out of Dodge. Well, that’s the power of smell.  But essential oils, when you look at that, have such an impact on the body that when you flip it on its head, you start to realize, what does the fake essential oil do to me?  What do the synthetic fragrances do to me?  And that is where I get shaken in my boots because artificial fragrances, Doc, are linked to neurological inflammation, Alzheimer’s, cancer, dementia, autoimmunity.  And, of course, the “minor things” like ADHD, learning disabilities, COPD, asthma. That’s the minor stuff, right? But you say that to someone who suffers with that, it’s debilitating.  Artificial fragrances are killing people all day long.  Artificial flavors are powerful.

Dr. Weitz:                            How common are artificial fragrances?

Dr. Zielinski:                        Everywhere. It’s everywhere.

Dr. Weitz:                            Right.

Dr. Zielinski:                        Everything you smell … And, see, you remember, you’re old enough and I’m old enough, don’t you remember when soap didn’t smell like anything. It was soap, right? People that have been around for a while … You remember when there weren’t all these fake smells everywhere.  And when’s the last time you’ve been to, let’s say, a restroom, a public restroom? And we frequent public gas stations because we travel a lot, right? So we’re traveling, my family and I take road trips up to Michigan, down to Florida. We live in Georgia. And I can’t tell you how many times I’m in the gas station restroom taking a pit stop with the kids and I hear this, “Psst. Psst.” And, “What in the world’s happening?” I look in the corner. “Oh, someone’s spraying me with an artificial fragrance that makes the pooh pooh smell good.”  They’re poisoning us. It’s fumigating in the bathroom. I can’t handle … But gag. You want a cool tip? People are, “Well, it’s okay. It doesn’t bother me.” If you are not bothered by artificial fragrances, if you could walk in the Bed Bath & Beyond or Bath & Bodyworks, if you could go into the cleaning aisle in Walmart and not get sick, not get a headache, if you don’t get a runny nose, if you don’t sneeze, that’s a problem. And that’s synonymous to having diabetic neuropathy where you don’t feel pain and next thing you know, you have a sore in the bottom of your feet that can end up with gangrene and can get amputated because pain is a sensation that tells you there’s something wrong.  If you put your hand into a fire and keep it there, it will burn off. And that’s exactly what’s happened with our sense of smell and we become desensitized to it. From birth, from birth, you’re born in a sterile environment with all these fake chemical smells at birth. 99% of kids born in the hospital and then they go home with all these fake smells. Mama is filled with perfume and all this beautiful stuff that makes her smell good. Wow. What does that do to our sense of smell, the primal sense that we have to protect ourselves? And what does it do to the brain?  And you wonder. You wonder why autism? You wonder why learning disabilities? We wonder why dementia and Alzheimer’s is on the rise? We’re causing brain inflammation. And that is why I’m trying to propose and sell everyone on this idea of this essential oil lifestyle is you are using and being and eating and surrounding yourself with essential oils all day long. You don’t even realize it.  Start to think about it and start to fix it where you’re replacing the fake with the real. And you’ll find your body will respond wonderfully.


Dr. Weitz:            Interesting. I’ve really been enjoying this discussion, but I’d like to take a minute to tell you about a new product that I’m very excited about. I’d like to tell you about a new wearable called the Apollo. This is a device that can be worn on the wrist or the ankle, and it uses vibrations to stimulate your parasympathetic nervous system. This device has amazing benefits in terms of getting you out of that stressed out sympathetic nervous system and stimulating the parasympathetic nervous system. It has a number of different functions, especially helping you to relax, to focus, to concentrate, get into a deeper meditative state, even to help you sleep, and there’s even a mode to help you wake up. This all occurs through the scientific use of subtle vibrations.

                                For those of you who might be interested in getting the Apollo for yourself to help you reset your nervous system, go to apolloneuro.com and use the affiliate code, Weitz10. That’s my last name, WEITZ10. Now, back to the discussion.



Dr. Weitz:                            So how do essential oils differ from herbal medicine?

Dr. Zielinski:                        Simple word is concentration. You can’t find essential oils in nature. I think it’s important to recognize that they are a hundred percent natural, but they’re still manufactured. So, again, picking up my little bottle here. If you’re listening, you can’t see it, but I’m just holding up a bottle of essential oil. You’re looking at roughly three pounds of lavender flowers, steam distilled. Again, where are you going to see a pool of lavender in nature? You’re not. You’re not going to go into a rose garden, “Oh, there’s a beautiful rose essential oil. Let me touch it.” It doesn’t exist.  So I love herbs and I love herbalism. I love spices and we love supplements, all that stuff, but they’re very minor when it comes to the therapeutic efficacy. Essential oils have true pharmaceutical grade effect on the body. Nothing, no herb, no spice, no supplement, no food, can compare to the therapeutic efficacy that essential oils can have simply by virtue of their concentration matter.  And that’s important to realize because one drop will have the effect of, let’s say, your blood sugar. Let’s say, cinnamon. Great example. Cinnamon is highly effective at helping balance blood sugar, help increase insulin sensitivity. But just one or two drops, just drops of cinnamon bark essential oil has the same equivalency of two to three teaspoons of cinnamon bark powder. And how do you compare? So that’s it. It’s true concentration.  Very similar, but also a different chemical constituency because when you steam distill plant matter, you only get the volatile components. Again, those that evaporate. Those heavier components … Well, again, we’re getting deep in the chemistry and plant biology here, but there are chemicals that are too heavy. Those won’t go through the steam distillation process. And a perfect example is frankincense and boswellia, boswellic acids. A lot of people use boswellic acid for its pain relieving, cancer fighting property. A lot of supplements have BAs, boswellic acids in them. Your frankincense oil won’t have boswellic acid in it.  So what does that mean? As a researcher, as a consumer, you’re, “Okay, what essential oil do I want to use, let’s say, for …” Let’s throw out breast cancer? And you see a study that says, “Oh, frankincense has a property that could help with breast cancer and the researchers poll, “Oh, it’s because of the boswellic acid.” Well, that doesn’t apply to my world. And the reason why I’m sharing that is because there’s a lot of mismanaged and misappropriated research out there and very well intentioned bloggers that are saying, “Hey, frankincense is great for XYZ because of the boswellic acids,” but it’s, well, there are no boswellic acids in the essential oil.  So the reason I’m sharing that with you is because when you extract something through steam distillation or solvent extraction, you’re getting a different constituency. The plant is so … It has a myriad of different ways that we could use the plant, whether you use a bark or a leaf, whether it’s steamed distilled or solvent extracted, it’s wonderful. A cannabis oil is not the same as cannabis essential oil or CBD, completely different products, all oily based from marijuana plant, completely different chemical structures.

So that means you just got to learn what’s what and, quite frankly, most people aren’t willing to put the time and the effort, and I don’t expect them to, to dive into this stuff. That’s why I think so many people buy our books because I do the research. I’ve gone to aromatherapy school. I’ve laid it out. I’m, “Okay, this is what you use for this. This is what you consider for that,” and let’s try to make this a little bit simpler.  And I know your audience is, dare I say, a little more advanced or educated than the average so I’m talking in a way that I … Typically, don’t talk a lot because I understand, I’ve seen the previous guests and I know what you offer.  In functional medicine, we need to step up and we need to recognize one size does not fit all and we need to look at essential oils as a key part of this tool belt that we need to treat and help people.

Dr. Weitz:                            So before we get into specific conditions, would you say that, let’s say, we’re treating a patient for a specific chronic condition, would essential oils be something that we would add to our herbal protocol? Would you recommend using them in place of it? Would it be … It seems to me it would make sense to add it as an additional component in the treatment plan.

Dr. Zielinski:                        Yeah, it would be … What I would do is I would look at an essential oil before I would look at a pharmaceutical.

Dr. Weitz:                            Right.

Dr. Zielinski:                        That’s how I want people to look at it.

Dr. Weitz:                            [crosstalk 00:21:36].

Dr. Zielinski:                        So your herbs are always there. But that’s what I mean, your herbs are always there. Your supplements are always there.

Dr. Weitz:                            Right.

Dr. Zielinski:                        It’s just now, when in the protocol do you, “Okay, we need something stronger now.” That’s where the essential oil comes into play. And it’s a first step. If we were going to look at it first for people with minor issues, you could try herbs if you want. Or some people go right to the aspirin. The easiest thing is, my medicine cabinet has no pharmaceuticals in it at all. No over the counter. It’s filled with essential oils. That, to me, is the protocol in my life, is if I need something of that nature.  Otherwise, if I have … There is this compounding effect, going back to frankincense. I do want boswellic acids in my life. I do want herbs. I do want spices. I do want supplements. So you use them in conjunction with essential oils. Only, though, and here’s the thing, only if you want that level of therapeutic efficacy. And I think that’s important because I don’t use essential oils because I have to. I use essential oils because I want to currently because I’m not sick.   And let me clarify. I’m not taking a multivitamin of essential oils. I don’t take a drop of frankincense every day to prevent cancer. I don’t live like that. That’s not my philosophy. I use essential oils going back to my lifestyle approach. It’s in my body care because I don’t use the fake fragrances. It’s in my food because I don’t use the fake flavoring. I like it behind me in my diffuser because I don’t like the fake aerosols, and my body just loves it.

So we use essential oils all day long, but when it comes to actual preventing or treating disease, that’s where it’s, okay, it’s a different mindset. And, again, I don’t take cinnamon oil to balance my blood sugar because I’m not pre-diabetic or diabetic. But, if I were, then that’s when I would look at it in conjunction with herbs and other treatments.  A lot of people, quite frankly, they don’t even bother with … Once they reach a certain stage of their condition, the minimum efficacy that a supplement or a herb can have, they’ll go right to the essential oil because, again, you can’t compare. It’s just, who wants to take 15 pills of a turmeric when you can just have two drops of an essential oil? That’s how concentrated these are. And when you use them in a medicinal dose, then you understand it is that level.  So a lot folks, if they have low grade issues, they don’t even bother with the essential oil because they’re eating habits, they’re stress relieving habits or whatever there is, their supplement habits, protocols will help.  So, I guess, I just want to paint that picture is when it comes to ingesting, that’s the key. Ingesting essential oils. You only ingest essential oil medicinally when you want that true pharmaceutical grade punch.

Dr. Weitz:                            And so I know we’re going to talk about aromatherapy, which is our topic for today. But in terms of ingesting essential oils, are they, typically, put into a capsule or do you put some drops in a glass of water? Or what form are they ingested?

Dr. Zielinski:                        Yeah. And actually, let me … I’m glad you said that. Let me correct you. This is aromatherapy. See, isn’t that interesting? This is the misnomer. I’m so glad you said this. People think aromatherapy, they only think of smelling pretty stuff.  Aromatherapy is the therapeutic use of aromatic compounds. So how you use essential oils, depending on what method, will determine your aromatherapy response.  So aromatherapy is ingesting it. Aromatherapy is topical application. Aromatherapy is inhaling it. So that’s where we’ve got to get out of this mindset of, “Oh, I just go to the store to get something smelly and nice.” That is ancient aromatherapy because, quite frankly, and let’s be real, our ancestors didn’t have essential oils like we have them today. And how do I know that? Well, steam distillation wasn’t invented till the 9th Century A.D. by an Arab alchemist. So, again, my well-intentioned multilevel marketing friends who are Christian saying, “Oh, Jesus used frankincense and myrrh.” It’s Christmas time right now coming up here. Gold, frankincense and myrrh. You how many times I’ve been told people are convinced that Jesus used frankincense oil? No way. It was impossible. Why? There was no way for them to extract it.

So when you think about where we’re at today, traditional aromatherapy used to be burning leaves and incense. Cool. And then they got smart. Our ancestors started to put aromatic plants in oil. Actually coming from the Bible. God told Moses, “Hey, get this big old vat of olive oil, put some myrrh, calamus, cinnamon, cassia and just let that steep and hang out for a while.” A.k.a, he gave them an anointing oil recipe, which was a herbal extract, extracting out some of the essential oil in this wonderfully, beautiful aromatic experience that was aromatherapy.  And why would God do that? Well, I don’t know, but I’ll tell you. They were sacrificing animals, blood sacrifices. There’s a lot of risk for infection. And there’s very few things, by the way, that are antimicrobial like essential oils. This stuff kills MRSA on contact. I mean what kills MRSA? Antibiotic resistant bacteria. What kills anti-fungal resistant fungi? Essential oils. There is no known resistance to them, to anything on the planet.  That’s why researchers today are looking at Carvacrol, which is a primary component of oregano to help with COVID. Hey, this is very cool preliminary research. No one’s making claims that COVID’s going to cure the pandemic. But the researchers, medical researchers are saying, “Look, we know the benefits of using Carvacrol for destroying bacterial cell walls and also to kill viruses. We should look at Carvacrol a.k.a. Oregano oil to help with COVID-19.” The research is being done as we speak.

So this is pretty cool stuff when you look at it. So all that to say, when you ingest essential oils, there’s two primary ways of doing it. Going back to your Coca-Cola, your peppermint patties, your flavored ice cream, that’s what’s known as a culinary dose, very, very minor. One drop of oregano in your spaghetti sauce. That’s enough. But it gives you a nice minor … It’s like herbs. It’s just like using weed. That’s our substitution guide is, if a recipe calls for one to two, let’s say, teaspoons of a herb, a spice or a zest, a lemon or orange zest, just use one drop of oil. That’s a literal substitution in your recipe. But what it does, it has such a powerful antioxidant punch, antiviral punch, that the herb doesn’t have. And that’s the culinary dose.  But if you want a true medicinal dose, yes, you need a gel capsule. You need to have … I recommend a vegan gel capsule. If you’re treating the gut for those people … Excuse me … Who are trying to look at minimizing, managing, or even, hopefully, reversing the symptoms of SIBO, Crohn’s, irritable bowel, leaky gut, you need an enteric coded capsule, which is a fancy way of saying it’s a polymer time release capsule. So when you take the capsule, your body won’t digest it until it gets down to your intestines.

So that’s how you literally treat gut issues because the gut is distal colon. And there’s research sharing, suggesting, proving, three to six drops of peppermint essential oil, going back to peppermint, can help soothe the symptoms and help people with SIBO. And they’ve done actual research up to that level.  So in our book, we take what traditional aromatherapy has taught, we take what we know from the biochemistry, we take what we also know of the metabolic pathways of how drugs are metabolized and we share dosing requirements. And, typically, when you’re dosing internally, you’re looking at three to six drops in a capsule and it’s potent.  Topical, want to point out, topical aromatherapy is think transdermal patch, right? Pain patches now, nicotine patches. We’ve seen this for years. We know that chemicals seep through the skin and get into the bloodstream to have a therapeutic effect. The same thing with essential oils. So what we try to do is teach people the safe way of diluting them and making Sabs. Again, this is huge, different strategy than I want to smell good.  And, don’t get me wrong, our body care is all with essential oils. All of it, because we want to smell good but we also like that nice minor medicinal, just a happy, feely, good thing. But when something goes wrong, I have an infection or we’re trying to treat something or whatever it might be, a headache, a migraine, we know to up the dose to a certain level and now we get that therapeutic effect.

Dr. Weitz:                            Cool. So let’s start with sleep. How can essential oils be helpful in promoting quality sleep?

Dr. Zielinski:                        Yeah. Instantly. Instantly can put you in the parasympathetic state. Instantly.

Dr. Weitz:                            So what would you recommend for sleep?

Dr. Zielinski:                        Yeah. Traditionally lavender is a good start. Doc, one thing I love about essential oils, and, again, there’s a lot of things we do. I mean, we’re the granola, hippie, urbanite, yuppy people that give birth at home. That’s me and my wife and our family. There’s a lot that we do, but when it comes to it, a lot of the things that your other guests are sharing besides forest bathing, by the way, that was a great interview, essential oils are forest bathing, by the way. I mean that’s a whole … What do you think makes forest bathing so potent and so healthy and so helpful? Primarily the volatile organic compounds being made from the plants.

Dr. Weitz:                            Right.

Dr. Zielinski:                        So one thing that’s really important is that when you look at this discussion, you start to realize, “Okay, I need to find something that works for me and maybe lavender is a right approach. Or maybe I should try something else.” But I digress.  The one thing that I want to encourage people with is unlike … And, again, this is my sales pitch. I’ve got to do it. Unlike a lot of the things that we learned and a lot of the wonderful things that your experts and other guests have showed, what is easier, literally easier, and even cost effective than getting a 10 or $15 bottle of lavender putting two or three drops in a diffuser and press “On” right before you go to a bed? There is zero barrier to entry, right? Essential oils are the gateway to natural health, natural living, just like cigarettes are the gateway to drugs, right?  That is … I want to impress everyone how easy this is. So nothing on the planet is as easier or cost effective than getting a couple drops, putting in a diffuser, pressing “On.” Done. So that’s what you do. You get a water diffuser, 15/20 bucks on Amazon. Get a good essential oil. Again, I share with you how to find a good essential oil. That’s a whole another discussion, but there are a lot of fakes out there. There are a lot of counterfeits. You got to find the real deal. Once you get one, a couple drops of lavender. Wonderful.

Now, if you have a little more on your budget, and I want to recognize … We have five kids. I get it. Not everyone has a blank check. Vetiver Roman Chamomile they’re super effective, but they can get a little pricey. So what are other oils you could use? Well, geranium, clary sage, a lot of women like these oils. They’re the traditional women’s health oils. They’re wonderful for calm and peace. Again, when you breathe these in, these volatiles organic compounds and you automatically get in that parasympathetic state, it’s instant. So that would be a good way of starting.  Some of the … Going back to the tree oils and forest bathing, all those oils can help: Pine, frankincense, sandalwood, cedarwood, anything with a “wood” at the end of it. It’s a wonderful, wonderful way. And that’s just aromatic. That’s just through the aromatic compounds being emitted from the diffuser.  But if you really want to get into it and that doesn’t help you enough, that’s where you could use a topical application and giving yourself a neck rub or a foot rub. That’s where taking an actual lavender capsule can give you that. If you’re overdosing on a melatonin supplement just to get through the night, you might need something a little more, I don’t know, dare I say stronger? You might need a stronger approach at first until you’ll get so sensitive to just smelling lavender where it just puts you right there.

Dr. Weitz:                            So I want to ask next about the use of essential oils for dementia and Alzheimer’s. And I wanted to say before you answer that question, in your chapter on that, I noticed that you wrote that, “We should think twice before using hand sanitizer because it might increase the risk of brain inflammation because of damage to our microbiomes.” And all I could think is, “Boy, there very well might be a huge increase in the risk of dementia and Alzheimer’s as a result of the massive use of hand sanitizer in the last two years.”

Dr. Zielinski:                        Yeah, that was tough to get in the book actually. My publisher wanted to cut that part out. And I wrote this book in quarantine. It was the very beginning of lockdown quarantine in COVID 2019. Wait, I’m sorry. 2020. So when I wrote this book, I just … Again, my job’s easy. I’m not a practicing aromatherapist. I’m not a practicing chiropractor. I’m a researcher and I’m an author, I’m a speaker and I share what the researchers say. So this is the easiest thing.  Look, a couple of years ago in Oxford University Journal … Again, this isn’t … I love aromatherapists, but they have a stigma of being hippies that smell like patchouli. So the medical world and a lot of people just marginalize them, “Oh, that’s pseudoscience. We get that as chiropractors. It’s pseudoscience.” Oxford University isn’t pseudo science of any sort. It’s the premier university on the planet next to Harvard and Yale, whatever your ranking is.  There’s a journal called Evolution, Medicine and Public Health that found a strong link between over sanitized wealthier countries and higher rates of Alzheimer’s. They conducted this study over 192 countries, basically, the whole world and they found the more sanitized a country I, the higher the rates of Alzheimer’s like a linear relationship.  Now, no. I didn’t use the word. It’s really important. It’s not a play on words. I’m not trying to be smart here. I didn’t say “clean” I said “sanitary.” All right? Huge difference. Soap and water will get your hands clean. But if you want to quote, “Sanitize your hands,” you need something else. And the problem is we’ve over sanitized our life to the point where we’ve, literally, destroyed …. And the research has concluded. Why? It’s the lack of bacteria on your hands. This is really hard for some people to conceptualize. Please bear with me.

There is a gut microbiome. I know you’ve had a lot of your speakers talk about this in the past. There’s also a skin microbiome and there’s a brain microbiome. What do you think makes us who we are? So when we have a lack of bacteria on our hands because of hand sanitizer, it’s been linked to a poorly developed immune system, which puts your brain at risk for brain and neurological inflammation. I mean, are you serious?  Now, when you compound that with fake chemicals and toxic chemicals, cleaning products and artificial fragrances that directly put the brain in neurological inflammation, it’s no wonder that we’re in the cognitive state that we are. And we’re decreasing rapidly. Why? Because we spend a vast majority of our time indoors.  I mean, even before I wrote this book, the most recent research we had was a couple of years ago when the Environmental Protection Agency was clear and they said, “Look, we spend 93% of our time indoors.” And the reason they’re sharing that is the air inside of our houses are two to five times, some up to a hundred times, more polluted than outside. You’re better off breathing toxic smog in LA than you are in your house if you live in an apartment that you can’t control the airflow. No joke. It’s bad stuff. Bad News Bears in your home.  So why is the EPA talking like this? Well, they recommend having a HEPA purifier. Now HEPA air purifiers are COVID protocol for hospitals and nursing homes and schools and all that stuff. I actually bought air purifiers for our kids’ school. Every room in the school have them. It’s that important. But that research was done a couple years or ago before COVID and that was 93% of our time spent indoors.

What do we know about life since? I mean, we’re looking at 99 to a hundred percent of people’s time. Literally, a hundred percent. Some people haven’t left their home in two years. Is indoor. So what are we breathing all day long? We think about the airborne pathogens. Doc, I’ve been talking this way for quite a while, almost 10 years. And it took COVID to bring word awareness that I’ve been trying to preach for a long time, at least in my life, right? I’m 41 years old. Airborne pathogens. People think COVID. No. Think the VOCs that are being emitted from your carpet, your cleaning material. Think about the aerosols, the fragrances. Think about the stuff that’s constantly just around you. That is public enemy number one. That’s the stuff that puts our brain at risk for inflammation in our immune system, dampening, and puts us at a slew of host of toxic burden that could be linked to chronic disease.

So that, for number one, what’s the solution? Well, don’t use hand sanitizer. I mean, unless … Going back to my road trip lifestyle my wife and I take with our kids a few times a year, unless I’m in the middle of the road with no bathroom nearby changing a poopy diaper, I’m not using hand sanitizer ever, ever. It’s not part of my life. And you know what? I had to break up with hand sanitizer because I used to be an addict. And I’ll admit. I had an OCD years ago. Every time I touched a doorknob, every time I did anything, I had a hand sanitizer. Do you know what’s part of kids’ school supply list? Paper, pencil, erasers, markers, hand sanitizer. You can’t walk into school without a hand sanitizer.  So what we do is we make our own. Basically, an alcohol based with essential oil. Done. No toxic chemicals. And why this is even more important is not only what the research shares about brain inflammation and dampening the immune system, but how many more products does the FDA have to ban? It just happened again last month. Oh, another one. High levels of benzine, a known carcinogen. You better not use this hand sanitizer.  There’s dozens out there in the market that are just poison. And, finally, because so many people are using them getting sick and dying, the FDA is finally saying, “Hey …” But what about all the people that have been hurt? What about all the people that just got diagnosed with cancer? They have no idea why. And maybe it’s because a contributing factor could be the hand sanitizer that just got recalled.

 We need to think twice. And there should be no antibacterial products in your possession, zero. So, yes, this conversation … “Okay. Well, you just overwhelmed me. If they’re in my food, they’re in my air, essential oils, fake essential oils, whatever. What do I do? Where do I start?” Number one, you start with your hand sanitizer. And if you have to use it, if you work at a hospital or if your kids need it, make your own. Just get the highest proof alcohol you can. Whatever moonshine, vodka you could get at the store, get 15/20 drops of essential oil, get a spray bottle, bada boom, bada bing, you’re done. It’s so easy. That’s the best hand sanitizer, effective hand sanitizer. It will kill everything.

But here’s a cool thing. Besides some dehydrating aspect and, by the way, alcohol will dehydrate your skin, essential oils have what’s known as cell selectivity. And, again, I have an easy job as a Christian. When I don’t understand something, I’m, “Hey, it’s just the wisdom of God. It’s how God created it.” Well, the scientists can’t explain why, but essential oils target the pathogenic microorganisms and leave the good stuff alone.

 So we all know about probiotics, good, healthy bacteria. If you ingest essential oils, people are ingesting oregano to help cure and repair leaky gut, they’re ingesting essential oils, they’re putting them on their skin to kill the viruses and bacterial fungi. You don’t have to worry about ruining your microbiome. That’s pretty cool stuff when you think of it. Again, the wisdom of God. Science can’t explain it. So that’s if you need it.  But what else? What’s another good step. Well, think about your body care and think … Because, again, we’re talking Alzheimer’s, we’re talking dementia, we’re talking you’re 41 years old. I’m 41 years old. You’re 30. You’re 25. You could smell pretty. You could smell good. Guys, whatever, handsome, good looking, whatever, you could smell good and you don’t have to hurt yourself at the same time. No perfume, no cologne. Throw it away.

Start making your own. Start experimenting. Because what do you think are the basis for your perfumes and colognes? The perfumers are taking the essential oil and then they’re loading them up with chemicals and preservatives to give you this, ugh, toxic. I can’t even handle going down the perfume aisle like I used to. I used to love those Acqua di Gios and Armani’s expensive stuff. Couple drops of essential oil.

You know what’s funny? I’ll never forget speaking … A mutual friend, a colleague, Dr. Peter Osborne, functional medicine doc invited me to speak at a conference a couple years ago. And I flew into Houston on the way to Dr. Osborne’s office and the Uber driver, again, this big, burly Latino guy, he says, “Man, you smell good. What are you wearing?” And I’m, “Citrus oils.” He’s, “What?” Boom. Had a cool conversation. I get more compliments from dudes than I do how good I smell. It’s you smell good, you smell normal, you smell healthy, you smell like we should smell. You smell like nature. Just pointing out.

But you know when I do it, it moisture … My body care. Why am I saying that? Because it’s our body care. A little bit of coconut oil, a little bit of essential oil. Done. Yeah, you could get fancy. We got all the fun little SháSu [inaudible 00:44:00] recipes, all that cool stuff if you want to do it. But it’s so easy and your body responds so well. Everyone has olive oil or you should, or coconut oil in your kitchen. That’s it. That’s half the battle.

 So how are we treating, how are we preventing Alzheimer’s? It’s this life’s style? And another thing everyone should do, throw away the aerosols. No more pooh pooh sprays and plugins. Throw that trash … Oh, wait … And here’s the thing. If you’re like my wife, I’m sorry. You’ve just got to let go. Throw it away. When I hit my revelation, this was over a decade ago, I’m, “Sabrina, this stuff is bad for us. We can’t use this.” My wife said, “We can’t throw away …” The clean plate club, like my grandma who came from the Great Depression couldn’t throw away anything. She goes, “We can’t throw it away. We can’t. We got to use it and then we’ll transition out.” No. This is poison. We had a little bit … Because she wasn’t there yet, right?

By the way, if you’re a zealot like me, be patient with your spouse. If you’re a zealot like me, be patient, right? That’s the problem that we’re having right now, especially in the context of the pandemic. We have zealots on both sides of the fence. Be patient with your loved ones. Because, for me, it’s, “You know what? It’s not going to kill me. I know it’s harmful, but you know what? Breathing in this thing, isn’t going to kill me today and it’s not worth a divorce.”

I mean, hey, I’m giving marriage advice here, which helped me in a big way because if you’re gluten free and if your husband’s eating pizza and breads sticks all day long, that’s going to cause marital problems. That’s the number one thing we always get. How do I get my family on board? Because I’m there. And women listening are usually the spear headers. Women listening, most are … Just statistically, women are usually the caretakers of the home and they’re the ones who get this. It’s really hard for men, typically, to get this stuff, right? It’s a female dominated industry across the board.


Dr. Weitz:                            I’d like to interrupt this fascinating discussion we’re having for another few minutes to tell you about another really exciting product that has changed my life and the life of my family, especially as it pertains to getting good quality sleep. It’s something called the chiliPAD, C-H-I-L-I-P-A-D. It can be found at the website chilisleep.com, which is C-H-I-L-I-S-L-E-E-P dot com.

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If you go to chilisleep.com and you use the affiliate code, Weitz20, that’s my last name, W-E-I-T-Z, 20. You’ll get 20% off a chiliPAD. So, check it out and let’s get back to this discussion.


Dr. Weitz:                            So give me a couple of essential oils we can use as, let’s say, I have a patient on a functional medicine approach for dementia, what are some essential oils we can add to the protocol?

Dr. Zielinski:                        Yeah. Well, rosemary, the herb of remembrance. And going back to herbalism, a lot of those herbs and spices, rose for love, rosemary for, again, memory, there’s a reason, and our ancestors are very observant, very intuitive. So if you want to help cognitive function, rosemary. You can diffuse it, you can apply it topically, you can even adjust it. It’s safe.  But cinnamon, believe it or not … And I don’t know how much time you even have to get in depth with this, but the primary approach to Alzheimer’s treatment is using a drug known as an acetylcholinesterase inhibitor. So low acetylcholine levels, which is a neurotransmitter in the brain, low levels of acetylcholine is the hallmark sign of Alzheimer’s and dementia. And you need acetylcholine for brain synapses and cognitive function.  So what medicine has done is, okay, we have low levels of this neurotransmitter, so what we should do according to the pharmaceutical mentality, is let stop the natural breakdown of acetylcholine. Well, how do you do that? Well, there’s an enzyme known as acetylcholinesterase. Anything with an “ase” is an enzyme, right? So there’s an enzyme known as acetylcholinesterase that naturally breaks down the acetylcholine.  Well, why would that be? Well, because we’re on a cycle. Just like your skin, literally, regenerates itself every 28 days, everything is being used and built, used and built, used and built. And so what the drug approach is, is to stop the enzyme from breaking down acetylcholine so there’ll be higher levels of acetylcholine. Okay. The problem with that is (a), it doesn’t work. It’s not effective. It can’t cure the disease and the side effects are horrendous. I mean, bad stuff, including dizziness, vomiting, memory loss, which is ironic, and death.  Well, research has shown that cinnamaldehyde, which is the primary component of cinnamon bark, has an 80% efficacy against acetylcholinesterase. Wow. I mean, you’re talking ingesting and inhaling cinnamon bark oil can help my brain function? Wild, isn’t it? And there are other oils.

Dr. Weitz:                            It could also help with blood sugar control because-

Dr. Zielinski:                        Thank you.

Dr. Weitz:                            … a typical protocol for dementia, Alzheimer’s, is going to be a ketogenic diet to try to control blood sugar.

Dr. Zielinski:                        Yes. Yes. And you have basil. I’ll read a list. Other oils that are known for their acetylcholinesterase activity: You have rosemary again, sage, thyme, lemon balm, also known as melisma, lavender, bergamot and basil, and then others.  So, again, this is what I do. I go through the research. I share … Okay, this is preliminary stuff. I mean, we have admittedly, though, let’s be real, we have very little human trials over the course of many, many years to test therapeutic efficacy of oils versus drugs. I get that. So a lot of this is “theoretic,” a lot of this is experimental. But I’m telling you something, if used properly there are zero side effects to using essential oils, other than the rare case of some allergy. And part of that is knowing what drug interaction might occur if you ingest them.

And that’s what we include in the book. It’s actually the only thing that I think exists for the layperson. And even going through aromatherapy school, there is nothing as in depth and simple to look at as a chart. We have this drug interaction chart in the book that says, “A drug for Alzheimer’s, the drugs for diabetes, the drugs for insomnia or whatever,” says, “Look, you can’t ingest these essential oils or you can have an interaction.”  Most people don’t realize that clove oil is a blood thinner. So if you’re on Warfarin, you could cause internal hemorrhaging. And the problem is most multilevel marketing companies and other companies include clove in their “Immunity boosting blend.” Why? Because clove oil has some of the highest antioxidant compound ability than anything on the planet. The ORAC scale of clove is a million.

Dr. Weitz:                            Wow.

Dr. Zielinski:                        I mean, a million compared to wild blueberry’s antioxidant load of ORAC points of what? Five to 7,000. We’re talking a hundred or a thousand times more potent,-

Dr. Weitz:                            [inaudible 00:51:53].

Dr. Zielinski:                        … clove oil. So that’s what we’re dealing with.  Again, going back to your urban spice examples, this is highly concentrated stuff, but you got to be careful, though. If you’re ingesting oils, really make sure you’re working with a properly trained functional medicine practitioner, someone who understands, at the very least who could do a little bit of research and help you because if you’re on a pharmaceutical, again, be really, really careful with any potential interaction.

Dr. Weitz:                            In your chapter on Alzheimer’s you also talk about Anosmia, which is the loss of sense of smell that can happen with Alzheimer’s disease. And we also, as you know, have a virus around, and the infection with that virus can lead to a loss of sense of smell.  Is there an essential oil protocol that can help to return a sense of smell in either Alzheimer’s or in viral infections or both?

Dr. Zielinski:                        There’s no protocol other than the standard of care in this space is to be stimulating your olfactory nerves on a regular basis. That could help. Very similar to stimulating hair follicle growth to help if you’re losing hair. By the way, rosemary is wonderful at stimulating hair follicles, could help regenerate hair growth. So that’s what we try to do is … I hate to use the phrase, fake it till you make it, but the reality is if you have lost your sense of smell, you want to do what you’ve always done. You don’t want to stop. You don’t want to stop diffusing essential oils. You don’t want to stop.  And you might want to even be a little more targeted where you could get an aromatherapy inhaler. And let me pull one up here. You can go online, just type up aromatherapy, personal aromatherapy inhaler. And this looks like a lipstick or a chap stick tube. And it’s just a glass tube with a cotton wick that is saturated with essential oils. And this is concentrated essential oil, but it’s personal. It doesn’t affect the room. You could use this on the airplane, your neighbor next door or right next to you won’t smell this.  But this is a nice way of getting more concentrated, essential oil vapor. And this could help stimulate … You could plug one nostril, breathe in through the other. It’s also a wonderful meditative technique for people that are really trying to focus and relax and calm. Essential oils do wonders with and comes to mental clarity and focus and all that.

But the thing is, though, I’m glad you mentioned the Anosmia because even though you might not … And we didn’t even talk too much about mood or memory or emotions, but essential oils work primarily on the emotional level to stimulate memory. So when you walk into grandma’s house this Thanksgiving and you smell turkey and stuffing and cranberry sauce, that’s going to stimulate, hopefully, happy memories of holidays in the past because the smell triggers a memory in the brain. And you know what happens? You’ll, literally, manifest the same hormone and neurotransmitter production that you did when the memory was made. It’s wonderful. That’s why smelling something can bring you back right there. You’re a five year old kid sitting on Santa’s lap because you smell peppermint. He had peppermint stick smell on him.  Now, you won’t get that. You won’t experience that manifestation, the emotional benefit, of inhaling essential oils if you don’t have your sense of smell, but because essential oils work, regardless if you want them to or not, inhaling certain essential oils like orange, lime, grapefruit, will stimulate a production of dopamine or serotonin in the brain.

So what am I saying? You use essential oils if you can’t smell them because you know that your body’s going to respond, at least on a physiological level. So on a physiological level they will respond if you can’t even smell, you don’t have the sense of smell, but on a psychological level, you won’t have any benefit.  So, okay, okay. I get it. And it was a shame that so many people have been affected by COVID that way. My wife, even now her sense of smell has been dampened since COVID. I mean, at one point she couldn’t smell anything for a few months. Myself included. Mine went back really quick, thank God. Hers, she’s still at 75%. She’s not at a hundred percent yet, but we still do what we do.  And we’ve had wonderful, wonderful feedback from our community members and people that read our books. They follow this, “You know what? I’m not there a hundred percent, but I’m doing a lot better.” Because sense of smell is so important with flavor, with just experience of life, especially at the psychological level of enjoying aroma, it’s so key.

Dr. Weitz:                            So let’s maybe cover one more topic. I was thinking maybe cancer.

Dr. Zielinski:                        Yeah. Yeah. Very respectfully, bleach in a Petri dish will kill cancer cells. I think it’s important to recognize the studies that we have are virtually all in vitro cells in Petri dish or we’re dealing with tumors on animals. We have no studies, no studies on humans, and that’s my disclaimer. But there’s a lot of research, though, a lot. We’re talking about specific cancer cell lines and types.

And I actually have a chart in the book that covers the exhaustive … At a point when we wrote this in 2020, the exhaustive list of all the research done on what specific cancers. And you’d be surprised. You’d be surprised at certain … And maybe it’s just because that’s what the research has done. And that was just what the researchers felt they should try. But there are very specific oils that seem to have pretty potent efficacy on certain cancers.

And so that’s a thought is that I hope if this is something that you are facing … And, again, I don’t have an anti-cancer protocol because I don’t have cancer. I’m not there. But if you do, if you have been diagnosed, working with an integrative oncologist I think is so important. Someone, an oncologist, who recognizes that there are alternatives that could help.

And here’s the thing that I want to stress is that there is zero scientific rationale or zero research to suggest that people should not be using essential oils if they’re undergoing cancer treatments. And that seems to be one of the biggest misnomers in conventional oncology is oncologists by and large will just recommend against anything.

I was privileged and blessed to follow a beautiful young woman in her story overcoming breast cancer and we created a documentary. And one thing the doctor told her at one point was, “Don’t even take vitamin C.” And she’s, “Why?” And she’s, “Well, we don’t want anything to interact with the chemo and make it less effective. We are just going to put you in a state where your immune system is just useless.” It’s, God, what research? It was fear based. It’s all CYA covering their assets. They’re so fearful of malpractice and lawsuits.

And so what this woman did … And if you’re interested and if you want a movie that you’ll cry to tonight, I guarantee a tear, an emotional. This is a documentary. It’s won Film Festival. It was the most inspirational movie of 2020. Go to hopeforbreastcancer.com. Go to hopeforbreastcancer. Watch it for free. It’s my gift for the world. Just watch it. It’s a wonderful film and it’s a wonderful story.

But this woman, Angie, she started doing things without her oncologist knowing about it, “I’m going to use essential oils.” She started making her own capsules. She was telling me the story. Why am I mentioning this? Because this is where essential oils come into play. It’s not all or nothing. You should never look at your life, you should never look at health thinking, “I can only go natural or I can only go conventional.” There’s no balance in that. You have to do what’s right for you.

But here’s the thing, though, regardless of what you choose, you should, and I want to encourage you to have essential oils be part of something, because they should be part of everything, in my opinion. They should be part of it to help you, whether you’re on the all natural route, whether you’re on the conventional route or whether you’re integrative, in the middle.

So, Angie, her name was, from this story, she found herself … And I’ll never forget this … She walked into the chemo room because she took chemo, and she ended up stopping earlier on, she didn’t take the whole system, the whole round and all the … But at one point she walked in on her second or third treatment, and everyone around her, just pale, ash colored skin, they looked like death. I mean, even with her losing her hair, she looked good. Her skin was vibrant, she had the sparkle in her eye, she was not absolutely just annihilated. Yeah, she got sick and she had some side effects, but she just pointed out, it almost felt like she almost felt guilty. She was going through chemo like everyone. Everyone else was barely walking in.

And she accredits that to her natural lifestyle, the food she was eating, the supplements she was taking, the stress, mind, body, prayer, meditation, the essential oils she was using to help.

So that’s what I want to stress. We cover cancer very respectfully in the book. No cure all claims. I’m very much in tune. And I promote … Because here’s a quote. I want to actually quote this from my book, from Biomed Research International: “Essential oils have been reported to improve the quality of life of the cancer patients by lowering their level of their agony. EO [inaudible 01:01:39].” And just that alone. “Essential oils can be used for improving the health of the cancer patient and is a source of a novel anti-cancer compound.”

So why did I include this? Well, I hope some brave cancer patient will show this to their doctor and be, “Look, you can’t recommend me not to take frankincense. This research suggested it could help me.” So you might not want to choose that doctor if you have a doctor that’s just going to say flat out, “No.” We need to work with educated professionals who at least will support you in your decision to do whatever it is that you want to do.

With that said, and we glossed over this, there’s nothing that I know that has such a wonderful effect like essential oils on symptoms, everything: Nausea, headaches. I mean, again, going back to the Alzheimer’s chapter, we have this whole chart of symptoms that Alzheimer’s patients deal with, elderly patients, everything from aggression to bed sores to just stomach issues, you name it, just dry skin. Essential oils are wonderful at symptom based management.

That’s what we focus on in the book is helping people manage the symptoms related to cancer. And there’s a ton of them, and just what to do and how to consider … That way you’re not tempted to maybe go with some pharmaceuticals that will end up destroying your gut lining and making you more immune susceptible to disease and all that stuff.

So I feel it’s a very respectful approach. Again, no cure all claims, but we want to help you. If you’re losing weight, there are essential oils to help you. You want to eat more. I mean, that’s something most people don’t think about. Everyone’s in this, “I want to lose weight,” but if you’re cachexic, if you’re wasting away, if you are struggling to eat, going back to lavender, those oils that puts you in that parasympathetic state will make you want to eat, will help with hunger. So that’s something to think about. Same thing with bruising and swelling. We have a bruise cream. And constipation, all that kind of stuff.

So anyway, I just want to help your lifestyle and that’s it. At the end of the day we’d done … With that documentary, especially walking through and seeing and hearing these stories of these beautiful cancer patients going through what they’ve gone through, it seems to be the quality of life through the journey that really makes or breaks them.

And, yes, everyone wants to cure cancer. Everyone wants to avoid cancer. I get that. But what about the process? What about the day to day? And maybe your chemo or your radiation or your essential oil therapy, maybe it doesn’t save your life, ultimately, but if you could do something to give you an extra three or four or five months, would you not want that? And would you not want three or four or five months of good health and vibrancy and being able to enjoy your family and friends?

It’s a finite way of thinking to only focus on the end result when we lose today because all we are guaranteed is today. I can’t guarantee you to tomorrow. I can’t guarantee myself an hour from now. All I have is this moment. And that’s really the message, not only the documentary, but it’s the message of our whole ministry is to help people do better in the moment so that you have a more abundant life.

Dr. Weitz:                            That’s great. Thank you Dr. Zielinski.  And everybody get The Essential Oils Apothecary. I’m assuming it’s available at all the places books are available?

Dr. Zielinski:                        Yes, sir. Yes.

Dr. Weitz:                            So Amazon, Barnes & Noble, et cetera?

Dr. Zielinski:                        Yeah, everywhere. And for those people who want to take a deep dive, we cover 25 different chronic conditions in depth, everything from fibromyalgia to insomnia, to depression, substance abuse, even libido and erectile dysfunction. These chronic conditions that are robbing people of the abundant life. We go in depth and sharing everything with you that the research suggests on how essential oils can help.  If you pick up a copy, we have a gift. And you go to eoapothecary.com and you just sign up for our book bonus gift and you’ll get about six and a half hours of Masterclass videos for free and my wife and I show you how to make several of these recipes. And we cover these topics more in depth, like heart disease and other things that we just didn’t have enough space in the book to cover. So go there. We got charts, PDFs, downloads, all kinds of fundamental things. Go to eoapothecary.com.

Dr. Weitz:                            Excellent. Thank you so much, Dr. Zielinski.

Dr. Zielinski:                        Thanks for having me, Doc.

Dr. Weitz:                            [crosstalk 01:06:15] podcast.

Dr. Zielinski:                        Appreciate you.



Dr. Weitz:                            Thank you for making it all the way through this episode of the Rational Wellness Podcast. And if you enjoyed this podcast, please go to Apple Podcast and give us a five star ratings and review. That way more people will be able to find this Rational Wellness Podcast when they’re searching for health podcasts.  And I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica Weitz Sports Chiropractic and Nutrition Clinic. So if you’re interested, please call my office (310) 395-3111 and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz.   Thank you and see you next week.



Regenerative Medicine with Dr. Joy Kong: Rational Wellness Podcast 237

Dr. Joy Kong discusses Regenerative Medicine with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.] 


Podcast Highlights



Dr. Joy Kong is a UCLA-trained, triple board-certified physician, anti-aging and stem cell specialist, educator, CEO, and founder of the Thea Center for Regenerative Medicine in California.  Dr. Kong focuses on the prevention of aging, as well as chronic and degenerative conditions that are difficult to treat.  She runs the THEA Center for Regenerative Medicine.

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 and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.


Podcast Transcript

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

Hello, Rational Wellness podcasters, today, we have an interview with Dr. Joy Kong on regenerative medicine. According to Nature Magazine, regenerative medicine is a branch of medicine that develops methods to regrow, repair or replace damaged or disease cells, organs or tissues. Regenerative medicine includes the generation and use of therapeutic stem cells, tissue engineering, and the production of artificial organs.

These stem cells can be harvested from embryos, from bone marrow or fat cells of adults, from the umbilical cord blood from newborns or from the amniotic fluid. Dr. Joy Kong is a UCLA trained, triple board certified physician and anti-aging and stem cell specialist. She’s also the CEO and founder of the THEA Center for regenerative medicine in California.  Dr. Kong focuses on the prevention of aging as well as chronic and degenerative conditions that no one else has been able to heal. She believes that complete healing can only come from looking at the whole person, mind, body, and soul. Dr. Kong, thank you so much for joining us today.

Dr. Kong:             Thank you so much. It’s a pleasure to be here.

Dr. Weitz:            Absolutely. Perhaps you can start by telling us a little bit about your own personal journey and how you got into this type of work.

Dr. Kong:             Yeah. It’s definitely a unique and fun journey. I grew up on a university campus in Beijing, China. It’s a science and technology university. I spent my first 20 years in China. It was kind of, getting a taste of just how important food is, how your health it’s contributed to by many factors. Exercise was definitely emphasized. Then also, I was always impressed with the… I wasn’t impressed until I came to this country, realizing how Western medicine is dominating everything. Because when I was in China, my mom would have a medicine drawer and it would have Chinese medicine, Western medicine, everything is all jumbled together, and she would just ask me, “Okay, what are you dealing with? What’s the problem?” I’ll give her my symptoms, and then she would just reach into the drawer and she would dig out some, either Western medicine tablets or some Eastern medicine, whatever concoction it was.  Because it depends on the condition, depending on what you’re dealing with. Sometimes Chinese medicine work better, sometimes Western medicine work better. I grew up with the acceptance for this very inclusive approach to medicine. Then when I came here, of course, I love science and I was going to go get a PhD in neuroscience, because I loved the brain, which was probably why later on, I became a psychiatrist and then did some addiction medicine, because, I think the brain is the final frontier. It’s really fascinating.

The psychiatry discipline, as interesting as it is, it’s really be a dichotomy between psychotherapy and drugs. You are either going to the route of talking to people about their childhood experiences and how they’re dealing with life or you’re going into diagnosing somebody to fit them into DMS-5. Once you put them in a category, that makes everything easy. Once you put someone in the box, then you know exactly what medications used in that box.  It’s all about matching the symptoms and the drug. The problem is that you’re omitting a bunch of steps in the middle. Between the symptoms, never mind why you’re having the symptoms, between the symptoms of the drugs, there could be so many opportunities that were missed. The opportunity to check, was there toxicity involved? Was it heavy metal? Was it some organic toxins? If you don’t get rid of toxins, that’s a problem.

If you are not looking at certain hormones like thyroid hormone, male or female hormones, you’re not optimizing the signals your body’s receiving. A simple hormone like thyroid is a master hormone governing so many things and it governs how your mental state is. That was barely checked. The only thing psychiatrists checked is the TSH, which is just not very helpful, because it just shows a very, very little piece of picture and missed majority of people who have thyroid problems.

All these missed opportunities, nutrition. We were not trained in anything that can help prevent or can help optimize a person. We jumped into medication right away. I did psychiatry with the training, altogether, that was 11 years. In the process, I was trying to incorporate Eastern wisdom or a holistic approach to health.  I found it very exhausting when no other psychiatrist was trying to do that, and I was the only one who was trying to understand everything about the patient and I was still given half an hour for follow up visits. I come home exhausted and just… I had to do a lot of self-care to just keep up my spirit.

Dr. Weitz:            Essentially, you were trying to practice Functional Medicine approach, but within an allopathic model.

Dr. Kong:             Right, in the dark and with no assistance, and no language to put it together. When I found the discipline was called anti-aging medicine, which is just an off shoot of functional medicine or integrated medicine, it’s just a different name to the same thing. You’re looking at the body from a diverse, many, many angles and each angle you can address it by very, very detailed, very fine tuned tools, whether nutrition or hormones or detoxification or microbiome, there’s so many ways that you can address it.  All of a sudden there’s a language to what we can do to bridge the gap between symptoms and drugs. There’s so many things we can do. By the time you did all these things, probably drugs would not be necessary at all. We missed the entire, I would say, probably 96%, 97% of psychiatry probably practiced that way, which means you missed so much opportunity to optimize a person’s health, and I think that’s a disservice to people.

Dr. Weitz:            When you’re talking about the brain, what percentage of patients do you think actually have a brain? No, I’m just kidding.

Dr. Kong:             Or how many doctors? Oh my God, where do our brain go? Go catch it. My job is to help more doctors find the part of their brain that actually is open to improvements in their thinking. Because I see so many doctors, probably I’m going to offend a lot of doctors, but probably 95% of doctors, till this day, because I hear from patients of how stuck the doctors’ frame of mind was. That they’re so stuck that they’re not open to see evidence outside.  Whatever they were taught in medical school and whatever they learned during conferences, which are all sponsored by drug companies, by the way. Anything beyond that, they are not open to it. If it’s 95%, then where do people go? Where do patients go? We see that every day. I’m sure, you do functional medicine, you’ve done it for a long time, that’s what you see-

Dr. Weitz:            Absolutely. Here’s a perfect example, I was just talking to a patient who went to see a doctor in Florida at the Cleveland Clinic, and they didn’t run the Cleveland Heart Labs because they have this very narrow, Western focus. Even though they work for the Cleveland Clinic, which has pioneered some of the more detailed, advanced lipid profiles that a lot of functional medicine doctors do, they don’t even do those tests, because they’re too complicated, they’re too long, and they just want to get to the point, here’s your elevated LDL, here’s your stat, et cetera.

Dr. Kong:             Oh my God. Yeah. It’s sad. It’s sad that I started telling people, I said, “Us doctors, us physicians have become very efficient killers. We’re the third leading cause of death. So, be careful when you go see a doctor, just remember, it could be as dangerous as cancer or heart disease, just be aware, fire be aware.”

Dr. Weitz:            I think it’s great that you see regenerative medicine, stem cells as part of a functional medicine approach to a person’s overall health and prevention of chronic diseases, as well as trying to get to the root causes of these conditions and reverse them, and not just treat symptoms.

Dr. Kong:             Yeah. Regenerative medicine, really, that was part of the whole anti-aging medicine, functional medicine, it’s in the framework because it’s really tapping into the body’s own healing capabilities. It’s human cells, and especially when you tap into certain cell types in younger cells, they have tremendous ability to send out signals for your body to heal.  Instead of throwing one drug, that’s targeting that one A to B linear relationship, we’re sending you cells, which contains intelligence that can send you hundreds or thousands of these cell made molecules, and that each molecule can affect 100 different mechanisms and actions. All of a sudden, you have this global healing that’s going on.  That is really exciting. Of course, it’s exciting on paper, and what excited me more was actually hearing stories of how people were healed. Just because something sounds great, doesn’t make it great. But when you actually see it at work, that’s what’s really inspiring. I started seeing that, which was incontrovertible evidence.  Then, I was like, this is just too amazing, and I was learning about the science and looking at the safety, which was incredible safety data, and efficacy. Then I started doing it for my own patients. That’s when it became really fun. When somebody-

Dr. Weitz:            Let’s get into the nitty gritty about stem cells. Teach us about stem cells. What are the best types of stem cells to use in therapy?

Dr. Kong:             I would say there’s no one stem cell that cures everything. Different types of stem cells in our body, they all have their own functions. Otherwise, they wouldn’t be there. Our body is very-

Dr. Weitz:            Maybe you can define what a stem cell is.

Dr. Kong:             A stem cell… All of us started in life as one stem cell. The fertilized egg is one stem cell and that one stem cell has such an incredible potential, it can form any cell in the body. The cell continue to divide and it will retain that kind of potent potential, up to a certain stage. When they use embryonic stem cells, they were actually harvesting the cells at day five to seven of the embryos. Embryo, which is a little ball.  In that ball, those cells are highly potent. Any of those else can form pretty much all organs and tissues of the entire body, except for the sperm and egg. That’s the only difference. They can form just about anything. But they will further differentiate.  The ball will get a bigger and more convoluted and more complex and then they will become other stem cells. All those cells, that’s derived from them are still stem cells, but they lose certain potentials, they become more specialized stem cells, and they can still form, maybe a particular region or a particular tissue type of the human body. So, they keep dividing. It’s almost like a continuum. There’s no, this is first generation staff of cells, second generation, there’s no. There’s a continuum… It’s 1.5, 1.55, it’s continuing as they lose their potential and they earn their specialty, so they start to specialize.

In our human body, we have all kinds of stem cells in our body. For example, the hematopoietic progenitor cells, which can form all the blood cells in the body. That’s a stem cell. We have mesenchymal stem cells. Some people doesn’t believe is a stem cell, but it’s certainly of incredible potential, and in the Petri dish, you can make them into, especially from umbilical source, you can push them into different directions, including bone, fat, muscle and neurons or liver cells. There’s a diverse potential that they can’t become particular cells.  But at certain point, then you become a very specialized cell. You can’t become anything else, but that cell. That’s a progenitor cell that you can sit there and that’s what’s called tissue specific stem cell. For example, in your liver, you have liver stem cells. So, if you liver get damaged, those stem cells who can only become liver cells get activated and they will divide and they will replace the damaged tissue.  There are all these different levels of stem cells. When it comes to therapy, what do we use? One stem cell type that’s really popular, probably the most popular is the mesenchymal stem cells. This is a very, very fascinating type of cells, because they are everywhere in our body. Anywhere we have blood circulation, you have these cells.

The way they are is that, think of a gecko, holding on this tube, which is a blood vessel. They’re holding onto it and they’re sensing what’s going through that tube, all the blood and the signals, and they’re also communicating with the neighboring cells. They’re sensing things and they are also figuring out what’s going on locally and they will either secrete certain molecules based on what they sense or if they’re needed, they’re going to actually going to squeeze themselves into the blood vessels.  They have this very fluid role that they can, what I call like a conductor of the symphony of regeneration. They have this fluidity. They’re everywhere in our body. The benefit of using this type of cells is first of all, these cells are such type of a master cell. A master in the sense that it’s controlling things. It’s able to sense things and then send out appropriate molecules to make changes.  It can send out things into the bloodstream to make overall changes, or it can travel to a specific site and start to secrete different molecules and tell the immune system to bring certain cells to come and clear-

Dr. Weitz:            Where do we get these mesenchymal stem cells from?

Dr. Kong:             There are definitely people who get it from a person’s own. You hear about bone marrow. Unfortunately, bone marrow has 0.1% to 0.01% of mesenchymal stem cells, and has a low percentage of the hematopoietic stem cells, but it has a lot of immature, early immune cells. The bone marrow transplant is one way to get it, even though the amount is minuscule.  A place that has higher percentage is the fat derived stem cells. It sounds counterintuitive, but what’s interesting is they’re not getting it from the fat, they’re getting it from all the blood vessels that are supplying the fat. That’s where the cells are. If you can separate the cells from that tissue, from the blood vessels, that’s where you can get them.

The beauty of these cells is that they work with your immune system. There’s very little potential for rejection. Of course, you don’t have rejection issues with your own cells, but if you are giving transplants, they tend to modulate the immune system, so that immune system is not super amped up. It tends to shift the body from an anti-inflammatory to anti-inflammatory status. Is actually being used for organ transplant. You can transplant an organ, and if you also give the person mesenchymal stem cells, it’s more likely for the organ to survive, instead of being rejected. It has that kind of function.  That makes it very, very, very easy to use, because you’re not going to get different kinds of reactions. The problem is… A person will say, well then of course I want to use my own. Unfortunately, as you grow older, you have less and less of them. Just to give you stats, when you were born, every one in 10,000 cells is a mesenchymal stem cell.  When you reach your teenage years, it becomes one in 100,000, it’s tenfold less, right? Then when you reach your 40s, is one in 400,000. When you reach your 80s, is one in 2 million. You’re running out of the stem cells and the stem cells you do have in your body are a lot less potent. They’re just not working as well, and they lose some of their intelligence.

Dr. Weitz:            We want the stem cells from younger people.

Dr. Kong:             I’m sorry, unfortunately that’s the truth. I was trying to figure out whether or not that’s true. That’s when I delved into all this literature and start to just look at what works better? What works better? People are paying a lot of money for these treatments. I need to give them the best. Apparently, no one has really looked at all the research that’s been out there, because I’ve been presenting this information at different conferences and still, very few doctors really understand the differences.  When you look at all the research that’s been done, for at least 10 years, comparing these different tissue sources. I actually have the lecture online, it’s called Are all MSCs Created Equal? It’s a 40 minute lecture that goes in great detail.  After you watch a lecture, you look at the evidence, none of them was my opinion. All I presented was evidence. Then you can draw your own conclusion. To me, it was very obvious what is a superior source, which is the birth tissue source. We’re not going into the realm of fetal cells or embryonic stem cells, which are not even legal in this country. I think they have their own issues.

Dr. Weitz:            It reminds me of clinics overseas that put the blood of young people into older people as a form of anti-aging.

Dr. Kong:             Yeah, there are a lot of things floating in the blood. We can get those similar elements from the birth tissue.


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Dr. Weitz:            Now, is there rejection issues when you’re using stem cells from somebody else?

Dr. Kong:             I wouldn’t call it rejection issues. Depending on what kind of cells you’re using, if you’re using high percentage of mesenchymal stem cells, I have not seen rejection. There are once in a while, I would say maybe one in 200, 300 people, there may be somebody that has a hypersensitivity type of constitution, hyper histamine reaction that they may break out with half the food that you and I can’t eat or half the medications that we can take with no problem. Those are the only people I’m a little bit more cautious about. But the vast majority, I’ve never seen any issue.

Dr. Weitz:            Okay. How do stem cells work to heal tissues?

Dr. Kong:             The stem cells, if we’re talking about mesenchymal stem cells, I’m just going to stick with mesenchymal stem cells, because that’s what we’re looking at these days, for most research. These mesenchymal stem cells, they are attracted to signals. We talked about how they… I always think the image of salmon swimming upstream, because they’re sensing the density, probably of the signals. So, they’re following the signals.  Once they get to the area, then they have all these different actions. It’s really fascinating. First of all, they can send out certain molecules in the vicinity where they can bring in different immune cells. Immune cells, one is that they can clean up the damaged tissue. You need macrophages, you need neutrophil, you need things to get things gobbled up and cleared away, or if there’s infection, kill them off, and you take away what the damage is.  Then the cells also has ability to communicate with the local stem cells. It’s not the mesenchymal stem cells themselves, that becomes to replace a tissue. That was misconception, that’s what people thought a while ago. But really the way it does, is that it talks to your local stem cells and tell the local cells, “Hey, wake up. Stop being dormant. Come out and fill up this tissue, replace it with healthy tissue.”

That’s one part of the function. That’s called paracrine effect. So, sending out signals. But has some other really direct effects. For example, has direct antimicrobial effect. It actually S antimicrobial peptides, and then it also has what’s called anti-apoptotic. It actually saves tissue. Let’s say you have some tissue that’s damaged either, can be by heat, by radiation, by whatever, the damage.  When tissue is damaged, they actually leak out calcium, leak out all these signals that tells neighboring cells to die. Things are not dying just from being damaged, but also from the signals from the damaged cells. What stem cells can do is to prevent the neighboring cells from dying, so they have a protection kind of a mechanism.  Then they also have apoptotic… They can be anti-apoptotic, so preventing programed cell death when necessary, but they can also cause programed cell death when it is old, senescent cells or cancerous, precancer cells, because they can recognize, there’s something wrong with the cells. So, I’m going to tell the cells to die. It also can promote… These mesenchymal stem cells can promote angiogenesis, or promoting blood vessel formation.  It doesn’t do you a whole lot of good to have a lot of cells, but with no blood supply. Also, there’s another thing that they do, that’s really fun, they’ve caught that on electro microscopy, what’s called mitochondria transfer. These new young cells actually can transfer their healthy, vibrant mitochondria into the host cells. In a way, injecting some life force into the host. There are a lot of different mechanism of actions. It’s pretty exciting.

Dr. Weitz:            Okay. What are some of the mesenchymal cell conditions that stem cells can really benefit?

Dr. Kong:             Okay. First of all-

Dr. Weitz:            Can they be a viable alternative for patients who say, are in need of a knee or hip or shoulder replacement?

Dr. Kong:             Yeah. Let me just do a disclaimer, since the FDA, it’s very much watching out for consumers and I’m watching out for consumers as well. We cannot make any claims because so far, with the one exception of blood disorders that stem cells are indicated for, there’s been no other FDA approved indications. Let’s say somebody has blood disorder, they can give them a bone marrow transplant, or even umbilical cord blood transplant, and that can help replace their bone marrow supply and help regenerate their entire hematopoietic system.  That’s good. That I can say, yes, stem cells can treat that. Everything else, I cannot use the word treat. When we talk about conditions, it’s really about the mechanism of why the condition happens and then how stem cells can help assist repair.  I have seen that happen over and over and over in my clinic. Of course, I also founded an academy, which is called American Academy of Integrative Cell Therapy. Our mission is to educate healthcare providers on how stem cell therapy can help with different conditions.  There’s actually course when doctors take the course, they actually take away over 300 published articles, they’re all categorized by organ systems and disease categories. There are research, very active research into many, many disease categories, showing really encouraging results. That’s what I’m trying to show to doctors so they can help their patients.

Dr. Weitz:            Do you have patients who’ve seen you, who had severely degenerative knee who were told they needed a knee replacement, that you treated them with stem cells? Then also, when is it a good idea to use PRP versus stem cells, or when do you use PRP with stem cells?

Dr. Kong:             Okay. What you said, you just described my first stem cell patient. My very first stem cell patient, he was 69 at the time, now he’s 74. He had bilateral arthritis, which he went the two orthopedic surgeons who both told him he absolutely needed bilateral knee replacement. He didn’t really want to do that, he wanted to see if stem cells could help him.  At the time, I did give him an IV treatment because the outer one third of the cartilage of a knee joint is nourished by the blood supply. The inner two thirds is nourished by the synovial fluid. I wanted to attack from both angles. When I give it through IV, it can help nourish the outer one third of the cartilage, and injecting into the knee joint, that helped provide the stem cells to us right there, because it’s very difficult to get the stem cells from blood, into the joint space.  What’s fascinating was that… First of all, this is five years later, he’s walking about four miles every day, his knees are doing fantastic. He doesn’t even think about it very much. What’s really interesting was the next day, he told me, he said, “Hey, I slept through the night. I haven’t slept through the night for decades, because of my shoulder injury.”

When he was late teens, his car rolled over, damaged his shoulder, and it never, I guess, never fully healed. Every time when he turns around, turns in his bed, the sharp pain will wake him up. I never touched his shoulder, I didn’t even know about the problem off his shoulder. I just gave him a simple IV injection, and then one injection into his knee. This is five years later, his shoulder was fixed. I never touched his shoulder. That just shows you the intelligence of the cells that they can find where you need repair. That’s one thing. Then you asked about PRP. The way I do injections-

Dr. Weitz:            Hang on one second, let me just ask you about that patient with the knee. Did you go back and do maybe another imaging, maybe another MRI? If you did, would we see that the cartilage was regrown, do you think?

Dr. Kong:             I didn’t do it on this patient, but there was another patient, which I did not even inject into the knee, I just gave her IV treatment and she did have a pre-injection MRI, and then post, a few months after. It showed her knee cartilage has regrown, which shocked her orthopedic surgeon who had never seen anything like that, because they didn’t know about stem cells. Of course, you don’t see regrowth of the knee.  The body is incredible. If you just give the right signal, it can do amazing things. I want people to feel hopeful, to realize, your body is this incredibly intelligent machine. We can’t even make a single cell. Our human mind can’t even make a cell, let alone this entire body. There’s incredible intelligence that you are walking around with.  Anyhow, as far as the PRP… PRP is obtained from a person’s blood. You take the blood and you spin it out. You get some more growth factors from the platelets, because platelets do secrete a lot of growth factors and help promote healing and all that. It is very helpful. I almost never use PRP alone, I can. But it’s like when you have the best tool in the world, why would you use the second rate?  Yes, maybe because it’s a lot cheaper. But you get much longer lasting results. For example, erectile dysfunction, a lot of people do PRP, inject PRP into the penis. For people who have done it for a long time, specialty clinics. The feedback I got was PRP injections, the effect may last, two to three months. But when you do stem cells, it lasts at least six months, six to 12 months.

There’s a difference in the potential of the cells, because when the cells can keep secreting these beneficial factors and they actually help repair DNA, which I haven’t mentioned because stem cells will secrete exosomes. It will respond to environment and secrete the correct combination of molecules into the exosomes. Exosomes contain micro RNA. These micro RNA can actually get into cell nucleus and help repair DNA.  That’s what causes the long term benefits. I believe that some of the antiaging benefits has a lot to do with that. When you make the DNA younger, when you make it function better, then you are dialing back the clock. The PRP has potential, but it’s shorter lived and it doesn’t nearly have as much potential as the stem cells. But I do like using it because you’re giving extra… I use it with stem cells for all kinds of injections. We can inject into the penis, or any joints and muscle, tendon repairs, or hair, face restoration.  I do use PRP in all those cases, because I like the extra growth factors, and the fact that they do nourish the stem cells and help the stem cells work even better. That’s my philosophy on-

Dr. Weitz:            For regrowing cartilage in joints, or helping patients with degenerative needs to feel better. Do you recommend specific foods or nutritional supplements to help facilitate that? I’m thinking about things like glucose [inaudible 00:35:13]-

Dr. Kong:             Those are great. Those are good.

Dr. Weitz:            Yeah. Collagen supplements, SPM, fish oil, et cetera.

Dr. Kong:             Absolutely. We do advise our patients with all that, and also, I incorporate peptides as well. There are good peptides that help with muscular skeletal healing, like TB-500.

Dr. Weitz:            Which are your favorite peptides?

Dr. Kong:             BPC-157 and TB-500 are two of my favorites. Very-

Dr. Weitz:            What do you think about the oral BPC-157?

Dr. Kong:             I haven’t tried it. It’s supposed to work well, but I don’t… Have you tried it?

Dr. Weitz:            Yeah. We’ve been using it. We find it’s very helpful for leaky gut and it does help with some musculoskeletal injuries as well.

Dr. Kong:             Yeah, right. Great for gut healing, just overall fantastic anti-aging agent.

Dr. Weitz:            Let’s see, let’s talk about degenerative neurological conditions like Alzheimer’s.

Dr. Kong:             Things like Alzheimer’s, I really believe, whether or not it’s Alzheimer’s or Parkinson’s or MS, these are all kinds of different names for the same problem. Like autoimmune disease, whether or not you manifest in the gut or in the brain or in your muscles, it’s really the similar pathophysiology. We still don’t know exactly why yet, although we know there’s rampant inflammation. There are a lot of different theories. But I think, no matter what the cause is, the final funnel is inflammation.  If you can help reduce the inflammation, you can definitely help reverse some of the processes. But as far as helping with these conditions, I’ve definitely helped people with Alzheimer’s, with MS, with Parkinson’s. Definitely, I’ve seen improvements. Improvements, probably no medication has been able to achieve, but did I get them to be 100% back? No. I wish I did. I did get a person 100% back, that he’s on the brink of death, who had liver cirrhosis, which was really shocking to me, because he was already in hospice. That traditional medicine, there’s no remedy. That’s it.

Dr. Weitz:            It’d be interesting to take patients who are going through the Bredesen Protocol, as you probably know, Dr. Dale Bredesen is actually helping to reverse Alzheimer’s in patients. He just published the first study with 25 patients using a full functional medicine approach. It’d be interesting to add stem cells to his protocols.

Dr. Kong:             Absolutely. Absolutely. I remember my first dementia patient, she was very, very late stage. When she came to me, she came with her husband, she was singing and she was asking me if she could marry me. She was completely just not… She’s in her 60s, her mind is very far away from her. She also had not been feeding herself for two months, that she might be hungry, but there’s no volition, there’s no ability to just pick up a knife and fork and just eat.  What’s interesting was the next day, after the stem cell therapy, about 10 o’clock, she had, again, a plate of food in front of her and she just picked up a knife and fork and just ate. Her husband was looking at her in shock. Then she looked at her husband like, what’s your problem? Why are you staring at me? It was really interesting, and I do believe that’s the acute anti-inflammatory action that her brain pathways has been so clogged up, that the communication was stopped, signals could not get across. Once you calm the inflammation, all of a sudden, you got the brain pathways actually are communicating.


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Dr. Weitz:            How do you administer stem cells for a patient with a degenerative neurological condition? Are they injected into the brain or are they just put intravenously?

Dr. Kong:             I do it through intravenous. I know there’s some doctors who inject into the brain, which you can do as well, but there’s more, inject into the spinal canal or into the ventricles, which is even more high risk, But even injecting into spinal canal, you’re talking about much higher risk. But one thing I love about doing IV treatment is that, I still believe that all these neurodegenerative conditions, they’re still a systemic issue. They’re just manifesting the brain.  When you can repair your body, all of a sudden your brain can function better. This is all one entity. It’s, blood brain barrier, whatever. It is all one continuum. You want to treat everything. That’s my philosophy.

Dr. Weitz:            What about stem cells for patients with cardiomyopathy for congestive heart failure?

Dr. Kong:             There’s some good research supporting the benefits. Definitely-

Dr. Weitz:            I think in those cases, it’s typically injected directly into the heart.

Dr. Kong:             Not necessarily. Intravenous is fantastic because, if you think about intravenous administration, the first place to go back to is your heart, and then get to come to the lungs and go back to your heart. If your heart has a lot of need, the cells are going to be attracted to those inflammation, those screaming signals.

Dr. Weitz:            How are stem cells beneficial for antiaging?

Dr. Kong:             I actually did a presentation at a few conferences, particularly about this subject, because I realized, because I’m interested in this and I want to help people to live longer and more vibrantly, but what are the evidence? I started looking up, what kind of evidence there has been. It’s really fascinating.  Yes, it has shown beneficial anti-aging effects in humans, but there’s probably more convincing evidence in animal because you can actually observe lifespan. When they did experiments in mice and rats, it’s pretty consistent, the lifespan extension is about 30%, with regular IV infusions of young stem cells. So, young mesenchymal stem cells.  It is really cool. I think one experiment started giving these old mice, young stem cells and these old mice are so old that they’re the human equivalent age of 75 years of age, where half of their peers have died. That’s how they started the treatment point.

They give it to one group, just sham, like a placebo. The other group, they gave them real stem cells. The group that got real stem cells, I think was like monthly infusion, they actually, from the time of the experiment, to the time they died, it was three times as long as the group that got placebo. Not only they live longer, but they’re moving better, they’re fast better, their cognition is better.  Then there’s other studies that were actually looking at acetylcholine levels, growth factor levels of both the muscles and the brain, and it was really incredible because when they gave the older animal younger cells, all these measurements have gone back to the younger level. That’s pretty incredible evidence. What you can measure actually went back to younger level or even better than younger. It was really fascinating. You can imagine how it helps with maintaining physical health, the muscle mass, and then your brain health, just from those things they measured.

Dr. Weitz:            What about patients with diabetes? Can stem cells potentially cause them to be able to regenerate those pancreatic beta cells?

Dr. Kong:             Yeah, absolutely. This is another thing that’s really exciting, because not only type 2 diabetes, it can help reverse, but also type 1 diabetes. We’re seeing of regeneration of beta cells in the pancreas and actually endogenous secretion of insulin.

Dr. Weitz:            Do we have cases of patients who were type 1 who are no longer insulin dependent?

Dr. Kong:             I don’t have those patients, but certainly people have done studies on patients and published results.

Dr. Weitz:            Interesting. Now, what about cancer? First thing, when I think of stem cells and cancer is since stem cells cause cells to grow, you might not want to use them in patients with cancer, because you might cause the cancer cells to grow as well, right?

Dr. Kong:             Yeah. That was my original hesitation. I used to not treat patients who had cancer within the last three years. But what’s interesting was, as I delve deeper into the science and the research, what I saw was yes, if you’re using cells from your own body, from your own fat or bone marrow, boy, you’re taking a risk. Because when they put… For example, this one study, when they put this brain tumor cell, very virulent glioblastoma, when they put the brain cells next to the tumor cells, next to the mesenchymal stem cells, that’s extracted from fat, the tumor actually grew.  But what’s interesting was that when they put mesenchymal stem cells from the umbilical cord next to the tumor cells, the tumor shrunk. They did the same experiment, putting the cancer cells, transplanted it on the animal, put it on the animal body and then put the mesenchymal stem cells either from the fat or from the umbilical cord next to the cancer cells, the same thing happened.  If it’s next to mesenchymal stem cells from the fat, the cancer grew. If it’s next to MSCs from the umbilical cord, the cancer shrunk. We can’t just lump all stem cells together, because when you have young stem cells, they have capabilities that you no longer have when you get older. There’s degeneration. There’s degeneration of life, that’s why we die.

The cells, all the stem cells in your body have lost its capacity, lost its original capacity. It’s not as vital, and that includes the capability to detect cells that shouldn’t be there and have the ability to destroy it. Somehow, as we get older, we lost that ability. I would be very, very, very cautious with somebody that uses their own stem cells. If they have any proclivities for cancer. Of course, the problem with embryonic stem cells is that they can become a tumor themselves. They can just go crazy and wild and start to become all kinds of tissue called teratoma. That is something that doesn’t happen with umbilical cord-derived MSCs.  It’s almost like the umbilical cord-derived MSCs are still very vital, very young, but has lost some of this wildness. So, it’s not going crazy anymore.

Dr. Weitz:            With a cancer patient, if you were considering doing regenerative therapy, you wouldn’t want to take embryonic stem cells, because they might have too much growth potential. If you take cells from your own body, they may already have an oncogenic potential. So, better to take stem cells from a younger person who’s past the embryonic stage and potentially they may have more anti-cancer fighting properties?

Dr. Kong:             Right. The cells from your own body, it’s not so much they have oncogenic potentials, is that they are indiscriminately telling everybody to grow. If you have existing cancers, then these cells are not going to be able to tell the difference, and it’s just going to tell everything to grow, and then that’s going to promote your cancer growth. That’s the part to be very careful with.

Dr. Weitz:            Right. What about the cosmetic stuff, like care growth and skin?

Dr. Kong:             Yeah, that’s the really fun stuff.

Dr. Weitz:            I’ve seen pictures of these vampire facelifts. It’s pretty gross looking.

Dr. Kong:             It’s pretty incredible. I have pictures of my patients just plastic-

Dr. Weitz:            You take this spiny roller and you make little holes in their face.

Dr. Kong:             I inject stem cells into the skin, and then I do micro needling on top, and the results are just incredible. Even with one treatment, drastic, drastic improvements in skin. It’s amazing what these cells can do. Same thing with hair. The hair is going to take a little longer because the hair follicles, the way they come out, every six weeks, they’re not all at once, they’re not active all at once. You can target one group, but then there all these other group are still dormant. So, you have to do it again.  It takes about three sessions. But we’re seeing great results. If you’re completely bald, if it’s shiny, I’m sorry, we can’t do it. But if you’re just thinning, it’s like great, I can help you.

Dr. Weitz:            Cool. Okay. I think those are the questions that I had prepared. Any final thoughts you want to leave our viewers and listeners?

Dr. Kong:             Yeah, sure. I’m all about full health. I really truly believe that one can only achieve a real health and happiness by taking care of yourself physically and mentally, which is understanding why you do the things you do, and what has affected you in the past, and spiritually, all three are very important. That’s probably another reason at clinic, we start doing ketamine treatment.  I find it transformative, and I do think spirituality has a lot to do with it. It lets you out of your own little ego and tap into a whole different realm and capabilities. It’s actually really helpful for chronic pain, but it’s great for depression, anxiety, PTSD, addiction. I want to help people heal fully. That’s something I’m really excited about, what we’re doing in the clinic. Again, that’s Western medicine, that’s an anesthetic, but it happens to be tremendous in what it can do in promoting brain regeneration. That’s another huge tool.

Dr. Weitz:            Ketamine, is that similar to the low dose psilocybin type treatment?

Dr. Kong:             It is not low dose, what we do.

Dr. Weitz:            Okay.

Dr. Kong:             I guess people can do it low dose, but the way we do it is an IV infusion. So, it takes about an hour.

Dr. Weitz:            Ketamine, is it a psychedelic?

Dr. Kong:             Well, it wasn’t developed as a psychedelic, it was developed as an anesthetic, so you can do surgery on people at much higher dose. But what they realized is that at much, much, much lower dose people have a psychedelic experience, but they also get healed of their depression, and the PTSD. A lot of these things go away at the same time. That’s how it got started. It’s a much, much lower dose than anesthetic dose, an extremely safe… It’s actually one of the safest anesthetics in the world. It is one of the essential medications on WHO’s list.  It’s an extraordinary medication, but now we’re using it. Right now is the only FDA approved psychedelic medication.

Dr. Weitz:            Okay. That’s great. How can listeners get a hold of you? What’s your clinic information, your website?

Dr. Kong:             Our clinic is in the greater Los Angeles area. Right now our clinic website is THEA CRM. So, THEA Center for Regenerative Medicine. You can just look up THEA, T-H-E-A-C-R-M.com. They can also look me up on YouTube. I have a lot of interesting videos on YouTube, just my name, Joy Kong MD, that’s the channel. I go into more about different types of stem cell treatments and just a lot of nitty gritties that people don’t talk about.

Dr. Weitz:            Thank you, Joy.

Dr. Kong:             You’re so welcome. It’s fun talking about all this, getting the information out.

Dr. Weitz:            Absolutely. Thank you for sharing some interesting information.

Dr. Kong:             Yeah. Thank you for being willing to learn and join the excitement.

Dr. Weitz:            Always learning. That’s one of the great things about doing a podcast.

Dr. Kong:             Yes. Okay.

Dr. Weitz:            Okay. Thank you.

Dr. Kong:             You’re welcome. Take care. Bye-bye.



Dr. Weitz:            Thank you for making it all the way through this episode of the Rational Wellness Podcast. If you enjoyed this podcast, please go to Apple Podcasts and give us a five star ratings and review. That way, more people will be able to find this Rational Wellness Podcast when they’re searching for health podcasts. I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica, Weitz Sports Chiropractic and Nutrition Clinic. If you’re interested, please call my office 310-395-3111 and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz.  Thank you and see you next week.



Healthy Bones with Dr. Joe & Lara Pizzorno: Rational Wellness Podcast 236

Lara Pizzorno and Dr. Joe Pizzorno discuss how to Promote Bone Health and Reverse Osteoporosis with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.] 


Podcast Highlights

2:31  An acid forming diet like the Standard American Diet (SAD) contributes to bone loss by leaching calcium out of the bones to restore your pH to the right alkaline balance.  This concept of an alkaline diet affecting the pH of the body has been criticized by medical researchers because they measured people’s blood pH before and after an alkaline or acid diet, and they found no difference in blood pH, so they criticized this whole idea. But the body works very hard to maintain the blood pH in a very narrow range but that process may involve the kidneys excreting more acid, which increases risk of kidney stones, and it may involve the body taking calcium out of the bones to help alkalinize the blood. If you want to prevent and reverse osteoporosis, the first thing you need to do is to alkalinize the diet by eating fewer animal products and by reducing salt consumption.  If people consume too much salt, it puts so much load on the kidneys that the kidneys can’t get rid of acid as well. You need to add more vegetables and fruits, which are generally more alkaline.  Even though you may want to reduce animal protein, it is still important to get enough protein, say at least 65-70 mg per day, but you need to balance out this protein with enough calcium, say 1200 mg of calcium per day.  Calcium can come from broccoli, spinach, and dairy other than milk, provided that you can tolerate both the lactose and you don’t form antibodies to milk protein.

12:22  The high sugar and carbohydrate content of the Standard American diet (SAD) cause blood sugar and insulin spikes and this creates inflammation.

12:50:  Unhealthy fats like saturated and trans fats can negatively impact bone health. The healthiest fats are the Omega 3s, which should be in a proper balance of 4:1 with Omega 6 fats.

13:29  But are saturated fats really unhealthy?  If the saturated fat is from grass fed animals, then it is healthier than from animals that are fed corn.  Beef that is pastured will have conjugated linoleic acid, CLA, which is anti-inflammatory and beneficial. Also, if animals are fed corn, then their fat will have high levels of arachidonic acid, which may be causing the problems that are being blamed on saturated fat, according to Dr. Pizzorno.  The other thing to consider is that animals store toxins, like heavy metals in their bones, so bone broth may not be a good idea.

18:05  Flouride.  According to Lara, flouride in small amounts may be beneficial, but in the US excess flouride–flourosis–is very common in younger people, so we are probably best avoiding toothpaste with flouride and avoiding flouride in the water.  Flouride replaces the calcium in the bones and the teeth but it makes for a different bone structure, which is not as well connected. 

20:53  Heavy metals.  Heavy metals can play a negative role in bone health, esp. cadmium, lead, and mercury.  Cadmium causes damage to the bones and the kidneys.  Our kidneys are really good at scavenging cadmium and clearing it out of the blood, but it can get stuck in the kidneys and poisons the kidneys.  The kidneys are responsible for converting  1-hydroxy vitamin D into 2-hydroxy vitamin D, which is the active form. Cadmium also poisons the osteoblasts in the bones, which are responsible for laying down new bone.  Studies done in Seattle show that 20% of the osteoporosis of women was coming from cadmium that came from eating soy products.  If lead is present in the bones, pregnant women’s bones will release the lead to go into the bones of the baby, unless plenty of calcium is included in the diet.

25:32  Lara found out in her early 40s that she had severe osteopenia after taking a DEXA scan at a trade show. She was shocked.  But everybody in her family has had osteoporosis, so she has a genetic tendency. She discovered that her vitamin D level was low and at the time the recommended amount was 400 IU, but she  found that she needed 10,000 IU per day to bring her level up.  She also started taking vitamin K2 MK7, which is required to activate the Gla proteins (Osteocalcin, which pulls calcium into your bones, and Matrix Gla protein, which prevents calcium from depositing in your soft tissues like your blood vessels, your kidneys, your breasts and your brain).  Unfortunately K2 is not present in many foods. It is found in small amounts in certain cheeses but the only good food source is a fermented soybean product called Natto, that smells like dirty socks, so supplementation is necessary.  You should get 100-200 mcg of MK7 and you should have equal amounts of vitamin A and D.  If you have cardiovascular or kidney damage, then take 360 mcg of MK7.  Lara also take B complex. She had a H. pylori infection in her gut, which can decrease hydrochloric acid production and HCL is need for calcium absorption.  She took triple antibiotic therapy, which cured her H. pylori.  Now at age 73 Lara has healthy bones with no osteopenia.

37:21  Drugs that interfere with bone health.  There are a number of prescription drugs that can interfere with bone health, including statins, certain blood pressure medications, and even antidepressants.  Statins, esp. at higher dosages are bad for bone by interfering with cholesterol production and we need cholesterol to make our hormones that are good for bone health.  Cholesterol is used to make vitamin D and to transport vitamin K.  Dr. Pizzorno feels that cholesterol has been overly villified as the use of statin medications has been promoted as the answer for preventing heart disease. Dr. Pizzorno wrote an article, The Vilification of Cholesterol for (Profit ?) about this topic.  Some blood pressure medications interfere with bone health. Thiazide diuretics protect bone, while loop diuretics and calcium channel blockers harm bone.  SSRIs, which are antidepressants, promote bone loss. They increase the production of serotonin and serotonin binds to a receptor on the surface of newly formed osteoblasts and stops them from developing, so your bone building cells don’t develop.

44:44  Calcium.  Some studies that have shown a negative effect on heart health with calcium supplementation did not also give vitamin D and vitamin K. You need all three of these nutrients working together.  And magnesium should be taken with calcium in a Calcium: Magnesium ratio of 2:1.  With respect to types of calcium, despite a lot of claims, calcium hydroxyapatite is not a more effective form of calcium and it contains phosphorus, which is bad for bones, for cardiovascular disease, and for kidneys.  Calcium citrate can be a good choice, since citrate is an alkalinizing agent and it can be absorbed without producing a lot of stomach acid.  Lara recommends consuming about 1,200 mg of calcium per day from both diet and supplements with no more than 500 mg at a time.  It is best to take calcium supplements with a meal since the hydrochloric acid produced for the meal will make it easier to absorb the calcium. She also recommends taking strontium citrate to promote greater bone density.  Strontium has a bad reputation because of a pharmaceutical version of strontium ranelate that was developed that was toxic because of the ranelic acid.  Strontium is a natural bisphosphanate.  It acts through several different mechanisms both to increase osteoblast activity and to increase calcium absorption.  There are also some other trace minerals that are synergistic with calcium, including potassium.

58:11  Boron. Boron is very helpful for bone. It slows down the activation of the 24-hydroxylase enzyme that breaks down estrogen and testosterone. Boron is even used in cancer treatment.  Most people should consume 3 mg boron per day and those with with degenerative joint disease like osteoarthritis would benefit from 6 mg per day.  Research shows that 6 mg of boron per day prevents bone loss. Here is a paper that Lara wrote about boron, Nothing Boring About Boron.  



Lara Pizzorno is the co-author of the newly released book, Healthy Bones, Healthy You!, which she co-wrote with her husband, Dr. Joe Pizzorno.  Lara is the best selling author of a previous book on bone, “Your Bones: How you can prevent Osteoporosis and have strong bones for life-naturally” .  Lara is also the editor of Longevity Medicine Review and the senior medical editor for SaluGenecists and Integrative Medicine Advisors. 

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 and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.


Podcast Transcript

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

I’m very excited today to be getting the opportunity to speak with Lara and Dr. Joe Pizzorno on bone health. Lara Pizzorno is the bestselling author of a previous book on bone health, Your Bones: How You Can Prevent Osteoporosis and Have Strong Bones for Life Naturally, and she is now the co-author of this newly released book, Healthy Bones, Healthy You, which she co-wrote with her husband, Dr. Joe Pizzorno.  Lara is also the editor of Longevity Medicine Review and the senior medical editor for SaluGenecists and Integrative Medicine Advisors. Dr. Joe Pizzorno is one of the most important naturopathic doctors, educators, researchers, and one of the founding members of the functional medicine movement. Dr. Pizzorno has written or co-authored more than 12 books, including the Encyclopedia of Natural Medicine, which has now sold over two million copies and pretty much everybody who has an interest in natural medicine has a copy on their bookshelf, the Textbook of Natural Medicine, Natural Medicine for the Prevention and Treatment of Cancer, and The Toxic Solution, among others.  Thank you so much for joining us today on the Rational Wellness Podcast.

Dr. Pizzorno:                      Good to be with you. Thanks for the invitation.

Dr. Weitz:                           Before we get into the questions, I wanted to tell you that this new Health Bones book is really a great read and it goes into incredible depth about so many aspects of bone health that are often not discussed, such as, how heavy metals negatively impact bone health, how common chronic diseases such as heart disease, kidney disease, IBS and hypothyroid impact bone health and what to do about it. I think both laypersons and practitioners will learn a lot from reading this book, and not just about bone.

Lara:                                   Thanks.

Dr. Weitz:                           You guys did a great job. Lara, let’s start by talking about some of the factors that cause bone loss in our US culture including the standard American diet? How does a diet that’s high in acid-forming foods contribute to osteopenia and osteoporosis?

Lara:                                   Well, when the overall pH of the body is not in good balance, your body will constantly try to reestablish that healthy balance because many cellular activities can’t happen properly, the enzymes won’t activate, unless they’re at a certain pH level, so when you lose that level, your body instantly tries to reestablish it, and the way that it does that is by making you, typically you’re more acidic and so it tries to withdraw alkaline compounds from your bones, namely calcium, to restore the alkaline balance, and if you’re chronically doing that, you just keep pulling calcium out of your bones and eventually that results in bone loss.

Dr. Weitz:                           Right. Now, I agree with you, but some folks criticize this whole concept of alkaline balance because they say that the blood levels, your pH in your blood, is always going to stay in a very narrow range no matter what, so it’s not really that relevant.

Lara:                                   Okay. I’m going to let Joe do this one because he’s on PubMed with papers on this issue.

Dr. Pizzorno:                      This is my topic.

Lara:                                   Yeah.

Dr. Pizzorno:                      Dr. Weitz, one of the things I enjoy about my life right now is I get to go back and look at age-old natural medicine concepts from the perspective of modern science. I suspect you’ve had this experience, as well. If you look back and read the writers of 100 years ago, they had some great clinical insights but they were limited by the science and technology of the time, their understanding of medicine at the time. They started to notice that people who ate what they thought was an acid-forming diet seemed to be less healthy than people who ate an alkaline-forming diet. They started advising people to eat a more alkaline-forming diet.  What the MDs said was they went through and said, “Oh, well, let’s see what this idea is valid.” They measured people’s blood pH before and after an alkaline or acid diet, and they found no difference in blood pH, so they poo-pooed the whole idea. Okay. Well, there’s two problems with that. Number one, as you well know, since you’re medically trained, the body works really hard to maintain the pH over a very, very, narrow range, because, as Lara said, our enzymes require an exact pH. If you vary on the pH, they don’t work very well, so by making it the very narrow range, so when a person’s eating an acid-forming diet, that means that the foods that are eaten are metabolized to form more acid. Not that the food itself is acid, but it’s how it’s metabolized, the body has to adapt.

The first thing it does is the kidneys start excreting more acid compounds, and which makes you have more kidney stones, by the way, but kidneys adapt. As long as a person has good kidney function and is relatively younger, not too much trouble.  But as people get older, their kidneys don’t function as well. They’re now less able to get rid of excess acid. Now the body has to adapt in other ways. What’s it do? It takes calcium out of the bone to normalize the pH, so it looks like the body’s just fine because the blood pH hasn’t changed, but we look at what’s going on in the bone to adapt to the excess acidity, it’s bad.  And it turns out that, and the research has been, taking older, post-menopausal women, with osteoporosis, don’t give them vitamin D, don’t give them vitamin C, and calcium.  You just alkalize their diet, and they start rebuilding bone. Now, of course, we do way better than just alkalizing, but it’s part of the picture. I think you’ll hear from Lara again and again, you have to deal with the whole picture, not just one piece of it and expect that to fix it.

Dr. Weitz:                           How do we alkalize their diet? What do we take out? What do we put in?

Dr. Pizzorno:                      You want to decrease the acid-forming things and increase the alkaline-forming things, so what causes excess acid?  Sulfur-containing amino acids account for about one half of the excess acidity in the diet. Okay, so, you have to eat less sulfur-containing amino acids which tend to mean less animal products. The other half is really surprising. It sure surprised me, is excess salt consumption, because when people consume too much salt, it puts so much of a load on the kidneys, the kidneys can’t get rid of the acid, as well.  And then in terms of the alkaline side, fruits and vegetables. A plant-based diet is alkaline. Just, once again, a plant-based diet is more alkaline.

Lara:                                   Also calcium. There have been studies done on people with post-menopausal women with bone loss, and the ones who are getting written, because protein is a big issue, and meat is a really good source of protein, and so you don’t want to skimp on your protein, but you have to have the calcium to balance the effects of the protein, and when they looked at people who were consuming at least 1,200 milligrams of calcium daily and 65, 70 grams of protein a day, they did better than the people who were consuming less protein and less calcium, and of course the people who consume a lot of protein and not much calcium really tanked. Not a good outcome.

Dr. Weitz:                           What are the sources of calcium in the diet? Is dairy a good source?

Lara:                                   Well, of course Dairy’s an excellent source and there are many vegetables that are good sources of calcium. In the book, I have a whole table of the common sources and what a serving provides and so forth. There’s dozens of them. If you like broccoli, broccoli’s a good source, spinach.

Dr. Weitz:                           Yeah. Now, dairy’s a controversial one, especially in the natural medicine, functional medicine movement. I think a lot of us have sort of soured on dairy in the sense that the dairy proteins are highly allergenic and difficult to digest, and then most of the dairy products are homogenized and pasteurized and there’s problems for a lot of people in breaking down the lactose in dairy, so I think that dairy is not as popular these days among natural doctors and practitioners.

Lara:                                   I think that’s true. I also think that the key issue with dairy, if someone reacts to casein, to dairy protein, then they need to avoid dairy. It’s going to cause inflammation, and anything that chronically causes inflammation will excessively activate the osteoclasts, which are the cells that break down bone, but if someone is not reactive to dairy, then dairy foods can be very beneficial. The issue with dairy, the one thing that you really have to avoid if you’re going to have dairy is milk. Things that are fermented, the cheeses and so forth, they’re very low lactose content, and even in the quote, unquote, lactose-reduced milk or lactose-free milk, all they do is apply lactase, which is the enzyme that breaks apart lactose, to the milk, so you still have the components of lactose which are glucose and then another sugar called galactose, and galactose is an incredibly inflammatory sugar.  It is used in research to prematurely age animals, and the amount that is used in the research to have this effect is comparable to what you would get if you drank two glasses of milk a day. You can get away with one, but more than that, you do not want to have. Outside of that, milk has whey. It’s a very anabolic protein. If you can tolerate milk, I mean, dairy products, fine, just don’t have a lot of milk.

Dr. Pizzorno:                      Yeah. I think if you can-

Dr. Weitz:                           What do you think about raw milk versus pasteurized milk, and then, a lot of other people in the natural medicine world have moved away from cow’s milk to sheep’s milk or goat’s milk or camel’s milk.

Lara:                                   I’ve never tried camel’s milk.

Dr. Weitz:                           According to Dr. Vojdani, it’s the least allergenic of all the animal milks.

Lara:                                   Yeah. I don’t think it’s readily accessible in the US.

Dr. Weitz:                           There is one company that distributes it.

Lara:                                   Well, if you can get it and you like it, okay, but again, I think it will still have lactose in it. You’d have to check the lactose content of the milk.

Dr. Pizzorno:                      I think also, Doctor, as long as there’s not an analogy, fermented dairy products, we’re okay with, but the raw dairy products in terms of raw lactose, as Lara said, we see problems with it.

Dr. Weitz:                           Right, so, essentially, you’re talking about cheeses and yogurt, right?

Lara:                                   Right, and there are some cheeses that have high content of vitamin K2, which is incredibly protective for bone and the cardiovascular system.

Dr. Weitz:                           Right. Right. Yeah. I definitely want to get into the vitamins in a few minutes. Other aspects of the standard American diet that contribute to bone loss. You talk in your book about a diet that’s high in sugar and refined carbohydrates. Why is this bad?

Lara:                                   Because those cause insulin spikes, and when sugar is in the bloodstream and it’s not absorbed well into the cells, it’s very inflammatory.

Dr. Weitz:                           Okay, and what is the role of unhealthy fats in bone health and which fats are healthy and which fats are unhealthy?

Lara:                                   Well, the healthiest fats are the Omega-3s, properly balanced with Omega-6s which are also helpful when they’re in no more than 4 to 1 Omega-6 to Omega-3 balance. Both types are healthful. The unhealthy fats are the too much saturated fat, and of course the trans fats are extremely unhealthful in any amount, and those are really in processed foods, primarily, so you want to limit trans fats as much as you can.

Dr. Weitz:                            Now, I think the trans fat is uncontroversial, but some in the natural medicine movement have come to see saturated fat, in some cases, as not necessarily unhealthy or maybe a healthier source of fat, and as I’m sure you know, a lot of people recommend grass-fed butter and other sources of saturated fats. What do you think about, or coconut oil which also has a fair amount of saturated fat?

Lara:                                      I think it depends on the life of the animal from which the meat or fat or anything else was derived. Animals, beef, that’s pastured, will have, in the fat, is going to have a compound called conjugated linoleic acid, CLA, which is extremely anti-inflammatory and highly beneficial, and then I don’t think it’s as much of a problem. We need fat. Our bodies need fat. 25 to 30% of the diet, at least, should be fat, but the type of fat that’s consumed is what the issue is, I think.

Dr. Pizzorno:                      I’d like to add a little nuance to this. I wonder if you see this, as well. Whenever a new idea comes out or another new fad comes out, I was try and step back and say, “Okay, now, how does that match up with nature?” Somebody comes out and says, “Well, this food source that people have been eating is a major cause of disease,” well, I look at, first, has something been done to the food to make it bad, or is it a valid concept, and so many of these times, what they’re doing is they’re making a mistake. For example, this whole thing about saturated fat. Now, yes, at high enough dosages, could be a problem, but in most situation, the saturated fat research came from animals fed corn, so that they have high levels of arachidonic acid.  There’s a direct correlation between arachidonic acid and saturated fat. It’s not the saturated fats causing the problem, it’s the arachidonic acid.  And arachidonic acid is only a problem because, rather than feeding cows grass, getting all this better balance of fats, well, we’re giving them corn. Not only giving them corn, but we’re also giving them medicine chemicals that are poisoning them. It gets in their milk, so we’ve actually gone from a relatively healthy food in a natural environment, particularly fermented, at the milk part, or even as the meat, eating the meat when it’s wild, to now this domesticated thing which has all the wrong fats in it, all these toxins in it, and it’s not healthy food.

Lara:                                   Animals store toxins in fat.

Dr. Pizzorno:                      Yes. All these toxins are fat soluble.

Lara:                                   Bones and fat. I’m not a big fan of bone broth because toxins get stored, and heavy metals in particular get stored in bone, then you make a nice, big broth of that and drink it all up. Not a good idea.

Dr. Weitz:                           Right. I guess you’re probably not a fan of liver either, huh?

Lara:                                   Well, if it’s a healthy animal that was pastured and not exposed to a lot of garbage, the liver should be healthful.

Dr. Pizzorno:                      On the other hand-

Lara:                                   Yeah, Joe?

Dr. Pizzorno:                      The liver’s where the toxins are detoxified.

Dr. Weitz:                           Exactly.

Dr. Pizzorno:                      Think about what that means.

Lara:                                   Yeah.


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Dr. Weitz:                            You mentioned fluoride in the book, and so is fluoride good or bad for bone? I know most dentists are highly tout fluoride as good for your teeth because they do these studies and they see the fluoride gets incorporated into the teeth. What do you think about fluoride?

Lara:                                  In very small amounts, it’s fine. In larger amounts, it’s an oxidant, and it’s a very, very powerful oxidant, and they’ve now shown that in the United States, fluorosis, you know the brown kind of pitting on the teeth, is extremely common now in younger people who’ve been exposed to it and in the water and everything. I think we’re just getting too much, so it’s like many, many things. In smaller amounts, it’s beneficial and useful, but when the intake is excessive, it can be harmful, and so that’s what I think about fluoride.

Dr. Weitz:                          Yeah. I think the fluoride just replaces the calcium and it’s actually a poorer mineral to be incorporated into the teeth and bones.

Lara:                                  It makes a different bone structure, yes, and it’s not well connected.

Dr. Weitz:                          The fluoride we’re getting in the water is not even some really clean source of fluoride. It’s coming from the fertilizer industry and it’s this toxic byproduct that they’re throwing in our water, and then, as you say, we’re getting excess fluoride from all these other sources, like people who use these Teflon pans and the PFOAs and the PFOSs that have seeped into the water supply all over the country, so those are also toxic sources of fluoride.

Lara:                                  This is Joe’s area, if you want to elaborate.

Dr. Pizzorno:                      Yes, of grave concern. I thought the fluoride was coming from, it was aluminum manufacturing, aluminum production-based products.

Dr. Weitz:                           What kind of manufacturing?

Dr. Pizzorno:                      I thought the fluoride came as a waste product in aluminum manufacturing production.

Dr. Weitz:                           Is that right?

Dr. Pizzorno:                      That’s my understanding.

Dr. Weitz:                           I thought it was coming from fertilizer manufacturers or something.

Dr. Pizzorno:                      You may be correct. I don’t know. I’m aware that-

Dr. Weitz:                           Anyway, we know it’s a toxic form of fluoride that’s being dumped into the water.

Dr. Pizzorno:                      Yeah. This is a great example of a small amount of a naturally occurring element has been negatively associated with cavities, which is great. Doesn’t mean we put in a bunch of a different form of fluoride into our water supply and saturate people with the water supply, with toothpaste, with getting their mouth washed by dentists. Now, we’re way overloading our systems for fluoride, and there’s some pretty worrisome research on fluoride. I don’t want to get into that, because we’re getting beyond the scope of this book, but people need to-

Dr. Weitz:                           That’s one of the great things about this book, is you mentioned some of the concepts like heavy metals that most people don’t think of as being associated with poor bone health, but you got to take all those into consideration if you’re really going to take a functional medicine approach to bone health, and those can be some of the keys, and just taking vitamin D and calcium’s not enough. You mentioned other heavy metals that play a potentially negative role on bone health.  You mentioned, in specific, lead, cadmium, and mercury.

Dr. Pizzorno:                      Right. Well, this is the area of the book that I had the most involvement with, so [inaudible 00:21:33] why I’m missing so much. Let me give you kind of a big statement first, then I’ll get into specifics. As Lara’s writing this book, and the previous one, she would comment to me about what she’s working on or ask me questions with my medical background. Now she’s getting her master’s degree in nutrition, which is exciting, so she won’t have to ask me as many questions, I guess.

Lara:                                   No. He’s teaching me chemistry now. We’re doing organic chemistry together. It’s very entertaining.

Dr. Pizzorno:                      Not that that’s going to be important to bone health, I think, oh, wow, that’s interesting for heart health. Then she’d talk about something else, and I’d say, “Well, that’s important for the kidneys.” Then she’d talk about something else, I said, “That’s important for the brain.” I started to realize that all this physiology she’s trying to normalize in the bones was the same physiology everywhere in the body, so when we’re writing this new book, the people who are helping us try to figure out what name to give it, when they say, “Healthy bones, healthy you,” when they first said that to me, I said, “Wow. What a great idea,” because the things we do to make the bones healthier make everything else in the body work better, as well.

Cadmium is an example.  Cadmium causes a lot of damage, and a lot of that damage is in the bones and the kidneys, so our kidneys are really good at scavenging the cadmium.  It gets all the cadmium out of the blood within a day or two.  It’s really good at it.  The problem is, it gets stuck in the kidneys and it basically poisons the kidneys.  Why is that important for bone health?  Well, the kidneys are responsible for converting 1-hydroxy vitamin D into 2-hydroxy vitamin D, and that 2-hydroxy vitamin D is the most active form. Happens in the kidneys. The kidneys are poisoned by cadmium, the cadmium conversion, and then directly in the bones themselves, well, it turns out the osteoblasts are responsible for laying down new bones after the osteoclasts have taken them out.

Well, cadmium poisons the osteoblasts, so it can’t form new bone as well, so cadmium is really bad on bone. There were studies done here in Seattle where they determined that 20% of osteoporosis in women in Seattle was due to cadmium and the cadmium was coming from eating soy products that were conventionally grown, because conventionally grown soybeans with high phosphate fertilizers, they’re often contaminated with cadmium. Cadmium goes right into the soybeans, you eat the soybeans, it goes right into our bodies, poison the kidneys, poison the bones.

Lara:                                   It’s not just soybeans that are soaking up cadmium from the high phosphate fertilizers. it’s conventionally grown foods. They all have more cadmium in them now. Another thing with cadmium and the other nutrients is that when there’s a heavy metal around and there’s also a nutrient, like a mineral that you want to absorb in the soil, you’re going to absorb more of the heavy metal if you don’t have enough of the nutrient around. They compete, and so, one example is lead and calcium.  They’ve done studies where they’ve given young pregnant women extra calcium because that way they’re releasing less lead from their bones as their pregnant, because, you know, you’re withdrawing calcium from your bones to help form the bones of the baby, and so if you have lead in your body, that lead is coming out, and it can get into the child, so they’ve done studies where they’ve looked at making sure that young pregnant women have plenty of calcium because it will interfere with that release from the bone, so there is a balance.  People take vitamin D, and as you know, vitamin D helps us absorb calcium. If calcium isn’t around, vitamin D is going to help you absorb cadmium and lead and mercury from the food that’s conventionally grown.

Dr. Weitz:                            Well, maybe we should segue into your story, which I know involved finding out that you needed a lot more vitamin D, maybe you can tell us about your story about bone health.

Lara:                                    Sure. Well, I was in my early ’40s. I’m now 73 and I have really great bones, but when I was in my early ’40s, we were at a medical conference and we went to the exhibit hall and they were showing a new piece of equipment that doctors could have in their office that was reasonably inexpensive for clinicians, and it would check your bone mineral density in your ankle. This was, what, like, 30 years ago now, and so, DEXAs were being used, but they weren’t as frequently being used and there was less awareness. The machine for the doctor’s offices were so much less expensive, they were selling it to say, “Get this in your office, and then if someone tests badly on this, then you make sure you get them into the big DEXA X-ray, so we went over, and I got checked, and I just, I’m healthy.

I follow everything that this man tells me to do, and I’ve been very healthy and even though everybody in my family had osteoporosis, I thought, “Oh, no, not me. I eat right. I exercise, et cetera.” I already had severe osteopenia. I was about 45, so this was well before menopause, so that’s what started our little adventure into trying to figure out what on earth was causing this, and for me it turned out to be genetic, which actually isn’t surprising. I mean, if some disease runs in a person’s family, chances are they have a genetic susceptibility that increases their risk for developing that condition.  For me, it turned out to be vitamin D. At that time, I think the recommendation for vitamin D was, like, 400 IU a day. It turned out that for me to get my vitamin D levels up into anywhere resembling normality, I needed over 10,000 IU every day.

Dr. Weitz:                            Yeah. I remember, at the time they would tell us how dangerous the fat-soluble vitamins were and could be really toxic if you take too much vitamin D or vitamin A.

Lara:                                    Yeah. Our friends thought I was going to turn into a pillar of calcium, like Lot’s wife, with a vitamin D genetic susceptibility, but I didn’t and I started to rebuild bone, finally. Also, we live in Seattle, so it rains here all year long. The sun comes out for a couple months a year and you just can’t make a lot of vitamin D here. It’s not easy, so the combination of my genetic susceptibility plus living in Seattle really was causing my bone loss, and that was the start. Then, after we identified that, I started to very slowly regain some bone, and then I was the editor of a medical journal called Longevity Medicine Review, which I think is still up, some of the issues are still up online, and i was asked to write a paper on vitamin K, and so I started reading all the research on vitamin K and I thought, wow, this is really important, especially vitamin K2 which pretty much no one knew about.  I started taking vitamin K2 and that helped. Do you want me to talk about why that helped?

Dr. Weitz:                            Sure.

Lara:                                    Vitamin K2 is required to activate what are called the Gla proteins. I call them the glamorous proteins, because they really make you glamorous in terms of not having cardiovascular disease and not having bone loss, because these proteins, one of them is called osteocalcin and it pulls calcium into your bones, and the other one is called Matrix Gla protein, and it prevents calcium from depositing in your soft tissues like your blood vessels and your kidneys and your breasts and your brain, so vitamin K2 is really important. It’s not present in … Blue cheese has a fair amount of it, but outside of that, in the western diet, there are a few cheeses that supply a little.  It’s very, very tiny amounts of vitamin K2 are available, and you really have to eat a Japanese fermented soybean product called Nattō. Yeah. It’s slimy, gross. Smells like dirty gym socks.

Dr. Weitz:                            [crosstalk 00:30:03]. Yep.

Lara:                                    Yeah. It’s bad, so basically people need to take vitamin K2 to get enough, and I started doing that. That made a big difference. Do you want me to go along the odyssey of some of the other things? There have been a number of them.

Dr. Weitz:                            Absolutely. Yeah. No. [crosstalk 00:30:19].

Lara:                                    I am truly the poster person for osteoporosis.

Dr. Weitz:                            Because, I’ve talked to a number of people who said, “Well, I did all the natural stuff. I took my vitamin D and the calcium and so therefore there’s nothing you can do,” and it’s like …

Lara:                                    No. Vitamin D helps us absorb calcium. That’s it. It does nothing to determine what happens to the calcium once it’s in your bloodstream. That’s the job of vitamin K2, and if you don’t have it around, chances are your calcium’s going to go into your blood vessels.

Dr. Weitz:                            By the way, what about MK4 versus MK7, since we’re on the topic?

Lara:                                    Yeah. MK7 is far more potent and the reason why is that, in your liver, the MK7 is put into cholesterol, and cholesterol travels around the system for three or four days before it’s eliminated, broken down. The MK4 version goes into triglycerides which are cleared within six to eight hours, so when you take MK7 you can take a really small amount. Typically 100 micrograms or between 1 and 200 micrograms is enough for most people because it’s building up in your system, in your cholesterol, and so it’s always available for you to use, whereas the MK4 version, you have to take 15,000 micrograms every six hours to have that stay available for you, so it’s a difference of 45,000 micrograms a day versus about 180 micrograms a day, so I think MK7 is a better choice for most people.  There are a few genetic polymorphisms that make some people very, very effective at using vitamin K, and they’re recycling it more quickly and so on, and so for those people, there are some people who do fine on MK4, but it’s a very small number of the population, and you can have that checked, easily.

Dr. Weitz:                            The dosage of MK7 that you recommend for most people?

Lara:                                    Well, it’s 100 to 200 micrograms is enough for most people but it really depends on, there’s a balance that you want to achieve between vitamin K, vitamin D and vitamin A. They all work together. Your intake of vitamin D and vitamin A should be pretty comparable. They balance each other, and then vitamin D actually increases your production of the proteins osteocalcin and Matrix Gla protein that you need to have vitamin K2 around to activate, and so if you’re taking more vitamin D, you need a little more vitamin K. There’s a chart in the book where I say, “If you need this much of vitamin D, you need this much vitamin A and you need this much vitamin K,” but typically it’s 100 to 180 micrograms for vitamin K2 in the MK form.  If you already have chronic kidney disease or cardiovascular disease, then in the research they’re using dosages of 360 micrograms per day. It’s extremely safe. There’s not even a tolerable upper limit set for vitamin K2. It’s so safe.

Dr. Weitz:                            Good. Yeah, so let’s hear the rest of your story. What were some of the other key factors in helping you overcome your bone issue?

Lara:                                      Okay, so there was K2, and then, I grew up in Florida and I’ve developed lots of pre-cancerous skin problems, basil squamous skin cancers, and I finally realized that I wasn’t getting enough vitamin A. You need the comparable amount of vitamin … The vitamin A and vitamin D balance each other’s activities, and you really need both of them. We don’t eat meat, so that liver you were talking about, we don’t do that. There aren’t a lot of other really good sources of vitamin A, and beta carotene is not vitamin A. About over 80% of people do a lousy job of getting beta carotene into vitamin A, which I also hadn’t known about.

I wrote a couple of review articles on vitamin A and I learned all this stuff, then I started taking vitamin A. That was another thing that I learned. I try to take as much, comparable amount of vitamin A to vitamin D, and because we do not eat meat, I need to take it as a supplement, and then, the vitamin K. You want that to be in balance, as well, so that was kind of the next thing. Then, I discovered that magnesium is a really important mineral for bone, and if you do not activate vitamin B6 into its form of P5P, pyridoxal-5-phosphate, you have a lot of difficulty getting magnesium into yourself, because that’s the job of P5P, so that’s another snip I have.  I don’t do that very well, so I take a little of that. Actually, I take a B complex, because all the B vitamins work together, and just taking one can kind of mess up the pachinko game that goes on among them all. I think those are kind of the biggest ones, the B vitamins, but, yeah.

Dr. Weitz:                            I think you mentioned having a H. pylori infection, as well.

Lara:                                    Oh, yes. Yes. Sometimes, I think that I have experienced many things so that I would know what to do about them. H. pylori was certainly one. For years, I never knew when I would be six. Joe is the president of Bastyr University. We had many formal evenings and dinners and things and I never knew when I would be so six to my stomach I couldn’t stand up from the dining table and leave, so that was an adventure, and I’m old, so this was back when Barry Sears discovered helicobacter pylori. Before this, I had gone to doctors who had told me, “You just need to breathe deeply. You’re not relaxed and that’s what’s causing all of this,” at which point I had control myself from ripping out their throat.  I did refuse to pay for the consult, but, yeah, so, we discovered that.

Dr. Weitz:                            How did you the H. pylori?

Lara:                                    We did triple antibiotic therapy. Oh, yeah.

Dr. Weitz:                            Triple antibiotic therapy.

Lara:                                    Yeah, and I remember, shortly after that, Joe was invited to China to set up reciprocal programs with some Chinese medical schools for students to come here and our students to go there, and here we are in China where conditions aren’t particularly sanitary, and everybody else in our group got sick except for me. I was the only one whose digestion was fine after getting rid of my H. pylori. Many, many older adults have h. pylori. It’s extremely common and it disrupts your ability to digest your food properly because it interferes with stomach acid production, and then you lose bone, and that’s a very, very easy thing to check, and it can make a huge difference for someone.

Dr. Weitz:                            Now, one of the things you mention in your book is how a number of conventional drugs interfere with bone health, and you mentioned high dose statins, certain blood pressure medications and even antidepressants. Perhaps you can talk about those a little bit.

Dr. Pizzorno:                      Wait for a second. Dr. Weitz, thank you for reading our book. I’ve written a lot of books, and so many times I’ll be interviewed very politely by somebody who didn’t bother to read my book, so I appreciate the invitation, but it would be nice if they read it. You clearly read it.

Dr. Weitz:                           Absolutely. I consider that my obligation for having the opportunity to getting to speak with you.

Dr. Pizzorno:                      Okay.

Dr. Weitz:                           Yeah. Let’s start with high dose statins are bad for bone-

Lara:                                   High doses, quite a bit more than, what is it, milligrams a day.

Dr. Weitz:                           Milligrams of Lipitor, or, yeah.

Lara:                                   Yeah, so, at that level, it actually seems to be protective for bone, but when you start going to the higher levels, it can help promote bone loss, and part of the reason why is that statins interfere with cholesterol production, and if you’re really excessively producing cholesterol, that’s a good thing, but if you take so much that you’re significantly suppressing your ability to produce any cholesterol, you know, we use cholesterol. We use it to do things like make hormones like estrogen and testosterone and so forth, and we need those hormones for our bones.

Dr. Weitz:                           They make vitamin D and transport our vitamin K2.

Lara:                                   Exactly. Yeah, so, again, it’s one of those balance things. A little bit might be helpful, but if you have to take a really high dose, you need to make sure you’re getting checked and do everything you can to mitigate against the adverse effects of it.

Dr. Pizzorno:                      This is one of my pet peeves. I wrote a [inaudible 00:39:23] paper about three years ago now, and you can go to PubMed and read it if you want, entitled Vilification of Cholesterol for Profit. You may recall a newscast came out that basically said, “50% of people over the age of 40 should be on a statin drug because they’re so safe and they’re only beneficial,” and they quoted a very large study, 10,000 person double blind, consumer controlled study. Well, that’s pretty impressive, and here’s where there’s a problem when you look at the abstract versus reading the study.  You look at the abstract, wow. That’s pretty impressive. I guess statin drugs are safe and they have benefit, but when we actually look at the data, the way they did it was this 10,000 person trial started with an open label trial. What that means is everybody got the statin drug, then anybody who had an adverse reaction was removed from the trial and then those where left over, half got statin drug, half got placebo, and they found 1% adverse drug reaction to the statin drug. Well, that sounds pretty good, but you need to ask yourself, “Now, how many people did they remove from the study?”  Out of that 10,000, they removed 3,000, so 30,000 of people had a reaction. Now, of course, some of those could be placebo and not real, but then when you do the post-marketing surveillance on what percent of people have an adverse reaction to statin drugs, guess what? It’s 25 to 30%, so they basically, from my perspective, created a study designed to produce the result they wanted, rather than valid information.

Dr. Weitz:                            Those of us in the natural world here seeing patients have known this. We see so many patients who complain about the muscle aches and the brain fog and all the other side effects they get from statins, and meanwhile they’re publishing these results, as you said, showing 2% of the people have these side effects.

Dr. Pizzorno:                      [inaudible 00:41:22] it’s not true, but they make money, so they keep doing it.

Dr. Weitz:                            Absolutely, absolutely, and they even talked about the poly pill which was going to be given to every single person for prevention, and it would contain a low dose statin, as well as, I think it was going to have a blood pressure medication and maybe metformin or something.

Dr. Pizzorno:                       Yes. That was exact. That’s what they were doing. Metformin, statin, and a blood pressure [inaudible 00:41:47].

Dr. Weitz:                            Certain blood pressure medications actually can interfere with bone. Can you talk about which ones?

Lara:                                    If I can remember which ones off the top of my head.

Dr. Weitz:                            Yeah. I took-

Lara:                                    Well, they use [crosstalk 00:42:02] to help lower blood pressure.

Dr. Weitz:                            This is how you can tell that this was such a good book. I’ve got this pad of notes I took while I was reading it, sitting on my back porch drinking a glass of organic red wine. I’m glad that you said small amounts of alcohol are good for bone.

Lara:                                    Small amounts of alcohol are really good for you. Yeah.

Dr. Weitz:                            You said that Thiazide diuretics protect bone, while-

Lara:                                    Right. Loop diuretics cause bone loss.

Dr. Weitz:                            Calcium channel blockers harm bone.


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Dr. Weitz:                            You also mentioned that SSRIs, antidepressants, promote bone loss.

Lara:                                    Yeah. It’s interesting how they do that. That one, I do remember. What happens is they-

Dr. Weitz:                            Those are so commonly prescribed.

Lara:                                    Very commonly prescribed, and they increase the gut production of serotonin and then that serotonin binds to a receptor on the surface of newly forming osteoblasts, and stops them from developing, and so, your bone building cells don’t develop, and that’s a problem.

Dr. Weitz:                            Yeah. I certainly understand. Let’s talk about calcium supplements, and we’ve known for a long time that calcium is beneficial, but of course, when a few of these studies came out showing that calcium increased risks for heart attack, everybody freaked out and now it was like, no, no, you can’t take calcium. Just take vitamin D. If you’re going to take calcium, just take a little bit, because if you take a lot it’s going to calcify your arteries, so what do we know about the truth about calcium? How much should we be taking? How much is it safe? What form?  I noticed you talked about some of the forms that we’ve been told for years, like hydroxyapatite are the best forms of calcium, actually not as beneficial as we thought they were, or maybe not beneficial at all, so tell us about calcium supplements.

Lara:                                   Okay, so, the first thing is the papers that came out, they were primarily written by a group headed by Boland and his team in Australia, and they looked at studies where only calcium was given or calcium and vitamin D were given, and no vitamin K, okay? As I mentioned before, vitamin D helps us absorb calcium. It does nothing to control what happens to that, and if you don’t have vitamin K available, you’re not going to activate the proteins that pull that calcium into your bones where you want it and prevent it from depositing in your arteries where you don’t, so that is essentially the answer to that issue.  You’ve just got to have … The nutrients work together, and you need the team, not just one or two of them.

Dr. Weitz:                           By the way, one of the reasons why they did some of these studies is because earlier studies had shown that people who consumed more calcium had a lower risk of heart problems.

Lara:                                   That’s interesting.

Dr. Pizzorno:                      [inaudible 00:46:36] calcium, magnesium.

Lara:                                   Yeah. Maybe it was magnesium, as well, because those two have to be in balance, too, and that’s another big problem in the modern world.

Dr. Weitz:                           Let’s finish with the calcium first.

Lara:                                   Okay. Okay. On types of calcium, the reason the hydroxyapatite is not more effective, two reasons that I really don’t like hydroxyapatite. One, it’s hyped. It’s really expensive. It’s overpriced calcium, and when you consume it, in your stomach, your body is going to break it apart, okay? The calcium ions, if you produce any stomach acid, the calcium ions are going to be released from whatever their partner is, and then you’ll absorb the calcium ions. You do not absorb it as a blob. You absorb calcium ions and then the apatite is very, very high in phosphate, phosphorous, and high phosphate levels are one of the problems with the American diet, largely because of phosphate additives in all the processed foods.  I wrote a review paper on this, and it’s on PubMed, entitled Canaries in the Phosphate Toxicity Coalmines, which is what we are. The latest research has shown that they’ve known about this for people with kidney disease for a long time, but now they’ve discovered that high phosphate intake is causing cardiovascular disease in everybody, not just people whose kidney function is impaired.

Dr. Pizzorno:                       It increases the rate at which the kidneys degenerate.

Lara:                                   Right, so I don’t think adding more phosphorous phosphate to your, taking that as a supplement, is really a good idea, so I don’t suggest taking that. If you do not produce any stomach acid, then calcium citrate is going to disassociate, even without any stomach acid present, but it has a lot less calcium ion in it than calcium carbonate, and they’ve done many studies showing that people who produce stomach acid, calcium carbonate is fine. In fact, the research that they used to initially show that calcium carbonate was a problem and that calcium citrate was so much better, they took a group of older people who were hypochlorhydric, meaning they did not produce much stomach acid, and they tested them before breakfast, when they were fasting.  They gave them a supplement. They didn’t produce stomach acid in response to the supplement. They didn’t absorb any calcium. They took the same group of people, and they didn’t report this part of the study, and they gave them breakfast, and guess what, they absorbed their calcium just fine. I think there’s a lot of misinformation. Studies have been used to promote various products in a not very truthful way.

Dr. Weitz:                            [inaudible 00:49:30], you know calcium citrate probably has the added benefit of citrate being sort of an alkalizing-

Dr. Pizzorno:                       Alkalizing agent.

Lara:                                    Absolutely.

Dr. Pizzorno:                      [crosstalk 00:49:38]. Yes.

Lara:                                    Yeah.

Dr. Weitz:                            But how much calcium in supplements is it safe to take? At one time we were doing 1,500, even 2,000 milligrams, and then after those studies, everybody pulled way back. Now people say just 500, 800. What do you think is for, if you’re working with a woman with osteoporosis, how much is safe, and then how important is it to take it at certain times of the day, to split it up, et cetera?

Lara:                                    You want to be getting about 1,200 milligrams of calcium per day. In some of the research on post-menopausal women, some people have benefited from as much as 1,500 milligrams per day, but that’s total. It’s not just from a pill that you’re taking. You’re supposed to be eating real food that has calcium in it, and you’re supposed to look at what you’re getting from your diet and then supplement the additional, so the company that I work with, am I allowed to mention a company name or anything?

Dr. Weitz:                            Of course. Yeah. [crosstalk 00:50:41].

Lara:                                    I work with a company called AlgaeCal. In their product, it provides 720 milligrams of calcium. Because the research shows that the majority of people in the US are consuming between 450 to 600 milligrams of calcium daily from their diet, which is way less than you actually need, so if you take the supplement, which is 720 milligrams over the course of the day, you divide it into 2 servings of 350 milligrams each, and the total from your diet and the supplement comes out to between 12 and 1,500 milligrams daily. The fractional calcium absorption, which is how much of the mineral you’re actually going to absorb from what you swallowed, tops out at 500 milligrams.  After you have consumed 500 milligrams of calcium, the transport mechanisms, the compounds in your gut that help you absorb the calcium, will be maxed out. They can’t carry anymore.

Dr. Weitz:                            Don’t consume more than 500 milligrams of calcium-

Lara:                                    … at a time. At one time, yeah, and then you need three or four hours for things to reestablish themselves and for those transporters to be available.

Dr. Weitz:                            Better with a meal? Better in the evening? What do you think?

Lara:                                    Definitely better with a meal. You cannot release the calcium ions from the food matrix or from their stabilizing partners, like calcium bound to carbonate. It won’t release without the presence of stomach acid, and we produce stomach acid in response to a food intake, so definitely with a meal. Whenever you eat.

Dr. Weitz:                            Now, the reason for taking it at night is because some of the studies seem to indicate you lose bone while you sleep.

Lara:                                    Well, that’s why I suggest that people take strontium at night. Bone renewal is a housekeeping function, right? Just like all the repair functions, and those ramp up at night when we’re not busy doing a lot of other things, so it’s best to, I suggest that people, if they take strontium, they should take it at night. They’ll get the most benefit from it at night.

Dr. Weitz:                            Okay, so, calcium with meals, maybe split it up. No more than 500 milligrams at a meal, and then, let’s get into strontium because that’s a controversial compound and I’ve talked to other bone experts who were very negative on strontium and you write in your book that that’s partially because some of the studies of this prescription form of strontium, strontium [inaudible 00:53:24], or strontium ranelate were-

Lara:                                    Ranelate, right.

Dr. Weitz:                            … were potentially harmful.

Lara:                                    Right. When Servier, the company that created strontium ranelate, developed it, they did so because they look at over 100 years of research showing that many, many different natural forms of strontium were beneficial and caused no adverse effects. Then, for some reason that I wish I-

Dr. Pizzorno:                      … to make it [inaudible 00:53:52].

Lara:                                      … to make it … Well, yeah, but why they picked ranelic acid, which is a toxin, to combine it with, God only knows. I so wish they’d put it with something that wasn’t toxic, because it would have been a fabulous drug and a lot of people would’ve benefited, but they combined it with this toxin, and when you consume that, just like for calcium, the strontium ions disassociate from the toxin, and the claim was that ranelic acid wasn’t going to be absorbed and it wasn’t going to do anything. Well, that wasn’t true, and there’s now been research that shows that it’s absorbed and it has adverse effects, and it’s part of the group of aromatic compounds that cause things like rashes, DRESS syndrome, blood clots and all that, all those things that are the adverse effects of strontium ranelate, but in the research on natural forms of strontium, there have never been, in more than 100 years, none of these forms of strontium have caused any of these adverse effects, and strontium is so beneficial for bone.  It acts through so many different mechanisms, both to increase osteoblast activity, increase calcium absorption. There’s even a special calcium receptor that only responds to strontium. It’s activated by strontium and helps you absorb more calcium, and then strontium also helps lessen osteoclast activation, those cells that break down bone, so it’s a really incredible-

Dr. Weitz:                            It’s a natural bisphosphonate.

Lara:                                    Well, bisphosphonates only poison osteoclasts. That’s all they do.

Dr. Weitz:                            Right. Okay.

Dr. Pizzorno:                       That’s a good point. [inaudible 00:55:47].

Dr. Weitz:                            Strontium citrate is the form you like, right?

Lara:                                    Right, and again, the citrate is alkalizing, so that’s helpful-

Dr. Weitz:                            What’s the ideal dosage?

Lara:                                    Well, it depends, just like everything else. If someone has frank osteoporosis, then they would probably benefit from the typical dose, which is 680 milligrams per day, but if someone’s bones are in good shape or they only have osteopenia, they can do a half a dose and they’ll still get benefit from it. There have been studies showing benefits from that. Once my bones were in good shape, I stopped taking strontium. Until I wrote the big review on strontium and I learned all the ways that it supports healthy bone renewal, so I started taking a half a dose, and that’s what I do.  Also, strontium also helps you sleep better. It helps tune down some brain activity that would keep you awake, and I find it really helpful for that.

Dr. Weitz:                            Okay, and now we should have magnesium in a two to one ratio, calcium to magnesium. You recommend that in the book?

Lara:                                    Yes, and that is a big problem because everybody’s taking calcium and vitamin D with nothing else. The standard American diet is really depleted of magnesium because of the way food is grown. You want to talk about that? Then, that balance is off, and when it’s off, it promotes lots of bad things, like cancer as well as bone loss, so it’s really [crosstalk 00:57:26]-

Dr. Weitz:                            I talked to one doctor who’s an expert at bone, and he said that he looked through all the literature and he couldn’t find any literature that substantiated this two to one calcium, magnesium ratio.

Lara:                                    If you send me his email I’ll send him a bunch of papers.

Dr. Weitz:                            Okay.

Lara:                                    I mean, it’s there, for sure.

Dr. Pizzorno:                       Yeah. Actually, I was [inaudible 00:57:48] about that, as Lara’s digging into it, that I’d always heard two to one, but I actually had never saw any research. When Lara actually dug up some research on it, I was quite intrigued. Now, I’m surprised, it was actually two to one.

Dr. Weitz:                            Two to one calcium and magnesium, and then what other nutrients are synergistic?

Lara:                                    Well, a lot of trace minerals. If you skim the book, you saw a whole list of them.

Dr. Weitz:                            You mentioned boron. How important is boron?

Lara:                                    Oh, boron is my favorite trace mineral. I actually wrote a paper on that, too. It’s on PubMed. It’s called Nothing Boring about Boron.

Dr. Pizzorno:                       Mention how many citations, how many research [crosstalk 00:58:25]-

Lara:                                    Yeah. I’m on ResearchGate, and every week they send me, “You had X number of people read this article that you wrote.” Over 3,000 doctors have read boron now.

Dr. Weitz:                            Wow.

Lara:                                    Yeah. A lot.

Dr. Pizzorno:                       Nothing Boring about Boron.

Lara:                                    Yeah. There’s nothing about it.

Dr. Pizzorno:                      [inaudible 00:58:42].

Lara:                                    It’s so helpful in so many ways. After I read all the research on boron, I started on boron. One of the things it does is it slows down the activation of the enzyme called 24-hydroxylase enzyme, that breaks down estrogen, testosterone, so you keep it around longer, but it’s not harmful. It doesn’t make you keep around so much that it would increase cancer risk. In fact, they use boron in cancer treatment, it’s so beneficial, but that’s one of the things it does, and so you get more benefit.

Dr. Weitz:                            What’s the dosage you like of boron?

Lara:                                    You need at least three milligrams, but then there’s a bunch of research showing that six milligrams, particularly for people who have osteoarthritis or degenerative osteo, what?

Dr. Pizzorno:                       Yeah. Degenerative [inaudible 00:59:38].

Lara:                                    Yeah, degenerative joint disease of any kind. They’ve done a number of studies using six milligrams of boron. They’ve had a lot of success with it, and there have been several studies just on bone loss and it helped to prevent bone loss.

Dr. Weitz:                            Now, you also wrote that phytate-rich foods are actually protective of bone.

Dr. Pizzorno:                       Not what we were taught 50 years ago.

Lara:                                    Yeah, well, phytates bind things in the colon that you really want to have leave, and if they don’t leave and they get re-absorbed, they’re inflammatory, and again, anything that promotes-

Dr. Weitz:                            Dr. Gundry’s not going to agree with you on this.

Lara:                                    That’s okay. I’m happy to disagree with him.

Dr. Weitz:                            Let’s hit one final topic, which is exercise. What is the most effective form of exercise to improve bone density? I’ve looked into some of the data on the type of exercise that’s beneficial, and most people recommend some form of resistance training or weight lifting, and yet, a number of the studies really didn’t show much benefit and some of the studies have shown that ballistic or high impact loading is necessary to really turn around bone and stimulate bone building. I know that this is controversial. Do you really want to take somebody who’s older with osteoporosis and have them do ballistic training and suffer compression fractures?  This has also led Dr. John Jaquish, who I interviewed previously, to create his OsteoStrong centers where he has these machines that load your bones to supposedly four times your body weight. I know there’s a lot of controversy. What do you think is the best way for us to exercise to strengthen our bones, and what’s safe for osteoporotic patients?

Lara:                                      Well, I think the most important thing is weight bearing exercise every day for an hour. This stuff of, come into my facility and in 20 minutes once a week, you’re going to rebuild your bones. Uh-uh (negative). Not happening.

Dr. Weitz:                            [crosstalk 01:02:12] 10 minutes.

Lara:                                      Yeah. Bones need stimulation. When the muscles are stressed and the torque is applied to bone, the type of cell and bone, which is actually the most prevalent type of cell and bone, they’re called osteocytes, and they’re machanosensors, and they start the bone renewal process, and they don’t start it until they’re activated, and they’re activated by weight bearing exercise, so exercise is just critical. Really, the best type of exercise is something you’re actually going to do every day for an hour, and there are several types. The having somebody to do the things where they did the pull ups and then people dropped to the floor-

Dr. Weitz:                            That was the LIFTMOR trial.

Lara:                                      I don’t think so. The people survived it and they didn’t get any broken bones, but I wouldn’t want to chance it with patients that I try to help. I think some of these people are very fragile, and you don’t want to do things that is possibly going to cause a fracture, so there are three types of exercise that I really like that people can do in their own home, easily, with very little equipment. Yoga for osteoporosis, I think is an excellent one. It was a protocol created by a doctor, by Dr. Loren Fishman. He’s an MD at Columbia and he teaches a course for, people can be trained to become certified, and I have done his course. People who do a lot of yoga, I know, take the training, so that’s an excellent one.

It’s a series of 12 poses. They can be done at home. You can access the videos for them online for free. There’s books out, and he has proven in peer reviewed, published research, that it is effective, and what happens is you do these poses and they put torque on certain areas and you hold the pose and it’s isometric, and it really puts torque on the muscle and it signals those osteocytes and they build bone. I’m also a Stott Pilates instructor. I love pilates. It’s very safe form of exercise, can easily be adapted so that you don’t do any of the C curve type things that could cause compression, but you can get really good core strength and it helps people stand up more erect and carry their body properly.  It can really work the muscles, and then my favorite is Bar 3, which is a combination of pilates, bar, and yoga. You get all three types of exercises. It’s an hour a day. There are 40 minute classes or 30 minute classes. It’s very accessible online. All you need is a mat, and you can do it in your own home, so I think people need to find something that they enjoy enough that they’ll do it.

Dr. Weitz:                            If they’re willing to do anything, ideally, would it be better to do an hour of weight training?

Lara:                                    Well, if they’re doing it with someone who’s watching them at least until they really understand how to move the weights, and all, I think an hour of weight training will be helpful, but part of it is when you’re, and Dr. Fishman talks about this, say you’re on a machine and you’re doing a leg press and you kind of lie back on the machine and you do the leg press. That’s not functional movement. That’s not how we live in our life, and I think the exercises that allow us to do the type of functional movements that puts stress on the muscles and the ligaments and activate the osteocytes in the bone that we actually do in our life, is probably the best approach.

Dr. Weitz:                            Squats and dead lifts more so than leg press.

Lara:                                    Yeah.

Dr. Pizzorno:                       Exactly.

Lara:                                    Yeah. In Bar 3, I probably did 50 squats today with weights, as part of Bar 3, to music. It was fun, sort of.

Dr. Weitz:                            Great. Thank you for spending some time with us and giving us some great information. Any final thoughts for listeners and viewers?

Lara:                                    You’re a terrific interviewer. I’m astounded at the great questions and how you really looked at the book, and I think you pulled many of the most important things out of it, and I greatly appreciate your help in doing that. I hope it will be helpful for people to hear this interview, and thank you.

Dr. Weitz:                            Get this book. The name of the book again is Healthy Bones, Healthy You, and it’s available, Amazon, Barnes and Noble and everywhere else, right?

Lara:                                    I think so.



Dr. Weitz:                            Thank you for making it all the way through this episode of the Rational Wellness Podcast, and if you enjoyed this podcast, please go to Apple Podcasts and give us a five star ratings and review. That way more people will be able to find this Rational Wellness Podcast when they’re searching for health podcasts, and I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica weight, sports, chiropractic and nutrition clinic, so if you’re interested, please call my office. (310)395-3111, and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz. Thank you, and see you next week.